Hypercoagulation detected by Rotational Thromboelastometry predicts mortality in COVID-19: A risk model based on a prospective observational study.

ABSTRACT Background: Severe disease due to COVID-19 has been shown to be associated with hypercoagulation. The aim of this study was to assess Rotational Thromboelastometry (ROTEM®) as a marker of coagulopathy in hospitalized COVID-19 patients. Methods: This was a prospective, observational study where patients hospitalized due to a COVID-19 infection were eligible for inclusion. Conventional coagulation tests and ROTEM were taken after hospital admission, and patients were followed for 30 days. A prediction model including variables ROTEM EXTEM-MCF (Maximum Clot Firmness), which in previous data has been suggested a suitable marker of hypercoagulation, age and respiratory frequency was developed using logistic regression to evaluate the probability of death. Results: Out of the 141 patients included, 18 (13%) died within 30 days. In the final prediction model, the risk of death within 30 days for a patient hospitalized due to COVID-19 was increased with increased EXTEM-MCF, age and respiratory frequency. Longitudinal ROTEM data in the severely ill subpopulation showed enhanced hypercoagulation. In an in vitro analysis, no heparin effect on EXTEM-CT (Coagulation Time) was observed, supporting a SARS-CoV-2 effect on prolonged initiation of coagulation. Conclusions: Here we show that hypercoagulation measured with ROTEM predicts 30-days mortality in COVID-19. Longitudinal ROTEM data strengthen the hypothesis of hypercoagulation as a driver of severe disease in COVID-19. Thus, ROTEM may be a useful tool to assess disease severity in COVID-19 and could potentially guide anticoagulation therapy.

PENGARUH TERAPI ACTIVE CYCLE OF BREATHING TECHNIQUE (ACBT) TERHADAP FREKUENSI PERNAFASAN (RESPIRATORY RATE) PADA PENDERITA TUBERKULOSIS PARU DI RUMAH SAKIT UMUM IMELDA PEKERJA INDONESIA MEDAN

Pulmonary tuberculosis is a major public health problem in the world and is the second leading cause of death from infectious diseases. The purpose of this study was to determine the effect of active cycle of breathing technique (ACBT) therapy on breathing frequency in patients with pulmonary tuberculosis. Quantitative research method, with a Quasi Experimental research design with a pre-test and one-group post-test approach. The study was carried out in the Orchid room of the Imelda Indonesian Workers General Hospital in Medan in July - August 2021. The study population was 45 patients with pulmonary tuberculosis and the sample technique of this study was Nonprobability Sampling. The number of samples was 41 pulmonary tuberculosis patients according to the researcher's criteria. The data analysis technique used is Wilcoxon test analysis. The results of the study There was an effect of breathing patterns before the administration of active cycle of breathing technique (ACBT) Therapy on the improvement of respiratory frequency in patients with pulmonary tuberculosis with a value of M ± SD = 17.1081 ± 2.94188. There is an effect of breathing pattern after administration of active cycle of breathing technique (ACBT) Therapy on the respiratory frequency of Pulmonary Tuberculosis Patients with a value of M ± SD = 27.0400 ± 2.82076. There is a difference in the effect of breathing patterns before and after administration of active cycle of breathing technique (ACBT) therapy on the Improvement of respiratory frequency in pulmonary tuberculosis patients with a significant value of 0.000 < 0.005. Abstrak Tuberkulosis paru adalah masalah pokok kesehatan pada masyarakat didunia dan merupakan penyebab kematian ke dua dari penyakit infeksi. Tujuan penelitian untuk mengetahui pengaruh pemberian terapi active cycle of breathing technique (ACBT) terhadap frekuensi pernafasan pada penderita tuberkulosis paru. Metode penelitian kuantitatif, dengan desain penelitian Quasi Eksperiment dengan pendekatan pre test dan post test one group. Penelitian dilaksanakan di ruangan Anggrek Rumah Sakit Umum Imelda Pekerja Indonesia Medan pada bulan Juli - Agustus 2021. Populasi penelitian sebanyak 45 orang pasien Tuberkulosis Paru dan teknik sampel penelitin ini adalah Nonprobability Sampling. Jumlah sampel 41 orang pasien tuberkulosis paru sesuai dengan kriteria peneliti. Teknik analisa data yang digunakan adalah analisis uji Wilcoxon. Hasil penelitian ada pengaruh pola nafas sebelum pemberian terapi active cycle of breathing technique (ACBT) terhadap perbaikan frekuensi pernafasan pada penderita tuberkulosis paru dengan nilai M ± SD =17.1081 ± 2.94188. Ada pengaruh pola nafas sesudah pemberian terapi active cycle of breathing technique (ACBT) terhadap frekuensi pernafasan pasien tuberkulosis paru dengan nilai M ± SD = 27.0400 ± 2.82076. Ada perbedaan pengaruh pola nafas sebelum dan sesudah pemberian terapi active cycle of breathing technique (ACBT) terhadap perbaikan frekuensi pernafasan pasien tuberkulosis paru dengan nilai signifikan 0,000 < 0,005.

Single Slow-Paced Breathing Session at Six Cycles per Minute: Investigation of Dose-Response Relationship on Cardiac Vagal Activity

The practice of slow-paced breathing (SPB) has been linked to a range of positive outcomes, such as decreasing symptoms of depression, anxiety, and stress, as well as increasing well-being. Among the suggested mechanisms of action, SPB has been shown to increase cardiac vagal activity (CVA). The present study aimed to investigate whether there is a dose-response relationship modulating the effects of SPB on CVA. A total of 59 participants were involved in this study. In a within-subject design, participants attended the lab five times, and realized SPB at six cycles per minute with different durations (5, 10, 15, and 20 min), as well as a control condition without SPB. CVA was indexed via the root mean square of successive differences (RMSSD). During SPB, findings showed an increase in RMSSD in all conditions compared to the control condition. However, no differences were found in RMSSD among the different session durations, during SPB or during the resting measurement completed immediately after SPB. Noteworthily, session duration showed an influence on the spontaneous respiratory frequency in the resting measurement occurring immediately after SPB. Specifically, respiratory frequency appears to decrease with session duration, thus potentially contributing to additional relaxing effects.

Are eSports more than just sitting? A study comparing energy expenditure

Aim: To investigate the energy expenditure of amateur eSport athletes between sitting and an eSport gaming session. Materials & methods: Eleven amateur male eSport athletes (age: 21.73 ± 3.50 years, weight: 76.00 ± 12.51 kg, height: 1.81 ± 0.06 m) were included. After recording the resting values, eSports playing values were recorded using an open circulation oxygen consumption analyzer (QuarkCPET, COSMED, Albano Laziale, Italy). Also, action per min (APM) scores were recorded. Results: When comparing the respiratory frequency, metabolic equivalent of task values and energy expenditure values of the participants, a significant increase was observed in all three values (p < 0.05 for each). Conclusion: eSports players, who are considered to be physically inactive by sitting, spend approximately 40% more energy than sitting, even at the amateur level. According to APM, more energy can be spent in tournaments and at the elite level.

Orexin contributes to eupnea within a critical period of postnatal development

Orexin neurons are active in wakefulness and mostly silent in sleep. In adult rats and humans, orexin facilitates the hypercapnic ventilatory response but has little effect on resting ventilation. The influence of orexin on breathing in the early postnatal period, and across states of vigilance, have not been investigated. This is relevant as the orexin system may be impaired in Sudden Infant Death Syndrome (SIDS) cases. We addressed three hypotheses: 1) orexin provides a drive to breathe in infancy; 2) the effect of orexin depends on stage of postnatal development; and 3) orexin has a greater influence on breathing in wakefulness compared with sleep. Whole body plethysmography was used to monitor breathing of infant rats at three ages: postnatal days ( P) 7–8, 12–14, and 17–19. Respiratory variables were analyzed in wakefulness (W), quiet sleep (QS), and active sleep (AS), following suvorexant (5 mg/kg ip), a dual orexin receptor antagonist, or vehicle (DMSO). Effects of suvorexant on ventilatory responses to graded hypercapnia ([Formula: see text] = 0.02, 0.04, 0.06), hypoxia ([Formula: see text] = 0.10), and hyperoxia ([Formula: see text] = 1.0) at P12–14 were also tested. At P12–14, but not at other ages, suvorexant significantly reduced respiratory frequency in all states, reduced the ventilatory equivalent in QW and QS, and increased [Formula: see text] to ∼5 mmHg. Suvorexant had no effect on ventilatory responses to graded hypercapnia or hypoxia. Hyperoxia eliminated the effects of suvorexant on respiratory frequency at P12–14. Our data suggest that orexin preserves eupneic frequency and ventilation in rats, specifically at ∼2 wk of age, perhaps by facilitating tonic peripheral chemoreflex activity.

PENGARUH PERBEDAAN JENIS KELAMIN TERHADAP FREKUENSI NAFAS, DENYUT JANTUNG, SUHU SHANK, DAN SUHU REKTAL AYAM KUB

This study aimed to determine the effect of sex differences on the physiology of chickens including respiratory frequency, heart rate, shank temperature, and rectal temperature of KUB chickens. The research was conducted on 10--16 August 2017 at Cage Integrated Field Laboratory, Faculty of Agriculture, University of Lampung. This study used 50 chickens (25 males and 25 females) aged 13 weeks with an average weight of 850 g. Data were collected after measuring the temperature and humidity at 08.00-17.00 for 3 consecutive days to determine the extreme temperature of the environment. The variables in this study were respiratory rate, heart rate, shank temperature, and rectal temperature of KUB chickens at extreme temperatures. The results were analyzed using the t-test at the 5% significance level. The t-test results showed that the sex of KUB chickens had no significant effect on respiratory frequency, heart rate, shank temperature, and rectal temperature. Key words : Chicken physiological, KUB chicken, Sex type

Effect of agarwood leaf extract on production performance of broilers experiencing heat stress

Background and Aim: The open house cage is mainly influenced by the environmental heat from the sun and the heat released by the chicken. Heat stress can affect physiological conditions so that it has an impact on decreasing productivity. This study aims to determine the effect of agarwood leaf extract in feed on the physiological condition and production performance of broilers experiencing heat stress and to generate prediction equations for the optimal level of the extract in feed. Materials and Methods: A total of 200 22-day-old broilers (Cobb 500™) underwent four treatments with five replications each, namely, feed without agarwood leaf extract (control) (T0), and feed with 250 (T1), 300 (T2), and 350 mg of agarwood leaf extract/kg body weight (T3). The parameters observed include physiological condition (heart rate, respiratory frequency, and body temperature) as well as production performance (feed consumption, body weight gain [BWG], and feed conversion). Results: The administration of agarwood leaf extract significantly (p<0.05) decreased heart rate and respiratory frequency. However, there was no significant difference (p>0.05) in body temperature, glucose levels, hemoglobin and erythrocyte concentrations, as well as production performance which include weight gain, feed consumption, and feed conversion ratio. Meanwhile, broilers treated with agarwood leaf extract had a significantly lower heart rate and respiratory frequency (p<0.05) compared to the control. However, broilers given agarwood leaf extract showed better body weight, consumption, and ration conversion compared to the control. Conclusion: Agarwood leaf extract in feed reduces heart rate and respiratory frequency but has no significant effect on body temperature and hematological parameters (glucose levels, hemoglobin, and erythrocyte concentrations) as well as production performance (feed consumption, weight gain, and feed conversion). These results indicate that the administration of 350 mg/kg body weight agarwood leaf extract is most effective to reduce feed consumption and increase BWG.

Effect of the Spatial Distribution of the Temperature and Humidity Index in a New Zealand White Rabbit House on Respiratory Frequency and Ear Surface Temperature

The objective of this study was to characterize and evaluate the temperature and humidity index (THI) of New Zealand white (NZW) rabbits kept in a rabbit house using geostatistical techniques. Furthermore, we sought to evaluate its relationship with respiratory frequency (RF) and ear surface temperature (EST). The experiment was conducted at the Federal University of Lavras, Brazil. A total of 52 NZW rabbits were used. For the characterization of the thermal environment, the dry bulb temperature (tdb, °C), relative humidity (RH, %), and dew point temperature (tdp, °C) were collected at 48 points in the rabbit house at 6:00 a.m., 12:00 p.m., and 6:00 p.m. for seven days. The RF and EST of the animals was monitored. Subsequently, the THI was calculated and the data were analyzed using geostatistical tools and kriging interpolation. In addition, the RF and EST data were superimposed on the rabbit house’s THI data maps. The magnitude of the variability and structure of the THI inside the rabbit house were characterized and the heterogeneity was visualized. Critical THI points inside the rabbit house and in locations where animals with high RF and ESTs were housed were identified, thus providing information about improving the production environment.