LA Group Research Articles

Utilizing Learning Analytics to Support Students' Academic Self-efficacy and Problem-Solving Skills

The use of the flipped classroom (FC) model in higher education is becoming increasingly common. Although the FC model has many benefits, there are some limitations using this model for learners who do not have self-directed learning skills and do not have a developed learner autonomy. One of these limitations is that students with low academic self-efficacy (ASE) cannot improve their problem-solving skills (PSS). In the FC model, it is thought that these problems can be solved and supported by providing learning analytics to the learners and making recommendations and guidance based on these results. The aim of this study is to investigate the effect of recommendations and guidance based on learning analytics on ASE and PSS. The research was conducted according to experimental design with pretest–posttest control group and mixed methods approach (QUAN + qual) was used. This study was carried out on 44 university students randomly assigned to experimental group (LA group) and control group (non-LA groups). While feedback messages showing learning analytics to LA groups students were sent via learning management system (LMS) on a weekly basis, non-LA groups students did not receive any feedback messages. The experimental process of the study continued for 7 weeks within the FC model. Research data were obtained through ASE scale, problem-solving inventory and student opinion form. The results of the research show that sending feedback messages showing learning analytics to students has a statistically significant effect on their ASE and PSS. The qualitative findings of the study confirm the results obtained from the quantitative findings. Based on the current implementation, various suggestions were summarized for instructors, instructional designers, and researchers.

The impact of topical lidocaine and timing of LMA removal on the incidence of airway events during the recovery period in children: a randomized controlled trial

BackgroundThe timing of laryngeal mask airway (LMA) removal remains undefined. This study aimed to assess the optimal timing for LMA removal and whether topical anesthesia with lidocaine could reduce airway adverse events.MethodsThis randomized controlled trial assessed one-to-six-year-old children with ASA I-II scheduled for squint correction surgery under general anesthesia. The children were randomized into the LA (lidocaine cream smeared to the cuff of the LMA before insertion, with mask removal in the awake state), LD (lidocaine application and LMA removal under deep anesthesia), NLA (hydrosoluble lubricant application and LMA removal in the awake state) and NLD (hydrosoluble lubricant application and LMA removal in deep anesthesia) groups. The primary endpoint was a composite of irritating cough, laryngeal spasm, SpO2 < 96%, and glossocoma in the recovery period in the PACU. The secondary endpoints included the incidence of pharyngalgia and hoarseness within 24 h after the operation, duration of PACU stay, and incidence of agitation in the recovery period. The assessor was unblinded.ResultsEach group included 98 children. The overall incidence of adverse airway events was significantly lower in the LA group (9.4%) compared with the LD (23.7%), NLA (32.6%), and NLD (28.7%) groups (P=0.001). Cough and laryngeal spasm rates were significantly higher in the NLA group (20.0 and 9.5%, respectively) than the LA (5.2 and 0%, respectively), LD (4.1 and 1.0%, respectively), and NLD (9.6 and 2.1%, respectively) groups (P=0.001). Glossocoma incidence was significantly lower in the LA and NLA groups (0%) than in the LD (19.6%) and NLD (20.2%) groups (P< 0.001). At 24 h post-operation, pharyngalgia incidence was significantly higher in the NLA group (15.8%) than the LA (3.1%), LD (1.0%), and NLD (3.2%) groups (P< 0.001).ConclusionsLMA removal in the awake state after topical lidocaine anesthesia reduces the incidence of postoperative airway events.Trial registrationChiCTR, ChiCTR-IPR-17012347. Registered August 12, 2017.

Comparison of an estradiol patch and GnRH-antagonist protocol with a letrozole/antagonist protocol for patients without oocyte development, fertilization and/or embryo development in previous IVF cycles

Background: Diminished ovarian reserve (DOR) is a challenge for clinicians in IVF cycles and several treatment modalities have been suggested to improve outcomes. The aim of this study was to compare live birth rates following ovarian stimulation using a luteal phase estradiol (E2)/gonadotropin releasing hormone (GnRH) antagonist protocol (LPG group) with a letrozole/antagonist (LA group) protocol in patients with DOR. Methods: A total of 51 women with DOR, previously canceled IVF cycles and aged 40 years or less were investigated. In the LPG group (n = 26), a transdermal E2 patch was applied every other day starting 10 days after the luteinizing hormone (LH) surge. At day 11 after the LH surge, GnRH antagonists were administered for three consecutive days. In the LA group (n = 25), letrozole (5 mg/day) treatment was begun on the second day of menstruation and administered for 5 consecutive days. In both groups, gonadotropins were initiated on the second day of menstruation. Results for the two groups were compared using chi-square and Student’s t-test, as appropriate. Results: Although the initial and total gonadotropin doses were significantly higher in the LPG group, the peak E2 levels, number of oocytes and fertilization rates and cancellation rates were similar. Trends toward improved live birth rates per transfer (23% vs. 11%) and per cycle (11.5% vs. 4%) were seen in the LPG group compared to the LA group, although the differences were not statistically significant. Discussion: DOR patients with previously canceled IVF cycles may be treated with either the LPG or LA protocols.

Stimulation of follicle growth and development during estrus in Ettawa Grade does fed a flushing supplement of different polyunsaturated fatty acids.

Background and Aim:Flushing with the manipulation of fatty acids, particularly polyunsaturated fatty acids, like linoleic and α-linolenic acids in the ration, is a strategy to raise the nutritional status of the female mammals to improve ovarian function and follicle development. This study was designed to investigate the effectiveness of flushing supplementation with different types of polyunsaturated and saturated fatty acids in stimulating follicle growth and development during estrus in Ettawa Grade does with a low initial body condition score (BCS ≤2).Materials and Methods:Eighteen Ettawa Grade does in the second parity, with an average body weight of 32.11±2.19 kg, were divided into three groups according to the fatty acid supplemented to their ration: (i) About 2.8% lauric acid flushing (group); (ii) 2.8% linoleic acid flushing (LA group); and (iii) 2.8% α-linolenic acid flushing (ALA group). The ration was formulated to be isocaloric (total digestible nutrient = 77%) and isonitrogenous (crude protein = 15%). The experiment was conducted for 35 days; that is, 14 days for acclimatization and synchronization of the estrous cycle and 21 days for fatty acid flushing until the appearance of the next estrus. A completely randomized design was applied.Results:According to the results, none of the different fatty acids in the ration affected the nutrient intakes, BCSs, average daily gains, and plasma glucose, cholesterol, and progesterone concentrations of the three groups of does. However, the BCSs (by 0.8-0.9) and the plasma cholesterol concentrations were higher after fatty acid flushing for 21 days than before the flushing period. The ALA group had the highest number of large-sized preovulatory follicles, whereas the LAURIC group had the highest plasma estradiol concentration during estrus. All three groups had similar plasma progesterone concentrations during estrus after fatty acid flushing.Conclusion:Flushing supplementation with 2.8% ALA from flaxseed oil gave the best results in terms of stimulating the highest number of large-sized preovulatory follicles in Ettawa Grade does.

LAPAROSCOPIC RESECTIONS WITH TRANSANAL SPECIMEN EXTRACTION IN RECTAL CANCER SURGERY (a systematic review and meta-analysis)

INTRODUCTION: the NOSES technique allows one to remove specimen without incisions on the anterior abdominal wall and is accompanied by fewer complications by reducing the frequency of wound infections. The results of these surgical operations on colorectal tumors are presented in a limited number of heterogeneous studies, which necessitates obtaining objective data using metaanalysis.STUDY OBJECTIVE: compare the short and long-term outcomes of two methods for surgical treatment of colorectal cancer.MATERIALS AND METHODS: a systematic review is carried out in accordance with PRISMA practice and recommendations.RESULTS: nine comparative studies were selected for the period from 2014 to 2019. 1693 patients were included in the meta-analysis: in 765 (45%), the tumor preparation was removed transanally (NOSES group) and in 928 (55%) it was removed via minilaparotomic access (LA group). The tumor size in the NOSES group was 0.5 cm smaller (OR=0.5, CI95% 0.2-0.8, p=0.0004) than in the LA group. In regards to other parameters the groups had no publication bias. The duration of the operation when comparing NOSES with LA was comparable (p =0.11). VAS pain was on average 2 points (OR=1.8, CI95% 1.2-2.4, p&lt;0.00001) more pronounced in the LA group. The postoperative bed day was less in the group with transanal removal of the preparation (OR=0.8, CI95% 0.4-1.3, p=0.0003). The chance of developing postoperative complications in the NOSES group was (OR=0.5, CI95% 0.4-0.8, p=0.0004) with a frequency of 62/765 (8%) cases, compared with the control group - 130/931 (14%). The chance of developing wound infection was higher in the LA group (OR=0.2, CI95% 0.1-0.3, p &lt;0.00001). There were no differences in the incidence of colorectal anastomotic leakage (p=0.97). There were also no differences in the five-year overall (p=0.74) and cancer-specific survival (p=0.76).CONCLUSION: using NOSES technologies creates better conditions for the rehabilitation of patients due to the low frequency of postoperative complications due to the absence of wound infection and is a safe manipulation. However, the presence of publication biases requires a careful interpretation of the data obtained.

Longan (Dimocarpus longan Lour.) Aril ameliorates cognitive impairment in AD mice induced by combination of D-gal/AlCl3 and an irregular diet via RAS/MEK/ERK signaling pathway

Ethnopharmacological relevanceAccording to the theory of traditional Chinese medicine (TCM), Alzheimer's disease (AD) is identified as “forgetfulness” or “dementia”, and it can be caused by spleen deficiency. Longan Aril (the aril of Dimocarpus longan Lour., LA) is a kind of Chinese medicine, and it can improve intelligence attributed to entering the spleen-meridian. This study aimed to explore the therapeutic effects of LA on AD mice with spleen deficiency, and to understand anti-AD mechanism of LA. Material and methodsA mouse model of AD with spleen deficiency was established by D-gal (140 mg/kg, intraperitoneal injection) and AlCl3 (20 mg/kg, intragastrical administration) in combination with an irregular diet for 60 days, in which mice in LA group were daily given LA (0.5, 1.0 or 2.0 g/kg). The anti-AD effects of LA were evaluated by the Morris water maze, enzyme-linked immunosorbent assay (ELISA), hematoxylin and eosin (H&E), Nissl, and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays. The anti-AD mechanism of LA was studied by using metabolomics, and the expressions of RAS/MEK/extracellular signal-regulated kinase (ERK) signaling pathway-related proteins were detected by Western blotting. ResultsLA improved learning and memory abilities, superoxide dismutase (SOD) level, and form and number of Nissl bodies, while reduced the levels of Aβ42, phosphorylated-tau (p-tau), reactive oxygen species (ROS), malondialdehyde (MDA), monoamine oxidase-B (MAO-B), histological injury, and apoptosis rate in AD group (P < 0.05, P < 0.01 or P < 0.001). The anti-AD mechanism of LA may be related to RAS/MEK/ERK and other signaling pathways, in which the expressions of RAS/MEK/ERK signaling pathway-related proteins significantly reduced (P < 0.05 or P < 0.01). ConclusionsLA could improve the cognitive ability and reduce the pathologic impairment in AD mice, which might be partly mediated via inhibition of RAS/MEK/ERK singling pathway.

Effectiveness and safety of fluoroscopy-guided acupuncture for subacromial impingement syndrome: A randomized, patient-assessor blind, parallel clinical trial

BackgroundSubacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain, and acupuncture treatment is widely used as treatment. However, no studies have examined image-guided acupuncture for SIS. This study evaluated the effectiveness and safety of low-dose X-ray guided acupuncture (LA) in patients with SIS. MethodsA total of 54 patients with SIS were randomly allocated to the LA group and the conventional acupuncture (CA) group. Two acupuncture treatment sessions were conducted for a week, and follow up was conducted after three weeks. The primary outcome was pain intensity measured by the visual analogue scale (VAS) during the Neer and Hawkins test. The incidence rate of shoulder impingement sign, the modified Constant-Murley score (CMS) and the Shoulder Pain and Disability Index (SPADI) were assessed as other outcomes. All indicators were assessed at baseline and after one week and three weeks. For safety evaluation, adverse events were monitored in both groups. ResultsThe change in pain during the Neer test after one week from baseline was more significant in the LA group than in the CA group (p=0.008). However, the Hawkins test did not show a difference between the two groups. The incidence rate of shoulder impingement sign and the changes in CMS and SPADI were not significantly different between the two groups at one week, but after three weeks, SPADI was more significantly improved in the LA group (p=0.024). No adverse events were related to this trial. ConclusionLA was more effective than CA in relieving pain and improving function in terms of VAS and SPADI. Trial registrationThis study was registered at the Clinical Research Information Service: KCT0002751.

The Influence of Altitude on Erythropoietin Resistance Index in Maintenance Hemodialysis Patients: Data from Tibetan Plateau

Background: It is known that hypoxia influences many of the biologic processes involved in erythropoiesis; therefore, the high-altitude hypoxia may affect erythropoietin (EPO) responsiveness in maintenance hemodialysis (MHD) patients. This study aimed to evaluate the impact of altitude on EPO responsiveness in MHD patients. Methods: In this retrospective study, MHD patients from Tibet Autonomous Region People’s Hospital (3,650 m above sea level) and Peking University People’s Hospital (43.5 m above sea level) were recruited between May 2016 and December 2018. Patients were divided into 2 groups according to altitude. Variables including age, sex, dialysis vintage, dialysis modality, duration of EPO use, EPO doses, and laboratory tests were collected and analyzed. EPO responsiveness was measured in terms of the EPO resistance index (ERI). ERI was defined as the weekly weight-adjusted dose of EPO (IU/kg/week) divided by hemoglobin concentration (g/dL). The association between ERI and altitude was estimated using a multivariable linear regression model. Results: Sixty-two patients from Tibet Autonomous Region People’s Hospital (high-altitude [HA] group) and 102 patients from Peking University People’s Hospital (low-altitude [LA] group) were recruited. The ERI for HA group and LA group was 6.9 ± 5.1 IU w⁻¹ kg⁻¹ (g/dL)⁻¹ and 11.5 ± 6.4 IU w⁻¹ kg⁻¹ (g/dL)⁻¹, respectively. After adjusting for covariates by multivariable regression, altitude was independently associated with ERI (R² = 0.245, p < 0.001). Conclusion: Altitude had an independent negative correlation with ERI. This result supported the hypothesis that altitude-associated hypoxia improved EPO responsiveness in MHD patients.

Thrombin generation in subjects with lupus anticoagulant without prior thrombosis or gestational morbidities

BackgroundLupus anticoagulant (LA) can be a cause of thrombosis and/or pregnancy morbidities, producing antiphospholipid syndrome (APS). An increase in thrombin generation (TG) is correlated with prothrombotic status. Several changes in TG-derived parameters have been reported in APS patients. ObjectivesEvaluate whether the TG phenotype of APS can also be described in LA subjects without clinical manifestations of APS, and to investigate the possible influence of both LA potency and antiphospholipid (aPL) profile on it. ResultsTG was analyzed in 153 cases of LA and 41 healthy controls. We have observed prolongation of both lag time (3.7 min vs 2.32 min, p < 0.001) and time to peak (6.48 min vs 5.27 min, p < 0.001), increased peak height (221.7 nM vs 182.7 nM, p < 0.001), slightly higher ETP (221.7 nM·min vs 182.7 nM·min, p = 0.041), and higher velocity index (100.7 nM/min vs 74.53 nM/min, p = 0.001) in LA subjects compared to controls. After adding thrombomodulin (TM), ETP%inh was significantly lower in LA group (37.90% vs 59.90%, p < 0.001) showing resistance to TM/activated protein C (APC). Significant differences were found in lag time, time to peak and ETP%inh according to the potency and aPL profile. ConclusionsPreviously described differences in TG-derived parameters in APS patients have been confirmed in incidental LA subjects: prolonged lag time and time to peak, slightly higher ETP, higher peak height, and less sensitivity to TM/APC. High LA potency and triple-positive aPL profile enhance differences in lag time, time to peak and, especially, increase APC resistance, but no effect in ETP was observed.

Gut Microbiota Diversity in Lean Athletes Is Associated with Positive Energy Balance

Introduction: In contrast to obesity, little is known about the human lean phenotype associated with gut microbiota composition. Objective: We aimed to investigate whether the bacterial composition of lean athletes with a positive energy balance differs from the equal-calorie food group. Methods: Twenty-four male participants were included in this cross-sectional study: lean athletes with a positive energy balance (LA, n 12) and control group athletes (CTRLs, n 12). Nutritional data, resting and total energy expenditure, and body composition were determined. DNA was extracted from stool samples and subjected to 16S rRNA gene analysis. Results: We found 7 differentially abundant bacterial taxa between the LA and CTRL groups. Of those, 5 were significantly less abundant and 2 were enriched in the LA group. The following categories significantly associated with the community structure were identified: body fat parameters, BMI, energy intake and expenditure, oxygen consumption, and respiratory exchange ratio. Conclusions: Although we are far from a detailed interpretation of lean human body maintenance, the primary findings of our study suggest that gut microbial composition may be a factor influencing the regulation of weight gain in lean athletes with a positive energy balance.

Comparison of regional and local anesthesia for arteriovenous fistula creation in end-stage renal disease: a systematic review and meta-analysis

BackgroundArteriovenous fistulae (AVF) are the hemodialysis access modality of choice for patients with end-stage renal disease. However, they have a high early failure rate. Good vascular access is essential to manage long-term hemodialytic treatment, but some anesthesia techniques directly affect venous diameter as well as intra- and post-operative blood flow. The main purpose of this meta-analysis was to compare the results of regional and local anesthesia (RA and LA) for arteriovenous fistula creation in end-stage renal disease.MethodsWe conducted a systematic review and meta-analysis to synthesize evidence from 7 randomized controlled trials (565 patients) and 1 observational study (408 patients) with the aim of evaluating the safety and efficacy of RA versus LA in surgical construction of AVF.ResultsPooled data showed that RA was associated with higher primary patency rates than LA (odds ratio [OR], 1.88; 95% confidence interval [CI]: 1.24–2.84; P = 0.003; I2 = 31%). Additionally, brachial artery diameter was significantly increased in the RA versus LA group (mean difference [MD], 0.83; 95% CI: 0.75–0.92; P < 0.001; I2 = 97%) and the need for intra- as well as post-operative pain killers was significantly less (RA, P = 0.0363; LA, P = 0.0318). Moreover, operation duration was significantly reduced using RA versus LA (MD, − 29.63; 95% CI: − 32.78 - -26.48; P < 0.001; I2 = 100%).ConclusionsThis meta-analysis suggests that RA is preferable to LA in patients with end-stage renal disease in guaranteeing AVF patency and increasing brachial artery diameter.

Antidiabetic and antioxidant effects of Lupinus albus L. seed roasting ethanol extract in streptozotocin diabetic rats

Diabetes mellitus (DM) may cause specially health problem which can effect most of tissue such as liver, kidney and brain. Thus, this research aimed to examining the effects of Lupinus albus L. seed ethanol extract (LA) on the liver and renal tissues malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and glutathione (GSH) level of diabetic rats. Sprague–Dawley, adult a total of 28 male rats were used in the study that were randomly divided into four groups with 7 animals in each group: Control, STZ-DM, LA and STZ-DM+LA group. Diabetes was induced in rats by a single dose of 60 mg/kg/i.p. Streptozotocin (STZ) injection (STZ-DM and STZ-DM+LA groups). Lupinus albus L. ethanol extract was given at a dose of 10 mg/kg/p.o. via intragastric tube for 20 days (LA and STZ-DM+LA groups). At the end of the study, biochemical and histopathological examination in kidney and liver tissues were examined. STZ application significantly increased the oxidative stress and lipid peroxidation. When the dose of 10 mg/kg of LA significantly decreased the level of plasma glucose and liver and renal MDA. Meanwhile, the levels of liver and renal CAT, SOD, GPx and GSH were significantly increased in diabetic rats treated with Lupinus albus L. seed ethanol extract. These results indicate the role of Lupinus albus L. seed extract might as antidiabetic, antioxidant and reducing of the oxidative stress and lipid peroxidation. Extracted after Lupinus albus seed’ roasting is a pioneer in literature and the use of LA in ethnomedicine for diabetes.

Open vs laparoscopic adrenalectomy for localized adrenocortical carcinoma.

The purpose of the study was to compare the long-term outcomes of patients with localized adrenocortical carcinoma (ACC) subjected to open vs laparoscopic surgery. Retrospective study. This retrospective study included 46 patients with the ACC ENSAT stage I-stage III of whom 23 underwent open surgery (OA group), whereas 23 were subjected to laparoscopic adrenalectomy (LA group). The main outcomes analysed in the study were differences between the OA and LA groups in recurrence-free survival (RFS) and overall survival (OS). Patients in OA group had larger tumours (120 [70-250] mm vs 75 [26-110] mm; P<.001), higher Ki-67 index (16 [1-65] % vs 10 [1-25] %; P=.04) and higher disease stage (P=.01) compared with the patients in the LA group. The median duration of follow-up for patients underwent OA and LA was 51 (12-174) and 53 (5-127) months, respectively. Eight patients (5 OA and 3 LA) experienced recurrent disease, whereas six patients (3 OA and 3 LA) died during follow-up. No differences in RFS and OS were found between patients who underwent open or laparoscopic surgery. The study demonstrated that in patients with localized ACC and without invasion of extra-adrenal tissues, LA is a plausible treatment option in terms of RFS and OS. However, our results are limited to referral centres with large experience in the management of patients with ACC and may not necessarily apply to nonspecialized centres.

Asthma rehabilitation at high vs. low altitude and its impact on exhaled nitric oxide and sensitization patterns: Randomized parallel-group trial

BackgroundAllergens and pollution are reduced at high altitude. We investigated the effect of asthma rehabilitation at high altitude (HA, 3100 m) compared to low altitude (LA, 760 m) on exhaled nitric oxide (FeNO) and on specific IgE levels for house dust mites (HDM,d1) and common pollen (sx1). MethodsFor this randomized controlled trial adult asthmatics living <1000 m were randomly assigned to a 3-week in-hospital-rehabilitation (education, physical- and breathing-exercises) at either LA or HA. Changes in FeNO, d1 and sx1 from baseline to end-rehabilitation were measured. Results50 asthmatics (34 females) were randomized [mean ± standard deviation LA: n = 25, 44 ± 11 years, total IgE 267 ± 365kU/l; HA: n = 25, 43 ± 13 years, total IgE 350 ± 445kU/l]. FeNO significantly improved at HA from 69 ± 56 ppb at baseline to the first day at altitude 23 ± 19 ppb and remained decreased until end-rehabilitation with 37 ± 23 ppb, mean difference 95%CI -31(-50 to −13, p = 0.001) whereas at LA FeNO did not change. A significant decrease in d1 and sx1 at end-rehabilitation was observed in the LA-group [mean difference 95%CI -10.2 kUA/l (−18.9 to −1.4) for d1 and -4.95 kUA/l(-9.69 to −0.21) for sx1] but not in the HA-group. No significant difference between groups [d1 5.9 kUA/l(-4.2 to 16.2) and sx1 4.4 kUA/l(-3.5 to 12.4)] was found. ConclusionRehabilitation at HA led to significant FeNO reduction starting from the first day until end-rehabilitation despite unchanged levels of specific IgE. The significant decrease in d1 and sx1 at end-rehabilitation in the LA group might be explained by less HDM in the hospital and/or reduced seasonal pollen, as this decrease was not observed at HA.

Four-year outcomes of small incision lenticule extraction (SMILE) to correct high myopic astigmatism

AimsTo evaluate the long-term outcomes of small incision lenticule extraction (SMILE) in subjects with myopic astigmatism of ≥2.00 dioptres (D).MethodsPatients who underwent SMILE 4 years prior with astigmatism ≥2.00 D...

Detection of Nonpalpable Tiny Axillary Lymph Nodes Surrounded by Adipose Tissue Using a Near-Infrared Camera.

Background: It is not always possible to detect nonpalpable small lymph nodes (LNs) surrounded by adipose tissue under the wavelength of visible light. A newly developed near-infrared camera with InGaAs element was able to capture photographs using light at >1000-nm wavelength, at which the difference in absorbance between water and lipids is large. This study investigated the ability to detect nonvisible small LNs using light at 1300-nm wavelength. Methods and Results: Following retrieval of LNs through axillary LN dissection from 20 patients with breast cancer, residual specimens were simultaneously photographed using light at 970-, 1070-, 1200-, 1300-, 1450-, and 1600-nm wavelengths. A total of 45 specimens were observed pathologically at the selected portions in which the 1300-nm light was absorbed (high absorbance group [HA group], n = 25) and those in which the 970-nm light was absorbed instead (low absorbance group [LA group], n = 20). All specimens categorized in the HA group detected the LNs, whereas none of those categorized in the LA group detected an LN. The sensitivity and specificity in the identification of an LN were 1.0. The LNs detected using this camera were significantly smaller than those detected by surgeons (3.00 ± 2.93 mm vs. 5.90 ± 3.91 mm, p < 0.01). Discussion: The light at 1300-nm wavelength was absorbed by axillary LNs. This camera detected LNs that were undetectable by surgeons. This novel technology may be applied to lymphatic microsurgery and contribute to the development of a minimally invasive LN dissection method.

Histopathological Examination of the Effects of Local and Systemic Bisphosphonate Usage in Bone Graft Applications on Bone Healing

The effect of bisphosphonates on the resorption process of normal bone tissue has been clearly mentioned in the literature, while their effect on the grafting material is a new research area. Limited former study is not sufficient to determine the strength, reliability and dosage of bisphosphonates. In this study, our aim is to examine the effects of local and systemic use of bisphosphonates in bone graft applications on bone healing, histopathologically. Therefore, 32 Sprague-Dawley rats are separated into four groups. In the first group, only an empty bone defect is made on tibia and the tissue is sutured primarily without any other application. In the second group, bone defect is filled with allograft material and closed without any other application. In the third group (LA), alendronate solution is locally added to the graft material before its application to the site of bone defect. In the fourth group, alendronate is applied systemically after the site of bone defect is grafted and primarily closed. After 6weeks, all rats are killed and the obtained samples are examined histopathologically. Local and systemic application of alendronate increases new bone formation in a statistically significant degree. In LA group, newly formed bone was observed more mature and well developed. Alendronate application does not cause an increase in inflammation, fibrosis and necrosis. There is no increased necrosis with alendronate application. Local and systemic application of alendronate in bone grafting increases bone formation without any other complication. But we believe that further research should be made on dosage, usage and possible side effects.

Gender differences in professional social media use among anaesthesia researchers

BackgroundRecent studies suggest that female researchers are less visible on social media. The objective of this observational work was to compare the use of professional social networks between male and female anaesthesia researchers. MethodsAmong four anaesthesia journals, we analysed the first/last authors (FA/LA) of the most frequently cited articles in 2016–2017 and the authors who published more than one article per year between 2013 and 2018 (prolific authors). We compared the use of the professional social networks Twitter, LinkedIn, and ResearchGate by the selected authors and analysed the proportion of women in FA and LA position. The variables are presented as median (inter-quartile range). ResultsThe analysis included 260 FA, 232 LA, and 297 prolific authors. Despite similar declared skills and number of citations, women had lower scientific reputation scores on ResearchGate (RG score: 32.0 [24.4–41.1] vs 20.3 [15.1–29.2]; P<0.0001 in the FA group; 39.3 [34.3–43.4] vs 35.7 [30.3–39.5], P<0.01 in the LA group; and 41.5 [35.6–45.7] vs 36.8 [28.1–42.7], P<0.01 in the prolific group). In all groups, women were significantly less followed on ResearchGate than men. In the three groups, the Twitter (22.7%, 25.0%, and 23.6%, respectively) and LinkedIn (59.2%, 56.5%, and 62.3%, respectively) usage rate were similar with no difference between men and women in each group. Of the 260 articles included, 94 (36.2%) manuscripts had female FA, whereas 41 (15.8%) had female LA. ConclusionIn anaesthesia, the visibility of female researchers on the social network dedicated to scientific research is lower than that of male researchers.

Verbal working memory resources and comprehension of relative clauses in children with cochlear implants

Verbal working memory resources may impact syntax comprehension. Thirteen Italian children with cochlear implants (CIs) were assessed in relative clause (RC) comprehension, digit span and nonword repetition and compared to 13 chronological age peers (CA) and 13 younger controls (LA) with normal hearing (NH). The RC comprehension task tested subject relatives (SR), object relatives with preverbal (OR) and postverbal subjects (ORp) where number features were manipulated. Children with CIs show worse performance than controls in RC comprehension and nonword repetition. In the RC task, number features facilitated comprehension by children with NH, but not by children with CIs. The memory measure that predicted RC comprehension was digit span. In the LA group, backward digit span predicted comprehension of all RC types. Forward digit span predicted comprehension of ORs with number mismatch in the CA group, and comprehension of ORs with number mismatch and ORps in children with CIs. In these conditions, high memory resources are needed to exploit number features in theta-role assignment.

Preemptive local anesthetic infiltration reduces opioid requirements without attenuation of the intraoperative electrical stapedial reflex threshold in pediatric cochlear implant surgery.

Background and Aims:Total intravenous anesthesia using remifentanil provides good surgical condition without affecting the intraoperative electrical stapedial reflex threshold (ESRT). However, remifentanil results in hyperalgesia and increases postoperative opioid requirements. Local anesthetic infiltration is alternative methods to opioid for providing analgesia. However, otologists avoids its use as it can abolish the ESRT. We investigated the effect of the preemptive local anesthetic infiltration on intraoperative ESRT and opioid requirements in pediatric cochlear implant surgery performed under TIVA.Material and Methods:Prospective, randomized, double-blinded, controlled study including 70 child undergoing cochlear implant under TIVA were randomly assigned to a local anesthesia (LA group, n = 35) or control (CT group, N = 35). The primary outcome was the total tramadol consumption during the first 24 h postoperative, and the secondary outcomes were time to first analgesia request, postoperative pain scores, the ESRT and, propofol and remifentanil requirements. The incidence of postoperative vomiting was recorder as well.Results:The total tramadol consumption during the first 24 h after surgery was significantly less in the LA group than in CT group (8.25 [4.3] vs. 16.5 [6.57] mg, P < 0.01). The time to first analgesic request was significantly prolonged in the LA group as compared with the CT group [8 [2–12] vs. 3 [0–8] h, P < 0.01). The postoperative Faces, Legs, Activity, Cry Consolability pain scores were significantly lower in the LA group at 15 min, 30 min, 2, 4 and 6 h postoperative. Mean remifentanil infusion rate [mean (standard deviation)] was significantly higher in in the CT group than in the LA group [0.7 (0.3) vs. 0.5 (0.2) μg/kg/min; P = 0.001).The ESRT response, propofol requirements, and the incidence of postoperative vomiting had no significant differences between both groups.Conclusion:Preemptive local anesthetic infiltration reduced opioid requirements without attenuation of the ESRT in pediatric cochlear implant surgery performed under TIVA.