Efficacy of premixed versus sequential administration of dexmedetomidine as an adjuvant to intrathecal hyperbaric bupivacaine in lower limb surgery

Objective: To evaluate the efficacy of intrathecal hyperbaric bupivacaine premixed with dexmeditomidine compared with sequential administration in separate syringes on block characteristics, haemodynamic parameters, side effect profile and postoperative analgesic requirement.Trial design: This was a prospective, randomised clinical studyMethod: Sixty orthopaedic patients scheduled for elective lower limb surgery under spinal anaesthesia were divided into two groups to receive either intrathecal hyperbaric bupivacaine 12.5 mg premixed (Group P) with dexmeditomidine 10 μg (diluted to 0.5 ml with normal saline) or by sequential administration in separate syringes (Group S). Outcome: Block characteristics, haemodynamic parameters, side effect profile and postoperative analgesic requirement were compared in both groups.Results: Time to achieve T10 spinal level was significantly less in group S (4.467 + 0.973 min) compared with group P (5.5 + 1.167 min). Similarly, patients in group S achieved Modified Bromage III earlier (6.1 + 1.296 min) than group P (7.5 + 1.333 min), p-value 0.0001.Conclusion: Dexmeditomidine given sequentially in a separate syringe as adjuvant to intrathecal hyperbaric bupivacaine can result in faster onset of both sensory and motor block and prolongs the duration of spinal anaesthesia, minimises clinically significant side effects and reduces the postoperative analgesic requirement.Keywords: dexmedetomidine, hyperbaric bupivacaine, intrathecal bloc

Effective Emergency Communication through Public Displays: A Real-Time Evaluation with the Emergency Communication Display Test

In the study of "Effective Emergency Communication through Public Displays," our research indicates major advancements and problems in using public displays to disseminate essential information during crises. According to data research, there has been a 33% rise in the deployment of high-resolution 4K TVs, showing a technical change toward improved message visibility and clarity. Geographic distribution has improved, with a 10% increase in ideal placements in high-risk regions due to population density and vulnerability evaluations. Message design and content adherence to plain language standards, as well as the usage of visual aids and standardized symbols, have all increased by 5%. The psychological components of message reception highlight the necessity of simple language and high-resolution panels, as LED screens result in a 15% higher message understanding rate than LCD screens, while jargon-laden messages raise audience anxiety levels by 25%. Although resilience evaluations have shown a 15% increase in the existence of backup power supplies and a 10% rise in remote monitoring capabilities, 20% of installations still have physical vulnerabilities. These results suggest a complete strategy to improving the efficacy of public displays for emergency communication, highlighting the need of continual technological improvements and best practices to protect the safety and well-being of different groups during disasters

Estrogen Treatment Reverses Prematurity-Induced Disruption in Cortical Interneuron Population

Development of cortical interneurons continues until the end of human pregnancy. Premature birth deprives the newborns from the supply of maternal estrogen and a secure intrauterine environment. Indeed, preterm infants suffer from neurobehavioral disorders. This can result from both preterm birth and associated postnatal complications, which might disrupt recruitment and maturation of cortical interneurons. We hypothesized that interneuron subtypes, including parvalbumin-positive (PV(+)), somatostatin-positive (SST(+)), calretinin-positive (CalR(+)), and neuropeptide Y-positive (NPY(+)) interneurons, were recruited in the upper and lower cortical layers in a distinct manner with advancing gestational age. In addition, preterm birth would disrupt the heterogeneity of cortical interneurons, which might be reversed by estrogen treatment. These hypotheses were tested by analyzing autopsy samples from premature infants and evaluating the effect of estrogen supplementation in prematurely delivered rabbits. The PV(+) and CalR(+) neurons were abundant, whereas SST(+) and NPY(+) neurons were few in cortical layers of preterm human infants. Premature birth of infants reduced the density of PV(+) or GAD67(+) neurons and increased SST(+) interneurons in the upper cortical layers. Importantly, 17 beta-estradiol treatment in preterm rabbits increased the number of PV(+) neurons in the upper cortical layers relative to controls at postnatal day 14 (P14) and P21 and transiently reduced SST population at P14. Moreover, protein and mRNA levels of Arx, a key regulator of cortical interneuron maturation and migration, were higher in estrogen-treated rabbits relative to controls. Therefore, deficits in PV(+) and excess of SST(+) neurons in premature newborns are ameliorated by estrogen replacement, which can be attributed to elevated Arx levels. Estrogen replacement might enhance neurodevelopmental outcomes in extremely preterm infants.SIGNIFICANCE STATEMENT Premature birth often leads to neurodevelopmental delays and behavioral disorders, which may be ascribed to disturbances in the development and maturation of cortical interneurons. Here, we show that preterm birth in humans is associated with reduced population of parvalbumin-positive (PV(+)) neurons and an excess of somatostatin-expressing interneurons in the cerebral cortex. More importantly, 17 beta-estradiol treatment increased the number of PV(+) neurons in preterm-born rabbits, which appears to be mediated by an elevation in the expression of Arx transcription factor. Hence the present study highlights prematurity-induced reduction in PV(+) neurons in human infants and reversal in their population by estrogen replacement in preterm rabbits. Because preterm birth drops plasma estrogen level 100-fold, estrogen replacement in extremely preterm infants might improve their developmental outcome and minimize neurobehavioral disorders

Spike Field Coherence (SFC) for Ripples in Rat Hippocampus

The aim of this project was to determine coherence between two types of neural recordings which can be obtained from the rat hippocampus: spikes and local field potentials. Extracellular recording makes it possible to determine spiking activity from individual neurons in the vicinity of the recording electrode. Local field potential recording gives a combined activity of many neurons (thousands) at once to determine an overall picture of the coordination of the cells in real time. Here we examine the relationship between these two signals, focusing on place cells which spike at their maximal rate only at certain positions in physical space. Examining these cells using spike-field coherence techniques we determined that during running and rest behaviors, the place cells have different patterns of firing. During run sessions on a linear track, they would fire maximally at their preferred position on the track and showed high spike-field coherence with the theta band (4 Hz – 10 Hz) of the LFP. During rest sessions on the same track, when ripples occur, the place cells would fire sequentially, essentially replaying back the run session firing at a much faster timescale and with high spike-field coherence in the gamma band (100 Hz – 250 Hz) of the LFP

TO STUDY THE PERCEIVED BARRIERS AND MOTIVATORS FOR DELAYED ACCEPTANCE OF FIRST DOSE OF COVID-19 VACCINATION: A SINGLE CENTRE STUDY

Objectives: COVID-19 pandemic has triggered an unprecedented global scientific collaboration to develop COVID-19 vaccines which is the most effective way to defeat COVID-19 pandemic. The WHO has identified vaccine hesitancy as a grave global health threat and even after 7 months of free vaccination program, India is lagging behind to achieve the targets essential for herd immunity. Hence, we initiated this survey to study the perceived barriers and motivators for delayed acceptance of first dose of COVID-19 vaccination. Methods: A survey was conducted during free COVID-19 vaccination camps using a pretested, validated, and anonymous pro forma including eight questions regarding perceived barriers and six regarding perceived motivators for acceptance of the first dose of COVID-19 vaccination and valid responses were analyzed according to age groups and gender. Results: During our survey, 1144 valid responses were received and analyzed. Results showed fear of side effects as the most sighted barrier among study population, gender, and age groups. Compulsory requirement of vaccination for joining job/college was the most sighted motivator among study population, gender, and 18–30 years age group whereas fear of 3rd wave was most sighted motivator among 31–44 years, 45–59 years, and >60 years age group. Conclusion: In spite of free COVID-19 vaccine and intensive campaigns, it seems that adequate vaccination targets might not be achieved and results of our survey suggest needs for increased focus on the perceived barriers as well as the perceived motivators to increase vaccination acceptance