Assessment of Psychomotor Recovery after Etomidate and Propofol Induction: A Randomized Double-Blind Trial

Background: The very idea of faster recovery and early ambulation has prompted patients to opt for day care surgeries. The concept of ERAS (enhanced recovery after surgery) is the backbone to achieve this goal. We conducted this study with primary objective to compare the post-operative recovery with etomidate and propofol in terms of early recovery (awakening), intermediate recovery (psychomotor and cognitive recovery) and ambulation “home readiness” and secondary objective to study the adverse effects. Methods: 60 eligible patients scheduled for day care gynaecological procedures were randomised in two groups of 30 each. Group E received etomidate 0.2mg/kg and group P received propofol 2mg/kg. Early, intermediate and late postoperative recovery (ambulation) was studied in both groups. Results: Demography between the groups were comparable while hemodynamic fluctuations were more with propofol (p>0.05), early recovery was faster with etomidate (p = 0.07), psychomotor tests revealed better alertness with etomidate (p= 0.1) and patient could ambulate earlier in etomidate group. Conclusion: Both propofol and Etomidate facilitate early recovery but etomidate provides hemodynamic stability with early awakening, more alert patients and better ambulation and was found to be superior for day care surgeries.

Whole-brain functional connectivity neuromarkers uncover the cognitive recovery scheme for overt hepatic encephalopathy after liver transplantation

Neurocognitive impairment is present in cirrhosis and may be more severe in cirrhosis with the overt hepatic encephalopathy (OHE). Liver transplantation (LT) may reverse the impaired brain function. MRI of resting-state functional connectivity can help unravel the underlying mechanisms that lead to these cognitive deficits and recovery. Sixty-four cirrhotic patients (28 with OHE; 36 without) and 32 healthy controls were recruited for resting-state fMRI. The patients were scanned before and after LT. We evaluated pre- and postsurgical neurocognitive performance in cirrhotic patients using psychomotor tests, i.e. number connection test (NCT) and digit symbol test (DST). Network-based statistics found significant disrupted connectivity in both groups of cirrhosis with OHE and without compared to controls. However, the presurgical connectivity disruption in patients with OHE was included in a greater number of connections than those without (65 vs. 17). The decrease in FC for both OHE and non-OHE patient groups was reversed to the level of controls after LT. An additional hyperconnected network (i.e., higher than controls) was observed in OHE patients after LT (p=0.009). Regarding the neural-behavior relationship, the functional network that predicted cognitive performance in healthy individuals, showed no correlation in presurgical cirrhotic patients. Such an impaired neural-behavior relationship was re-established after LT for non-OHE patients but not for OHE. OHE patients displayed abnormal hyperconnectivity and persistently impaired neural-behavior relationship after LT. Our results suggest that patients with OHE may undergo a different trajectory of postsurgical neurofunctional recovery in comparison to those without, which needs further clarification in the future study.

Analysis of Motor Intervention Program on the Development of Gross Motor Skills in Preschoolers

This study aimed to investigate the influence of a structured movement activity program on the motor development of children aged three to five years attending preschool. Participants were 136 preschool students with normative development at three to four years old who lived in the Region of Murcia (Spain). The McCarthy Children’s Psychomotricity and Aptitude Scales (MSCA) battery of psychomotor tests was used to evaluate the motor development profiles of preschoolers before and after the intervention. The sample was divided into two groups: an intervention group (28 students) and a comparison group (108 students). A structured 24 week physical education program was used in the intervention group. An experiential program based on free play was used in the comparison group during the same period. Preschoolers in both groups got a significant improvement in the contrast of pre-intervention with post-intervention in limb coordination. Statistically significant differences in the post-intervention measurements between the comparison group and the intervention group on arm and leg coordination were observed, whereby the intervention group presented higher arm coordination values (F1,134 = 14,389, p = 0.000, η2 = 0.097) and higher leg coordination values (F1,134 = 19,281, p = 0.000, η2 = 0.126) than the comparison group. It was pointed out that structured physical activity education is better educational methodology than free play to achieve adequate motor development in preschool children.

DEVELOPING OF HADANG TRADITIONAL GAME THROUGH PLYOMETRIC TRAINING ON FIFTH GRADE STUDENTS OF SD NEGERI 98 NORTH BENGKULU

Fighting games are regional games from Indonesia that we can now meet and play with children. This game is a team game consisting of two teams, each team consists of 5-7 people. The core of the game is to confront the opponent so that he can't get past the line with the rules that have been determined. To win a player must collect points by passing the guards from the row to the last row, and vice versa. This study aims to determine the results of the development of the method of plyometric training (Scissor Jump, Stride Jump Crossover, Lateral Bound) and for playing games. Plyometric is a method of training that focuses on movement at high speed. The method used in this study is research-based development (R & D), aimed at developing plyometric training products. The research sample is the fifth grade students of SD North 98 North Bengkulu, amounting to 28 people. In the initial observation researchers have obtained data in the form of pre-tests and the results of interviews from both teachers and students. Based on the results of the study using the plyometric method shows that the basic physical condition of the fifth grade students of North Bengkulu Elementary School 98 in the good category. This is evidenced by the results of cognitive and psychomotor tests that have been conducted on small group trials with the acquisition of a percentage of 20% (2 people) with very good categories, 50% percentage (5 people) with good categories, 10% percentage (1 person) with enough categories and a percentage of 20% (2 people) with less categories. Whereas in large group trials there was a percentage of 21% (6 people) with a very good category, a percentage of 43% (12 people) with a good category, a percentage of 25% (7 people) with enough categories, and a percentage of 11% (3 people) with less category. Thus, it can be concluded that the plyometric method is feasible to be used for fifth grade students of North Bengkulu Elementary School 98. Suggestions to teachers assess that the use of the plyometric method is an alternative in the learning process, especially traditional games.

Optimal Assessment and Quantification of Iodine Nutrition in Pregnancy and Lactation: Laboratory and Clinical Methods, Controversies and Future Directions

Iodine intake must be boosted during pregnancy to meet the demands for increased production and placental transfer of thyroid hormone essential for optimal foetal development. Failure to meet this challenge results in irreversible brain damage, manifested in severity from neurological cretinism to minor or subtle deficits of intelligence and behavioural disorders. Attention is now being focused on explaining observational studies of an association between insufficient iodine intake during pregnancy and mild degrees of intellectual impairment in the offspring and confirming a cause and effect relationship with impaired maternal thyroid function. The current qualitative categorisation of iodine deficiency into mild, moderate and severe by the measurement of the median urinary iodine concentration (MUIC) in a population of school-age children, as a proxy measure of dietary iodine intake, is inappropriate for defining the degree or severity of gestational iodine deficiency and needs to be replaced. This review examines progress in analytical techniques for the measurement of urinary iodine concentration and the application of this technology to epidemiological studies of iodine deficiency with a focus on gestational iodine deficiency. We recommend that more precise definitions and measurements of gestational iodine deficiency, beyond a spot UIC, need to be developed. We review the evidence for hypothyroxinaemia as the cause of intrauterine foetal brain damage in gestational iodine deficiency and discuss the many unanswered questions, from which we propose that further clinical studies need to be designed to address the pathogenesis of neurodevelopmental impairments in the foetus and infant. Agreement on the testing instruments and standardization of processes and procedures for Intelligence Quotient (IQ) and psychomotor tests needs to be reached by investigators, so that valid comparisons can be made among studies of gestational iodine deficiency and neurocognitive outcomes. Finally, the timing, safety and the efficacy of prophylactic iodine supplementation for pregnant and lactating women needs to be established and confirmation that excess intake of iodine during pregnancy is to be avoided.

MENINGKATKAN HASIL BELAJAR TARI DENGAN MENGGUNAKAN MEDIA AUDIO VISUAL DI SMP NEGERI 2 BUKITTINGGI

This article aims to describe the use of audiovisual media in learning to improve the learning results of dance in SMP Negeri 2 Bukittinggi. This type of research is research action class (classroom action research) and measures planning (plan), persiapaan the implementation of the action, observation (observation), reflection (reflection). Research procedures can be divided into three stages: preparation, implementation, and completion. The research instrument was its own researchers and supporting instruments such as assisted with writing instruments, video cameras and photo cameras. And techniques in analyzing the data is carried out by means of direct data processing in the field. The results showed that the audio visual media can improve the learning results of dance students in learning the art of dance in the SMP Negeri 2 Bukittinggi. With the media can also attract the attention of students and reduce the saturation level of the students in the teaching and learning process. On cycle I results on tests of learning psychomotor cycle I IE 7 persons complete and the 25 people are not completely cognitive tests, while 18 people has been completed and 14 persons thoroughly, but not in cycle II has experienced an increase in psychomotor tests i.e. 30 people has been completed and 2 people don't completely, whereas in cognitive tests there were 26 people thoroughly and 6 people don't completely. The increase in the natural occurring due to use of audio visual media triggers and learning interest of students and coupled with planning that designed everything possible to improve the results of learning by doing evaluasai on each meeting.Keywords: results of studying dance, audio visual media

MENINGKATKAN HASIL BELAJAR SISWA DALAM PEMBELAJARAN SENI TARI MELALUI METODE PEMBELAJARAN COOPERATIF LEARNING TIPE JIGSAW DI SMP NEGERI 3 KOTA SOLOK

This article aims to improve the learning outcomes of dance through the Jigsaw learning method for the students of SMP 3 Solok. The type of research used is classroom action research. The instrument in this study was post test and the form of assessment consisted of two forms, they were knowledge (cognitive) and skill (psychomotor) tests. The types of data in this study were primary and secondary data. The technique of collecting data was done by doing the observation, test and documentation. The data were analyzed using qualitative and quantitative analysis. To see an increase in student learning outcomes was done by comparing the percentage of students' mastery in learning before and after receiving the action. The results of the study shows that the use of the Jigsaw method in learning dance can improve students learning activities and outcomes. The percentage of completeness of students learning outcomes in the cognitive increased in cycle 2, it is 97%. Whereas, the percentage of completeness of student learning outcomes only reached 70% in cycle 1. The results of learning (psychomotor) skills of students are also very good, seen from the percentage of completeness of students learning outcomes are increase from 56.6% in cycle 2 to 90%. Then, it can be concluded that the implementation of learning with the application of Jigsaw cooperative learning can improve outcomes and students learning activities.Keywords: increased, the results of the study, the art of dance, cooperatif learning type of jigsaw

The new target therapy to prevent weight gain associated to atypical antipsychotics: PKCβ

Antipsychotic drugs are currently used in clinical practice for a variety of mental disorders. Clozapine is the most effective medication for treatment-resistant schizophrenia, in controlling aggression and suicidal behavior in psychosis. Although clozapine is associated with a low likelihood of extrapyramidal symptoms and other neurological side effects, weight gain and metabolic side effects are well known in clinical practice exposing the patient to a greater risk of cardiovascular disorders, premature death, as well as psychosocial issues leading to non-adherence. The mechanisms underlying this pharmacologically activated disorders are still controversial. Based on our in vitro results, we have characterized in vivo the effects of the selective PKCβ inhibitor, Ruboxistaurin (LY-333531) on a preclinical model of long-term clozapine-induced weight gain. Cell biology, biochemistry and psychomotor tests have been performed on wild type and PKCβ (-/-) mutant mice to investigate the contribution of endogenous PKCβ and its pharmacological inhibitor on the neuroleptic effect of clozapine. Lastly, we also shed light on a novel aspect of the mechanism underlying of clozapine-induced weight gain, demonstrating that the clozapine-dependent PKCβ activation promote the inhibition of the lipid droplet-selective autophagy process, opening the way to new therapeutic intervention approach.Disclosure of interestThe authors have not supplied their declaration of competing interest.