ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.

Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.

Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.

Myths and fitness interdependence: Beyond coalitional longevity.

This comment seeks to extend the authors' argument by considering how perceived fitness interdependence is generated in different settings. Based primarily on research from political science, it argues that strategic agents may seek to design myths that emphasize not only the longevity of their coalitions, but also internal features such as material and status equality and institutional impartiality.

Should an Interval Appendicectomy Be Performed by a Minimally Invasive Gynaecologist?

Objective: We aimed to explore the abnormal pathology findings in appendix specimens removed based on intraoperative abnormal appearance during elective surgery for benign gynaecological conditions by a minimally invasive gynaecologist, as well as the associated complication rate.

Materials And Methods: This retrospective cohort study was conducted in a tertiary referral surgical centre for benign gynaecological conditions between the years 2004-2023. It included patients who underwent appendicectomy by a trained minimally invasive gynaecologist based on observations during surgery for benign gynaecological conditions.

Comprehensive Analysis of Thrombotic Microangiopathy Following Renal Transplantation.

Thrombotic microangiopathy is a severe complication of renal transplantation. Little is known about risk factors, incidence of autoantibodies against complement components, and prognosis. Clinical and laboratory data were retrospectively collected for 13 patients diagnosed with post-transplant thrombotic microangiopathy (PT-TMA) in 2011-2018.

The Role of Coronary Computed Tomography Angiography in the Diagnosis, Risk Stratification, and Management of Patients with Diabetes and Chest Pain.

Coronary artery disease (CAD) affects over 200 million individuals globally, accounting for approximately 9 million deaths annually. Patients living with diabetes mellitus exhibit an up to fourfold increased risk of developing CAD compared to individuals without diabetes. Furthermore, CAD is responsible for 40 to 80 percent of the observed mortality rates among patients with type 2 diabetes.

Randomized double-blind study on safety and tolerability of TP-102 phage cocktail in patients with infected and non-infected diabetic foot ulcers.

Background: Phage therapy offers a promising alternative for treating serious infections, including diabetic foot ulcers (DFUs), through the lytic action of phages. This randomized double-blind study was conducted to evaluate the safety and tolerability of the TP-102 bacteriophage cocktail in patients with DFUs non-infected and infected with Staphylococcus aureus, Pseudomonas aeruginosa, and/or Acinetobacter baumannii.

Methods: Nineteen participants with DFUs were randomized after susceptibility testing.

The importance of proper naming - A review of Neuroscience-based Nomenclature (NbN).

Neuroscience-based Nomenclature (NbN) is a pharmacologically-driven classification of psychotropics, aiming to revise the current indication-based classification (antipsychotics, antidepressants, anxiolytics etc.). Whereas the number of psychotropics has risen dramatically over the years, the current nomenclature preserves a rather narrow categorization that overlooks the rich neurobiological knowledge accumulated to date.

Broad repression of DNA repair genes in senescent cells identified by integration of transcriptomic data.

Cellular senescence plays a significant role in tissue aging. Senescent cells, which resist apoptosis while remaining metabolically active, generate endogenous DNA-damaging agents, primarily reactive oxygen species. Efficient DNA repair is therefore crucial in these cells, especially when they undergo senescence escape, resuming DNA replication and cellular proliferation.

Predicting gene sequences with AI to study codon usage patterns.

Selective pressure acts on the codon use, optimizing multiple, overlapping signals that are only partially understood. We trained AI models to predict codons given their amino acid sequence in the eukaryotes and and the bacteria and to study the extent to which we can learn patterns in naturally occurring codons to improve predictions. We trained our models on a subset of the proteins and evaluated their predictions on large, separate sets of proteins of varying lengths and expression levels.

Assessing clinical and morphological features of megalotrichosis induced by Tyrosine kinase inhibitors versus Prostaglandins analogues.

Purpose: Describing the features of Megalotrichosis (MT) induced by Tyrosine kinase inhibitors (TKI) and differentiate it from Prostaglandins (PGs)-induced MT.

Methods: Medical data of patients with MT referred to our center between 2012-2021 were retrieved for: demographic parameters, medical, surgical and oncologic background, and ophthalmologic background along with diagnoses and treatment. Time from PGs/TKI introduction to MT presentation, MT clinical characteristics, associated complaints, and prescribed therapies in relevant cases were also documented.

Clinical outcomes by baseline metastases in patients with renal cell carcinoma treated with lenvatinib plus pembrolizumab versus sunitinib: Post hoc analysis of the CLEAR trial.

Lenvatinib plus pembrolizumab significantly improved efficacy versus sunitinib in treatment of advanced renal cell carcinoma (aRCC) in the phase 3 CLEAR study. We report results of an exploratory post hoc analysis of tumor response data based on baseline metastatic characteristics of patients who received lenvatinib plus pembrolizumab versus sunitinib, at the final overall survival analysis time point of CLEAR (cutoff: July 31, 2022). Treatment-naïve adults with aRCC were randomized to: lenvatinib (20 mg PO QD in 21-day cycles) plus pembrolizumab (n = 355; 200 mg IV Q3W); lenvatinib plus everolimus (not reported here); or sunitinib (n = 357; 50 mg PO QD; 4 weeks on/2 weeks off).

Middle ear secretions following spontaneous CSF leak repair may represent effusion rather than CSF leak.

Objective: To characterize middle ear (ME) effusion still present 2 months after repair surgery for spontaneous cerebrospinal fluid (CSF) leak via the temporal bone (TB).

Study Design: A retrospective chart review (2011-2022).

Setting: Tertiary referral academic center.

Clinical features and prognosis of transient global amnesia in Israel: 6 years' single-center experience.

Background: Transient global amnesia (TGA) is a benign neurological syndrome of unknown etiology, causing sudden anterograde amnesia that lasts up to 24 h. During the episode of TGA, other cognitive functions are normal. This is the first study describing the characteristics of the disease in Israel.

Deep neural networks and humans both benefit from compositional language structure.

Deep neural networks drive the success of natural language processing. A fundamental property of language is its compositional structure, allowing humans to systematically produce forms for new meanings. For humans, languages with more compositional and transparent structures are typically easier to learn than those with opaque and irregular structures.

Three Decades of Outpatient Plastic Surgery Safety: A Review of 42,720 Consecutive Cases.

Background: Outpatient plastic surgery offers cost-effective solutions and enhanced privacy but demands careful patient assessment for suitability and vigilant anticipation of adverse events. This study provides recommendations to enhance patient safety in outpatient settings by analyzing over 40,000 consecutive cases spanning across three decades.

Methods: We retrospectively reviewed all consecutive cases completed by board-certified plastic surgeons at an accredited outpatient surgical center between 1995-2023.

Residues R177 and S178 of the human Na/H antiporter NHA2 are involved in its inhibition by the flavonoid phloretin.

The Homo sapiens Na/H antiporter NHA2 (SLC9B2) transports Na or Li in exchange for protons across cell membranes, and its dysfunction results in various pathologies. The activity of HsNHA2 is specifically inhibited by the flavonoid phloretin. Using bioinformatic modeling, we predicted two amino acids (R177 and S178) as being important for the binding of phloretin to the HsNHA2 molecule.

Revisional Surgery Due to Weight Regain or Insufficient Weight Loss Following One Anastomosis Gastric Bypass.

Introduction: One anastomosis gastric bypass (OAGB) is a common procedure associated with satisfactory outcomes. Revisional surgery due to weight regain or insufficient weight loss (WR/IWL) after OAGB is underreported.

Methods: A retrospective analysis of a single-bariatric surgeon database was conducted.

Infants born during COVID-19 pandemic experience increased susceptibility to airway hyperresponsiveness.

Background: Asthma, allergic rhinitis, atopic dermatitis, and food allergy are type 2 inflammation diseases. Since the 1960s, the prevalence of those diseases has steadily increased, presumably due to the "Hygiene hypothesis" which suggests that early exposure of infants to pathogens, siblings, and environmental dust, has a protective effect against the development of allergic diseases. The COVID-19 pandemic increased environmental hygiene due to lockdowns, masks, and social distancing.

Targeted CRISPR/Cas9 Lipid Nanoparticles Elicits Therapeutic Genome Editing in Head and Neck Cancer.

Squamous cell carcinomas of the head and neck (HNSCC) originate in the upper aerodigestive tract, including the oral cavity, pharynx, and larynx. Current treatments of locally advanced HNSCC often lead to high treatment failure, and disease recurrence, resulting in poor survival rates. Advances in mRNA technologies and lipid nanoparticle (LNP) delivery systems led to several clinical trials involving LNP-CRISPR-Cas9 mRNA-based therapeutics.

Gastrointestinal Perforations Associated With JAK Inhibitors: A Disproportionality Analysis of the FDA Adverse Event Reporting System.

Background: Gastrointestinal perforations have been reported in a small number of rheumatoid arthritis (RA) patients treated with Janus kinase (JAK) inhibitors in clinical trials. However, large-scale postmarketing data repositories are needed to further investigate this potentially rare but serious adverse event.

Methods: A retrospective, pharmacovigilance study of the FDA adverse event reporting system (July 2014 to September 2023) assessing the reporting of gastrointestinal perforations following JAK inhibitors compared to biological disease-modifying antirheumatic drugs (bDMARDs) in RA patients.

Left Atrial Strain in Omicron-Type COVID-19 Patients.

Background: Information about left atrial (LA) 2-dimensional (2D) strain parameters in patients with the Omicron variant of COVID-19 is limited. The aim of this study is to evaluate LA strain (LAS) in COVID-19 patients with the Omicron variant and compare it to that of propensity-matched patients with the wild-type (WT) variant.

Methods: A total of 148 consecutive patients who were hospitalized with Omicron COVID-19 underwent an echocardiographic evaluation within the first day after hospital admission and were compared to propensity-matched patients (1:1) with the WT variant.

A local-to-global inequality for spectral invariants and an energy dichotomy for Floer trajectories.

We study a local-to-global inequality for spectral invariants of Hamiltonians whose supports have a "large enough" disjoint tubular neighborhood on semipositive symplectic manifolds. As a corollary, we deduce this inequality for disjointly supported Hamiltonians that are -small (when fixing the supports). In particular, we present the first examples of such an inequality when the Hamiltonians are not necessarily supported in domains with contact-type boundaries, or when the ambient manifold is irrational.