Long-term clinical outcomes of intravascular imaging-guided percutaneous coronary intervention versus angiography-guided percutaneous coronary intervention in complex coronary lesions: a systematic review and meta-analysis.

Background: In this study, we aim to discuss the long-term clinical outcomes of intravascular ultrasound imaging-guided percutaneous intervention (IVUS-PCI) versus angiography-guided percutaneous coronary intervention (PCI) in complex coronary lesions over a mean period of 2 years. Methods: A systematic search and meta-analysis were conducted to assess the efficacy of using intravascular ultrasound or optical coherence tomography guidance in coronary artery stenting compared to angiography. Results: A total of 11 randomized controlled trials with 6740 patients were included. For the primary outcome, a pooled analysis (3.2 vs 5.6%). For secondary outcomes, the risk was significantly low in image-guided percutaneous intervention compared with angiography. Conclusion: Intravascular imaging-guided PCI is significantly more effective than angiography-guided PCI in reducing the risk of target lesion revascularization, target vessel revascularization, cardiac death, major adverse cardiovascular events and stent thrombosis.

Mental Nerve Neurectomy: A Comparison of Titanium Screw Versus Gutta-Percha Oburation of the Mental Foramen.

OBJECTIVE:  This study aims to compare the two mental foramen obturating techniques in parameters like operator's ease, postoperative displacement of obturation material, and remission of pain after peripheral neurectomy in patients with trigeminal neuralgia. STUDY DESIGN:  This study adopts a single-centered comparative analytical approach. PLACE AND DURATION OF STUDY: This study was performed in the Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry (AFID), from October 1, 2023, to February 10, 2024. METHODOLOGY: Sixty patients fulfilling the inclusion criteria were included and divided into two groups (30 each), and peripheral neurectomy was performed under local anesthesia. In one group, gutta-percha sticks were used to obturate the foramina, and in the other group, titanium screws were used. Postoperatively, the operator's ease, postoperative displacement, and relapse of pain were recorded. RESULTS:  Titanium screws were easy to handle, and there was no relapse of pain because of no displacement postoperatively when compared with gutta-percha sticks, which were hard to manipulate and showed a relapse of pain. CONCLUSIONS:  Titanium screws have better postoperative outcomes when compared with gutta-percha sticks in terms of the operator's ease, relapse of pain, and postoperative displacement.

Construction and Validation of the Belief in Divine Retribution Scale for Pakistani Muslims.

The purpose of the study was to construct and validate a Belief in Divine Retribution Scale for the Pakistani Muslim population. The process of construction and validation was completed by following standardized guidelines for scale construction (Boateng et al., 2018). The present study was carried out in four phases. In phase I, the task of item generation was completed through literature review and interviews (inductive and deductive approaches). Phase II aimed at exploration of factor structure. Exploratory factor analysis was carried out on a sample of seven hundred Muslim participants. Data for EFA were collected through a purposive sampling technique, which comprised both men (n = 339) and women (n = 361) with an age range of 18 to 69 years. Results of EFA revealed a two-factor structure with a cumulative variance of 42.59 and with a Cronbach alpha reliability of .83. To confirm the obtained factor structure, Phase III was carried out on a sample of three hundred Muslim participants. The results of CFA confirmed the two-dimensional factor structure with a good model fit to the data. Phase IV provided evidence of convergent and discriminant validity of the scale. Moreover, data for validation were collected from an independent sample (N = 204). Finally, the results of validation revealed that there exists a significant positive correlation of Belief in Divine Retribution Scale with Belief in Just World Scale, which provided evidence of convergent validity. However, there exists a non-significant correlation of Belief in Divine Retribution Scale with Religious Practice Subscale of Short Muslim Practice and Belief Scale, and it provided evidence of discriminant validity. Implications along with limitations and suggestions for future research have also been mentioned.

Insights into hippocampal perfusion using high-resolution, multi-modal 7T MRI.

We present a comprehensive study on the non-invasive measurement of hippocampal perfusion. Using high-resolution 7 tesla arterial spin labeling (ASL) data, we generated robust perfusion maps and observed significant variations in perfusion among hippocampal subfields, with CA1 exhibiting the lowest perfusion levels. Notably, these perfusion differences were robust and already detectable with 50 perfusion-weighted images per subject, acquired in 5 min. To understand the underlying factors, we examined the influence of image quality metrics, various tissue microstructure and morphometric properties, macrovasculature, and cytoarchitecture. We observed higher perfusion in regions located closer to arteries, demonstrating the influence of vascular proximity on hippocampal perfusion. Moreover, ex vivo cytoarchitectonic features based on neuronal density differences appeared to correlate stronger with hippocampal perfusion than morphometric measures like gray matter thickness. These findings emphasize the interplay between microvasculature, macrovasculature, and metabolic demand in shaping hippocampal perfusion. Our study expands the current understanding of hippocampal physiology and its relevance to neurological disorders. By providing in vivo evidence of perfusion differences between hippocampal subfields, our findings have implications for diagnosis and potential therapeutic interventions. In conclusion, our study provides a valuable resource for extensively characterizing hippocampal perfusion.

Engineered nanomicelles inhibit the tumour progression via abrogating the prostaglandin-mediated immunosuppression.

Cancer treatment is challenged due to immunosuppressive inflammatory tumour microenvironment (TME) caused by infiltration of tumour-promoting and inhibition of tumour-inhibiting immune cells. Here, we report the engineering of chimeric nanomicelles (NMs) targeting the cell proliferation using docetaxel (DTX) and inflammation using dexamethasone (DEX) that alters the immunosuppressive TME. We show that a combination of phospholipid-DTX conjugate and PEGylated-lipid-DEX conjugate can self-assemble to form sub-100 nm chimeric NMs (DTX-DEX NMs). Anti-cancer activities against syngeneic and xenograft mouse models showed that the DTX-DEX NMs are more effective in tumour regression, enhance the survival of mice over other treatment modes, and alter the tumour stroma. DTX-DEX NMs cause a significant reduction in myeloid-derived suppressor cells, alter the polarization of macrophages, and enhance the accumulation of cytotoxic CD4+ and CD8+ T cells in tumour tissues, along with alterations in cytokine expression. We further demonstrated that these DTX-DEX NMs inhibit the synthesis of prostaglandins, especially PGE2, by targeting the cyclooxygenase 2 that is partly responsible for immunosuppressive TME. Therefore, this study presents, for the first time, the engineering of lithocholic acid-derived chimeric NMs that affect the prostaglandin pathway, alter the TME, and mitigate tumour progression with enhanced mice survival.

Post-pandemic paradigm shift toward telemedicine and tele-education; an updated survey of the impact of Covid-19 pandemic on neurosurgery residents in United States.

Background: Several strategies were implemented during the Covid-19 pandemic to enhance residency training and patient care. Objective: This study aims to assess the post-pandemic landscape of neurosurgical training and practice. Method: A survey consisting of 28 questions examining the challenges faced in neurosurgery and the adaptive measures was conducted among US neurosurgery residents from May 2022 to May 2023. Results: This study encompassed 59 neurosurgical residents, predominantly male (72.9%) and in later years of training (66.1%) and were distributed across 25 states. Telemedicine and tele-education were pivotal during the pandemic, with virtual lecture series, standalone lectures, and virtual discussions highly favored. Remote didactic learning increased for nearly half of the residents, while 54.2% resumed in-person instruction. Telemedicine was deemed effective by 86.4% for evaluating neurosurgical patients. Access to teaching environments was restricted for 61.0% of residents, impacting their training. The pandemic significantly influenced elective surgeries, with complete cancellations reported by 42.4%. Reduced faculty engagement was noted by 35.6% of residents, while 47.5% reported a negative impact on the overall resident experience. The majority (76.3%) considered changes to their training reasonable given the global health situation. Conclusions: Strategies implemented during the peak of the pandemic remain crucial in shaping neurosurgery training. Telemedicine has become indispensable, with widespread adoption. Tele-education has also expanded, providing additional learning opportunities. However, traditional didactic courses and hands-on experiences remain essential for comprehensive training. Balancing technology-driven methods with established approaches is crucial for optimizing neurosurgical education and maintaining high-quality patient care.

Psychological impact of the COVID-19 pandemic in children with autism spectrum disorder - a literature review.

Objective: This review summarizes evidence pertaining to the impact of the COVID-19 pandemic on the psychological health of children and adolescents with autism spectrum disorder (ASD). Materials and Methods: An electronic search was conducted using four major databases: PubMed, ScienceDirect, Web of Science, and Google Scholar. Using an umbrella methodology, the reference lists of relevant papers were reviewed, and citation searches were conducted. The study included articles written in English between January 2020 and March 2021 that focused on the psychological health of autistic children and adolescents. Results: All eight studies included in the final review were cross-sectional. Three of the eight studies were conducted in Italy, two in Turkey, and one study each in Portugal, Spain, and the United Kingdom, with a total of 1,407 participants. All studies used a mixture of standardized and non-standardized questionnaires to collect data. The total number of patients were 1407 at a mean age of 9.53 (SD = 2.96) years. Seven studies report gender; male 74.7% (657/880) and female 25.3% (223/880). The finding showed that behavioral issues in children and adolescents with ASD have significantly increased; 521 (51.9 percent) of the 1004 individuals with ASD presented with behavioral changes, including conduct problems, emotional problems, aggression, and hyperactivity. Some studies also found increased anxiety and difficulties managing emotions. Only one study reported clinical stabilization in children with ASD during COVID-19. Finally, 82.7% of families and caregivers of children with ASD (544 out of 658) faced challenges during COVID-19. Conclusion: Although the studies in this review suggest a general worsening of ASD children's clinical status, it remains difficult to draw definitive conclusions at this moment, with newer COVID-19 variants on the rise worldwide. During this difficult pandemic period, caregivers, families, and healthcare professionals are recommended to pay more attention to the ASD patients' health and care needs.

Distinct Time-resolved Brain-wide Coactivations in Oxygenated and Deoxygenated Hemoglobin.

OBJECTIVE: Human resting-state networks (RSNs) estimated from oxygenated (HbO) and deoxygenated hemoglobin (HbR) data exhibit strong similarities, while task-based studies show different dynamics in HbR and HbO responses. Such a discrepancy might be explained due to time-averaged estimations of RSNs. Our study investigated differences between HbO and HbR on time-resolved brain-wide coactivation patterns (CAPs). APPROACH: Diffuse optical tomography was reconstructed from resting-state whole-head functional near-infrared spectroscopy data of HbR and HbO in individual healthy participants. Timeaveraged RSNs were obtained using the group-level independent component analysis. Time-resolved CAPs were estimated using a clustering approach on the time courses of all obtained RSNs. Characteristics of the RSNs and CAPs from HbR and HbO were compared. MAIN RESULTS: Spatial patterns of HbR and HbO RSNs exhibited significant similarities. Meanwhile, HbR CAPs revealed much more organized spatial and dynamic characteristics than HbO CAPs. The entire set of HbR CAPs suggests a superstructure resulted from brain-wide neuronal dynamics, which is less evident in the set of HbO CAPs. These differences between HbO and HbR CAPs were consistently replicated in individual session data. CONCLUSION: Our results suggest that human resting brain-wide neuronal activations are preserved better in time-resolved brainwide patterns, i.e., CAPs, from HbR than those from HbO, while such a difference is lost between time-averaged HbR and HbO RSNs. SIGNIFICANCE: Our results reveal, for the first time, HbR concentration fluctuations are more directly coupled with resting dynamics of brain-wide neuronal activations in human brains.

Microplastic contamination in the agricultural soil-mitigation strategies, heavy metals contamination, and impact on human health: a review.

Microplastic pollution has emerged as a critical global environmental issue due to its widespread distribution, persistence, and potential adverse effects on ecosystems and human health. Although research on microplastic pollution in aquatic environments has gained significant attention. However, a limited literature has summarized the impacts of microplastic pollution the agricultural land and human health. Therefore, In the current review, we have discussed how microplastic(s) affect the microorganisms by ingesting the microplastic present in the soil, alternatively affecting the belowground biotic and abiotic components, which further elucidates the negative effects on the above-ground properties of the crops. In addition, the consumption of these crops in the food chain revealed a potential risk to human health throughout the food chain. Moreover, microplastic pollution has the potential to induce a negative impact on agricultural production and food security by altering the physiochemical properties of the soil, microbial population, nutrient cycling, and plant growth and development. Therefore, we discussed in detail the potential hazards caused by microplastic contamination in the soil and through the consumption of food and water by humans in daily intake. Furthermore, further study is urgently required to comprehend how microplastic pollution negatively affects terrestrial ecosystems, particularly agroecosystems which drastically reduces the productivity of the crops. Our review highlights the urgent need for greater awareness, policy interventions, and technological solutions to address the emerging threat of microplastic pollution in soil and plant systems and mitigation strategies to overcome its potential impacts on human health. Based on existing studies, we have pointed out the research gaps and proposed different directions for future research.

Unpacking the optimistic mindset of business students towards entrepreneurship.

Entrepreneurial ventures are established in large numbers in China. The success rate of these entrepreneurial ventures is lower than that of new startups. Mismanagement and a lack of creative skills among entrepreneurs are cited as reasons for entrepreneurial failure in China. The current study investigates the impact of entrepreneurial networking and new venture intention on entrepreneurial success in China, with psychological capital and entrepreneurial optimism serving as moderators. 483 responses were collected from business students in China for data analysis. The findings of the study reveal that the impact of entrepreneurial networking and new venture intention on entrepreneurial success in China, with the moderating role of psychological capital and entrepreneurial optimism, is significant. The theoretical framework of this research has novelty as it introduces new moderating relationships of psychological capital and entrepreneurial optimism in the model of entrepreneurial success. Practically, this study has revealed that entrepreneurial success can be achieved with entrepreneurial networking, entrepreneurial optimism, psychological capital, and new venture intention. The directions of this research point out additional gaps in the literature that scholars should discuss in subsequent studies.

Increased iron in the substantia nigra pars compacta identifies patients with early Parkinson'sdisease: A 3T and 7T MRI study.

Degeneration in the substantia nigra (SN) pars compacta (SNc) underlies motor symptoms in Parkinson's disease (PD). Currently, there are no neuroimaging biomarkers that are sufficiently sensitive, specific, reproducible, and accessible for routine diagnosis or staging of PD. Although iron is essential for cellular processes, it also mediates neurodegeneration. MRI can localize and quantify brain iron using magnetic susceptibility, which could potentially provide biomarkers of PD. We measured iron in the SNc, SN pars reticulata (SNr), total SN, and ventral tegmental area (VTA), using quantitative susceptibility mapping (QSM) and R2* relaxometry, in PD patients and age-matched healthy controls (HCs). PD patients, diagnosed within five years of participation and HCs were scanned at 3T (22 PD and 23 HCs) and 7T (17 PD and 21 HCs) MRI. Midbrain nuclei were segmented using a probabilistic subcortical atlas. QSM and R2* values were measured in midbrain subregions. For each measure, groups were contrasted, with Age and Sex as covariates, and receiver operating characteristic (ROC) curve analyses were performed with repeated k-fold cross-validation to test the potential of our measures to classify PD patients and HCs. Statistical differences of area under the curves (AUCs) were compared using the Hanley-MacNeil method (QSM versus R2*; 3T versus 7T MRI). PD patients had higher QSM values in the SNc at both 3T (padj = 0.001) and 7T (padj = 0.01), but not in SNr, total SN, or VTA, at either field strength. No significant group differences were revealed using R2* in any midbrain region at 3T, though increased R2* values in SNc at 7T MRI were marginally significant in PDs compared to HCs (padj = 0.052). ROC curve analyses showed that SNc iron measured with QSM, distinguished early PD patients from HCs at the single-subject level with good diagnostic accuracy, using 3T (mean AUC = 0.83, 95 % CI = 0.82-0.84) and 7T (mean AUC = 0.80, 95 % CI = 0.79-0.81) MRI. Mean AUCs reported here are from averages of tests in the hold-out fold of cross-validated samples. The Hanley-MacNeil method demonstrated that QSM outperforms R2* in discriminating PD patients from HCs at 3T, but not 7T. There were no significant differences between 3T and 7T in diagnostic accuracy of QSM values in SNc. This study highlights the importance of segmenting midbrain subregions, performed here using a standardized atlas, and demonstrates high accuracy of SNc iron measured with QSM at 3T MRI in identifying early PD patients. QSM measures of SNc show potential for inclusion in neuroimaging diagnostic biomarkers of early PD. An MRI diagnostic biomarker of PD would represent a significant clinical advance.

Exploring the Impact of Social Media Sites on Compulsive Shopping Behavior: The Mediating Role of Materialism.

Purpose: This study aims to examine the influence of social media sites and television advertisements on compulsive shopping behavior, and whether this influence is mediated by materialism in the university students of Saudi Arabia. Methods: Data was collected from 487 students at Saudi universities. AMOS and Structural equation modeling (SEM) were utilized to examine the data. The research supports the Hypothesis that adolescents who are more materialistic are more prone than less materialistic adolescents to engage in compulsive shopping behavior. Results: The findings were consistent with other research, suggesting that the same remains true in the culture of Saudi Arabia. The research's findings show that television advertisements and the use of social media sites positively related to compulsive shopping behavior among university students, and materialism mediated the relationship between television advertisements and social media sites. Conclusion: The research emphasizes the significance of comprehending the materialistic attitude and consumption choices of adolescents and offers crucial information for scholars, decision-makers, and management of top companies.

OsUGE2 Regulates Plant Growth through Affecting ROS Homeostasis and Iron Level in Rice.

BACKGROUND: The growth and development of rice (Oryza sativa L.) are affected by multiple factors, such as ROS homeostasis and utilization of iron. Here, we demonstrate that OsUGE2, a gene encoding a UDP-glucose 4-epimerase, controls growth and development by regulating reactive oxygen species (ROS) and iron (Fe) level in rice. Knockout of this gene resulted in impaired growth, such as dwarf phenotype, weakened root growth and pale yellow leaves. Biochemical analysis showed that loss of function of OsUGE2 significantly altered the proportion and content of UDP-Glucose (UDP-Glc) and UDP-Galactose (UDP-Gal). Cellular observation indicates that the impaired growth may result from decreased cell length. More importantly, RNA-sequencing analysis showed that knockout of OsUGE2 significantly influenced the expression of genes related to oxidoreductase process and iron ion homeostasis. Consistently, the content of ROS and Fe are significantly decreased in OsUGE2 knockout mutant. Furthermore, knockout mutants of OsUGE2 are insensitive to both Fe deficiency and hydrogen peroxide (H2O2) treatment, which further confirmed that OsUGE2 control rice growth possibly through Fe and H2O2 signal. Collectively, these results reveal a new pathway that OsUGE2 could affect growth and development via influencing ROS homeostasis and Fe level in rice.

Simulation of transvascular transport of nanoparticles in tumor microenvironments for drug delivery applications.

Nanomedicine is a promising approach for tumor therapy but penetration is challenged by complex tumor microenvironments. The purpose of this study is to design nanoparticles and analyze their transport in two abnormal microenvironments through a 2-D simulation. Employing a Computational Fluid Dynamics (CFD) approach, tumor vascular-interstitial models were initially simulated, and the impact of nanoparticles on the velocity profile and pressure gradient within the tumor microenvironment was observed. Through meticulous mesh analysis, it was determined that optimal outcomes were achieved using a quadrilateral meshing method for pancreatic tumor and a quad/tri meshing method for hepatic tumor. Results showed an increase in vessel diameter correlated with elevated blood flow velocity, reaching a maximum of 1.40 × 10^-3 m/s with an expanding cell gap. The simulation results for pressure distribution show that as vessel diameter increases, the velocity of nanoparticles in blood increases and decreases the pressure of blood. Intriguingly, distinct fluid flow patterns in pancreatic and hepatic tumors, emphasize how microenvironmental differences, specifically cell pore size, profoundly impact therapeutic agent transport, with implications for drug delivery strategies in cancer therapy. These simulation-based insights enable researchers to anticipate nanofluid behavior in realistic settings. Future work, incorporating immune cells, will enhance the understanding of nanoparticle efficiency in cancer therapy.

Early neurological changes in aging cervical spine: insights from PROMIS mobility assessment.

Many studies have shown that the prevalence of degenerative spinal cord compression increases with age. However, most cases at early stages are asymptomatic, and their diagnosis remains challenging. Asymptomatic cervical spinal cord compression (ASCC) patients are more likely to experience annular tears, herniated disks, and later develop symptomatic compression. Asymptomatic individuals do not typically undergo spinal cord imaging; therefore, an assessment test that is both sensitive and specific in diagnosing ASCC may be helpful. It has been demonstrated that the Patient Reported Outcome Measure Information System (PROMIS) mobility test is sensitive in detecting degenerative cervical myelopathy (DCM) symptoms. We investigated the use of the PROMIS mobility test in assessing clinical dysfunction in ASCC. In this study, 51 DCM patients and 42 age-matched healthy control (HC) were enrolled. The degree of cervical spinal cord compression was assessed using the high-resolution cervical spinal cord T2 Weighted (T2w) MRIs, which were available for 14 DCM patients. Measurements of the spinal cords anterior-posterior (AP) diameter at the region(s) that were visibly compressed as well as at different cervical spine levels were used to determine the degree of compression. The age-matched HC cohort had a similar MRI to establish the normal range for AP diameter. Twelve (12) participants in the HC cohort had MRI evidence of cervical spinal cord compression; these individuals were designated as the ASCC cohort. All participants completed the PROMIS mobility, PROMIS pain interference (PI), PROMIS upper extremity (UE), modified Japanese orthopedic association (mJOA), and neck disability index (NDI) scoring scales. We examined the correlation between the AP diameter measurements and the clinical assessment scores to determine their usefulness in the diagnosis of ASCC. Furthermore, we examine the sensitivity and specificity of PROMIS mobility test and mJOA. Compared to the HC group, the participants in the ASCC and DCM cohorts were significantly older (p = 0.006 and p < 0.0001, respectively). Age differences were not observed between ASCC and DCM (p > 0.999). Clinical scores between the ASCC and the HC group were not significantly different using the mJOA (p > 0.99), NDI (p > 0.99), PROMIS UE (p = 0.23), and PROMIS PI (p = 0.82). However, there were significant differences between the ASCC and HC in the PROMIS mobility score (p = 0.01). The spinal cord AP diameter and the PROMIS mobility score showed a significant correlation (r = 0.44, p = 0.002). Decreasing PROMIS mobility was significantly associated with a decrease in cervical spinal cord AP diameter independent of other assessment measures. PROMIS mobility score had a sensitivity of 77.3% and specificity of 79.4% compared to 59.1% and 88.2%, respectively, for mJOA in detecting cervical spinal cord compression. Certain elements of ASCC are not adequately captured with the traditional mJOA and NDI scales used in DCM evaluation. In contrast to other evaluation scales utilized in this investigation, PROMIS mobility score shows a significant association with the AP diameter of the cervical spinal cord, suggesting that it is a sensitive tool for identifying early disability associated with degenerative change in the aging spine. In a comparative analysis of PROMIS mobility test against the standard mJOA, the PROMIS mobility demonstrated higher sensitivity for detecting cervical spinal cord compression. These findings underscore the potential use of PROMIS mobility score in clinical evaluation of the aging spine.

Solvent Geometry Regulated J- and H-Type Aggregates of Photoswitchable Organogelator: Phase-Selective Thixotropic Gelation and Oil Spill Recovery.

We demonstrate supramolecular polymerization and formation of 1D nanofiber of azobenzene based organogelator (AZO-4) in cyclic hydrocarbon solvents (toluene and methylcyclohexane). The AZO-4 exhibits J- and H-type aggregates in toluene: MCH (9 : 1) and MCH: toluene (9 : 1) respectively. The type of aggregate was governed by the geometry of the solvents used in the self-assembly process. The J-type aggregates with high thermal stability in toluene is due to the enhanced interaction of AZO-4 π- surface with the toluene π-surface, whereas H-aggregate with moderate thermal stability in MCH was due to the interruption of the cyclic hydrocarbon in van der Waals interactions of peripheral chains of AZO-4 molecule. The light induced reversible photoisomerization is observed for both J- and H-aggregates. The macroscopic property revealed spontaneous and strong gelation in toluene preferably due to the strong interactions of the AZO-4 nanofibers with the toluene solvent molecules compared to the MCH. The rheological measurements revealed thixotropic nature of the gels by step-strain experiments at room temperature. The thermodynamic parameter (ΔHm) of gel-to-sol transition was determined for all the gels to get more insight into the gelation property. Furthermore, the phase selective gelation property was extended to the oil spill recovery application using diesel/water and petrol/water mixture.

Systematic review protocol for complications following surgical decompression of degenerative cervical myelopathy.

BACKGROUND: Degenerative Cervical Myelopathy (DCM) is one of the most common degenerative disorders of cervical spine and sources of cord dysfunction in adults. It usually manifests with neurologic presentations such as loss of dexterity and gait issues. Treatment for moderate and severe cases of DCM is surgical decompression of the region. There are many approaches available for surgical intervention which could be categorized into anterior and posterior based on the side of neck where operation takes place. Additionally, for certain cases the hybridized anterior-posterior combined surgery is indicated. While there are many technical differences between these approaches with each having its own advantages, the complications and safety profiles of them are not fully disclosed. This protocol aims to systematically search for current reports on complications of surgical decompression methods of DCM and pool them for robust evidence generation. METHOD: Search will be carried out in PubMed, Scopus, and Cochrane databases for retrospective and prospective surgical series, cohorts, or trials being performed for DCM with at least a sample size of 20 patients. Query strings will be designed to capture reports with details of complications with no year limit. Studies not being original (e.g., review articles, case reports, etc.), not in English, having patients younger than 18-years-old, and not reporting at least one complication will be excluded. Two independent reviewers will review the titles and abstracts for first round of screening. Full text of retrieved studies from previous round will be screened again by the same reviewers. In case of discrepancy, the third senior reviewer will be consulted. Eligible studies will then be examined for data extraction where data will be recorded into standardized form. Cumulative incidence and 95% confidence intervals of complication will be then pooled based on generalized linear mixed models with consideration of approach of surgery as subgroups. Heterogeneity tests will be performed for assessment of risk of bias. DISCUSSION: This systematic review is aimed at providing practical information for spine surgeons on the rates of complications of different surgical approaches of DCM decompression. Proper decision-making regarding the surgical approach in addition to informing patients could be facilitated through results of this investigation.