Hydrochemical characterization and pCO dynamics in the surface waters of Himalayan River: A case study of river Alaknanda.

Chemical weathering processes are becoming increasingly important in studies on carbon cycling because they are responsible for increased solute fluxes in the proglacial zone, can effectively sequester atmospheric CO and raise carbon budgets for lateral transport via rivers. Here, we examined the hydrochemical and hydrogeochemical processes, solute sources and factors controlling riverine pCO of the Alaknanda River and its tributaries for three sampling seasons, viz. pre-monsoon (May 2021), post-monsoon (October 2021) and winter (January 2022).

Optimal Treatment Strategies for cT2 Staged Adenocarcinoma of the Esophagus and the Gastroesophageal Junction: A Multinational, High-volume Center Retrospective Cohort Analysis.

Objective: To evaluate outcomes after primary surgery (PS) or neoadjuvant treatment followed by surgery (NAT/S) in cT2 staged adenocarcinomas of the esophagus (EAC) and gastroesophageal junction (GEJ), a multinational high-volume center study was undertaken.

Background: The optimal treatment approach with either NAT/S or PS for clinically staged cT2cN any or cT2N0 EAC and GEJ remains unknown due to the lack of randomized controlled trials.

Methods: A retrospective analysis of prospectively maintained databases from 10 centers was performed.

Landet: an efficient physics-informed deep learning approach for automatic detection of anatomical landmarks and measurement of spinopelvic alignment.

Purpose: An efficient physics-informed deep learning approach for extracting spinopelvic measures from X-ray images is introduced and its performance is evaluated against manual annotations.

Methods: Two datasets, comprising a total of 1470 images, were collected to evaluate the model's performance. We propose a novel method of detecting landmarks as objects, incorporating their relationships as constraints (LanDet).

Contact lens-related complications in austere conditions among military personnel: a systematic review.

Introduction: Military service personnel are required to deploy to austere environments where they are exposed to harsh conditions. Many service personnel continue to wear contact lenses when deployed as they are an effective alternative to spectacles by affording superior ergonomic functionality, although they are associated with significant complications. We aimed to explore the prevalence and type of contact lens-related complications among deployed service personnel worldwide.

4A after access: a new mnemonic to aid timely administration of IV/IO treatment in trauma patients.

Administration of medication is a well-established part of prehospital trauma care. Guidance varies on the types of recommended medications and when they should be administered. Mnemonics have become commonplace in prehospital medicine to facilitate recall and retention.

Unilateral Axillary Lymphadenopathy After COVID-19 Vaccine Causing Medial Cord Plexopathy: A Case Report.

Case: The global reach of coronavirus disease 2019 has led to the rollout of new generation messenger ribonucleic acid (mRNA) vaccines. As populations are vaccinated, some side effects will become more apparent. We present a case of unilateral lymphadenopathy resulting in a transient plexopathy presenting as neuralgic pain, paresthesia, and numbness in the hand.

Management of deep surgical site infections of the spine: a Canadian nationwide survey.

Background: Deep surgical site infections after spinal instrumentation represent a significant source of patient morbidity and poorer outcomes. Given lack of evidence or guidelines on the variety of procedural options in the management of deep spine surgical site infections, the purpose of this survey was to document and investigate the use of these techniques across Canada.

Methods: A 34-question survey evaluating surgical techniques for irrigation and debridement in postoperative thoracolumbar infection was distributed to Canadian adult spine surgeons.

Survival after surgery for spinal metastases: a population-based study.

Background: There are limited published data on population estimates of survival after spinal surgery for metastatic disease. We performed a population-based study to evaluate survival and complications among patients with cancer who underwent surgery for spinal metastases in Ontario, Canada, between 2006 and 2016.

Methods: We used health administrative databases to identify all patients who underwent surgery for spinal metastases in Ontario between Jan.

Obstructive jaundice, early satiety and xerostomia in an 82-year-old woman.

Amyloid light-chain (AL) amyloidosis is a multisystem disease with obstructive jaundice and gastrointestinal (GI) involvement being uncommon initial presentations. Patients with AL amyloidosis seldom have jaundice and advanced GI tract involvement as their presenting symptoms. This case report describes an 82-year-old lady who presented with a 6-month history of early satiety, weight loss, xerostomia and progressive jaundice.

Lower Extremity and Trunk Electromyographic Muscle Activity During Performance of the Y-Balance Test on Stable and Unstable Surfaces.

Background: The Star Excursion Balance Test (SEBT) has been used as a rehabilitation exercise. To improve its efficacy, efficiency, and method variations, the Y-Balance Test (YBT) with anterior (A), posterolateral (PL), and posteromedial (PM) directions of the SEBT has been recommended. Electromyographic activity has been reported to change when the same task is performed on various surfaces.

A Review of Strategies to Improve Biomechanical Fixation in the Cervical Spine.

Study Design: Systematic review.

Objectives: Review the surgical techniques and construct options aimed at improving the biomechanical strength of cervical constructs.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

A computer-game-based rehabilitation platform for individuals with fine and gross motor upper extremity deficits post-stroke (CARE fOR U) - Protocol for a randomized controlled trial.

Background & Purpose: Activity-based neuroplasticity and re-organization leads to motor learning via replicating real-life movements. Increased repetition of such movements has growing evidence over last few decades. In particular, computer-game-based rehabilitation is found to be effective, feasible and acceptable for post-stroke upper limb deficits.

The Problem of Fairness in Synthetic Healthcare Data.

Access to healthcare data such as electronic health records (EHR) is often restricted by laws established to protect patient privacy. These restrictions hinder the reproducibility of existing results based on private healthcare data and also limit new research. Synthetically-generated healthcare data solve this problem by preserving privacy and enabling researchers and policymakers to drive decisions and methods based on realistic data.

Assessment of non-point source of pollution using chemical mass balance approach: a case study of River Alaknanda, a tributary of River Ganga, India.

The low ionic concentration meltwaters of the rivers originating from the Himalayan glaciers play a significant role in diluting the high solute load emanating from Ganga plain catchments. Hence, any change in the qualitative and quantitative characteristics of the Himalayan tributaries of River Ganga under the changing climatic scenario will impact the hydrochemical parameters of River Ganga as well. Hydrochemical investigations have been carried out in the River Alaknanda, a tributary of River Ganga during the period September 2016-May 2018 and revealed that TSS and COD values were observed above the prescribed criteria limit of 10 mg/L for drinking purpose for river as prescribed by CPCB.

Surgeon clinical practice variation and patient preferences during the informed consent discussion: a mixed-methods analysis in lumbar spine surgery.

Background: Patients with lumbar disc herniation may greatly benefit from microdiscectomy. Although spine surgeons performing microdiscectomy routinely obtain informed consent, the potential adverse events they disclose often vary. Moreover, little is known about what disclosures are deemed most valuable by patients.

EFFECTS OF LOWER EXTREMITY AND TRUNK KINETIC CHAIN RECRUITMENT ON SERRATUS ANTERIOR MUSCLE ACTIVATION DURING FORWARD PUNCH PLUS EXERCISE ON STABLE AND UNSTABLE SURFACES.

Background: The stabilizing action of the serratus anterior (SA) muscle is vital in maintaining normal scapulothoracic rhythm. This warrants investigation of exercises to discern which are best to activate the SA muscle. Recruitment of the muscles in the trunk and lower extremity kinetic chain during exercises has demonstrated increased SA activation due to the myofascial connections between various segments of the body.

Training surgeons and the informed consent discussion in paediatric patients: a qualitative study examining trainee participation disclosure.

Background: The process of obtaining informed consent is an important and complex pursuit, especially within a paediatric setting. Medical governing bodies have stated that the role of the trainee surgeon must be explained to patients and their families during the consent process. Despite this, attitudes and practices of surgeons and their trainees regarding disclosure of the trainee's participation during the consent process has not been reported in the paediatric setting.

Hip and Trunk Muscle Activity During the Star Excursion Balance Test in Healthy Adults.

Context: Dynamic balance is a measure of core stability. Deficits in the dynamic balance have been related to injuries in the athletic populations. The Star Excursion Balance Test (SEBT) is suggested to measure and improve dynamic balance when used as a rehabilitative tool.

Current Uses of the Transtrochanteric Approach to the Hip: A Systematic Review.

Background: The indications and technique for the transtrochanteric approach to the hip have evolved greatly since its initial popularization in the 1960s. The purpose of this systematic review was to assess current uses of this approach on the basis of indications, osteotomy technique, trochanteric fixation method, complications, and functional outcome.

Methods: A comprehensive search of MEDLINE and Embase databases from January 2000 to July 2017 was performed in accordance with the PRISMA guidelines.

Completeness in clerking: The surgical admissions proforma.

Background: The accessibility of surgical patient data is a key safety concern, and relies on efficient clerking and handovers. This project assessed whether the introduction of a surgical clerking proforma improved the recording of patient information in the surgical admissions unit (SAU) at Northwick Park Hospital.

Materials And Methods: Existing patient notes were assessed on content and ease of access, using two independent surveys conducted over a 5-day period.

Levels of evidence: a comparison between top medical journals and general pediatric journals.

Background: Given the large number of publications in all fields of practice, it is essential that clinicians focus on the resources that provide the highest level of evidence (LOE). We sought to determine the LOE that exists in the field of pediatrics, present in the general pediatric as well as high impact clinical literature.

Methods: Clinical pediatric literature, published between April 2011 and March 2012 inclusive in high-impact clinical journals (HICJ) (New England Journal of Medicine, Journal of the American Medical Association, & The Lancet) and the highest-impact general pediatric journals (GPJ) (Pediatrics, Journal of Pediatrics, & Archives of Pediatrics & Adolescent Medicine), was assessed.

Effects of lower extremity and trunk muscles recruitment on serratus anterior muscle activation in healthy male adults.

Background: Poor activation of the serratus anterior (SA) muscle may result in abnormal shoulder rhythm, and secondarily contribute to impingement and rotator cuff tears. Sequential activation of the trunk, pelvis, and lower extremity (LE) muscles is required to facilitate the transfer of appropriate forces from these body segments to the upper extremity. Myofascial connections that exist in the body, and LE and trunk muscles (TM) activity may influence scapular and upper limb activity.