Non-invasive hemoglobin screening device: a promising digital method for reducing anemia prevalence through routine screening and timely intervention.

BACKGROUND: Several non-invasive technologies are nowadays available in the market which claim to determine the hemoglobin levels instantly without the requirement of the blood sample. But no study has shown the significance of such non-invasive devices on a routine basis for determining their impact on anemia reduction programs. This study is conducted to determine the impact of regular hemoglobin screening on the women population to determine its potential in reducing anemia, using a digitalized non-invasive device. METHOD: A cross-sectional study was conducted on 203 women of reproductive age group, residing in the Moradabad district. Repetitive readings were taken after a time interval of a minimum of 1 month for determining the impact of regular screening. The entire data collection process was carried out using the EzeCheck mobile app. RESULTS: It was observed that the prevalence of anemia was reduced upon the second time screening and was accepted by the women population. Repetitive testing has a significant impact on reducing anemia prevalence. Also, the simplified non-invasive technology for estimating the hemoglobin values, makes the user more comfortable to take the test. CONCLUSION: Non-invasive devices should be used regularly to keep track of hemoglobin levels which will help in the effective treatment of anemia. The mobile app-based testing could help to easily evaluate the reports of the patients from any remote location with instant result interpretation and health assistance.

Radiopathologic findings of multifocal nodular hepatic steatosis.

Multifocal nodular hepatic steatosis (MFNHS) is a rare benign clinical entity mimicking metastatic disease. This study is designed to describe the imaging and histopathologic findings and clinical course of patients with MFNHS. In this retrospective study during 2005 and 2023, 10 patients with an imaging and pathologic diagnosis of MFNHS were included. The imaging and histopathology findings were reviewed in each case. The follow-up images were reviewed to assess the clinical course of the disease. The mean age was 50.0 ± 10.5 years, and the male-to-female ratio was 4:6. Three patients had a past medical history of cancer. All patients were found to have lesions suspicious of malignancy on either ultrasound (US) or computed tomography (CT) requiring further workup. Six patients underwent magnetic resonance imaging (MRI), and 4 patients underwent an image-guided biopsy which resulted in hepatic steatosis. During the follow-up period, the majority of patients (71.5%) remained unchanged or improved, while 2 patients (28.5%) progressed. MRI is a reliable modality in detecting and characterizing MFNHS and should be considered to further assess multiple hepatic lesions in cases where the clinical suspicion is not high for metastasis.

A Snapshot of Selenium-enclosed Nanoparticles for the Management of Cancer.

Among the primary causes of mortality in today's world is cancer. Many drugs are employed to give lengthy and severe chemotherapy and radiation therapy, like nitrosoureas (Cisplatin, Oxaliplatin), Antimetabolites (5-fluorouracil, Methotrexate), Topoisomerase inhibitors (Etoposide), Mitotic inhibitors (Doxorubicin); such treatment is associated with significant adverse effects. Antitumor antibiotics have side effects similar to chemotherapy and radiotherapy. Selenium (Se) is an essential trace element for humans and animals, and additional Se supplementation is required, particularly for individuals deficient in Se. Due to its unique features and high bioactivities, selenium nanoparticles (SeNPs), which act as a supplement to counter Se deficiency, have recently gained worldwide attention. This study presented a safer and more economical way of preparing stable SeNPs. The researcher has assessed the antiproliferative efficiency of SeNPs-based paclitaxel delivery systems against tumor cells in vitro with relevant mechanistic visualization. SeNPs stabilized by Pluronic F-127 were synthesized and studied. The significant properties and biological activities of PTX-loaded SeNPs on cancer cells from the lungs, breasts, cervical, and colons. In one study, SeNPs were formulated using chitosan (CTS) polymer and then incorporated into CTS/citrate gel, resulting in a SeNPs-loaded chitosan/citrate complex; in another study, CTS was used in the synthesis of SeNPs and then situated into CTS/citrate gel, resulting in Se loaded nanoparticles. These formulations were found to be more successful in cancer treatment.

A paper-based chromogenic strip and electrochemical sensor for the detection of 4-(dimethylamino)azobenzene.

Natural and synthetic dyes are added to different food commodities to enhance their appearance and acceptance by consumers. Acute and chronic exposure owing to the consumption of non-permitted dyes may lead to health concerns such as allergic reactions, eczema, and asthma. 4-(Dimethylamino)azobenzene (4-DMAAB) is a non-permitted dye that has been reported in adulterated mustard oil. Consumption of 4-DMAAB poses severe risks due to its mutagenic and carcinogenic properties. Several sensitive methods such as FT-NIR, FT-MIR and SERS are available for the detection of 4-DMAAB. Here, a spectrophotometric method was developed for the detection of 4-DMAAB. The developed method was translated to a point-of-test paper-based, chromogenic strip which showed a detection limit of 0.025 mM for 4-DMAAB. Also, an electrochemical sensor was developed by electro-depositing the test solution on a screen-printed electrode. The electrochemical sensor showed an LOD of 0.027 ± 0.008 mM with recovery in the range of 91-107% of 4-DMAAB. Oil samples collected from the market were processed by liquid-liquid extraction and the content of 4-DMAAB was assessed. The developed point-of-use sensors for the detection of 4-DMAAB have potential for use by the consumers, food industry and regulatory agencies for on-site analysis and assuring the quality of edible oils.

Capture of Volatile Iodine Gas and Identification of Adsorption Sites in the Pore Network of Unsubstituted Imidazole Linker-Incorporated Zeolitic Imidazolate Framework-8.

The incorporation of unsubstituted imidazole (Im) in zeolitic imidazolate framework-8 (ZIF-8) crystallized in sodalite topology is proposed to improve gas capture and gas separation performance drastically. However, the incorporation of unsubstituted Im in ZIF-8 has remained challenging due to the thermodynamic instability of zinc and Im bonding in sodalite topology. We have incorporated up to 24.4 (mol %) Im linker in highly crystalline ZIF-8 with similar morphology and sodalite topology using a delayed linker addition strategy at room temperature. Im incorporation brings significant tuning to the pore architecture of ZIF-8, as confirmed by positron annihilation lifetime spectroscopy. The modifications in the pore architecture are primarily due to linker defects produced in the frameworks during crystallization and the elimination of steric hindrance due to the absence of a methyl group on Im. The Im-incorporated ZIF-8 shows significant enhancement in iodine capture as well as higher crystal structure stability under iodine vapor exposure as compared to pristine ZIF-8. Through ortho-positronium interaction with the adsorbed molecular iodine in the pore network of the frameworks, it is confirmed that iodine is preferentially adsorbed at cavity and intercrystalline voids, whereas aperture sites remain unoccupied by iodine molecules.

Implications of In Vitro Multi-Serine Phosphorylation of Alpha-Synuclein in Aggregation and Cytotoxicity.

Post-translational modifications guide the functional diversity and identity of proteins. Phosphorylation is one such post-translational modification that has been reported in pathological proteins related to various neurodegenerative disorders such as α-synuclein (α-syn) phosphorylation in Parkinson's disease and other synucleinopathies. In α-syn, the phosphorylation has mostly been observed at S129; however, the occurrence of other serine modifications at S9, S42, and S87 is partially explored. In pathogenic conditions, where α-syn is phosphorylated by complex kinase pathways, multi-site modifications may happen and alter the mechanism of α-syn aggregation. Here, using Polo-like kinase 2 and G-protein coupled receptor kinase 4, the in vitro phosphorylation of α-syn was performed, which revealed multi-serine phosphorylation. Mass spectrometry with customized proteolytic digestion showed prominent phosphorylation at S129 and modifications at S87 and S42 with PLK2 and S87 with GRK4. The phosphorylation at the identified serine residues was further validated with NMR and western blotting. Multi-serine phosphorylation aggravates the aggregation potential of monomeric α-syn, seeding capacity, and cytotoxicity in the SH-SY5Y cell line. This study proposes evidence for in vitro multi-site phosphorylation and its significance in α-syn aggregation, toxicity, and related pathogenesis.

Fine-Tuning of the Pore Aperture and Framework Flexibility of Mixed-Metal (Zn/Co) Zeolitic Imidazolate Framework-8: An In Situ Positron Annihilation Lifetime Spectroscopy Study under CO2 Gas Pressure.

The mixed-metal (Zn/Co) strategy has been used to enhance the gas separation selectivity of zeolitic imidazolate framework-8 (ZIF-8)-based membranes. The enhancement in selectivity has been attributed to possible modifications in the grain boundary structure, pore architecture, and flexibility of the frameworks. In the present study, we used in situ positron annihilation lifetime spectroscopy (PALS) under varying CO2 pressure to investigate the tuning of the pore architecture and framework flexibility of mixed-metal (Zn/Co) ZIF-8 frameworks with varying Co contents. The random distribution of Zn and Co metal nodes within the highly crystalline frameworks having an SOD topology was established using electron microscopy, Fourier transform infrared spectroscopy, and Raman spectroscopy. The inherent aperture as well as cavity size of the frameworks, and the pore interconnectivity to the outer surface, were observed to vary with the Co content in ZIF-8 due to the random distribution of Zn and Co metal nodes in the frameworks. The aperture size is reduced with the incorporation of an additional metal (Zn or Co) in ZIF-67 or ZIF-8, respectively. The aperture size remains the smallest for a lower Co content (∼0.20) in ZIF-8. The framework flexibility determined by in situ PALS measurements under CO2 pressure continuously reduces with increasing Co content in ZIF-8. A smaller aperture size as well as low flexibility of ZIF-8 with a low Co content is seen to be directly correlated to a higher separation selectivity of membranes prepared with this mixed-metal composition.

Unravelling the flexibility of Mycobacterium tuberculosis: an escape way for the bacilli.

The persistence of Mycobacterium tuberculosis makes it difficult to eradicate the associated infection from the host. The flexible nature of mycobacteria and their ability to adapt to adverse host conditions give rise to different drug-tolerant phenotypes. Granuloma formation restricts nutrient supply, limits oxygen availability and exposes bacteria to a low pH environment, resulting in non-replicating bacteria. These non-replicating mycobacteria, which need high doses and long exposure to anti-tubercular drugs, are the root cause of lengthy chemotherapy. Novel strategies, which are effective against non-replicating mycobacteria, need to be adopted to shorten tuberculosis treatment. This not only will reduce the treatment time but also will help prevent the emergence of multi-drug-resistant strains of mycobacteria.

How Reliable Are YouTube Videos for General Surgery Residents Learning?

Introduction  YouTube is one of the top-searched online video streaming platforms. However, the content of YouTube may not match the standards required for clinical skills learning. Therefore, we investigated the quality of top-viewed YouTube videos related to three basic surgical procedures that need to be performed by general surgery residents in their first year of training in our institute. Methods  We searched YouTube for the top 10 viewed demonstration videos related to ultrasound-guided abscess drainage, chest tube insertion, and central line insertion. For the eligible videos, we calculated the likes ratio, view ratio, and video power index. The videos' quality was assessed using LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) scores. The videos were categorized into high-quality (LAP-VEGaS score ≥ 11) and low-quality videos (LAP-VEGaS score < 11). The different descriptive (view counts, duration, and likes-dislikes) and calculated parameters stated above were compared between the two video quality-based groups. Results The selected videos were uploaded between July 2008 and March 2022. Their mean view counts were 460391.13±373760.19. Their mean video duration was 8.12±4.26 minutes. Their mean likes and dislikes were 2578.38±2977.43 and 144.10±129.80, respectively. The mean like ratio and the mean view ratio were 93.42±13.53 and 317.76±827.79, respectively. The mean video power index was 310.67±827.96. The mean LAP-VEGaS scores for ultrasound-guided abscess drainage, chest tube insertion, and central line insertion-related videos were 6.80, 11.10, and 11.20, respectively. The numbers of likes and dislikes were significantly higher for high-quality videos. Conversely, the view counts, the view ratio, and the video power index were significantly lower for high-quality videos. Conclusion  Top-viewed videos related to general surgery procedural demonstrations are of low quality. The video view counts, popularity, and likes-dislikes are highly unreliable indicators of surgical video's usefulness. There is a need for regulatory mechanisms to screen the YouTube content suitable for general surgery residents learning. The residents should therefore be cautious while making inferences based on YouTube videos.

New Genomic Regions Identified for Resistance to Spot Blotch and Terminal Heat Stress in an Interspecific Population of Triticum aestivum and T. spelta.

Wheat is one of the most widely grown and consumed food crops in the world. Spot blotch and terminal heat stress are the two significant constraints mainly in the Indo-Gangetic plains of South Asia. The study was undertaken using 185 recombinant lines (RILs) derived from the interspecific hybridization of 'Triticum aestivum (HUW234) × T. spelta (H+26)' to reveal genomic regions associated with tolerance to combined stress to spot blotch and terminal heat. Different physiological (NDVI, canopy temperature, leaf chlorophyll) and grain traits (TGW, grain size) were observed under stressed (spot blotch, terminal heat) and non-stressed environments. The mean maturity duration of RILs under combined stress was reduced by 12 days, whereas the normalized difference vegetation index (NDVI) was 46.03%. Similarly, the grain size was depleted under combined stress by 32.23% and thousand kernel weight (TKW) by 27.56% due to spot blotch and terminal heat stress, respectively. The genetic analysis using 6734 SNP markers identified 37 significant loci for the area under the disease progress curve (AUDPC) and NDVI. The genome-wide functional annotation of the SNP markers revealed gene functions such as plant chitinases, NB-ARC and NBS-LRR, and the peroxidase superfamily Cytochrome P450 have a positive role in the resistance through a hypersensitive response. Zinc finger domains, cysteine protease coding gene, F-box protein, ubiquitin, and associated proteins, play a substantial role in the combined stress of spot blotch and terminal heat in bread wheat, according to genomic domains ascribed to them. The study also highlights T. speltoides as a source of resistance to spot blotch and terminal heat tolerance.

Ablation zone considerations in cryoablation of RCC: accuracy of manufacturer provided model and change from first to second freeze cycle.

PURPOSE: To determine the accuracy of manufacturer models and difference in ice ball dimensions from the first to second freeze cycles during cryoablation of renal cell carcinoma (RCC). METHODS: All patients who underwent cryoablation for RCC and had either a uniform type of needle placed in a pattern consistent with manufacturer provided data (n = 48) or computed tomography performed during the first and second freeze cycles (n = 28) were retrospectively reviewed. Ice ball measurements were made in relationship to the cryoablation probes. Factors which may affect the manufacturer prediction or change in the size of the ice ball from first to second freeze cycles were evaluated. RESULTS: The visualized ice ball was significantly smaller than predicted in the long axis (LA) (Visualized: 29 mm ± 8; Predicted: 54 mm ± 7; p < 0.001), perpendicular transverse (PTR) (Visualized: 31 mm ± 7; Predicted: 52 mm ± 6; p < 0.001) and perpendicular craniocaudal (PCC) (Visualized: 30 mm ± 8; Predicted: 50 mm ± 7; p < 0.001). Furthermore, in the LA, PTR and PCC directions the achieved ice ball size was significantly closer to the predicted size as the total number of probes increased (p = 0.006, p = 0.048 and p = 0.023, respectively). The ice ball was significantly larger in the LA (3 mm (range: -7, 14 mm), p < 0.001), PTR (3 mm (range: -4, 11 mm), p < 0.001), and PCC (3 mm (range: 0, 26 mm), p < 0.001) dimensions on the second as compared to the first freeze cycle. CONCLUSION: The manufacturer provided model overestimates the size of the visualized Ice ball and Ice balls formed on the second freeze are significantly larger (median 3 mm) than those formed on the first freeze.

An in vitro evaluation of efficacy of ViaSpan, aloe vera, gatorade solution, and propolis storage media for maintaining the periodontal ligament cell viability.

Background: Replantation is a commonly performed method for avulsed tooth. A vital periodontal membrane (periodontal ligament [PDL]) is significant for the successful healing of replanted teeth. Hence, various storage media are used to preserve the viability of periodontal cells before replantation. Objectives: The present study was conducted to evaluate the efficacy of ViaSpan, Aloe vera, Gatorade solution, and propolis storage media for maintaining the PDL cell viability. Materials and Methods: The present study was conducted on 40 recently extracted teeth which were randomly divided into four study storage groups: Group I: ViaSpan, Group II: Aloe vera, Group III: Gatorade solution, and Group IV: Propolis. Later they were subjected to centrifugation, and the cells from supernatant were colored with 0.4% trypan blue for determination of viability. The obtained data were statistically evaluated with SPSS package (21.0 version, Inc.; Chicago, IL, USA) using analysis of variance, Mann-Whitney test, and Post hoc tests. Results: The mean viable periodontal cell in Group I was 30.2 cumm, in Group II was 24.6 cumm, Group III was 14.5 cumm, and Group IV in 31.4. The difference was significant (P < 0.01). Post hoc test between different groups revealed a significant difference in mean viable periodontal cells (P < 0.001). Propolis, ViaSpan, and Aloe vera had higher pH and osmolality values. Conclusion: This study found that propolis had higher periodontal cell viability followed by ViaSpan solution and Aloe vera and least in Gatorade solution. Propolis, ViaSpan, and Aloe vera media can be used as a storage media.

Résumé Contexte: la Replantation est une méthode couramment utilisée pour la dent avulsée. Une membrane parodontale vitale (ligament parodontal [PDL]) est important pour la guérison réussie des dents replantées. Par conséquent, divers supports de stockage sont utilisés pour préserver la viabilité du parodontal les cellules avant la réimplantation. Objectifs: la présente étude a été menée pour évaluer L'efficacité de ViaSpan, Aloe vera, solution de Gatorade, et des supports de stockage de propolis pour maintenir la viabilité des cellules PDL. Matériaux et Méthodes: la présente étude a été menée sur 40 récemment dents extraites qui ont été divisées au hasard en quatre groupes de stockage d'étude: Groupe I: ViaSpan, Groupe II: aloe vera, Groupe III: Gatorade solution, et groupe IV: Propolis. Plus tard, ils ont été soumis à une centrifugation et les cellules du surnageant ont été colorées avec 0,4% de trypan bleu pour la détermination de la viabilité. Les données obtenues ont été évaluées statistiquement avec le package SPSS (version 21.0, Inc. Chicago, ILLINOIS, états-unis) en utilisant l'analyse de la variance, le test de Mann-Whitney et les tests post hoc. Résultats: la cellule parodontale viable moyenne dans le Groupe I était de 30,2 cumm, dans Le groupe II était de 24,6 cumm, le Groupe III de 14,5 cumm et le Groupe IV de 31,4. La différence était significative (P < 0,01). Essai post hoc entre différents groupes ont révélé une différence significative dans les cellules parodontales viables moyennes (P < 0,001). Propolis, ViaSpan et aloe vera avaient plus valeurs de pH et d'osmolalité. Conclusion: Cette étude a révélé que la propolis avait une viabilité cellulaire parodontale plus élevée suivie D'une solution de ViaSpan et Aloe vera et moins dans la solution de Gatorade. La Propolis, le ViaSpan et L'aloe vera peuvent être utilisés comme support de stockage. Mots-clés: aloe vera, Gatorade, cellules parodontales, propolis, ViaSpan.

Local recurrence following complete radiologic response in patients treated with transarterial chemoembolization for hepatocellular carcinoma.

PURPOSE: The purpose of this study was to determine the local progression rate and identify factors that may predict local progression, in patients who achieve a complete response (CR) radiologically after undergoing transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: One-hundred-forty-seven patients, who achieved CR of 224 HCCs after TACE, were retrospectively reviewed. There were 109 men and 38 women with a mean age of 61.6 ± 6.8 (SD) years (range: 45.4-86.9 years). Logistic mixed-effects and Cox regression models were used to evaluate associations between clinical factors and local progression. RESULTS: A total of 75 patients (75/147; 51%) and 99 (99/224,44.2%) lesions showed local progression at a median of 289.5 days (Q1: 125, Q3: 452; range: 51-2245 days). Pre-treatment, international normalization ratio (INR) (1.17 ± 0.15 [SD] vs. 1.25 ± 0.16 [SD]; P <0.001), model for end-stage liver disease (9.4 ± 2.6 [SD] vs. 10.6 ± 3.2 [SD]; P = 0.010) and Child-Pugh score (6 ± 1 [SD] vs. 6.4 ± 1.3 [SD]; P = 0.012) were significantly lower while albumin serum level (3.4 ± 0.62 [SD] vs. 3.22 ± 0.52 [SD]; P = 0.033) was significantly greater in those who showed local progression as compared to those who did not. In terms of local-recurrence free survival, the number of TACE treatments (hazard ratio [HR]: 2.05 [95% CI: 1.57-2.67]; P<0.001), INR (HR: 0.13 [95% CI: 0.03-0.61]; P = 0.010) and type of TACE (P = 0.003) were significant. Patients with local progression on any tumor did not differ from those who did in terms of overall survival (P = 0.072), however, were less likely to be transplanted (20/75, 26.7%) than those who did not (33/72; 36.1%) (P = 0.016). CONCLUSION: A significant number of patients who achieve CR of HCC after TACE have local progression. This emphasizes the importance of long-term follow up.

A quick and simple paper-based method for detection of furfural and 5-hydroxymethylfurfural in beverages and fruit juices.

Improper storage and transportation of non-alcoholic beverages can, over longer periods, induce Maillard reaction, degrading nutritional components and generating genotoxic and carcinogenic by-products such as furfural and 5-hydroxymethylfurfural (HMF), rendering products unsafe for human consumption. Here, we describe a rapid quantitative solution-based method and test-strips for detection of furfural and HMF. The standard spectroscopic method indicated an LOD of 0.006 ±â€¯0.003% (v/v) and 0.005 ±â€¯0.002% (v/v) for furfural and HMF, respectively in fruit juice samples. The novel chromogenic test-strip has sensitivity of 0.008% (v/v) and 0.004% (v/v) for furfural and HMF, respectively in the same samples of fruit juice. Thus, the developed method and test-strips were specific for furfural and HMF and can be used to help ensure food safety and quality in various industrial applications.

Neck Masses: Clinico-Radio-Pathological Evaluation.

Neck masses are defined as any swelling or enlargement of the structures in between the inferior border of mandible and clavicle and are a common clinical finding that can be encountered in patients of all age groups. There are many potential causes of neck masses so it is important to proceed in affordable, easy available and cost effective diagnostic technique for the proper and early diagnosis of neck masses. As there is very few study data available over clinico-radio-pathological analysis of neck masses, that's why this study is done. The present study has been carried out on 200 patients with clinically palpable neck masses presenting at ENT department in a tertiary care hospital. Neck swellings were classified into four main headings i.e. Lymph node swelling, Thyroid swelling, Salivary gland swellings and Skin and soft tissue swelling. After taking detailed history followed by complete General, Local and ENT examination, FNAC was done followed by USG. We came to the conclusion that neck masses have very variable presentations, and FNAC is a riskless, easy and fast tool which can be used in forming a diagnosis and appropriate management of neck masses.

A Randomized Controlled Trial to Study the Rationale of Antibiotic Prophylaxis in Diagnostic Rigid Cystoscopy: A Relook in The Era of Antibiotic Stewardship.

BACKGROUND: In the era of widespread antibiotic (AB) resistance, the role of prophylaxis in diagnostic cystoscopy is controversial. AIM: This study aimed to compare the incidence of postcystoscopy positive urinary culture (PC-PUC) and urinary tract infection (UTI) in patients undergoing diagnostic rigid cystoscopy with and without prophylaxis with preprocedural single-dose intravenous AB. MATERIALS AND METHODS: This prospective study was done in patients with preprocedural sterile urine undergoing elective diagnostic rigid cystoscopy. Patients were randomized into two groups, with one group receiving preprocedure single dose of intravenous cefuroxime sodium as prophylaxis half to 1 h before the procedure (Group AB prophylaxis) and the other group receiving no antibiotic prophylaxis (Group NAB). All patients were followed up till 1-month postprocedure, for any symptoms of urinary infection, mandatory urine microscopy and culture at 24-48 h, 1 week and 4 weeks post procedure, and addition sample in case of any urinary symptoms or fever. RESULTS: A total of 225 patients were studied, with 110 in AB prophylaxis and 115 in NAB groups. The use of prophylaxis did not decrease the incidence of PC-PUC (8.7%-3.6%; P = 0.167) or UTI (6.1%-1.8%; P = 0.102). Females and diabetics had significantly higher risk of PC-PUC, on univariate and multivariate analysis, not affected by prophylaxis. CONCLUSION: Preprocedural AB prophylaxis does not decrease the incidence of postcystoscopy bacteriuria significantly. Females and diabetics have significantly increased risk, but prophylaxis has no role in them either.

Splenic embolization in trauma: results of a survey from an international cohort.

PURPOSE: A questionnaire regarding splenic embolization in trauma was submitted to an international sample of IR faculty members, to compare their practice to the available recommendations. METHODS: A 21 multiple-choice questionnaire was sent to an international cohort of 96 IR faculty. Questions included the initial patient evaluation, embolization materials and techniques, post-procedure management, availability of an institutional protocol, and use of guidelines. RESULTS: For each question, there were from a minimum of 45 to a maximum of 52 responders: 94% require a CT with contrast prior to embolization, and 87% use the American Association for the Surgery of Trauma (AAST) scale to grade the splenic injuries. Embolization is performed across all values of the AAST scale. Of the patients with injuries of grade III or greater, embolization is primarily done for those patients who are hemodynamically stable. Unstable patients are embolized less frequently and primarily in cases in which the injuries are of a lower grade. Coils are the preferred material for proximal embolization (69%). Particles/Gelfoam is the preferred material for distal embolization (38%). In total, 63% administer intravenous antibiotics before the procedure and 15% administer intra-arterial antibiotics during the procedure. After embolization, follow-up imaging is recommended by 87%, antibiotics are administered regularly by 33%, clinical follow-up is recommended by 73%, and vaccination against encapsulated organisms is routinely recommended by 39%. CONCLUSIONS: There is significant variability among a heterogeneous cohort of respondents. Available recommendations may not be sufficiently addressing the practice of splenic embolization.

Anxiety-like behavior in female mice is modulated by STAT3 signaling in midbrain dopamine neurons.

The central signaling actions of cytokines are mediated by signal transducer and activator of transcription (STAT3). STAT3 activation plays a pivotal role in the behavioral responses to the adiposity hormone leptin, including in midbrain dopamine (DA) neurons where it mediates the influence of leptin to diminish physical activity and running reward in male mice. Leptin also has anxiolytic effects which have been tied to the mesolimbic DA system. To assess the contribution of STAT3 signaling in mesolimbic DA neurons on feeding, mesolimbic DA tone and anxiodepressive behaviors in female mice, we generated DA-specific STAT3 knockout mice by crossing mice expressing Cre under the control of the dopamine transporter with STAT3-LoxP mice. Feeding, locomotion, wheel running, conditioned place preference for palatable food and amphetamine locomotor sensitization were unaffected by DA-specific STAT3 deletion. Conversely, knockout mice exhibited heightened anxiety-like behavior (open field test and elevated plus maze) along with increased basal and stress-induced plasma corticosterone, whereas indices of behavioral despair (forced swim and tail-suspension tasks) were unchanged. In accordance with biochemical evidence of increased D1 receptor signaling (phospho-DARPP32Thr34) in the central nucleus of the amygdala (CeA) of knockout mice, local microinjections of a D1 receptor antagonist reversed the anxiogenic phenotype of knockout mice. In addition to alluding to sex differences in the signaling mechanisms mediating anxiety-like behavior, our findings suggest that activation of STAT3 in midbrain dopamine neurons projecting to the CeA dampens anxiety in a D1R-dependent manner in female mice.

Full Endoscopic Lumbar Transforaminal Interbody Fusion in DDD Lumbar Degenerative Disc Disease: A Latest Technique.

BACKGROUND: Lumbar interbody fusion has long been used in the treatment of degenerative disc disease. Lumbar spinal interbody fusion surgery traditionally is an open surgical technique. Although lumbar spinal interbody fusions using endoscopy have been reported, the endoscope was used partially for the interbody fusion. We are reporting a case where lumbar interbody fusion with discectomy was entirely done through direct visualization with the endoscope. METHODS: We report a case of a 55-year-old woman who underwent the transforaminal percutaneous full-endoscopic lumbar interbody fusion technique (FELTIF) under continuous and direct visualization at the L5-S1 level. To facilitate the interbody fusion, a foraminoplasty with complete resection of the superior articular process (SAP) and a partial pediculectomy of the S1 pedicle was performed. End plate sparing decortication techniques were used under direct video endoscopic visualization. The cage and bone graft insertion occurred through the endoscopic working cannula, thereby protecting the retracted traversing and exiting nerve roots at the surgical level. Posterior supplemental fixation with percutaneous pedicle screws was performed to complete the circumferential fusion. RESULT: The VAS leg score was reduced to 2 from preoperative score of 7 and the VAS back score reduced 3 from preoperative score of 9. Her neurogenic symptom score improved from 8 before surgery to 1 at the last follow-up. The fusion is assessed by plain radiographs in follow up. CONCLUSIONS: We concluded that the insertion of an interbody fusion cage device directly through an endoscopic working cannula was technically feasible. Future research should focus on examining the clinical outcomes of this technique. LEVEL OF EVIDENCE: 4.

Radiopharmaceuticals: An insight into the latest advances in medical uses and regulatory perspectives.

The growing armamentarium of potential radioisotopes and increased demand for radiopharmaceuticals (RPs) have catapulted their biomedical applications on a trajectory of higher growth in the modern healthcare establishment. Nuclear medicine technology is now regarded as an essential tool for diagnosis, palliation, therapy, and theranostic applications. The associated radiation safety issues need to be emphasized in the form of adequate regulatory action to warrant their safe and effective use. The RPs attracts considerable attention from both pharmaceutical and nuclear regulators due to their constituent pharmaceutical and radioactive components. So, a critical examination of applications of RPs, the latest advances in their development, and the existing regulatory guidelines for RPs have been carried out. This review presents a brief overview of RPs and recent studies on their diagnostic, therapeutic, and theranostic applications. Comprehensive comparative information on regulatory perspectives of RPs in major pharmaceutical jurisdictions such as the United States (US), the European Union (EU), and India reveals ambiguities and heterogeneity. The present studies discuss the importance of RPs in the current healthcare domain, their recent applications, and strive to intensify the concern for an ambient and harmonized regulatory setup.