Inconsistent Outcomes Research Articles

The Clinical Relationship Between HLA-B27 And Juvenile Spondyloarthropathyh

Juvenile spondyloarthropathies (JSpA) encompass a cluster of interconnected rheumatic conditions that manifest during the formative stages of an individual’s life, specifically prior to their sixteenth birthday. The primary characteristics of juvenile spondyloarthropathies include both axial and peripheral arthritis, enthesitis, extra-articular symptoms, and a strong association with the human leukocyte antigen HLA-B27. There exists substantial evidence of the involvement of tumor necrosis factor and interleukin-17 in the pathophysiology of these conditions. A variety of non-biological and biological therapies have been employed in the treatment of these intricate disorders, showing inconsistent outcomes. This study examines the correlation between HLA-B27 and juvenile spondyloarthropathies, as well as the involvement of HLA-B27 in the pathology of the disease. The present study focuses on the clinical characteristics of HLA-B27 in juvenile spondyloarthropathies and examines the recently recommended therapy for individuals with juvenile spondyloarthropathies.

Microfeed Incorporated with Probiotic for Aquaculture: A Review

Ensuring the availability of high-quality larvae in sufficient quantities remains a significant bottleneck for the grow-out phase of aquaculture. Over the past century, various alternative dietary solutions for larval stages have been explored, encompassing bacteria, microalgal pastes, yeasts, and various inert microparticles, though with inconsistent outcomes. This review aimed to discuss the innovative integration of probiotics into microfeeds, highlighting encapsulation, coating, and fermentation techniques to propel aquaculture productivity. Microfeeds, which are often nutrient-rich and easily assimilated in powdered or liquid form, play a crucial role in larval fish nutrition. These can be classified into microencapsulated, dry, liquid, and live feeds. The choice of microfeed is pivotal, ensuring appeal, digestibility, and water stability tailored to each larval stage. As probiotics gain popularity in aquaculture for their potential to enhance growth, bolster disease resistance, and improve water quality, their administration methods have diversified. The probiotics can be administered through direct immersion and bath treatments to biofloc systems and feed additives. The results indicated that microfeed incorporated with probiotics showed a positive result impact on the aquaculture industry.

An Exploration of the Pepper Robot’s Capabilities: Unveiling Its Potential

The application of social robots is increasing daily due to their various capabilities. In real settings, social robots have been successfully deployed in multiple domains, such as health, education, and the service industry. However, it is crucial to identify the strengths and limitations of a social robot before it can be employed in a real-life scenario. In this study, we explore and examine the capabilities of a humanoid robot, ‘Pepper’, which can be programmed to interact with humans. The present paper investigates five capabilities of Pepper: mapping and navigation, speech, hearing, object detection, and face detection. We attempt to study each of these capabilities in-depth with the help of experiments conducted in the laboratory. It has been identified that Pepper’s sound and speech recognition capabilities yielded satisfactory results, even with various accents. On the other hand, Pepper’s built-in SLAM navigation is unreliable, making it difficult to reach destinations accurately due to generated maps. Moreover, its object and face detection capabilities delivered inconsistent outcomes. This shows that Pepper has potential for improvement in its current capabilities. However, previous studies showed that with the integration of artificial intelligence techniques, a social robot’s capabilities can be enhanced significantly. In the future, we will focus on such integration in the Pepper robot, and the present study’s exploration will help to establish a baseline comprehension of the in-built artificial intelligence of Pepper. The findings of the present paper provide insights to researchers and practitioners planning to use the Pepper robot in their future work.

Cognitive and emotional predictors of quality of life and functioning after COVID-19.

A long-term decline in health-related quality of life (HRQoL) has been reported after coronavirus disease 2019 (COVID-19). Studies with people with persistent symptoms showed inconsistent outcomes. Cognition and emotion are important determinants in HRQoL, but few studies have examined their prognostic significance for HRQoL and functionality in post-COVID patients with persisting symptoms. We aimed to describe QoL, HRQoL, and functioning in individuals post-COVID with varying COVID-19 severities and to investigate the predictive value of cognitive and emotional variables for QoL, HRQoL, and functioning. In total, 492 participants (398 post-COVID and 124 healthy controls) underwent a neurobehavioral examination that included assessments of cognition, mood, QoL/HRQoL (WHOQOL-BREF, EQ-5D), and functioning (WHODAS-II). Analysis of covariance and linear regression models were used to study intergroup differences and the relationship between cognitive and emotional variables and QoL and functioning. The Physical and Psychological dimensions of WHOQoL, EQ-5D, and WHODAS Cognition, Mobility, Life Activities, and Participation dimensions were significantly lower in post-COVID groups compared with a control group. Regression models explaining 23.9%-53.9% of variance were obtained for the WHOQoL-BREF dimensions and EQ-5D, with depressive symptoms, post-COVID symptoms, employment status, income, and mental speed processing as main predictors. For the WHODAS, models explaining 17%-60.2% of the variance were obtained. Fatigue, depressive symptoms, mental speed processing, and post-COVID symptoms were the main predictors. QoL/HRQoL and functioning after COVID-19 in individuals with persistent symptoms were lower than in non-affected persons. Depressive symptoms, fatigue, and slower mental processing speed were predictors of lower QoL/HRQoL and functioning.

Quality of Surgical Outcome Reporting in Randomised Clinical Trials of Multimodal Rectal Cancer Treatment: A Systematic Review.

Randomised controlled trials (RCTs) continue to provide the best evidence for treatment options, but the quality of reporting in RCTs and the completeness rate of reporting of surgical outcomes and complication data vary widely. The aim of this study was to measure the quality of reporting of the surgical outcome and complication data in RCTs of rectal cancer treatment and whether this quality has changed over time. Eligible articles with the keywords ("rectal cancer" OR "rectal carcinoma") AND ("radiation" OR "radiotherapy") that were RCTs and published in the English, German, Polish, or Italian language were identified by reviewing all abstracts published from 1982 through 2022. Two authors independently screened and analysed all studies. The quality of the surgical outcome and complication data was assessed based on fourteen criteria, and the quality of RCTs was evaluated based on a modified Jadad scale. The primary outcome was the quality of reporting in RCTs and the completeness rate of reporting of surgical results and complication data. A total of 340 articles reporting multimodal therapy outcomes for 143,576 rectal cancer patients were analysed. A total of 7 articles (2%) met all 14 reporting criteria, 13 met 13 criteria, 27 met from 11 to 12 criteria, 36 met from 9 to 10 criteria, 76 met from 7 to 8 criteria, and most articles met fewer than 7 criteria (mean 5.5 criteria). Commonly underreported criteria included complication severity (15% of articles), macroscopic integrity of mesorectal excision (17% of articles), length of stay (18% of articles), number of lymph nodes (21% of articles), distance between the tumour and circumferential resection margin (CRM) (26% of articles), surgical radicality according to the site of the primary tumour (R0 vs. R1 + R2) (29% of articles), and CRM status (38% of articles). Inconsistent surgical outcome and complication data reporting in multimodal rectal cancer treatment RCTs is standard. Standardised reporting of clinical and oncological outcomes should be established to facilitate comparing studies and results of related research topics.

Prediction of Duration of Dry Bamboo Leaf Counting Using Fuzzy Logic

Dry bamboo leaves are selected as a planting medium for ornamental plants to enhance nutrient content and improve soil drainage. Before being processed into fertilizer, dry bamboo leaves need to be shredded first. The leaf counting process for planting ornamental plants in villages still relies on manual methods such as using knives and scissors, which can be time-consuming and less effective. In response to this issue, a device for shredding dry bamboo leaves has been developed to improve efficiency and facilitate the leaf counting process. The innovation created is a household-scale dry bamboo leaf shredder that is more affordable and easy to mobilize due to its compact dimensions and lighter weight. The device is also easy to operate, as the shredding occurs when it is closed, and the process stops when it is opened, ensuring safe use for various users. The manual control of bamboo leaf weight and counting duration results in inconsistent shredding outcomes. Therefore, development has been carried out on the dry bamboo leaf shredder with artificial intelligence capabilities, specifically using fuzzy logic to automate the counting duration based on the size and weight of the bamboo leaves being inputted.

Pengaruh Akuisisi Terhadap Performa Finansial Pada Perusahaan di Bursa Efek Indonesia

The purpose of this observation is to determine the impact of acquisitions on the financial performance of companies that implement acquisition strategies listed on the IDX. To assess a company's financial performance, comparisons are usually used, including: Comparison of current assets with current debt, comparison of total debt with total assets, and comparison of net profit after tax with sales. The literature review method is applied in this observation which is carried out by reviewing the results of past observations that are in line with this topic, but there are inconsistent outcomes. Observations applied by (Utari, Asriany, and Hamid 2022) which state that in acquiring companies they must be able to assess the financial performance of target companies so that the risk of loss will be reduced. While the observations applied by (Firdaus and Dara 2020) provide information that there is no change in the company's financial performance after the acquisition, the company's financial performance remains stable between pre and post acquisition. Based on this explanation, this observation was chosen to determine the impact of acquisitions on the financial performance of companies with acquisition strategies listed on the IDX.

The effectiveness of continuing education programmes for health workers in rural and remote areas: a systematic review and meta-analysis.

Health workers in rural and remote areas shoulder heavy responsibilities for rural residents. This systematic review aims to assess the effectiveness of continuing education programs for health workers in rural and remote areas. Eight electronic databases were searched on 28 November 2021. Randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effectiveness of continuing education for health workers in rural and remote areas were included. The quality of the studies was assessed using the risk of bias tool provided by Effective Practice and Organization of Care. A meta-analysis was performed for eligible trials, and the other findings were presented as a narrative review because of inconsistent study types and outcomes. A total of 17 studies were included, four of which were RCTs. The results of the meta-analysis showed that compared to no intervention, continuing education programs significantly improved the knowledge awareness rate of participants (odds ratio=4.09, 95% confidence interval 2.51-6.67, p<0.05). Qualitative analysis showed that 12 studies reported on the level of knowledge of participants, with all showing positive changes. Eight studies measured the performance of health workers in rural and remote areas, with 87.50% (n=7) finding improved performance. Two studies reported on the impact of continuing education programs for health workers in rural and remote areas on patient health, with only one showing a positive change. One study from India measured the health of communities, which showed a positive change. The results of this study showed that continuing education programs are an effective way to address the lack of knowledge and skills among health workers in rural and remote areas. Few studies have examined the effectiveness of education programs for health workers in rural and remote areas in improving patient health outcomes. It is not yet known whether the delivery of continuing education programs to health workers in rural areas has a positive impact on patient and community health. Future attention should continue to be paid to the impact on these outcomes.

Topical Atropine for Childhood Myopia Control

Clinical trial results of topical atropine eye drops for childhood myopia control have shown inconsistent outcomes across short-term studies, with little long-term safety or other outcomes reported. To report the long-term safety and outcomes of topical atropine for childhood myopia control. This prospective, double-masked observational study of the Atropine for the Treatment of Myopia (ATOM) 1 and ATOM2 randomized clinical trials took place at 2 single centers and included adults reviewed in 2021 through 2022 from the ATOM1 study (atropine 1% vs placebo; 1999 through 2003) and the ATOM2 study (atropine 0.01% vs 0.1% vs 0.5%; 2006 through 2012). Change in cycloplegic spherical equivalent (SE) with axial length (AL); incidence of ocular complications. Among the original 400 participants in each original cohort, the study team evaluated 71 of 400 ATOM1 adult participants (17.8% of original cohort; study age, mean [SD] 30.5 [1.2] years; 40.6% female) and 158 of 400 ATOM2 adult participants (39.5% of original cohort; study age, mean [SD], 24.5 [1.5] years; 42.9% female) whose baseline characteristics (SE and AL) were representative of the original cohort. In this study, evaluating ATOM1 participants, the mean (SD) SE and AL were -5.20 (2.46) diopters (D), 25.87 (1.23) mm and -6.00 (1.63) D, 25.90 (1.21) mm in the 1% atropine-treated and placebo groups, respectively (difference of SE, 0.80 D; 95% CI, -0.25 to 1.85 D; P = .13; difference of AL, -0.03 mm; 95% CI, -0.65 to 0.58 mm; P = .92). In ATOM2 participants, the mean (SD) SE and AL was -6.40 (2.21) D; 26.25 (1.34) mm; -6.81 (1.92) D, 26.28 (0.99) mm; and -7.19 (2.87) D, 26.31 (1.31) mm in the 0.01%, 0.1%, and 0.5% atropine groups, respectively. There was no difference in the 20-year incidence of cataract/lens opacities, myopic macular degeneration, or parapapillary atrophy (β/γ zone) comparing the 1% atropine-treated group vs the placebo group. Among approximately one-quarter of the original participants, use of short-term topical atropine eye drops ranging from 0.01% to 1.0% for a duration of 2 to 4 years during childhood was not associated with differences in final refractive errors 10 to 20 years after treatment. There was no increased incidence of treatment or myopia-related ocular complications in the 1% atropine-treated group vs the placebo group. These findings may affect the design of future clinical trials, as further studies are required to investigate the duration and concentration of atropine for childhood myopia control.

Efficacy of N-acetylcysteine plus pirfenidone in the treatment of idiopathic pulmonary fibrosis: a systematic review and meta-analysis

BackgroundNumerous studies have demonstrated the potential of pirfenidone to enhance the prognosis of patients afflicted with idiopathic pulmonary fibrosis (IPF). Although N-acetylcysteine (NAC) is utilized as an antioxidant in IPF treatment, the combination of NAC and pirfenidone has produced inconsistent outcomes in certain studies. To assess the clinical effectiveness and safety of NAC plus pirfenidone (designated as the treatment group) versus pirfenidone monotherapy (designated as the control group), we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs).MethodsRCTs of NAC plus pirfenidone were reviewed searching from databases and networks of unpublished and published studies in any language. Using pair-wise meta-analysis, changes in pulmonary function test (PFT) parameters and safety were evaluated.ResultsTwo independent reviewers selected and obtained data from 5 RCTs (n = 398), comprising 1 study from Japan, 1 from Europe, and 3 from China. NAS plus pirfenidone as compared to pirfenidone monotherapy for IPF may not reduce the incidence of skin effects(RR 1.26 [95%CI 0.64 to 2.45]) and mortality(RR 0.35 [95%CI 0.07 to 1.68])(both moderate certainty). NAS plus pirfenidone as compared to pirfenidone monotherapy for IPF may not reduce the incidence of at least one side effects(RR 1.00 [95%CI 0.84 to 1.19]; low certainty),severe side effects(RR 0.67 [95%CI 0.30 to 1.47]; low certainty) and gastrointestinal effects(RR 0.67 [95%CI 0.41 to 1.09]; low certainty) with possibly no effect in Δ%DLco(SMD -0.17 [95%CI -0.15 to 0.48]; low certainty). Meanwhile, the effect of NAS plus pirfenidone as compared to pirfenidone monotherapy on ΔFVC(SMD 0.18 [95%CI -0.68 to 1.05]), Δ%FVC(SMD -2.62 [95%CI -5.82 to 0.59]) and Δ6MWT(SMD -0.35 [95%CI -0.98 to 0.28]) is uncertain(extremely low certainty).ConclusionModerate certainty evidence suggests that NAS plus pirfenidone, compared to pirfenidone monotherapy for IPF, does not reduce the incidence of skin effects and mortality.

RANK and RANKL Expression in Tumors of Patients with Early Breast Cancer

AbstractThe receptor activator of nuclear factor-κB (RANK) pathway was associated with the pathogenesis of breast cancer. Several studies attempted to link the RANK/RANKL pathway to prognosis; however, with inconsistent outcomes. We aimed to further contribute to the knowledge about RANK/RANKL as prognostic factors in breast cancer. Within this study, protein expression of RANK and its ligand, RANKL, in the tumor tissue was analyzed in association with disease-free survival (DFS) and overall survival (OS) in a study cohort of patients with early breast cancer.607 samples of female primary and early breast cancer patients from the Bavarian Breast Cancer Cases and Controls Study were analyzed to correlate the RANK and RANKL expression with DFS and OS. Therefore, expression was quantified using immunohistochemical staining of a tissue microarray. H-scores were determined with the cut-off value of 8.5 for RANK and 0 for RANKL expression, respectively.RANK and RANKL immunohistochemistry were assessed by H-score. Both biomarkers did not correlate (ρ = −0.04). According to molecular subtypes, triple-negative tumors and HER2-positive tumors showed a higher number of RANK-positive tumors (H-score ≥ 8.5), however, no subtype-specific expression of RANKL could be detected. Higher RANKL expression tended to correlate with a better prognosis. However, RANK and RANKL expression could not be identified as statistically significant prognostic factors within the study cohort.Tumor-specific RANK and RANKL expressions are not applicable as prognostic factors for DFS and OS, but might be associated with subtype-specific breast cancer progression.

Epidemiological Models and Epistemic Perspectives: How Scientific Pluralism may be Misconstrued

AbstractIn a scenario characterized by unpredictable developments, such as the recent COVID-19 pandemic, epidemiological models have played a leading part, having been especially widely deployed for forecasting purposes. In this paper, two real-world examples of modeling are examined in support of the proposition that science can convey inconsistent as well as genuinely perspectival representations of the world. Reciprocally inconsistent outcomes are grounded on incompatible assumptions, whereas perspectival outcomes are grounded on compatible assumptions and illuminate different aspects of the same object of interest. In both cases, models should be viewed as expressions of specific assumptions and unconstrained choices on the part of those designing them. The coexistence of a variety of models reflects a primary feature of science, namely its pluralism. It is herein proposed that recent over-exposure to science’s inner workings and disputes such as those pertaining to models, may have led the public to perceive pluralism as a flaw—or more specifically, as disunity or fragmentation, which in turn may have been interpreted as a sign of unreliability. In conclusion, given the inescapability of pluralism, suggestions are offered as to how to counteract distorted perceptions of science, and thereby enhance scientific literacy.

Abstract 12421: Guided Advanced Cardiovascular Life Support Mobile App Improves Trainee Experience and Performance During Simulated Cardiac Arrest: A Randomized Controlled Trial

Introduction: Leading hospital code teams is stressful for resident physicians, and variability in training and experience may result in inconsistent care and outcomes. Nearly all bedside aids like AHA advanced cardiovascular life support (ACLS) pocket cards and third-party ACLS mobile apps lack step-by-step guidance or reminders. Our team designed a guided ACLS mobile app to help trainees lead more effective hospital resuscitations and conducted a randomized controlled trial to assess user experience and performance according to 2020 AHA ACLS guidelines. Hypothesis: A guided ACLS app will improve subjective user experience and adherence to AHA ACLS guidelines. Methods: The ACLS mobile app was developed using Swift UIKit. Internal Medicine, Emergency Medicine, Surgery, and Anesthesia residents (N = 46) were randomized to lead a simulated code for cardiac arrest due to massive pulmonary embolism using either AHA pockets cards (N = 22) or the ACLS app (N = 24). User experience was assessed via surveys. Code outcomes, guideline adherence, and errors were analyzed from video recordings. A focus group of 22 residents provided feedback. Statistical analysis was conducted using R software and included two-sided t-tests and Fisher exact tests. Results: App users showed significantly increased confidence (1.0 vs 0.3; p = 0.005), backboard use (96% vs 27%; p &lt;0.001), end-tidal CO2 monitoring (58% vs 27%; p = 0.042), correct thrombolytic administration (54% vs 23%; p = 0.035), and achieving return of spontaneous circulation (50% vs 18%; p = 0.032) compared to controls. Focus group results showed that 100% of the participants would use the app and that 82% preferred the guided app to AHA pocket cards. Conclusions: The guided app improves user confidence and adherence to AHA ACLS guidelines and addresses the need for greater standardization in hospital code management. Validation studies are necessary to confirm its effectiveness in clinical practice.

Model-based predictions of protective HIV pre-exposure prophylaxis adherence levels in cisgender women

Most human immunodeficiency virus (HIV) infections occur in cisgender women in resource-limited settings. In women, self-protection with emtricitabine/tenofovir disoproxil fumarate pre-exposure prophylaxis (FTC/TDF-PrEP) constitutes a major pillar of HIV prevention. However, clinical trials in women had inconsistent outcomes, sparking uncertainty about adherence requirements and reluctance in evaluating on-demand regimens. We analyzed data from published FTC/TDF-PrEP trials to establish efficacy ranges in cisgender women. In a ‘bottom-up’ approach, we modeled hypotheses in the context of risk-group-specific, adherence–efficacy profiles and challenged those hypotheses with clinical data. We found that different clinical outcomes were related to the proportion of women taking the product, allowing coherent interpretation of the data. Our analysis showed that 90% protection was achieved when women took some product. We found that hypotheses of putative male/female differences were either not impactful or statistically inconsistent with clinical data. We propose that differing clinical outcomes could arise from pill-taking behavior rather than biological factors driving specific adherence requirements in cisgender women.

Hypoxemia Trajectory of Non-COVID-19 Acute Respiratory Distress Syndrome Patients. An Observational Study Focusing on Hypoxemia Resolver Status.

Most studies on acute respiratory distress syndrome (ARDS) group patients by severity based on their initial degree of hypoxemia. However, this grouping has limitations, including inconsistent hypoxemia trajectories and outcomes. This study explores the benefits of grouping patients by resolver status based on their hypoxemia progression over the first 7 days. This is an observational study from a large single-center database. Medical Information Mart for Intensive Care (MIMIC)-IV and MIMIC Chest X-ray JPEG databases were used. Mechanically ventilated patients that met the Berlin ARDS criteria were included. The primary outcome was the proportion of hypoxemia resolvers vs. nonresolvers in non-COVID-19 ARDS patients. Nonresolvers were defined as those whose hypoxemia worsened or remained moderate or severe over the first 7 days. Secondary outcomes included baseline admission characteristics, initial blood gases and ventilation settings, length of invasive mechanical ventilation, length of ICU stay, and ICU survival rates across resolver groups. A total of 894 ICU admissions were included in the study. Of these, 33.9% were hypoxemia nonresolvers. The resolver groups showed no significant difference in age, body mass index, comorbidities, or Charlson score. There was no significant difference in the percentage of those with initial severe hypoxemia between the two groups (8.1% vs. 9.2%; p = 0.126). The initial Pao2/Fio2 ratio did not significantly increase the odds ratio (OR) of being a nonresolver (OR, 0.84; 95% CI, 0.65-1.10). Nonresolver mortality was 61.4%, comparable to the survival rates seen in nonresolvers in a previous large COVID-19 ARDS study. Our study shows that resolver status is a valuable grouping in ARDS. It has significant advantages over grouping by initial degree of hypoxemia, including better mapping of trajectory and comparable outcomes across other studies. While it may offer insights into disease-specific associations, future studies should include resolver status analysis for more definitive conclusions.

Radiofrequency Thermocoagulation Through the Foramen Rotundum Versus the Foramen Ovale for V2 Primary Trigeminal Neuralgia: A Systematic Review and Meta-analysis

BACKGROUND: Percutaneous radiofrequency thermocoagulation (RFT) through the foramen rotundum (FR) is a new approach for the treatment of V2 trigeminal neuralgia (TN). Some studies have shown the novel method seems to have advantages over traditional RFT through the foramen ovale (FO). The optimal interventional surgical strategy for isolated V2 TN remains controversial. OBJECTIVES: The purpose of our study was to perform a systematic review and meta-analysis to evaluate the clinical results of RFT through the FR and the traditional FO puncture approach. STUDY DESIGN: A systematic review of randomized controlled trials for thermocoagulation through the foramen rotundum versus the foramen ovale for V2 primary trigeminal neuralgia. METHODS: Randomized controlled trials or nonrandomized controlled trials published from January 2000 through October 2022 that compared RFT through the FR and the FO for V2 primary TN were found through a comprehensive search in 3 electronic databases (PubMed, EMBASE, Cochrane library). A total of 3 studies (105 patients) were included in this systematic review and meta-analysis. RESULTS: The results indicate that there are no statistically significant differences between the FR group and the FO group in terms of postoperative immediate effect rate (postoperative one week) (P &gt; 0.1; standardized mean difference [SMD] = 0.67 [0.26- 1.71]) and recurrence rate (P &gt; 0.1; SMD = 0.67 [0.26 - 1.71]). The long-term effect rate (postoperative one year) was significantly higher in the FR group (P &lt; 0.05; SMD = 0.12 [0.01 - 0.22]). The FO group had a significantly higher total complication rate compared with the FR group (P &lt; 0.01; SMD = 0.12 [0.03 - 0.53]). LIMITATIONS: The limitations of this systematic review and meta-analysis include the small range of study populations. Heterogeneity caused by inconsistent follow-up time, outcome measurements, and RF parameters are other limitations. CONCLUSION: In conclusion, RFT of the maxillary nerve through the FR for the treatment of primary V2 TN had a better long-term effect rate and fewer complications in comparison with thermocoagulation of the Gasserian ganglion through the FO. No differences were found between both interventions in terms of immediate effect rate and recurrence rate. KEY WORDS: Radiofrequency thermocoagulation, primary trigeminal neuralgia, foramen rotundum, foramen ovale, systematic review, meta-analysis

A Mini-Review of Magnesium Sulfate's Anti-Inflammatory, Immune, and Neuroprotective Mechanisms in Subarachnoid Hemorrhage

Subarachnoid hemorrhage (SAH) is a severe neurological condition frequently associated with devastating complications. This mini-review explores the therapeutic potential of magnesium sulfate (MS) in this setting. We conducted an updated search across several academic databases, focusing on articles examining MS's anti-inflammatory, immune-modulating, and neuroprotective properties in this setting. The findings suggested that MS can inhibit specific inflammatory pathways, reduce pro-inflammatory markers, modulate immune responses by inhibiting microglial activation, and offer neuroprotection through mechanisms such as NMDA receptor antagonism. However, despite the promising aspects of MS for SAH complications management, available clinical studies yield inconsistent outcomes. Additional research is necessary for full clinical validation.

Fetal mosaicism, should conventional karyotype always be performed?

The application of classical cytogenetic and DNA-based molecular techniques to detect cell lineages of mosaicism derived from cultured or noncultured fetal cells may result in discordant results. This retrospective study aimed to assess the inconsistent diagnostic outcomes, technical availability, and limitations of chromosomal microarray analysis (CMA) and karyotyping for mosaicism. A total of 75 fetuses diagnosed with mosaicism by karyotype analysis or CMA were selected, and the results from both the methods were compared and further analyzed. A total of 42 (56%, 42/75) CMA results were consistent with karyotypes, consisting of 22 cases of mosaic sex chromosomal abnormalities, 8 routine autosomal aneuploidy cases, 8 other autosome aneuploidy cases, 3 large cryptic genomic rearrangements, and 1 small supernumerary marker chromosome. Discrepancy between karyotype analysis and CMA was observed in 33 (44%, 33/75) mosaicisms involving 15 sex chromosomal abnormalities, 1 routine autosomal aneuploidies, 5 other autosome aneuploidy cases, 8 large cryptic genomic rearrangements, and 4 small supernumerary marker chromosomes. Considering the disparities between methods as well as the cell populations analyzed, both CMA and karyotype analysis have their own advantages and disadvantages. Therefore, CMA should ideally be used in combination with karyotyping to detect more cases of mosaicism than using either test alone.

Pro-environmental behavior in a common-resource dilemma: The role of beliefs

Despite the overwhelming scientific evidence about the anthropogenic nature of climate change, a vocal minority continues to spread skepticism. This inhibits pro-environmental action and fosters a false perception of social reality, leading people to underestimate the pro-environmental intentions and actions of others required to facilitate rapid and deep decarbonization. Previous efforts to address these beliefs through environmental interventions have yielded inconsistent outcomes. In two studies, we jointly examine the role of first-order climate change beliefs and beliefs about others' behavior (Study 1) as well as second-order climate change beliefs (Study 2) in pro-environmental decision-making in controlled laboratory settings. The studies involve a common-resource dilemma – in which a negative environmental externality is triggered depending on the group's collective decision-making. Our findings show that while first-order climate change beliefs weakly predict pro-environmental behavior, second-order climate change beliefs do not correlate with participants' choices when accounting for first-order climate change beliefs. However, beliefs about others' behavior strongly predict people's choices. We discuss the results in terms of the role different types of beliefs play in environmental decision-making.

Clinical Characteristics and Outcomes of Patients with Intracerebral Hemorrhage: Nonsurgical Versus Surgical Treatment.

Primary intracerebral hemorrhage (ICH) is a stroke subtype with high morbidity and mortality. Surgical treatments for ICH may be one of the beneficial modalities. There are inconsistent clinical outcomes of surgical treatments in several randomized controlled trials. This study aimed to evaluate if surgical treatment can reduce mortality in patients with ICH in a real-world setting. This was a retrospective analytical study. The inclusion criteria were consecutive adult patients aged 18 years or over admitted to neurosurgery ward due to ICH, and indicated for surgical treatment according to the 2015 guideline for the management of spontaneous ICH. The outcomes of this study included mortality, length of stay, Barthel index, Glasgow Outcome Score (GOS), and Glasgow Coma Scale (GCS). Descriptive statistics were used to execute the differences between those who underwent and did not undergo surgical treatments. Factors associated with mortality were computed by multivariate logistic regression analysis. There were 110 patients with ICH who met the study criteria. Of those, 34 (30.91%) patients underwent surgical treatment: mainly craniotomy (16 patients; 47.06%). The surgical treatment group had significantly higher proportions of large ICH of 30 mL or over (62.96% vs. 27.54%; P = 0.002) and intraventricular hemorrhage (70.59% vs. 46.05%; P = 0.023) than the nonsurgical treatment group. However, both groups had comparable outcomes in terms of mortality, length of stay, Barthel index, GOS, and GCS. The mortality rate in the surgery group was 47.06%, whereas the nonsurgery group had a mortality rate of 39.47 (P = 0.532). There were three independent factors associated with mortality, including age, GCS, and intraventricular hemorrhage. The adjusted odds ratio (95% confidence interval) of these factors was 1.06 (1.02-1.12), 5.42 (1.48-19.81), and 5.30 (1.65-17.01). Intraventricular hemorrhage was more common in the elderly than in the nonelderly group (66.00% vs. 43.33%; P = 0.022). Surgical treatment may not be beneficial in patients with severe ICH, particularly with intraventricular hemorrhage, large ICH volume, or low GCS. Elderly patients with ICH may also have high mortality if intraventricular hemorrhage is present.