Evaluation of the Repatriation Process for Major Trauma Patients: Our Experience at Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust.

Introduction:  Major trauma patients succumb to significant injuries that require transfer to a major trauma center (MTC) for appropriate management. After the acute phase of treatment is over, the challenge arises when these patients require repatriation back to their local National Health Service hospitals for further rehabilitation. According to the "Major Trauma Clinical Network Specification," one of the metrics is for patients to be repatriated to their local trauma unit within 48 hours of getting an accepting consultant.

Light Wavelength Modulates the Effects of Lighted Nights on Sleep, Metabolism and Oxidative Stress in Female Zebra Finches.

Artificial light at night (LAN) reduces the natural darkness and negatively impacts behavior, physiology, and higher brain functions in both captive and wild animals. The inevitable widespread usage of LAN exposure is usually from the broad spectrum dim LAN (dLAN). Here, we investigated whether a monochromatic light would affect the dLAN-induced effects on sleep, metabolism and oxidative stress in a diurnal vertebrate, the zebra finch (Taeniopygia guttata).

Virtual Fracture Clinic: A Helping Hand for an Overburdened Traditional Fracture Clinic in a Busy Major Trauma Center.

Introduction Virtual fracture clinics (VFCs) were established to improve the efficiency of orthopedic care by reducing unnecessary face-to-face consultations, decreasing waiting times, and providing timely specialist advice. This study aims to evaluate the utilization of the VFC at Addenbrooke's Hospital, Cambridge University Hospital NHS Foundation Trust (Cambridge, GBR), over 12 months and assess its effectiveness in managing patients referred from emergency departments and minor injury units. Methods This retrospective study included all patients referred to the VFC between January 2023 and January 2024.

Abrupt change in the timing of the day/night negatively affects sleep behaviour and cognitive performance in diurnal zebra finches.

We investigated the consequence of abrupt directional shifts in the timing of light (hence darkness) period on sleep behaviour, novel object exploration and cognitive performance in diurnal zebra finches maintained under an equinox (12:12h LD) photoperiod. To two cohorts of birds ( = 80), the timing of 12 h light-on (hence of the darkness) for a week was either advanced by 6 h by reducing the dark period or delayed by 6 h by lengthening the dark period, with controls maintained on LD cycle as before. The first cohort of birds were examined for the effects on 24 h activity and feeding behaviors, while the second cohorts of birds were examined for the effects on sleep, neophobia and cognitive performance; the latter two were tested by the novel object exploration and spatial learning, respectively.

A Comparison of the Ultrasound-Guided Dorsal Penile Block and Ultrasound-Guided Caudal Epidural Block for Postoperative Analgesia in Children Undergoing Hypospadias Surgery: A Randomized Controlled Study.

Introduction: Hypospadias repair is a common pediatric surgical procedure. While caudal epidural block (CB) is the standard analgesic technique, dorsal penile nerve block (DB) serves as a viable alternative. This study evaluated and compared the postoperative analgesic effectiveness of CB and DB in children undergoing hypospadias repair.

A Comparison of Phenylephrine and Norepinephrine Infusions in Preventing Hypotension After Subarachnoid Block in Caesarean Section: A Randomized, Double-Blind Study.

Background Prophylactic vasopressor infusion is commonly recommended during cesarean section under spinal anesthesia to prevent hypotension. Norepinephrine is gaining recognition as a viable alternative to phenylephrine in obstetric anesthesia, primarily due to its lower propensity to cause reflex bradycardia. This study compares the efficacy and safety of prophylactic intravenous infusions of norepinephrine and phenylephrine, administered at varying infusion rates, on maternal hemodynamics and neonatal outcomes during cesarean delivery.

What imaging characteristics are suggestive of malignancy in patients with femoral neck fractures? A look at calcar impaction lesions.

Introduction: Femoral heads are often sent for histological analysis when malignancy is suspected following a neck of femur (NOF) fracture. Anecdotally, a commonly seen lytic appearance on plain radiographs prompts suspicion of malignancy but does not correlate with histology results.

Aim: To evaluate the radiographic patterns of NOF fractures deemed suspicious for malignancy, and correlate those patterns with their subsequent histology results.

Comparative Analysis of the Postoperative Analgesic Effect of Caudal Ropivacaine Versus Ropivacaine With Nalbuphine in Infra-Umbilical Pediatric Surgeries: A Randomized, Double-Blind Pilot Study.

Postoperative pain in children leads to an immense stress response than adults, leading to an increased hospital stay and "pain memory." Caudal epidural anesthesia is one of the most reliable, popular, and safe techniques that provide proper analgesia for infra-umbilical surgeries. A combination of local anesthetics and opioids reduces the dose-related adverse effects of each drug independently.

Analgesic Efficacy Comparison Between Ultrasound-Guided Erector Spinae Plane Block and Retrolaminar Block in Patients Undergoing Modified Radical Mastectomy: A Randomized Controlled Trial.

Introduction: Breast cancer is the most common cancer in females. Surgery is the gold standard therapy, with modified radical mastectomy (MRM) being the most commonly performed procedure for breast cancer. Management of postoperative pain after MRM poses a clinical challenge and hence receives utmost priority.

Dimly illuminated nights alter behavior and negatively affect fat metabolism in adult male zebra finches.

This experiment investigated the effects of an ecologically relevant level of dim light at night (dLAN) on behavior, physiology and fat metabolism associated gene expressions in central and peripheral tissues of adult male zebra finches that were hatched and raised in 12:12 h LD cycle (Ev, day = 150 ± 5 lx; Ev, night = 0 lx) at 22 ± 2 °C temperature. Half of the birds (n = 8) were maintained on LD cycle and temperature, as before (control), to the other half of birds the 12 h dark period was dimly illuminated at ~ 5 lx (dim light at night, dLAN; Ev, day = 150 ± 5 lx; Ev, night =  ~ 5 lx) for 6 weeks. The exposure to dLAN altered the 24 h activity and feeding patterns with enhanced activity and feeding at night.

Comparative Analysis of the Postoperative Analgesic Effects of Caudal Epidural Injection of Ropivacaine Combined With Fentanyl Versus Ropivacaine Alone in Lumbosacral Spine Surgeries: A Randomized Double-Blinded Study.

Introduction: A single injection of local anesthetic as a caudal epidural block provides pain relief for 2-4 hours. This duration can be extended by adding adjuvants such as opioids (morphine, fentanyl, buprenorphine, tramadol), ketamine, α2 agonists (dexmedetomidine, clonidine), and adrenaline. Caudal analgesia also reduces the need for intravenous opioids during and after surgery, which helps avoid the systemic side effects of opioids.

The Relation of Preoperative HbA1c Level With Intraoperative and Postoperative Complications in Type-2 Diabetic Patients: An Observational Study.

Background Perioperative dysglycemia increases morbidity and mortality, particularly among those with diabetes mellitus (DM), and elevated HbA1c levels, reflecting long-term blood glucose, are linked to poor healing and higher infection rates. This study investigates the link between preoperative HbA1c levels and perioperative outcomes in type-2 DM patients. Methodology This prospective observational study was conducted in India between January 2021 and April 2022.

Novel therapeutic agents in clinical trials: emerging approaches in cancer therapy.

Novel therapeutic agents in clinical trials offer a paradigm shift in the approach to battling this prevalent and destructive disease, and the area of cancer therapy is on the precipice of a trans formative revolution. Despite the importance of tried-and-true cancer treatments like surgery, radiation, and chemotherapy, the disease continues to evolve and adapt, making new, more potent methods necessary. The field of cancer therapy is currently witnessing the emergence of a wide range of innovative approaches.

Whole-body exposure to filtered fraction of diesel exhaust induced localized testicular damage through attenuated functional response of glutathione-s-transferase in adult male Wistar rats.

The possible vulnerability of the male reproductive system to environmental pollutants such as air pollution necessitates a thorough investigation of the underlying mechanisms involved in the dysregulation of male reproductive function. The present study was designed to investigate the influence of the filtered fraction of diesel exhaust (predominantly comprising gases) on male reproductive function in Wistar rat model. Adult male rats were randomly assigned into three groups (n=8/group): Control (unexposed) group (CG-A), the Clean air group in WBE chamber (CAG-A), and Filtered diesel exhaust group in WBE chamber (FDG-A).

A Randomized Study Comparing Ultrasound-Guided Internal Jugular Vein Cannulation Using Two Techniques: Short-Axis Out-of-Plane With Dynamic Needle Tip Positioning Versus Long-Axis In-Plane.

Introduction Internal jugular vein (IJV) cannulation is a routine procedure in operating rooms, critical care units, and perioperative settings. Ultrasound guidance has notably increased the success rates of IJV cannulation. A modified ultrasound technique known as the short-axis out-of-plane method with dynamic needle tip positioning (DNTP) allows for continuous visualization of the needle tip throughout the procedure.

Liver Histopathology in Pediatric Patients with Choledochal Cyst.

Aim: The aim is to study the various histopathological changes in the liver in pediatric patients with choledochal cyst (CC) and correlate with the presentation and type of cyst.

Methods: In a prospective observational study including all pediatric patients who underwent CC excision, histopathological changes of the liver in the form of cholestasis (CHS), portal inflammation (PI), bile duct proliferation (BDP), and fibrosis were studied and graded using a scoring system. They were analyzed in relation to age, sex, symptoms, and type of the cyst.

Undiagnosed vertebral fragility fractures in patients with distal radius fragility fractures: an opportunity for prevention of morbimortality in osteoporotic patients in developing countries.

Unlabelled: Our study investigates vertebral fractures in individuals with distal radius fractures. Among 512 patients, 41.21% had vertebral fractures, predominantly in the lumbar spine.

The Hidden Enemy Within: Uncovering the Secrets of HIV Tissues Reservoirs and Current mRNA Vaccine Development.

Human Immunodeficiency Viruses (HIV) continue to pose a significant global health threat despite the availability of antiretroviral therapy (ART). As a retrovirus, HIV persists as a stable, integrated, and replication-competent provirus within a diverse array of long-lived cells for many years, often termed “latent reservoirs” in individuals. Thus, this review aims to furnish a comprehensive overview of diverse tissue reservoirs where HIV persists, elucidating their pathogenesis and advancement in their strategies for clinical management.

Radial Arterial Cannulation by Ultrasound-Guided Dynamic Needle-Tip Positioning Using the Short-Axis Out-of-Plane Approach Versus the Long-Axis In-Plane Approach: A Randomized Controlled Study.

Introduction Radial artery cannulation is a commonly performed invasive procedure for assessing a patient's hemodynamic status and collecting blood samples. Ultrasound guidance has shown benefits in improving the success rate of first-attempt cannulation. Two main approaches, short-axis out-of-plane (SAOOP) and long-axis in-plane (LAIP), are commonly used.

A microdosimetry analysis of reversible electroporation in scattered, overlapping, and cancerous cervical cells.

We present a numerical method for studying reversible electroporation on normal and cancerous cervical cells. This microdosimetry analysis builds on a unique approach for extracting contours of free and overlapping cervical cells in the cluster from the Extended Depth of Field (EDF) images. The algorithm used for extracting the contours is a joint optimization of multiple-level set function along with the Gaussian mixture model and Maximally Stable Extremal Regions.

Study of secondary organic aerosol formation and aging using ambient air in an oxidation flow reactor during high pollution events over Delhi.

Secondary aerosols constitute a significant fraction of atmospheric aerosols, yet our understanding of their formation mechanism and fate is very limited. In this work, the secondary organic aerosol (SOA) formation and aging of ambient air of Delhi are studied using a potential aerosol mass (PAM) reactor, an oxidation flow reactor (OFR), coupled with aerosol chemical speciation monitor (ACSM), proton transfer reaction time of flight mass spectrometer (PTR-ToF-MS), and scanning mobility particle sizer with counter (SMPS + C). The setup mimics atmospheric aging of up to several days with the generation of OH radicals.

Dispersive Modeling of Normal and Cancerous Cervical Cell Responses to Nanosecond Electric Fields in Reversible Electroporation Using a Drift-Step Rectifier Diode Generator.

This paper creates an approximate three-dimensional model for normal and cancerous cervical cells using image processing and computer-aided design (CAD) tools. The model is then exposed to low-frequency electric pulses to verify the work with experimental data. The transmembrane potential, pore density, and pore radius evolution are analyzed.