Vertebral Artery Injury in Cervical Spine Fracture Dislocation: An Observational Study in a Tertiary Care Center.

BACKGROUND: The incidence of traumatic vertebral artery injury (VAI) associated with cervical spine trauma varies widely in published trauma series. The primary aim of this study was to determine the incidence of traumatic VAI in patients who suffered cervical spine injuries by means of routine magnetic resonance imaging, and the secondary objective was to identify any associations with injury mechanism, level of injury, and neurologic injury severity.  Materials and methods: A retrospective review was conducted on 96 patients who suffered cervical spine fracture dislocation with or without an associated spinal cord injury (SCI) in Indian Spinal Injuries Center (ISIC), New Delhi, India from January 2013 to April 2023. Cervical magnetic resonance imaging (MRI) was used to diagnose VAI. Patient's age, sex, cervical injury level, mechanism of injury, neurologic level of injury, association with foraminal fracture, facet dislocation, and clinical sequelae of vertebral artery injury were analyzed. RESULTS: In this study, of 96 patients who met the inclusion criteria, 18 patients (18.75%) had VAI on the MRI study. Thirteen (72.22%) of the eighteen patients had right-sided injuries, four (22.22%) had left-sided injuries, and one (5.55%) had bilateral injuries. There was an associated SCI in every VAI patient. VAI was significantly more common in patients who had ASIA A (61%, n = 11) and ASIA B (22%, n = 4) injuries, and no VAI was noted in neurologically intact patients (p<0.001). The incidence of VAI was higher in the flexion distraction type of injury (n = 12, 66%). The most commonly involved cervical spine injury level was C5-C6 (27%, n = 5), followed by 22% (n = 4) at C4-C5 and C6-C7 levels. About 27.8% (n = 5) of VAI was associated with foraminal fractures, and 72% (n = 13) of VAI was associated with facet dislocations, of which 44% (n = 8) were bifacetal and 28% (n = 5) were unifacetal dislocations. On clinical symptoms, only one (5.56%) patient had a headache, and 17 (94.4%) had no clinical features due to VAI. CONCLUSION: The incidence of traumatic vertebral artery disease is not very uncommon and requires careful and meticulous screening and management. Otherwise, complications like pseudoaneurysm, neurologic deficit, late-onset hemorrhage, infarction, and death can happen. Mostly, it is associated with high-velocity injuries and neurological injuries. MRI can be used as a good screening tool, which can be aided by a CT angiogram or digital subtraction angiography for confirmation. Proper pre-operative evaluation of vascular injury in cervical spine fracture dislocation is very important for patient counseling, patient management, and surgical planning.

Enhancing reniform nematode management in sweetpotato by complementing host-plant resistance with non-fumigant nematicides.

The reniform nematode (Rotylenchulus reniformis Linford and Oliveira) adversely impacts the quality and quantity of sweetpotato storage roots. Management of R. reniformis in sweetpotato remains a challenge because host plant resistance is not available, fumigants are detrimental to the environment and health, and crop rotation is not effective. We screened a core set of 24 sweetpotato plant introductions (PIs) against R. reniformis. Four PIs were resistant and 10 were moderately resistant to R. reniformis suggesting these PIs can serve as sources of resistance for sweetpotato resistance breeding programs. PI 595869, PI 153907, and PI 599386 suppressed 83% to 89% egg production relative to the susceptible control 'Beauregard', and these PIs were employed in subsequent experiments to determine if their efficacy against R. reniformis can be further increased by applying non-fumigant nematicides oxamyl, fluopyram and fluensulfone. A 34% to 93% suppression of nematode reproduction was achieved by the application of non-fumigant nematicides, with oxamyl providing the best suppression followed by fluopyram and fluensulfone. Although sweetpotato cultivars resistant to R. reniformis are currently not available and there is a need for the development of safer yet highly effective non-fumigant nematicides, results from the current study suggest that complementing host plant resistance with non-fumigant nematicides can serve as an important tool for effective and sustainable nematode management.

Discovery of N-(1-(6-Oxo-1,6-dihydropyrimidine)-pyrazole) Acetamide Derivatives as Novel Noncovalent DprE1 Inhibitors against Mycobacterium tuberculosis.

Decaprenylphosphoryl-ß-d-ribose oxidase (DprE1) is a promising target for treating tuberculosis (TB). Currently, most novel DprE1 inhibitors are discovered through high-throughput screening, while computer-aided drug design (CADD) strategies are expected to promote the discovery process. In this study, with the aid of structure-based virtual screening and computationally guided design, a series of novel scaffold N-(1-(6-oxo-1,6-dihydropyrimidine)-pyrazole) acetamide derivatives with significant antimycobacterial activities were identified. Among them, compounds LK-60 and LK-75 are capable of effectively suppressing the proliferation of Mtb with MICMtb values of 0.78-1.56 µM, comparable with isoniazid and much superior to the phase II candidate TBA-7371 (MICMtb = 12.5 µM). LK-60 is also the most active DprE1 inhibitor derived from CADD so far. Further studies confirmed their high affinity to DprE1, good safety profiles to gut microbiota and human cells, and synergy effects with either rifampicin or ethambutol, indicating their broad potential for clinical applications.

Novel Derivatives of Quinoxaline-2-carboxylic Acid 1,4-Dioxides as Antimycobacterial Agents: Mechanistic Studies and Therapeutic Potential.

The World Health Organization (WHO) reports that tuberculosis (TB) is one of the top 10 leading causes of global mortality. The increasing incidence of multidrug-resistant TB highlights the urgent need for an intensified quest to discover innovative anti-TB medications In this study, we investigated four new derivatives from the quinoxaline-2-carboxylic acid 1,4-dioxide class. New 3-methylquinoxaline 1,4-dioxides with a variation in substituents at positions 2 and 6(7) were synthesized via nucleophilic aromatic substitution with amines and assessed against a Mycobacteria spp. Compound 4 showed high antimycobacterial activity (1.25 µg/mL against M. tuberculosis) and low toxicity in vivo in mice. Selection and whole-genomic sequencing of spontaneous drug-resistant M. smegmatis mutants revealed a high number of single-nucleotide polymorphisms, confirming the predicted mode of action of the quinoxaline-2-carboxylic acid 1,4-dioxide 4 as a DNA-damaging agent. Subsequent reverse genetics methods confirmed that mutations in the genes MSMEG_4646, MSMEG_5122, and MSMEG_1380 mediate resistance to these compounds. Overall, the derivatives of quinoxaline-2-carboxylic acid 1,4-dioxide present a promising scaffold for the development of innovative antimycobacterial drugs.

Trends and inequity in improved sanitation facility utilisation in Bangladesh: Evidence from Bangladesh Demographic and Health Surveys.

Improved sanitation is indispensable to human health. However, lack of access to improved sanitation remains one of the most daunting public health challenges of the twenty-first century in Bangladesh. The aim of the study was to describe the trends in access to improved sanitation facilities following the inequity gap among households in different socioeconomic groups in Bangladesh. Data from the Bangladesh Demographic and Health Survey (BDHS) 2007, 2011, 2014, and 2017-18 were extracted for this study. Inequity in access to improved sanitation was calculated using rich-poor ratio and concentration index to determine the changes in inequity across the time period. In Bangladesh, the proportion of households with access to improved sanitation increased steadily from 25.4% to 45.4% between 2007 and 2014, but slightly decreased to 44.0% in 2017-18. Age, educational status, marital status of household head, household wealth index, household size, place of residence, division, and survey year were significantly associated with the utilisation of improved sanitation. There is a pro-rich situation, which means that utilisation of improved sanitation was more concentrated among the rich across all survey years (Concentration Index ranges: 0.40 to 0.27). The government and other relevant stakeholders should take initiatives considering inequity among different socioeconomic groups to ensure the use of improved sanitation facilities for all, hence achieving universal health coverage.

Impact of non-fumigant nematicides on reproduction and pathogenicity of Meloidogyne enterolobii and disease severity in tobacco.

Meloidogyne enterolobii is a highly aggressive quarantine pathogen which threatens the multibillion-dollar tobacco industry and is not manageable with the currently available management methods in tobacco. There is currently no known host plant resistance in tobacco and previous studies have shown that the lower level of the currently recommended rate of non-fumigant nematicides does not provide satisfactory management of M. enterolobii. The current study was conducted with the hypothesis that M. enterolobii can be better managed using a single soil application of the maximum allowed rate of non-fumigant nematicides. Treatments involved three non-fumigant chemical nematicides (oxamyl, fluopyram, and fluensulfone), a biological nematicide derived from Burkholderia, and a non-treated control. Fluensulfone significantly suppressed the nematode reproduction relative to the control, the suppression being 71% for eggs and 86% for the second stage juveniles (J2). Fluopyram also suppressed nematode reproduction, although this was statistically insignificant, with the suppression being 26% and 37% for eggs and J2, respectively. Oxamyl significantly suppressed J2 (80%), but not eggs (50%) in relation to the control. The most significant reduction of disease severity was achieved by the application of fluensulfone (64%), followed by oxamyl (54%) and fluopyram (48%). Except for fluensulfone, which significantly reduced the root biomass, none of the nematicides significantly impacted root and shoot biomass. The biological nematicide did not significantly affect nematode reproduction, pathogenicity, or disease severity. The results from the current study suggest that while the non-fumigant nematicides provided a good level of the nematode suppression, more research is needed to improve the efficacy of non-fumigant nematicides through employing better application methods or finding better chemistries.

Efficacy, Safety, and Reliability of the Single Anterior Approach for Subaxial Cervical Spine Dislocation.

Background Though there is ongoing controversy regarding the best treatment option for cervical spine dislocation (CSD), anterior cervical surgery with direct decompression is becoming widely accepted. However, managing all cases of subaxial CSD entirely by a single anterior approach is rarely seen in the published literature. Methods The study comprised patients with subaxial CSD who underwent surgical stabilization utilizing a single anterior approach. Most of the CSD was reduced and anterior cervical discectomy and fusion (ACDF) were performed. Anterior cervical corpectomy and fusion (ACCF) were done in unreduced dislocations. The patient's neurological condition, radiological findings, and functional outcomes were assessed. SPSS version 25.0 (IBM Corp., Armonk, NY) was used for statistical analysis. Results The total number of operated cases was 64, with an average of 42 months of follow-up. The mean age was 34.50±11.92 years. The most prevalent level of injury was C5/C6 (57.7%). Reduction was achieved in 92.2% of cases; only 7.8% of patients needed corpectomy. The typical operative time was 84.25±9.55 minutes, with an average blood loss of 112.12±25.27 ml. All cases except complete spinal cord injury (CSI) were improved neurologically (87.63%). The mean Neck Disability Index (NDI) was 11.14±11.43, and the pre-operative mean visual analog score (VAS) was finally improved to 2.05±0.98 (P<0.05). In all cases, fusion was achieved. The most common complication was transient dysphagia (23.4%). After surgery, no patient developed or aggravated a neurological impairment. Implant failure was not observed at the final follow-up except for two cases where screws were pulled out partially. Conclusion Based on the results of this study, a single anterior approach is a safe and effective procedure for subaxial CSD treatment with favorable radiological, neurological, and functional outcomes.

Long-Segment Versus Short-Segment Pedicle Screw Fixation Including Fractured Vertebrae for the Management of Unstable Thoracolumbar Burst Fractures.

Background For the treatment of unstable thoracolumbar fractures, this study compared the results of short-segment fixation with fracture level inclusion (SSFIFL) with long-segment pedicle fixation (LSPF). Methodology In this prospective case series study conducted from January 2015 to January 2019, 80 patients with partial spinal cord lesions were investigated. For the comparison, two groups of 40 patients each were chosen and treated with SSFIFL and LSPF. The outcomes were measured using pre and postoperative radiological parameters and clinical parameters. The radiographic variables included the kyphotic angle with loss of correction, kyphotic deformation, and the Beck index. Mean blood loss, operative time, and cost-effectiveness were also examined for clinical indicators such as the American Spinal Injury Association Impairment Scale, Visual Analog Scale (VAS), and Oswestry Disability Index (ODI). Results There were no substantial variations between the groups regarding age or gender, trauma etiology, fracture level, or fracture pattern. Between the two categories, there appeared to be no notable change in radiological indicators such as kyphotic angle, kyphotic deformation, and Beck index at the end of follow-up (p = 0.120, 0.360, and 0.776, respectively). Both groups had similar neurological outcomes (p = 0.781). In terms of ODI and VAS, statistically, there was no discernible difference (p = 0.567 and 0.161, respectively). In this study, however, there was less surgical time, blood loss, and implant cost (p = 0.05). Conclusions When fracture level is included in a short-segment fixation, the radiological and clinical results are comparable to long-segment posterior fixation. Ultimately, this treatment has proven to be not only a motion segment-saving procedure but also cost-effective.

Molecular mechanisms of resistance and treatment efficacy of clofazimine and bedaquiline against Mycobacterium tuberculosis.

Clofazimine (CFZ) and bedaquiline (BDQ) are currently used for the treatment of multidrug-resistant (MDR) Mycobacterium tuberculosis (Mtb) strains. In recent years, adding CFZ and BDQ to tuberculosis (TB) drug regimens against MDR Mtb strains has significantly improved treatment results, but these improvements are threatened by the emergence of MDR and extensively drug-resistant (XDR) Mtb strains. Recently, CFZ and BDQ have attracted much attention for their strong clinical efficacy, although very little is known about the mechanisms of action, drug susceptibility test (DST), resistance mechanisms, cross-resistance, and pharmacokinetics of these two drugs. In this current review, we provide recent updates on the mechanisms of action, DST, associated mutations with individual resistance and cross-resistance, clinical efficacy, and pharmacokinetics of CFZ and BDQ against Mtb strains. Presently, known mechanisms of resistance for CFZ and/or BDQ include mutations within the Rv0678, pepQ, Rv1979c, and atpE genes. The cross-resistance between CFZ and BDQ may reduce available MDR-/XDR-TB treatment options. The use of CFZ and BDQ for treatment in the setting of limited DST could allow further spread of drug resistance. The DST and resistance knowledge are urgently needed where CFZ and BDQ resistance do emerge. Therefore, an in-depth understanding of clinical efficacy, DST, cross-resistance, and pharmacokinetics for CFZ and BDQ against Mtb can provide new ideas for improving treatment outcomes, reducing mortality, preventing drug resistance, and TB transmission. Along with this, it will also help to develop rapid molecular diagnostic tools as well as novel therapeutic drugs for TB.

Reconfigurable high-order mode pass filter for mode-division multiplexing.

In mode division multiplexing (MDM) optical system, the mode filter has become an inseparable part to reduce modal crosstalk and transmit the desired modes unabatedly. As filtering out lower-order mode is difficult, here we propose a reconfigurable structure of a higher-order mode pass filter consisting of two tunable mode converters and a directional coupler (DC) in a three-mode planar waveguide platform. By switching the working states of the mode converters, the structure can also be used as a fundamental mode (TE0) pass filter and hence dynamic output signals can be achieved. For the second-order mode (TE2) transmission, the simulated excess loss is ∼0.61 dB at 1.550 µm and the extinction ratio remains ≥24 dB (power ratio of TE0 & TE2 Launch) and ≥25 dB (power ratio of TE1 & TE2 Launch) at the entire C-band (1.530-1.565 µm). The device has negligible polarization dependence and hence the TM polarization exhibits similar results.

Forced Convective Heat Transfer Coefficient Measurement of Low Concentration Nanorods ZnO-Ethylene Glycol Nanofluids in Laminar Flow.

This paper presents the experimental forced convective heat transfer coefficient (HTC) of nanorods (NRs) zinc oxide-ethylene glycol nanofluids (ZnO-EG NFs) in laminar flow. First, ZnO NRs were synthesized using a hydrothermal method that uses zinc acetate dihydrate [Zn(CH3COO)2·2H2O] as a precursor, sodium hydroxide as a reducing agent, and polyvinylpyrrolidone (PVP) as a surfactant. The hydrothermal reaction was performed at 170 °C for 6 h in a Teflon-lined stainless-steel tube autoclave. The sample's X-ray diffraction (XRD) pattern confirmed the formation of the hexagonal wurtzite phase of ZnO, and transmission electron microscopy (TEM) analysis revealed the NRs of the products with an average aspect ratio (length/diameter) of 2.25. Then, 0.1, 0.2, and 0.3 vol% of ZnO-EG NFs were prepared by adding the required ZnO NRs to 100 mL of EG. After that, time-lapse sedimentation observation, zeta potential (ζ), and ultraviolet-visible (UV-vis) spectroscopy was used to assess the stability of the NFs. Furthermore, the viscosity (µ) and density (ρ) of NFs were measured experimentally as a function of vol% from ambient temperature to 60 °C. Finally, the HTC of NFs was evaluated utilizing a vertical shell and tube heat transfer apparatus and a computer-based data recorder to quantify the forced convective HTC of NFs in laminar flow at Reynolds numbers (Re) of 400, 500, and 600. The obtained results indicate that adding only small amounts of ZnO NRs to EG can significantly increase the HTC, encouraging industrial and other heat management applications.

Synthesis and Characterization of Novel 2-Acyl-3-trifluoromethylquinoxaline 1,4-Dioxides as Potential Antimicrobial Agents.

The emergence of drug resistance in pathogens leads to a loss of effectiveness of antimicrobials and complicates the treatment of bacterial infections. Quinoxaline 1,4-dioxides represent a prospective scaffold for search of new compounds with improved chemotherapeutic characteristics. Novel 2-acyl-3-trifluoromethylquinoxaline 1,4-dioxides with alteration of substituents at position 2 and 6 were synthesized via nucleophilic substitution with piperazine moiety and evaluated against a broad panel of bacteria and fungi by measuring their minimal inhibitory concentrations. Their mode of action was assessed by whole-genomic sequencing of spontaneous drug-resistant Mycobacterium smegmatis mutants, followed by comparative genomic analysis, and on an original pDualrep2 system. Most of the 2-acyl-3-trifluoromethylquinoxaline 1,4-dioxides showed high antibacterial properties against Gram-positive strains, including mycobacteria, and the introduction of a halogen atom in the position 6 of the quinoxaline ring further increased their activity, with 13c being the most active compound. The mode of action studies confirmed the DNA-damaging nature of the obtained quinoxaline 1,4-dioxides, while drug-resistance may be provided by mutations in redox homeostasis genes, encoding enzymes potentially involved in the activation of the compounds. This study extends views about the antimicrobial and antifungal activities of the quinoxaline 1,4-dioxides and can potentially lead to the discovery of new antibacterial drugs.

Discovery of novel DprE1 inhibitors via computational bioactivity fingerprints and structure-based virtual screening.

Decaprenylphosphoryl-ß-D-ribose oxidase (DprE1) plays important roles in the biosynthesis of mycobacterium cell wall. DprE1 inhibitors have shown great potentials in the development of new regimens for tuberculosis (TB) treatment. In this study, an integrated molecular modeling strategy, which combined computational bioactivity fingerprints and structure-based virtual screening, was employed to identify potential DprE1 inhibitors. Two lead compounds (B2 and H3) that could inhibit DprE1 and thus kill Mycobacterium smegmatis in vitro were identified. Moreover, compound H3 showed potent inhibitory activity against Mycobacterium tuberculosis in vitro (MICMtb = 1.25 µM) and low cytotoxicity against mouse embryo fibroblast NIH-3T3 cells. Our research provided an effective strategy to discover novel anti-TB lead compounds.

Comparative genome analysis reveals high-level drug resistance markers in a clinical isolate of Mycobacterium fortuitum subsp. fortuitum MF GZ001.

Introduction: Infections caused by non-tuberculosis mycobacteria are significantly worsening across the globe. M. fortuitum complex is a rapidly growing pathogenic species that is of clinical relevance to both humans and animals. This pathogen has the potential to create adverse effects on human healthcare. Methods: The MF GZ001 clinical strain was collected from the sputum of a 45-year-old male patient with a pulmonary infection. The morphological studies, comparative genomic analysis, and drug resistance profiles along with variants detection were performed in this study. In addition, comparative analysis of virulence genes led us to understand the pathogenicity of this organism. Results: Bacterial growth kinetics and morphology confirmed that MF GZ001 is a rapidly growing species with a rough morphotype. The MF GZ001 contains 6413573 bp genome size with 66.18 % high G+C content. MF GZ001 possesses a larger genome than other related mycobacteria and included 6156 protein-coding genes. Molecular phylogenetic tree, collinearity, and comparative genomic analysis suggested that MF GZ001 is a novel member of the M. fortuitum complex. We carried out the drug resistance profile analysis and found single nucleotide polymorphism (SNP) mutations in key drug resistance genes such as rpoB, katG, AAC(2')-Ib, gyrA, gyrB, embB, pncA, blaF, thyA, embC, embR, and iniA. In addition, the MF GZ001strain contains mutations in iniA, iniC, pncA, and ribD which conferred resistance to isoniazid, ethambutol, pyrazinamide, and para-aminosalicylic acid respectively, which are not frequently observed in rapidly growing mycobacteria. A wide variety of predicted putative potential virulence genes were found in MF GZ001, most of which are shared with well-recognized mycobacterial species with high pathogenic profiles such as M. tuberculosis and M. abscessus. Discussion: Our identified novel features of a pathogenic member of the M. fortuitum complex will provide the foundation for further investigation of mycobacterial pathogenicity and effective treatment.

Sterilizing Effects of Novel Regimens Containing TB47, Clofazimine, and Linezolid in a Murine Model of Tuberculosis.

TB47, a new drug candidate targeting QcrB in the electron transport chain, has shown a unique synergistic activity with clofazimine and forms a highly sterilizing combination. Here, we investigated the sterilizing effects of several all-oral regimens containing TB47 plus clofazimine and linezolid as a block and the roles of fluoroquinolones and pyrazinamide in them. All these regimens cured tuberculosis within 4 to 6 months in a well-established mouse model, and adding pyrazinamide showed a significant difference in bactericidal effects.

Gut probiotic bacteria of Barbonymus gonionotus improve growth, hematological parameters and reproductive performances of the host.

This study aimed to isolate and identify probiotic bacteria from the gut of Barbonymus gonionotus and evaluate their effects on growth, hematological parameters, and breeding performances of the host. Five probiotic bacteria viz. Enterococcus xiangfangensis (GFB-1), Pseudomonas stutzeri (GFB-2), Bacillus subtilis (GFB-3), Citrobacter freundii (GFB-4), and P. aeruginosa (GFB-5) were isolated and identified using 16S rRNA gene sequencing. Application of a consortium of probiotic strains (1-3 × 1.35 × 109 CFU kg-1) or individual strain such as GFB-1 (1.62 × 109 CFU kg-1), GFB-2 (1.43 × 109 CFU kg-1), GFB-3 (1.06 × 109 CFU kg-1), GFB-4 (1.5 × 109 CFU kg-1) or GFB-5 (1.43 × 109 CFU kg-1feed) through feed significantly improved growth, histological and hematological parameters and reproductive performances of B. gonionotus compared to untreated control. Moreover, the application of these probiotics significantly increased gut lactic acid bacteria and activities of digestive enzymes but did not show any antibiotic resistance nor any cytotoxicity in vitro. The highest beneficial effects on treated fishes were recorded by the application of GFB-1, GFB-2, GFB-3, and a consortium of these bacteria (T2). This is the first report of the improvement of growth and health of B. gonionotus fishes by its gut bacteria.

Efficacy, safety, and reliability of surgery on the lumbar spine under general versus spinal anesthesia- an analysis of 64 cases.

QUASI-EXPERIMENTAL DESIGN PURPOSE: Compare intra and postoperative parameters, surgeons' satisfaction, and cost-effectiveness between general anesthesia (GA) and spinal anesthesia (SA) on patients undergoing surgery in the lumbar spine surgery. OVERVIEW OF LITERATURE: Surgery on the lumbar spine is the commonest surgical procedure among all spinal surgical practices. Both the GA and SA are shown to be suitable techniques for performing the surgery safely. GA is used most frequently. But, SA became increasingly more popular because it allows the patient to self-position thereby reducing various complications associated with GA in a prone position. METHODS: A total of 64 patients from June 2016 to July 2019 who underwent either discectomy, laminectomy, or lamino-foraminotomy for herniated lumbar disc or canal stenosis in 1 or 2 levels were included. During the study period, 32 patients were non-randomly selected for each of the GA and SA groups. The heart rate (HR), mean arterial pressure (MAP), blood loss, total anesthetic time, surgeons' satisfaction, analgesic requirements, cost of the procedure, and hospital stay were recorded and compared. RESULTS: In the context of demographic characteristics, baseline HR, or MAP, no significant differences were noted between SA and GA groups. Mean anesthetic time, mean PACU time, mean doses of analgesic requirement, cost of anesthesia, and the surgeon's satisfaction was significantly lower in the SA Group (P < 0.05). The blood loss, duration of operation, and hospital stay were not significant too. No major Intra and postoperative complications were reported nor were significant differences found in either series. CONCLUSION: Safety and efficacy of SA in comparison to GA were similar for the patients undergoing surgery on the lumbar spine. Notable advantages of SA include shorter anesthesia duration, fewer drug requirements, relative cost-effectiveness, and fewer complications rate. Successful surgery can be performed using either anesthesia type.

Mental Health of Physicians During COVID-19 Outbreak in Bangladesh: A Web-Based Cross-Sectional Survey.

There have been numerous studies about the health implication of COVID-19 on patients, but little attention has been paid to the impacts of the pandemic on physicians. Our paper attends to this gap by exploring the mental health of physicians in Bangladesh during the COVID-19 pandemic. This is particularly important since the mental health of physicians impacts not only on themselves, but also their professional performance and hence the care of patients. This study examined physicians' mental health outcomes by evaluating the prevalence and associated potential risk factors of anxiety and depression. Using a web-based cross-sectional survey, we collected data from 114 physicians. Seven-item Generalized Anxiety Disorder (GAD-7) scale and Nine-item Patient Health Questionnaire (PHQ-9) were used to measure the anxiety and depression, respectively. Multivariate logistic regression models were used to explore the potential risk factors related to anxiety and depression. The prevalence of anxiety and depression were 32.5 and 34.2%, respectively. Findings revealed that marital status, work per day and current job location were the main risk factors for anxiety while sex, age, and marital status were the main risk factors for depression. Our results highlight the need to implement policies and strategies for positively impacting the mental health of physicians during and after the COVID-19 pandemic.

Additive Opto-Thermomechanical Nanoprinting and Nanorepairing under Ambient Conditions.

We demonstrate an opto-thermomechanical (OTM) nanoprinting method that allows us not only to additively print nanostructures with sub-100 nm accuracy but also to correct printing errors for nanorepairing under ambient conditions. Different from other existing nanoprinting methods, this method works when a nanoparticle on the surface of a soft substrate is illuminated by a continuous-wave (cw) laser beam in a gaseous environment. The laser heats the nanoparticle and induces a rapid thermal expansion of the soft substrate. This thermal expansion can either release a nanoparticle from the soft surface for nanorepairing or transfer it additively to another surface in the presence of optical forces for nanoprinting with sub-100 nm accuracy. Details of the printing mechanism and parameters that affect the printing accuracy are investigated. This additive OTM nanoprinting technique paves the way for rapid and affordable additive manufacturing or 3D printing at the nanoscale under ambient conditions.

Print metallic nanoparticles on a fiber probe for 1064-nm surface-enhanced Raman scattering.

This Letter presents 1064-nm surface-enhanced Raman scattering (SERS) on an optical fiber probe, or 1064-nm-SERS-on-fiber. Metallic nanoparticles are printed on an optical fiber probe by using optothermal surface bubbles under ambient conditions. An optothermal surface bubble is a laser-induced micro-sized bubble that is formed on a solid-liquid interface. The SERS activity of the optical fiber probe for 1064-nm Raman microscopy is tested with rhodamine 6G in aqueous solution. The 1064-nm-SERS-on-fiber can reduce the fluorescent background noise that commonly exists in other Raman systems. It can also compensate for the decreased Raman signal due to the use of an infrared Raman laser. The 1064-nm-SERS-on-fiber will find potential applications in low-background-noise biosensing and endoscopy.