Volatile vs Total intravenous Anaesthesia for major non-cardiac surgery: a pragmatic randomised triaL (VITAL).

Background: Improving outcomes after surgery is a major public health research priority for patients, clinicians and the NHS. The greatest burden of perioperative complications, mortality and healthcare costs lies amongst the population of patients aged over 50 years who undergo major non-cardiac surgery. The Volatile vs Total Intravenous Anaesthesia for major non-cardiac surgery (VITAL) trial specifically examines the effect of anaesthetic technique on key patient outcomes: quality of recovery after surgery (quality of recovery after anaesthesia, patient satisfaction and major post-operative complications), survival and patient safety.

Anterior vertebral tethering for adolescent idiopathic scoliosis: our initial ten year clinical experience.

Background: Anterior vertebral tethering (AVT) is a minimally invasive alternative to fusion surgery for adolescent idiopathic scoliosis (AIS) that offers the potential for definitive scoliosis treatment with the possibility of preservation of the growth, motion, function and overall health of the spine. This study represents our first ten years using AVT to treat AIS.

Methods: In this retrospective review we analyzed our first 74 AIS patients treated with AVT 2010-2020.

PEARLS - A multicentre phase II/III trial of extended field radiotherapy for androgen sensitive prostate cancer patients with PSMA-avid pelvic and/or para-aortic lymph nodes at presentation.

PEARLS is a multi-stage randomised controlled trial for prostate cancer patients with pelvic and/or para-aortic PSMA-avid lymph node disease at presentation. The aim of the trial is to determine whether extending the radiotherapy field to cover the para-aortic lymph nodes (up to L1/L2 vertebral interspace) can improve outcomes for this patient group.

Anterior vertebral tethering: imaging of tether rupture.

Anterior vertebral tethering, also known as vertebral body tethering, is an evolving, minimally invasive surgical technique to correct spinal curvature in skeletally immature patients. The procedure involves placement of vertebral screws that are connected by an anterolateral tether. This procedure may be complicated by rupture of the non-radiopaque tether.

Memory-guided foraging and landscape design interact to determine ecosystem services.

Many studies examine how the landscape affects memory-informed movement patterns, but very few examine how memory-informed foragers influence the landscape. This reverse relationship is an important factor in preventing the continued decline of many ecosystem services. We investigate this question in the context of crop pollination services by wild bees, a critical ecosystem service that is in steep decline.

Estimating duration distribution aided by auxiliary longitudinal measures in presence of missing time origin.

Understanding the distribution of an event duration time is essential in many studies. The exact time to the event is often unavailable, and thus so is the full event duration. By linking relevant longitudinal measures to the event duration, we propose to estimate the duration distribution via the first-hitting-time model (e.

A Thoracoscopic Technique Used in Anterior Vertebral Tethering for Adolescent Idiopathic Scoliosis.

Anterior vertebral tethering (AVT) is a relatively recent alternative to posterior spinal fusion for progressive curves in growing patients with idiopathic scoliosis. AVT uses a thoracoscopic approach to minimize trauma to the thoracic wall and chest cavity. There are limited technical descriptions of this method.

Characterizing Anesthetic Management and Perioperative Outcomes Associated with a Novel, Fusionless Scoliosis Surgery in Adolescents.

Anterior vertebral tethering (AVT) is a novel "fusionless" surgical approach to correct scoliosis. This study aims to characterize the anesthetic management and perioperative outcomes of AVT and traditional posterior spinal fusion (PSF) after establishing the technique at our institution. Scoliosis correction procedures performed in patients aged 10 to 21 years between January 2014 and August 2017 were identified in the electronic medical record.

Stereoselective Synthesis of Fused Vinylcyclopropanes by Intramolecular Tsuji-Trost Cascade Cyclization.

A stereoselective intramolecular Tsuji-Trost cascade cyclization of (homo)allylic vicinal diacetates with a pendant β-ketoamide or related carbon nucleophile to give γ-lactam-fused vinylcyclopropanes is reported. In addition to two new rings, the products contain three new C-C stereocenters (two of which are quaternary) with a 9:1 dr. Moreover, the reaction proceeds in >94% enantiospecificity with optically enriched starting materials, using an inexpensive carbohydrate as the source of chirality.

Diagnosis of non-osseous spinal metastatic disease: the role of PET/CT and PET/MRI.

The spine is the third most common site for distant metastasis in cancer patients with approximately 70% of patients with metastatic cancer having spinal involvement. Positron emission tomography (PET), combined with computed tomography (CT) or magnetic resonance imaging (MRI), has been deeply integrated in modern clinical oncology as a pivotal component of the diagnostic work-up of patients with cancer. PET is able to diagnose several neoplastic processes before any detectable morphological changes can be identified by anatomic imaging modalities alone.

Distinctive trajectory groups of mental health functioning among assertive community treatment clients: an application of growth mixture modelling analysis.

Objective: Assertive community treatment (ACT) studies that have used conventional, statistical growth modelling methods have not examined different trajectories of outcomes or covariates that could influence different trajectories, even though heterogeneity in outcomes has been established in other research on severe mental illness. The purpose of our study was to examine the general trend in mental health functioning of ACT clients over a 2-year follow-up time period, to discover groups of ACT clients with distinctive longitudinal trajectories of mental health functioning, and to examine if some of the key sociodemographic and illness-related factors influence group membership.

Method: A 2-year, prospective, within-subjects study of 216 ACT clients within southern Ontario, collected functional outcome data at baseline and 12 and 24 months using the Colorado Client Assessment Record.

Polygenic inheritance of adolescent idiopathic scoliosis: a study of extended families in Utah.

A heritability study of 69 extended Utah families with a history of adolescent idiopathic scoliosis (AIS) indicates that AIS is a polygenic, multifactorial condition. Each family reported a history of AIS within four generations; a total of 247 individuals were confirmed via X-rays and medical records to have AIS. Coefficient of kinship was more than 25 standard deviations higher for these 69 families than for the general population.

Primary paraganglioma of the parathyroid: a case report and clinicopathologic review.

Paragangliomas are relatively uncommon neoplasms that arise in adrenal and extra-adrenal paraganglia of the autonomic nervous system. Parasympathetic paraganglioma develop predominantly in the head and neck. It is exceedingly uncommon to develop a primary intraparathyroid paraganglioma.

The effect of two clinically relevant fusionless scoliosis implant strategies on the health of the intervertebral disc: analysis in an immature goat model.

Study Design: Immature goat spines were instrumented at 5 levels with 2 different fusionless scoliosis implants. Instrumented and subadjacent spinal segments were analyzed to determine the effect on the disc and endplate.

Objective: Analyze the regional biochemistry and histology of spinal motion segments in healthy goat spines treated with 2 clinically relevant, fusionless scoliosis implants.

Static versus dynamic loading in the mechanical modulation of vertebral growth.

Study Design: Measures of absolute and relative growth modulation were used to determine the effects of static and dynamic asymmetric loading of vertebrae in the rat tail.

Objectives: To quantify the differences between static and dynamic asymmetric loading in vertebral bone growth modulation.

Summary Of Background Data: The creation and correction of vertebral wedge deformities have been previously described in a rat-tail model using static loading.

Relative versus absolute modulation of growth in the fusionless treatment of experimental scoliosis.

Study Design: Absolute and relative growth modulation of apical spinal segments were measured during creation and correction of an experimental scoliosis in a goat model.

Objective: To differentiate relative and absolute changes in growth on the concavity and convexity of an experimental scoliosis treated with anterior vertebral stapling.

Summary Of Background Data: The creation and correction of vertebral wedge deformities have been previously described in a rat tail model using external fixation as well as in a goat model using anterior vertebral body stapling.

Anterior cervical fixation: analysis of load-sharing and stability with use of static and dynamic plates.

Background: Anterior plates provide stability following decompression and fusion of the cervical spine. Various plate designs have emerged, and they include static plates with fixed-angle screws, rotationally dynamic plates that allow the screws to toggle in the plate, and translationally dynamic plates that allow the screws to both toggle and translate vertically. The goal of this study was to document the effects of plate design following a single-level corpectomy and placement of a full-length strut graft and the effects following 10% subsidence of the graft.

Creation of an experimental idiopathic-type scoliosis in an immature goat model using a flexible posterior asymmetric tether.

Study Design: Longitudinal follow-up of animals after a surgically initiated scoliosis.

Objective: To create a progressive, structural, idiopathic-type, lordoscoliotic curve convex to the right in the thoracic spine of the immature goat using a flexible posterior asymmetric tether with minimal disruption of the spinal elements along the curve.

Summary Of Background Data: Our previous work created an experimental scoliosis model using a rigid posterior asymmetric tether to study the safety and efficacy of fusionless scoliosis treatments.

Mechanical modulation of vertebral growth in the fusionless treatment of progressive scoliosis in an experimental model.

Study Design: Wedging of apical spinal segments was measured during creation and correction of an experimental scoliosis in a goat model.

Objectives: To create and correct apical vertebral wedge deformities in a progressive experimental scoliosis model by purely mechanical means.

Summary Of Background Data: The creation and correction of vertebral wedge deformities has been previously described in a rat tail model using external fixation.

The search for idiopathic scoliosis genes.

Study Design: A cohort of 145 patients with adolescent idiopathic scoliosis (AIS) were identified and contacted to determine whether they had a family history of scoliosis. These results were submitted to an internal genealogical database to screen for potential connections to other AIS families. The severity and incidence of AIS in extended family groups were also analyzed.

Inadvertent social information and the avoidance of parasitized male mice: a role for oxytocin.

Social information can be acquired either directly or indirectly from cues inadvertently produced by individuals with similar interests and requirements ("inadvertent social information," ISI). These inadvertent cues provide "public information" that other individuals can use to guide their behavior. We show here that female mice use olfactory ISI to determine their choice of, and responses to, males and that the use of this ISI involves the gene for oxytocin (OT).

Three-dimensional analysis of 2 fusionless scoliosis treatments: a flexible ligament tether versus a rigid-shape memory alloy staple.

Study Design: Experimental scoliosis was created and subsequently corrected in goats. The 3-dimensional (3-D) effects of the treatments were analyzed.

Objective: To analyze the 3-D effect of 2 different fusionless scoliosis treatment techniques on an experimental idiopathic-type scoliosis using plain radiographs and computerized tomography.