bluuebunny/crossref_metadata_2025 huggingface dataset:
Modified Smith–Petersen approach with rectus-sparing reduces severe avascular necrosis for developmental dysplasia of the hip at walking age: minimum 5-year follow-up
Authors: Miao Mingyuan , Jin Sheng , Cai Haiqing , Cai Haoqi , Bian Jingxia , Wang Zhigang
Published: December 2022

Background

Developmental dysplasia of the hip (DDH) is one of the most common orthopedic malformations in children. Open reduction for DDH at walking age remains a major concern. The goal of this study is to evaluate the mid-term effect of a modified Smith–Petersen approach which preserves the rectus femoris on DDH at walking age, in particular avascular necrosis (AVN).

Methods

A retrospective review of DDH patients aged between 12 and 24 months was carried out between January 2010 and June 2016. Open reduction through the Smith–Petersen approach (Group A) and modified Smith–Petersen approach, which preserves the rectus femoris (Group B), were both used. Measurement of hip geometry included acetabular index, the International Hip Dysplasia Institute classification, and AVN degree. Clinical records included operation time, bleeding volume, and abduction angle.

Results

There were 101 children (119 hips) with DDH who met the inclusion criteria. There were 66 hips in Group A and 53 in Group B. The mean surgical age at open reduction was 17.0 ± 2.4 months, with a mean 104.9 ± 19.5 months at last follow-up. There was no statistical difference in surgical age between the two groups (17.2 vs. 16.4 months). There was no significant difference in the incidence of all types of clinically significant AVN between group A and group B (27.3 vs. 18.9%), but the incidence of severe AVN was lower in group B (19.7 vs. 5.7%, P = 0.026). In addition, the lower the age at the time of open reduction, the lower the severity of AVN (P = 0.002).

Conclusions

These mid-term data suggest that the modified Smith–Petersen approach with rectus-sparing could reduce severe AVN more than the classical Smith–Peterson approach in open reduction in DDH at walking age. In addition, early open reduction can reduce the postoperative degree of AVN.
Safety, effectiveness, and adherence of a short and all-oral treatment regimen for the treatment of rifampicin-resistant tuberculosis in Niger: a study protocol of a pragmatic randomised clinical trial with stratified block randomisation
Authors: Souleymane Mahamadou Bassirou , Decroo Tom , Soumana Alphazazi , Maman Lawan Ibrahim , Gagara-Issoufou Assiatou , Halidou-Moussa Souleymane , Ortuño-Gutiérrez Nimer , Adehossi Eric , Mamadou Saïdou , Van Deun Armand , Piubello Alberto
Published: December 2022

Background

Rifampicin-resistant tuberculosis (RR-TB) treatment requires combination treatment, which frequently causes serious adverse events and globally results in not much more than 60% treatment success. In Niger, a high cure rate was obtained with a RR-TB treatment strategy based on a second-line injectable drug (SLID)-containing Short Treatment Regimen (STR), with linezolid replacing the SLID in patients with ototoxicity. Given the availability of novel anti-tuberculosis drugs, WHO recommends all-oral RR-TB treatment. Considering the high level of success with the Niger treatment strategy, it would only be justified to replace it in case robust evidence shows that the WHO all-oral bedaquiline/linezolid (BDQ/LZD)-containing STR (experimental arm) performs better than the Niger RR-TB treatment strategy, (control arm) in terms of safety, effectiveness and adherence.

Methods

A pragmatic randomised clinical trial (RCT) using stratified block randomisation, conducted between April 2021 and March 2024, prospectively enrols participants diagnosed with RR-TB in one of the four RR-TB units of the nation. Depending of the month in which patients are diagnosed with RR-TB, patients with FQ-susceptible RR-TB are enrolled in either the experimental arm or control arm.

Discussion

To increase the feasibility of conducting a RCT, embedded in routine activities of all Niger’s RR-TB Units, we used a creative trial design. We randomised by monthly blocks, whereby the regimen used changes every month, using the month of RR-TB diagnosis as stratifying variable. This approach was deemed feasible for Niger's national tuberculosis programme, as it simplifies the work of the clinicians running the RR-TB units. Our creative design may serve as an example for other national programs. Findings will inform national and international RR-TB treatment guidelines, and will also strengthen the evidence-base on how to develop robust RR-TB treatment regimens.

Trial registration

Pan African Clinical Trial Register PACTR202203645724919. Registered on 15 March 2022.
Outcome of adult patients with JIA treated with the biosimilar Benepali®: results of the biologic register JuMBO
Authors: Vollbach Kristina , Tenbrock Klaus , Wagner Nobert , Horneff Gerd , Klein Ariane , Foeldvari Ivan , Haas Johannes-Peter , Aries Peer , Gauler Georg , Striesow Frank , Hoff Paula , Scholz Christine , Tatsis Stefanie , Seipelt Eva , Klotsche Jens , Minden Kirsten
Published: December 2022

Background

To analyze therapy adherence, safety, and outcome in adult patients with juvenile idiopathic arthritis (JIA) treated with the etanercept biosimilar Benepali® (Biogen Inc, Cambridge, USA).

Methods

Data from the prospective registry, JuMBO (Juvenile arthritis MTX/Biologics long-term Observation), were used for the analysis. JuMBO is a long-term observational cohort study. It follows adult patients with JIA who were formerly included in the national JIA biologic register (BiKeR Registry). Both registries provide individual trajectories of clinical data and outcomes from childhood to adulthood in JIA patients treated with disease-modifying anti-rheumatic drugs (DMARDs).

Results

Eighty-three patients from the German JuMBO registry were treated with Benepali®. Of these, 74% had switched from Enbrel® (Pfizer Inc., NYC, USA) the originator of etanercept to Benepali® for cost reasons. Therapy survival of patients treated with Benepali® in comparison to Enbrel® in patients matched by significant parameters was comparable. Adverse events (AE) were reported in 25.3% and serious adverse events (SAE) in 9.6% of patients. Physicians rated no SAE causative related to Benepali®. The majority of SAEs were surgical/medical procedures and there was only one infection. All efficacy parameters (cJADAS-10, Physician Global Assessment, number of joints with active arthritis, patients’ overall well-being, pain, and HAQ) demonstrated improvement over 24 months (p-values were not significant). 9.6% of patients permanently discontinued Benepali® because of an AE.

Conclusions

Tolerability and effectiveness of the biosimilar Benepali® were satisfactory and therapy survival was comparable to the originator. Further data on therapy with biologics and biosimilars such as Benepali® must be collected by registries such as BiKeR and JuMBO in order to optimize therapy and patient outcomes and to reduce costs in the health system in the long term.
Agreement between estimated computed tomography perfusion ischemic core and follow-up infarct on diffusion-weighted imaging
Authors: Yang Wenjin , Hoving Jan W. , Koopman Miou S. , Tolhuisen Manon L. , van Voorst Henk , Berkheme Olvert A. , Coutinho Jonathan M. , Beenen Ludo F. M. , Emmer Bart J.
Published: December 2022

Background

Computed tomography perfusion (CTP) is frequently performed during the diagnostic workup of acute ischemic stroke patients. Yet, ischemic core estimates vary widely between different commercially available software packages. We assessed the volumetric and spatial agreement of the ischemic core on CTP with the follow-up infarct on diffusion-weighted imaging (DWI) using an automated software.

Methods

We included successfully reperfused patients who underwent endovascular treatment (EVT) with CTP and follow-up DWI between November 2017 and September 2020. CTP data were processed with a fully automated software using relative cerebral blood flow (rCBF) < 30% to estimate the ischemic core. The follow-up infarct was segmented on DWI imaging data, which were acquired at approximately 24 h. Ischemic core on CTP was compared with the follow-up infarct lesion on DWI using intraclass correlation coefficient (ICC) and Dice similarity coefficient (Dice).

Results

In 59 patients, the median estimated core volume on CTP was 16 (IQR 8–47) mL. The follow-up infarct volume on DWI was 11 (IQR 6–42) mL. ICC was 0.60 (95% CI 0.33–0.76), indicating moderate volumetric agreement. Median Dice was 0.20 (IQR 0.01–0.35). The median positive predictive value was 0.24 (IQR 0.05–0.57), and the median sensitivity was 0.3 (IQR 0.13–0.47). Severe core overestimation on computed tomography perfusion > 50 mL occurred in 4/59 (7%) of the cases.

Conclusions

In patients with successful reperfusion after EVT, CTP-estimated ischemic core showed moderate volumetric and spatial agreement with the follow-up infarct lesion on DWI, similar to the most used commercially available CTP software packages. Severe ischemic core overestimation was relatively uncommon.
Risk factors for colonization and infection with multidrug-resistant Pseudomonas aeruginosa in intensive care unit: protocol for a systematic review and meta-analysis
Authors: Eyebe Serge , Nana-Djeunga Hugues C. , Guewo-Fokeng Magellan , Wafeu Guy Sadeu , Vouking Marius Zambou , Massoda Salomon , Evina Christine D. , Zoumabo Aurelia Condomat , Ongolo-Zogo Pierre , Zahar Jean-Ralph
Published: December 2022

Background

Infection with resistant Pseudomonas aeruginosa (RPA) in the intensive care unit (ICU) is known to be either endogenous or exogenous or both, but the roles of each of these contamination routes are yet to be clarified. Data regarding prevalence, risk factors, and environmental factors associated with RPA in ICU are very scanty and even when they exist, they seem to be contradictory. So, there is a strong interest in understanding both individual and environmental factors associated with RPA infection. This systematic review aims to investigate individual and environmental factors associated with the colonization and infection with RPA in ICU.

Methodology

MEDLINE (Pubmed), EMBASE (OVID), the Cochrane Library (Wiley), Web of Science, CINAHL (EBSCOHost), and LILACS (BIREME) will be searched from inception onwards. Grey literature will be identified through Google Scholar and Open Grey. Two reviewers will independently screen all citations, abstracts, and full-text articles. Potential conflicts will be resolved through discussion. Methodological quality including bias will be appraised using appropriate approaches. A narrative synthesis will describe the quality and content of the epidemiological evidence. Prevalence, odds ratio, relative risk, and hazard radio with their respective 95% confidence intervals will be calculated. A meta-analysis of data extracted from eligible studies with similar populations and RPA testing will be performed. The analysis will evaluate factors influencing the estimates. A random effect model will be used to summarize effect sizes.

Discussion

Two contrasting hypotheses on risk factors of acquisition, colonization, and infection of RPA are being debated, especially in a context where available data are scanty or exhibit high discrepancy. Indeed, most of the reviews have been focalized on hospitalized patients, and not in ICU, and few of them address the issue of environmental factors. To fill that gap, this review will combine both analyses of individual and environmental risk factors using prevalence studies in ICU and evaluation of different methodologies. These two hypotheses will be tested and challenged and could serve as a basis for a more in-depth study to fill the methodological gaps that will be identified as part of this current review.

Systematic review registration

This protocol has been submitted to the Prospective Register of Systematic Reviews (PROSPERO) and the registration number attributed was CRD42021233832 of 07 March 2021.
All-cause mortality after major gastrointestinal bleeding among patients receiving direct oral anticoagulants: a protocol for a systematic review and meta-analysis
Authors: Chornenki Nicholas L. J. , Tritschler Tobias , Stucki Fabian , Odabashian Roupen , Leentjens Jenneke , Khan Faizan , Ly Valentina , Siegal Deborah M.
Published: December 2022

Background

Gastrointestinal (GI) bleeding represents the single most frequent site of anticoagulant-related bleeding. Adverse outcomes after major GI bleeding including mortality are not well characterized and, as a result, may be underappreciated in clinical practice. We aim to conduct a systematic review and meta-analysis of the risk for 30-day all-cause mortality after major GI bleeding among patients receiving DOACs.

Methods

Electronic databases including MEDLINE, EMBASE, and Cochrane CENTRAL will be systematically searched to identify randomized controlled trials and prospective and retrospective cohort studies reporting 30-day all-cause mortality in adults with DOAC-related major GI bleeding. At least two investigators will independently perform study selection, risk of bias assessment, and data extraction. The proportion of deaths following a major GI event relative to the number of major GI bleeding events will be calculated for each individual study, and results across studies will be pooled using random-effects meta-analysis. We will assess risk of bias using criteria proposed by the GRADE group for prognostic studies.

Discussion

The findings of this systematic review and meta-analysis will provide clinicians and patients with estimates of mortality after the most common major bleeding event to support shared decision making about anticoagulation management.

Trial registration

PROSPERO CRD42022295815.
Technology-based interventions for health challenges older women face amid COVID-19: a systematic review protocol
Authors: Su Zhaohui , Cheshmehzangi Ali , Bentley Barry L. , McDonnell Dean , Šegalo Sabina , Ahmad Junaid , Chen Hengcai , Terjesen Lori Ann , Lopez Emme , Wagers Shelly , Shi Feng , Abbas Jaffar , Wang Caifeng , Cai Yuyang , Xiang Yu-Tao , da Veiga Claudimar Pereira
Published: December 2022

Background

Pandemics, such as COVID-19, are dangerous and socially disruptive. Though no one is immune to COVID-19, older persons often bear the brunt of its consequences. This is particularly true for older women, as they often face more pronounced health challenges relative to other segments in society, including complex care needs, insufficient care provisions, mental illness, neglect, and increased domestic abuse. To further compound the situation, because protective measures like lockdowns can result in unintended consequences, many health services older women depend on can become disrupted or discontinued amid pandemics. While technology-based interventions have the potential to provide near-time, location-free, and virtually accessible care, there is a dearth of systematic insights into this mode of care in the literature. To bridge the research gaps, this investigation aims to examine the characteristics and effectiveness of technology-based interventions that could address health challenges older women face amid COVID-19.

Methods

A systematic review of randomized trials reporting on technology-based interventions for older women (≥65 years) during COVID-19 will be conducted. The databases of Web of Science, ScienceDirect, PubMed/MEDLINE, PsycINFO, CINAHL, and Scopus will be searched. Retrieved citations will be screened independently by at least two reviewers against the eligibility criteria. Included studies will be assessed using the Cochrane ROB-2 tool. Data will be extracted independently by the reviewers. Where possible, meta-analyses will be performed on relevant study outcomes and analysed via odds ratios on the dichotomized outcomes. Where applicable, heterogeneity will be measured using the Cochrane Q test, and publication bias will be assessed via funnel plots and Egger’s regression test.

Discussion

Technology has the potential to transform healthcare for the better. To help society better safeguard vulnerable populations’ health and quality of life, this investigation sets out to gauge the state-of-the-art development of technology-based interventions tailored to the health challenges older women face amid COVID-19. In light of the growing prevalence of population ageing and the inevitability of infectious disease outbreaks, greater research efforts are needed to ensure the timely inception and effective implementation of technology-based health solutions for vulnerable populations like older women, amid public health crises like COVID-19 and beyond.

Systematic review registration

PROSPERO CRD42020194003
q-ROF mappings and Suzuki type common fixed point results in b-metric spaces with application
Authors: Rashid Maliha , Shahid Lariab , Agarwal Ravi P. , Hussain Aftab , Al-Sulami Hamed
Published: December 2022

In the present paper the concepts of q-rung orthopair fuzzy mappings (q-ROF mapping) and q-rung$( \alpha ,\beta ) $(α,β)-cuts are introduced. Some common fixed point results for q-ROF mappings are presented in b-metric spaces using Suzuki-type contractive conditions. Examples in support of obtained results are also presented. We have also presented an application of our result for the existence of solution of nonlinear fractional integral inclusion. The results are of their own kind in the literature of q-ROF sets and will pave the way for further research in the area.
Bona fide atypical scrapie faithfully reproduced for the first time in a rodent model
Authors: Vidal Enric , Sánchez-Martín Manuel A. , Eraña Hasier , Lázaro Sonia Pérez , Pérez-Castro Miguel A. , Otero Alicia , Charco Jorge M. , Marín Belén , López-Moreno Rafael , Díaz-Domínguez Carlos M. , Geijo Mariví , Ordóñez Montserrat , Cantero Guillermo , di Bari Michele , Lorenzo Nuria L. , Pirisinu Laura , d’Agostino Claudia , Torres Juan María , Béringue Vincent , Telling Glenn , Badiola Juan J. , Pumarola Martí , Bolea Rosa , Nonno Romolo , Requena Jesús R. , Castilla Joaquín
Published: December 2022

Atypical Scrapie, which is not linked to epidemics, is assumed to be an idiopathic spontaneous prion disease in small ruminants. Therefore, its occurrence is unlikely to be controlled through selective breeding or other strategies as it is done for classical scrapie outbreaks. Its spontaneous nature and its sporadic incidence worldwide is reminiscent of the incidence of idiopathic spontaneous prion diseases in humans, which account for more than 85% of the cases in humans. Hence, developing animal models that consistently reproduce this phenomenon of spontaneous PrP misfolding, is of importance to study the pathobiology of idiopathic spontaneous prion disorders. Transgenic mice overexpressing sheep PrPC with I112 polymorphism (TgShI112, 1–2 × PrP levels compared to sheep brain) manifest clinical signs of a spongiform encephalopathy spontaneously as early as 380 days of age. The brains of these animals show the neuropathological hallmarks of prion disease and biochemical analyses of the misfolded prion protein show a ladder-like PrPres pattern with a predominant 7–10 kDa band. Brain homogenates from spontaneously diseased transgenic mice were inoculated in several models to assess their transmissibility and characterize the prion strain generated: TgShI112 (ovine I112 ARQ PrPC), Tg338 (ovine VRQ PrPC), Tg501 (ovine ARQ PrPC), Tg340 (human M129 PrPC), Tg361 (human V129 PrPC), TgVole (bank vole I109 PrPC), bank vole (I109I PrPC), and sheep (AHQ/ARR and AHQ/AHQ churra-tensina breeds). Our analysis of the results of these bioassays concludes that the strain generated in this model is indistinguishable to that causing atypical scrapie (Nor98). Thus, we present the first faithful model for a bona fide, transmissible, ovine, atypical scrapie prion disease.
Key predictors of undernutrition among children 6–59 months in the Buea Health District of the Southwest region of Cameroon: a cross sectional community-based survey
Authors: Ngassa Andinwoh Betterdel , Meriki Henry Dilonga , Mbanga Clarence Mvalo , Nzefa Léonie Dapi , Mbhenyane Xikombiso , Tambe Ayuk Betrand
Published: December 2022

Background

According to the 2018 Demographic and Health Survey, undernutrition remains a public health problem among Cameroonian children under-five. This varies across the country, greatest in areas with ongoing humanitarian crisis, such as the Southwest region. However, data on the burden of undernutrition in the Southwest region is sparse. This study aimed to assess the prevalence and predictors of undernutrition among children under-five in the Buea health district of the Southwest region of Cameroon.

Methods

This was a community based cross-sectional study of 321 children under-five/caretaker pairs, surveyed from households selected using multistage randomized sampling. Data were collected by trained data collectors, with the aid of a structured, pre-tested questionnaire that captured information on sociodemographic characteristics, food security, dietary diversity and anthropometric measurements. The weight, height/length and mid upper arm circumference (MUAC) were measured using standardized instruments. Stunting, Wasting and Underweight of children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. Data was analysed using SPSS version 27.0. Predictors of malnutrition were obtained using multivariate logistic regression, adjusting for potential confounders.

Results

Overall, 31.8% (102/321) of the children were undernourished (26.5% stunted, 1.6% underweight, 3.7% wasted). Drinking water from inappropriate sources (OR: 2.32, 95% CI: 1.30–4.15) and a Dietary Diversity Score < 4 (OR: 2.59, 95%CI: 1.46–4.61) were independently associated with increased risk of stunting. Children of the male sex were more likely to be wasted than females (OR: 5.34, 95%CI: 1.09–26.14).

Conclusion

Childhood undernutrition, particularly stunting is common in the Buea Health District. Risk factors of undernutrition identified are potentially modifiable, highlighting the need for nutrition specific and sensitive interventions to improve dietary diversity, and the need to improve access to safe drinking water, and educate caretakers on the importance of clean potable water, good sanitation and hygiene for the proper growth and development of their children.
Associations of Prolonged Occupational Sitting with the Spectrum of Kidney Disease: Results from a Cohort of a Half-Million Asian Adults
Authors: Tsai Min-Kuang , Gao Wayne , Chien Kuo-Liong , Baw Chin-Kun , Hsu Chih-Cheng , Wen Chi-Pang
Published: December 2022

Background

Kidney diseases are viewed as continuously progressing diseases from microalbuminuria and chronic kidney disease (CKD), to end-stage renal disease (ESRD) and its mortality including deaths. The report on the association between prolonged sitting and kidney diseases is limited.

Methods

We examined a cohort of 455,506 participants in a screening program in Taiwan conducted between 1996 and 2017. Data on occupational sedentary behavior and physical activity were collected with a standardized questionnaire. The outcomes of ESRD and death were identified by linking with the Catastrophic Illness Dataset and Cause of Death Data. The association between prolonged sitting and CKD, the incidence of ESRD, and death were assessed using logistic regression models to compute odds ratios (ORs) and Cox proportional hazards models for hazard ratios (HRs).

Results

More than half of the participants, i.e., 265,948 (58.4%), were categorized as “prolonged sitting” during their work. During a median of 13 years of follow-up, we identified 2227 individuals undergoing dialysis and 25,671 deaths. Prolonged occupational sitting was significantly associated with a higher risk of CKD (OR: 1.26, 95% confidence interval: 1.21, 1.31), ESRD (HR: 1.19, 95% CI 1.03, 1.38), and kidney-specific mortality (HR: 1.43, 95% CI 1.07, 1.91) compared to mostly standing participants after controlling for physical activity and other risk factors. Inactive prolonged sitting carries a significantly higher risk of ESRD than physically active mostly standing participants (HR: 1.34, 95% CI 1.04, 1.73). However, active prolonged sitting decreased the risk of ESRD (HR: 1.03, 95% CI 0.79, 1.34) compared to inactive prolonged sitting.

Conclusion

The results suggest that prolonged occupational sitting is associated with a greater risk of the spectrum of kidney disease, proteinuria, CKD, dialysis (ESRD), and mortality for all causes and kidney diseases. Physical activity, even at a minimal level of 15 min/day (90 min/week) of moderate-intensity exercise, was associated with a reduction in these risks.
Effect of age on response to anti-VEGF agents in patients with center involving diabetic macular edema in a tertiary hospital
Authors: Alshalan Hanan A. , Arevalo J. Fernando , Alomary Saleh I. , Ardah Husam I. , Hazzazi Mohammd A.
Published: December 2022

Purpose

The aim of the current study is to evaluate the effect of age as an independent factor for the response to two anti-VEGF agents, intravitreal ranibizumab and intravitreal aflibercept, among patients presented with central-involving DME in one tertiary care center in Riyadh, Saudi Arabia.

Methods

Retrospective cohort study.

Results

A total of 210 eyes of 121 patients were included in the study. The mean age was 61.2 ± 11.40 years, 50.4% were males. On characterizing groups based on age, the group of patients 60 years or younger are 48 patients (mean age 51.5 ± 9.92) and 52.1% of them are females. On the other hand, the group of patients older than 60 years are 73 patients (mean age 67.6 ± 6.85) and 52.1% of them are males. The two anti-VEGF agents used were aflibercept (88.1%) and ranibizumab (11.9%). The mean BCVA using ETDRS letter score improved after treatment (5.55238095 ± 15.9538695) and the mean change in CST decreased after treatment (− 106.91 ± 117.385 μm). Regarding age, we found that there is no significant difference in mean improvement of BCVA in patients according to their age (p = 0.5429), patients younger than 60 years old gained 5.64 ETDRS letter score and those older than 60 years old gained 5.49 improvement. Similarly, mean improvement in CST was different between patients younger than 60 years old (− 125.1 μm) and those who were older than 60 years old (− 94 μm) with a trend favoring younger patients but this difference was not statistically significant (p = 0.08).

Conclusion

Age is a clinically significant factor affecting the outcome of anti-VEGF injections. Patients’ CST had a difference of > 30 μm on average between the two age groups favoring younger patients. However, it was not statistically significant, maybe a bigger sample size is needed to prove statistical significance.
Anesthesia and analgesia for common research models of adult mice
Authors: Ahmadi-Noorbakhsh Siavash , Farajli Abbasi Mohammad , Ghasemi Maedeh , Bayat Gholamreza , Davoodian Nahid , Sharif-Paghaleh Ehsan , Poormoosavi Seyedeh Mahsa , Rafizadeh Melika , Maleki Maryam , Shirzad-Aski Hesamaddin , Kargar Jahromi Hossein , Dadkhah Masoomeh , Khalvati Bahman , Safari Tahereh , Behmanesh Mohammad Amin , Khoshnam Seyed Esmaeil , Houshmand Gholamreza , Talaei Sayyed Alireza
Published: December 2022

Anesthesia and analgesia are major components of many interventional studies on laboratory animals. However, various studies have shown improper reporting or use of anesthetics/analgesics in research proposals and published articles. In many cases, it seems “anesthesia” and “analgesia” are used interchangeably, while they are referring to two different concepts. Not only this is an unethical practice, but also it may be one of the reasons for the proven suboptimal quality of many animal researches. This is a widespread problem among investigations on various species of animals. However, it could be imagined that it may be more prevalent for the most common species of laboratory animals, such as the laboratory mice. In this review, proper anesthetic/analgesic methods for routine procedures on laboratory mice are discussed. We considered the available literature and critically reviewed their anesthetic/analgesic methods. Detailed dosing and pharmacological information for the relevant drugs are provided and some of the drugs’ side effects are discussed. This paper provides the necessary data for an informed choice of anesthetic/analgesic methods in some routine procedures on laboratory mice.
Near-infrared spectroscopy measured cerebral oxygenation in full-term infants during transition: an observational study
Authors: Farag Marwa Mohamed , Ghazal Hesham Abd E. L.-Rahim , Ibrahim Alaa , Hammad Bahaa
Published: December 2022

Background

Brain is one of the most sensitive organs to hypoxia during resuscitation. NIRS-measured cerebral oxygenation is an evolving brain monitoring tool for neonatal resuscitation.

Methods

We undertook a prospective observational study for monitoring of cerebral oxygenation and peripheral preductal saturation at 1, 5, and 10 min after birth. Fractional tissue oxygen extraction was calculated as well. In addition to studying factors affecting cerebral oxygenation at those points in time. For the current cohort, cerebral oxygenation centile charts were provided at those time points. This work was registered in the cinicaltrial.gov NCT05158881.

Results

Sixty healthy term neonates were enrolled to define reference ranges and centile charts of cerebral oxygenation at 1, 5, and 10 min after birth. The strongest correlations between cerebral oxygenation metrics and peripheral preductal saturation were at 5 min after birth withrvalue = 0.628. Using logistic regression analysis to determine the most significant factors affecting NIRS-measured crSO2 in healthy full-term neonates, we found that the mode of delivery was the most significant factor with OR = 4.000 (1.367–11.703) at 5 min and 8.726 (2.517–30.25) at 10 min.

Conclusions

Normal values for NIRS may help to identify infants with cerebral oxygenation below a certain value indicating regional hypoxia at certain time points and can guide neonatal resuscitation interventions. Caesarean section is the most significant factor affecting cerebral oxygenation during the transition of healthy full-term neonates.
A narrative review of pox: smallpox vs monkeypox
Authors: Jayswal Samiksha , Kakadiya Jagdish
Published: December 2022

The famed variola (smallpox) virus and the monkeypox virus (MPXV) are closely related, and MPXV causes a milder form of febrile rash disease in people. Human monkeypox was mostly an uncommon zoonotic illness that was restricted to West and Central African wooded areas in the twentieth century. The global population’s smallpox vaccine-induced immunity, however, has started to decrease as the number of cases and the geographic breadth have both increased significantly in this century. Several countries have seen human monkeypox outbreaks since May 2022. A possible shift in the monkeypox transmission pattern that might represent a bigger worldwide danger is raised by the atypical nature of these outbreaks, which are characterized by their high-case numbers and absence of ties to endemic countries. Here, we explore a wide range of MPXV biology topics.
The Early Reception of the Phillips Curve in the United Kingdom: New Evidence from the Papers of the Council on Prices, Productivity, and Incomes
Authors: Cristiano Carlo
Published: December 2022

As shown in a 2018 article by Cristiano and Paesani, the element of Phillips's 1958 article that immediately obtained attention in the policy debate was the estimate of the unemployment rate compatible with price stability. Building on this previous work and based on the unpublished papers of the Council on Prices, Productivity, and Incomes and other published sources, the present article throws fresh light on why the curve paper failed to influence policymaking. At least two reasons may account for this. First, by the late 1950s and early 1960s, works based on inferential statistics still failed to obtain widespread attention among professional economists in the United Kingdom. Second, Phillips's 1958 article came at the beginning of a process that led to the abandonment, for some time at least, of the idea of buying price stability at the cost of increasing the unemployment rate.
Stereotactic Radiosurgery for Intraventricular Metastases: A Multicenter Study
Authors: Mantziaris Georgios , Pikis Stylianos , Xu Zhiyuan , Mullen Reed , Alzate Juan , Bernstein Kenneth , Kondziolka Douglas , Wei Zhishuo , Niranjan Ajay , Lunsford L. Dade , Liscak Roman , May Jaromir , Lee Cheng-chia , Yang Huai-che , Coupé François-Louis , Mathieu David , Sheehan Kimball , Sheehan Darrah , Palmer Joshua D. , Perlow Haley K. , Peker Selcuk , Samanci Yavuz , Peterson Jennifer , Trifiletti Daniel M. , Shepard Matthew J. , Elhamdani Shahed , Wegner Rodney E. , Speckter Herwin , Hernandez Wenceslao , Warnick Ronald E. , Sheehan Jason
Published: December 2022

BACKGROUND:

Intraventricular metastases (IVMs) are uncommon, and their optimal management remains debatable.

OBJECTIVE:

To define the safety and efficacy of stereotactic radiosurgery (SRS) in the treatment of IVMs.

METHODS:

This retrospective, multicenter study included patients managed with SRS for IVMs. SRS-induced adverse events, local tumor or intracranial progression, and the frequency of new-onset hydrocephalus or leptomeningeal spread were documented. Analyses of variables related to patient neuroimaging or clinical outcomes were also performed.

RESULTS:

The cohort included 160 patients from 11 centers who underwent SRS for treatment of 1045 intracranial metastases, of which 196 were IVMs. The median survival from SRS was 10 months. Of the 154 patients and 190 IVMs with imaging follow-up, 94 patients (61%) experienced distant intracranial disease progression and 16 IVMs (8.4%) progressed locally. The 12- and 24-month local IVM control rates were 91.4% and 86.1%, respectively. Sixteen (10%) and 27 (17.5%) patients developed hydrocephalus and leptomeningeal dissemination post-SRS, respectively. Adverse radiation effects were documented in 24 patients (15%). Eleven patients (6.9%) died because of intracranial disease progression.

CONCLUSION:

SRS is an effective treatment option for IVMs, with a local IVM control rate comparable with SRS for parenchymal brain metastases. Leptomeningeal spread and hydrocephalus in patients with IVM occur in a minority of patients, but these patients warrant careful follow-up to detect these changes.
Clinical Outcomes of Liposomal Bupivacaine Erector Spinae Block in Minimally Invasive Transforaminal Lumbar Interbody Fusion Surgery
Authors: Dincer Alper , Wang Andy , Kanter Matthew J. , Olmos Michelle , Yang Michael , Riesenburger Ron I. , Kryzanski James T.
Published: December 2022

BACKGROUND:

Postoperative pain is a barrier to early mobility and discharge after lumbar surgery. Liposomal bupivacaine (LB) has been shown to decrease postoperative pain and narcotic consumption after transforaminal lumbar interbody fusions (TLIFs) when injected into the marginal suprafascial/subfascial plane-liposomal bupivacaine (MSSP-LB). Erector spinae plane (ESP) infiltration is a relatively new analgesic technique that may offer additional benefits when performed in addition to MSSP-LB.

OBJECTIVE:

To evaluate postoperative outcomes of combining ESP-LB with MSSP-LB compared with MSSP-LB alone after single-level TLIF.

METHODS:

A retrospective analysis was performed for patients undergoing single-level TLIFs under spinal anesthesia, 25 receiving combined ESP-LB and MSSP-LB and 25 receiving MSSP-LB alone. The primary outcome was length of hospitalization. Secondary outcomes included postoperative pain score, time to ambulation, and narcotics usage.

RESULTS:

Baseline demographics and length of surgery were similar between groups. Hospitalization was significantly decreased in the ESP-LB + MSSP-LB cohort (2.56 days vs 3.36 days, P = .007), as were days to ambulation (0.96 days vs 1.29 days, P = .026). Postoperative pain area under the curve was significantly decreased for ESP-LB + MSSP-LB at 12 to 24 hours (39.37 ± 21.02 vs 53.38 ± 22.11, P = .03) and total (44.46 ± 19.89 vs 50.51 ± 22.15, P = .025). Postoperative narcotic use was significantly less in the ESP-LB + MSSP-LB group at 12 to 24 hours (13.18 ± 4.65 vs 14.78 ± 4.44, P = .03) and for total hospitalization (137.3 ± 96.3 vs 194.7 ± 110.2, P = .04).

CONCLUSION:

Combining ESP-LB with MSSP-LB is superior to MSSP-LB alone for single-level TLIFs in decreasing length of hospital stay, time to ambulation, postoperative pain, and narcotic use.
Transdural Approach for Resection of Craniovertebral Junction Cysts: Case Series
Authors: Jamshidi Aria M. , Govindarajan Vaidya , Levi Alan D.
Published: December 2022

BACKGROUND:

Craniovertebral junction (CVJ) cysts, including retro-odontoid pseudotumors, are challenging pathologies to treat and manage effectively. Surgical intervention is indicated when these lesions result in progressive myelopathy, intractable pain, or instability.

OBJECTIVE:

To present a case series of older patients who underwent successful resection retro-odontoid lesions using transdural approach.

METHODS:

A single-center, retrospective observation study of older patients who underwent transdural resection of CVJ cysts at a single institution was performed. Summary demographic information, clinical presentation, perioperative and intraoperative imaging, and Nurick scores were collected and analyzed.

RESULTS:

Eight patients were included (mean age [±SD] 75.88 ± 9.09 years). All patients presented with retro-odontoid lesions resulting in severe cervical stenosis, cord compression, and myelopathy. The mean duration of surgery was 226 ± 83.7 minutes. The average intraoperative blood loss was 181.2 cc. The average hospital stay was 4.5 days ± 1.3 (range, 3-7 days). The average follow-up time was 12.5 ± 9.5 months. No intraoperative complications were encountered. The Nurick classification score for myelopathy improved at the final postoperative examination (2.38 ± 1.06 vs 1 ± 1.07). Three patients demonstrated a pre-existing deformity prompting an instrumented fusion. Both computed tomography and MRI evidence of complete regression of retro-odontoid cyst were noted in all patients on the final follow-up.

CONCLUSION:

Posterior cervical transdural approach for ventral lesions at the CVJ is a safe and effective means of treating older patients with progressive myelopathy. This technique provides immediate spinal cord decompression while limiting neurological complications commonly associated with open or endoscopic anterior transpharyngeal approaches.
Laforin targets malin to glycogen in Lafora progressive myoclonus epilepsy
Authors: Mitra Sharmistha , Chen Baozhi , Wang Peixiang , Chown Erin E. , Dear Mathew , Guisso Dikran R. , Mariam Ummay , Wu Jun , Gumusgoz Emrah , Minassian Berge A.
Published: December 2022

Glycogen is the largest cytosolic macromolecule and is kept in solution through a regular system of short branches allowing hydration. This structure was thought to solely require balanced glycogen synthase and branching enzyme activities. Deposition of overlong branched glycogen in the fatal epilepsy Lafora disease (LD) indicated involvement of the LD gene products laforin and the E3 ubiquitin ligase malin in regulating glycogen structure. Laforin binds glycogen, and LD-causing mutations disrupt this binding, laforin–malin interactions and malin's ligase activity, all indicating a critical role for malin. Neither malin's endogenous function nor location had previously been studied due to lack of suitable antibodies. Here, we generated a mouse in which the native malin gene is tagged with the FLAG sequence. We show that the tagged gene expresses physiologically, malin localizes to glycogen, laforin and malin indeed interact, at glycogen, and malin's presence at glycogen depends on laforin. These results, and mice, open the way to understanding unknown mechanisms of glycogen synthesis critical to LD and potentially other much more common diseases due to incompletely understood defects in glycogen metabolism.
Clearing of hemozoin crystals in malaria parasites enables whole-cell STED microscopy
Authors: Kehrer Jessica , Pietsch Emma , Heinze Julia , Spielmann Tobias , Frischknecht Friedrich
Published: December 2022

Malaria is a devastating mosquito-borne parasitic disease that manifests when Plasmodium parasites replicate within red blood cells. During the development within the red blood cell, the parasite digests hemoglobin and crystalizes the otherwise toxic heme. The resulting hemozoin crystals limit imaging by STED nanoscopy owing to their high light-absorbing capacity, which leads to immediate cell destruction upon contact with the laser. Here, we establish CUBIC-P-based clearing of hemozoin crystals, enabling whole-cell STED nanoscopy of parasites within red blood cells. Hemozoin-cleared infected red blood cells could reliably be stained with antibodies, and hence proteins in the hemozoin-containing digestive vacuole membrane, as well as in secretory vesicles of gametocytes, could be imaged at high resolution. Thus, this process is a valuable tool to study and understand parasite biology and the potential molecular mechanisms mediating drug resistance.

This article has an associated First Person interview with the first author of the paper.
Radiobiological evaluation considering the treatment time with stereotactic radiosurgery for brain metastases
Authors: Nakano Hisashi , Takizawa Takeshi , Kawahara Daisuke , Tanabe Satoshi , Utsunomiya Satoru , Kaidu Motoki , Maruyama Katsuya , Takeuchi Shigekazu , Onda Kiyoshi , Koizumi Masahiko , Nishio Teiji , Ishikawa Hiroyuki
Published: December 2022

Objective:

We evaluated the radiobiological effect of the irradiation time with the interruption time of stereotactic radiosurgery (SRS) using CyberKnife® (CK) systemfor brain metastases.

Methods:

We used the DICOM data and irradiation log file of the 10 patients with brain metastases from non–small-cell lung cancer (NSCLC) who underwent brain SRS. We defined the treatment time as the sum of the dose–delivery time and the interruption time during irradiations, and we used a microdosimetric kinetic model (MKM) to evaluate the radiobiological effects of the treatment time. The biological parameters, i.e. α0, β0, and the DNA repair constant rate (a + c), were acquired from NCI-H460 cell for the MKM. We calculated the radiobiological dose for the gross tumor volume (GTVbio) to evaluate the treatment time’s effect compared with no treatment time as a reference. The D95 (%) and the Radiation Therapy Oncology Group conformity index (RCI) and Paddick conformity index (PCI) were calculated as dosimetric indices. We used several DNA repair constant rates (a + c) (0.46, 1.0, and 2.0) to assess the radiobiological effect by varying the DNA repair date (a + c) values.

Results:

The mean values of D95 (%), RCI, and PCI for GTVbio were 98.8%, 0.90, and 0.80, respectively, and decreased with increasing treatment time. The mean values of D95 (%), RCI, and PCI of GTVbio at 2.0 (a+c) value were 94.9%, 0.71, and 0.49, respectively.

Conclusion:

The radiobiological effect of the treatment time on tumors was accurately evaluated with brain SRS using CK.

Advances in knowledge:

There has been no published investigation of the radiobiological impact of the longer treatment time with multiple interruptions of SRS using a CK on the target dose distribution in a comparison with the use of a linac. Radiobiological dose assessment that takes into account treatment time in the physical dose in this study may allow more accurate dose assessment in SRS for metastatic brain tumors using CK.
A administração presidencial e as tradições do direito administrativo
Authors: Merrill Thomas W.
Published: December 2022

O direito administrativo americano tem sido caracterizado há muito tempo por duas tradições distintas: a positivista e a de processo. A tradição positivista enfatiza que os órgãos administrativos são criados por lei e devem agir de acordo com as exigências da lei. A tradição de processo enfatiza que as agências devem agir de acordo com as normas de tomada de decisões fundamentadas, que enfatizam que todos os interesses relevantes devem ter a oportunidade de expressar suas opiniões, e as agências devem explicar suas decisões de forma pública e articulada. No século XX, o direito administrativo americano conquistou uma grande síntese dessas duas tradições, com o resultado de que as deficiências da perspectiva positivista — tais como delegações muito amplas de discrição às agências — eram aceitáveis, desde que as normas de processo fossem vigorosamente aplicadas. O professor Peter Strauss e outros arquitetos dessa síntese nunca imaginaram que a tradição de processo pudesse deslocar completamente o direito positivo. Nos últimos anos, entretanto, analistas começaram a argumentar que a tradição de processo pode assumir uma vida própria e funcionar como um substituto completo para a tradição positivista. Isto pode ser visto em uma variedade de contextos onde as tradições de supremacia legislativa são fracas, tais como regimes de tratados multinacionais e várias formas de “administração presidencial”. Este ensaio oferece algumas razões de ceticismo sobre as perspectivas de longo prazo do direito administrativo baseado unicamente na tradição de processo. Ao atuar na tradição positivista, os tribunais funcionam como agentes de soberania. Seus julgamentos, supondo que sejam percebidos como fiéis à lei, são sustentados pelo poder soberano do Estado, o que significa que é provável que sejam obedecidos. A tradição de processo repousa em normas de razoabilidade, com relação às quais pessoas razoáveis podem discordar. Especialmente quando a revisão judicial é fraca ou inexistente, é improvável que as instituições de revisão interna tenham capital institucional suficiente para impor seus julgamentos sobre a razoabilidade a outros agentes governamentais. A aplicação das normas do direito administrativo pode vir a ser vista como uma mera questão de opinião contestável. Em vez de agir como um controle do abuso administrativo, o direito administrativo pode se transformar em uma racionalização para o exercício do poder bruto.
Normas de referência da agência de águas (e saneamento básico) no Brasil a partir do novo marco legal do setor (Lei nº 14.026/2020)
Authors: Heinen Juliano
Published: December 2022

No presente artigo, pretende-se estabelecer os elementos teórico-dogmáticos das normas de referência a serem editadas pela Agência Nacional de Águas e Saneamento Básico (ANA) no setor, a partir da disciplina jurídica oriunda da recente Lei nº 14.026/2020. Tal legislação estruturou o novo marco legal do saneamento básico no Brasil. Abordou-se, primeiramente, como se desenvolve a regulação no setor de saneamento básico, destacando-se a complexidade que tal âmbito jurídico impõe, seja pela multiplicidade de atos normativos, seja pela especificidade técnica, seja pelos múltiplos atores que ali se inserem. Objetivamente, pretende-se, neste artigo, demonstrar que o setor contará com uma série de regulações oriundas de agentes diversos, todas elas amparadas em uma regulação de referência de natureza nacional, a ser editada por agência reguladora federal. Como este panorama é inédito no Brasil, optou-se por estruturar a pesquisa por meio do método de abordagem dedutivo e exploratório, conformando o detalhamento do tema a partir de precisões dogmáticas, para se conseguir analisar as causas da regulação do saneamento básico e se demonstrar qual é a natureza das “normas de referência”, seu alcance e sua finalidade.