Use of Caudal Quadratus Lumborum Block with Ropivacaine as Part of an Opioid-Free Analgesic Protocol in Dogs Undergoing Orchiectomy: A Randomized Trial.

In veterinary medicine, the use of loco-regional anesthesia techniques is increasing. The Quadratus Lumborum block (QL) is an interfascial loco-regional technique that involves the release of local anesthetic (LA) between the Quadratus Lumborum and the Small Psoas (Pm) muscle. The study aims to evaluate the effect of the QL block on reducing the total amount of opioids in dogs undergoing pre-scrotal orchiectomy. A group of 36 dogs was enrolled in a randomized blinded study. The animals were divided into two groups: 18 in the experimental group (QL) and 18 in the control group (C). The QL group received 0.4 mL kg-1 of ropivacaine 0.5% for each hemiabdomen (total amount of 3 mg kg-1 of ropivacaine, 1.5 mg kg-1 per side). The C group was brought into the operating room (OR) after receiving the same clipping as the QL group. In the intraoperative period, opioid consumption in the QL group was significantly lower than in the C group. No differences were found in the post-operative phase. No side effects were reported when performing the QL technique. The QL block performed at the level of L6 appears to be a valid approach to reducing opioid use in dogs undergoing orchidectomy with a pre-scrotal surgical approach.

[The regional aspect of Russian healthcare development (using the example of the Krasnodar territory)].

The article examines the modern aspects of the development of Russian healthcare in the regional context with an analysis of the main implemented measures and sources of financing. The efficiency of the industry's functioning directly affects the life expectancy and health of citizens; therefore, the analysis of priorities and sources of their financing is an urgent area of research. Most of the projects and plans in healthcare are focused on the long term, so the main part of the subprograms does not change significantly, defining the strategy, but priorities may change in the short term, and accordingly funding will be adjusted in the context of the main sources. Taking into account the leading positions of the region, we can note its leadership in the development of the industry in question. The socio-economic situation in the country also has an impact, for example, most experts pay attention to the fact that prices for medicines and medical equipment have increased, and this creates additional difficulties during planning and forecasting. Some expenses are simply necessary and at the same time take away significant funding - paying for medical care to the insured unemployed population and providing subsidies to state budgetary healthcare institutions, reducing the possibilities of other areas. The main source of financing for most subprograms is the budget of the Krasnodar Territory, the federal budget participates to a much lesser extent. The article touches upon the factors influencing the implementation of the state program «Development of healthcare¼ in the region and, as a result, the main key indicators of quality of life. The conducted practical research made it possible to determine in detail the current trends in the development of the industry in the regional aspect (using the example of the Krasnodar Territory).

Sex differences in chest electrical impedance tomography findings.

Objective.Electrical impedance tomography (EIT) has been used to determine regional lung ventilation distribution in humans for decades, however, the effect of biological sex on the findings has hardly ever been examined. The aim of our study was to determine if the spatial distribution of ventilation assessed by EIT during quiet breathing was influenced by biological sex.Approach.219 adults with no known acute or chronic lung disease were examined in sitting position with the EIT electrodes placed around the lower chest (6th intercostal space). EIT data were recorded at 33 images/s during quiet breathing for 60 s. Regional tidal impedance variation was calculated in all EIT image pixels and the spatial distribution of the values was determined using the established EIT measures of centre of ventilation in ventrodorsal (CoVvd) and right-to-left direction (CoVrl), the dorsal and right fraction of ventilation, and ventilation defect score.Main results.After exclusion of one subject due to insufficient electrode contact, 218 data sets were analysed (120 men, 98 women) (age: 53 ± 18 vs 50 ± 16 yr (p= 0.2607), body mass index: 26.4 ± 4.0 vs 26.4 ± 6.6 kg m-2(p= 0.9158), mean ± SD). Highly significant differences in ventilation distribution were identified between men and women between the right and left chest sides (CoVrl: 47.0 ± 2.9 vs 48.8 ± 3.3% of chest diameter (p< 0.0001), right fraction of ventilation: 0.573 ± 0.067 vs 0.539 ± 0.071 (p= 0.0004)) and less significant in the ventrodorsal direction (CoVvd: 55.6 ± 4.2 vs 54.5 ± 3.6% of chest diameter (p= 0.0364), dorsal fraction of ventilation: 0.650 ± 0.121 vs 0.625 ± 0.104 (p= 0.1155)). Ventilation defect score higher than one was found in 42.5% of men but only in 16.6% of women.Significance.Biological sex needs to be considered when EIT findings acquired in upright subjects in a rather caudal examination plane are interpreted. Sex differences in chest anatomy and thoracoabdominal mechanics may explain the results.

Dose Contribution to the Regional Lymph-Node Metastases and Point B from Intracavity and Interstitial Hybrid Brachytherapy in Locally Advanced Cervical Cancer.

PURPOSE: Analyzing dose distributions to regional lymph-node metastases (RLNMs) in locally advanced cervical cancer (LACC) patients undergoing intracavitary and interstitial hybrid brachytherapy (IC/IS). METHODS: Dose distributions of eleven LACC patients with 38 RLNMs, and who received 38 IC/IS sessions were analyzed in EQD2, considering RLNM positions and ipsilateral interstitial needles; these RLNMs, excepting the para-aortic region, were classified into four groups. RESULTS: RLNMs had a median of two ipsilateral interstitial needles per session. Significant differences were observed in total RLNM D90, depending on whether the position was cranial or caudal of the uterine base (85.5 vs. 378.9 cGy, p < 0.0001), and whether the RLNM D90 was associated with a number of ipsilateral interstitial needles between 0-1 or 2 or more (68.4 vs. 112.2 cGy, p = 0.006) per session. At each session, Group 1 RLNMs (cranial of the uterine base, 0-1 ipsilateral interstitial needle) had a mean D90 of 21.1 cGy; Group 2 (cranial, 2 or more), 73.8; Group 3 (caudal, 0-1), 94.7; and Group 4 (caudal, 2 or more), 136.1. CONCLUSION: RLNMs located caudal of the uterine base associated with two or more ipsilateral interstitial needles in IC/IS had a higher dose contribution, which should be considered when calculating the RLNMs' dose of external beam boost irradiation.

Microbial communities assembly in wastewater treatment plants in China.

Community assembly processes determine community structure. Deterministic processes are essential for optimizing activated sludge (AS) bioreactor performance. However, the debate regarding the relative importance of determinism versus stochasticity remains contentious, and the influencing factors are indistinct. This study used large-scale 16S rRNA gene data derived from 252 AS samples collected from 28 cities across China to explore the mechanism of AS community assembly. Results showed that the northern communities possessed lower spatial turnover and more significant dispersal limitation than those in the south, whereas the latter had more substantial deterministic processes than the former (14.46 % v.s. 9.12 %). Meanwhile, the communities in the south exhibited lower network complexity and stability. We utilized a structural equation model to explore the drivers of deterministic processes. Results revealed that low network complexity (r = -0.56, P < 0.05) and high quorum sensing bacteria abundance (r = 0.25, P < 0.001) promoted deterministic assembly, which clarifies why determinism was stronger in southern communities than northern ones. Furthermore, total phosphorus and hydraulic retention time were found to be the primary abiotic drivers. These findings provide evidence to understand the community deterministic assembly, which is crucial for resolving community structure and improving bioreactor performance.

Increases in Global and East Asian Nitrogen Trifluoride (NF3) Emissions Inferred from Atmospheric Observations.

Nitrogen trifluoride (NF3) is a potent and long-lived greenhouse gas that is widely used in the manufacture of semiconductors, photovoltaic cells, and flat panel displays. Using atmospheric observations from eight monitoring stations from the Advanced Global Atmospheric Gases Experiment (AGAGE) and inverse modeling with a global 3-D atmospheric chemical transport model (GEOS-Chem), we quantify global and regional NF3 emission from 2015 to 2021. We find that global emissions have grown from 1.93 ± 0.58 Gg yr-1 (± one standard deviation) in 2015 to 3.38 ± 0.61 Gg yr-1 in 2021, with an average annual increase of 10% yr-1. The available observations allow us to attribute significant emissions to China (0.93 ± 0.15 Gg yr-1 in 2015 and 1.53 ± 0.20 Gg yr-1 in 2021) and South Korea (0.38 ± 0.07 Gg yr-1 to 0.65 ± 0.10 Gg yr-1). East Asia contributes around 73% of the global NF3 emission increase from 2015 to 2021: approximately 41% of the increase is from emissions from China (with Taiwan included), 19% from South Korea, and 13% from Japan. For Japan, which is the only one of these three countries to submit annual NF3 emissions to UNFCCC, our bottom-up and top-down estimates are higher than reported. With increasing demand for electronics, especially flat panel displays, emissions are expected to further increase in the future.

The impact of residential environment on stroke onset and its spatial heterogeneity: A multiscale exploration in Shanghai.

BACKGROUND: Stroke is a worldwide concern due to its high disability and mortality rates, especially in many countries entering ageing societies. This study aims to understand the spatial heterogeneity of stroke onset and residential environment influence scopes from multiscale. METHODS: The 2013 to 2022 spatiotemporal distribution pattern of stroke onset was obtained via out-patient data from a hospital in Shanghai. Then nine residential environmental factors were selected to estimate the association of stroke onset by multiscale geographically weighted regression (MGWR), in three scenarios. RESULTS: Accessibility to pubs/bars (PUB) and building density (BD) were the top two residential environmental factors both for the entire sample and by gender. Stress-related environmental factors have a greater impact on the onset of stroke in men but are limited in scope. The population of elderly people have relevance to environmental variables heterogeneity. The indicators relating to unhealthy food and alcohol suggest that habit-inducing environmental factors have a limited impact on stroke onset, but rather that pre-existing habits play a greater role. CONCLUSIONS: MGWR analyses individual components across multiple bandwidths, revealing geographical disparities in the impact of elements that would otherwise be undetected on a global scale. Environmental factors have a limited impact on the onset of stroke. When society is faced with both heavy ageing and fiscal constraints, some of the blue-green space budgets can be scaled back to invest in more secure facilities.

Abnormalities of brain structure and function in cervical spondylosis: a multi-modal voxel-based meta-analysis.

Background: Previous neuroimaging studies have revealed structural and functional brain abnormalities in patients with cervical spondylosis (CS). However, the results are divergent and inconsistent. Therefore, the present study conducted a multi-modal meta-analysis to investigate the consistent structural and functional brain alterations in CS patients. Methods: A comprehensive literature search was conducted in five databases to retrieve relevant resting-state functional magnetic resonance imaging (rs-fMRI), structural MRI and diffusion tensor imaging (DTI) studies that measured brain functional and structural differences between CS patients and healthy controls (HCs). Separate and multimodal meta-analyses were implemented, respectively, by employing Anisotropic Effect-size Signed Differential Mapping software. Results: 13 rs-fMRI studies that used regional homogeneity, amplitude of low-frequency fluctuations (ALFF) and fractional ALFF, seven voxel-based morphometry (VBM) studies and one DTI study were finally included in the present research. However, no studies on surface-based morphometry (SBM) analysis were included in this research. Due to the insufficient number of SBM and DTI studies, only rs-fMRI and VBM meta-analyses were conducted. The results of rs-fMRI meta-analysis showed that compared to HCs, CS patients demonstrated decreased regional spontaneous brain activities in the right lingual gyrus, right middle temporal gyrus (MTG), left inferior parietal gyrus and right postcentral gyrus (PoCG), while increased activities in the right medial superior frontal gyrus, bilateral middle frontal gyrus and right precuneus. VBM meta-analysis detected increased GMV in the right superior temporal gyrus (STG) and right paracentral lobule (PCL), while decreased GMV in the left supplementary motor area and left MTG in CS patients. The multi-modal meta-analysis revealed increased GMV together with decreased regional spontaneous brain activity in the left PoCG, right STG and PCL among CS patients. Conclusion: This meta-analysis revealed that compared to HCs, CS patients had significant alterations in GMV and regional spontaneous brain activity. The altered brain regions mainly included the primary visual cortex, the default mode network and the sensorimotor area, which may be associated with CS patients' symptoms of sensory deficits, blurred vision, cognitive impairment and motor dysfunction. The findings may contribute to understanding the underlying pathophysiology of brain dysfunction and provide references for early diagnosis and treatment of CS. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, CRD42022370967.

Erector spinae plane infiltration and anterior rami of spinal nerve: a cadaveric study.

BACKGROUND: The erector spinae plane block (ESP block) is frequently employed for thoracic, abdominal, and spinal surgeries, yet its precise mechanism of action remains a subject of debate. While initially postulated to influence both ventral and dorsal rami of the spinal nerve, recent studies indicate a predominant impact on the dorsal rami with limited involvement of the ventral rami. To elucidate this mechanism, we conducted an observational study to assess the distribution of ESP infiltration to the ventral rami. METHODS: We performed 20 ESP infiltrations bilaterally in 10 unembalmed cadavers, targering the T9 transverse process level. A volume of 20 mL of ropivacaine 0.2% and methylene blue 0.01% was used. Dissection was carried out to assess dye distribution, with a focus on involvement of the ventral and dorsal rami, as well as lateral and longitudinal spread within the spinal muscular plane. RESULTS: No evidence of dye staining was observed in the ventral rami in any of the cadavers; however, the dorsal rami consistently displayed staining. The dye exhibited extensive longitudinal diffusion across the paravertebral musculature, spanning a median of 10 vertebral spaces (T5-L2). The range extended from 3 to 18 spaces, with an IQR of 11 levels (T4-L2), predominantly affecting the longissimus and iliocostalis muscles. CONCLUSIONS: The infiltration of injectate into the ESP does not contact the ventral rami of segmental spinal nerves. The inference that an in vivo ESP block is a paravertebral "by-proxy" is, therefore, unlikely.

Effect of epidural anesthesia on the optic nerve sheath diameter in patients with pre-eclampsia: a prospective observational study.

INTRODUCTION: Optic nerve sheath diameter (ONSD) reflects intracranial pressure and is increased in pre-eclampsia. Administrating a significant volume of epidural solution into the epidural space can potentially increase ONSD. We investigated the impact of epidural local anesthetic injection on ONSD in patients with pre-eclampsia. METHODS: Patients with pre-eclampsia (n=11) and normotensive pregnant women (n=11) received de novo epidural anesthesia for cesarean delivery. We administered 21 mL of an epidural solution containing 2% lidocaine and 50 µg fentanyl into the lumbar epidural space in incremental doses. ONSD was measured at baseline, 3, 10, and 20 min after completing the epidural injection, after delivery, and at the end of surgery. Primary outcome was the change in ONSD from baseline to 3 min after epidural injection in patients with pre-eclampsia and normotensive pregnant women. Serial changes in the ONSD were analyzed using a linear mixed model. RESULTS: At baseline and 3 min after epidural drug injection, ONSD was significantly larger in patients with pre-eclampsia than in normotensive mothers (5.7 vs 4.1 mm, p=0.001 and 5.4 vs 4.1 mm, p<0.001, respectively). However, there were no significant changes in ONSD at 3 min after injection from baseline in either group (p>0.999). Linear mixed model demonstrated that ONSD did not change after epidural anesthesia in either group (p=0.279 and p=0.347, respectively). CONCLUSIONS: Despite a higher baseline ONSD in pre-eclampsia, epidural anesthesia did not further increase ONSD. Our findings indicate that epidural anesthesia can be safely administered in patients with pre-eclampsia at risk of increased intracranial pressure, without other intracranial pathology. TRIAL REGISTRATION NUMBER: NCT04095832.

An evaluation of the regional heterogeneity of museums' operational efficiency and productivity changes across Chinese provinces.

Museums are critical in safeguarding cultural heritage and cultivating community educational opportunities. This research aims to evaluate operational efficiency (OE), the impact of technological change on total factor productivity change (TFPC), and the regional heterogeneity of museum performance in three regions and 31 provinces across China. To this end, the study employed DEA-SBM and the Malmquist Productivity Index to gauge OE, TFPC, and determinants of TFPC (efficiency change or emerging technologies change) across 31 provinces for 2012-2021. Results reveal that the average OE of the Chinese Museum is 0.8394. It shows a 16.06 % growth potential in the operational efficiency of Chinese Museums. Further, the OE of Chinese Museums declined over the study period from 0.8965 in 2012 to 0.8088 in 2021. Beijing, Fujian, and Hunan are ranked top with a Museum's OE Score of 1. The average MI score of Chinese Museums is 0.9744, and technology change is the main determinant of Decline in productivity change as EC = 0.9992 is greater than TC = 0.9846. The MI of Liaoning, Shanghai, Ningxia, Jiangxi, Chongqing, Sichuan, Guangdong, and Tianjin is over 1, indicating growth in total factor productivity over the study period. The eastern region of China shows higher operational efficiency and total factor productivity scores of museums than the central and western regions. The results of the Kruskal-Wallis test proved that a statistically significant difference exists among different regions of China for the OE, MI, EC, and TC of museums.

Unveiling an Uncommon Scenario of Co-occurrence of Multiple Odontomes With Impacted Maxillary Lateral Incisor and Canine in a 17-Year-Old Girl: A Unique and Rare Case Report.

This case report presents the enigma of multiple odontomes with overretained deciduous teeth leading to the impaction of permanent successors (22, 23) in an abnormal position in a 17-year-old female patient who reported the chief complaint of maligned teeth. Permanent maxillary canines and lateral incisors are the most common teeth to face the brunt of impaction due to a wide range of etiological factors. It is imperative for a clinician to diagnose cases at an early stage to accelerate the rate of eruption of such teeth. This is especially important in cases where initially the etiology seems to be simple but on careful and judicious evaluation of the case, numerous other etiologies are found to map together for the underlying pathology. This case discusses how the presence of multiple odontomes with delayed exfoliation of deciduous teeth leads to the impaction of a permanent successor. Understanding the underlying pathology is seemingly important to devise intricate treatment mechanics for traction of impacted teeth without taxing anchorage from dental units and taking cognizance of the amount of alveolar bone loss post-removal of multiple odontomes. The appropriate thickness of alveolar bone scaffolding is required for the canine to extrude down, with an adequate band of marginal gingiva encircling the cement-enamel junction of the impacted canine, preventing any kind of fenestration and dehiscence. Hence, meticulous care was taken during surgical exposure and removal of odontomes to preserve an adequate labial cortical plate intact for traction. These excavated tooth-like structures were later subjected to histopathological evaluation, which confirmed the diagnosis of compound odontomes.

Postoperative Medial Plantar and Sural Neuropathy With Complex Regional Pain Syndrome.

This case illustrates a distinct presentation of coexistent medial plantar and sural neuropathy leading to the development of complex regional pain syndrome (CRPS) in a 49-year-old male patient. CRPS is a broad medical diagnosis describing prolonged and excessive pain that is out of proportion to exam and has historically been diagnosed according to the Budapest criteria. To our knowledge, this is a rare report of a case of medial plantar and sural neuropathy further complicated with CRPS, status-post calcaneal fracture, surgery, and post-surgical boot placement. The case highlights the complexity of diagnosing and managing multiple concurrent neuropathies and underscores the need for interdisciplinary approaches in treating CRPS to improve patient outcomes.

An rs-fMRI based neuroimaging marker for adult absence epilepsy.

OBJECTIVE: Approximately 20-30 % of epilepsy patients exhibit negative findings on routine magnetic resonance imaging, and this condition is known as nonlesional epilepsy. Absence epilepsy (AE) is a prevalent form of nonlesional epilepsy. This study aimed to investigate the clinical diagnostic utility of regional homogeneity (ReHo) assessed through the support vector machine (SVM) approach for identifying AE. METHODS: This research involved 102 healthy individuals and 93 AE patients. Resting-state functional magnetic resonance imaging was employed for data acquisition in all participants. ReHo analysis, coupled with SVM methodology, was utilized for data processing. RESULTS: Compared to healthy control individuals, AE patients demonstrated significantly elevated ReHo values in the bilateral putamen, accompanied by decreased ReHo in the bilateral thalamus. SVM was used to differentiate patients with AE from healthy control individuals based on rs-fMRI data. A composite assessment of altered ReHo in the left putamen and left thalamus yielded the highest accuracy at 81.64 %, with a sensitivity of 95.41 % and a specificity of 69.23 %. SIGNIFICANCE: According to the results, altered ReHo values in the bilateral putamen and thalamus could serve as neuroimaging markers for AE, offering objective guidance for its diagnosis.

Fast resolution of mild midvetricular takotsubo syndrome triggered by blunt chest trauma: case study.

Blunt chest trauma (BCT) may rarely trigger stress-induced takotsubo syndrome (TTS) which requires dif f erential diagnosis with myocardial contusion and BCT-induced myocardial infarction. So far reported cases have been presented as apical ballooning or inverted (reverse) TTS forms but not as a midventricular variant. The authors described a case of a 53-year-old female admitted to Intensive Care Unit after motor vehicle accident with BCT and airbag deployment during car roll over. For some time after the accident, she was trapped in a car with her head bent to the chest. After being pulled out from the car, she had impaired consciousness and therefore was intubated by the rescue team. Trauma computed tomography scan did not reveal any injuries. However, ECG showed ST-segment depression in II, III, aVF, V4-6, and discrete ST-segment elevation in aVR. Troponin I and NTpro-BNP increased to 2062 ng/l and 6413 pg/ml, respectively. Echocardiography revealed mild midventricular dysfunction of the left ventricle with ejection fraction (EF) and global longitudinal strain (GLS) reduced to 45% and -17.6%, respectively. On day two, the patient's general condition improved and stabilized, so she was extubated. Normalization of ECG, EF and GLS (but not regional LS) was observed on day three. She was discharged home on day fi ve. Post-hospital examinations documented that segmental longitudinal strain remained abnormal for up to 4 weeks. The authors conclude that fast ECG and echocardiographic evolution may result in underestimation of the posttraumatic TTS diagnosis, especially if it takes atypical form and its course is mild. Longitudinal strain evaluation can be helpful in cardiac monitoring of trauma patients.

Intravenous Lidocaine for the Management of Chronic Pain: A Narrative Review of Randomized Clinical Trials.

Background: Chronic pain remains a serious health problem with significant impact on morbidity and well-being. Available treatments have only resulted in relatively modest efficacy. Thus, novel therapeutic treatments with different mechanisms have recently generated empirical interest. Lidocaine is postulated to provide anti-inflammatory and anti-nociceptive effect through its action at the N-methyl-D-aspartate (NMDA) and voltage gated calcium receptors. Emerging research indicates that lidocaine could be a reasonable alternative for treating chronic pain. Objective: Considering the evidence surrounding lidocaine's potential as a therapeutic modality for chronic pain, we conducted a narrative review on the evidence of lidocaine's therapeutic effects in chronic pain. Methods: A review of the PubMed, and Google scholar databases was undertaken in May 2022 to identify completed studies that investigated the effectiveness of lidocaine in the treatment of chronic pain from database inception to June 2022. Results: A total of 25 studies were included in the narrative review. Findings on available studies suggest that intravenous infusion of lidocaine is an emerging and promising option that may alleviate pain in some clinical populations. Our narrative synthesis showed that evidence for intravenous lidocaine is currently mixed for a variety of chronic pain syndromes. Findings indicate that evidence for efficacy is limited for: CRPS, and cancer pain. However, there is good evidence supporting the efficacy of intravenous lidocaine as augmentation in chronic post-surgical pain. Conclusion: Lidocaine may be a promising pharmacologic solution for chronic pain. Future investigation is warranted on elucidating the neurobiological mechanisms of lidocaine in attenuating pain signaling pathways.

The impact of market integration on industrial green transformation: A case study of the yangtze river delta in China.

Regional integration plays an important role in dicarbon reduction and sustainability development. Based on dynamic panel model and spatial econometric model, this study analyzes the impact of market integration (MI) on industrial green transformation (IGT). The study finds that: (1) MI has a nonlinear relationship with the IGT. With the increasing of MI degree, the IGT shows the characteristic of first rising and then declining. (2) MI plays a role in the IGT mainly through industrial agglomeration, resource mismatch and green technological progress, respectively. (3) The impact of MI on IGT exhibits spatial heterogeneity. Although MI significantly promotes IGT in core cities, its impact on the IGT in peripheral cities is not significant. (4) The IGT has spatial spillover effect, and the improvement of MI degree in adjacent regions can also promote the IGT in the cities.

Recapitulation and investigation of human brain development with neural organoids.

Organoids are 3D cultured tissues derived from stem cells that resemble the structure of living organs. Based on the accumulated knowledge of neural development, neural organoids that recapitulate neural tissue have been created by inducing self-organized neural differentiation of stem cells. Neural organoid techniques have been applied to human pluripotent stem cells to differentiate 3D human neural tissues in culture. Various methods have been developed to generate neural tissues of different regions. Currently, neural organoid technology has several significant limitations, which are being overcome in an attempt to create neural organoids that more faithfully recapitulate the living brain. The rapidly advancing neural organoid technology enables the use of living human neural tissue as research material and contributes to our understanding of the development, structure and function of the human nervous system, and is expected to be used to overcome neurological diseases and for regenerative medicine.

Knowledge, Attitude, and Practices of Labor Analgesia Amongst Obstetric Residents: A Cross-Sectional Survey.

BACKGROUND: Labor analgesia plays a crucial role in ensuring a comfortable and positive birthing experience. It provides physiological benefits to both the mother and the child. Knowledge, awareness, and communication between the anesthesiologist and the obstetrician are essential for the safe conduct of labor analgesia. We conducted this cross-sectional online survey amongst obstetric residents to assess their knowledge, attitude, and practices of labor analgesia. METHODS: A structured questionnaire consisting of 19 questions was circulated amongst obstetric residents of various hospitals via electronic mode of communication. The responses were analyzed using statistical methods. RESULTS: Among the obstetric residents that we surveyed, 75.7% of them only sometimes employed labor analgesia for their patients. The most commonly employed methods of pain relief are opioids and non-steroidal anti-inflammatory drugs (NSAID). Most of them feel that pain-free labor is necessary because it makes the whole labor process a pleasurable one. Labor analgesia was mostly advocated at patients' request and demand. The barrier to using labor analgesia was most commonly found to be the non-availability of labor analgesia services. CONCLUSION: Despite the increasing awareness of labor analgesia there still lies a gap between the attitude toward it and the practice of it. Further education to rectify the misconceptions and barriers needs to be taken for providing beneficial services to pregnant females.