OBJECTIVE: To investigate the impact of surgical approach and post-operative prophylaxis on heterotopic ossification (HO) development after total hip arthroplasty (THA).
METHODS: A retrospective analysis of 312 patients who underwent THA between January 2009 and April 2016. Patients were categorized by surgical approach (direct lateral or posterolateral), prosthesis type, and post-operative prophylaxis (Etoricoxib 60 mg daily for two weeks). Two orthopaedic surgeons independently assessed radiographs at serial intervals, and HO was graded as per Brooker classification. Bivariate analysis and regression modelling were performed to assess the associations and confounding effects of different variables, RESULTS: Bivariate analysis identified factors correlated with higher HO incidence: absence of prophylaxis, older age, longer symptom evolution, and lower pre-surgery physical activity. Regression modelling showed a correlation between the direct-lateral approach, post-operative prophylaxis, symptom evolution, and higher HO incidence.
CONCLUSIONS: Patients with longer symptom evolution before surgery and without post-operative prophylaxis are at higher risk of developing HO. While the direct lateral approach showed higher HO rates, the difference was insignificant. A two-week prophylactic regimen of Etoricoxib 60 mg daily after THA effectively reduced HO formation. Pharmacological prophylaxis should be evaluated case-by-case, considering patient characteristics and risk factors.

UNASSIGNED: Bowel cancer is a significant global health concern, ranking as the third most prevalent cancer worldwide. Laparoscopic resections have become a standard treatment modality for resectable colorectal cancer. This study aimed to compare the clinical and oncological outcomes of medial to lateral (ML) vs lateral to medial (LM) approaches in laparoscopic colorectal cancer resections.
UNASSIGNED: A retrospective cohort study was conducted at a UK district general hospital from 2015 to 2019, including 402 patients meeting specific criteria. Demographic, clinical, operative, postoperative, and oncological data were collected. Participants were categorised into LM and ML groups. The primary outcome was 30-day complications, and secondary outcomes included operative duration, length of stay, lymph node harvest, and 3-year survival.
UNASSIGNED: A total of 402 patients (55.7% males) were included: 102 (51.6% females) in the lateral mobilisation (LM) group and 280 (58.9% males) in the medial mobilisation (ML) group. Right hemicolectomy (n=157, 39.1%) and anterior resection (n=150, 37.3%) were the most performed procedures. The LM group had a shorter operative time for right hemicolectomy (median 165 vs. 225 min, P<0.001) and anterior resection (median 230 vs. 300 min, P<0.001). There was no significant difference between the two groups in terms of wound infection (P=0.443), anastomotic leak (P=0.981), postoperative ileus (P=0.596), length of stay (P=0.446), lymph node yield (P=0.848) or 3-year overall survival rate (Log-rank 0.759).
UNASSIGNED: The study contributes to the limited evidence on ML vs LM approaches. A shorter operative time in the LM group was noted in this study, contrary to some literature. Postoperative outcomes were comparable, with a non-significant increase in postoperative ileus in the LM group. The study emphasises the safety and feasibility of both approaches.

Assessing the economic value of livestock such as cattle, goats, sheep, pigs, chickens and fish can offer information about their financial performance and economic importance at farm, national and global scale. Such information is needed for decision-making surrounding livestock finance, investment and strategic development. The aim of this study was to provide an overview of the key livestock valuation methods and associated data requirements. The study was conducted using a literature review. Five key livestock valuation methods were identified and described: historical costs, net current market value, replacement costs, net present value and cost of production. The findings of this study may be of interest to livestock scientists, veterinarians, policy-makers and other stakeholders who aim to assess the economic value of livestock herds. The Global Burden of Animal Diseases programme relied on the outcomes of this study to identify methods for the estimation of the economic value of livestock at the global scale and for its Ethiopia and Indonesia case studies.
L\'estimation de la valeur économique des animaux d\'élevage (bovins, caprins, ovins, porcins, poulets et poissons d\'élevage) peut apporter un éclairage sur leurs performances financières et leur intérêt économique à l\'échelle d\'une exploitation, d\'un pays ou du monde. Ces informations sont indispensables pour étayer les décisions de financement, d\'investissement et de développement stratégique des élevages. L\'étude présentée par l\'autrice vise à donner une vue d\'ensemble des principales méthodes d\'estimation de la valeur des animaux d\'élevage et des exigences qui leur sont associées en termes de données. L\'étude repose sur un examen de la littérature sur le sujet. Cinq méthodes principales d\'estimation de la valeur des animaux d\'élevage y sont répertoriées et décrites : coûts historiques, valeur marchande courante nette, coûts de remplacement, valeur actuelle nette et coûts de production. Les résultats de cette étude pourraient intéresser les spécialistes de l\'élevage, les vétérinaires, les décideurs politiques et d\'autres parties prenantes qui cherchent à évaluer la valeur économique des cheptels. Le programme \" Impact mondial des maladies animales \" s\'est appuyé sur les résultats de cette étude pour retenir les méthodes d\'estimation de la valeur économique des animaux d\'élevage appliquées à l\'échelle mondiale ainsi que dans les études de cas conduites en Ethiopie et en Indonésie.
Evaluar el valor económico del ganado, como vacas, cabras, ovejas, cerdos, pollos y peces, puede ofrecer información sobre su desempeño financiero y su importancia económica tanto a nivel de la explotación como a escala nacional y mundial. Esta información es necesaria para la toma de decisiones en materia de financiación, inversión y desarrollo estratégico de la ganadería. El objetivo de este estudio era ofrecer una visión general de los principales métodos de valoración del ganado y de las necesidades de datos conexas. Para ello, se llevó a cabo una revisión bibliográfica y se distinguieron y describieron cinco métodos fundamentales de valoración de la ganadería: costes históricos, valor actual de mercado neto, costes de reposición, valor actual neto y costes de producción. Las conclusiones de este estudio pueden ser de interés para científicos que trabajan en el ámbito de la ganadería, veterinarios, responsables de la toma de decisiones y otras partes interesadas en la evaluación del valor económico del ganado. El programa sobre el Impacto Global de las Enfermedades Animales se basó en los resultados de este estudio para definir métodos de estimación del valor económico del ganado a escala mundial y para sus estudios de caso de Etiopía e Indonesia.

Limping is a common presenting complaint in children. Despite this, it remains to be a diagnostic challenge for treating physicians due to an expanded list of etiologies. It arises from a spectrum of disorders, ranging from physiological variations of gait at different stages of development to systemic causes, such as inflammatory diseases or musculoskeletal infections. On rare occasions, non-musculoskeletal causes could result in limping. The diagnostic challenge increases in younger age children where a detailed physical examination that helps identify the exact source of pathology may not be possible. In older patients who have a well-developed gait cycle, the physical assessment might be easier. Clinical assessment in a child presenting with a limp includes gait analysis, which is essential to guide the appropriate request of diagnostic laboratory tests and imaging studies. In this paper, we provide a practical guide for a trainee in General Pediatric and Pediatric Rheumatology on an approach to a limping child, aiming to identify the common causes of limping and to describe normal and abnormal gait cycles. We also discuss other diagnostic considerations in the assessment of these children.

UNASSIGNED: Septic arthritis of the hip in children and adolescents is a common condition requiring timely diagnosis and intervention. Surgical irrigation and debridement is typically performed through the anterior approach because of concerns about injury to the medial femoral circumflex artery leading to avascular necrosis. While there are multiple studies investigating the sequelae of anterior and medial approaches for reduction of developmental dislocation of the hip, none have compared these approaches for the pediatric septic hip. We hypothesize that there will be no significant difference in the rate of avascular necrosis when comparing the medial and anterior approaches to the septic hip in pediatric patients.
UNASSIGNED: A retrospective review was performed of pediatric septic hips treated with irrigation and debridement through either a medial or anterior approach at a single institution over an 18-year period of time. The primary outcome measure was the development of avascular necrosis.
UNASSIGNED: Thirteen of 164 patients (7.9%) developed avascular necrosis. Avascular necrosis was noted in 9 of 101 patients who had anterior approach and 4 of 63 patients who underwent medial approach (p = 0.76). The average age for patients developing avascular necrosis was 10.0 years old versus 6.8 years old in patients who did not develop avascular necrosis (p = 0.01). The average follow-up was 3.3 years in patients with avascular necrosis versus 1.5 years for patients who did not develop avascular necrosis (p = 0.01).
UNASSIGNED: Medial approach to the pediatric septic hip does not increase the rate of avascular necrosis compared to the anterior approach.
UNASSIGNED: Retrospective comparison study, Level III.

Several influential theories have proposed that interoceptive signals, sent from the body to the brain, contribute to neural processes that coordinate complex behaviors. Using pharmacological agents that do not cross the blood-brain barrier, we altered interoceptive states and evaluated their effect on decision-making in rhesus monkeys. We used glycopyrrolate, a non-specific muscarinic (parasympathetic) antagonist, and isoproterenol, a beta-1/2 (sympathetic) agonist, to create a sympathetic-dominated physiological state indexed by increased heart rate. Rhesus monkeys were trained on two variants of an approach-avoidance conflict task, where they chose between enduring mildly aversive stimuli in exchange for a steady flow of rewards, or cancelling the aversive stimuli, forgoing the rewards. The delay to interrupt the aversive stimuli and the reward were used as a measure of the cost-benefit estimation that drove the monkeys\' decisions. Both drugs altered approach-avoidance decisions, substantially reducing the delay to interrupt the aversive stimuli. To determine whether this autonomic state lowered tolerance to aversive stimuli or reduced the subjective value of the reward, we tested the effects of glycopyrrolate on a food preference task. Food preference was unaltered, suggesting that the sympathetic dominated state selectively reduces tolerance for aversive stimuli without altering reward-seeking behaviors. As these drugs have no direct effect on brain physiology, interoceptive afferents are the most likely mechanism by which decision making was biased toward avoidance.

BACKGROUND: This study aims to investigate international measures for pandemic control in the workplace based on guidelines from international organizations to learn from their experiences.
METHODS: We conducted a qualitative study using content analysis. The search method involved reviewing published guidelines on preventing and responding to the COVID-19 pandemic in workplaces. After the screening process, ten guidelines were included in the content analysis. During the analysis, 200 meaning codes, 49 subcategories, and eleven categories were identified. Trustworthiness criteria were utilized to ensure the accuracy and strength of the findings.
RESULTS: Eleven categories of international content during the COVID-19 pandemic were legal requirements and duties of employees and employers, structural and program changes, risk assessment, risk communication, information and training, internal and external consultation and cooperation, provision of facilities and tools for workplace hygiene, special conditions, special groups, closing and reopening workplaces, reducing contact and exposure and mental health.
CONCLUSIONS: Protecting employees during a pandemic requires a multifaceted approach and strong advocacy. The operational plan for pandemic control should be developed based on the level of risk, with support tailored to employees\' conditions and needs. Cooperation among international organizations is essential to develop a standardized plan and issue comprehensive guidelines in response to health emergencies with a global perspective and local implementation, drawing from the lessons learned during the COVID-19 pandemic.

Trigonal meningiomas are rare intraventricular tumours that present a surgical challenge. There is no consensus on the optimal surgical approach to these lesions, though the transtemporal and transparietal approaches are most frequently employed. We aimed to examine the approach-related morbidity and surgical nuances in treating trigonal meningiomas. This retrospective review assimilated data from 64 trigonal meningiomas operated over 15 years. Details of clinicoradiological presentation, surgical approach and intraoperative impression, pathology and incidence of various postoperative deficits were recorded. In our study, Trigonal meningiomas most frequently presented with headache and visual deterioration. The median volume of tumours was 63.6cc. Thirty-one meningiomas each (48.4%) were WHO Grade 1 and WHO Grade 2, while 2 were WHO Grade 3. The most frequent approach employed was transtemporal (38 patients, 59.4%), followed by transparietal (22 patients, 34.4%). After surgery features of raised ICP and altered mental status resolved in all patients, while contralateral limb weakness resolved in 80%, aphasia in 60%, seizures in 70%, and vision loss in 46.2%. Eighteen patients (28.13%) developed transient postoperative neurological deficits, with one patient (1.5%) developing permanent morbidity. Surgery for IVMs results in rapid improvement of neurological status, though visual outcomes are poorer in patients with low vision prior to surgery, longer duration of complaints and optic atrophy. The new postoperative deficits in some patients tend to improve on follow up. Transtemporal and transparietal approaches may be employed, based on multiple factors like tumour extension, loculation of temporal horn, size of lesion with no significant difference in their safety profile.

UNASSIGNED: Falcotentorial meningiomas (FM) are surgical challenges for protecting sinus, and the technique notes on the management of superior sagittal or transverse sinus are required for good results.
UNASSIGNED: We improved the technique notes on the management of superior sagittal or transverse sinus in three FM patients with signs of increased intracranial pressure or chronic headache.
UNASSIGNED: All patients underwent surgeries in the prone position, and occipital/sup-occipital/sub-occipital craniotomy was performed. In one patient, the skull was removed traditionally with exposure of the confluence of sinuses, superior sagittal, and transverse sinus, while the longitudinal skull bridge was left to suspend the dura for protecting the superior sagittal sinus in one patient, and the transverse skull bridge was left to suspend the dura for protecting the transverse sinus in one patient. The dura was opened infratentorially or supratentorially to spare the sinus and then the \"skull bridge\" was suspended. The tumor was then removed completely without brain swelling or significant venous bleeding. Complete tumor resection was confirmed by early postoperative imaging, and all patients recovered well without postoperative morbidity.
UNASSIGNED: The authors recommend the \"skull bridge\" to suspend the dura for optimal control of the venous sinuses during FM surgery (less venous bleeding).

Accumulating evidence from both cross-sectional and cue-reactivity studies supports the application of the Ambivalence Model of Craving (AMC) from the substance use literature to food craving. The focus of this extant work has been on the association between the two dimensions of food craving (approach and avoidance) and disordered eating behaviors. The present study extended existing validity data by investigating approach and avoidance food craving profiles and their associations with 1) disordered eating behaviors and 2) thinness/restriction and eating expectancies - a risk factor for disordered eating that is explicitly described by the AMC. It was anticipated that food craving profiles would parallel those defined by the AMC (i.e., approach oriented, avoidance oriented, ambivalent, indifferent) and that profiles defined by high avoidance food craving would be higher in compensatory behaviors, restricting behaviors, and thinness/restriction expectancies, while those defined by high approach food craving would be higher in binge eating and eating expectancies. A sample of 407 undergraduate students (54% female, 47% non-Hispanic White; Mage = 21 years) reported demographics, food craving disordered eating behaviors, and thinness/restriction and eating expectancies via an anonymous online survey. Latent profile analysis was used to test hypotheses. Hypotheses were partially supported. Four profiles were identified, but similar levels of approach and avoidance food craving were observed in each profile, with the intensity of the cravings increasing across the four profiles. Endorsement of disordered eating behaviors and expectancies also increased in intensity across the profiles. Findings suggest an additive, rather than interactive, effect of food craving.