Mean Length Research Articles

Morphometric analysis of styloid process in human cadavers with clinical implications

Styloid process is a bilateral bony projection of temporal bone related to important neurovascular structures in the head and neck region. Elongated styloid process with length more than 30mm is frequent encounter in multiple imaging techniques in various studies which have been cause of many neurological and vascular signs and symptoms in living. Present study aims at analyzing the morphometric parameters of styloid process in cadavers with clinical correlation. The aim of this study isto measure morphometric parameters of styloid process in human cadavers, to estimate the prevalence rate of elongated styloid process and to analyze the clinical effects of elongated styloid process. Present study is an observational descriptive study done on styloid processes retrieved from forty human cadavers and fifteen dry skulls from the department of anatomy in the present institution. The morphometric parameters included length and breadth of the styloid process. Spatial orientation of the structures close to styloid process were studied and any deviation was duly documented. A total of 110 styloid processes were studied in which four elongated styloid processes were identified with a prevalence rate of 3.6%. Mean lengths on right and left side measured 16.1mm and 16.07mm respectively with more lengthy styloid process on the right side. Mean breadths of 5.7mm and 5.13mm on right and left sides were measured respectively. Identifying the presence of elongated styloid process is of paramount importance in diagnosing the signs and symptoms manifested in Eagle’s syndrome. Expanding knowledge on the morphometry of styloid process is of great advantage to head and neck surgeons and radiologists, which can be enhanced by present study.

Analisis Pemerolehan Bahasa pada Anak Usia 38 Bulan Berdasarkan Mean Longh of Utterance

Language acquisition is a natural process where children acquire language without meaning to. Mean Length of Utterance (MLU) is used to measure language acquisition in a child's speech. MLU measures the average length of a child's utterances which reflects the language products produced. The aim of this research is to determine first language development in children aged 3 years 2 months. The research method used was descriptive qualitative with the subject being a child named Arabella. Data was collected through documentation techniques, namely recording and transcribing children's speech. The analysis results show that Arabella has 100 utterances with 210 morphemes. The MLU is 2.1 which means Arabella is in stage III for 27-28 months of age according to Brown's theory. Arabela's age should be at Stage VIII MLU. In terms of phonological acquisition, Arabella has mastered the pronunciation of vowels and some consonants well. However, some consonants such as /f/, /q/, /r/, /v/, /x/, and /z/ are still difficult for Arabella to pronounce.

Longitudinal Improvement of Quality of Life in Children With Legg-Calve-Perthes Disease Treated With Proximal Femoral Varus Osteotomy.

Proximal femoral varus osteotomy (PFVO) is commonly performed to improve femoral head containment and decrease deformity in Legg-Calve-Perthes disease (LCPD). Little is known about how PFVO impacts the quality of life after surgery. The purpose of this study was to determine the longitudinal changes to patient-reported physical, mental, and social health measures after PFVO. This is a retrospective review of prospectively collected Patient-Reported Outcomes Measurement Information System (PROMIS) data from 20 patients with unilateral LCPD treated with a PFVO. We collected seven PROMIS measures (mobility, anxiety, fatigue, depressive symptoms, pain interference, anger, and peer relationships) before and approximately 1, 3, 8, 12, and 18 months after surgery. We compared PROMIS scores across different time points using repeated measures ANOVA and multiple pairwise comparisons with Tukey adjustment. The relationship between presurgery and postsurgery mental health scores was analyzed using a Spearman correlation. The mean age at PFVO was 8.2 ± 1.6 years. The mean length of follow-up was 17.0 ± 2.1 months. There was a significant improvement in the mobility score between preoperation and 12 months (P=0.0031) and 18 months postoperation (P<0.0001). Anxiety scores significantly improved from preoperation and 18 months postoperation (P=0.0014). A significant reduction in the pain interference score between preoperation and 12 and 18 months postoperation (P<0.0001) was observed. Peer relationships significantly improved from one month postoperatively to 18 months postoperation (P=0.0355). Individual variations were also observed with some patients having elevated depressive symptoms and anxiety scores. Moderate correlations between preoperative and postoperative anxiety and depressive symptoms scores were observed. PROMIS mobility, anxiety, pain interference, and peer relationship scores improved significantly after PFVO. While the mean anxiety, depressive symptoms, peer relationships, and anger scores were in normal ranges at each visit, individual variations with elevated anxiety and depressive symptom scores were observed. This new longitudinal PROMIS data will better inform patients and families about the quality of life and recovery experience after PFVO. Level IV-therapeutic study.

Controlled ligation and elongation of uniformly truncated amyloid nanofibrils.

This study investigates the production and inter-fibril interactions of uniformly truncated amyloid nanofibrils. By varying extrusion cycles (0, 50, and 100) and using carbonate filters with 100 nm and 200 nm pore sizes, precise fibril length control was achieved. Atomic force microscopy (AFM) confirmed that the mean length of the truncated fibrils corresponded to the respective pore size as extrusion cycles increased. AFM imaging combined with bicinchoninic acid assay analysis elucidated the mechanism underlying fibril truncation during extrusion. Subsequent incubation at 60 °C revealed that 200 nm-long fibrils assembled into denser structures than 100 nm-long fibrils, likely due to strain energy introduced during truncation, which appears to facilitate twisting during ligation and elongation between truncated fibrils. These findings advance understanding of the end-to-end elongation mechanisms of amyloid nanofibrils, shedding light on their structural dynamics and polymorphic properties.

Nerve transfer of the median flexor pollicis brevis branch to the deep branch of the ulnar nerve for ulnar nerve palsy: a cadaveric feasibility study.

An ulnar nerve (UN) palsy is devastating for hand function, resulting in an intrinsic minus position or claw hand with a loss of pinch grip. Distal nerve transfers facilitate faster reinnervation of hand intrinsic muscles in cases of proximal ulnar nerve lesions. The traditional anterior interosseous nerve (AIN) to UN motor transfer is commonly used, however, this still leads to long reinnervation times for the distal intrinsic muscles, important for the thumb to index pinch grip. This study investigated the feasibility of a more distal nerve transfer, from the median thenar to the deep branch of the UN (DBUN), in six cadaveric hands. A separate branch of the median nerve to the superficial head of flexor pollicis brevis (sFPB) arose distally of the thenar branch from the common digital nerve of the thumb shortly before the bifurcation of the ulnar palmar digital nerve to the thumb in all specimens, with a mean distance to the thenar branch of 8.3 ± 5.3 mm. The sFPB motor branch had a mean length of 11.5 ± 1.5 mm. The mean distance between the division of the dorsal cutaneous branch of the UN, where the AIN to UN motor transfer is usually performed, and the transfer between the sFPB branch to the DBUN was 132 ± 11 mm. A distal nerve transfer between the median innervated motor branch to the sFPB to the DBUN shortens the reinnervation distance for the first dorsal interosseous, the adductor pollicis, and the deep head of the FPB muscles, which is a prerequisite for restoration of the pinch grip.

Anatomical Characterization of the Motor Branch to the Fourth Lumbrical: A Cadaver Study.

The branching pattern of the deep motor branch of the ulnar nerve (DBUN) in the hand is complex. The anatomy of the motor branch innervating the fourth lumbrical (4L), where paralysis results in a claw hand deformity after ulnar nerve injury, is not well defined. This cadaver study focused on mapping and defining anatomical landmarks in relation to the motor branch to the 4L. Ten fresh-frozen cadaver hands were dissected. The DBUN was exposed and followed distally, identifying all motor branches, until the branch to the 4L was seen. The small finger flexor tendons were reflected distally to enable visualization of the entire 4L motor branch and its distal entry point. The origin of the 4L motor branch was mapped in relation to fixed anatomical landmarks in the hand. A consistent motor branch to the 4L and third palmar interosseous (3PI) muscles was seen originating from the DBUN in all specimens. The mean number of motor branches innervating the hypothenar muscles proximal to the 4L/3PI motor branch was 2.1 (range 1 to 5). The mean distance from the origin of the DBUN to the 4L/3PI motor branch was 2.9 cm (range 2.5 to 4.2 cm). The mean length of the 4L/3PI branch was 3.1 cm (range 2.3 to 4.5 cm). In seven specimens, the 4L/3PI branch demonstrated an intramuscular course through the 3PI before terminating in the 4L. In three specimens the 4L/ 3PI branch ran on the volar surface of the 3PI before terminating in the 4L. A consistent 4L/3PI motor branch was mapped and characterized in all specimens. These findings provide a guide for intraoperative localization of the 4L/3PI motor branch and also may provide further evidence to explain findings seen after distal nerve transfers to treat ulnar nerve injury.

Prevalence and characteristics of microspurs in patients with spontaneous intracranial hypotension compared to the general population.

In patients diagnosed with spontaneous intracranial hypotension (SIH), microspurs are considered the culprit lesion in most ventral dural leaks (type I). The imaging characteristics of discogenic spurs, and their prevalence in the general population has not been reported in the literature. This observational case-control study was conducted comparing the prevalence and characteristics of discogenic microspurs between SIH patients with a type I leak treated at a tertiary hospital between 2013 and 2023 and an age-and sex matched cohort of trauma patients. Each group consisted of 85 patients (mean age 51.6 years ± 11.9 years), 74% (58/85 patients) were female. The prevalence of discogenic microspurs in the control group and SIH group was 31.8% and 90.6%, respectively.The mean length of the culprit microspur responsible for a dural leak was larger compared to the mean length of all co-incidental microspurs from both the SIH and the control group not causing a dural leak (2.6mm versus 1.6mm, p<0.001).Our multivariate logistic regression revealed that an increasing length of a microspur (OR 1.942, CI 1.35-2.80, p<0.001) and a narrower diameter of the spinal canal (OR 0.85, CI 0.76-0.96, p=0.008) were predictive for a dural tear. A discogenic microspur is a common incidental finding and may be found in almost one third of the general population. The length of the culprit microspur and the diameter of the spinal canal are distinct morphological characteristics for type I associated CSF leaks. CI = Confidence interval; CSF = Cerebrospinal fluid; CT = Computed tomography; ED = Emergency department; MRI = Magnetic resonance imaging; OR = Odds ratio; SD = Standard deviation; SIH = Spontaneous intracranial hypotension.

Variation in the population structure of bluegill bully (Gobiomorphus hubbsi) with distance upriver: implications for river connectivity

ABSTRACT The bluegill bully is a small (TL < 100 mm) eleotrid fish that inhabits fast flowing habitats in New Zealand rivers. Bluegill bullies are amphidromous with larvae developing at sea and juveniles migrating upriver to adult rearing habitats in freshwaters. Throughout New Zealand, more than 90% of adults occur within 50 km upstream of river mouths. This species, therefore, has a relatively restricted longitudinal distribution in rivers compared with most other amphidromous fish species in New Zealand. In the Motu River, females were smaller than males (mean TL of 62 mm versus 72 mm). The mean length of both sexes increased with distance upriver, and although females dominated the population (77% of all fish), the proportion of males increased with distance upriver. Consequently, population structure in terms of both fish size and sex ratio varied with distance upriver. Due to the spatial variation in population structure, the loss of riverine connectivity resulting from anthropogenic obstructions may reduce habitat for the larger fish, especially the largest males. It may also alter population structure, thereby influencing selective pressures contributing to population fitness and further impacting populations of this vulnerable native fish.

Pseudomonas fungipugnans sp. nov., a potently antifungal bacterium isolated from moss.

A novel strain, 681, was isolated from a moss sample taken from the Chrutzelried woods in Canton Zürich, Switzerland. The strain showed potent activity against several fungi and oomycetes. It was affiliated to the Pseudomonas genus by 16S rRNA gene sequence phylogeny. Genome sequencing showed a G+C content of 59.9 mol%. The highest average nucleotide identity was 86.63%, and the highest digital DNA-DNA hybridization value was 32.2% (with Pseudomonas nunensis ln5), considerably below the thresholds for species delineation. Multi-locus phylogeny using 81 concatenated sequences indicated that the strain represented a new species within the Pseudomonas mandelii subgroup. This study details its characterization as a new species. The 681 genome was screened in silico using antiSMASH to reveal candidate secondary metabolite clusters for the strong antifungal activity exhibited by 681. Of the 15 clusters identified, we disrupted the seven best and tested for activity against Fusarium solani. The pyrrolnitrin, rhizoxin, novel PKS-NRPS and acaterin gene clusters contributed significantly to the observed antifungal activity. Phenotypic analyses found that strain 681 cells were aerobic, Gram-negative, motile rods (mean length 2.60 µm and mean width of 0.67 µm) with one to three polar flagella. Optimal growth was at 30 °C, but growth also occurred at 8 °C. The pH range was 6-7, with some growth at pH 8. Robust growth occurred at 0-3% (w/v) NaCl and weak growth at 4% (w/v) NaCl, with the optimum at 1% (w/v) NaCl. Strain 681 was oxidase positive, hydrolysed arginine under anaerobic conditions, showed intense fluorescence on King's medium B and produced a hypersensitive response in tobacco leaves. Following our investigations, we propose the designation Pseudomonas fungipugnans sp. nov. for this new species. The type strain, 681, is available from the DSMZ and LMG/BCCM culture collections under the designations DSM 115721 and LMG 33039, respectively.

Use of the Ostial Flash balloon in aorto-ostial chronic total occlusion percutaneous coronary intervention.

The use of the Ostial Flash balloon (Ostial Corporation) has received limited study in aorto-ostial chronic total occlusion (CTO) percutaneous coronary artery intervention (PCI). The authors evaluated the outcomes of Ostial Flash balloon use in a large CTO-PCI registry (PROGRESS-CTO, NCT02061436). The Ostial Flash balloon was used in 54 of 907 aorto-ostial CTO PCIs in 905 patients (6.0%). The mean patient age was 65.1 ± 10.7 and 80.6% were men, with a high prevalence of diabetes mellitus, hypertension, prior PCI, and prior myocardial infarction. The mean occlusion length was 40.5 ± 25.1 mm, 52.2% had moderate to severe calcification, and the mean Japanese-CTO score was 2.8 ± 1.1. Lesions treated with the Ostial Flash balloon were more frequently located in the right aorto-ostium (79.6% vs 66.0%, P = .002). In the Ostial Flash group, the most common successful CTO crossing technique was antegrade wiring (46.3%), followed by the retrograde approach (40.7%); intravascular imaging was used in 61.1% of cases. Technical success (92.6% vs 87.9%, P = .300) and the incidence of major adverse cardiac events (MACE) (5.6% vs 3.6%, P = .450) was similar in the Ostial Flash vs non-Ostial Flash patients, respectively. In multivariable analysis, PCI of proximal right coronary artery CTOs was independently associated with use of the Ostial Flash balloon (odds ratio 2.2; 95% CI, 1.1-4.8; P = .036). The Ostial Flash balloon is infrequently used in aorto-ostial CTO PCI. Although there were no differences in MACE with use of the balloon, randomized controlled trials are needed to determine its effectiveness.

The Levator Veli Palatini: Are all Segments Created Equal?

The levator veli palatini (LVP) muscle has two segments with distinct roles in velopharyngeal function. Previous research suggests longer extravelar segments with shorter intravelar segments may lead to a more advantageous mechanism for velopharyngeal closure. The purpose of this study was to examine whether the distribution of the LVP intravelar and extravelar segments differs between children with cleft palate with and without VPI and controls. The study included 97 children: 37 with cleft palate +/- lip with VPI, 37 controls, and 19 with cleft palate with normal resonance. Measures included mean LVP length, mean extravelar LVP length, and intravelar LVP length. Overall mean LVP length was similar (P = .267) between controls and children with cleft palate (with and without VPI). However, there was a significant difference (P < .001) between group for both intravelar and extravelar LVP lengths: the intravelar segment was significantly longer in those with VPI compared to controls and children with cleft palate and normal resonance; and the extravelar segment was significantly shorter in those with VPI compared to controls and children with cleft palate and normal resonance. Results from this study demonstrate a significant difference between the distribution of the functional segments of the LVP among children with VPI, with a more disadvantageous distribution of the muscle segments among those with VPI.

Comprehensive cost-of-illness analysis of pressure ulcer treatment: A real-world study at a Czech university hospital.

Pressure ulcers (PUs) impose a significant economic burden on healthcare systems, affecting patient quality of life and leading to substantial treatment costs. This study presents a cost-of-illness analysis of PU treatment in hospitalized patients in the Czech Republic, based on real-world clinical data. The analysis was conducted using a comprehensive methodology at a Czech university hospital, involving 304 hospitalizations. The study included all hospitalized patients with PUs. Data were collected employing a bottom-up, person-based approach, which refers to the collection and analysis of cost data at the individual patient level. This method captures detailed resource utilization for each patient. The methodology accounted for both systemic and local costs, including materials, medications, caregiver time, and procedures. The study involved 304 hospitalizations, with a mean length of stay of 13 days. The total cost of PU treatment, excluding pharmacotherapy, had a median of €678, while including pharmacotherapy, the median cost rose to €929. Younger patients incurred higher treatment costs. Significant cost variations were observed among different departments. We developed and applied a novel cost model to quantify the expenses associated with PUs, which accurately highlighted the financial burden in the hospital care setting. We present a rigorous methodology for PU cost-of-illness analysis, providing a valuable tool for future research and clinical practice. This comprehensive approach supports the development of targeted interventions to reduce the incidence and severity of PUs, ultimately improving patient care and reducing healthcare costs.

Outcomes of Patients with Hematological Malignancies Admitted to the Intensive Care Unit at a Tertiary Care Center in Saudi Arabia

Abstract Background: Patients with hematological malignancies (HM) are at risk for complications, including neutropenia and admission to the intensive care unit (ICU). Granulocyte colony-stimulating factors (GCSF) can accelerate progenitor cells’ proliferation and differentiation, and thus compensate for neutropenia. In patients with HM admitted to ICUs in Saudi Arabia, the outcome and impact of GCSF use on neutropenia duration and severity is understudied. Objective: To evaluate the outcome and impact of GCSF on neutropenia in patients with HM admitted to the ICU of a tertiary care center in Saudi Arabia. Methods: This retrospective study included all consecutive patients diagnosed with an HM admitted to the ICU at King Saud University Medical City, Riyadh, Saudi Arabia, from 2018 to 2022. Data on demographics, clinical information, ICU admission, and outcomes were collected. Results: A total of 44 patients with HM admitted to the ICU were included, of which 43.2% were females and the mean age was 50.2 ± 21.1 years. The mean length of ICU stay was 12.3 ± 14.7 (range: 0–62) days. ICU mortality was 61.4%, with no further mortality within 90 days after discharge. There was no significant association between survival and age (P = 0.205), gender (P = 0.7), and neutropenia (P = 0.566) or the use of GCSF prior to ICU admission (P = 0.882). There was a significant association between the category of ICU intervention and survival (P = 0.007). Conclusion: Patients with hematological malignancies who were admitted to an ICU in Saudi Arabia had a high mortality, regardless of neutropenia or the use of granulocyte colony-stimulating factor.

Outcomes of Popliteal Artery Injury; Level 1 Trauma Center Experience from Pakistan

Background: Traumatic vascular injuries, especially popliteal artery injuries, carry a high risk for limb loss which poses a major healthcare problem for patient management in the developing world. Aims: This study is aimed to investigate the outcomes after traumatic popliteal artery injuries. Our primary objective was to evaluate limb salvage. Secondary objectives included evaluating postoperative functional outcomes at 3 and 6 months. Methods: A retrospective study was conducted at the Department of Vascular &amp; Endovascular Surgery SMBBIT, Karachi from January, 2020 to December, 2022 after ethical review. All patients with a proven popliteal artery were included and data was collected regarding the patients’ demographics, mode of injury, time since injury, coexisting injuries, and peri-operative complications. Results: We identified 103 cases of Popliteal artery injury, including 96% (n=99) males, with a mean age of 30 +/- 12.75 years. The commonest mechanism of injury was firearm assault totaling 59.2% (n=61). The median (IQR) time since presentation was 10 hours. 31.1% (n=32) cases presented within 6 hours of injury. RGSV interposition graft repair was undertaken in 70.9% (n=73) cases while the rest underwent primary amputation (25.2%, n=26) or Popliteal artery ligation (3.9%, n=4). The mean length of stay was 9.0 days (Median 7.0). We recorded a single post-operative mortality (0.9%). At 3- months follow up, 3 patients had undergone a secondary amputation. 18 cases were complicated by wound infections needing debridement. At 6 months, 68.1% were fully ambulating independently fully whereas 23.4% of the patients were ambulating with difficulty. Limb salvage rates were comparable for patients presenting initially to our hospital and referred cases. Conclusions: In conclusion, popliteal artery injuries remain a significant challenge with difficult limb salvage. Early diagnosis, prompt intervention, and meticulous wound care are crucial for optimizing.

Temporal measurements for Second Language speaking fluency

This study investigates the relationship between temporal measurements and second language (L2) speaking fluency, focusing on speech rate (SR), mean length of utterance (MLU), and pausing patterns (PP). The study recruited 60 advanced English L2 adult learners (male and female) who were presented with a picture book where each page included only one picture representing a specific sequence of the story's development. The participants’ main task was to orally describe the story where their oral descriptions were electronically recorded using PsychoPy software. The primary goal was to determine which of the above-mentioned temporal measurements significantly influence L2 speaking assessment. These participants’ spoken samples were evaluated by five English language instructors using standardized L2 speaking assessment rubric. A statistical analysis was conducted to examine the effect of these three temporal measurements on L2 speaking assessment. The results showed that SR (average words per minute) and PP (average pause duration per minute), but not mean length of utterance (MLU), were significant factors of L2 speaking fluency assessment. However, the interaction between these factors was not significant. That is, SR and PP factors provide a listener with a positive impression about L2 speakers’ speaking performance. These results are consistent with other studies that examined L2 speaking fluency. The findings also underline the importance of listeners’ impression when it comes to L2 speaking assessment. In addition, the study highlights the effect of temporal measurements on L2 speaking assessments and provides insights for both evaluators and learners on the factors affecting L2 fluency assessment.

Clinical And Socio-Demographic Profile Of Chidren Aged 6-59 Month With Severe Acute Malnutrition Presenting In A Tertiary Care Hospital In Nuh, Haryana

Background: Malnutrition adversely affects achievement of all the milestones namely motor, sensory, cognitive and social. Methods: The records of 150 patients with severe acute malnutrition over a period of one year (July 2022-July 2023) were reviewed, and a statistical comparison of various variables were made. Results: As per study, mean weight(kg) 7.48 ± 2.02, mostly i.e.78.67% were having weight &lt;-3 SD. Mean height or length(cm) was 77.5 ± 11.14 ,majority was in between 2SD to -3SD i.e. 48.00%, MUAC was &lt; 11.5 among 123 (82%), 11.6-12.5 among 10 (6.67%), 12.6-13.5 among 17 (11.33%).There were 41.33% males and 58.67% females.Of study population, Birth order was 1st among 9 (6.0%), 2nd among 11 (7.33%), 3rd among 38 (25.33%) and 4th and above among 92 (61.34%) subjects with a mean of 4.05± 1.52.Among my study most of children were mixed Feeding 53.34%,while only 13.33% were Exclusive breast feed while 33.33% were Top feed .Immunization was Complete among 10.67%, Incomplete among 62.67% and Unimmunized among 26.67% subjects. Pedal Edema was present among 44 (29.33%) subjects and absent in 106(70.67%).The presenting complaint reported were anemia (38.67%), pneumonia (26.67%), acute gastroenteritis (12.67%), hypoglycemia (10.00%), Dehydration (8.0%) and UTI (4.00%) and most common presenting complication wasanemia (80%), followed by pneumonia (52%), acute gastroenteritis (34.00%), dehydration (29.67%), Lethargy/hypoglycaemia (30%), meningitis (8.00%), tuberculosis(5.33%)and UTI (4.00%)As per my study, complication are more severe unvaccinated children, however effect is statistically insignificant (p&gt; 0.05) Conclusion: SAM was most common in 13-24 months age group and with increasing age, a lesser proportion of children were affected with SAM. There was a strong correlation between adverse outcomes and dietary risk factors such as the length of time spent nursing exclusively, using a bottle, and delaying the introduction of supplementary foods. Most common co-morbidities were anaemia and pneumonia.

Association between serum albumin levels at admission and clinical outcomes in pediatric intensive care units: a multi-center study

BackgroundAlbumin, a vital component in regulating human blood oncotic pressure, plays an important role in the prediction of prognosis in pediatric patients.Previous research identified significant differences in serum albumin levels of healthy and critically ill children.MethodsThe present study aims to investigate the correlation between albumin levels measured during pediatric intensive care unit(PICU) admission and clinical outcomes. In 2022, a comprehensive analysis of the records was conducted retrospectively in four tertiary hospital PICUs in different cities in the south-east region of Turkey. We then conducted a ROC analysis to predict mortality based on hypoalbuminemia.A cut-off value was determined, and the patients were divided into two groups: hypoalbuminemic and normoalbuminemic.Based on this cut-off level, we evaluated the association between admission serum albumin levels and mortality, length of stay, laboratories, need for mechanical ventilation, and extracorporeal treatments.ResultsA total of 1329 patients admitted to the PICUs between January 1, 2022 and January 1, 2023 were included. The mortality rate amounted to 16.2%.The mean albumin level was 4.03 ± 0.69 g/dl in the surviving and 3.35 ± 0.90 g/dl in the non-surviving group(p < 0.001).The average length of stay in the PICU amounted to 8.98 ± 17.07, while the mean length of hospital stay was 11.23 ± 18.81days.Patients with hypoalbuminemia had significantly longer stays in the PICU and hospital as compared to those with normal albumin levels(p = 0.025 and p < 0.001,respectively).We found robust evidence that albumin levels are a strong predictor of mortality, with a predictive rate of 84.5%(OR:0.322, 95% CI:0.263–0.395, p < 0.001).The cut-off value was 3.785(AUC:0.731, Sensitivity:68.3%, Specificity:67%). A negative correlation was identified between albumin levels and lactate, C- reactive protein (CRP), and Blood urea nitrogen (BUN) levels across all patients. Conversely, a positive correlation was observed between neutrophil, lymphocyte, platelet, hemoglobin, sodium, and glucose levels. However, in patients with a cut-off point of 3.785 for albumin levels, a negative correlation was observed between albumin and lactate, CRP, and creatine levels. Conversely, a positive correlation was found between bicarbonate, platelet, hemoglobin, and glucose levels. Based on these findings, we conclude that hypoalbuminemia is associated with a higher rate of inotrope therapy and mechanical ventilation support. Furthermore, the rates of plasmapheresis, continuous renal replacement therapy, and extracorporeal membrane oxygenation initiation were markedly reduced in patients with elevated albumin levels (p < 0.001).ConclusionThe serum albumin, which is an excellent and cost-effective biomarker that can be readily and economically evaluated in any center worldwide, as evidenced by the findings of our study, is a highly efficacious indicator of admission albumin levels for the prediction of mortality and outcomes in PICUs. Furthermore, it predicts the selection of appropriate treatment and mechanical supports. It is straightforward to utilise, as it does not necessitate the use of scoring systems or tests that require lengthy and intricate analyses, and it is readily available.

Outcomes of Growth-Friendly Surgical Treatment of Early Onset Scoliosis in Children With Prune Belly Syndrome: A Preliminary Report.

Prune belly syndrome (PBS) is a rare condition characterized by absence of abdominal musculature, cryptorchidism, and obstructive uropathy. The most common orthopaedic problem is scoliosis, yet no reports on growth-friendly surgical treatment of early-onset scoliosis (EOS) exist. Our purpose was to evaluate outcomes of distraction-based implants in children with PBS. This was a multicenter retrospective review. Children with PBS treated with TGR, MCGR, or VEPTR with a minimum 2-year follow-up were identified. Demographics, radiographic/surgical data, complications, and unplanned returns to the operating room (UPROR) were collected. Quality of life was measured using EOSQ-24. Seven patients (100% male) were identified. The mean age at index surgery was 5.6 years. The mean length of follow-up was 4 years (range: 2 to 11y). Implant types included MCGR (4 patients), TGR (2 patients), and VEPTR (1 patient). Two patients had pelvic fixation. The mean major curve magnitude was 87 degrees preindex, 47 degrees postindex, and 53 degrees at the last follow-up. Mean kyphosis was 55 degrees preindex, 25 degrees postindex, and 42 degrees at the most recent follow-up. Mean T1-T12 and T1-S1 lengths increased 4.4 and 4.8cm, respectively, between preindex and last follow-up.Complications occurred in 3 patients. One patient had 3 TGR breakages resulting in 3 UPRORs to revise the rods and 1 superficial wound infection treated with antibiotics. Another patient was readmitted for respiratory failure after TGR lengthening and a third patient had a superficial infection manifested by incisional swelling after MCGR insertion that resolved with antibiotics. Two patients have undergone definitive fusion and 1 patient has retained his TGR definitively. The other patients are still undergoing rod lengthening. Children with PBS can develop severe scoliosis at a young age. Distraction-based implants can successfully control scoliosis while allowing spinal growth. The complication rate is comparable to patients with idiopathic EOS treated with growth-friendly implants. Therapeutic level IV.

Posterior Vault Distraction Osteogenesis for Craniosynostosis-Surgical Outcomes Over 12 Years.

Posterior vault distraction osteogenesis (PVDO) allows significant increase in intracranial volume but is associated with complications including cerebrospinal fluid (CSF) leaks, infection and device failure. The authors outline their outcomes over 12 years and the impact of PVDO on pre-existing Chiari malformation type 1 (CM). Retrospective review of all PVDOs in our unit over a period of 12 years from 2011 to 2023. Results: 51 patients. The mean age of surgery 9 months. The mean length of follow-up 72 months. 82% no complications, 12% dural tear with 2% CSF leak; 4% infection, 2% device failure, 10% blood transfusion. CM in 20% of patients-all are multisuture with 90% lambdoid synostosis involvement. CM is unchanged in the majority of patients post-PVDO. PVDO safe and effective with no re-do posterior vault expansions over 12 years. CM does not tend to resolve after PVDO and high-risk groups include multisuture and Crouzons.

Genomic-Inbreeding Landscape and Selection Signatures in the Polo Argentino Horse Breed.

Analyzing genetic variability and inbreeding trends is essential for effective breed management in animal populations. To this, the characterization of runs of homozygosity (ROH) provides a good genomic approach to study the phenomena. The Polo Argentino (PA) breed, globally recognized as the best adapted to playing polo, is known for its strong influence of Thoroughbreds, intense selective breeding, and extensive use of reproductive biotechnologies. This study investigates the PA's genomic variability, by characterizing the ROH landscape and identifying ROH islands (ROHi) as potential genomic footprints for the breed. PA horses (n = 506) were genotyped using EquineGGP™ array v5 (70 k). We calculated the inbreeding coefficient based on ROH (FROH-ancestral and recent) using a chromosomal approach. Finally, we identified genomic regions with increased ROH frequency (ROHi) and their associated genes. An average of 79.5 ROH per horse was detected, with a mean length of 4.6 Mb. The average FROH was 0.151, but most of them (54%) corresponded to ancestral inbreeding (ROH < 5.5 Mb). However, 4 ROHi were identified in ECA 1, 3, 7 and 17, containing 67 genes, some of which were related to behavior, neurodevelopment, and metabolic functions. This genomic analysis determined, for the first time, the length and location of homozygosity segments in the PA breed and identified ROHi associated with potential genomic regions and genes for positive selection in the breed.