Management of incidental durotomies in an integrated Orthopaedic and Neurosurgical Spinal Unit.

Introduction: Incidental durotomy (ID) is an intraoperative event associated to prolonged bed rest and hospital stay, antibiotic use, higher patient dissatisfaction, and leg pain among other complications of its postoperative course. Several repair techniques and postsurgical care have been proposed for its management. This study was designed to develop an agreed protocol in cases of ID among Orthopaedic Surgeons (OS) and Neurosurgeons (NS) integrated into a Spinal Surgery Unit. Research question: Incidental durotomies management protocol. Materials and methods: From 997 eligible cases operated in Hospital del Mar (Barcelona, Spain) from April 2018 to March 2022, demographic, clinical, surgical and postoperative data was collected for statistical analysis from the morbidity and mortality database, with 79 identified IDs. Redo procedures were significantly associated to OS, and cervical and anterior/lateral approaches to NS, both groups were not comparable. Results: ID occurred in 7.9% of cases, more frequently after the lockdown (p=0.03), in females (p=0.04), during posterior approaches (p=0.003), and less frequently in the cervical spine (p=0.009). IDs were linked to postoperative infections (p< 0.001) and nerve root damage (p< 0.001). Patients without ID evolved more satisfactorily during the postoperative period (p=0.002), and those with CSF leak (20/79) spent on bed rest more than twice the time as those without (p<0.001). Multivariable logistic regression showed strong association between posterior approaches and ID, between complicated postoperative courses and ID. Discussion and conclusions: ID is linked to an adverse postoperative recovery, and it should be primarily repaired under microscope, with early mobilization of patients after surgery.

Efficiency and efficacy of vitrification in 35 654 sibling oocytes from donation cycles.

STUDY QUESTION: Is oocyte vitrification/warming as efficient and effective as using fresh oocytes in donation cycles? SUMMARY ANSWER: IVF with vitrified donor oocytes is less efficient than using fresh oocytes, but its efficacy remains comparable to that of fresh cycles. WHAT IS KNOWN ALREADY: Oocyte vitrification is used to preserve the reproductive potential of oocytes. A small number of randomized controlled trials carried out by experienced groups have shown that this technique provides fertilization, pregnancy, implantation and ongoing pregnancy rates comparable to those of fresh oocytes. However, large registry-based analyses have consistently reported lower live birth rates (LBRs) in cycles using vitrified oocytes. It is not clear whether this decrease may be due to the effect of vitrification per se on the oocytes or to the lower efficiency of the technique, as some of the oocytes do not survive after warming. STUDY DESIGN, SIZE, DURATION: Retrospective cohort analysis of 1844 cycles of oocyte donation (37 520 oocytes), each donor in the study provided enough oocytes for at least one reception cycle with fresh oocytes (2561 cycles) and one reception cycle with vitrified oocytes (2471 cycles) from the same ovarian stimulation (sibling oocytes). Overall, 35 654 oocytes were considered in the analysis. All embryo transfers (n = 5032) were carried out between 2011 and 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS: Differences in reproductive outcomes after the first embryo transfer were evaluated using Pearson's Chi-squared test and regression analysis adjusted for recipient's age, BMI, sperm origin and state, day of embryo transfer, morphological score and number of transferred embryos. We performed two additional sub-analyses, to test whether the efficiency and/or effectiveness of vitrification/warming impacts reproductive results. One analysis included paired cycles where the same number of fresh and vitrified oocytes were available for ICSI (SAME sub-analysis), while the second analysis included those cycles with a 100% survival rate post-warming (SAME100 sub-analysis). MAIN RESULTS AND THE ROLE OF CHANCE: Baseline and cycle characteristics of participants were comparable between groups. Overall, fertilization rates and embryo morphological scores were significantly lower (P < 0.001) when using vitrified oocytes; moreover, vitrified oocytes also resulted in lower reproductive outcomes than sibling fresh oocytes using both unadjusted and adjusted analyses: ongoing pregnancy (32.1% versus 37.5%; P < 0.001; OR 0.88, 95% CI 0.77, 1.00) and live birth (32.1% versus 31.9%; P = 0.92; OR 1.16, 95% CI 0.90, 1.49). However, when the efficiency of warming was taken into account, reproductive outcomes in recipients became comparable: ongoing pregnancy (33.5% versus 34.1%; P = 0.82; OR 1.11, 95% CI 0.87, 1.43) and LBR (32.1% versus 32%; P = 0.97; OR 1.15, 95% CI 0.89, 1.48). Moreover, after selecting only cycles that, in addition to having the same number of oocytes available for ICSI, also had 100% post-warming survival rate in the vitrified group, reproductive outcomes were also comparable between fresh and vitrified oocytes: ongoing pregnancy (34.8% versus 32.4%; P = 0.42; OR 1.32, 95% CI 0.98, 1.77) and live birth (32.9% versus 31.0%; P = 0.52; OR 1.27, 95% CI 0.95, 1.71), indicating that reproductive outcomes of these cycles are affected by the efficiency of the vitrification/warming technique performed rather than the oocyte damage due to the fast cooling process to which oocytes are subjected. LIMITATIONS, REASONS FOR CAUTION: An open vitrification system was used for all cases, and oocyte vitrification/warming was performed by experienced embryologists with consistently high survival rates; caution must be exerted when extrapolating our results to data obtained using other open vitrification systems, closed vitrification systems or to IVF units with survival rates <90%. WIDER IMPLICATIONS OF THE FINDINGS: This is the largest cohort study comparing reproductive outcomes of vitrified and fresh sibling donor oocytes to date. We found that, when the number of oocytes available after warming is equal to the number of fresh oocytes, reproductive results including live birth are comparable. Consequently, the efficiency of vitrification must be taken into account to achieve the same reproductive outcomes as with fresh oocytes. We recommend implementing strict indicators of vitrification/warming efficiency in clinics and refining vitrification/warming protocols to maximize survival. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by intramural funding of Clínica EUGIN and by the Secretary for Universities and Research of the Ministry of Economy and Knowledge of the Government of Catalonia (GENCAT 2015 DI 048). The authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER: N/A.

The transcriptome of human oocytes is related to age and ovarian reserve.

STUDY QUESTION: How does the human oocyte transcriptome change with age and ovarian reserve? SUMMARY ANSWER: Specific sets of human oocyte messenger RNAs (mRNAs) and non-coding RNAs (ncRNAs) are affected independently by age and ovarian reserve. WHAT IS KNOWN ALREADY: Although it is well established that the ovarian reserve diminishes with increasing age, and that a woman's age is correlated with lower oocyte quality, the interplay of a diminished reserve and age on oocyte developmental competence is not clear. After maturation, oocytes are mostly transcriptionally quiescent, and developmental competence prior to embryonic genome activationrelies on maternal RNA and proteins. STUDY DESIGN, SIZE, DURATION: A total of 36 vitrified/warmed MII oocytes from 30 women undergoing oocyte donation were included in this study, processed and analyzed individually. PARTICIPANTS/MATERIALS, SETTING, METHODS: Total RNA from each oocyte was independently isolated, amplified, labeled, and hybridized on HTA 2.0 arrays (Affymetrix). Data were analyzed using TAC software, in four groups, each including nine oocytes, according to the woman's age and antral follicular count (AFC) (mean ± SD): Young with High AFC (YH; age 21 ± 1 years and 24 ± 3 follicles); Old with High AFC (OH; age 32 ± 2 years and 29 ± 7 follicles); Young with Low AFC (YL; age 24 ± 2 years and 8 ± 2 follicles); Old with Low AFC (OL; age 34 ± 1 years and 7 ± 1 follicles). qPCR was performed to validate arrays. MAIN RESULTS AND THE ROLE OF CHANCE: We identified a set of 30 differentially expressed mRNAs when comparing oocytes from women with different ages and AFC. In addition, 168 non-coding RNAs (ncRNAs) were differentially expressed in relation to age and/or AFC. Few mRNAs have been identified as differentially expressed transcripts, and among ncRNAs, a set of Piwi-interacting RNAs clusters (piRNAs-c) and precursor microRNAs (pre-miRNAs) were identified as increased in high AFC and old groups, respectively. Our results indicate that age and ovarian reserve are associated with specific ncRNA profiles, suggesting that oocyte quality might be mediated by ncRNA pathways. LARGE SCALE DATA: Data can be found via GEO accession number GSE87201. LIMITATIONS, REASONS FOR CAUTION: The oldest woman included in the study was 35 years old, thus our results cannot readily be extrapolated to women older than 35 or infertile women. WIDER IMPLICATIONS OF THE FINDINGS: We show, for the first time, that several non-coding RNAs, usually regulating DNA transcription, are differentially expressed in relation to age and/or ovarian reserve. Interestingly, the mRNA transcriptome of in vivo matured oocytes remains remarkably stable across ages and ovarian reserve, suggesting the possibility that changes in the non-coding transcriptome might regulate some post-transcriptional/translational mechanisms which might, in turn, affect oocyte developmental competence. STUDY FUNDING AND COMPETING INTEREST(S): This work was supported by intramural funding of Clinica EUGIN and by the Secretary for Universities and Research of the Ministry of Economy and Knowledge of the Government of Catalonia. J.H. and A.S. are employees of Affymetrix, otherwise there are no competing interests.

Are parent-reared red-legged partridges (Alectoris rufa) better candidates for re-establishment purposes?

Aiming to produce game birds suitable for re-establishment purposes, we studied the survival and behavior of 31 adult red-legged partridges reared by their natural parents in captivity (parent-reared) and 67 wild red-legs (35 adults and 32 subadults). Birds were radio-tracked and released in a game estate where management targeting small game species was conducted and shooting was not allowed. Survival of parent-reared partridges was shorter (mean 108 d) than wild adults (mean 160 d), though no significant differences were found. Parent-reared birds showed a longer escape reaction (mean 11.7 sec) than wild adults (mean 0.4 sec) and were mainly predated by terrestrial predators (52%), whereas the most important source of predation in wild red-legs was raptors (49%). The home range of parent-reared (mean 23 ha) was not significantly lower than wild adults (mean 27 ha). Nineteen percent of parent-reared and 31.4% of wild adults paired successfully, and we recorded 6 pairs in which one bird was wild and the other parent-reared and one pair in which both birds were parent-reared. A small proportion of red-legs started incubation (parent-reared 12.9%, wild 20%), and the proportion completing incubation was similar among wild and parent-reared birds. Overall, parent-reared red-legs showed similar survival and behavior compared to wild red-legs and better than intensively reared, so parent-reared red-legs should be chosen for the re-establishment of wild populations.

Electrolyzed water as novel technology to improve hygiene of drinking water for dairy ewes.

Tap water alone (TW) or treated with 3% of slightly acidic electrolyzed water (SAEW) were used in this experiment to study its effect on water quality, blood biochemical parameters and milk yield and composition. Each type of water was supplied to one group of 10 milking ewes for 25 days. Weekly water samples from troughs were taken. On days 1, 12 and 25, milk yield was measured, and milk and blood samples were taken. SAEW reduced (P < 0.05) bacterial counts (aerobic mesophilic, total coliform and streptococcus). Blood gases, biochemical parameters and milk yield and its composition were not affected (P > 0.05). SAEW can be used at 3% rate as a powerful and economic agent for sanitizing drinking water for dairy ewes with no effects on animal performance.

Influence of the breeding system on the escape response of red-legged partridges (Alectoris rufa).

This study aimed to determine the influence of the breeding system on the escape response of red-legged partridges comparing 147 free-born partridges captured in the wild (W) and 164 partridges from a commercial hunting farm with an intensive production system (F). All birds were individually released to the natural environment using wooden cages; the escape response was recorded with a high resolution video camera and 4 behavior parameters were analyzed: reaction time or latency, escape type, angle at the moment of flight start, and distance flown. There were significant differences on the mean reaction time depending on the origin of the partridges: 0.43 s, with a maximum of 9 s, for the W and 52.90 s, with a maximum of 120 s, in 32.3% of the F birds. Only one of the W partridges (0.68%) escaped by walking, whereas all the other W birds, and 69.5% of the F partridges, flew; the differences in the type of escape reaction between origins were significant. Considering the angle of flight start, the differences were also significant because 98.6% of W partridges showed less than 45 degrees angles, whereas 37.7% of F birds showed angles of more than 45 degrees. Thus, we can conclude that the breeding system has a great influence on the escape response of the red-legged partridges. The intensive management production systems used on the commercial game farms produced obvious changes in the escape reaction of the red-legged partridges, and this could explain the low ability of these birds to integrate and to survive in the wild due to the high predation pressure they undergo when they are used in repopulation processes.

Use of radiotracking techniques to study a summer repopulation with Red-Legged partridge (Alectoris rufa) chicks.

On a private property with a stable population of wild Red-Legged partridge (Alectoris rufa) and an appropriate habitat for the survival of the species, reinforcement repopulations were carried out using 54 birds that were 2 to 3 mo old and reared on a commercial game farm. This study aimed to evaluate the effectiveness of repopulations, the behavior in the wild of released partridges, and the possible causes of success or failure of reinforcement population operations. The releases were carried out during August and September of 2 consecutive years. All birds were equipped with radio transmitter collars to determine their behavior after release. Two release methods were used in yr 1: an acclimatization cage (AC) method and a direct release method on the day of the birds arrival (DR). The aim of the release in yr 2 was to collect data to determine the influence of year conditions using the DR method. Of the 54 released birds, none remained alive by the time of the reproductive period in the following spring. The mean survival time was 16.79 d for the AC method and was 11.89 and 5 d for the DR method in yr 1 and 2, respectively. Of the recorded mortalities, we assigned 81.13% to predation, 7.55% to hunting, and 11.32% to unknown causes of death, accidents, or starvation. Repopulation was not successful at providing a long-term increase in partridge numbers, with most birds falling victim to predation within 1 mo of release. Dispersion is the maximum distance from the release point at which each bird was located. The postrelease mean dispersion was 437.65 m for the AC method and was 647.57 and 266.07 m for the DR method in yr 1 and 2, respectively.

The influence of season on quality characteristics of hot-boned beef m. longissimus thoracis.

Samples of m. longissimus thoracis (LT) muscle were randomly collected from 70 Omani beef cattle 1 h after slaughter between August 2001 and July 2002 in the Muscat Municipality central slaughterhouse to investigate the effect of seasonal parameters on meat quality during the hot and cool seasons of Oman. The collection period (12 months) was divided into two seasons according to ambient temperatures and relative humidity and termed: Cool Season (November-March with average temperature of 21.2±1.40 °C and 57.9±1.61% relative humidity) and Hot Season (April-October with average temperature of 34.3±1.67 °C and 48.8±7.57% relative humidity). The season had a significant effect on meat quality characteristics of the LT muscle. Muscles collected during the hot season had significantly (P<0.001) higher ultimate pH values (6.24) with significantly (P<0.001) lower Warner-Bratzler (WB) shear force values (10.12) than those collected during the cool season (5.54 and 15.58). In these hot-boned samples, there was a linear relationship between ultimate pH and WB shear values. Cooking loss was significantly (P<0.001) higher for cool season samples (26.01%) than from hot season samples (19.75%). Beef from the hot season group had significantly (P<0.001) darker meat than that of the cold season group, based on L* (31.45 vs 35.58), a* (18.53 vs 23.19) and b* (4.16 vs 6.40) colour measurements. There was a linear relationship between ultimate pH and cooking loss, L*, a* and b*. These results indicated that heat stress (>30 °C) lead to physiological stress in beef cattle, which in turn increased muscle ultimate pH and influenced related meat quality characteristics.

A psychophysiological evaluation of the perceived urgency of auditory warning signals.

One significant concern that pilots have about cockpit auditory warnings is that the signals presently used lack a sense of priority. The relationship between auditory warning sound parameters and perceived urgency is, therefore, an important topic of enquiry in aviation psychology. The present investigation examined the relationship among subjective assessments of urgency, reaction time, and brainwave activity with three auditory warning signals. Subjects performed a tracking task involving automated and manual conditions, and were presented with auditory warnings having various levels of perceived and situational urgency. Subjective assessments revealed that subjects were able to rank warnings on an urgency scale, but rankings were altered after warnings were mapped to a situational urgency scale. Reaction times differed between automated and manual tracking task conditions, and physiological data showed attentional differences in response to perceived and situational warning urgency levels. This study shows that the use of physiological measures sensitive to attention and arousal, in conjunction with behavioural and subjective measures, may lead to the design of auditory warnings that produce a sense of urgency in an operator that matches the urgency of the situation.

Biocybernetic system evaluates indices of operator engagement in automated task.

A biocybernetic system has been developed as a method to evaluate automated flight deck concepts for compatibility with human capabilities. A biocybernetic loop is formed by adjusting the mode of operation of a task set (e.g., manual/automated mix) based on electroencephalographic (EEG) signals reflecting an operator's engagement in the task set. A critical issue for the loop operation is the selection of features of the EEG to provide an index of engagement upon which to base decisions to adjust task mode. Subjects were run in the closed-loop feedback configuration under four candidate and three experimental control definitions of an engagement index. The temporal patterning of system mode switching was observed for both positive and negative feedback of the index. The indices were judged on the basis of their relative strength in exhibiting expected feedback control system phenomena (stable operation under negative feedback and unstable operation under positive feedback). Of the candidate indices evaluated in this study, an index constructed according to the formula, beta power/(alpha power + theta power), reflected task engagement best.