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BACKGROUND: Complicated mild traumatic brain injury (cmTBI) is a common neurosurgical disorder that consumes a significant amount of healthcare resources without a clearly established benefit. Best practices for the management of cmTBI regarding triage, hospital admission, and the necessity for repeat imaging are controversial. Our objective is to describe the rate of radiographic progression and neurologic decline for isolated traumatic subarachnoid hemorrhage (itSAH) patients admitted to the hospital. We hypothesized that only a minority of itSAH patients suffer radiographic progression and that radiographic progression is not necessarily associated with neurologic decline. METHODS: Database queries and direct patient chart reviews were used to gather patient data. T-tests and Fisher's exact tests were performed. RESULTS: A total of 340 patients with cmTBI associated with itSAH were included for analysis. The radiographic progression rate was 5.6%. There was no statistically significant association between age, gender, GCS at presentation, anticoagulation status, and risk of radiographic progression. However, subgroup analysis on anticoagulated patients did show those on warfarin had a statistically significant risk of radiographic progression (p = 0.003). No patient developed neurologic decline, irrespective of whether they developed radiographic progression. CONCLUSION: Secondary triaging, hospital admission, ICU stay, and repeat HCT might not be necessary for awake, GCS 13-15 patients with itSAH without any other significant injuries. In the case of anticoagulant use, but not necessarily antiplatelet use, the medication should be reversed, and admission should be considered.
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Intradural disc herniations (IDH) account for 0.27% of all disc herniations. Cervical IDH account for 3% of these, with only 47 cases reported in the literature, making it an extremely rare diagnosis. Brown-Séquard syndrome is the most common presentation of cervical IDH. Emergent decompression is usually necessary. We present the case of a 56-year-old woman who presented with Brown-Séquard syndrome secondary to a spontaneous intradural C5-6 disc herniation. A posterior transdural approach was recommended to arrest her neurological deficit and promote improvement. The patient consented to the procedure. Institutional Review Board approval was not necessary, given this treatment was necessary and indicated. A standard posterior cervical exposure and C5-6 laminectomies were performed. The dura was opened with a "peeling" technique. The compressive disc fragments were removed. A dural defect was identified along the C6 nerve root sleeve. Fluoroscopy was used to confirm the communication of the defect with the C5-6 disc space. A single 5-0 Prolene suture was used to repair the defect, approximating the anterior dura with a flap from the nerve root sleeve. The patient had an uneventful postoperative course. At 7-month follow-up, her neurological deficits had nearly resolved. Surgeons should consider IDH in the differential diagnosis for sudden neurologic decline in the setting of an intradural mass and should be familiar with the association between cervical IDH and Brown-Séquard syndrome. The posterior transdural approach provides excellent exposure, easier management of dural defects, and ability to handle a variety of intradural pathologies and may avoid the need for concomitant fusion.
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Vertebral artery tortuosity is a common phenomenon with an estimated incidence of 2.7%. However, it is symptomatic in very rare instances, with only 21 cases reported in the literature. When a neurovascular conflict can be clearly identified, microsurgical decompression should be the treatment of choice. This can be performed through a variety of different strategies which can achieve either direct or indirect decompression. We present the case of a 68-year-old female who suffered from progressive right-sided C5 radiculopathy and deltoid weakness for over a year secondary to a neurovascular conflict between a V2 vertebral artery loop and the C5 nerve root. Microvascular decompression with vertebral artery transposition using an anterolateral approach was recommended for pain management and arrest of her neurological deficit, and the patient consented to the procedure. Institutional Review Board approval was not necessary given that this treatment was necessary and indicated. The longus colli is mobilized, and the anterior wall of the foramen transversarium is exposed. The foramen transversarium is drilled to unroof the vertebral artery. The neuroforamen is identified. A tailored foraminotomy is performed to expose the neurovascular conflict. The vertebral artery loop is dissected away from the C5 nerve root and transposed outside the neuroforamen. The transposition is maintained with Teflon felts. The patient had immediate resolution of her pain and weakness. Surgeons should be aware of this rare cause of radiculopathy and should be familiar with the surgical technique for vertebral artery mobilization. Direct decompression should be the goal of treatment when possible.
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The escalation of global urbanization and industrial expansion has resulted in an increase in the emission of harmful substances into the atmosphere. Evaluating the effectiveness of titanium dioxide (TiO2) in photocatalytic degradation through traditional methods is resource-intensive and complex due to the detailed photocatalyst structures and the wide range of contaminants. Therefore in this study, recent advancements in machine learning (ML) are used to offer data-driven approach using thirteen machine learning techniques namely XG Boost (XGB), decision tree (DT), lasso Regression (LR2), support vector regression (SVR), adaBoost (AB), voting Regressor (VR), CatBoost (CB), K-Nearest Neighbors (KNN), gradient boost (GB), random Forest (RF), artificial neural network (ANN), ridge regression (RR), linear regression (LR1) to address the problem of estimation of TiO2 photocatalytic degradation rate of air contaminants. The models are developed using literature data and different methodical tools are used to evaluate the developed ML models. XGB, DT and LR2 models have high R2 values of 0.93, 0.926 and 0.926 in training and 0.936, 0.924 and 0.924 in test phase. While ANN, RR and LR models have lowest R2 values of 0.70, 0.56 and 0.40 in training and 0.62, 0.63 and 0.31 in test phase respectively. XGB, DT and LR2 have low MAE and RMSE values of 0.450 min-1/cm2, 0.494 min-1/cm2 and 0.49 min-1/cm2 for RMSE and 0.263 min-1/cm2, 0.285 min-1/cm2 and 0.29 min-1/cm2 for MAE in test stage. XGB, DT, and LR2 have 93% percent errors within 20% error range in training phase. XGB has 92% and DT, and LR2 have 94% errors with 20% range in test phase. XGB, DT, LR2 models remained the highest performing models and XGB is the most robust and effective in predictions. Feature importances reveal the role of input parameters in prediction made by developed ML models. Dosage, humidity, UV light intensity remain important experimental factors. This study will impact positively in providing efficient models to estimate photocatalytic degradation rate of air contaminants using TiO2.
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BACKGROUND OBJECTIVES: Biological approaches for vector mosquito control such as sterile insect technique (SIT) requires sterilization of male mosquitoes through specific radiation doses for sterility induction in males. Under the SIT program, the males used must be compatible with the wild males in vigor, flight and selection of mate. Much of this potential is determined by the diet provided in the larval stages and optimizing the irradiation doses that cause complete sterility but have very minimal effect on the lives of irradiated males. The current study is designed to evaluate gamma radiation doses for inducing sterility in male Aedes aegypti mosquitoes with a genomic background from Pakistan (Swat district) and to assess the effects of radiation exposure on the competency of irradiated males and other life traits of irradiated mosquitoes. METHODS: Sterilization of 17-hour-old male pupae (groups of 50 pupa/cup in three replicates) of the Ae. aegypti Swat strain was conducted using radiation doses of 30, 60, 70, 90, and 105 gray (Gy) from (Co60) at the Nuclear Institute for Food and Agriculture (NIFA) in Peshawar, Pakistan. Post-irradiated pupae were released in adult cages. Virgin females of the same cohort were released (1:1) to mate with the irradiated males. Mortality, longevity, mating competitiveness of males, and female fecundity were recorded. RESULTS: An average of 71 eggs per female was recorded in control with 86% hatch rate. Individual females mated with a 60 Gy treated males produced 60 ± 0.6 eggs per female with 17% hatch rate, and those mated with 70 Gy males produced 42 ± 0.01 eggs with a nil hatch rate, whereas females mated with males treated with ≥70 Gy doses did not reproduce to next generation. Females in groups of 50 mated with 60, 70 Gy treated males (equal pairs), produced 369±1.3 and 98±0.01 eggs with 15% and zero hatch rate. Significant dose dependent reduction in longevity was observed for >30 Gy doses. The matting competence of irradiated males was about half that of un-irradiated males. INTERPRETATION CONCLUSION: Aedes aegypti with a Pakistani genomic background treated with a ≥70 Gy dose of gamma radiation induced complete sterility in males and provided the first- step foundation for SIT application in Pakistan. Further extensive studies are required to optimize the SIT techniques so that fully sterile males with very minor quality changes can be produced on large scales for field trials.
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The treatment of spinal pathologies has evolved significantly from the times of Hippocrates and Galen to the current era. This evolution has led to the development of cutting-edge technologies to improve surgical techniques and patient outcomes. The University of Missouri Health System is a high-volume, tertiary care academic medical center that serves a large catchment area in central Missouri and beyond. The Department of Neurosurgery has sought to integrate the best available technologies to serve their spine patients. These technological advancements include intra-operative image guidance, robotic spine surgery, minimally invasive techniques, motion preservation surgery, and interdisciplinary care of metastatic disease to the spine. These advances have resulted in safer surgeries with enhanced outcomes at the University of Missouri. This integration of innovation demonstrates our tireless commitment to ensuring excellence in the comprehensive care of a diverse range of patients with complex spinal pathologies.
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Enfermedades de la Columna Vertebral , Humanos , Missouri , Enfermedades de la Columna Vertebral/cirugía , Centros Médicos Académicos/organización & administración , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Procedimientos Neuroquirúrgicos/métodos , Procedimientos Quirúrgicos Robotizados/métodos , Procedimientos Quirúrgicos Robotizados/tendencias , Columna Vertebral/cirugíaRESUMEN
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: In patients undergoing elective posterior cervical laminectomy and fusion (PCLF) with a minimum of 5-year follow-up, we sought to compare reoperation rates between patients with an upper instrumented vertebra (UIV) of C2 versus C3/4. SUMMARY OF BACKGROUND DATA: The long-term outcomes of choosing between C2 versus C3/4 as the UIV in PCLF remain unclear. METHODS: A single-institution, retrospective cohort study from a prospective registry was conducted of patients undergoing elective, degenerative PCLF from December 2010 to June 2018. The primary exposure was UIV of C2 versus C3/4. The primary outcome was reoperation. Multivariable logistic regression controlled for age, smoking, diabetes, and fusion to the thoracic spine. RESULTS: Of the 68 patients who underwent PCLF with 5-year follow-up, 27(39.7%) had a UIV of C2, and 41(60.3%) had a UIV of either C3/4. Groups had similar duration of symptoms (P=0.743), comorbidities (P>0.999), and rates of instrumentation to the thoracic spine (70.4% vs. 53.7%, P=0.210). The C2 group had significantly longer operative time (231.8±65.9 vs. 181.6±44.1 mins, P<0.001) and more fused segments (5.9±1.8 vs. 4.2±0.9, P<0.001). Reoperation rate was lower in the C2 group compared with C3/4 (7.4% vs. 19.5%), though this did not reach statistical significance (P=0.294). Multivariable logistic regression showed increased odds of reoperation for the C3/4 group compared with the C2 group (OR=3.29, 95%CI=0.59-18.11, P=0.170), though statistical significance was not reached. Similarly, the C2 group had a lower rate of instrumentation failure (7.4% vs. 12.2%, P=0.694) and adjacent segment disease/disk herniation (0% vs. 7.3%, P=0.271), though neither trend attained statistical significance. CONCLUSIONS: Patients with a UIV of C2 had less than half the number of reoperations and less adjacent segment disease, though neither trend was statistically significant. Despite a lack of statistical significance, whether a clinically meaningful difference exists between UIV of C2 versus C3/4 should be validated in larger samples with long-term follow-up. LEVEL OF EVIDENCE: Level-3.
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BACKGROUND OBJECTIVES: Insect growth regulators (IGRs) are biological hormone analogue or mimics used as pesticides to inhibit the growth of larva during their molting and skin shedding. This study aimed to test the effect of IGRs on the eggs hatching and post-hatching inhibition of Aedes mosquitoes and understanding its effect in the mosquito breeding habitats for reduction in adult emergence. METHODS: Experiments on the evaluation of three insect growth regulators (IGRs) for the control of different stages of Aedes aegypti was carried out during 2020-21. Each experiment consisted of four treatments viz., Pyriproxyfen, Novaluron, and Larvicol at 1.0 ppm and distilled water as a control. All experiments were carried out in completely randomized design (CRD) except eggs which were carried out in factorial design each with three replications. RESULTS: All tested IGRs performed better in affecting eggs, larval and pupal stages of Ae. aegypti. Highest eggs hatching inhibition (80%) of fresh eggs occurred in Pyriproxyfen followed by Novaluron (66%) and lowest in Larvicol (62%). Eggs hatch inhibition of embryonated eggs was lower than fresh eggs. Pyriproxyfen caused 69%, Novaluron 59% and Larvicol 39% eggs hatch inhibition of embryonated eggs. Both Pyriproxyfen and Novaluron performed better in causing 98-100% larval mortality followed by Larvicol (39%). Larval development to pupal stage was completely prevented by both Pyriproxyfen and Novaluron. Although Larvicol resulted in lowest eggs hatch and larval inhibition but prevented pupae to emerge as adults. Results further showed 70-89% mortality of 3rd instar larvae of Ae. aegypti when exposed to Pyriproxyfen and Novaluron solutions after 30 days storage at lab. temperature (27±2°C), RH 70±5. INTERPRETATION CONCLUSION: None of the IGRs was more effective at the pupal stage but showed carry-on activity of growth inhibition and mortality of the successive stages of development when used against eggs stages. Therefore, we recommend early application of IGRs at mosquito habitats during the beginning and onset of the season when very early stages of mosquitoes are available in the field.
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Aedes , Hormonas Juveniles , Larva , Control de Mosquitos , Compuestos de Fenilurea , Pupa , Piridinas , Animales , Aedes/efectos de los fármacos , Aedes/crecimiento & desarrollo , Aedes/fisiología , Hormonas Juveniles/farmacología , Larva/efectos de los fármacos , Larva/crecimiento & desarrollo , Control de Mosquitos/métodos , Piridinas/farmacología , Compuestos de Fenilurea/farmacología , Pupa/efectos de los fármacos , Pupa/crecimiento & desarrollo , Femenino , Nitrilos/farmacología , Insecticidas/farmacología , Óvulo/efectos de los fármacosRESUMEN
OBJECTIVE: In a cohort of employed patients undergoing elective cervical spine surgery with an uncomplicated postoperative course, the authors sought to determine the demographic, functional, and occupational characteristics associated with return to work (RTW) following surgery. METHODS: A retrospective cohort study of prospectively collected data was undertaken of patients undergoing elective cervical spine surgery for degenerative disease in the Quality Outcomes Database. Study inclusion criteria were: 1) employed prior to surgery and planned to RTW, 2) no unplanned readmissions, 3) achieved 30% improvement on the Neck Disability Index (NDI), and 4) were satisfied with the surgical outcome at 3 or 12 months postoperatively. A multivariable Cox regression model was built using demographic, functional, operative, and occupational characteristic to predict time to RTW. RESULTS: Of 5110 included patients, 4788 (93.7%) returned to work within 12 months, with a median time of 35 (IQR 19-60) days. Patients who did RTW were significantly younger (51.3 ± 9.4 vs 55.8 ± 9.6 years, p < 0.001), more often underwent an anterior approach (85.8% vs 80.7%, p = 0.009), were significantly more privately insured (82.1% vs 64.0%, p < 0.001), and were less likely to have workers' disability insurance (6.7% vs 14.6%, p < 0.001) compared with patients who did not RTW. On multivariable Cox regression, demographic factors associated with a longer RTW were older age (hazard ratio [HR] 0.99, 95% CI 0.99-1.00, p < 0.001) and Black race (HR 0.71, 95% CI 0.62-0.81, p < 0.001). Male sex was associated with a shorter RTW time (HR 1.19, 95% CI 1.11-1.26, p < 0.001). Regarding baseline functional status, worse preoperative NDI (HR 0.99, 95% CI 0.99-0.99, p < 0.001) was associated with a longer RTW, whereas the absence of myelopathy was associated with a shorter RTW (HR 1.17, 95% CI 1.09-1.25, p < 0.001). Having a sedentary (HR 1.81, 95% CI 1.65-1.99, p < 0.001), light-intensity (HR 1.60, 95% CI 1.45-1.76, p < 0.001), and medium-intensity (HR 1.11, 95% CI 1.01-1.22, p = 0.037) occupation was associated with a shorter RTW time compared with a heavy-intensity occupation at any time point. Heavy-intensity occupations were independently the strongest predictor of longer RTW. Similar predictors of shorter RTW were found in a subanalysis of occupation intensity and among operative approaches used. CONCLUSIONS: Among patients undergoing elective degenerative cervical spine surgery who had favorable surgical outcomes and planned to RTW before surgery, 94% had a successful RTW. Age was the strongest predictor of lower odds of RTW. Regarding time to RTW, having a sedentary, light-intensity, or medium-intensity occupation was associated with a shorter RTW time compared with a heavy-intensity occupation. These findings highlight the importance of considering the demographic and occupational characteristics when predicting postoperative RTW in patients with satisfactory surgical outcomes.
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Vértebras Cervicales , Procedimientos Quirúrgicos Electivos , Reinserción al Trabajo , Humanos , Masculino , Femenino , Persona de Mediana Edad , Reinserción al Trabajo/estadística & datos numéricos , Vértebras Cervicales/cirugía , Estudios Retrospectivos , Adulto , Evaluación de la Discapacidad , Empleo/estadística & datos numéricos , Resultado del TratamientoRESUMEN
BACKGROUND AND OBJECTIVES: Although risk factors for unplanned readmission after cervical spine surgery have been widely reported, less is known about how readmission itself affects patient-reported outcome measures (PROMs). Using the Quality Outcomes Database registry of patients undergoing elective cervical spine surgery, we sought to (1) determine the impact of unplanned readmission on PROMs and (2) compare the effect of specific readmission reasons on PROMs. METHODS: An observational study was performed using a multi-institution, retrospective registry for patients undergoing cervical spine surgery. The occurrence of 90-day unplanned readmission classified into medical, surgical, pain only, and no readmissions was the exposure variable. Outcome variables included 12-month PROMs of Neck Disability Index (NDI), Numeric Rating Scale (NRS)-neck/arm pain, EuroQol-5D (EQ-5D), and patient dissatisfaction. Multivariable models predicting each PROM were built using readmission reasons controlling for demographics, clinical characteristics, and preoperative PROMs. RESULTS: Data from 13 355 patients undergoing elective cervical spine surgery (82% anterior approach and 18% posterior approach) were analyzed. Unplanned readmission within 90 days of surgery occurred in 3.8% patients, including medical (1.6%), surgical (1.8%), and pain (0.3%). Besides medical reasons, wound infection/dehiscence was the most common reason for unplanned readmission for the total cohort (0.5%), dysphagia in the anterior approach (0.6%), and wound infection/dehiscence in the posterior approach (1.5%). Based on multivariable regression, surgical readmission was significantly associated with worse 12-month NDI, NRS-neck pain, NRS-arm pain, EQ-5D, and higher odds of dissatisfaction. Pain readmissions were associated with worse 12-month NDI and NRS-neck pain scores, and worse dissatisfaction. For specific readmission reasons, pain, surgical site infection/wound dehiscence, hematoma/seroma, revision surgery, deep vein thrombosis, and pulmonary embolism were significantly associated with worsened 12-month PROMs. CONCLUSION: In patients undergoing elective cervical spine surgery, 90-day unplanned surgical and pain readmissions were associated with worse 12-month PROMs compared with patients with medical readmissions and no readmissions.
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BACKGROUND CONTEXT: Unplanned readmissions following lumbar spine surgery have immense clinical and financial implications. However, little is known regarding the impact of unplanned readmissions on patient-reported outcomes (PROs) following lumbar spine surgery. PURPOSE: To evaluate the impact of unplanned readmissions, including specific readmission reasons, on patient reported outcomes 12 months after lumbar spine surgery. STUDY DESIGN/SETTING: A retrospective cohort study of prospectively collected data was conducted using patients included in the lumbar module of the Quality and Outcomes Database (QOD), a national, multicenter spine registry. PATIENT SAMPLE: A total of 33,447 patients who underwent elective lumbar spine surgery for degenerative diseases were included. Mean age was 59.8 (SD=14.04), 53.6% were male, 89.5% were white, 45.9% were employed, and 47.5% had private insurance. OUTCOME MEASURES: Unplanned 90-day readmissions and 12-month patient-reported outcomes (PROs) including numeric rating scale (NRS) scores for back and leg pain, Oswestry Disability Index (ODI) scores, EuroQol-5 Dimension (EQ-5D) scores, and North American Spine Society (NASS) patient-satisfaction scores. METHODS: The lumbar module of the QOD was queried for adults undergoing elective lumbar spine surgery for degenerative disease. Unplanned 90-day readmissions were classified into 4 groups: medical, surgical, pain-only, and no readmissions. Medical and surgical readmissions were further categorized into primary reason for readmission. 12-month PROs assessing patient back and leg pain (NRS), disability (ODI), quality of life (EQ-5D), and patient satisfaction were collected. Multivariable models predicting 12-month PROs were built controlling for covariates. RESULTS: A total of 31,430 patients (94%) had no unplanned readmission while 2,017 patients (6%) had an unplanned readmission within 90 days following lumbar surgery. Patients with readmissions had significantly worse 12-month PROs compared with those with no unplanned readmissions in covariate-adjusted models. Using Wald-df as a measure of predictor importance, surgical readmissions were associated with the worst 12-month outcomes, followed by pain-only, then medical readmissions. In separate covariate adjusted models, we found that readmissions for pain, SSI/wound dehiscence, and revisions were among the most important predictors of worse outcomes at 12-months. CONCLUSIONS: Unplanned 90-day readmissions were associated with worse pain, disability, quality of life, and greater dissatisfaction at 12-months, with surgical readmissions having the greatest impact, followed by pain-only readmissions, then medical readmissions. Readmissions for pain, SSI/wound dehiscence, and revisions were the most important predictors of worse outcomes. These results may help providers better understand the factors that impact outcomes following lumbar spine surgery and promote improved patient counseling and perioperative management.
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Readmisión del Paciente , Calidad de Vida , Adulto , Humanos , Masculino , Persona de Mediana Edad , Femenino , Resultado del Tratamiento , Estudios Retrospectivos , Complicaciones Posoperatorias/epidemiología , Dolor , Vértebras Lumbares/cirugíaRESUMEN
This study presents an experimental and finite element analysis of reinforced concrete beams with solid, hollow, prismatic, or non-prismatic sections. In the first part, a total of six beams were tested under four-point monotonic bending. The test matrix was designed to provide a comparison of structural behavior between prismatic solid and hollow section beams, prismatic solid and non-prismatic solid section beams, and prismatic hollow and non-prismatic hollow section beams. The intensity of shear was maximum in the case of prismatic section beams. The inclusion of a tapered section lowered the demand for shear. In the second part, Nonlinear Finite Element Modeling was performed by using ATENA. The adopted modeling strategy resulted in close agreement with experimental crack patterns at ultimate failure. However, the ultimate failure loads predicted by nonlinear modeling were generally higher than their corresponding experimental results. Whereas in the last part, the developed models were further extended to investigate the effect of the strength of concrete and ratio of longitudinal steel bars on the ultimate load-carrying capacity and cracking behavior of the reinforced concrete beams with solid, hollow, prismatic, or non-prismatic sections. The ultimate loads for each beam predicted by the model were found to be in close agreement with experimental results. Nonlinear modeling was further extended to assess the effects of concrete strength and longitudinal reinforcement ratio on failure patterns and ultimate loads. The parametric study involved beams reinforced with glass fiber-reinforced polymer (GFRP) bars against shear and flexural failure. In terms of ultimate load capacities, diagonal cracking, and flexural cracking, beams strengthened with GFRP bars demonstrated comparable performance to the beams strengthened with steel bars.
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The primary objective of this research was to identify and explore the most potent and efficacious cyclooxygenase inhibitors, utilizing indole acetic acid drugs as a lead molecule. To achieve this objective, various derivatives (2a-2c and 2e-2g) of the selected lead molecule, indomethacin, were synthesized using a reflux condensation process, targeting the hydroxyl group. The synthesized analogues were subjected to different spectroscopic procedures to determine their structure and confirm their analogues. These derivatives were further screened for acute toxicity and anti-nociceptive and anti-inflammatory activity using established protocols. Docking analysis was performed to evaluate the possible protein-ligand interaction. The test compounds were found to be safe at doses of 50, 75, 100, and 200 mg/kg, i.p. The pharmacological screening revealed that test compounds 2a-2f had a superior peripheral analgesic effect at a dose of 10 mg/kg, in comparison to the parent drug indomethacin, while compound 2g exhibited slightly lower activity at the same dose. The hot plate results showed lower central analgesic activity of the test compounds compared to the standard Tramal, but it was still significant. Anti-inflammatory results were significant, comparable to Diclofenac sodium and indomethacin, except for compounds 2b, 2c, and 2e at a dose of 10 mg/kg body weight. Molecular docking analysis demonstrated that the derived compounds had augmented negative binding energies (-149.39, -146.72, -160.85, -159.34, -140.03, and -150.91 KJ/mol) compared to the parent drugs (-141.07), which supported the research's theme of producing stronger derivatives of standard drugs with significant anti-nociceptive and anti-inflammatory potential. The derived compounds exhibited significant analgesic and anti-inflammatory activities and, therefore, have the potential to be studied further as new drug candidates for pain and inflammation.
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The current study regarding the effects of larval diets on the life table parameters of dengue mosquitoes, Aedes aegypti was conducted under laboratory conditions at 27 ± 2 °C and 60 ± 5% relative humidity at NIFA (Nuclear Institute for Food and Agriculture) Peshawar, Pakistan. The data on life table parameters of Ae. aegypti reared on Diet 1 (replacement diet), Diet 2 (Khan's diet for Anopheles), Diet 3 (Khan's modified diet) and Diet 4 (IAEA diet) were analyzed using the age-stage, two-sex life table software. Diet 4 (IAEA) was used as a control for comparison. The results indicated that significantly maximum percentage of egg hatching of Ae. aegypti was observed when reared on Diet 4 (73.86%) and Diet 3 (72.90%), while less % of egg hatching was recorded in Diet 1 (40.67%) and Diet 2 (55.53%). The data further showed that the Diet 3 had a highest intrinsic rate of increase (r) (0.097 ± 5.68 day-1), finite rate of increase (λ) (1.10 ± 6.26 day-1) and net reproductive rate (R0) (11.99 ± 1.52 eggs/female) followed by Diet 2 and Diet 4. The mean generation time (T) of Ae. aegypti reared on Diet 3 (23.67 ± 0.86 days) and Diet 1 (24.05 ± 0.61 days) was significantly shorter than Diet 2 (26.15 ± 0.71 days) and Diet 4 (26.41 ± 0.38 days). The overall results revealed that Diet 3 showed good results at different life table parameters of Ae. aegypti and can be used as the preferred diet in the Sterile Insect Technique (SIT) where the mass culture of mosquitoes is required.
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Aedes , Dengue , Animales , Femenino , Larva , Tablas de Vida , Dieta , HuevosRESUMEN
Resource utilization of agricultural and industrial wastes with minimal screening is highly desirable in the context of sustainable development and environmental protection. In this regard, the current study proposes a novel solution of integrating milled wheat straw (WS) with minimal screening and silica fume (SF) in the form of composite binary admixture (CBA) for the stabilization of highly expansive soils. The optimum amount of WS and SF to produce CBA was determined based on a series of Atterberg's limit tests. The mechanical performance of CBA-treated soil was assessed based on the unconfined compression, direct shear, and flexural tests which showed that unconfined compressive strength (qu), cohesion (c), and flexural strength (f) were increased by 94.3%, 65.7%, and 90.7%, respectively, with an addition of 16% of CBA and 28 days of curing. Furthermore, the CBA-treated soil underwent only a 26% reduction in deformability index (ID) with an addition of 24% CBA. Furthermore, volumetric change response was assessed based on ID consolidation and swelling tests which showed that compression index (Cc), recompression index (Cr), swell potential, free swell index (FSI), and swell pressure were reduced by 72.5%, 47.7%, 59%, 35.8%, and 65%, respectively, with an addition of 16% CBA in the soil and 28 days of curing. In addition, wetting-drying (W-D) cycle tests demonstrated that CBA-treated soil was less vulnerable to W-D seasons as compared to untreated soil. Mineralogical and microstructural tests revealed that the balanced Ca:Si and Ca:Al environment created by CBA within the soil matrix produces cementing compounds, i.e., CSH and CAH, imparts strong bonds, and causes aggregation improving the mechanical response of expansive soil.
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Suelo , Triticum , Residuos Industriales , Agricultura , Gases , Dióxido de SilicioRESUMEN
INTRODUCTION: Symptomatic intracranial atherosclerotic disease (sICAD) is estimated to cause over 10% of strokes annually in the US alone. Previous investigations employing stenting, most notably SAMMPRIS trial, have produced unfavorable results in regards to both periprocedural complications and risk of recurrent stroke. However, newer generation balloon-mounted drug-eluting stents (BM-DES) have been hypothesized to harbor several technical advantages that may confer improvements in these critical metrics. METHODS: Prospectively maintained databases from eight comprehensive stroke centers were reviewed to identify adult patients undergoing RO-ZES for the treatment of sICAD between January,2019 and December,2021. Only patients that presented with either recurrent stroke or TIA, intracranial stenosis 70-99%, with at least one stroke on best medical management were included. The primary outcome was 30-days composite of stroke, ICH, and/or mortality. A propensity-score matched analyses was performed comparing the results of RO-ZES to the intervention arm of SAMMPRIS. RESULTS: A total of 132 patients met the inclusion criteria for analysis (mean age:64.2 years). Mean severity of stenosis (±SD) was 81.4% (±11.4%). Four (3.03%) stroke and/or deaths were reported within 30 days in RO-ZES group. A propensity-score matched analysis based on age, HLD, HTN, DMII, and smoking demonstrated a statistically significant decreased risk of 30-day stroke and/or death rate in RO-ZES in comparison to SAMMPRIS (2.6% vs. 15.6%, respectively; OR 6.88, 95% CI 1.92-37.54, p < 0.001). CONCLUSIONS: Patients treated with RO-ZES had a decreased rate of 30-day major complications in comparison to SAMMPRIS. Further large-scale prospective studies are warranted to evaluate the safety and efficacy of RO-ZES for the treatment of sICAD.
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Accidente Cerebrovascular , Adulto , Humanos , Persona de Mediana Edad , Constricción Patológica/cirugía , Resultado del Tratamiento , Accidente Cerebrovascular/etiología , Stents/efectos adversos , Estudios ProspectivosRESUMEN
PURPOSE: The modified Japanese Orthopedic Association (mJOA) score consists of six sub-domains and is used to quantify the severity of cervical myelopathy. The current study aimed to assess for predictors of postoperative mJOA sub-domains scores following elective surgical management for patients with cervical myelopathy and develop the first clinical prediction model for 12-month mJOA sub-domain scores.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Byron F.] Last name [Stephens], Author 2 Given name: [Lydia J.] Last name [McKeithan], Author 3 Given name: [W. Hunter] Last name [Waddell], Author 4 Given name: [Anthony M.] Last name [Steinle], Author 5 Given name: [Wilson E.] Last name [Vaughan], Author 6 Given name: [Jacquelyn S.] Last name [Pennings], Author 7 Given name: [Jacquelyn S.] Last name [Pennings], Author 8 Given name: [Scott L.] Last name [Zuckerman], Author 9 Given name: [Kristin R.] Last name [Archer], Author 10 Given name: [Amir M.] Last name [Abtahi] Also, kindly confirm the details in the metadata are correct.Last Author listed should be Kristin R. Archer METHODS: A multivariable proportional odds ordinal regression model was developed for patients with cervical myelopathy. The model included patient demographic, clinical, and surgery covariates along with baseline sub-domain scores. The model was internally validated using bootstrap resampling to estimate the likely performance on a new sample of patients. RESULTS: The model identified mJOA baseline sub-domains to be the strongest predictors of 12-month scores, with numbness in legs and ability to walk predicting five of the six mJOA items. Additional covariates predicting three or more items included age, preoperative anxiety/depression, gender, race, employment status, duration of symptoms, smoking status, and radiographic presence of listhesis. Surgical approach, presence of motor deficits, number of surgical levels involved, history of diabetes mellitus, workers' compensation claim, and patient insurance had no impact on 12-month mJOA scores. CONCLUSION: Our study developed and validated a clinical prediction model for improvement in mJOA scores at 12 months following surgery. The results highlight the importance of assessing preoperative numbness, walking ability, modifiable variables of anxiety/depression, and smoking status. This model has the potential to assist surgeons, patients, and families when considering surgery for cervical myelopathy. LEVEL OF EVIDENCE: Level III.
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Pueblos del Este de Asia , Enfermedades de la Médula Espinal , Humanos , Hipoestesia , Modelos Estadísticos , Resultado del Tratamiento , Estudios Prospectivos , Pronóstico , Vértebras Cervicales/cirugía , Enfermedades de la Médula Espinal/cirugíaRESUMEN
BACKGROUND: Symptomatic intracranial atherosclerotic disease (sICAD) is estimated to cause 10% of strokes annually in the United States. However, treatment remains a challenge with several different stenting options studied in the past with unfavorable results. OBJECTIVE: To report the 30-day stroke and/or death rate associated with intracranial stent placement for sICAD using Resolute Onyx Zotarolimus-Eluting Stent (RO-ZES) and provide a comparison with the results of Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. METHODS: Prospectively maintained databases across 8 stroke centers were used to identify adult patients treated with RO-ZES for sICAD between January 2019 and December 2021. Primary end point was composite of 30-day stroke, intracerebral hemorrhage, and/or death. Propensity score matching was performed using age, hypertension, lipid disorder, cigarette smoking, and symptomatic target vessel to create a matched group for comparison between RO-ZES and the SAMMPRIS medical management and treatment groups (SAMMPRIS percutaneous angioplasty and stenting [S-PTAS]). RESULTS: A total of 132 patients met the inclusion criteria for analysis (mean age: 64.2 years). Mean severity of stenosis was 81.4% (±11.4%). A total of 4 (3.03%) stroke and/or deaths were reported within 30 days of treatment in the RO-ZES group compared with 6.6% in the SAMMPRIS medical management group (OR [odds ratio] 2.26, 95% CI 0.7-9.56, P = .22) and 15.6% in the S-PTAS group (OR 5.9, 95% CI 2.04-23.4, P < .001). Propensity score match analysis of 115 patients in each group demonstrated 30-day stroke and/or death rate of 2.6% in the RO-ZES group and 15.6% in the S-PTAS group (OR 6.88, 95% CI 1.92-37.54, P < .001). CONCLUSION: Patients treated with RO-ZES had a relatively low 30-day stroke and/or death rate compared with the S-PTAS group. Further large-scale prospective studies are warranted to evaluate the safety and efficacy of RO-ZES for the treatment of sICAD.
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Stents Liberadores de Fármacos , Accidente Cerebrovascular , Adulto , Humanos , Persona de Mediana Edad , Constricción Patológica/cirugía , Stents Liberadores de Fármacos/efectos adversos , Puntaje de Propensión , Resultado del Tratamiento , Accidente Cerebrovascular/prevención & control , Accidente Cerebrovascular/etiología , Stents/efectos adversos , Infarto Cerebral/etiologíaRESUMEN
Introduction: Surgical management of degenerative lumbar spine disorders is effective at improving patient pain, disability, and quality of life; however, obtaining a durable posterolateral fusion after decompression remains a challenge. Interbody fusion technologies are viable means of improving fusion rates in the lumbar spine, specifically various graft materials including autograft, structural allograft, titanium, and polyether ether ketone. This study assesses the effectiveness of Tritanium posterolateral cage in the treatment of degenerative disk disease. Methods: Nearest-neighbor 1:1 matched control transforaminal lumbar interbody fusion with PEEK vs. Tritanium posterior lumbar (PL) cage interbody fusion patients were identified using propensity scoring from patients that underwent elective surgery for degenerative disk diseases. Line graphs were generated to compare the trajectories of improvement in patient-reported outcomes (PROs) from baseline to 3 and 12 months postoperatively. The nominal data were compared via the χ2 test, while the continuous data were compared via Student's t-test. Results: The two groups had no difference regarding either the 3- or 12-month Euro-Qol-5D (EQ-5D), numeric rating scale (NRS) leg pain, and NRS back pain; however, the Tritanium interbody cage group had better Oswestry Disability Index (ODI) scores compared to the control group of the PEEK interbody cage at both 3 and 12 months (p=0.013 and 0.048). Conclusions: Our results indicate the Tritanium cage is an effective alternative to the previously used PEEK cage in terms of PROs, surgical safety, and radiological parameters of surgical success. The Tritanium cohort showed better ODI scores, higher fusion rates, lower subsidence, and lower indirect costs associated with surgical management, when compared to the propensity-matched PEEK cohort.