F1000Research

IntroductionRapid and safe endotracheal intubation is of paramount importance in the general anaesthesia practices. Safety of such practices while performing surgical procedures in people with critical coronary lesions assumes increased significance.The use of succinylcholine and rocuronium are common but the association with the application of these medications and concomitant haemodynamic changes on major adverse cardiac events (MACE) has not been adequately studied. The aim of this study is to assess the safety and efficacy of succinylcholine in comparison with rocuronium for MACE in cardiac surgical population. MethodsRetrospective analysis of data collected from administrative and surgical databases of a tertiary care centre. The patients were divided in two groups,wherein the Group A constituted patients who belonged to succinylcholine and Group B represents the patients who were treated with rocuronium.The baseline demographic characteristics, MACE including intubation difficulty score and Cormack Lahne grade of intubation were recorded. ResultsA total of 134 patients were included in the study. Baseline characters were similar in both the groups. There were 2 deaths in the succinylcholine group while 3 in the rocuronium group. The MACE was not statistically significant (p= 0.0505) in both groups. Cormack Lahane scale and intubation difficulty scale were similar in both groups. ConclusionSuccinylcholine was found to be equally efficient and safe in comparison with rocuronium in terms of MACE during coronary artery bypass surgery.

The open science movement aims to transform the research landscape by promoting research transparency in order to enable reproducibility and replicability, lower the barriers for collaboration, and reduce unnecessary duplication. Recently, in recognition of the value of open science, funding agencies have begun to mandate open science policies as a condition in grantee awards. However, operationalization and implementation of an open science policy can have unanticipated costs and logistical barriers, which can impact both the funder, as well as the grantee. These factors should be considered when implementing an open science policy. The Aligning Science Across Parkinsons (ASAP) initiative utilizes a comprehensive open science policy, which, in addition to requiring immediate free online access to all publications, also requires all newly-generated datasets, protocols, code, and key lab materials be shared by the time of publication. Moreover, preprints must be posted to a preprint repository by the time of manuscript submission to a journal for review. Here, we outline the potential costs associated with implementing and enforcing this open science policy. We recommend that funders take these considerations into account when investing in open science policies within the biomedical research ecosystem.

We conducted the first systematic text mining review of online media coverage of genome-wide association studies (GWAS) and analyzed trends in media coverage, readability, themes, and mentions of ethical, legal, and social issues (ELSI). Over 5,000 online news articles published from 2005 to 2018 all over the world were included in analyses. Our results show that while some GWAS attract a great deal of online interest many are not reported on, and that those that are covered are described in language too complex to be understood by the general public. Ethical issues are largely unaddressed, while suggestions for translation are increasing over time. Our review identifies areas that need to improve to increase the effectiveness and accuracy of the communication of genetic research findings in online media. We have also developed a website where all results described below can be explored interactively: https://jjmorosoli.shinyapps.io/newas/.

Microblogging platform Twitter allows researchers to showcase their work, receive constructive feedback, find jobs, and build scientific collaborations. While existing literature has analyzed the benefits of Twitter in the development and distribution of scientific knowledge, most of the studies only took into account a limited number of researchers, which affected the generalizability of derived results. Our study analyzed the activity of 6,000 biomedical scientists on Twitter using data-driven approaches, a third of whom were female. Furthermore, we estimated that up to a quarter of the members of the scientific community are engaged on Twitter. While the number of male scientists joining the microblogging platform every year has decreased, the number of female scientists has remained roughly the same. Scientists are very selective in who they are following as compared to the general public. We also found that the type of tweets and retweets one posts may affect the number of followers, specifically, that a moderate to high level of professionalism and a high level of positivity is correlated with followers count. Moreover, female scientists send fewer negative tweets as compared to male scientists (31.1% for females and 34.7% for males). Our analysis could provide insights and launch a conversation on the advantages and limitations of using Twitter for disseminating scientific information and engaging in constructive discussion and collaborations within the scientific community.

Objectives1) To study the changes in central corneal thickness (CCT) which is an indirect indicator of corneal endothelial dysfunction after uncomplicated small incision cataract surgery (SICS) and 2) To study changes in macular thickness following uncomplicated SICS. MethodsThis was a prospective study conducted in Reiyukai Eiko Masunaga eye hospital, Banepa, Nepal. Those who fulfill inclusion criteria were included in the study. Small incision cataract surgery was performed on 68 eyes of 62 patients Change in central corneal thickness and central macular thickness from baseline was observed post-surgery on 1st day, 1 week and 6 weeks. Results33 females and 35 males were included in the study. Mean age was 58.26 years. This difference of visual acuity between pre and post-operative state was statistically significant. The 1st post-operative day (POD) and 1 week POD values when compared with preoperative CCT values were statistically significant. But the 6 weeks POD when compared to preoperative CCT values were not statistically significant. The 1st POD, 1 week POD and 6 weeks POD CMT values when compared with preoperative CMT values were statistically significant. ConclusionThis study revealed that there was a significant rise in CCT after SICS which gradually tended to normalize at 6 weeks. Similarly there was a gradual rise in CMT after SICS persisting even at 6 weeks. However these changes were subtle and there was a marked improvement of visual acuity after SICS. SynopsisThere was statistically significant increase in central corneal thickness and central macular thickness following uncomplicated small incision cataract surgery, the former of which tends to normalize at 6 weeks post-surgery.

Micro-RNAs (miRNAs) analysis from RNA-seq experiment data provides additional depth into the cellular gene regulation. Such analysis has been simplified using miRDeep2 tool available in freely accessible Galaxy Europe server and miRBase database that compiled the miRNAs in many organisms. Here, we are describing a step by step protocol on how to ultilised the tool and most importantly on how to prepared and compiled miRDeep2 results to be used for downstream analysis such as investigating the differential expression of the detected miRNAs. Currently miRDeep2 miRNAs count result output in the Galaxy are in the broken HTML page and processing such data are troublesome for further analysis unless the user setting up their software dependencies for the tool to run. Hence, we proposed a method to process this output so that it is usable for downstream processing without a single coding required.

Differentiating microbial communities among samples is a major objective in biomedicine. Quantifying the effect size of these differences allows researchers to understand the factors most associated with communities and to optimize the design and clinical resources required to address particular research questions. Here, we present Evident, a package for effect size calculations and power analysis on microbiome data and show that Evident scales to large datasets with numerous metadata covariates.

This article presents the results of a survey of the three major multidisciplinary journals (Nature, Proceedings of the National Academy of Science, Science). Fifty articles involving experiments necessitating the agreement of an ethics committee were searched in each of the three journals to June 30th 2023. Because PNAs announced that a Statistical Review Committee was created and working since September 2023, a further set of 50 articles was retrieved and analyzed from 2024 January 1st. The following items were checked in articles: an explicit statement of approval from an animal ethics committee, the calculation of the appropriate samples size needed and how randomization and blinding were performed, the minimum sample size reported, the presence of repeats, and the methods used to limit type I and type II errors. No clear experimental design was fully reported in any article. The major problems were 1) extremely small sample sizes (<4/group) in nearly half of the articles, 2) confusion between biological repeats and technical replications, and 3) lack of correction for multiple comparisons. These errors led to major inflation of type I and type II errors. In conclusion, only 10 percent of the articles analyzed presented correct statistical methodology.

BackgroundPoint-of-care platelet function tests are used by anaesthetists and surgeons to create risk management plans for patients who have recently taken antiplatelet medication. Thromboelastography (TEG), one method of determining platelet function, sometimes takes >60 minutes to produce results. Previous studies have shown a novel parameter, area under the curve at 15 minutes (AUC15), correlates with clinical outcomes but used privately-owned, custom-made software to calculate AUC15. This study aimed to create a formula that clinicians can use to approximate AUC15 which correlates to the most widely used measure of platelet function, percentage of platelet aggregation. MethodsPlatelet function after 15 minutes can be approximated by the equation: AUC15 = 225(tan({theta})) where {theta} = (MAADP/MAThrombin). A retrospective database review was performed on eligible platelet function tests that assessed ADP receptor inhibition on a TEG 6s Hemostasis Analyzer (Haemonetics(R)) across 15 months. Results were analysed using a bivariate scatter plot with linear regression line and a two-tailed Pearson correlation coefficient was calculated. ResultsForty-seven tests were retrieved, of which, forty-five were eligible for analysis. Pearson two-tailed correlation coefficient showed that AUC15 correlated significantly with percentage of platelet aggregation (R = 0.748, 95% CI [0.582, 0.854], p < 0.001). ConclusionThis study creates the first practical method for clinicians to approximate platelet function on TEG analysers after 15 minutes, instead of >60 minutes, using routinely generated outputs and a calculator. Clinicians who use this method will afford themselves more time to create risk management plans for patients which may improve patient outcomes.

BackgroundBreast cancer (BC) is the most common cancer worldwide, with surgery being the main curative approach. However, postoperative complications (PC) are frequent and may compromise recovery. Identifying strategies to optimize surgical prognosis is clinically relevant. ObjectiveTo synthesize the effects of multimodal, exercise-based prehabilitation on PC, hospital length of stay (HLS), reoperations, and readmissions in patients with BC undergoing surgery. MethodsA systematic search was conducted in PubMed and Web of Science. Eligible studies were randomized or non-randomized controlled trials including patients with BC, implementing prehabilitation with physical activity or exercise, and assessing PC, HLS, reoperations, and/or readmissions. ResultsTwo studies fulfilled the inclusion criteria. No significant differences were observed between prehabilitation and control groups for PC, HLS, reoperations, or readmissions. Nonetheless, one study reported more favourable outcomes in PC and reoperations related to previous breast surgery in patients undergoing prehabilitation. ConclusionsExercise-based prehabilitation may reduce PC and unplanned reoperations associated with prior surgery in patients with BC, although no differences were found for HLS or readmissions compared with usual care. Given the limited number of trials, further research is required to determine the potential benefits of prehabilitation on surgical outcomes in BC.

Textbooks of anaesthesia describe in detail the calculations associated with splitting ratios created in variable bypass vapourisers. These calculations are based on assumptions of carrier gas flow (eg:assume 150 ml) as practised with measured flow vaporizers[1,2]. Carrier gas flow in a variable bypass vaporizer is agent specific,dynamic,unknown and operator independent.Therefore assuming carrier gas flow in calculations related to variable bypass vaporisers is without rationale[3]. In spite of technological advance,the amount of vapour produced is calculated based on clinically impractical assumptions. A simple method and formula is suggested for the quick estimate of vapour output, carrier gas flow and determine the splitting ratio while operating a sevoflurane variable bypass vaporizer.

IntroductionEmergence agitation is the abnormal mental status that develops as the result of anesthesia administration during the transition from unconsciousness to complete wakefulness. It occurs in all age groups but is more common in pediatrics. If emergence agitation is not prevented, it can lead to serious life-threatening phenomena. Thus, preventing the occurrence of emergence agitation would reduce the unwanted side effects and makes emergence smooth. ObjectiveThis study aimed to assess the effectiveness of propofol in the mitigation of emergence agitation among pediatric patients undergone elective surgery under general anesthesia at Jimma University Medical Center. MethodsA prospective observational cohort study was conducted from October 1/2022 to December 30/2022 among pediatric patients aged 2-14 years who underwent elective surgery under general anesthesia. A total of 76 patients were enrolled in the study in two groups (propofol and non-propofol) with 38 patients in each. Data were collected from all study populations who fulfilled the inclusion criteria. The incidence and severity of EA were assessed by the pediatric anesthesia emergence delirium scale in the post-anesthesia care unit at different time intervals. The presence of emergence agitation was considered when the pediatric anesthesia emergence delirium scale was [&ge;] 12 and severity was classified as no agitation [0-11], agitation [12-15], severe agitation [[&ge;] 16]. The data were checked manually for completeness then entered and cleaned using Epi Info, version 7, and exported to Statistical Package for Social Sciences (SPSS) software, version 26.0 for analysis. Normality was tested using the shapiro-wilk test, and histogram. A comparison of numerical variables between the study groups was done using an independent sample t-test. Chi-square/Fischer exact test was used to compare categorical variables and presented as numbers and percentages. The incidence of EA was also presented in confidence interval and relative risk. A p-value less than 0.05 was taken as statically significant. ResultThe overall incidence of EA in both groups was 48.7% (37%-60.4%). The incidence of EA in the propofol group and non-group was 34.2% (19.6%-51.4%) vs 63.2% (46%-78.2%) respectively p=0.012, which means that EA was significantly decreased in the propofol group in comparison to the non-propofol group. There was a significant reduction in the severity of EA at time intervals of 5th and 15th minutes; P =0.012 vs 0.029 respectively. However, there was no significant difference in the severity of EA at the 30th minute between the groups; P=0.08. The relative risk of EA in the propofol group was 0.54; 95% confidence interval (CI) 0.3270.896. This showed propofol group had less risk of emergence agitation in comparison to the non-propofol group. Conclusion and Recommendation: The administration prophylactic propofol at the end of surgery is vital in reducing both the incidence and severity of emergence agitation and makes recovery smooth. Thus, we recommend the routine prophylactic propofol at the end of surgery to reduce the incidence and severity of postoperative emergence agitation in pediatric patients.

tRNA, as well as their derived products such as short interspersed nuclear elements (SINEs), pseudogenes and transfer-RNA, derived fragments (tRFs) has now been shown to be vital for cellular life, functioning and adaptation during different stress conditions in all diverse life forms. In this study, we have developed PtRNAdb (www.nipgr.ac.in/PtRNAdb), a plant exclusive tRNA database containing 113849 tRNA gene sequences from phylogenetically diverse plant species. We have analysed a total of 106 nuclear, 89 plastidial and 38 mitochondrial genomes of plants by tRNAscan-SE software package, and after careful curation of the output data, we developed this database and integrated the data. The information about the tRNA gene sequences obtained, were further enriched with consensus sequence based study of tRNA genes based on their isoacceptors and isodecoders. We have also built covariance models based on the isoacceptors and isodecoders of all the tRNA sequences using infernal tool. The user can also perform BLAST not only against PtRNAdb entries but also against all the tRNA sequences stored in PlantRNA databases; and annotated tRNA genes across the plant kingdom available at NCBI. For the users ease, we have also incorporated the tRNAscan-SE tool for tRNA gene prediction, and ViennaRNA package for structural analysis on the home page of PtRNAdb. This resource is believed to be of high utility for plant researchers as well as molecular biologists to carry out further exploration of plant tRNAome on a wider spectrum, as well as for performing comparative and evolutionary studies related to tRNAs and their derivatives across all domains of life. Database URLhttp://www.nipgr.ac.in/PtRNAdb/

Advances in the next generation sequencing (NGS) technologies, their cost effectiveness and well-developed pipelines using computational tools/softwares has allowed researchers to reveal ground-breaking discoveries in multi-omics data analysis. However, there is still uncertainty due to massive upsurge in parallel tools and difficulty in choosing best practiced pipeline for expression profiling of RNA sequenced (RNA-seq) data. Here, we detail the optimized pipeline that works at a fast pace with enhanced accuracy on personal computer rather than using cloud or high-performance computing clusters (HPC). The steps include quality check, base filtration, quasi-mapping, quantification of samples, estimation and counting of transcript/gene expression abundances, identification and clustering of differentially expressed features and visualization of the data. The tools FastQC, Trimmomatic, Salmon and some other scripts in Trinity toolkit were applied on two paired-end datasets. An extension of this pipeline may also be formulated in future for the gene ontology enrichment analysis and functional annotation of the differential expression matrix to make this data biologically more significant.

Breastfeeding has many benefits for the newborn and mother therefore, the World Health Organization guidelines recommend exclusive breastfeeding for the first 6 months, with continued breastfeeding for up to two years. However, exclusive breastfeeding rates in the first 6 months in Thailand were reported to be approximately, 14% in 2019. Research has highlighted that many mothers have a lack of belief in their ability to breastfeed, and some physical conditions, such as tiredness and difficulty continually holding their baby in a comfortable position. Additionally, first-time breastfeeding can contribute to mothers having difficulties breastfeeding during the early postnatal period. Therefore, the Arm sling innovation (device) has been designed to provide support and comfort whilst holding the newborn. This study compared the effectiveness of the breastfeeding arm sling innovation to support breastfeeding in cross-cradle hold position and normal cross-cradle hold position breastfeeding in first-time mothers. A quasi-experimental pretest-posttest research design was used to evaluate the effectiveness of breastfeeding before and after the intervention among first-time mothers in the postnatal unit, at Ramathibodi hospital, Thailand. A total of 46 postpartum mothers participated in the study. The results showed that the effectiveness of breastfeeding reported by mothers between using a normal cross-cradle hold position and using breastfeeding arm sling innovation was statistically significantly different (t = 4.32, P < 0.001) with helping to hold the baby securely without slipping (t=5.68, p<0.001) and mothers can continue to breastfeed (t=2.09, p <0.001). Majority of mothers were satisfied with the support of using the breastfeeding arm sling innovation design. The breastfeeding arm sling innovation contributes to the effectiveness of breastfeeding by assisting and supporting the mother and babys position to breastfeed more comfortably, thus assisting first-time mothers to feel comfortable, confident, and able to continue breastfeeding.

While the biomedical community has embraced data sharing (e.g. results, raw data) and supported establishment of large research consortia (e.g. the Human Microbiome Project) aimed to standardize the quality of important sets of microbiome sequencing data, the reusability of most microbiome data is still limited by the quality of its associated metadata. To ensure that microbiome data is indeed FAIR (Findable, Accessible, Interoperable, and Reusable), it is necessary to consider tools and approaches that make it easier to provide high-quality metadata that is fit for purpose moving forward. Such tools and approaches could be informed by current efforts to harmonize and improve the quality of extant microbiome metadata.

BackgroundTo analyze the influence of body position on the motor development of preterm infants in the first year of life corrected for prematurity. MethodsThis controlled, randomized, open trial included 30 preterm infants randomly assigned to one of the following three groups: prone group (n = 9), supine group (n = 10), and control group (n = 11). Intervention: Motor development was assessed at four time points using the Alberta Infant Motor Scale: first outpatient visit and at 4, 8 and 12 months corrected age. ResultsIn the third assessment at 8 months corrected age, the supine group exhibited better motor development than the other groups (p = 0.02). In the control group, the number of infants with normal development decreased from 11 (100%) in the first assessment to 5 (45.45%) in the last assessment. Most infants of mothers who received guidance on body positioning achieved normal motor development in the first year of life (63.1%). Greater dispersion from normal Alberta Infant Motor Scale scores was observed in infants at 8 and 12 months of age. ConclusionsGuidance on body positioning of preterm infants at home appears to have a positive influence in the first year of life. Child care strategies after hospitalization should be supported to permit full development of the child. Whats NewThis study reinforces home care programs with specialized orientation for motor development of preterm newborns. By the end of the first year of life most infants in the experimental groups (supine and prone positions) achieved a normal motor development, which did not happen in the control group.

Brachial plexus block has been gained popularity after its introduction because of provision of quality anesthesia and optimal postoperative analgesia in upper arm surgeries, and introduction of ultrasound guidance in recent years further enhances the practice because of efficacy and safety of procedure. This retrospective observational study evaluated the outcome and safety of ultrasound-guided brachial plexus block (supraclavicular and interscalene approach) in a tertiary care hospital of Bangladesh over 3-years period (January 2017 to December 2019) through analyzing preoperative anesthesia evaluation form, anesthesia documents and postoperative records. 113 patients were covered during the study period, of which 59 (52.2%) were males and 54 (47.8%) were females. Mean age of the patients were 38.94 {+/-} 20.37 years. Majority of the patients (63.7%) were in ASA grading I. Operative time for surgeries were 115.30 {+/-} 35.19 minutes. duration of sensory and motor block were 618 {+/-} 55 minutes and 450 {+/-} 74 minutes respectively. And first dose of postoperative analgesic was given after 705 {+/-} 94 minutes of surgery. Tachycardia and hypertension were observed in 4.4% patients, where failure of motor blockade and puncture of subclavian vein were recoreded 1.8% and 0.9% respectively. Current study found that with ultrasound guidance in skilled hands, brachial plexus blockade through combination of supraclavicular and interscalene approaches can provide quality anesthesia and analgesia with minimal complications.

BackgroundThe utilization of stem cells (SCs) has led the way into a new era of therapeutics known as regenerative medicine. Their renewal property offers exciting possibilities in reversing tissue damage caused by metabolic and degenerative changes. Research should be conducted increasingly to explore the possibilities of SC utilization in Pakistan. ObjectivesTo assess the level of knowledge, perception, and attitude of medical students regarding stem cell research (SCR) and its application, to obtain a better insight into the future of stem cell therapy in Pakistan as it is a rapidly emerging field in medicine. Materials and MethodsThis cross-sectional study was carried out using a self-administered questionnaire filled by 206 medical students from different medical colleges in Pakistan. A convenience sampling method was used. Knowledge and attitude scores were calculated based on answers to 28 well-structured questions. Data was analyzed using SPSS. ResultsThe mean values of the answers showed that 60.2% (n=124) of the students had a good knowledge and 39.8% (n=82) had poor knowledge of stem cells. Whereas, 56.8% (n=117) expressed a positive attitude and 43.2% (n=89) expressed a negative attitude towards SCR. Independent t-test applied on knowledge score and attitude showed that the mean knowledge score of people with a positive attitude is higher i.e. 21.25 as compared to the mean knowledge score of people with negative attitude i.e. 19.21. And the difference of the means is significant at p=0.007. Thus, the attitude of students was observed to be significantly dependent on their knowledge about SCR. ConclusionThe results show that medical students have baseline knowledge about SC therapy and a positive attitude towards it. Seminars, workshops should be conducted and this topic should be added to their syllabus so that they obtain proper information about SCR and encourage further research.

Background. A recent meta-analysis by Dang et al. [1] concluded that enteral supplementation with docosahexaenoic acid (DHA), with or without arachidonic acid (ARA) did not significantly affect retinopathy of prematurity (ROP) outcomes in preterm infants. Of four eligible trials that supplemented both DHA and ARA, only two contributed to each ROP outcome analyzed, and severe ROP was not assessed. Methods. We replicated the eligibility criteria and search strategy of Dang et al., restricted to trials that supplemented both DHA and ARA, and reanalyzed three ROP endpoints (any ROP, ROP requiring treatment, and severe ROP [stage 3 and/or treated]) using complete outcome records from all eligible trials. Crude risk ratios (RR) were pooled by Mantel-Haenszel fixed-effect meta-analysis. Gestational age-adjusted odds ratios (adjOR) were pooled on the log scale by inverse-variance random-effects meta-analysis with restricted maximum likelihood (REML) estimation of between-study variance and Hartung-Knapp confidence intervals. Results. Five trials were included; one trial was identified in our replicated search but was excluded by Dang et al. without a stated rationale. The pooled estimate for any ROP was consistent with Dang et al. (RR 0.87 [95% CI 0.71-1.08]; adjOR 0.70 [0.46-1.08]). For ROP requiring treatment, the crude RR suggested a lower risk but did not reach statistical significance (RR 0.60 [0.35-1.04]), whereas the gestational age-adjusted estimate indicated lower odds (adjOR 0.47 [0.23-0.94]). For severe ROP, DHA+ARA supplementation produced a significant protective effect in both unadjusted and adjusted models (RR 0.56 [0.36-0.86]; adjOR 0.42 [0.19-0.96]). Conclusions. When all eligible trials contribute to each endpoint and severe ROP is included as an outcome, enteral DHA+ARA supplementation reduces severe ROP and is associated with lower odds of ROP requiring treatment after adjustment for gestational age. These findings differ from the conclusions of Dang et al. and support reconsideration of DHA+ARA supplementation as a strategy to reduce sight-threatening ROP in preterm infants.