Podcasts about results there

Circulation 68, No. 5, 939-950, 1983Background  Coronary artery bypass surgery (CABG) had grown in popularity through the 1970s and 1980s. By 1981, approximately 159,000 bypass surgeries had been done.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The goal of the CASS trial was to rigorously evaluate the effect of surgical vs medical therapy on total mortality in well-defined subsets of patients with coronary artery disease.Patients Eligible patients had to be 65 years of age or below and have angina that was Canadian Cardiovascular Society class I or II with or without a history of myocardial infarction, or had to have a well-documented MI more than 3 weeks before randomization. Clinical criteria for exclusion were prior CABG, unstable or progressive angina, angina more severe than class II (angina occurring after climbing one flight of stairs or walking two blocks is class III), congestive heart failure (New York Heart Association class III or IV), a coexisting illness that would increase the likelihood of death within 5 years, and a variety of practical exclusions that might limit active participation during follow-up.Angiographic requirements for participation in the trial included the presence of significant operable coronary artery disease, defined as either 70% or greater reduction in the diameter of the right, left anterior descending, or left circumflex coronary artery, or 50% or greater reduction in the diameter of the left main coronary artery. Patients with 70% or greater luminal diameter reduction of the left main were excluded. Also excluded were patients with LVEF (measured by left ventriculography) of less than 35% or those patients who required valve surgery or LV aneurysm repair.Baseline Characteristics There were 390 patients randomized in both the surgical and medical arm. The mean age was 51 years; 90% were males and 98% were White. Approximately 60% had previous MI, 30% had hypertension and only 3% had congestive heart failure. About 40% were smokers.Angiographic criteria were well matched—27% had one-vessel disease, 38% had two-vessel disease, and about a third had three-vessel disease. Nearly a third of patients in both groups had proximal LAD disease. The LVEF was more than 50% in 73-74% of patients in both groups. The LVEF was less than 50% in a fifth of patients in both arms.Procedures CASS authors were quite clear in the screening and randomization process. Slightly more than 16,600 patients were screened for participation in the trial at 11 centers. Figure 1 in the manuscript shows the reasons for exclusion, which included normal or minimal coronary disease (28%), Class 3 or 4 angina (36%), and left main disease more than 70%n (1.5%). Other exclusions totaled 16%.Ultimately there were 2099 patients eligible to be randomized, however, 1319 patients were not included in the trial due to physician preference.Randomization was stratified by clinical site, number of diseased vessels, and ejection fraction within three different clinical subgroups. Patients with angina and ejection fractions of at least 0.50 were randomized within group A (n =514), those with angina and EF less than 0.50 were randomized within group B (n=106) and those free of angina after well-documented MI were randomized within group C (n=160).A total of 954 distal anastomoses were constructed in 357 patients in the surgical group, an average of 2.7 per patient. A total of 334 distal anastomoses were evaluated in the 129 patients; 90% of the grafts were open, 97% of patients had at least one open graft, and in 81% of patients all grafts were patent. Medical therapy consisted mostly of nitrates, and beta-blockers. Statin drugs were not available during the trial. Endpoint The primary endpoint was all-cause mortality. It was assessed with the intention-to-treat method. Results There were no significant differences in mortality.At 5 years, the average annual mortality rate in patients assigned to surgical treatment was 1.1%. The annual mortality rate in those receiving medical therapy was 1.6%. Expressed differently, the rate of death at 5 years was 9.2% in the medical group versus 7.4% in the surgical group. Annual mortality rates in patients with single-, double-, and triple-vessel disease who were in the surgical group were 0.7%, 1.0%, and 1.5%; the corresponding rates in patients in the medical group were 1.4%, 1.2%, and 2.1%.There were also no significant differences in survival when patients were grouped according to degree of coronary artery disease (number of vessels) or EF or by a combination of diseased vessels and EF.Crossovers did occur. Approximately 23% of the 390 patients assigned to the medical group had surgery during the follow-up period (4.7% per year). Of the patients assigned to surgery, 31 of 390 patients (8%) did not have surgery.Conclusions The CASS authors write in the abstract of the manuscript that they observed excellent long-term survival in both groups and that for patients similar to those in the trial, surgery could be deferred until symptoms worsen.The CASS trial had caveats. First was that the 780 patients enrolled in the trial were highly selected from a total of more than 16,000 patients in the registry. The CASS registry revealed widely disparate annual mortality in patients managed medically, ranging from 1.3% for those with single-vessel disease and normal EF to 12.5% in those with three-vessel disease and impaired EF. Another caveat was the lower-than-expected annual mortality in the medical arm of only 1.6%. This was lower than previous surgery trials (3.3% noted in the European Collaborative Study and 4.3% reported in the Veterans Administration Study). CASS authors estimated a 2-4% annual mortality. This reduces the power to find differences in the two groups.It is interesting however, that for the 1319 patients in whom their physician declined randomization, the outcome in those treated medically was similar to that reported in the randomly assigned patients who received medical therapy.In conclusion, as early as the 1980s, the CASS study showed that stable coronary artery disease was quite stable, and that revascularization in selected patients did not improve survival over medical therapy. Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Lancet 1982;320:1173-1180Background: The first coronary artery bypass graft surgery (CABG) was performed in 1964 and by the 1970's it was commonly used for relief of angina. However, whether it improved survival was unknown. The European Coronary Surgery Study (ECSS) sought to test the hypothesis that CABG compared to medical therapy improved survival at 5 years.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Note to readers: Several preliminary reports of ECSS results were published at earlier time points (2 and 3-5 years). We are reporting the 5-year results since this was the prespecified hypothesis the investigators sought to test.Patients: Men under 65 years of age with angina pectoris of more than 3 months duration, a left ventricular ejection fraction >50%, and angiographic obstruction of >/=50% in at least 2 major coronary vessels with at least 1 vessel suitable for grafting. Patients with severe angina that could not be controlled with medical therapy were excluded.Baseline characteristics: No information is provided in the main paper on the number or characteristics of individuals screened to enrolled. There were 768 patients enrolled in the study. They were recruited from September, 1973 to March, 1976. The average age of patients was 50 years and the left ventricular ejection fraction was 65%. Approximately, 46% had a previous heart attack, 43% smoked, 35% had a high cholesterol, 15% had hypertension and 6% had diabetes. In terms of coronary anatomy, 53% had 3-vessel disease, 40% had 2-vessel disease, and 7% had left main disease.Procedures: Patients were randomly assigned to receive medical or surgical treatment. Medical measures varied based on location. The authors reported that strict standardization was not felt to be practical or necessary. Surgical treatment was either with saphenous-vein graft or internal mammary artery and was performed as soon as possible following randomization. The average time from randomization to surgery was approximately 4 months.Follow-up evaluations were performed 6 months after randomization and annually thereafter. Graft angiography was planned at 6 and 12 months after operation.Endpoints: The primary endpoint was all-cause death. The prespecified minimum follow-up time, set at the start of the trial, for all patients was 5 years. At the time of this report, some patients had been followed up to 8 years. A strict hypothesis was not tested (i.e., CABG would reduce death by X% compared to medical therapy). The primary analysis was a traditional intention to treat analysis and medical patients who crossed over to surgery and surgical patients who died prior to receiving surgery or refused surgery after randomization were retained within their original groups.Results: There were 767 patients included in the final analysis; 373 patients in the medical group and 394 in the surgical group (1 patient was lost from the surgical group immediately following randomization and was not counted in the group). At 5 years, 90 patients (24%) of the medical group had crossed over to surgery and 26 (7%) of the surgical patients were not operated on. An average of 1.9 grafts per patient were performed in the 2-vessel disease subgroup and 2.4 grafts per patient in the 3-vessel disease subgroup. The graft patency rate was 90% within 9 months and 77% between 9 and 18 months.Compared to medical therapy, surgery significantly reduced death at 5 years by 53% (7.6% vs 16.4%; p=0.00025). Operative (in-hospital) mortality was 3.6% for a total of 494 operations and 7.7% for 26 reoperations. Seven of 27 prespecified variables recorded at the time of randomization were found to be associated with significant treatment effect heterogeneity. They included: (i) extent of disease; (ii) location of lesion(s) in the proximal third of the left anterior descending artery (proximal LAD); (iii) resting ECG suggestive of previous possible or probable myocardial infarction and/or with other specified abnormalities (iv) ischemic ST-segment response predominantly in lead V5 during maximum level of a multistage symptom/sign-limited bicycle exercise test; (v) history of peripheral arterial disease; (vi) age; and (vii) mode of treatment.Subgroup analysis on the basis of coronary anatomy supported a significant advantage of surgery for patients with left main disease (14.3% vs 32.1%; p=0.11) and 3-vessel disease (6% vs 17.6%; p=0.003) but not in 2-vessel disease (8.8% vs 11.8%; p>0.20). The left main subgroup could have had 2- or 3-vessel disease and the p-value was insignificant due to the small sample size.Surgery significantly reduced death in patients with proximal LAD disease (7.3% vs 18%; p=0.0004) but not in those without it (6.7% vs 7.9%; p>0.20). In the subset of patients with 2-vessel disease and without proximal LAD disease, surgery caused a numerical increase in death at 5 years, attributed to operative mortality.Surgery significantly reduced death in patients with >/= 1.5mm exertional ST depression on bicycle testing (8.3% vs 21%; p=0.003) but not in those without it (5.1% vs 9.7%; p>0.20).Angina and exercise performance were significantly improved in the surgery group compared to medicine. Conclusions: Compared to medical therapy, bypass surgery using internal mammary arteries and saphenous vein grafts significantly reduced mortality at 5 years in men under 65 years of age with normal left ventricular function. Approximately 11 men would need to be treated with CABG to prevent 1 death. This represents a large benefit for bypass surgery in well-selected patients at the time the study was undertaken. Contemporary caveats to this interpretation include improvements in medical therapy since the publication of ECSS mainly involving aspirin and cholesterol lowering drugs for patients with CAD as well as an improvement in the general management of conditions like hypertension and diabetes. Also, smoking rates have significantly declined at the population level.Despite the impressive benefit of bypass surgery seen in this study, important treatment effect heterogeneity was identified for certain lower risk patient groups including those with 2-vessel disease, absence of proximal LAD disease, and minimal ST depression on symptom limited bicycle testing. Theoretically, such patients would be expected to benefit from bypass surgery even less today given the improvements in medical therapy mentioned above.Finally, it is worth pointing out the difference in treatment effects seen in this study compared to the Veterans Administration Cooperative Study that we reviewed earlier this week, which was a negative trial. In the Veterans Administration Cooperative Study, coronary bypass was performed primarily with saphenous vein grafting whereas ECSS used internal mammary arteries and saphenous vein grafts. Internal mammary arteries are superior conduits compared to vein grafts. They have improved long-term patency rates, which is attributed to their striking resistance to the development of atherosclerosis. Furthermore, they are used almost exclusively on the LAD, which is the most important vessel.In conclusion, ECSS demonstrated that CABG surgery dramatically reduced death at 5 years compared to medical treatment; however, we should be aware of the caveats mentioned above and appreciate that the trial was limited to highly selected male patients under the age of 65.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

Kindy Moves: the feasibility of an intensive interdisciplinary programme on goal and motor outcomes for preschool-aged children with neurodisabilities requiring daily equipment and physical assistanceMatthew Haddon, Loren West, Catherine Elliott, Corrin Walmsley, Jane Valentine, Natasha Bear, Dayna Pool, Healthy Strides Research Advisory CouncilAbstractObjectives: To determine the feasibility of an intensive interdisciplinary programme in improving goal and motor outcomes for preschool-aged children with non-progressive neurodisabilities. The primary hypothesis was that the intervention would be feasible.Design: A single group feasibility study.Setting: An Australian paediatric community therapy provider.Participants: Forty children were recruited. Inclusion criteria were age 2-5 years with a non-progressive neurodisability, Gross Motor Function Classification System (GMFCS) levels III-V or equivalent, and goals relating to mobility, communication and upper limb function. Exclusion criteria included orthopaedic surgery in the past 6 months, unstable hip subluxation, uncontrolled seizure disorder or treadmill training in the past month.Intervention: A goal-directed programme of three 2-hour sessions per week for 4 weeks (24 hours total). This consisted of treadmill and overground walking, communication practice, and upper limb tasks tailored by an interdisciplinary team.Primary and secondary outcome measures: Limited-efficacy measures from preintervention (T1) to postintervention (T2) and 4-week follow-up (T3) included the Goal Attainment Scaling (GAS), Canadian Occupational Performance Measure (COPM), Gross Motor Function Measure (GMFM-66) and 10-Metre Walk Test (10MWT). Acceptability, demand, implementation and practicality were also explored.Results: There were improvements at T2 compared with T1 for all limited-efficacy measures. The GAS improved at T2 (mean difference (MD) 27.7, 95% CI 25.8 to 29.5) as well as COPM performance (MD 3.2, 95% CI 2.8 to 3.6) and satisfaction (MD 3.3, 95% CI 2.8 to 3.8). The GMFM-66 (MD 2.3, 95% CI 1.0 to 3.5) and 10MWT (median difference -2.3, 95% CI -28.8 to 0.0) improved at T2. Almost all improvements were maintained at T3. Other feasibility components were also demonstrated. There were no adverse events.Conclusions: An intensive interdisciplinary programme is feasible in improving goal and motor outcomes for preschool children with neurodisabilities (GMFCS III-V or equivalent). A randomised controlled trial is warranted to establish efficacy.Trial registration number: ACTRN12619000064101.Keywords: Clinical trials; Developmental neurology & neurodisability; Neurological injury.

We chat with Team Kerr and also catch up with George Sherwood from Precision Nutrition as he gives great advice for Race Day Fueling. Episode 64 recap of results and Fixtures Contact the show & Useful Links: Email: runnersdiarycork@gmail.com Website: ⁠⁠https://www.therunnersdiary.com/⁠⁠ Instagram: ⁠⁠the_runnersdiary_cork⁠⁠ Facebook: ⁠⁠https://www.facebook.com/profile.php?id=100075951919957⁠⁠ YouTube: ⁠⁠https://youtube.com/@therunnersdiary⁠⁠ Featured fixturesEyeries 5 mile : 11th November 2.30pm We're on sale!! - Our annual Eyeries 5 Mile Road Race on Saturday 11th November 2023. Entries are now open - click the link! Hope to see you all there! https://eventmaster.ie/event/pMDRIvyTyo The Great Glenville Run - Sunday, November 26, 2023 The Great Glenville Run makes a welcome return in 2023. Lovely 4 mile run that starts and finishes in the quiet country village. The Post Race Spread is also not to be missed! Entries are now open - click the link! Hope to see you all there!  https://eventmaster.ie/event/8BlPt7qTV Thomas Kent 10K - Sunday, November 12, 2023 - Castlelyons Thomas Kent 10K returns to Castlelyons Sunday 12th November at 11am. AI permit Granted. Chip timing. Category prizes. Entries are now open - click the link! Hope to see you all there! https://www.facebook.com/Thomaskent10k/ Results AN COSANTOIR 10K AND 5K WALK Wednesday, 11 October 2023 TOTAL FINISHERS: 347 https://www.myrunresults.com/events/an_cosantoir_10k_and_5k_walk/4934/results Results of Bere Island 5 Mile Road Race 2023: There were 57 Finishers https://www.corkathletics.org/.../2997-results-of-bere Defence Forces 5k Results: There were 209 Finishers https://www.corkbhaa.com/.../defence-forces-5k-results-2023/⁠ SOLAS RUN & WALK FOR LIFE 2023 Sunday, 15 October 2023: TOTAL FINISHERS: 559 ⁠https://www.myrunresults.com/events/solas_run__walk_for_life_2023/4910/results⁠ AUTUMN OPEN INTERNATIONAL CROSS COUNTRY FESTIVAL 2023 Sunday, 15 October 2023 TOTAL FINISHERS: 425. https://www.myrunresults.com/.../autumn.../4689/results

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.03.23.534020v1?rss=1 Authors: Bell, S. M., Wareing, H., Hamshaw, A., De, S., New, E., Shaw, P. J., De Marco, M., Venneri, A., Blackburn, D. J., Ferraiuolo, L., Mortiboys, H. J. Abstract: Background: Astrocytes have multiple roles including providing neurons with metabolic substrates and maintaining neurotransmitter synaptic homeostasis. Astrocyte glucose metabolism plays a key role in learning and memory with astrocytic glycogen a key substrate supporting memory encoding. The neuronal support provided by astrocytes has a high metabolic demand. Deficits in astrocytic mitochondrial metabolic functioning and glycolysis could impair neuronal function. Changes to cellular metabolism are seen early in Alzheimers disease (AD). Understanding cellular metabolism changes in AD astrocytes could be exploited as a new biomarker or synergistic therapeutic agent when combined with anti-amyloid treatments in AD. Methods: In this project, we characterised mitochondrial and glycolytic function in astrocytes derived from patients with sporadic (n=6) and familial (PSEN1, n=3) forms of AD. Astrocytes were derived using direct reprogramming methods. Astrocyte metabolic outputs: ATP, and extracellular lactate levels were measured using luminescent and fluorescent protocols. Mitochondrial respiration and glycolytic function were measured using a Seahorse XF Analyzer. Hexokinase deficits identified where corrected by transfecting astrocytes with an adenovirus viral vector containing the hexokinase 1 gene. Results: There was a reduction of total cellular ATP of 20% (p=0.05 in sAD astrocytes) and of 48% (p less than 0.01) in fAD. A 44% reduction (p less than 0.05), and 80% reduction in mitochondrial spare capacity was seen in sAD and fAD astrocytes respectively. Reactive oxygen species (ROS) were increased in both AD astrocyte types (p=0.05). Mitochondrial complex I and II was significantly increased in sAD (p less than 0.05) but not in fAD. Astrocyte glycolytic reserve and extracellular lactate was significantly reduced when compared to controls in both sAD and fAD (p less than 0.05). We identified a deficit in the glycolytic pathway enzyme hexokinase, and correcting this deficit restored most of the metabolic phenotype in sAD but not fAD astrocytes. Conclusion: AD astrocytes have abnormalities in functional capacity of mitochondria and the process of glycolysis. These functional deficits can be improved by correcting hexokinase expression deficits with adenoviral vectors. This suggests that hexokinase 1 deficiency could potentially be exploited as a new therapeutic target for AD. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.02.25.529586v1?rss=1 Authors: Skerswetat, J., He, J., Shah, J. B., Aycardi, N., Bex, P. J. Abstract: Purpose: Visual acuity (VA) is a critical clinical endpoint, however tests typically require trained staff, are fixed in their range, and provide only limited information about individual performance. This study introduces the Angular Indication Measurement and applies it to VA (AIM-VA). Agreement, repeatability, and test duration of AIM-VA were compared to standard clinical tests. Methods: 29 and 22 adults took part in two separate experiments. 4*4 charts with Landolt-C optotypes of varying sizes and random gap-orientations were presented at 4m viewing distance. Optotype size was response-adaptively updated after each chart. Participants indicated the perceived gap location by clicking on the corresponding location on a surrounding response-ring and VA was estimated from the report errors as a function of target size. First, we compared AIM-VAs with that of ETDRS and FrACT. Second, we compared repeatability over two tests of AIM-VA and ETDRS. AIM-VA-specific psychometric functions generated a new parameter called range of stimulus detectability improvement (ROSDI) that represents the range over which VA varies with target size. Results: There were no significant differences among VA estimates from AIM, ETDRS and FrACT. AIM-VA's test-retest repeatability was comparable to that of ETDRS (95% Confidence Intervals in logMAR: AIM-VA [0.18 / -0.15] when using 3 adaptive steps and ETDRS [0.18 / -0.11]). Median ROSDI was {+/-}0.14logMAR 0.03. Test duration was not significantly different for AIM-VA and ETDRS, the latter being significantly faster than FrACT. Conclusions: AIM-VA estimates of VA were equivalent to FrACT and ETDRS. AIM-VA can be estimated in approximately the same time as ETDRS and with comparable test-retest reliability. AIM-VA is an intuitive, self-administered, adaptive, and personalized method that provides reliable and repeatable estimates of VA and additional performance outcomes. AIM's orientation judgement approach is generalizable to interrogate many other visual functions, e.g., contrast, color, motion, stereo-vision. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.02.11.528146v1?rss=1 Authors: Chalmers, K. J., Hutchinson, M. R., Dodds, K. N., Kwok, Y. H., Evans, S. F., Moseley, G. L. Abstract: Problem: The neuroimmune interface has been characterised in few areas of the body. The objective of this study was to investigate the neuroimmune interface in the mouse vagina through a novel ex vivo model, to determine whether LPS could directly activate and produce TRPV1-mediated neuronal activation. Method of Study: Concentrations of IL-1{beta} and IL-6 release into the supernatant at different times post ex vivo stimulation with LPS, capsaicin, or a combination of the two were assessed using enzyme-linked immunosorbent assay. Results: There were no differences in the supernatant concentration of IL-6 with different stimulation type nor stimulation time. Supernatant concentrations of IL-1{beta} were greater at the 20 hour time point than the 4 hour time point, and were greater for stimulations involving LPS. Conclusion: There is a clear pattern of pro-inflammatory neuroimmune responses following ex vivo stimulation of mouse vaginal tissues with capsaicin and LPS, evident as an increased IL-1{beta} output. This output is greatest at 20 hours post-stimulation, indicating this neuroimmune response is time-dependent. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

The Pilot episode!Locomotor and robotic assistive gait training for children with cerebral palsy Dayna Pool, Jane Valentine, Nicholas F Taylor, Natasha Bear, Catherine Elliotthttps://pubmed.ncbi.nlm.nih.gov/33225442/AbstractAim: To determine if robotic assisted gait training (RAGT) using surface muscle electrical stimulation and locomotor training enhances mobility outcomes when compared to locomotor training alone in children with cerebral palsy (CP).Method: Forty children (18 females, 22 males; mean age 8y 1mo, SD 2y 1mo; range 5y 1mo-12y 11mo) with CP in Gross Motor Function Classification System levels (GMFCS) III, IV, and V were randomly assigned to the RAGT and locomotor training (RAGT+LT) group or locomotor training only group (dosage for both: three 1-hour sessions a week for 6 weeks). Outcomes were assessed at baseline T1 (week 0), post-treatment T2 (week 6), and retention T3 (week 26). The primary outcome measure was the Goal Attainment Scale. Secondary outcome measures included the 10-metre walk test, children's functional independence measure mobility and self-care domain, the Canadian Occupational Performance Measure, and the Gross Motor Function Measure.Results: There were no significant differences between the groups for both the primary and secondary outcome measures. All participants completed the intervention in their original group allocation. There were no reported adverse events.Interpretation: The addition of RAGT to locomotor training does not significantly improve motor outcomes in children with CP in GMFCS levels III, IV, and V. Future studies could investigate health and well-being outcomes after locomotor training.What this paper adds: Marginally ambulant and non-ambulant children with cerebral palsy can participate in locomotor training. Robotic assisted gait training when added to locomotor training does not appear to be any more effective than locomotor training alone.https://pubmed.ncbi.nlm.nih.gov/33225442/

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.05.21.109660v1?rss=1 Authors: Borlase, N., Myall, D., Melzer, T. R., Livingston, L., Watts, R., Keenan, R. J., MacAskill, M., Anderson, T., Dalrymple-Alford, J. C. Abstract: Background: Previous research has shown an association between thalamus and cognition in Parkinson's disease (PD). Objectives: To investigate the microstructural integrity of the nuclei of the thalamus and relationship with cognition. Methods: Level II Movement Disorder Society Task Force Criteria characterised patients with Parkinson's disease as cognitively normal (PDN, n=51); with mild cognitive impairment (PD-MCI, n=16) or with dementia (PDD, n=15). Twenty-three healthy control subjects were included for comparison. A k-means clustering approach segmented the thalamus into regions representing nine major nuclei. Volume, fractional anisotropy and mean diffusivity of nuclei were compared between cognitive groups and the relationship with cognitive domain z-scores investigated using hierarchical Bayesian regression models. Results: There was an overall progressive increase in mean diffusivity as cognition deteriorated (PDN: 1.4 m2/s (95% uncertainty interval [0.2, 2.7]), PDMCI: 2.4 m2/s [0.8,4.0], PDD: 4.5 m2/s [2.8, 6.3]). The largest increase was in the lateral dorsal nucleus (PDN: 0.3 m2/s [-6.7, 7.2], PDMCI: 5.4 m2/s [-4.7, 16.1], PDD: 14.8 m2/s [5.0, 25.0]). Fractional anisotropy showed minimal change between cognitive groups (PDN: 0.001 [-0.005, 0,007], PDMCI: -0.005 [-0.013, 0.003], PDD: -0.005 [-0.014, 0.003]). Increase in mean diffusivity of the thalamus is associated with a global decline in cognition, the magnitude of the effect was greatest in lateral dorsal nucleus. Fractional anisotropy only showed evidence of a relationship with cognitive domain scores in the lateral dorsal nucleus. Conclusions: The relationship between lateral dorsal nucleus integrity and cognitive changes is likely due to its primary connectivity with frontal and temporal regions. Copy rights belong to original authors. Visit the link for more info

Kasey and Ashleigh have a theory - and they need your help to test it! Do you know any women who have risen to VP of Sales in 5 years or less? Your hosts can think of several men who have done it - but no women or people who identify as LGBTQ! Listen in as they discuss why this may be the case - then reach out and help them!SHOW NOTESMale Sales Leadership-Kasey and Ashleigh can think of a handful of male sales leaders who, within a 5 year timeframe, rose the ranks to a VP level position, but can't think of a single woman who's story matches that.Higher Base and Lower Commission-Kasey has a colleague who's trying to push leadership to adopt a higher base and lower commission for all sales roles. There's less risk associated, so would women be more likely to apply and stay?Potential vs. Results-There is a ton of evidence that proves men are more often promoted based on their potential whereas women are promoted based on their results.-If you look at Sales Hacker's 35 Most Influential Women in Sales, the average time it took to become a VP was between 12 and 15 years. For most of the women it took between 2 to 3 years to be promoted to a manager or director level role and they stayed at that level for close to 10 years.Software World-From the outside, software seems to be less progressive and disciplined when it comes to diversity compared to other older industries. Let us know, how does the software world compare?Effects-If it takes women longer to get into leadership positions, there is a cascade effect. Over a woman's lifetime they'll make less and there are fewer women at the top advocating for others like them who are just starting their career.Resources-Potential vs. Results-Sales Hacker's 35 Most Influential Women in SalesSend in a voice message: https://anchor.fm/othersideofsales/messageSupport this podcast: https://anchor.fm/othersideofsales/support

Background: Public health and governmental organizations are expected to provide guidance to the public on emerging health issues in accessible formats. It is, therefore, important to examine how such organizations are discussing cannabis online and the information that is being provided to the public about this increasingly legal and available substance. Methods: This paper presents a concise thematic analysis of both the volume and content of cannabis-related health information from selected (n = 13) national-level public health and governmental organizations in Canada and the U.S. on Twitter. Results: There were eight themes identified in Tweets including 1) health-related topics; 2) legalization and legislation; 3) research on cannabis; 4) special populations; 5) driving and cannabis; 6) population issues; 7) medical cannabis, and 8) public health issues. The majority of cannabis-related Tweets from the organizations studied came from relatively few organizations and there were substantial differences between the topics covered by U.S. and Canadian organizations. The organizations studied provided limited information regarding how to use cannabis in ways that will minimize health-related harms. Conclusions: Authoritative organizations that deal with public health may consider designing timely social media communications with emerging cannabis-related information, to benefit a general public otherwise exposed to primarily pro-cannabis content on Twitter. van Draanen J, Krishna T, Tsang C, Liu S. Keeping up with the times: how national public health and governmental organizations communicate about cannabis on Twitter. Subst Abuse Treat Prev Policy. 2019;14(1):38. Published 2019 Sep 12. doi:10.1186/s13011-019-0224-3. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Sections of the Abstract, Introduction, Methods, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739954/

Saffron for ADHDBaziar S, Aqamolaei A, Khadem E, et al. Crocus sativus L. Versus Methylphenidate in Treatment of Children with Attention-Deficit/Hyperactivity Disorder: A Randomized, Double-Blind Pilot Study. J Child Adolesc Psychopharmacol. 2019;29(3):205-212.The standard of care in treating ADHD is the use of stimulant medications, the most popular of which is methylphenidate (Ritalin).It works by blocking the reuptake of norepinephrine and dopamine in presynaptic neurons in the cerebral cortex and subcortical structures. NE and DA are the primary neurotransmitters responsible for learning, rewards, memory formation, and stimulation.Side effects include insomnia, nausea, loss of appetite, anticholinergic effects (dry mouth, pupil dilation and blurred vision, hyperthermia), orthostatic hypotension, and arrhythmias. Saffron (Crocus sativus) has been known as the world’s most expensive spice. About 90% of the world’s supply comes from Iran. In addition to its culinary application it is also used for its antispasmodic, antiseptic, antidepressant, anticancer, memory enhancement, anxiolytic, neuroprotective, and anticonvulsant effects. The primary mechanisms of saffron are thought to be reuptake inhibition of NE and DA, antagonism of NMDA receptors, and agonist of GABA-α.How the study was doneRandomized, double-blind, parallel-group clinical trial. Tehran University of Medical Sciences50 Males and females between the ages of 6 and 17 with ADHD completed.Patients were randomized to receive standard-dose methylphenidate (tid, at 30mg/day for kids >30kg) on a titration schedule or 30mg/day of saffron in three doses.Outcome measure was a parent and teacher rating scale measure at baseline, week 3, and week 6 of treatment.Results:There was no statistically significant difference between parent or teacher ratings of either inattentive or hyperactive behaviors between the two groups. In other words, both saffron and methylphenidate improved ADHD symptoms equally well. The saffron group reported fewer although not significantly fewer side effects.My thoughts:Stimulants lead to significant improvement in the quality of life for many people, however, they don’t work in everyone and many have undesirable side-effects.Coming down for the medication is hard and can lead to mood disturbancesPeople can become tolerant to stimulantsThey can become dependent on them in place of developing skills to manage their symptomsThis study was small, the first and only study of saffron for ADHD, and there was no placebo groupMore studies should be done to confirm the findingsSaffron is safe, give it a try, and let me know what you thinkDisclaimer: topics discussed on the podcast are for educational purposes only and should not be construed as medical advice. Consult with your medical provider about the appropriateness of these interventions in your individual case.Music credit: American Vernacular by RAGESupport the show (https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=Q6MJHU6BLWMWS&source=url)

In my last episode, I opened that I came to the realization that this podcast sucks! So, let's talk about why I actually think that, and it's about my content I share. What is the whole point of this podcast? Or listening to a podcast in general, especially a daily one? Here are my theories for why we invest time on anything actually: Results There is is, so here is how I'm going to actually deliver now: I need to drop this need for you to like me. I need to polarize you. To either drive you towards action or drive you away. Think like a magnet, only the ends attract or repel. I'm going to invoke emotion with you. You are not always to going to like it. I am done with being light on truth and impact, I want to provoke you. That's how we grow! Pattern interrupters. We use this to make change in our lives. Now normally, we wait until something drastic happens TO US (heart attack, finances, bankruptcy, divorce, spiritual warfare). Well, instead of waiting, let's search it out. An easy example of how we do this is by working out and making sure we mix things up to keep our muscles confused and therefore in growth! So we can use this in religion and politics. You need to search out chaos and growth by getting uncomfortable. Study opposing views. And be open to changing your viewpoint when you get evidence. Be in a state of growth and expansion. We don't by staying comfortable. Related Links: The Home for the SuperParent Syndrome Coaching with Me? The SuperParent Syndrome Facebook Page How can you support our podcast? Apple users, please subscribe and rate the SP podcast.  If you Android, this is found on Stitcher or Google Music. Tell a friend about the SP podcast.  Click on "share podcast" and they will love it and thank you forever! Join the FREE SP Facebook Page.  Great way to stay in touch, get resources, and videos!  Join Here. Sign Up for the 1% club - Free and get this in your inbox with challenges each day!  Thank You! ~Coach Nick

Study: See Hear: Psychological Effects of Music and Music-Video During Treadmill Running Abstract: Background: There is a paucity of work addressing the distractive, affect-enhancing, and motivational influences of music and video in combination during exercise. Purpose: We examined the effects of music and music-and-video on a range of psychological and psychophysical variables during treadmill running at intensities above and below ventilatory threshold (VT). Methods: Participants (N = 24) exercised at 10 % of maximal capacity below VT and 10 % above under music-only, music-and-video, and control conditions. Results: There was a condition × intensity × time interaction for perceived activation and state motivation, and an intensity × time interaction for state attention, perceived exertion (RPE), and affective valence. The music-and-video condition elicited the highest levels of dissociation, lowest RPE, and most positive affective responses regardless of exercise intensity. Conclusions: Attentional manipulations influence psychological and psychophysical variables at exercise intensities above and below VT, and this effect is enhanced by the combined presentation of auditory and visual stimuli.   Author: Jasmin Hutchinson Dr. Jasmin Hutchinson is an associate professor at Springfield University. She received her undergraduate degree (BSc in sport science, physical education, and social science) from Loughborough University, UK, a master’s degree in exercise science from Eastern Illinois University, and a PhD in sport psychology from Florida State University. Early on in her academic career she found an interest in the dual psychology/physiology relationship and has stuck with that passion ever since. She also has participated in marathons and is a fan of techno music … which Is awesome!   Links:   Author:   http://springfield.edu/academic-programs/exercise-science-and-sport-studies-department/jasmin-hutchinson-phd   Study:   http://link.springer.com/article/10.1007%2Fs12160-014-9647-2

Objective: To quantify the relationship between death from non-malignant respiratory diseases (NMRD) and exposure to silica dust or radon in a cohort of 58690 former German uranium miners. Methods: In the follow-up period from 1946 to 2008, a total of 2336 underlying deaths from NMRDs occurred, including 715 deaths from chronic obstructive pulmonary diseases (COPD) and 975 deaths from silicosis or other pneumoconiosis. Exposure to respirable crystalline silica and radon was individually assessed by means of a comprehensive job-exposure matrix. Risk analyses were based on a linear Poisson regression model with the baseline stratified by age, calendar year and duration of employment. Results: There was no increase in risk of death from COPDs or any other NMRDs in relation to cumulative exposure to silica (mean=5.9, max=56mg/m(3)-years), except in the group of deaths from silicosis or other pneumoconiosis. Here, a strong non-linear increase in risk was observed. Cumulative radon exposure (mean=280; max=3224 Working Level Months) was not related to death from COPDs or any other NMRDs. Conclusions: The present findings do not indicate a relationship between mortality from COPD with silica dust or radon. However, validity of cause of death and lack of control for smoking remain potential sources of bias.

Background: Students can improve the learning process by developing their own multiple choice questions. If a similar effect occurred when creating OSCE (objective structured clinical examination) stations by themselves it could be beneficial to involve them in the development of OSCE stations. This study investigates the effect of students developing emergency medicine OSCE stations on their test performance. Method: In the 2011/12 winter semester, an emergency medicine OSCE was held for the first time at the Faculty of Medicine at the University of Leipzig. When preparing for the OSCE, 13 students (the intervention group) developed and tested emergency medicine examination stations as a learning experience. Their subsequent OSCE performance was compared to that of 13 other students (the control group), who were parallelized in terms of age, gender, semester and level of previous knowledge using the matched-pair method. In addition, both groups were compared to 20 students who tested the OSCE prior to regular emergency medicine training (test OSCE group). Results: There were no differences between the three groups regarding age (24.3 +/- 2.6; 24.2 +/- 3.4 and 24 +/- 2.3 years) or previous knowledge (29.3 +/- 3.4; 29.3 +/- 3.2 and 28.9 +/- 4.7 points in the multiple choice {[} MC] exam in emergency medicine). Merely the gender distribution differed (8 female and 5 male students in the intervention and control group vs. 3 males and 17 females in the test OSCE group). In the exam OSCE, participants in the intervention group scored 233.4 +/- 6.3 points (mean +/- SD) compared to 223.8 +/- 9.2 points (p < 0.01) in the control group. Cohen's effect size was d = 1.24. The students of the test OSCE group scored 223.2 +/- 13.4 points. Conclusions: Students who actively develop OSCE stations when preparing for an emergency medicine OSCE achieve better exam results.

Background: Patellofemoral complications are one of the main problems after Total Knee Arthroplasty (TKA). Retropatellar pressure distribution after TKA can contribute to these symptoms. Therefore we evaluated retropatellar pressure distribution subdivided on the ridge, medial and lateral surface on non-resurfaced patella before and after TKA. Additionally, we analyzed axial femorotibial rotation and quadriceps load before and after TKA. Methods: Seven fresh frozen cadaver knees were tested in a force controlled knee rig before and after TKA (Aesculap, Tuttlingen, Germany, Columbus CR) while isokinetic flexing the knee from 20 degrees to 120 degrees under weight bearing. Ridge, medial and lateral retropatellar surface were defined and pressure distribution was dynamically measured while quadriceps muscles and hamstring forces were applied. Aside axial femorotibial rotation and quadriceps load was recorded. Results: There was a significant change of patella pressure distribution before and after TKA (p = 0.004). In physiological knees pressure distribution on medial and lateral retropatellar surface was similar. After TKA the ridge of the patella was especially in higher flexion grades strongly loaded (6.09 +/-1.31 MPa) compared to the natural knee (2.92 +/-1.15 MPa, p < 0.0001). Axial femorotibial rotation showed typical internal rotation with increasing flexion both before and after TKA, but postoperatively it was significantly lower. The average amount of axial rotation was 3.5 degrees before and after TKA 1.3 degrees (p = 0.001). Mean quadriceps loading after implantation of knee prosthesis did not change significantly (575 N +/- 60 N in natural knee and after TKA 607 N +/- 96 N; p = 0.28). Conclusions: The increased retropatellar pressure especially on the ridge may be one important reason for anterior knee pain after TKA. The trochlea of the femoral component might highly influence the pressure distribution of the non-resurfaced retropatellar surface. Additionally, lower axial femorotibial rotation after TKA might lead to patella maltracking. Changing the design of the prosthesis or a special way of patella shaping might increase the conformity of the patella to trochlea to maintain natural contact patterns.

Background: According to a national reference, 15% of German children and adolescents are overweight (including obese) and 6.3% are obese. An earlier study analysed the impact of childhood overweight and obesity on different components of direct medical costs (physician, hospital and therapists). To complement the existing literature for Germany, this study aims to explore the association of body mass index (BMI) with utilisation of pharmaceuticals and related costs in German children and adolescents. Methods: Based on data from 14, 836 respondents aged 3-17 years in the German Interview and Examination Survey for Children and Adolescents (KiGGS), drug intake and associated costs were estimated using a bottom-up approach. To investigate the association of BMI with utilisation and costs, univariate analyses and multivariate generalised mixed models were conducted. Results: There was no significant difference between BMI groups regarding the probability of drug utilisation. However, the number of pharmaceuticals used was significantly higher (14%) for obese children than for normal weight children. Furthermore, there was a trend for more physician-prescribed medication in obese children and adolescents. Among children with pharmaceutical intake, estimated costs were 24% higher for obese children compared with the normal weight group. Conclusions: This is the first study to estimate excess drug costs for obesity based on a representative cross-sectional sample of the child and adolescent population in Germany. The results suggest that obese children should be classified as a priority group for prevention. This study complements the existing literature and provides important information concerning the relevance of childhood obesity as a health problem.

Background: Nitric oxide (NO) shows differing concentrations in lower and upper airways. Patients after total laryngectomy are the only individuals, in whom a complete separation of upper and lower airways is guaranteed. Thus the objective of our study was to assess exhaled and nasal NO in these patients. Methods: Exhaled bronchial NO (FENO) and nasal nitric oxide (nNO) were measured in patients after total laryngectomy (n = 14) and healthy controls (n = 24). To assess lung function we additionally performed spirometry. Co-factors possibly influencing NO, such as smoking, infections, and atopy were excluded. Results: There was a markedly (p < 0.001) lower FENO in patients after total laryngectomy (median (range): 4 (1-22) ppb) compared to healthy controls 21 (9-41) ppb). In contrast, nNO was comparable between groups (1368 versus 1380 in controls) but showed higher variability in subjects after laryngectomy. Conclusions: Our data suggest that either bronchial NO production in patients who underwent laryngectomy is very low, possibly due to alterations of the mucosa or oxidant production/inflammation, or that substantial contributions to FENO arise from the larynx, pharynx and mouth, raising FENO despite velum closure. The data fit to those indicating a substantial contribution to FENO by the mouth in healthy subjects. The broader range of nNO values found in subjects after laryngectomy may indicate chronic alteration or oligo-symptomatic inflammation of nasal mucosa, as frequently found after total laryngectomy.

Background: Children with attention-deficit/hyperactivity disorder (ADHD) show a marked temporal variability in their display of symptoms and neuropsychological performance. This could be explained in terms of an impaired glial supply of energy to support neuronal activity. Method: We pursued one test of the idea with measures of a neurotrophin reflecting glial integrity (S100B) and the influences of 8 cytokines on the metabolism of amino-acids, and of tryptophan/kynurenine to neuroprotective or potentially toxic products that could modulate glial function. Serum samples from 21 medication-naive children with ADHD, 21 typically-developing controls, 14 medicated children with ADHD and 7 healthy siblings were analysed in this preliminary exploration of group differences and associations. Results: There were no marked group differences in levels of S100B, no major imbalance in the ratios of pro-to anti-inflammatory interleukins nor in the metabolism of kynurenine to toxic metabolites in ADHD. However, four trends are described that may be worthy of closer examination in a more extensive study. First, S100B levels tended to be lower in ADHD children that did not show oppositional/conduct problems. Second, in medicated children raised interleukin levels showed a trend to normalisation. Third, while across all children the sensitivity to allergy reflected increased levels of IL-16 and IL-10, the latter showed a significant inverse relationship to measures of S100B in the ADHD group. Fourthly, against expectations healthy controls tended to show higher levels of toxic 3-hydroxykynurenine (3 HK) than those with ADHD. Conclusions: Thus, there were no clear signs ( S100B) that the glial functions were compromised in ADHD. However, other markers of glial function require examination. Nonetheless there is preliminary evidence that a minor imbalance of the immunological system was improved on medication. Finally, if lower levels of the potentially toxic 3 HK in ADHD children were confirmed this could reflect a reduction of normal pruning processes in the brain that would be consistent with delayed maturation ( supported here by associations with amino-acid metabolism) and a reduced metabolic source of energy.

Background The authors estimated trends in 1-year case-fatality of stroke in relation to changes in vascular risk management from 1997 to 2005.Methods A cohort study was implemented using data for 407 family practices in the UK General Practice Research Database, including subjects with first acute strokes between 1997 and 2005. One-year case-fatality was estimated by year and sex. Rate ratios were estimated using Poisson regression.Results There were 19 143 women and 16 552 men who had first acute strokes between 1997 and 2005. In women, the 1-year case-fatality declined from 41.2% in 1997 to 29.2% in 2005. In men, the decline was from 29.2% in 1997 to 22.2% in 2005. The proportion of general practices that prescribed antihypertensive drugs to two-thirds or more of new patients with stroke increased from 6% in 1997 to 48% in 2005, for statins from 1% to 39% and for antiplatelet drugs from 11% to 39%. The rate ratio for 1-year mortality in 2005, compared with 1997--1998, adjusted for age group, sex, prevalent coronary heart disease, prevalent hypertension and deprivation quintile was 0.79 (0.74 to 0.86, p

Objective: To determine whether a history of terminations of pregnancy influences subsequent pregnancies in terms of pregnancy risks, prematurity and neonatal biometrics. Patients and methods: Based on the perinatal statistics of eight German federal states, data of 247,593 primiparous women with singleton pregnancies born between 1998 and 2000 were analyzed. The control group consisted of primiparous women without previous induced abortions. Maternal age was adjusted for. Results: There was an overall trend towards an increased rate of preterm delivery at = 2 previous induced abortions were 7.8% and 8.5%, respectively, compared to 6.5% in the control population (P=0.015). Preceding terminations of pregnancy did not alter the rate of small-for-gestational-age newborns. Psychosocial stress and symptoms associated with prematurity such as cervical incompetence and vaginal bleeding before and after 28 weeks of gestation occurred more frequently in women with previous induced abortion compared to the control group (P

Aim: To determine if botulinum toxin type A (BoNT-A) injections can reduce the frequency and severity of migraines. Methods: Patients (n = 127) were randomized to receive placebo or two doses of BoNT-A (Dysport (R)). The primary endpoint was reduction in number of migraine attacks up to week 8 and between weeks 8 and 12 after injection. Patient diaries were used to record secondary endpoints, including frequency, severity and duration of migraine attacks. Results: There was a mean reduction of 0.54 and 0.94 attacks/month with placebo and BoNT-A, respectively, and absolute attack count was less in the verum group (3.6 vs. 4.2 attacks/month), but this was not statistically significant. The patients' global assessment of efficacy was significantly better than placebo in the high-dose group (p = 0.02) but no effects were seen for the other secondary efficacy parameters. Conclusion: Our study showed a trend towards a reduced attack rate with verum but did not show any statistically significant efficacy of BoNT-A in the prophylactic treatment of migraine. Copyright (C) 2009 S. Karger AG, Basel

Background: An erythema migrans (EM) remaining smaller than 5 cm in diameter, called mini EM by us, has not been addressed in detail. Objective: To study the significance of the mini EM as a sign of Lyme borreliosis. Methods: Patients with suspected mini EM were retrospectively selected out of 257 consecutive patients with EM. The diagnosis of mini EM rested on the cultivation of Borrelia burgdorferi. Species and subtype analysis of culture isolates was performed using outer surface protein A (OspA) polymerase chain reaction followed by restriction fragment length polymorphism and sequencing of the OspA gene. Results: There was one patient with definite (0.4%) and another patient with a questionable mini EM. Borrelia garinii OspA type 6 was identified in the patient with the definite and B. burgdorferi sensu lato in the patient with the questionable mini EM. Conclusion: The mini EM represents an important and apparently uncommon sign of early Lyme borreliosis.

Background: In a cross-sectional analysis of cystic fibrosis (CF) patients with mild lung disease, reduced surfactant activity was correlated to increased neutrophilic airway inflammation, but not to lung function. So far, longitudinal measurements of surfactant function in CF patients are lacking and it remains unclear how these alterations relate to the progression of airway inflammation as well as decline in pulmonary function over time. Methods: As part of the BEAT trial, a longitudinal study to assess the course of airway inflammation in CF, we studied lung function, surfactant function and endobronchial inflammation using bronchoalveolar lavage fluid from 20 CF patients with normal pulmonary function ( median FEV1 94% of predicted) at three times over a three year period. Results: There was a progressive loss of surfactant function, assessed as minimal surface tension. The decline in surfactant function was negatively correlated to an increase in neutrophilic inflammation and a decrease in lung function, assessed by FEV1, MEF75/25%VC, and MEF25%VC. The concentrations of the surfactant specific proteins A, C and D did not change, whereas SP-B increased during this time period. Conclusion: Our findings suggest a link between loss of surfactant function driven by progressive airway inflammation and loss of small airway function in CF patients with limited lung disease.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.04.20.050799v1?rss=1 Authors: Jeong, T. S., Yee, G. T., Lim, T. G., Kim, W. K., Yoo, C. J. Abstract: Background Decompressive craniectomy is an important surgical treatment for patients with severe traumatic brain injury (TBI). Several reports have been published on the efficacy of non-watertight sutures in duraplasty performed in decompressive craniectomy. This study aims to evaluate the effectiveness of dura closure without sutures (non-suture duraplasty) in decompressive craniectomy for TBI. Methods One hundred and six patients were enrolled at a single trauma center between January 2017 and December 2018. We retrospectively collected the data and classified the patients into non-suture and suture duraplasty craniectomy groups. We compared the characteristics of patients and their intra/post-operative findings such as operative time, blood loss, imaging findings, complications, and Glasgow outcome scale. Results There were 37 patients in the non-suture group and 69 in the suture craniectomy group. There were no significant differences between the two groups with regard to general characteristics. The operative time was 205 min for the suture duraplasty group and 150 min for the non-suture duraplasty group, and that for the non-suture duraplasty group was significantly lesser (p=0.002). Blood loss was significantly lesser in the non-suture duraplasty group (1000 mL) than in the suture duraplasty group (1500 mL, p=0.028). There were no other significant differences. Conclusion Non-suture duraplasty involved shorter operative time and lesser blood loss when compared to suture duraplasty. Other complications and prognosis were similar in both groups. Therefore, it can be concluded that decompressive craniectomy with non-suture duraplasty is a safe and useful surgical technique in patients with TBI. Copy rights belong to original authors. Visit the link for more info