Success rate of prehospital emergency front-of-neck access (FONA): a systematic review and meta-analysis

Background Front-of-neck access (FONA) is an emergency procedure used as a last resort to achieve a patent airway in the prehospital environment. In this systematic review with meta-analysis, we aimed to evaluate the number and success rate of FONA procedures in the prehospital setting, including changes since 2017, when a surgical technique was outlined as the first-line prehospital method. Methods A systematic literature search (PROSPERO CRD42022348975) was performed from inception of databases to July 2022 to identify studies in patients of any age undergoing prehospital FONA, followed by data extraction. Meta-analysis was used to derive pooled success rates. Methodological quality of included studies was interpreted using the Cochrane risk of bias tool, and rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results From 909 studies, 69 studies were included (33 low quality; 36 very low quality) with 3292 prehospital FONA attempts described (1229 available for analysis). The crude median success rate increased from 99.2% before 2017 to 100.0% after 2017. Meta-analysis revealed a pooled overall FONA success rate of 88.0% (95% confidence interval [CI], 85.0–91.0%). Surgical techniques had the highest success rate at a median of 100.0% (pooled rate=92.0%; 95% CI, 88.0–95.0%) vs 50.0% for needle techniques (pooled rate=52.0%; 95% CI, 28.0–76.0%). Conclusions Despite being a relatively rare procedure in the prehospital setting, the success rate for FONA is high. A surgical technique for FONA appears more successful than needle techniques, and supports existing UK prehospital guidelines

Early Chinese Trade

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Inflammatory complications of CGRP monoclonal antibodies: a case series

BACKGROUND: Calcitonin gene-related peptide (CGRP) is expressed throughout the body and is a known mediator of migraine, exerting this biological effect through activation of trigeminovascular, meningeal and associated neuronal pathways located in close proximity to the central nervous system. Monoclonal antibodies (mAb) targeting the CGRP pathway are an effective new preventive treatment for migraine, with a generally favourable adverse event profile. Pre-clinical evidence supports an anti-inflammatory/immunoregulatory role for CGRP in other organ systems, and therefore inhibition of the normal action of this peptide may promote a pro-inflammatory response. CASES: We present a case series of eight patients with new or significantly worsened inflammatory pathology in close temporal association with the commencement of CGRP mAb therapy. CONCLUSION: This case series provides novel insights on the potential molecular mechanisms and side-effects of CGRP antagonism in migraine and supports clinical vigilance in patient care going forward

Next-to-Leading Order Constituent Quark Structure and Hadronic Structure Functions

We calculate the partonic structure of a constituent quark in the Next-to-Leading Order framework. The structure of any hadron can be obtained thereafter using a convolution method. Such a procedure is used to generate the structure function of proton and pion in NLO, neglecting certain corrections to $\Lambda_{QCD}$. It is shown that while the constituent quark structure is generated purely perturbatively and accounts for the most part of the hadronic structure, there is a few percent contributions coming from the nonperturbative sector in the hadronic structure. This contribution plays the key role in explaining the SU(2) symmetry breaking of the nucleon sea and the observed violation of Gottfried sum rule. These effects are calculated. We obtained an Excellent agreement with the experimental data in a wide range of $x=[10^{-6}, 1]$ and $Q^{2}=[0.5, 5000]$ $GeV^{2}$ for the proton structure function. We have also calculated Pion structure and compared it with the existing data. Again, the model calculations agree rather well with the data from experiment.Comment: 32 pages,10 figures, Accepted to publish in Phys. Rev.

Current status of acute hepatopancreatic necrosis disease (AHPND) of farmed shrimp in Malaysia

A report about a disease problem in cultured whiteleg shrimp (Penaeus vannamei) was first received by the National Fish Health Research Center (NaFisH) in 2011 from Perak State showing signs of white feces and slow death leading to serious mortality rate. Later, in September of the same year, the Malaysian Shrimp Farmers Association (MSFA) reported to Department of Fisheries (DOF) severe mortalities in almost all of the whiteleg shrimp farms throughout Peninsular Malaysia. Sampling of shrimps for disease diagnosis was then conducted by NaFisH. The bacteriological and histopathological examinations revealed respectively the isolation of V. parahemolyticus and massive sloughing of hepatopancreatic epithelial cells. The disease was subsequently identified as acute hepatopancreatic necrosis disease (AHPND). From our 3-year study, the annual prevalence rates of AHPND were 50%, 26% and 73% in 2011, 2012 and 2013, respectively. At present, AHPND still persists in Malaysia but at a lower prevalence. The risk factors associated with the disease were studied, however, varied environmental and management data analyzed were inconclusive to relate any one parameter directly to the disease. To help ensure the early detection of AHPND, an experimental observation study on `gut scorecard was carried out and this was confirmed by PCR and histopathology. Validation of this technique has yet to be carried out to ensure its reliability. We also examined the potential use of some commercial products such as probiotics and disinfectants available in the market but unfortunately results showed that they were not effective in controlling AHPND. Control measures applied by the farmers such as the use of probiotics were also verified but data generated likewise appeared to be inconclusive. On the contrary, our preliminary study on the antibacterial property of the plant extracts, i.e. betel and lemongrass, incorporated in the feed showed some prophylactic and chemotherapeutic potential against AHPND. However, comprehensive in vitro and in vivo trials are still currently being undertaken to elucidate its efficacy and practical applications. To ensure the shrimp industry s sustainability in Malaysia, results of our ongoing and future studies aimed at preventing and controlling unwarranted outbreaks of AHPND and other emerging transboundary diseases of penaeid shrimps will be continually disseminated to shrimp farmers and pertinent stakeholders

Adjunctive mood stabilizer treatment for hospitalized schizophrenia patients: Asia psychotropic prescripton study (2001-2008)

Recent studies indicate relatively high international rates of adjunctive psychotropic medication, including mood stabilizers, for patients with schizophrenia. Since such treatments are little studied in Asia, we examined the frequency of mood-stabilizer use and its clinical correlates among hospitalized Asian patients diagnosed with schizophrenia in 2001-2008. We evaluated usage rates of mood stabilizers with antipsychotic drugs, and associated factors, for in-patients diagnosed with DSM-IV schizophrenia in 2001, 2004 and 2008 in nine Asian regions: China, Hong Kong, India, Korea, Japan, Malaysia, Taiwan, Thailand, and Singapore. Overall, mood stabilizers were given to 20.4% (n=1377/6761) of hospitalized schizophrenia patients, with increased usage over time. Mood-stabilizer use was significantly and independently associated in multivariate logistic modeling with: aggressive behaviour, disorganized speech, year sampled (2008 vs. earlier), multiple hospitalizations, less negative symptoms, younger age, with regional variation (Japan, Hong Kong, Singapore>Taiwan or China). Co-prescription of adjunctive mood stabilizers with antipsychotics for hospitalized Asian schizophrenia patients increased over the past decade, and was associated with specific clinical characteristics. This practice parallels findings in other countries and illustrates ongoing tension between evidence-based practice vs. individualized, empirical treatment of psychotic disorders.published_or_final_versio

Tea drinking and cognitive function in oldest-old Chinese

10.1007/s12603-012-0077-1The Journal of Nutrition, Health & Aging169754-75

Wireless body sensor design for intra-vaginal temperature monitoring

Sensor nodes are small devices able to collect and retrieve sensorial data. The use of these sensors for medical purposes offers valuable contributions to improve patients’ healthcare, both for diagnosis and therapeutics monitoring. An important and common parameter used on healthcare diagnosis is the body temperature. It is monitored on several matters related with gynecological and obstetrics issues but, usually it is measure at the skin surface. Then, this paper proposes the design concepts of a new intra-body sensor for long-term intra-vaginal temperature collection. The embedded IEEE 802.15.4 communication module allows the integration of this sensor in wireless sensor networks for remote data access and monitoring. It is presented the sensor architecture, the construction of the corresponding testbed, and its performance evaluation. This sensor may be used on several applications, including fertile and ovulation period detection, and preterm labor prevention

Capturing genomic signatures of DNA sequence variation using a standard anonymous microarray platform

Comparative genomics, using the model organism approach, has provided powerful insights into the structure and evolution of whole genomes. Unfortunately, only a small fraction of Earth's biodiversity will have its genome sequenced in the foreseeable future. Most wild organisms have radically different life histories and evolutionary genomics than current model systems. A novel technique is needed to expand comparative genomics to a wider range of organisms. Here, we describe a novel approach using an anonymous DNA microarray platform that gathers genomic samples of sequence variation from any organism. Oligonucleotide probe sequences placed on a custom 44 K array were 25 bp long and designed using a simple set of criteria to maximize their complexity and dispersion in sequence probability space. Using whole genomic samples from three known genomes (mouse, rat and human) and one unknown (Gonystylus bancanus), we demonstrate and validate its power, reliability, transitivity and sensitivity. Using two separate statistical analyses, a large numbers of genomic ‘indicator’ probes were discovered. The construction of a genomic signature database based upon this technique would allow virtual comparisons and simple queries could generate optimal subsets of markers to be used in large-scale assays, using simple downstream techniques. Biologists from a wide range of fields, studying almost any organism, could efficiently perform genomic comparisons, at potentially any phylogenetic level after performing a small number of standardized DNA microarray hybridizations. Possibilities for refining and expanding the approach are discussed

Differentiating Non-Motor Symptoms in Parkinson's Disease from Controls and Hemifacial Spasm

10.1371/journal.pone.0049596PLoS ONE82