A Phase 3 Active-Controlled Trial of Liposomal Bupivacaine via Adductor Canal Block for Total Knee Arthroplasty.

Background: The efficacy, safety, pharmacokinetics, and pharmacodynamics of liposomal bupivacaine combined with bupivacaine hydrochloride administered via adductor canal block for total knee arthroplasty were evaluated.

Methods: This randomized, double-blind, active-controlled, multicenter trial (NCT05139030) enrolled adults undergoing primary unilateral total knee arthroplasty. Participants were randomized 1:1 to receive an adductor canal block administered as a single dose of liposomal bupivacaine 133 mg admixed with bupivacaine hydrochloride 50 mg (liposomal bupivacaine group) or bupivacaine hydrochloride 50 mg admixed with saline (bupivacaine group).

Acute decompensation of chronic hydrocephalus following elective abdominal surgery presenting as paroxysmal sympathetic hyperactivity: illustrative case.

Background: The management of asymptomatic untreated chronic hydrocephalus in adults remains controversial. Acute deterioration is uncommon. However, decompensation of stable patients has been described following trauma, physical activity, medical procedures, or Valsalva maneuvers.

Use of intrinsic coordinates to simulate the evolution of shocks in multirelaxing fluids.

Conventional time-domain algorithms that solve the augmented Burgers equation describing nonlinear propagation in a relaxing fluid have a high computational cost associated with discretizing thin shocks. The Burgers equation can be expressed using intrinsic coordinates [Hammerton and Crighton, J. Fluid Mech.

Novel biallelic variants affect the nuclear pore complex and expand the clinical spectrum to include brain malformations.

Biallelic variants in cause isolated or syndromic steroid-resistant nephrotic syndrome (SRNS), characterised by proteinuria, hypoalbuminaemia and focal segmental glomerulosclerosis that progresses to end-stage renal disease. Patients with syndromic SRNS have microcephaly, developmental delay or intellectual disability and short stature. Simplified gyration is observed in some individuals.

The nonlinearity parameter B/A.

The Reflections series takes a look back on historical articles from The Journal of the Acoustical Society of America that have had a significant impact on the science and practice of acoustics.

Endoscopic Treatment of Adult Hydrocephalus.

Intraventricular and periventricular lesions often result in obstructive hydrocephalus and can be effectively managed by ventriculoscopy. This avoids the significant risk of injury to vascular and neural structures that are encountered during open craniotomy and exposure of these deep lesions. It is important to consider endoscopic third ventriculostomy (ETV) in any adult patient with obstructive hydrocephalus given the significantly higher long-term success rate of primary ETV compared with VP shunts.

Cerebrospinal Fluid Shunts to Treat Hydrocephalus and Idiopathic Intracranial Hypertension: Surgical Techniques and Complication Avoidance.

This article provides an in-depth review of cerebrospinal fluid (CSF) shunts for managing hydrocephalus and idiopathic intracranial hypertension, with a focus on advanced surgical techniques and strategies to prevent complications. It examines the placement of ventricular, lumbar, peritoneal, atrial, and pleural catheters, highlighting the benefits of neuro-navigation, endoscopic visualization, and laparoscopic-assisted approaches. Evidence-based methods to reduce shunt infections, malfunctions, and overdrainage are discussed, along with a comparative analysis of shunt types tailored to individual patient needs.

Guidelines for Diagnosis and Management of Idiopathic Normal Pressure Hydrocephalus.

In 1965, Hakim and Adams described 3 patients with normal pressure hydrocephalus who responded to treatment with a ventriculoatrial shunt. Afterward the adoption of shunt treatment without clear diagnostic criteria and surgical techniques resulted in poor outcomes with significant complications. The clinical practice guidelines for the diagnosis and treatment of idiopathic normal pressure hydrocephalus were first published by the Japanese Neurosurgical Society in 2004 and the international guidelines were published in 2005.

Hydrocephalus Pathophysiology and Epidemiology.

Adult hydrocephalus is a common neurologic condition with an estimated prevalence of 85 per 100,000 globally, caused by abnormal cerebrospinal fluid (CSF) accumulation within the cerebral ventricles. Subtypes include idiopathic normal pressure hydrocephalus, posthemorrhagic, postinfectious, posttraumatic, and tumor-associated forms. Its pathophysiology involves glymphatic dysfunction, neuroinflammation, vascular compromise, and impaired CSF absorption.

Population Ecology-Quantitative Microbial Risk Assessment (QMRA) Model for Antibiotic-Resistant and Susceptible in Recreational Water.

Understanding and predicting the role of waterborne environments in transmitting antimicrobial-resistant (AMR) infections are critical for public health. A population ecology-quantitative microbial risk assessment (QMRA) model is proposed to evaluate urinary tract infection (UTI) development due to recreational waterborne exposures to () and antibiotic-resistant extended-spectrum β-lactamase-producing (ESBL) . The horizontal gene transfer (HGT) mechanism of conjugation and other evolutionary factors were modeled separately in the environment and the gut.

Interim 2024/25 influenza vaccine effectiveness: eight European studies, September 2024 to January 2025.

The 2024/25 influenza season in Europe is currently characterised by co-circulation of influenza A(H1N1)pdm09, A(H3N2) and B/Victoria viruses, with influenza A(H1N1)pdm09 predominating. Interim vaccine effectiveness (VE) estimates from eight European studies (17 countries) indicate an all-age influenza A VE of 32-53% in primary care and 33-56% in hospital settings, with some signals of lower VE by subtype and higher VE against influenza B (≥ 58% across settings). Where feasible, influenza vaccination should be encouraged and other prevention measures strengthened.

Cerebral blood flow during simulated central hypovolaemia in people with hypertension: does vertebral artery hypoplasia matter?

Adults with hypertension have higher prevalence of vertebral artery hypoplasia (VAH), which is associated with lower resting cerebral blood flow (CBF). We examined whether VAH impacts the ability to regulate CBF during haemodynamic stress when cardiac output and blood pressure are lowered via body negative pressure (LBNP). Participants underwent magnetic resonance angiography (MRA) at 1.

Offloading Interventions for the Management of Charcot Neuroarthropathy in Diabetes.

Background: The use of a nonremovable patellar tendon bearing (PTB) cast in Charcot neuroarthropathy (CA) has not been well studied. We describe the offloading devices, including PTB cast used in our setting for the treatment of CA.

Methods: We performed a retrospective observational study on patients with CA and diabetic foot ulcer (DFU) presenting to the multidisciplinary foot clinic at Royal Darwin Hospital, between January 2003 and June 2015.

The impact of beauvericin on rainbow trout intestinal epithelial cells at different temperatures and dosing methods.

Mycotoxins in aquatic feeds and their effects on fish are becoming more important in aquaculture, as fishmeal and fish oil in feeds are being replaced with more sustainable plant protein. Here, we investigated the potential of the mycotoxin, beauvericin (BEA), to impact the rainbow trout (RT) intestine by using cultures of the epithelial cell line, RTgutGC. BEA was dosed in different ways and exposed at temperatures ranging from 4 to 26 °C before being evaluated for cell viability by the metabolic reduction of Alamar Blue, by the accumulation of Neutral Red (lysosomal activity), cytotoxicity (CellTox Green), and for wound healing.

Trends in human parainfluenza virus in Scotland before and after the peak of the COVID-19 pandemic, January 2017 to October 2023.

BackgroundHuman parainfluenza viruses (HPIV) commonly cause upper respiratory tract infections, with potential for severe lower respiratory complications. Understanding seasonal increases informs strategies to prevent HPIV spreading.AimWe examined the impact of COVID-19 on HPIV epidemiological and clinical patterns in Scotland using non-sentinel and sentinel surveillance data.

Effects of an Initial Anti-CD19 CAR T-cell Therapy on Subsequent Anti-CD22 CAR T-cell Manufacturing and Clinical Outcomes in Patients with Relapsed/Refractory LBCL.

Late leukapheresis (>6 months after CAR19) resulted in less residual CAR19, higher CAR22 CD4+ naïve T and TCM cells, less TEM cells, and higher CD8+ TCM cells, but similar clinical outcomes to those with early leukapheresis. CAR22 responses were associated with higher transduction efficiency and CD8+ TCM and less CD8+ TEM cells.

Research priorities for improving cognitive and neuropsychological outcomes in hydrocephalus.

Hydrocephalus is a neurological disorder that impacts approximately 85 per 100,000 individuals worldwide and is associated with motor and cognitive impairments. While many advances in surgical interventions have helped substantially improve the survival rates and quality of life of those affected, there continues to be significant gaps in our understanding of the etiology of this heterogeneous condition as well as its specific neuropsychological and functional challenges across different phases of life. To address these limitations, the Hydrocephalus Association and Rudi Schulte Research Institute organized a workshop titled, "Improving Cognitive and Psychological Outcomes in Hydrocephalus", composed of top academics in the fields of hydrocephalus, cognition, and neuropsychology, as well as individuals with hydrocephalus or their caregivers.

Analytical solutions for acoustic vortex beam radiation from planar and spherically focused circular pistons.

Analytical solutions for acoustic vortex beams radiated by sources with uniform circular amplitude distributions are derived in the paraxial approximation. Evaluation of the Fresnel diffraction integral in the far field of an unfocused source and in the focal plane of a focused source leads to solutions in terms of an infinite series of Bessel functions for orbital numbers ℓ>-2. These solutions are reduced to closed forms for 0≤ℓ≤4, which correspond to orbital numbers commonly used in experiments.

The Community Acute Respiratory Infection surveillance programme: an evaluation of a newly established surveillance programme in Scotland.

The Community Acute Respiratory Infection (CARI) surveillance programme, established by Public Health Scotland (PHS) in November 2021, aims to monitor respiratory infections in communities, replacing prior schemes to ensure early detection of outbreaks and inform public health interventions. Positioned as a cornerstone of PHS's national infectious respiratory diseases plan, CARI is pivotal for safeguarding public health. This study presents key findings from the 2022/23 CARI season and evaluates the programme's performance during this period.

Predicting Syndromic Status Based on Longitudinal Data from Parental Reports of the Presence of Additional Structural and Functional Anomalies in Children Born with an Orofacial Cleft.

Orofacial clefts are the most common craniofacial congenital malformation in humans. Approximately 30% of clefts arise as part of a syndrome or sequence, characterised by co-existing structural and functional anomalies. Many syndromes are thought to be undiagnosed, although the presence of multiple anomalies may indicate the presence of a syndrome or sequence.

Tranexamic Acid in Rhytidectomy: A Split-Face Multi-Institutional Study.

Tranexamic acid (TXA) has the ability to reduce intraoperative bleeding and facilitate hemostasis in addition to its anti-inflammatory properties that can potentially aid in recovery among patients who underwent rhytidectomy. To compare postoperative ecchymosis in patients who underwent rhytidectomy with TXA added to the tumescent anesthetic. A multi-institutional, single-blind study was performed on patients who underwent rhytidectomy.