Novel Techniques in the Assessment of Sports-Related Traumatic Brain Injury

Mild traumatic brain injuries (mTBI) or concussions are a substantial health concern, particularly in collision and contact sports. Consequently, there is growing concern regarding the acute and chronic effects of repeated brain trauma. Traditional assessment of mTBI has been based on clinical or computed tomography (CT) assessments followed by a period of in-hospital observation in some cases. These may have significant time and cost implications while potentially exposing patients to ionizing radiation and providing a low sensitivity and specificity. Recent advancements have focused on novel modalities that may potentially predict early and long-term sequelae from mTBI with greater accuracy and provide the optimum personalized treatment plan in collaboration with the athlete. This chapter will outline state of the art in these modalities, from salivary and blood biomarkers imaging and neuropsychology assessments, and discuss their translational applicability to the clinical setting

Proximate chemical composition of sea grapes Caulerpa racemosa (J. Agardh, 1873) collected from a sub-tropical coast

Background: Nutritional fact study has prime importance to make the species edible and commercially viable to the consumers. Proximate chemical composition and amino acid profile were investigated to understand the nutritional value and protein quality of an edible algae Caulerpa racemosa. Methods: Samples were collected randomly by hand from the intertidal zone of the sub-tropical coastal Island St. Martin’s Island from February 2013 to May 2014. Samples were preserved using standard methods for chemical analysis. Proximate composition was determined using standard methods, Kjeldahl method for protein, Soxhlet method for crude lipid, H2SO4 (0.3 N) and NaOH (0.5 N) for dietary fibre, muffle furnace method for moisture content, ion-exchange chromatography for amino acid and statistical package used for validating the data. Results: The result of the study reveals that C. racemosa contains higher amount of proteins (19.72±0.77%), crude lipid (7.65±1.19%) and fibre (11.51±1.32%) compared to other green and brown algae. The higher concentration of aspartic acid (12.7±0.2%) and glutamic acid (9.2±0.7%) were observed in C. racemosa, while histidine (2.6±0.7%), methionine (1.4±0.4%) and tyrosine (3.8±0.2%) were the limiting amino acids. Lysine (6.6±0.2%), leusine (6.9±0.6%), glycine (6.5±0.4%), arginine (6.4±0.3%), alanine (7.6±0.6%) and threonine (6.2±0.5%) were obtained at a higher percentage of total amino acids. Conclusion: This study suggests that C. racemosa could be potentially used as a nutritious and functional food item for human consumption. Further studies on this edible species should be focused on fatty acid composition, vitamins, non-starch polysaccharide constituents, trace elements and sensory perceptions in order to depict safer and versatile utilization

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Quality evaluation and shelf life analysis of fruit juice cocktail containing Mango (Mangifera indica) and Pineapple (Ananas comosus)

The development of the innovative flavored juices by coalescing two or more distinct types of fruits is encouraged by the tremendous expansion of the juice industry. Fruit juice cocktails frequently contain high nutritional content as well as organoleptic features such as color, flavor, taste, and overall attractiveness of various fruits. The use of different heat treatments and storage temperatures on single juice has previously been extensively researched, however, only a limited study has been performed on a juice cocktail. Therefore, the effect of pasteurization temperature (60 °C and 90 °C) and storage temperature (4 °C and 25 °C) on physicochemical, microbial, and sensory properties of pineapple-mango juice cocktail was investigated. Standard procedures were used to determine physicochemical, microbiological, and sensory characteristics. The results of the study demonstrated a slight increase in TSS, acidity, and cloud stability during storage, while a gradual decrease in vitamin C, pH, total sugars, and Lovibond color. The S4 sample that was pasteurized at 60 °C for 20 min and maintained at 4°C storage temperature retained more vitamin C, acidity, and total sugar than the other samples. According to the microbiological data, the total viable count in the fruit juice cocktail samples varied from 3.42 × 102 to 8.5 × 107, and after two months of storage, the bacterial load in sample S4 increased from 3.52 × 102 to 5.5 × 103. The sensory evaluations revealed that all of the samples were widely accepted, with sample S4 having the greatest overall acceptance owing to the cocktails color, flavor, and taste. Therefore, this study demonstrates that perishable fruits may be turned into appealing juice cocktails, increasing the sensory characteristics and hence the products escalation value. These findings also promote the development of a healthy and nutritious, fruit-based juice cocktail

SODIUM AND WATER IMBALANCE AFTER SELLAR, SUPRASELLAR, AND PARASELLAR SURGERY.

Objective: To report the frequency of sodium and water disturbances (SWDs) in patients undergoing sellar, suprasellar, and parasellar surgery (SSPS). Methods: We conducted a cross-sectional, retrospective study on 115 patients in the Aga Khan University Hospital after ethical approval. Patients were 16 years old or older undergoing pituitary or sellar surgeries. We collected data on basic sociodemographic characteristics and clinical indication for surgery. We noted laboratory values for serum electrolytes, plasma and urine osmolality, urine sodium, and 24-hour fluid balance from the immediate postoperative day until discharge and follow-up. We recorded medical management plans. We also recorded diabetes insipidus (DI), syndrome of inappropriate antidiuretic hormone (SIADH), cerebral salt wasting (CSW), triphasic response, and hyponatremia, according to the diagnostic definitions. Finally, we performed data analysis using Statistical Package for the Social Sciences, version 19.0. Results: Of 115 patients, there were 61.7% males, mean age 42.3 ± 13.86 years, 91.3% had pituitary adenoma (73.0% nonfunctioning), and 86.1% underwent transsphenoidal surgical approach. Transient DI occurred from days 1 to 6, peaking with 57.4% on day 2. Permanent DI and SIADH were rare. We did not note typical triphasic response or CSW in any of the patients. However, isolated hyponatremia occurred in 11%, and 20.9% had DI with hyponatremia. Conclusion: Transient DI is the most common postoperative SWD after SSPS. Hyponatremia occurred alone and following DI. This is the first study describing postoperative SWDs after different sellar surgeries in Pakistan. Abbreviations: ADH = antidiuretic hormone CSW = cerebral salt wasting DI = diabetes insipidus SIADH = syndrome of inappropriate antidiuretic hormone SSPS = sellar, suprasellar, and parasellar surgery SWD = sodium and water disturbanc

First incidence of loose-shell syndrome disease in the giant tiger shrimp Penaeus monodon from the brackish water ponds in Bangladesh

The recent incidence of loose-shell syndrome disease (LSSD) in grow-out shrimp ponds appears to be a major problem in Bangladesh. Therefore, the aims of our study were (i) to observe clinical signs of LSSD to confirm its incidence and (ii) to identify the probable causative agents for LSSD in shrimp. Sampling was conducted randomly from five LSSD-affected ponds and three non-affected ponds near Bakkhali River; ecological parameters were measured. A total of 180 healthy shrimps were used for this experiment, where LSSD-affected shrimp extracts were either injected into the shrimps or mixed with water in the experimental tanks. Finally, microbial examinations were performed to identify the possible LSSD causative agents from the infected individuals. The total shrimp production was higher in ponds with healthy populations (185 kg/ha) than from LSSD-affected ponds (126–146 kg/ha); the survival rate of shrimp at harvest was significantly different (p < .01) between normal and LSSD-affected ponds. The prevalence of infection with white spot syndrome virus (WSSV) and monodon baculovirus (MBV) was found to be lower than that of the Vibrio infections. During the investigation, 8% of LSSD-affected individuals were WSSV positive and 5% were MBV positive, and 4% were infected by both. Our study suggested that the prevalence of LSSD in tiger shrimp might be associated with multiple Vibrio bacterial infections, poor soil and water quality, as well as poor pond management

Optimization of Phasor Measurement Unit Placement Using Several Proposed Case Factors for Power Network Monitoring

Recent developments in electrical power systems are concerned not only with static power flow control but also with their control during dynamic processes. Smart Grids came into being when it was noticed that the traditional electrical power system structure was lacking in reliability, power flow control, and consistency in the monitoring of phasor quantities. The Phasor Measurement Unit (PMU) is one of the main critical factors for Smart Grid (SG) operation. It has the ability to provide real-time synchronized measurement of phasor quantities with the help of a Global Positioning System (GPS). However, when considering the installation costs of a PMU device, it is far too expensive to equip on every busbar in all grid stations. Therefore, this paper proposes a new approach for the Optimum Placement of the PMU problem (OPP problem) to minimize the installed number of PMUs and maximize the measurement redundancy of the network. Exclusion of the unwanted nodes technique is used in the proposed approach, in which only the most desirable buses consisting of generator bus and load bus are selected, without considering Pure Transit Nodes (PTNs) in the optimum PMU placement sets. The focal point of the proposed work considers, most importantly, the case factor of the exclusion technique of PTNs from the optimum PMU locations, as prior approaches concerning almost every algorithm have taken PTNs as their optimal PMU placement sets. Furthermore, other case factors of the proposed approach, namely, PMU channel limits, radial bus, and single PMU outage, are also considered for the OPP problem. The proposed work is tested on standard Institute of Electrical and Electronics Engineering (IEEE)-case studies from MATPOWER on the MATLAB software. To show the success of the proposed work, the outputs are compared with the existing techniques

Current landscape of academic neurosurgical training in the United Kingdom: analysis by the Society of British Neurological Surgeons

Objective: Little is known about the impact of academic training on Neurosurgery in the United Kingdom (UK). The aim was to understand the early career clinical and research training journeys of potential future clinical academics, with a view to informing future policy and strategy to improve career development for academic neurosurgical trainees and consultants in the UK. Methods: An online survey from the Society of British Neurological Surgeons (SBNS) academic committee was distributed to both the SBNS and British Neurosurgical Trainee Association (BNTA) mailing lists in early 2022. Neurosurgical trainees for any period between 2007 and 2022 or who had done any dedicated academic or clinical academic placement were encouraged to complete the survey. Results: Sixty responses were received. Six (10%) were females and fifty-four (90%) were males. At the time of response, nine (15.0%) were clinical trainees, four (6.7%) were Academic Clinical Fellows (ACF), six (10.0%) were Academic Clinical Lecturers (ACL), four (6.7%) were post-CCT fellows, eight (13.3%) were NHS consultants, eight (13.3%) were academic consultants, eighteen (30.0%) were out of the programme (OOP) pursuing a PhD potentially returning to training, whilst three (5.0%) had left neurosurgery training entirely and no longer performing clinical neurosurgery. The mentorship was sought in most programmes, which tended to be informal. Self-reported success on a scale of 0 to 10 with 10 being the most successful, was greatest in the MD and the “Other research degree/fellowship group” which does not include a PhD. There was a significant positive association between completing a PhD and having an academic consultant appointment (Pearson Chi-Square = 5.33, p = 0.021). Conclusions: This study provides a snapshot to better understand the opinions of academic training in neurosurgery within the UK. Establishing clear, modifiable, and achievable goals, as well as providing tools for research success, may contribute to the success of this nationwide academic training

Current landscape of academic neurosurgical training in the United Kingdom: analysis by the Society of British Neurological Surgeons.

ObjectiveLittle is known about the impact of academic training on Neurosurgery in the United Kingdom (UK). The aim was to understand the early career clinical and research training journeys of potential future clinical academics, with a view to informing future policy and strategy to improve career development for academic neurosurgical trainees and consultants in the UK.MethodsAn online survey from the Society of British Neurological Surgeons (SBNS) academic committee was distributed to both the SBNS and British Neurosurgical Trainee Association (BNTA) mailing lists in early 2022. Neurosurgical trainees for any period between 2007 and 2022 or who had done any dedicated academic or clinical academic placement were encouraged to complete the survey.ResultsSixty responses were received. Six (10%) were females and fifty-four (90%) were males. At the time of response, nine (15.0%) were clinical trainees, four (6.7%) were Academic Clinical Fellows (ACF), six (10.0%) were Academic Clinical Lecturers (ACL), four (6.7%) were post-CCT fellows, eight (13.3%) were NHS consultants, eight (13.3%) were academic consultants, eighteen (30.0%) were out of the programme (OOP) pursuing a PhD potentially returning to training, whilst three (5.0%) had left neurosurgery training entirely and no longer performing clinical neurosurgery. The mentorship was sought in most programmes, which tended to be informal. Self-reported success on a scale of 0 to 10 with 10 being the most successful, was greatest in the MD and the "Other research degree/fellowship group" which does not include a PhD. There was a significant positive association between completing a PhD and having an academic consultant appointment (Pearson Chi-Square = 5.33, p = 0.021).ConclusionsThis study provides a snapshot to better understand the opinions of academic training in neurosurgery within the UK. Establishing clear, modifiable, and achievable goals, as well as providing tools for research success, may contribute to the success of this nationwide academic training