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Herein, we report the synthesis of a Mn(II)-based coordination polymer (CP); and its structure, phase consistency and thermal stability have been established by single-crystal X-ray diffraction (SCXRD), powder X-ray diffraction (PXRD) and thermalgravimetric analysis (TGA) respectively. This is the first example of paramgnetic Mn(II)-based CP that acts as pH-dependent emitting material [lem= 525 nm (pH = 2.0-4.0) and 450 nm (pH = 5.0-12.0)]. Its emission is quenched by Pd2+ in aqueous medium in presence of other thirteen cations with reasonably low pH-dependent limits of detection (LODs) [21.178 ppb (pH= 3), 15.005 ppb (pH = 7.0) and 59.940 ppb (pH = 10.0)] as described by well-established mechanism. Therefore, urgency of such stable sensor remains high in regard to the environmental pollution., (© 2024 Wiley‐VCH GmbH.)

Unspecific back pain (UBP) has long puzzled medical professionals. Historically, back pain (BP) was often attributed to mystical causes, treated with incantations or herbal concoctions. The Middle Ages shifted towards empirical practices, though still intertwined with superstition, using methods like leeches and bloodletting. The Renaissance introduced systematic healthcare approaches, laying the foundation for modern medicine. The 20th century saw significant advancements with diagnostic imaging, pharmacotherapy, physical therapy, and surgical interventions, though UBP remained elusive. Recent decades have seen a paradigm shift towards multidisciplinary approaches, addressing BP's multifactorial nature through holistic methods considering biomechanical, psychosocial, and lifestyle factors. This shift integrates quantitative research with hermeneutic interpretation, emphasizing evidence-based guidelines. Non-pharmacological interventions such as exercise therapy, electrotherapy, cognitive behavioral therapy, and mindfulness-based stress reduction have gained prominence, empowering individuals in their recovery. Technological innovations like virtual reality and artificial intelligence offer personalized treatment plans, optimizing outcomes. The future of BP treatment holds promise with advancements in regenerative medicine, neuromodulation, telemedicine, and remote monitoring platforms, enhancing accessibility and continuity of care, especially in underserved communities. However, challenges such as the opioid epidemic and healthcare disparities remain, necessitating judicious prescribing practices and equitable resource distribution. The evolving treatment landscape for UBP reflects the dynamic interplay between scientific progress, clinical innovation, and societal needs, aiming to alleviate the burden of back pain and improve quality of life.

Tissue-agnostic, molecularly targeted therapies are becoming increasingly common in cancer treatment. The molecular drivers of some classes and subclasses of tumors are rapidly being uncovered in an era of deep tumor sequencing occurring at the time of diagnosis. When and how targeted therapies should fit within up-front cytotoxic chemotherapy and radiation paradigms is yet to be determined, because many of them have been studied in single-arm studies in patients with relapsed or refractory cancer. Infant high-grade gliomas (HGGs) are biologically and clinically distinct from older child and adult HGGs, and are divided into 3 molecular subgroups. Group 1 infant HGGs are driven by receptor tyrosine kinase fusions, most commonly harboring an ALK, ROS1, NTRK, or MET fusion. Both larotrectinib and entrectinib are tropomyosin receptor kinase inhibitors with tissue-agnostic approvals for the treatment of patients with solid tumors harboring an NTRK fusion. This report discusses an 11-month-old female who presented with infantile spasms, found to have an unresectable, NTRK fusion-positive infant HGG. Larotrectinib was prescribed when the NTRK fusion was identified at diagnosis, and without additional intervention to date, the patient has continued with stable disease for >3 years. The only adverse event experienced was grade 1 aspartate transaminase and alanine transaminase elevations. The patient has a normal neurologic examination, is developing age-appropriately in all domains (gross motor, fine motor, cognitive, language, and social-emotional). She is no longer on antiseizure medications. To our knowledge, this is the first report of a patient with an infantile HGG receiving targeted therapy as first-line treatment with prolonged stable disease. A prospective study of larotrectinib in patients with newly diagnosed infant HGG is ongoing, and will hopefully help answer questions about durability of response, the need for additional therapies, and long-term toxicities seen with TRK inhibitors.

The current article explores the meaning of neuroscientific evidence in the legal domain. It takes a social-psychological perspective to discuss how group-based stereotypes affect legal decision-making critically. Examining how any interpretation is anchored and objectified is interesting as evidence is interpreted in the context. Dominantly, with the ubiquity of neuroscience in different domains, the brain is positioned as an authentic source of nurturing authenticity. It is observed that sometimes unquestionable scientific knowledge may surpass the rationality and intuition of judges. In one way, it is a boon; in another, it is shaping the whole framework of our knowledge system, where knowledge from brain studies reifies our understanding of human actions and thinking., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

A new Mannich base (2-(4-(2-hydroxy-3-methoxy-5-methylbenzyl)-piperazin-1-yl)methyl)-6-methoxy-4-ethylphenol (H2L) and its tetranuclear Ni II complex [Ni 4 L 2 (μ 1,1 -Cl) 2 (H 2 O) 4 ]Cl 2 (compound 1) are characterised using single-crystal X-ray diffraction measurements. Compound 1 contains four different Ni II centres in a rhombus-like structure. Two Ni atoms (Ni1 and Ni2) have a NiN 2 O 4 coordination sphere, while the other two (Ni3 and Ni4) have a NiO 4 Cl 2 coordination environment and Ni-Cl-Ni bridges connect them. Ni1 and Ni2 are linked to Ni3 and Ni4 by phenoxide bridges. Variable temperature magnetic susceptibility measurements of 1 indicate the presence of alternating antiferromagnetic coupling ( J 1 = -6.6(1) cm -1 ) through the phenoxide bridge along the sides of the rhombus and ferromagnetic coupling ( J 2 = 8.4(1) cm -1 ) through the double Cl bridge along the short diagonal of the rhombus with a zero-field splitting of | D | = 2.7(1) cm -1 . Compound 1 shows oxidase (catecholase-like and phenoxazinone synthase-like) activity. The oxidation of 3,5-di- tert -butylcatechol (3,5-DTBC) gives 3,5-di- tert -butylquinone (3,5-DTBQ) and H 2 O 2 and the oxidation of o -aminophenol (OAP) produces 2-aminophenoxazin-3-one (APX) and H 2 O with turnover numbers of 28.32 and 17.52 h -1 , respectively, under aerobic conditions. A mechanism for the oxidase activity catalysed by compound 1 is proposed in line with ESI-mass spectrometry, EPR spectroscopy, and electrochemical data. The reaction involves the cleavage of the tetranuclear Ni 4 -core to form a mononuclear Ni II complex in the presence of the substrate (3,5-DTBC/OAP). This Ni II complex is reduced to Ni I with the concomitant oxidation of the substrate (3,5-DTBQ/APX). Formation of a radical intermediate is confirmed using EPR. In the catecholase-like activity, O 2 is reduced to H 2 O 2 while in the phenoxazinone synthase-like activity O 2 produces H 2 O. Compound 1 participated in oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) in a strongly basic medium with an onset potential of 418 mV and a Tafel slope of 121 mV dec -1 for OER and an onset potential of 477 mV and Tafel slope of 146 mV dec -1 for HER.

Background: Isocitrate dehydrogenase 1 (IDH1) missense mutations occur at a frequency of 10%-15% in intrahepatic cholangiocarcinoma (iCCA). IDH1 mutations result in accumulation of (R)-2-hydroxyglutarate, an oncometabolite that leads to DNA hypermethylation and impairment of homologous recombination (HR). Impairment of HR results in a "BRCAness" phenotype which may confer sensitivity to poly(ADP ribose) polymerase (PARP) inhibition., Methods: We conducted a retrospective cohort review to identify patients with advanced, IDH1 mutated iCCA treated with a PARP inhibitor (PARPi) at the University of Michigan between 2018 and 2023. Patients are described with respect to prior lines of therapy, response to platinum-based chemotherapy, and progression-free survival (PFS) and overall survival (OS) from the time of PARPi initiation., Results: Between 2018 and 2023 we identified 40 patients with IDH1 mutated iCCA of which 6 patients were treated with a PARPi as monotherapy or in combination with an ATR inhibitor or anti-PD-1 immune checkpoint inhibitor. Majority of patients (n = 5) carried an IDH1 R132C mutation per tissue-based next generation sequencing. All patients had previously received at least one line of cisplatin-based systemic therapy for advanced disease prior to treatment with PARPi. PFS and OS from time of PARPi initiation ranged from 1.4 to 18.5 months and 2.8 to 42.4 months, respectively. Best response on PARPi therapy included 2 partial responses., Conclusion: This is the first case series to describe PARPi treatment in IDH1 mutated iCCA. Results underscore the limitation of PARPi monotherapy, potentially support combined PARPi therapies, and highlight a need for effective treatment options for patients with IDH1 mutated iCCA., (© The Author(s) 2024. Published by Oxford University Press.)

Background and Aims: Perineural catheters inserted through the costoclavicular (CC) technique of infraclavicular brachial plexus are helpful for postoperative analgesia. This trial compared postoperative local anaesthetic (LA) consumption in an ultrasound (US)-guided perineural catheter inserted by the CC technique with the conventional lateral sagittal (LS) technique., Methods: Eighty American Society of Anesthesiologists (ASA) I/II patients scheduled for upper limb orthopaedic surgery were randomly assigned to receive a perineural catheter by either the CC technique (Group CC) or LS technique (Group LS). Postoperatively, all patients received patient-controlled regional analgesia (PCRA): bolus-only regime with 0.125% bupivacaine 6 ml and a lock-out interval of 20 minutes. The primary outcome was the 24 h LA consumption. The secondary outcomes were time of activation of PCRA, pain scores, patient satisfaction scores, and block-related complications. Categorical variables are presented as frequency, while continuous variables are expressed as mean [standard deviation (SD)] or median [interquartile range (IQR)]. An independent t -test or Mann-Whitney U-test was used to compare these continuous variables. A P value less than 0.05 was considered to be statistically significant., Results: Patients in Group CC required less LA 24 h postoperatively (P < 0.001) and more time to activate PCRA ( P = 0.003). The mean 24 h LA requirement was 83.35 (SD: 31.92) in Group CC as compared to 121.40 (SD: 48.51) ml in Group LS. They also reported better satisfaction scores ( P = 0.001). Pain scores were comparable at all time points. Postoperatively, one patient in Group CC complained of paraesthesia, which subsided on removal of the catheter., Conclusion: Patients receiving post-operative analgesia by the CC catheter require lesser 24 h LA and report better satisfaction than those receiving analgesia through the LS technique., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Anaesthesia.)

Background and Aims: Maintaining the airway with a cuffed endotracheal tube (ETT) in the trachea remains one of the most essential anaesthesia skills. Many parameters were described to assess the difficulty of intubation in the preoperative period, but none allow the prediction of all difficult intubations. The correct posture of the anaesthesiologist is also an important factor for successful endotracheal intubation. The aim of this study was. This study aimed to compare the impact of two different positions of an anaesthesiologist (sitting vs. standing) at the time of endotracheal intubation., Methods: One hundred ten American Society of Anaesthesiologists (ASA) Physical Status I/II patients, aged between 17 to 65 years, Mallampati grade I/II, mouth opening 39-70 mm, thyromental distance (TMD) 6-6.5 cm, and sternomental distance (SMD) >13 cm, scheduled for elective laparoscopic cholecystectomy, were recruited. Patients were divided into two groups; Group I consisted of patients who underwent endotracheal intubation by an anaesthesiologist in a sitting posture, while Group II encompassed patients who underwent endotracheal intubation by anaesthesiologists in a standing posture. Assessment parameters include ease of intubation (IDS score), intubation time, intubation success rate, number of attempts, grade of laryngoscopy (Cormack Lehane score, POGO score), and complications like tooth and soft tissue damage., Results: The ease of intubation was higher in group I, 1(0-1), than in group II, 1(1-2) (p =  0.02), and there was a significant difference between the two groups. The Cormack Lehane grade (CL) was I/IIa/IIb/III in 19/23/13/0 in group I and I/IIa/IIb/III in 13/21/18/3 in group II. The first-attempt intubation success rate for groups I and II was 94.54 % and 92.72 % respectively., Conclusion: The sitting posture of an anaesthesiologist at the time of laryngoscopy provides a better intubating condition when compared with the standing posture., Registration: Clinical Trial Registry - India (CTRI) CTRI/2023/03/050371., (Copyright © 2024 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.)

Competing Interests: There are no conflicts of interest.

Competing Interests: There are no conflicts of interest.

Competing Interests: There are no conflicts of interest.

Background: In recent times, digital mental health interventions (DMHIs) have been proven to be efficacious; however, most are available only for English speakers, leaving limited options for non-English languages like Spanish. Research shows that mental health services in one's dominant language show better outcomes. Conversational agents (CAs) offer promise in supporting mental health in non-English populations. This study compared a culturally adapted version of an artificial intelligence (AI)-led mental health app, called Wysa, in Spanish and English., Objectives: To compare user engagement patterns on Wysa-Spanish and Wysa-English and to understand expressions of distress and preferred language in both versions of Wysa., Methods: We adopted a cross-sectional retrospective exploratory design with mixed methods, analyzing users from 10 Spanish-speaking countries between 1 February and 1 August 2022. A quantitative sample A (n = 2767) was used for descriptive statistics, including user engagement metrics with a Wilcoxon test. A subset qualitative sample B (n = 338) was examined for word count differences based on valence, and a content analysis was conducted to examine idioms of distress., Results: Compared to Wysa-English, Wysa-Spanish had more sessions ( P  < .001, d  = 0.18) and a greater volume of disclosure of distress. In Wysa-Spanish, the average length of a conversation was significantly longer than in Wysa-English ( P  < .001, d  = 0.44). Users preferred interventions with free text responses ("Thought recording") in Spanish ( P  < .01, d  = 0.41), and Spanish messages were significantly longer ( P  < .01, d  = 0.24). Wysa-Spanish saw more frequent expressions of negative emotions and feelings of self-harm and suicide., Conclusion: Given the high engagement within the Spanish version of Wysa, the findings demonstrate the need for culturally adapted DMHIs among non-English populations, emphasizing the importance of considering linguistic and cultural differences in the development of DMHIs to improve accessibility for diverse populations., Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article. DND, NR, and CS are employees of Wysa Inc., and CS owns equity in the company. The authors obtained the requisite permission to include the brand name., (© The Author(s) 2024.)

Non-clear cell renal cell carcinomas (non-ccRCCs) encompass diverse malignant and benign tumors. Refinement of differential diagnosis biomarkers, markers for early prognosis of aggressive disease, and therapeutic targets to complement immunotherapy are current clinical needs. Multi-omics analyses of 48 non-ccRCCs compared with 103 ccRCCs reveal proteogenomic, phosphorylation, glycosylation, and metabolic aberrations in RCC subtypes. RCCs with high genome instability display overexpression of IGF2BP3 and PYCR1. Integration of single-cell and bulk transcriptome data predicts diverse cell-of-origin and clarifies RCC subtype-specific proteogenomic signatures. Expression of biomarkers MAPRE3, ADGRF5, and GPNMB differentiates renal oncocytoma from chromophobe RCC, and PIGR and SOSTDC1 distinguish papillary RCC from MTSCC. This study expands our knowledge of proteogenomic signatures, biomarkers, and potential therapeutic targets in non-ccRCC., Competing Interests: Declaration of interests A.I.N., F.Y., and D.A.P. receive royalties from the University of Michigan for the sale of MSFragger software licences to commercial entities. All licence transactions are managed by the University of Michigan Innovation Partnerships office and all proceeds are subject to university technology transfer policy. Related to this work a provisional patent has been filed by University of Michigan, where A.M.C., A.I.N., S.M.D., R. Mannan, R. Mehra, Y.Z., S.C., A.D., X.W., G.X.L., and Y.H. are named as inventors., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Introduction: Hypospadias is a common congenital urogenital anomaly. Despite advancements in surgical techniques, still it presents challenges in management. An important aspect of hypospadias repair is the use of protective layers to cover neourethra. This review focuses on comparing the Single Dartos Flap (SDF) and Double Dartos Flap (DDF) techniques, used to cover the neourethra. These techniques differ in terms of the number of dartos layers used to cover the neourethra., Methods: This systematic review, follows PRISMA guidelines, included six RCTs from PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science, and CINAHL. Patients with hypospadias repair with use of SDF or DDF were analyzed for outcome, Urethrocutaneous fistula, meatal stenosis, glans dehiscence, penile torsion and cosmetic outcomes. Statistical analysis was done using Review Manager, with TSA and FI ensuring result robustness., Results: Six studies met inclusion criteria, and risk of bias assessment indicated low risk across all domains. Meta-analysis results favored DDF over SDF for reducing urethrocutaneous fistula (RR 0.37, 95% CI 0.20-0.68) but showed no significant difference in meatal stenosis and glans dehiscence. DDF also associated with lower risk of penile torsion (RR 0.05, 95% CI 0.01-0.35)., Conclusion: The systematic review, based on randomized controlled trials (RCTs), provides evidence supporting the use of DDF over SDF in hypospadias repair, particularly in distal hypospadias using the TIP procedure. The article emphasizes the potential advantages of DDF in reducing UCF but further robust evidence is needed to confirm these results based on the findings of TSA and FI., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The impact that the COVID-19 pandemic has had on health care workers' mental health, in particular, cannot be ignored. Not only did the pandemic exacerbate mental health challenges through elevated stress, anxiety, risk of infection, and social isolation, but regulations to minimize infection additionally hindered the conduct of traditional in-person mental health care., Objective: This study explores the feasibility of using Wysa, an artificial intelligence-led mental health app, among health care workers., Methods: A national tertiary health care cluster in Singapore piloted the use of Wysa among its own health care workers to support the management of their mental well-being during the pandemic (July 2020-June 2022). The adoption of this digital mental health intervention circumvented the limitations of in-person contact and enabled large-scale access to evidence-based care. Rates and patterns of user engagement were evaluated., Results: Overall, the opportunity to use Wysa was well-received. Out of the 527 staff who were onboarded in the app, 80.1% (422/527) completed a minimum of 2 sessions. On average, users completed 10.9 sessions over 3.80 weeks. The interventions most used were for sleep and anxiety, with a strong repeat-use rate. In this sample, 46.2% (73/158) of health care workers reported symptoms of anxiety (Generalized Anxiety Disorder Assessment-7 [GAD-7]), and 15.2% (24/158) were likely to have symptoms of depression (Patient Health Questionnaire-2 [PHQ-2])., Conclusions: Based on the present findings, Wysa appears to strongly engage those with none to moderate symptoms of anxiety. This evaluation demonstrates the viability of implementing Wysa as a standard practice among this sample of health care workers, which may support the use of similar digital interventions across other communities., (©Christel Lynne Chang, Chaitali Sinha, Madhavi Roy, John Chee Meng Wong. Originally published in JMIR Formative Research (https://formative.jmir.org), 19.04.2024.)

Nowadays, the search for new chemotherapeutic agents with low toxicity and high selectivity is a major concern. In this paper, we report the synthesis and characterization of a hybrid thiosemicarbazone/hydrazone ligand in its neutral form (L 1 H 2 ) and as the chloride salt ([L 1 H 3 ]Cl)-, three diorganotin (IV) complexes, and one complex with Sn (IV). The compounds have been fully characterized by IR, mass spectra, 1 H, 13 C, and 119 Sn NMR, 119 Sn CP/MAS NMR, and by single crystal X-ray diffraction. The organotin compounds have the empirical formula [SnR 2 L 1 ] ( R  = Me, Bu, and Ph), but in the solid state, they are polymeric species with seven coordination number due to weak coordination of the pyridine nitrogen, whereas in solution, the polymeric structure is lost to afford hexacoordinate monomeric species. Reaction with SnI 4 yields complex [Sn (L 1 ) 2 ]·EtOH, with the metal in a distorted dodecahedral arrangement. We have evaluated the antiproliferative activity of the two forms of the ligands and the four coordination compounds against MDA-MB-231, HeLa, PC3, and HepG2 cancer cell lines, and WI-38 normal cell line, and all the compounds present higher activity than cisplatin, used as the standard control. To investigate the mode of action, we have selected the most active complex, containing phenyl substituents, and used the triple negative breast cancer cell line MDA-MB-231. The results show that the complex induces apoptotic cell death promoted by generation of reactive oxygen species and by disruption of mitochondrial membrane potential., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Belén Blázquez-Tapias et al.)

Competing Interests: There are no conflicts of interest.

Competing Interests: There are no conflicts of interest.

Background: Opioids administered as bolus doses or continuous infusions are widely used for major and daycare surgeries. Opioid-free anesthesia is multimodal anesthesia and analgesia that does not use opioids, benefiting patients from opioid-related adverse effects. We compared the postoperative analgesic requirements of patients scheduled for elective laparoscopic cholecystectomy under opioid-free and opioid-based anesthesia., Methods: Study included 88 patients aged 18-60 years with American Society of Anesthesiologists physical status 1 and 2 who underwent elective laparoscopic cholecystectomy. Participants were randomly divided into two groups with 44 in each. The opioid-free group was administered an intravenous bolus of ketamine and dexmedetomidine, whereas fentanyl was used in opioid group. Primary outcome was to compare the total amount of fentanyl consumed by both groups during 6 h postoperative period. Episodes of postoperative nausea and vomiting (PONV) and vital signs were noted throughout the postoperative period to analyze the secondary outcomes., Results: Both groups had similar demographic characteristics. The opioid-free group required lesser analgesia within the first 2 h (61.4 ± 17.4 vs. 79.0 ± 19.4 of fentanyl, P < 0.001), which was statistically significant. However, fentanyl consumption was comparable between the groups at 6 h (152 ± 28.2 vs. 164 ± 33.4, P = 0.061). Compared with 4.5% of the participants in the opioid-free group, 34% of those in the opioid-based group developed moderate PONV., Conclusions: Opioid-free anesthesia in patients undergoing laparoscopic cholecystectomy reduced the requirement of analgesia in first two-hour postoperative period and was associated with decreased PONV.

Background: Lumbar spine surgery is associated with significant postoperative pain. Interfascial plane blocks, such as erector spinae plane (ESP) and thoracolumbar interfascial plane (TLIP) blocks, can play a significant role in multimodal analgesic regimens., Methods: Sixty patients aged 18 to 60 years undergoing elective single or double-level lumbar discectomy or primary lumbar laminoplasty were recruited into this randomized double‑blind study. All patients received general anesthesia and were randomly allocated to either modified TLIP (mTLIP) block (group M) or ESP block (group E). Postoperative and intraoperative fentanyl consumption, and postoperative pain scores, were recorded., Results: Total 48 h postoperative fentanyl consumption was higher in Group M (189.66±141.11 µg) than in Group E (124.16±80.83 µg; P =0.031). In the first 24 postoperative hours, fentanyl consumption was higher in Group M (150.3±120.9 µg) than in group E (89.9±65.3 µg; P =0.01) but was similar between groups in postoperative hours 24to 48 (39.0±20.2 µg versus 34.7±17.1 µg in group M and group E, respectively; P =0.37). Additional intraoperative fentanyl requirement was 57.66±21.76 µg in group M compared with 40.33±21.89 µg in group E ( P <0.01). Postoperative pain scores were higher in group M than in group E at 1, 2, 4, 6, 12, and 24 hours postoperatively ( P <0.001), but similar at 48 hours ( P =0.164)., Conclusion: Compared with the mTLIP block, the ESP block was associated with lower pain scores and a small decrease in perioperative fentanyl consumption in patients undergoing lumbar spine surgeries. Both blocks could form a part of a multimodal analgesic regimen in spine surgery patients., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Paediatric laparoscopic cholecystectomy (LC) is performed by both paediatric and adult surgeons. The aim of this review was to compare outcomes at paediatric centres (PCs) and adult centres (ACs)., Methods: A literature search was conducted, in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, for papers published between January 2000 and December 2020. Statistical analysis was performed using Stata ® version 16 (StataCorp, College Station, TX, US)., Results: A total of 92 studies involving 74,852 paediatric LCs met the inclusion criteria. Over half (59%) of the LCs were performed at ACs. No significant differences were noted in the male-to-female ratio, mean age or mean body mass index between PCs and ACs. The main indications were cholelithiasis (34.1% vs 34.4% respectively, p =0.83) and biliary dyskinesia (17.0% vs 23.5% respectively, p <0.01). There was no significant difference in the median inpatient stay (2.52 vs 2.44 days respectively, p =0.89). Bile duct injury was a major complication (0.80% vs 0.37% respectively, p <0.01). Reoperation rates (2.37% vs 0.74% respectively, p <0.01) and conversion to open surgery (1.97% vs 4.74% respectively, p <0.01) were also significantly different. Meta-analysis showed no significant difference in overall complications ( p =0.92)., Conclusions: The number of LCs performed, intraoperative cholangiography use and conversion rates were higher at ACs whereas bile duct injury and reoperation rates were higher at PCs. Despite a higher incidence of bile duct injury at PCs, the incidence at both PCs and ACs was <1%. In complex cases, a joint operation by both paediatric and adult surgeons might be a better approach to further improve outcomes. Overall, LC was found to be a safe operation with comparable outcomes at PCs and ACs.

Background: Polyglactin (PG) and polydioxanone (PDS) sutures are extensively used based on the surgeon's preference. The development of post-reconstruction urethrocutaneous fistula (UCF) is variably attributed to the choice of suture material for urethroplasty. This meta-analysis compares complications of hypospadias repair using PG and PDS sutures., Methods: The systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors conducted thorough searches in databases including MEDLINE, EMBASE, CENTRAL, Scopus, Google Scholar, and clinical trial registries. Outcome measures included UCF, meatal stenosis, wound infection, urethral stricture, glans dehiscence, and overall complications. Quantitative analysis was used with fixed or random-effect models to find the pooled risk ratio and I 2 heterogeneity., Results: The criteria for inclusion were met by five comparative studies with the inclusion of 1244 children altogether. Pooled analysis failed to show a statistically significant difference in the incidence of meatal stenosis, urethral stricture, wound infection, and total complications using PG and PDS sutures. However, it showed a reduction in the incidence of UCF with PDS suture hypospadias repairs (risk ratio=0.66, 95% CI 0.48 to 0.92)., Conclusions: PDS sutures are associated with decreased incidence of UCF than PG after hypospadias repair. The incidence of meatal stenosis, urethral stricture, wound infection, and total complications was not affected by the type of suture material used for repair., Clinical Implications: This meta-analysis suggests decreased incidence of UCF when PDS sutures are used for hypospadias repair which may impact the choice of suture material for repair., Prospero Registration Number: CRD42023409710., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Sulfonamide derivatives have numerous pharmaceutical applications having antiviral, antibacterial, antifungal, antimalarial, anticancer, and antidepressant activities. The structural flexibility of sulfonamide derivatives makes them an excellent candidate for the development of new multi-target agents, although long-time exposure to sulfonamide drugs results in many toxic impacts on human health. However, sulfonamides may be functionalized for developing less toxic and more competent drugs. In this work, sulfonamides including Sulfapyridine (a), Sulfathiazole (b), Sulfamethoxazole (c), and Sulfamerazine (d) are used to synthesize Schiff bases of 7-hydroxy-4-methyl-2-oxo-2H-chromene-8-carbalde-hyde (1a-1d). The synthesized compounds were spectroscopically characterized and tested against hospital isolates of three Gram-positive (Methicillin-resistant Staphylococcus aureus PH217, Ampicillin-resistant Coagulase-negative Staphylococcus aureus, multidrug-resistant (MDR) Enterococcus faecalis PH007 R ) and two Gram-negative bacteria (multidrug-resistant Escherichia coli, and Salmonella enterica serovar Typhi), compared to the quality control strains from ATCC (S. aureus 29213, E. faecalis 25922, E. coli 29212) and MTCC (S. Typhi 734). Two of the four Schiff bases 1a and 1b are found to be more active than their counterpart 1c and 1d; while 1a have showed significant activity by inhibiting MRSA PH217 and MDR isolates of E. coli at the minimum inhibitory concentration (MIC) of 150 μg/mL and 128 μg/mL with MBC of 1024 µg/mL, respectively. On the other hand, the MIC of 1b was 150 μg/mL against both S. aureus ATCC 29213 and Salmonella Typhi MTCC 734, compared to the control antibiotics Ampicillin and Gentamycin. Scanning electron microscopy demonstrated the altered surface structure of bacterial cells as a possible mechanism of action, supported by the in-silico molecular docking analysis., (© 2023. The Author(s) under exclusive licence to Sociedade Brasileira de Microbiologia.)

The development of sociotechnical codes by the legal system acts as a marker of good citizens and development of self where social norms matter. In most cases, despite cultural differences, socialization plays an important role in making sense of law. The question is, 'how does law come to mind and what is the role of brain? This question will be dealt keeping the debate on brain determinism and free will critically at the forefront., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Hypospadias is one of the most common genital birth defects. There are around 300 various techniques available for the repair of hypospadias. This study aims to compare the reported outcomes of Tubularized incised plate urethroplasty (TIP) and Grafted TIP (GTIP) repair in children undergoing primary hypospadias repair., Methods: This meta-analysisadhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and we framed our research question using the population, intervention, control and outcomes format. We conducted comprehensive electronic searches across various databases, employing a Boolean search strategy with predefined search terms. Only randomized controlled trials (RCTs) were included for quantitative analysis., Results: Totally, 10 RCTs met our inclusion criteria for quantitative analysis. The results indicated that urethrocutaneous fistula, glans dehiscence, and stricture rates were comparable between the two groups. The incidence of meatal stenosis was found to be significantly lower in the GTIP group with a relative risk (RR) of 0.32 (95% confidence interval (CI) 0.15 to 0.67)., Conclusion: The coucomes UCF, glans dehiscence, and stricture rates were comparable between the two groups. Notably, the incidence of meatal stenosis was found to be significantly lower in the grafted TIP group. In terms of operative time, our quantitative synthesis demonstrated that the TIP group had a shorter operative time than the GTIP group with significant heterogeneity., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

The article draws from critical psychology to discuss the rising debate on brain determinism and free will in the legal domain. As free will also corresponds to the context and culture, it can have both the public and private space of expressions. The rise of neuroscience and its influence in the legal domain offers a holistic and sociocultural meaning of responsibility. Even one becomes entitled to take free will as a 'necessary illusion' in order to be in the zone of 'moral as well as legal-social life forming activities'. In the criminal justice system free will is not taken as any kind of 'necessary illusion' but the conscious will and action of the person. This further throw light on how the wilful control of any criminal act is a social act and our brain is not separate from our collective will., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The development and utilization of coordination polymers (CPs) have drawn interest for potential applications in different fields. Detection of metal ions in efficient and selective manners is an important field of research. It paves the way to protect human health by balancing toxic metal ions and biologically active metal ions in the atmosphere. In this regard, a new one-dimensional (1D) 4-(1-naphthylvinyl)pyridine (4-nvp) based CP [Cd(NCS) 2 (4-nvp) 2 ] n (1) was synthesized and characterized structurally by single-crystal X-ray diffraction. Interestingly, this 1D CP underwent supramolecular aggregation via π⋯π stacking interactions, which specifically generated an environment for a potent "turn on" response in the presence of trivalent cations (Fe 3+ , Al 3+ , and Cr 3+ ) in the nanomolar range but remained silent in the presence of other metal ions. Density functional theory (DFT) computations and X-ray photoelectron spectroscopy (XPS) were performed to establish the sensing phenomena. Fascinatingly, utilizing the sensitivity of 1 in an aqueous medium, a hands-on portable cotton swab kit was developed for instant identification of these three important trivalent metal cations.

Background and Aims: The incidence of post-dural puncture headache (PDPH) following spinal anaesthesia in the obstetric population is around 0.5%-2%. Hydration, bed rest, caffeine, paracetamol, non-steroid anti-inflammatory drugs, epidural blood patches, etc., are the various modalities used for its management. This study aims to compare nebulised dexmedetomidine versus fentanyl for the treatment of PDPH in parturients after caesarean section under spinal anaesthesia., Methods: Ninety obstetric patients aged 18-35 years with American Society of Anesthesiologists (ASA) physical status II/III and suffering from PDPH as per the criteria of the International Headache Society after caesarean section under spinal anaesthesia were recruited in this double-blinded randomised study. Patients were randomised to Group D (dexmedetomidine 1 µg/kg nebulisation), Group F (fentanyl 1 µg/kg nebulisation), and Group S (saline nebulisation 4mL). The nebulisation was done 12 hourly for 72 hours. Assessment parameters included pain score and the requirement of additional treatment such as paracetamol, caffeine, and epidural blood patch. Analysis of variance test was used for continuous quantitative variables, and the Kruskal-Wallis test was used for quantitative discrete data., Results: The pain scores at 1, 6, 12, 24, 48, and 72 hours following nebulisation were significantly lower in Group D in comparison to groups F and S ( P < 0.001). The number of patients requiring additional analgesic therapy was lower in Group D in comparison to patients in other groups ( P < 0.001)., Conclusion: Dexmedetomidine nebulisation resulted in effective reduction in PDPH symptoms and pain scores. Nebulisation with fentanyl did not alleviate PDPH symptoms when compared to the control group., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Indian Journal of Anaesthesia.)

Competing Interests: There are no conflicts of interest.

Background and Aims: Mild to moderate sedation during bronchoscopy is essential for patient safety, comfort during and after the procedure, and to facilitate the performance of the bronchoscopist. Dexmedetomidine is a highly selective, centrally acting α-2 agonist used to provide conscious sedation during various procedures. The aim of this study was to compare the efficacy of three different doses of dexmedetomidine nebulization as an adjuvant to lignocaine during bronchoscopy., Material and Methods: Ninety American Society of Anesthesiologists physical status I/II patients, aged from 18 to 60 years, scheduled for an elective bronchoscopy, were recruited. They were divided into three groups: 30 patients in each group. Group I: The patient was nebulized with a mixture of 4 ml of 4% lignocaine and dexmedetomidine 0.5 μg/kg. Group II: The patient was nebulized with a mixture of 4% lignocaine, 4 ml, and dexmedetomidine, 1 μg/kg. Group III: The patient was nebulized with 4% lignocaine 4 ml and dexmedetomidine 1.5 μg/kg., Results: The mean cough score was (1.17 ± 0.37), (1.40 ± 0.49), and (1.70 ± 0.75) in group III, group II, and group I, respectively. A significant difference was found between the groups. Patients were more comfortable with a statistically significant difference in the comfort score in group III as compared to group II and group I., Conclusion: Dexmedetomidine nebulization in a dose of 1.5 μg/kg (compared to 1 μg/kg or 0.5 μg/kg) as an adjuvant to lignocaine, provides better bronchoscopy conditions and patient satisfaction., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Anaesthesiology Clinical Pharmacology.)

Competing Interests: There are no conflicts of interest.