Responsiveness Index versus the RASS-Based Method for Adjusting Sedation in Critically Ill Patients

Background. Sedation of intensive care patients is needed for patient safety, but deep sedation is associated with adverse outcomes. Frontal electromyogram-based Responsiveness Index (RI) aims to quantify the level of sedation and is scaled 0–100 (low index indicates deep sedation). We compared RI-based sedation to Richmond Agitation-Sedation Scale- (RASS-) based sedation. Our hypothesis was that RI-controlled sedation would be associated with increased total time alive without mechanical ventilation at 30 days without an increased number of adverse events. Methods. 32 critically ill adult patients with mechanical ventilation and administration of sedation were randomized to either RI- or RASS-guided sedation. Patients received propofol and oxycodone, if possible. The following standardized sedation protocol was utilized in both groups to achieve the predetermined target sedation level: either RI 40–80 (RI group) or RASS −3 to 0 (RASS group). RI measurement was blinded in the RASS group, and the RI group was blinded to RASS assessments. State Entropy (SE) values were registered in both groups. Results. RI and RASS groups did not differ in total time alive in 30 days without mechanical ventilation ( p = 0.72 ). The incidence of at least one sedation-related adverse event did not differ between the groups. Hypertension was more common in the RI group ( p = 0.01 ). RI group patients were in the target RI level 22% of the time and RASS group patients had 57% of scores within the target RASS level. The RI group spent significantly more time in their target sedation level than the RASS group spent in the corresponding RI level ( p = 0.03 ). No difference was observed between the groups ( p = 0.13 ) in the corresponding analysis for RASS. Propofol and oxycodone were administered at higher RI and SE values and lower RASS values in the RI group than in the RASS group. Conclusion. Further studies with a larger sample size are warranted to scrutinize the optimal RI level during different phases of critical illness.

Narkoba and Security Threats in Indonesia: Regional Responsiveness Index and Eradication Policies

This article aims to explain how the drug phenomenon with all its developments that occur in Indonesia, threats that arise against security, its impact and how efforts in overcoming it. The article is based on the results of a national survey of the city index for responding to drug threats in 173 districts and cities that have BNN representatives. Through quantitative methods with statistical calculations Index Kota Tanggap Ancaman Narkoba was divided into two categories of analysis units: family analysis unit and non-family analysis unit. The Index value obtained was transformed into categories that represent the level of responsiveness to the threat of narcotics. The results of the majority of regions in Indonesia are still not good responsiveness to the threat of drugs. Index values for all variables (family, institutional, territorial, community and legal resilience) are still below 40, except for family resilience at 64.84. These values also serve as indicators for developing integral policies so that prevention and abuse of drugs can be carried out.

Responsiveness index of sorghum (Sorghum bicolor (L.) Moench) grown under cadmium contaminated soil treated with putrescine and mycorrhiza

Effect of polyamine (putrescine) and mycorrhiza combination on putrescine and mycorrhiza responsiveness index was studied in sorghum. It is evident that the average putrescine and mycorrhiza responsiveness index was non-significantly enhanced by 48.40, 48.43 and 46% when exposed to higher dose of polyamine (putrescine) and mycorrhiza combination (T5) as compared to lower dose of polyamine (putrescine) and mycorrhiza combination (T4) at 30, 60 and 90 DAS of interval. Similarly, when plants were exposed to higher dose of polyamine (putrescine) and mycorrhiza combination (T11) than its putrescine and mycorrhiza responsiveness index was non-significantly enhanced by 11.03, 13.22 and 13.18% as compared to T10. When treatment, T17 was compared to T16, the putrescine and mycorrhiza responsiveness index increased significantly by 7.13, 6.73 and 5.35% at proposed DAS. So, the combination of putrescine and mycorrhiza showed the best combination for the mitigation of cadmium toxicity for the putrescine and mycorrhiza responsiveness index.

Responsiveness to Change of Self-Report and Device-Based Physical Activity Measures in the Living Well With Diabetes Trial

Background:This study evaluated the responsiveness to change in physical activity of 2 self-report measures and an accelerometer in the context of a weight loss intervention trial.Methods:302 participants (aged 20 to 75 years) with type 2 diabetes were randomized into telephone counseling (n = 151) or usual care (n = 151) groups. Physical activity (minutes/week) was assessed at baseline and 6-months using the Active Australia Survey (AAS), the United States National Health Interview Survey (USNHIS) walking for exercise items, and accelerometer (Actigraph GT1M; ≥1952 counts/minute). Responsiveness to change was calculated as responsiveness index (RI), Cohen’s d (postscores) and Cohen’s d (change-scores).Results:All instruments showed significant improvement in the intervention group (P < .001) and no significant change for usual care (P > .05). Accelerometer consistently ranked as the most responsive instrument while the least responsive was the USHNIS (responsiveness index) or AAS (Cohen’s d). RIs for AAS, USNHIS and accelerometer did not differ significantly and were, respectively: 0.45 (95% CI: 0.26–0.65); 0.38 (95% CI: 0.20–0.56); and, 0.49 (95% CI: 0.23–0.74).Conclusions:Accelerometer tended to have the highest responsiveness but differences were small and not statistically significant. Consideration of factors, such as validity, feasibility and cost, in addition to responsiveness, is important for instrument selection in future trials

Evaluation of the effects of atenolol and nifedipine retard on the functional status of cerebral circulation in patients with arterial hypertension in relation to risk factors

The effects of the conventional antihypertensive agents atenolol and nifedipine retard on the functional status of cerebral circulation were studied in patients with first- and second-degree arterial hypertension (AH) in relation to its risk factors. In smoking patients, atenolol was shown to increase the pulsation index, which can affect arterial elasticity. In AH patients having risk factors (familial history, smoking, and hypercholesterolemia), the antihypertensive effect of nifedipine retard did not increase the cerebrovascular responsiveness index, which is indicative of the decreased compensatory capacities of cerebral arteries.