Evaluation of Needles in Endoscopic Ultrasound-Guided Tissue Acquisition of Pancreatic Cancer for Genetic Yield and Quality.

BACKGROUND: Endoscopic ultrasound-guided fine needle biopsy (FNB) is the gold standard in tissue acquisition of pancreatic ductal adenocarcinoma (PDAC). There is a paucity of evidence of the impact of needle type or size on the genetic yield and quality. METHODS: Patients 18 years and older with PDAC who underwent FNB were retrospectively identified from a single database from 2016 to 2021. Genetic quantity is measured in micrograms (µg) and quality defined by RNA or DNA integrity number (RIN and DIN). FNB needles examined were Acquire 22 gauge (Boston Scientific, Marlborough, MA, USA) and ProCore 22 and 20 gauges (Cook Medical, Bloomington, IN, USA). RESULTS: Two hundred seventy-seven patients were identified. ProCore 20G needle procured higher RNA quantity (4125.8µg, IQR: 2003.8, 5954.8, p = 0.012) compared to ProCore 22G (2050µg IQR: 966.4, 3181.6) and Acquire 22G (2310.6µg, IQR: 1439.3, 4312). Median DNA quantity was 3340.5µg (Acquire 22G), 2610.4µg (ProCore 22G) and 3499.7µg (ProCore 20G) (p = 0.763). Median DIN was 7.3 (Acquire 22G and ProCore 22G) and 7.4 (ProCore 20G) (p = 0.449). Median RIN was 3.0 (Acquire 22G and ProCore 22G) and 2.7 (ProCore 20G) (p = 0.886). CONCLUSION: ProCore 20G was associated with higher quantity of RNA. There were no differences in the quality acquired by different needles.

Assessing cybersecurity risks and prioritizing top strategies In Vietnam's finance and banking system using strategic decision-making models-based neutrosophic sets and Z number.

The financial and banking system in Vietnam is currently confronted with a myriad of cybersecurity risks, a matter of paramount concern for the government, businesses, and individuals alike. These risks threaten the financial system's security, reliability, and integrity, potentially resulting in significant economic losses. This research endeavors to identify the prevailing cybersecurity risks in Vietnam's financial and banking system, assess their impact, and elucidate the interrelationships among these risks. Employing the Multi-Criteria Decision Making (MCDM) approach, the study integrates the DELPHI technique, Decision-Making Trial and Evaluation Laboratory (DEMATEL), and Combined Compromise Solution (COCOSO) methods, complemented by Neutrosophic Sets (NS) and Z-number concepts to enhance the accuracy and reliability of the findings. The research findings reveal the existence of 15 cybersecurity risks in Vietnam's financial and banking system, with Malware Infections and Supply Chain Vulnerabilities emerging as the most consequential risks. Moreover, the study identifies investing in advanced threat detection systems as the optimal strategy for mitigating cybersecurity risks in Vietnam. The results underscore the importance of addressing these critical risks to safeguard the financial infrastructure, focusing on deploying robust cybersecurity measures to enhance overall system resilience.

The effects of proton pump inhibitors during pregnancy on treatment of preeclampsia and related outcomes: a systematic review and meta-analysis.

OBJECTIVE: This systematic review evaluated the available evidence on the effects of proton pump inhibitors during pregnancy on preeclampsia and related maternal, fetal, and neonatal outcomes. DATA SOURCES: Five electronic databases (MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and Global Medicus Index) were searched on November 17, 2023. STUDY ELIGIBILITY CRITERIA: Randomized controlled trials of pregnant women who used any class or dose of proton pump inhibitor were eligible. METHODS: A meta-analysis was conducted for all outcomes of interest using random-effects models. Results were presented as risk ratios or mean difference. Quality assessment was performed using the Risk of Bias 2 tool, and Grading of Recommendations, Assessment, Development, and Evaluations assessment was completed to evaluate the certainty of the evidence. The study was registered in the International Prospective Register of Systematic Reviews under identifier CRD42023423673. RESULTS: Our search identified 3879 records that were screened independently by 2 authors. Nine reports (describing 8 trials) met our eligibility criteria, however, 6 trials were ultimately excluded from our analysis because women were only given proton pump inhibitors immediately before cesarean delivery for acid aspiration prevention. The 2 trials that were included in the meta-analysis evaluated the treatment of 177 women with diagnosed preeclampsia. For the primary outcomes, moderate-certainty evidence showed that the use of proton pump inhibitors likely has no effect on the risk for hemolysis, elevated liver enzymes, and low platelet count syndrome (risk ratio, 1.21; 95% confidence interval, 0.37-3.99; I²=0%) or perinatal mortality (risk ratio, 0.81; 95% confidence interval, 0.36-1.79; I²=0%), and there were insufficient data to conduct a meta-analysis on all other primary outcomes, including eclampsia and neonatal mortality. No trials investigated the use of proton pump inhibitors for the prevention of preeclampsia. CONCLUSION: Given the limited outcome data, we are uncertain about the effect of proton pump inhibitors on women with preeclampsia. Further trials are required to determine what (if any) effects proton pump inhibitors might have for preeclampsia prevention or treatment.

Factors influencing surgical outcomes of fixation with locking plate for three- and four-part proximal humerus fractures in patients aged 50 ​Years and older.

Background: Treating complex three- and four-part proximal humerus fractures, especially in the elderly, remains contentious, with internal fixation using locking plates and shoulder arthroplasty being primary options. Although proximal humerus locking plates are more commonly used than shoulder replacements, they have a high complication rate. Factors like low bone density, advanced age, multiple fragment fractures, and medial cortical support loss negatively impact treatment outcomes. This study evaluates the functional and radiographic outcomes of using locking plates for treating these fractures in patients aged 50 and older, and the factors influencing outcomes and complication rates at the Ho Chi Minh City Hospital for Trauma and Orthopedics. Method: A descriptive case series study was conducted on 58 patients aged 50 and older (15 males, 43 females) with three- and four-part proximal humerus fractures. These patients underwent open reduction and internal fixation with Locking - compression plate (LCP) periarticular proximal humerus plates at the Ho Chi Minh City Hospital for Traumatology and Orthopedics (HTO) from April 2020 to April 2022. The minimum postoperative follow-up period was 12 months. Results: The average age of the patients was 62.78 â€‹± â€‹7.73 years, with a mean follow-up of 26.24 â€‹± â€‹5.93 months. Among them, 41 had three-part fractures (70.68 â€‹%) and 17 had four-part fractures (29.32 â€‹%). At the final follow-up (≥12 months), the mean Constant-Murley score was 70.81 â€‹± â€‹9.15, and the mean QDASH score was 8.33 â€‹± â€‹2.77. Complications occurred in 6 cases (10.34 â€‹%). Complex fractures, such as four-part fractures with displacement greater than 2 â€‹mm, had lower Constant-Murley scores and higher QDASH scores (p â€‹< â€‹0.05). Age, gender, bone density by deltoid tuberosity index (DTI), bone grafting, and rotator cuff sutures showed similar trends, but the differences were not statistically significant. Conclusion: Open reduction and internal fixation (ORIF) provides good bone healing and functional outcomes for three- and four-part proximal humerus fractures. Factors such as age, gender, bone density, bone grafting, and rotator cuff sutures do not significantly affect outcomes. Therefore, osteoporosis should not be a contraindication for ORIF with locking plates in these cases. Complex fractures, however, often lead to poorer outcomes and higher complication rates post-surgery.

Comprehensive management of severe crush injury in a pediatric patient: A case report.

This case report presents the management of a severe crush injury in a 7-year-old male patient. The injury occurred following entrapment in a concrete mixer, resulting in extensive soft tissue trauma and vascular compromise. Prompt surgical intervention, including meticulous debridement and vascular reconstruction, was undertaken to optimize outcomes. Postoperative care involved serial debridement, negative pressure wound therapy, and subsequent skin grafting. Reconstructive procedures aimed to enhance hand function, yielding satisfactory outcomes at the three-month follow-up. This case underscores the importance of a multidisciplinary approach in managing pediatric crush injuries and highlights the role of collaborative care in optimizing outcomes.

Efficiency and safety of microvascular anastomotic coupler for wrist revascularization in traumatic injuries.

Introduction: Effective vascular anastomosis is crucial for successful hand surgery, particularly in traumatic injuries where rapid restoration of blood flow is essential. The Synovis microvascular anastomotic coupler system presents a novel approach by potentially offering faster and more reliable outcomes than traditional suturing methods. This study was conducted to assess the effectiveness and safety of the Synovis coupler for microvascular anastomoses in the wrist, evaluating anastomosis time, patency rates, and complication rates. Methods: This retrospective study examined 25 microvascular anastomoses (22 arteries and 3 veins) in 24 patients at a major trauma center. The primary outcomes measured were anastomosis time and vascular patency, which were assessed immediately post-operation and at subsequent follow-ups. Results: The average time required for anastomosis using the coupler was 7.3 min. Immediate post-operative vascular patency was 100%, with a long-term patency rate of 88%. Complications included arterial narrowing at the coupler site in 3 arteries, and complete occlusion in 3 arteries, accounting for a 12% long-term complication rate. Conclusion: Although the Synovis coupler demonstrated a significant reduction in anastomosis time and high patency rates, our data suggest that its effectiveness is more pronounced in venous anastomoses. The higher complication rates in arterial anastomoses warrant cautious use in these cases. Further research, including prospective randomized controlled trials, is needed to validate these findings and optimize patient selection criteria for using couplers in microvascular surgery.

Optimizing Surgical Outcomes in Congenital Syndactyly: Evaluation of Flap and Graft Techniques in Older Pediatric Patients.

Background Congenital syndactyly is a common congenital hand anomaly that impairs daily activities and impacts both functional and aesthetic outcomes. The fusion of adjacent fingers limits functionality and often requires surgical intervention to restore web spacing, maintain function, and improve appearance. This study evaluates surgical outcomes of congenital syndactyly treatment using flap and graft techniques, focusing on older patients. Methodology This study utilized retrospective data collected from patients aged 2 to 12 years diagnosed with congenital syndactyly. These patients underwent surgical separation procedures employing various flap techniques and full-thickness skin grafts. The chosen methods aimed to minimize scarring, secure optimal blood supply, and reduce postoperative complications. Postoperative assessments included web spacing, aesthetic appearance, and functional recovery. Results Patients generally experienced improved web spacing and proper alignment, with minimal contracture post-surgery. Flap and graft techniques effectively reduced visible scarring and provided favorable cosmetic results. Functional recovery was significant, allowing patients to resume age-appropriate tasks with minimal limitations, thereby restoring confidence in daily activities. Despite not undergoing early surgery, older patients still achieved marked improvements in web spacing, aesthetics, and overall function. Conclusions Surgical treatment of congenital syndactyly using flap and graft techniques significantly enhances both functional and aesthetic outcomes, even when the intervention is delayed beyond the recommended early age. Comprehensive planning and tailored approaches are crucial to achieving optimal web spacing, minimized scarring, and restored hand function. These measures ultimately improve the quality of life for patients, regardless of age at the time of surgery.

Management of neonatal upper limb trauma complicated by arterial injury: A case report.

This case report presents the clinical course and management of a 29-day-old female infant who presented with upper limb trauma secondary to entrapment beneath a sewing machine. Following admission, the patient exhibited clinical signs consistent with arterial injury and compartment syndrome, necessitating prompt diagnostic evaluation and surgical intervention. Despite challenges in arterial visualization via Doppler ultrasound, radiographic imaging confirmed displaced distal humerus fracture of the left upper limb, prompting further evaluation and surgical planning. Surgical decompression and stabilization were performed, followed by successful endovascular intervention utilizing digital subtraction angiography (DSA) to restore arterial perfusion. Subsequent development of compartment syndrome necessitated emergent fasciotomy, followed by wound care and skin grafting. Multidisciplinary rehabilitation facilitated optimal recovery, with the patient demonstrating improved motor function and sensory perception at six-month follow-up. This case underscores the importance of timely recognition, multidisciplinary collaboration, and prompt intervention in managing pediatric upper limb trauma complicated by arterial injury and compartment syndrome.

Friendly Environmental Strategies to Recycle Zinc-Carbon Batteries for Excellent Gel Polymer Electrolyte (PVA-ZnSO4-H2SO4) and Carbon Materials for Symmetrical Solid-State Supercapacitors.

In this report, we introduce a novel idea to prepare a redox additive in a gel polymer electrolyte system of PVA-ZnSO4-H2SO4 based on zinc-carbon battery recycling. Here, zinc cans from spent zinc-carbon batteries are dissolved completely in 1 M H2SO4 to obtain a redox additive in an aqueous electrolyte of ZnSO4-H2SO4. Moreover, carbon nanoparticles and graphene nanosheets were synthesized from carbon rod and carbon powder from spent zinc-carbon batteries by only one step of washing and electrochemical exfoliation, respectively, which have good electrochemical capability. The three-electrode system using a ZnSO4-H2SO4 electrolyte with carbon nanoparticles and graphene nanosheets as working electrodes shows high electrochemical adaptability, which points out its promising application in supercapacitor devices. Thus, the symmetrical solid-state supercapacitor devices based on the sandwich structure of graphene nanosheets/PVA-ZnSO4-H2SO4/graphene nanosheets illustrated the highest energy density of 39.17 W h kg-1 at a power density of 1700 W kg-1. While symmetrical devices based on carbon nanoparticles/PVA-ZnSO4-H2SO4/carbon nanoparticles exhibited a maximum energy density of 35.65 W h kg-1 at a power density of 1700 W kg-1. Moreover, these devices illustrate strong durability after 5000 cycles, with approximately 90.2% and 73.1% remaining, respectively. These results provide a promising strategy for almost completely recycling zinc-carbon batteries, one of the most popular dry batteries.

Navigating critical barriers for green bond markets using A fuzzy multi-criteria decision-making model: Case study in Vietnam.

As potent financial instruments channeling capital into climate and environmental projects, green bonds' issuance is frustrated by myriad obstacles. Therefore, this study aims to explore the critical barriers to green bond issuance in Vietnam. This study elucidates the salient barriers by utilizing an integrated multi-criteria decision-making methodology synthesizing the Fuzzy set theory-based Delphi, Decision-Making Trial and Evaluation Laboratory (DEMATEL), and DEMATEL-based Analytic Network Process (DANP). An extensive literature review of green bonds delineates five key dimensions related to impediments: Policy, Market, Financial, Capacity, and Awareness, with 38 discrete indicators representing potential obstacles. Firstly, employing a Fuzzy Delphi survey of 16 experts, 32 indicators are distilled for further analysis. Then, Fuzzy DEMATEL modeling evaluates the interrelationships and interactions among barriers. Finally, DANP is applied to obtain the relative importance of key barriers. Results unveil the five most formidable barriers as a weak regulatory framework and infrastructure (PO1), Limited availability of green bond issuance guidelines and templates (PO2), Insufficient incentives or tax benefits for green bond issuers (PO3), Limited coordination and alignment with international green bond standards (PO5), Lack of investor confidence in the quality and credibility of green projects (AW4), and Capacity constraints among issuers, particularly in smaller organisations or government agencies (CA1). The research contributes to the broader literature on green finance and offers valuable insights for promoting sustainable finance practices in Vietnam and other developing economies.

Z-number based fuzzy MCDM models for analyzing non-traditional security threats to finance supply chains: A case study from Vietnam.

Non-traditional security (NTS) threats have a vast and profound impact on many aspects of economic, political, social, and many other areas, especially supply chain finance (SCF), particularly in countries like Vietnam, which potentially affects the economic efficiency of businesses' supply chain financial, thereby affecting the general economy of the country and the world. In order to prevent and minimize the negative impacts caused by NTS threats to SCF, this study was conducted to identify NTS threats affecting SCF in Vietnam, at the same time calculate the weight of the impact level and find out the cause and effect relationship between them. Solution strategies are also proposed and ranked, thereby serving as a reference basis for relevant parties to choose appropriate response solutions. Due to the multi-criteria nature of NTS threats, the multiple criteria decision-making (MCDM) method is used in combination with the Z-number concept and Fuzzy set theory to approach the problem of certainty and increase the accuracy of study. The NTS threats are first identified through a literature review and then validated for suitability using the DELPHI technique (DELPHI). Suitable threats will be determined by relationship, weighted by Decision Making Trial And Evaluation Laboratory (DEMATEL) method. Proposed strategies are ranked using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. The results indicate that there are 19 NTS factors affecting SCF in Vietnam, and the global economic downturn, pandemic and health crisis, financial crisis and cybersecurity risk are the four root cause factors with the most decisive influence. Businesses and concerns need to prioritize addressing these four threats because they not only have a strong impact but also entail many other threats. The two strategies considered to be the most effective are a sustainable practice and a risk-hedging strategy. Businesses, governments, and stakeholders also should pay attention to the macroeconomic environment, technology, and environment and build sustainable businesses, regularly monitoring economic fluctuations and creating plans to prevent risks.

In Vitro and in Silico Study of New Biscoumarin Glycosides from Paramignya trimera against Angiotensin-Converting Enzyme 2 (ACE-2) for Preventing SARS-CoV-2 Infection.

In Vietnam, the stems and roots of the Rutaceous plant Paramignya trimera (Oliv.) Burkill (known locally as "Xáo tam phân") are widely used to treat liver diseases such as viral hepatitis and acute and chronic cirrhosis. In an effort to search for Vietnamese natural compounds capable of inhibiting coronavirus based on molecular docking screening, two new dimeric coumarin glycosides, namely cis-paratrimerin B (1) and cis-paratrimerin A (2), and two previously identified coumarins, the trans-isomers paratrimerin B (3) and paratrimerin A (4), were isolated from the roots of P. trimera and tested for their anti-angiotensin-converting enzyme 2 (ACE-2) inhibitory properties in vitro. It was discovered that ACE-2 enzyme was inhibited by cis-paratrimerin B (1), cis-paratrimerin A (2), and trans-paratrimerin B (3), with IC50 values of 28.9, 68, and 77 µM, respectively. Docking simulations revealed that four biscoumarin glycosides had good binding energies (∆G values ranging from -10.6 to -14.7 kcal/mol) and mostly bound to the S1' subsite of the ACE-2 protein. The key interactions of these natural ligands include metal chelation with zinc ions and multiple H-bonds with Ser128, Glu145, His345, Lys363, Thr371, Glu406, and Tyr803. Our findings demonstrated that biscoumarin glycosides from P. trimera roots occur naturally in both cis- and trans-diastereomeric forms. The biscoumarin glycosides Lys363, Thr371, Glu406, and Tyr803. Our findings demonstrated that biscoumarin glycosides from P. trimera roots hold potential for further studies as natural ACE-2 inhibitors for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Zinc-Carbon Battery Recycling for Investigating Carbon Materials for Supercapacitor Applications.

In this paper, carbon materials, including graphene nanosheets and carbon nanoparticles, were prepared from spent zinc-carbon batteries by the following two simple methods: electrochemical exfoliation and ultrasonication. Here, graphene nanosheets were synthesized by electrochemical exfoliation in 0.5 M H2SO4 by using a direct current power supply with two carbon rods from spent zinc-carbon batteries. Carbon nanoparticles were prepared by fast ultrasonication in a low-cost, green solution of DI water and ethanol. Graphene nanosheets in this study have high quality, large scale, and good electrochemical ability, while carbon nanoparticles have a unique nanosize and a good specific surface area. These carbon materials were applied for electrochemical measurements for supercapacitor studies and showed excellent stability at different temperatures. Moreover, electric double-layer capacitor devices based on graphene nanosheets and carbon nanoparticles were also used in electrochemical studies with strong stability and good electrochemical capability.

Management of Pediatric Supracondylar Humerus Fractures Using Lateral Cross-Wiring Technique Under Fluoroscopic Guidance.

BACKGROUND:  Supracondylar humeral fractures are the most prevalent elbow fractures in pediatric patients. Current treatment modalities typically involve closed reduction and fixation using percutaneous Kirschner wires. The lateral cross-wiring technique has demonstrated favorable functional and cosmetic outcomes, thereby reducing the incidence of ulnar nerve injury. OBJECTIVES:  This study aimed to assess the efficacy of the lateral cross-wiring technique in achieving optimal functional and cosmetic recovery while mitigating the risk of ulnar nerve injury in pediatric patients with displaced supracondylar humeral fractures. MATERIALS AND METHODS: A prospective analysis was conducted on 48 patients who underwent lateral cross-wiring for displaced supracondylar fractures (Gartland type III, including extension and flexion types) of the humerus. Follow-up assessments were performed over a minimum period of eight months post-surgery. RESULTS: Among the 48 patients, all demonstrated satisfactory restoration of the carrying angle and functional ability postoperatively. Notably, no iatrogenic cases of radial or ulnar nerve injury were observed during the follow-up period. CONCLUSION:  The lateral cross-wiring technique emerges as an effective treatment option for displaced supracondylar fractures of the humerus in pediatric patients. It facilitates both functional and cosmetic recovery while concurrently reducing the risk of ulnar nerve injury, thus warranting consideration in the management of such fractures.

THE RETROSPECTIVE ANALYSIS OF TRIGEN INTERTAN NAIL IN THE TREATMENT OF UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURES AT HOSPITAL FOR TRAUMATOLOGY AND ORTHOPAEDICS.

Background: Intertrochanteric fractures are highly prevalent among the elderly population, with approximately 90% occurring in individuals aged over 65. These geriatric fractures are associated with elevated mortality rates and significant functional impairment. Common treatment modalities for unstable intertrochanteric fractures include proximal femoral nail antirotation (PFNA) and the InterTan nail (IT). PFNA and IT are frequently employed due to their lower failure rates and favorable biomechanical properties, resulting in positive clinical outcomes for the management of unstable intertrochanteric fractures. The unique design of the IT nail, featuring two cephalocervical screws within an integrated mechanism, permits linear intraoperative compression and rotational stability of the neck and head fragment. In this study, we assess the clinical outcomes of IT nail utilization in the treatment of intertrochanteric fractures at the Hospital for Traumatology and Orthopedics. Methods: This study comprises a retrospective analysis and case series report. Between February 2021 and August 2021, we retrospectively evaluated 35 patients who underwent treatment with the IT nail for unstable intertrochanteric fractures. Epidemiological data, operative duration, intraoperative blood loss, intraoperative blood transfusion requirements, length of hospital stay, bone healing rates, and IT nail-related complications were recorded. Results: The mean age of the patients was 70.97 ± 16.97 years, with a mean operative time of 60 minutes, mean intraoperative blood loss of 160.86 ± 72.8 ml, mean intraoperative blood transfusion volume of 203.43 ± 189.29 ml, and a mean hospital stay of 7 days. Bone healing was observed in 97.14% of cases. Conclusions: The treatment of unstable intertrochanteric fractures using the IT nail in elderly patients was successful. Our findings indicate favorable clinical outcomes in terms of surgical duration, intraoperative blood loss, hospitalization duration, and union rates for elderly patients. Further investigations are warranted to validate these early results.

The effects of probiotics administration during pregnancy on preeclampsia and associated maternal, fetal, and newborn outcomes: a systematic review and meta-analysis.

OBJECTIVE: This study aimed to synthesize the available evidence on probiotic administration during pregnancy for the prevention of preeclampsia and its effects on related maternal, fetal, and newborn outcomes. DATA SOURCES: Six databases were systematically searched for eligible studies, namely Ovid MEDLINE, Embase, CINAHL, Cochrane, Global Index Medicus, and the Maternity and Infant Care Database, from inception to August 2, 2023. STUDY ELIGIBILITY CRITERIA: Randomized controlled trials that evaluated the effects of probiotic administration on women during any stage of pregnancy were eligible for inclusion. METHODS: The protocol was registered with the International Prospective Register of Systematic Reviews under identifier CRD42023421613. Evaluating study eligibility, extracting data, assessing risk of bias (ROB-2 tool), and rating certainty (Grading of Recommendations, Assessment, Development and Evaluations) were conducted independently by 2 authors. The primary outcomes were incidence of preeclampsia, eclampsia, and maternal mortality. A meta-analysis was performed, and the results were reported as risk ratios with 95% confidence intervals. RESULTS: A total of 29 trials (7735 pregnant women) met the eligibility criteria. There was heterogeneity across the trials in the population of enrolled women and the type of probiotic tested (20 different strains), although most used oral administration. Probiotics may make no difference to the risk of preeclampsia (risk ratio, 1.14; 95% confidence interval, 0.84-1.53; 11 trials; 2401 women; low certainty evidence), preterm birth at <37 weeks' gestation (risk ratio, 0.93; 95% confidence interval, 0.66-1.30; 18 trials, 4016 women; low certainty evidence), or gestational age at delivery (mean difference, -0.03 weeks [≈0.2 days]; 95% confidence interval, -0.16 to 0.10 weeks [≈ -1.1 to 0.7 days]; 13 trials, 2194 women; low certainty evidence). It is difficult to assess the effects of probiotics on other secondary outcomes because the evidence was of very low certainty, however, no benefits or harms were observed. CONCLUSION: Limited evidence suggests that probiotic supplementation does not affect the risk for preeclampsia. Further high-quality trials are needed to definitively assess the benefits and possible harms of probiotic supplementation during pregnancy. There is also a lack of data from trials that included women who were undernourished or who experienced microbial dysbiosis and for whom probiotic supplementation might be useful.

Development of a search filter to retrieve reports of interrupted time series studies from MEDLINE and PubMed.

BACKGROUND: Interrupted time series (ITS) studies contribute importantly to systematic reviews of population-level interventions. We aimed to develop and validate search filters to retrieve ITS studies in MEDLINE and PubMed. METHODS: A total of 1017 known ITS studies (published 2013-2017) were analysed using text mining to generate candidate terms. A control set of 1398 time-series studies were used to select differentiating terms. Various combinations of candidate terms were iteratively tested to generate three search filters. An independent set of 700 ITS studies was used to validate the filters' sensitivities. The filters were test-run in Ovid MEDLINE and the records randomly screened for ITS studies to determine their precision. Finally, all MEDLINE filters were translated to PubMed format and their sensitivities in PubMed were estimated. RESULTS: Three search filters were created in MEDLINE: a precision-maximising filter with high precision (78%; 95% CI 74%-82%) but moderate sensitivity (63%; 59%-66%), most appropriate when there are limited resources to screen studies; a sensitivity-and-precision-maximising filter with higher sensitivity (81%; 77%-83%) but lower precision (32%; 28%-36%), providing a balance between expediency and comprehensiveness; and a sensitivity-maximising filter with high sensitivity (88%; 85%-90%) but likely very low precision, useful when combined with specific content terms. Similar sensitivity estimates were found for PubMed versions. CONCLUSION: Our filters strike different balances between comprehensiveness and screening workload and suit different research needs. Retrieval of ITS studies would be improved if authors identified the ITS design in the titles.

Effects of electroconvulsive shock on the function, circuitry, and transcriptome of dentate gyrus granule neurons.

Therapeutic use of electroconvulsive shock (ECS) is 75% effective for the remission of treatment-resistant depression. Like other more common forms of antidepressant treatment such as fluoxetine, ECS has been shown to increase neurogenesis in the hippocampal dentate gyrus of rodent models. Yet the question of how ECS-induced neurogenesis supports improvement of depressive symptoms remains unknown. Here, we show that ECS-induced neurogenesis is necessary to improve depressive-like behavior of mice exposed to chronic corticosterone (Cort). We then use slice electrophysiology to show that optogenetic stimulation of adult-born neurons produces a greater hyperpolarization in mature granule neurons after ECS vs Sham treatment. We identify that this hyperpolarization requires the activation of metabotropic glutamate receptor 2 (mGluR2). Consistent with this finding, we observe reduced expression of the immediate early gene cFos in the granule cell layer of ECS vs Sham subjects. We then show that mGluR2 knockdown specifically in ventral granule neurons blunts the antidepressant-like behavioral effects of ECS. Using single nucleus RNA sequencing, we reveal major transcriptomic shifts in granule neurons after treatment with ECS+Cort or fluoxetine+Cort vs Cort alone. We identify a population of immature cells which has greater representation in both ECS+Cort and fluoxetine+Cort treated samples vs Cort alone. We also find global differences in ECS-vs fluoxetine-induced transcriptomic shifts. Together, these findings highlight a critical role for immature granule cells and mGluR2 signaling in the antidepressant action of ECS.

Type-I-interferon-responsive microglia shape cortical development and behavior.

Microglia are brain-resident macrophages that shape neural circuit development and are implicated in neurodevelopmental diseases. Multiple microglial transcriptional states have been defined, but their functional significance is unclear. Here, we identify a type I interferon (IFN-I)-responsive microglial state in the developing somatosensory cortex (postnatal day 5) that is actively engulfing whole neurons. This population expands during cortical remodeling induced by partial whisker deprivation. Global or microglial-specific loss of the IFN-I receptor resulted in microglia with phagolysosomal dysfunction and an accumulation of neurons with nuclear DNA damage. IFN-I gain of function increased neuronal engulfment by microglia in both mouse and zebrafish and restricted the accumulation of DNA-damaged neurons. Finally, IFN-I deficiency resulted in excess cortical excitatory neurons and tactile hypersensitivity. These data define a role for neuron-engulfing microglia during a critical window of brain development and reveal homeostatic functions of a canonical antiviral signaling pathway in the brain.

MICROSURGICAL REIMPLANTATION OUTCOMES FOR COMPLETE AND INCOMPLETE AMPUTATIONS OF DISTAL PHALANGES OF FINGERS.

Introduction: The intricate endeavor of replanting the distal phalanx of the finger remains a persistent challenge. In the pursuit of addressing this concern, microsurgical replantation procedures have been systematically examined for distal phalanx injuries encircling the distal interphalangeal (DIP) joint, conducted at the Orthopaedic Hospital situated in Ho Chi Minh City. Materials and Methods: This investigation encompassed a cohort of 31 patients, comprising individuals with 17 instances of complete and 21 instances of incomplete amputations of the distal phalanges. The subjects' ages spanned a range from 3 to 56 years. Results: The study divulged that eight fingers, involving four complete amputations and four incomplete amputations, did not achieve successful outcomes. In contrast, the remaining 30 fingers exhibited survival. A meticulous long-term follow-up of 17 fingers, extending over a period exceeding six months, unveiled commendable achievements encompassing satisfactory sensory recovery, cosmetic enhancement, and the resumption of pre-injury occupational activities by the patients. Discussion: Vein anastomosis was revealed as a notably challenging aspect of the surgical procedures. In scenarios where conventional vein suturing was rendered unfeasible, the innovative recourse of one-way drainage emerged as a viable alternative. Conclusion: The endeavor to replant the distal phalanx of the finger engenders a substantial level of complexity, particularly in the realm of venous anastomosis. This research underscores the need for focused efforts to address and surmount the intricacies associated with this aspect of surgical intervention.