28232 research outputs found
Sort by
148 Predictive Model for Return to Work After Elective Surgery for Lumbar Degenerative Disease: An Analysis From National Neurosurgery Quality Outcomes Database Registry
No full textINTRODUCTION: The current costs associated with spine care are unsustainable. The productivity loss and time away from work in gainfully employed patients contributes greatly to the financial burden. Therefore, it is vital to identify the factors associated with returning to work after lumbar spine surgery. We present a predictive model of ability to return to work (RTW) after lumbar spine surgery for degenerative spine disease
Modern slavery and adolescence: A rapid evidence review
No full textThis evidence review assesses existing academic and grey literature on adolescent experiences of modern slavery in all the seven GAGE countries. We focus on all forms of modern slavery present in each country, connecting them to broader dynamics and drivers of modern slavery such as migration, conflict, poverty, and family dynamics, with a specific focus on gender.
We then look at existing international and national legal frameworks in place to tackle modern slavery, and review evidence of four types of initiatives (preventive, remedial, rescue, legal/policy). We provide information on their different scopes and aims, and an overview of how they have worked so far. We conclude by providing a set of recommendations for program design and delivery, policies, and research
Evaluation of Five International HBV Treatment Guidelines: Recommendation for Resource-Limited Developing Countries Based on the National Study in Nepal.
No full textHepatitis B virus (HBV) infects the liver, causing cirrhosis and cancer. In developed countries, five international guidelines have been used to make a decision for the management of patients with chronic HBV infection. In this review, since the guidelines were established by clinical and epidemiological data of developed countries, we aimed to evaluate whether (1) HBV patient profiles of developing countries are similar to developed countries, and (2) which guideline can be applicable to resource-limited developing countries. First, as an example of the most recent data of HBV infections among developing countries, we evaluated the national HBV viral load study in Nepal, which were compared with the data from other developing countries. In Nepal, the highest number of patients had viral loads of 20-2000 IU/mL (36.7%) and belonged to the age group of 21-30 years; HBV epidemiology in Nepal, based on the viral loads, gender, and age groups was similar to those of not only other developing countries but also developed countries. Next, we reviewed five international HBV treatment guidelines of the World Health Organization (WHO), American Association for the Study of Liver Diseases (AASLD), National Institute for Health and Care Excellence (NICE), European Association for the Study of the Liver (EASL), and Asian Pacific Association for the Study of the Liver (APASL). All guidelines require the viral load and alanine aminotransferase (ALT) levels for decision making. Although four guidelines recommend elastography to assess liver cirrhosis, the WHO guideline alternatively recommends using the aspartate aminotransferase (AST)-to-platelet ratio index (APRI), which is inexpensive and conducted routinely in most hospitals. Therefore, in resource-limited developing countries like Nepal, we recommend the WHO guideline for HBV treatment based on the viral load, ALT, and APRI information
Respiratory Viral Infections and Their Association with Acute Febrile Illness Within Nicaragua
No full textAcute febrile illness (AFI) is defined as a non-localized fever of ≥ 38oC and affects many individuals around the world. Due to many different diseases causing AFI, it can often be difficult to diagnose patients with the correct etiology. As such, it is hypothesized that a significant percentage of patients within Leon, Nicaragua are often misdiagnosed with ailments such as dengue fever when a respiratory virus is the etiologic agent causing the patient’s AFI. 262 Nasopharyngeal swabs from patients ≧ 1 year old were obtained between January 2021 and March 2022 at the Hospital Escuela Oscar Danilo Rosales Arguello (HEODRA) located in Leon, Nicaragua. The DNA and/or RNA of each sample was extracted using the Qiagen EZ1 Advanced XL alongside the EZ1 virus kit. After DNA/RNA extraction the samples were then sequenced via real-time polymerase chain reaction (RT-PCR) on the Luminex Integrated System NxTAG Respiratory Pathogen Panel (RPP) platform which detects a multitude of respiratory pathogens. The RPP panel results were then cross-referenced with each patient’s sociodemographics, clinical symptoms, and end diagnosis. Around 20% of patient samples tested positive on the RPP in which rhinovirus/enterovirus and influenza A were the most detected targets. These patients were often younger and more likely to be male, work in an office, have a shorter fever and rhinitis, and be diagnosed with dengue. These results support the hypothesis as well as show differences in symptoms that providers can use to better diagnose patients.
</p
Relationship between body mass index and sagittal vertical axis change as well as health-related quality of life in 564 patients after deformity surgery.
No full textObjectiveObesity, a condition that is increasing in prevalence in the United States, has previously been associated with poorer outcomes following deformity surgery, including higher rates of perioperative complications such as deep and superficial infections. To date, however, no study has examined the relationship between preoperative BMI and outcomes of deformity surgery as measured by spine parameters such as the sagittal vertical axis (SVA), as well as health-related quality of life (HRQoL) measures such as the Oswestry Disability Index (ODI) and Scoliosis Research Society-22 patient questionnaire (SRS-22). To this end, the authors sought to clarify the relationship between BMI and postoperative change in SVA as well as HRQoL outcomes.MethodsThe authors performed a retrospective review of a prospectively managed multicenter adult spinal deformity database collected and maintained by the International Spine Study Group (ISSG) between 2009 and 2014. The primary independent variable considered was preoperative BMI. The primary outcome was the change in SVA at 1 year after deformity surgery. Postoperative ODI and SRS-22 outcome measures were evaluated as secondary outcomes. Generalized linear models were used to model the primary and secondary outcomes at 1 year as a function of BMI at baseline, while adjusting for potential measured confounders.ResultsIncreasing BMI (compared to BMI 30 appeared to be associated with poorer outcomes as determined by the ODI, this correlation did not reach statistical significance.ConclusionsBaseline BMI did not affect the achievable SVA at 1 year postsurgery. Further studies should evaluate whether even in the absence of a change in SVA, baseline BMIs in the obese range are associated with worsened HRQoL outcomes after spinal surgery
Oral sazetidine-A, a selective α4β2* nicotinic receptor desensitizing agent, reduces nicotine self-administration in rats.
No full textSazetidine-A selectively desensitizes α4β2 nicotinic receptors and also has partial agonist effects. We have shown that subcutaneous acute and repeated injections as well as chronic infusions of sazetidine-A significantly reduce intravenous (IV) nicotine self-administration in rats. To further investigate the promise of sazetidine-A as a smoking cessation aid, it is important to determine sazetidine-A effects with oral administration and the time-effect function for its action on nicotine self-administration. Young adult female Sprague-Dawley rats were trained to self-administer IV nicotine at the benchmark dose of 0.03 mg/kg/infusion dose in an operant FR1 schedule in 45-min sessions. After five sessions of training, they were tested for the effects of acute oral doses of sazetidine-A (0, 0.3, 1 and 3 mg/kg) given 30 min before testing. To determine the time-effect function, these rats were administered 0 or 3 mg/kg of sazetidine-A 1, 2, 4 or 23 h before the onset of testing. Our previous study showed that with subcutaneous injections, only 3 mg/kg of sazetidine-A significantly reduced nicotine self-administration, however, with oral administration of sazetidine-A lower dose of 1 mg/kg was also effective in reducing nicotine intake. A similar effect was seen in the time-effect study with 3 mg/kg of oral sazetidine-A causing a significant reduction in nicotine self-administration across all the time points of 1, 2, 4 or 23 h after oral administration. These results advance the development of sazetidine-A as a possible aid for smoking cessation by showing effectiveness with oral administration and persistence of the effect over the course of a day
Postsynaptic positioning of endocytic zones and AMPA receptor cycling by physical coupling of dynamin-3 to Homer.
No full textEndocytosis of AMPA receptors and other postsynaptic cargo occurs at endocytic zones (EZs), stably positioned sites of clathrin adjacent to the postsynaptic density (PSD). The tight localization of postsynaptic endocytosis is thought to control spine composition and regulate synaptic transmission. However, the mechanisms that situate the EZ near the PSD and the role of spine endocytosis in synaptic transmission are unknown. Here, we report that a physical link between dynamin-3 and the postsynaptic adaptor Homer positions the EZ near the PSD. Disruption of dynamin-3 or its interaction with Homer uncouples the PSD from the EZ, resulting in synapses lacking postsynaptic clathrin. Loss of the EZ leads to a loss of synaptic AMPA receptors and reduced excitatory synaptic transmission that corresponds with impaired synaptic recycling. Thus, a physical link between the PSD and the EZ ensures localized endocytosis and recycling by recapturing and maintaining a proximate pool of cycling AMPA receptors
Uncovering Blue Technology: An Inventory and Analysis of Technologies Addressing Illegal, Unreported, and Unregulated Fishing
No full textOverfishing disproportionately impacts the public health and economies of coastal developing nations (Golden et al. 2016). Illegal, unreported, and unregulated (IUU) fishing drives overfishing by undermining the ability of fishery managers to set and enforce harvest quotas and other management strategies (Sumaila et al. 2020). A variety of technological solutions – from satellite monitoring of fishing vessels to transparency tools facilitating consumption of legal catch – have been proposed as potential solutions to IUU fishing. Despite growing investment in these tools, no comprehensive inventory and analysis of these solutions exists, undermining collaboration in technological development, use of promising tools, and optimization of global funding. This project employed a systematic review of news media articles and seafood technology databases to catalog 168 anti-IUU technologies – the most comprehensive inventory of these technologies to date. Within these 168 technologies, the most commonly observed types of technologies were tools which integrate and synthesize data to support manager decision-making (Data Synthesis), tools which facilitate the reporting of catch (Electronic Catch Reporting), and tools which track vessel locations (VMS). The most frequently discussed parent organization within the news media corpus was Global Fishing Watch, and the species group to which technologies were most frequently applied was Tuna. Application location of these technologies covered the globe with no clear geospatial pattern while headquarters were concentrated in Europe and North America. We hypothesize that these results suggest a) a lack of collaboration in this space, b) the role of regulatory compliance and technology mode in driving technology development, c) the impact of demand by wealthy consumers on technology application and d) the export of anti-IUU technologies from Europe and North America to nations around the globe. We hope that this inventory provides insight and support to the development and application of technologies addressing IUU fishing
SRS-22R Minimum Clinically Important Difference and Substantial Clinical Benefit After Adult Lumbar Scoliosis Surgery.
No full textSTUDY DESIGN:Longitudinal cohort. OBJECTIVES:To determine if the minimum clinically important difference (MCID) and substantial clinical benefit (SCB) thresholds for the Scoliosis Research Society-22R (SRS22R) domains in patients with degenerative lumbar scoliosis are similar to those in patients with adult spinal deformity (ASD) with fusions extending into the thoracic spine. SUMMARY OF BACKGROUND DATA:The MCID and SCB thresholds for the SRS22R domains in patients with ASD and adolescent idiopathic scoliosis have been reported. METHODS:Patients enrolled in the NIH-sponsored Adult Symptomatic Lumbar Scoliosis (ASLS) trial who underwent surgery and completed the SRS22R preoperative and the SRS30 one-year postoperative were identified. One-year postoperative answers to the last eight questions of the SRS30 were used as anchors to determine the MCID and SCB for the Pain, Appearance, and Activity domains, and the Subscore and Total score using receiver operating characteristic (ROC) curve analysis. RESULTS:The sample population consisted of 147 patients. A total of 132 (89%) were females with a mean age of 59.4 years. There was a statistically significant improvement in all SRS22R scores from preoperative to one-year postoperative. There was also a statistically significant difference in domain scores among the different responses to the anchors. According to the ROC analysis, MCID was 1.17 for Appearance, 0.40 for Activity, 0.60 for Pain, 0.53 for Subscore, and 0.77 for Total; and SCB was 1.67 for Appearance, 0.60 for Activity, 0.62 for Subscore, and 1.11 for Total score. These are similar to previous reports of MCID and SCB thresholds for ASD patients who underwent fusion to the thoracic spine. CONCLUSION:The MCID and SCB thresholds for the SRS22R domains in patients with adult symptomatic lumbar scoliosis are very similar to the threshold values previously reported for adult deformity patients. LEVEL OF EVIDENCE:Level II