Choosing to perform mitral valve (MV) repair or replacement remains a hot and highly debated topic. The current guidelines seem to be conflicting in this specific field and the evidences at our disposal are scarce, only one small randomized trial and few larger retrospective studies. The meta-analysis by Gamal and coworkers tries to summarize the current evidences, concluding that MV replacement for the treatment of ischemic mitral regurgitation is at least as safe as repair and certainly offers a more stable result over time than the latter. Obviously, the implantation of a prosthesis, especially a mechanical one, brings with it a series of problems, such as anticoagulation and, above all, a possible lack of ventricular remodeling, especially if a chordal sparing replacement is not performed. It must be said, on the other hand, that isolated annuloplasty cannot act as a counterpart to replacement, because ischemic MR cannot be considered only an annular disease. Therefore, wanting to mimic the nature that, after an infarction, enacts a series of changes involving also the mitral leaflets and chordae, the surgeons are called to act also on these two entities and not only to downsize the annulus. In a nutshell, a procedure should not be opposed in a fundamentalist way to another one, but we must accept the concept of armamentarium where both procedures are present and tail on the single patient, and also on the surgeon’s expertise, the technique guaranteeing the best possible result.

In this paper, we consider the long time behavior of stochastic evolution equations. The exponential, polynomial and logarithmic decay for stochastic equations are considered. Sufficient conditions are given to obtain these exponents. All the results show the noise (time diffusion) will prevent the solutions to decay in $p$-th moment, which coincides with the fact that the noise is a diffusion process but it will be different in the sense of almost surely, and the partial diffusion operator (spatial diffusion) will accelerate the decay of solutions.

Ecological restoration of former agricultural land can improve soil condition, recover native vegetation, and provide fauna habitat. However, restoration benefits are often associated with time lags, as many attributes, such as leaf litter and coarse woody debris, need time to accumulate. Here we experimentally tested whether adding fine and coarse woody debris to a decade-old restoration sites can accelerate restoration benefits. We used a Multi-site Before-After / Control-Impact design to test the effects on 30 response variables over a period of two years, including those describing soil physical and biochemical properties, herbaceous vegetation and ant communities. We analysed the data using linear mixed-effect models and perMANOVAs. Of the 30 response variables, a significant effect of mulch or log additions was found for just four variables: volumetric water content, decomposition of tea leaves, native herbaceous species cover and species richness of opportunistic ants. Mulch addition had a positive effect on soil moisture when compared to controls but suppressed growth of native (but not exotic) herbaceous plants. Whilst other soil properties such as organic matter and dissolved organic carbon showed a positive response to mulch addition, the effect was not statistically significant. On plots with log additions, decomposition rates of tea leaves decreased, and species richness of opportunistic ants increased. However, we found no effect on total species richness and abundance of other ant functional groups. The benefit of mulch to soil moisture was offset by its disbenefit to native herbs in our study. Logs increased species richness of opportunistic ants, but given time, may provide habitat for cryptic species. Indeed, benefits to other soil biophysical properties, vegetation and ant fauna may require longer timeframes to be detected. Further research is needed to determine whether the type, quantity and context of mulch and log additions may improve restoration outcomes.

Objective : This study aims to compare the potential sinus distribution between high-volume nasal irrigation and nasal spray in chronic rhinosinusitis patients who have not undergone sinus surgery. Design and Setting : A randomized clinical study was conducted at the Otolaryngology-Head & Neck Surgery Department, Ramathibodi Hospital, Faculty of Medicine, Mahidol University. Participants : 40 patients undergoing endoscopic sinus surgery for chronic rhinosinusitis. Thirty-eight patients met the inclusion criteria and were randomly assigned to receive nasal irrigation or nasal spray mixed with fluorescein sodium preoperatively. Main outcome measures : The primary outcome was the mean difference in the staining score of fluorescein in all sinuses between the two groups. Results : The total staining score of fluorescein in all sinuses via nasal irrigation was statistically more significant than the score via nasal spray, with a mean difference score of 2.90, 95%CI: 1.22-4.58, p-value 0.001. The most significantly affected sinuses were specific to the maxillary and anterior ethmoid sinuses, whereas the frontal and sphenoid sinuses had the slightest solution distribution from both techniques. Conclusion : Nasal irrigation is a potential route to deliver drugs into the sinus in unoperated CRS patients. However, it is not considered a superior method to nasal spray at the most challenging anatomical areas, i.e., the frontal and sphenoid sinuses. Keywords : Corticosteroid use, Endoscopic sinus surgery, Irrigations, Topical therapy for chronic rhinosinusitis, Medical therapy for chronic rhinosinusitis, Nasal polyp, Nasal spray, Chronic rhinosinusitis

Immobilized enzymes have drawn widespread attention due to the enhanced stability, easy separation from reaction mixture, and the prominent recyclability. Nevertheless, it is still an ongoing challenge to develop potent immobilization techniques which are capable of stable enzyme encapsulation, minimal loss of activity, and modulability for various enzymes and applications. Here, microfibers with tunable size and composition were fabricated using a home-made microfluidic device. These microfibers were able to efficiently encapsulate bovine serum albumin (BSA), glucose oxidase (GOX) and horseradish peroxidase (HRP). But the physically adsorbed enzymes readily diffused from microfibers into the catalytic reaction system. The leakage of enzymes could be substantially inhibited by conjugating to polyacrylic acid (PAA) and incorporating into the alginate-based microfibers, enabling stable immobilization, improved recyclability, and enhanced thermostability. In addition, GOX and HRP-loaded microfibers were fabricated under the optimized conditions for the visual detection of glucose using the cascade reaction of these enzymes, showing sensitive color change to glucose with concentration range of 0-2 mM. Due to the tunability and versatility, this microfluidic-based microfiber platform may provide a valuable approach to the enzyme immobilization for the cascade catalysis and diagnoses with multiple clinical markers.

The chloroplast represents an attractive compartment for light-driven biosynthesis of recombinant products, and advanced synthetic biology tools are available for engineering the chloroplast genome (=plastome) of several algal and plant species. However, producing commercial lines will likely require several plastome manipulations, and this will present issues with respect to selectable markers: there are a limited number of markers available, these can be used only once in a serial engineering strategy, and it is undesirable to retain marker genes for antibiotic resistance in the final transplastome. To address these problems, we have designed a rapid iterative marker system for the green microalga Chlamydomonas reinhardtii that allows creation of marker-free transformants starting from wild-type strains. The system employs a dual marker encoding a fusion protein of E. coli aminoglycoside adenyltransferase (conferring spectinomycin resistance) and a variant of E. coli cytosine deaminase (conferring sensitivity to 5-fluorocytosine). Initial selection on spectinomycin allows stable transformants to be established and driven to homoplasmy. Subsequent selection on 5-fluorocytosine results in rapid loss of the dual marker through intramolecular recombination between the marker’s 3’UTR and the 3’UTR of the introduced transgene(s). We demonstrate the versatility of the CpPosNeg system by serial introduction of reporter genes into the plastome.

Environmental DNA (eDNA) is emerging as a potentially powerful tool to assess aquatic ecosystems, and to monitor fish assemblages. We conducted a pilot eDNA water sampling program at 5 Reserves within the National Estuarine Research Reserve System from temperate and tropical estuaries to better understand how eDNA data can support detection of fish species within an standardized monitoring network. Samples were collected in coordination with an existing long term monitoring program, and the sampling plan was designed to minimize additional work for field teams. We found that results varied; in some estuaries the number and type of fish species was consistent with expected occurrence, and eDNA analysis detected fish that often eluded traditional sampling methods. In warm turbid waters, however, we detected fewer species than expected, suggesting that additional processing is required at these sites. Managers interested in applying standardized eDNA monitoring across a range of sites may want to consider a decision tree protocol, where a baseline methodology is developed for all sites, enhanced by additional laboratory or analysis steps when specific conditions are present.

The rapid intensification of the livestock sector in Southeast Asia has been found to be associated with an extensive and expanding use of antibiotics. This raises concerns regarding the rise of drug-resistant bacteria in both animals and humans. Data on veterinary antibiotic use (ABU) and antibiotic resistance (ABR) are scarce in Lao PDR, as in most low and middle-income countries. This study aimed to explore the views of small to medium-scale pig, poultry and fish producers regarding the use of antibiotics. A total of 364 farmers were surveyed using a questionnaire and farm visits. Patterns of knowledge, attitudes and practices regarding ABU and ABR were explored with multiple factor analysis and hierarchical cluster analysis. Farms were assigned to one of three clusters in which specific farmers’ views were overrepresented. Cluster 1 (in which pig farms were overrepresented) held a positive attitude regarding preventive measures and information about antibiotics. In cluster 2 (in which poultry farms were overrepresented), there was a view that antibiotics should be used for disease prevention. Finally, in cluster 3 (in which fish farms were overrepresented), knowledge about ABU and ABR was weak, and ABU was very limited. No specific attitude was under or overrepresented. Farmers mentioned that they were unfamiliar with antibiotics and were uncertain about details concerning ABR (such as whether or not to consume animal products just after they received antibiotic treatment). Farmers from cluster 3 who did not give antibiotics to their animal (90 out of 114) and did not use vaccines (100 out of 114) were overrepresented. A total of 65% (171/263) of the antibiotics found on farms were included on the World Health Organization’s list of critically important antibiotics for human medicine. These critically important antibiotics were mostly found in clusters 1 (57/168, i.e., 33.8% farms had at least one critically important antibiotic) and 2 (63/171, 36.8%). These findings indicate that antibiotic stewardship strategies should tackle the use of critical antibiotics as well prophylactic treatments to prevent antibiotic misuse in small and medium- livestock farms.

Introduction: Lower socioeconomic status is associated with significantly poorer outcomes in weight, lung function, and pulmonary exacerbation rates in People with CF (PwCF). Global aim: We aim to reduce health disparities and inequities faced by PwCF by screening for and addressing unmet social needs. Specific aims: We aimed to increase routine Social Determinants of Health (SDoH) screening of eligible PwCF from 0% to 95% and follow-up within two weeks for those PwCF who screened positive and requested assistance from 0% to 95% by December 31, 2021. Methods: The Model for Improvement methodology was employed. A process map and a simplified failure mode effects analysis chart were created for the screening and SDoH follow-up process. Those who screened positive for SDoH and requested assistance, a follow-up contact was made to offer intervention. Intervention: Adult PwCF who had at least one UVA Clinic encounter in 2021 were screened for SDoH. The SDoH screening tool included eight domains: housing, food, transportation, utilities, health-care access, medication access, income/employment and education. Follow-up was completed with all PwCF who screened positive for SDoH. Results: A total of 132 of 142, (93.0%) PwCF eligible for screening completed the SDoH screening. Of the PwCF who completed screening, 56 (42.4%) screened positive for SDoH. A follow-up rate of 100% was achieved in June 2021 and maintained through December 2021. Conclusion: Implementing screening for SDOH and follow-up to mitigate social difficulties in adult PwCF at UVA was successful and could be reproduced at other CF care center.

A two-step integrated MOF and pressure/vacuum swing adsorption (P/VSA) process design has been recently established for gas separation. In the first step, selected MOF descriptors and process operating conditions are simultaneously optimized to maximize the process performance. Based on the obtained results, the second step (i.e., MOF matching) is addressed and exemplified by propene/propane separation in this work. Computational MOF synthesis and screening are carried out to find new advanced material candidates for enhancing the separation process efficiency. First, model-based property-performance relationships are developed for fast MOF screening. Then, MOF building blocks are extracted from 471 CoRE MOFs. With these building blocks, 45472 hypothetical MOFs are created. After model-based and molecular simulation-based screening, six candidates are left and sent to P/VSA process optimization. Finally, three candidates are found to meet the pre-defined separation specifications and one candidate shows a better process performance than the best out of the 471 MOFs.

Objective: To evaluate whether prolonged operative time is negatively associated with post-operative complications and length of stay in patients undergoing microvascular free flap reconstruction for complex head and neck defects. Methods: 342 consecutive patients undergoing microvascular reconstruction for head and neck defects between 2017-2019 at a single institution were evaluated. Operative outcomes and operative time were compared whilst controlling for patient and treatment related factors. Results: Mean operative time was 551 minutes and length of stay was 16.2 days. An 11% increase in the risk of a post-operative complication was observed for every additional hour of operative time (OR 1.11, 95%CI 1.03 – 1.21, p=0.011) after adjusting for patient and treatment factors. A cut-off of 9 hours yielded a 92% increase in complications on either side of this (OR 1.92, 95%CI 1.18 – 3.13, p=0.009). Increased operative time was also associated with increased length of stay and return to theatres, but not medical complications. Conclusion: Prolonged operative time is significantly associated with increase surgical complications, length of stay and return to theatres when performing microvascular reconstructive surgery for head and neck defects. Keywords : free flap, microsurgery, operative time, length of hospital stay, complication rate, head and neck surgery Key points : 1. This study analyzed a contemporary cohort over a relatively short period where outcomes can reliably be recorded and verified 2. This is the first Australian study that demonstrated operative time as it relates to surgical technique, comparing pedicled and free flaps and also stratified by flap type, oncological resection, or comorbidity 3. Operations more than 9 hours duration were associated with an 89% increase in the odds of developing a surgical complication 4. Prolonged operative time was also significantly associated with length of stay and return to theatres 5. Future studies are needed to investigate associations with each component of operative time element separately in a multi institutional design

The biopharmaceutical industry is capable of rapid responses in the face of unprecedent challenges, such as the COVID-19 pandemic; safe and efficacious vaccines were developed in record times. However, additional hurdles, including raw materials shortages, need be overcome to improve further the industry’s agility. During the development of a SARS-CoV-2 vaccine candidate, such supply limitations necessitated the determination of a cleaning in place (CIP) strategy for a multimodal core-shell resin both rapidly and efficiently. This is a challenging task with its complexity depending on the nature of the resin and the composition of the feed stream. Here, we describe the deployment of high throughput (HT) techniques to screen CIP conditions for cleaning Capto™ Core 700 resin exposed to clarified cell culture harvest of a SARS-CoV-2 vaccine candidate produced in Vero adherent cell culture. The best performing conditions, comprised of 30% n-propanol and ≥0.75 N NaOH, were deployed in cycling experiments, completed with miniature chromatography columns, to demonstrate their effectiveness. The success of the CIP strategy was ultimately verified at laboratory scale. Here, its impact was assessed across the entire purification process which also included an ultrafiltration/diafiltration step. It is shown that the implementation of the CIP strategy enabled the re-use of the Capto Core 700 resin for up to ten cycles without any negative impact on the purified product. Hence, the strategic combination of HT and laboratory scale experiments can lead rapidly to robust CIP procedures, even for a challenging to clean resin, and thus help to overcome supply shortages.

Soil is the largest carbon reservoir in terrestrial ecosystems, and thus minor changes in it can dramatically affect atmospheric CO 2 concentrations. The fragile ecological environment in the northwestern arid zone of China is susceptible to natural and anthropogenic disturbances, which lead to variations in structure and function of the ecosystem, as well as carbon source–sink dynamics. In this study, digital soil maps of soil organic carbon stocks (SOCS) were produced at a 90-m resolution for two periods (the 1980s and 2010s) based on historical soil profile data and a random forest model. The results showed that the prediction accuracy for SOCS in the topsoil (0–30 cm) was superior to that of the subsoil (30–100 cm). Among them, the mean annual evapotranspiration, normalized difference vegetation index during the growing season, multi-year mean temperature, and clay content were the main environmental factors affecting the spatial distribution of SOCS. In the past 30 years, the SOCS of the northwestern arid zone have decreased by 585.50 Tg, with a mean decline of 19.52 Tg C yr -1. The changes in SOCS caused by land-use conversion and reductions in SOCS were further shown to be attributable to grassland desertification and agricultural reclamation. These findings are valuable for exploring the carbon cycle in terrestrial ecosystems in the context of global climate change and for achieving China’s goal of carbon neutrality.

Patients with a history of ureterosigmoidostomy are at an increased risk of rectosigmoid adenocarcinoma. The cancer can occur many decades after the diversion, even if there was conversion to ileal urinary conduit. These patients may still be considered as high-risk individuals and screened for colorectal cancer accordingly.

We present here a case of the utility of Tomosynthesis in real time during surgery for margin assessment. This vigorous planning of operative steps allows one-step procedure with maximal outcome.

Background: Cancers have become highly prevalent in developing countries and Africa is not far from it. The treatment of these cancers increases the risk of infertility in women. Objectives: This review aims to understand the effects of different types of cancer treatments on the fertility of women. Search strategy: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were wielded for this systematic review. We systematically searched PubMed, Google Scholar and Medline databases to identify eligible articles on the effects of cancer treatments on the fertility of women. Selection criteria: The articles published between the years 2000 and 2021 were included in the current review. The search was limited to studies in humans and published in English. Data collection and analysis: The selected studies were scrutinized, and relevant data were extracted from the selected articles using excel sheet. Main results: A total of 19 articles were encompassed in this cutting-edge systematic review that met the selection criteria. Overall fertility deficits were observed in female survivors of cancers. Treatment with alkylating agents, second-line therapy and age> 35 years also influence chances of pregnancy. Pre-term delivery was also found to be linked to cancer-related therapy. Conclusions: The present study indicates that future measures should be taken to include assessment of women’s desire for future fertility and also provide fertility preservation options. Counseling tools and guidelines for referral to oncofertility specialists should be developed for newly diagnosed young patients. Funding: None.

Nowadays, tropical plants oils (e.g. palm oil and coconut oil) are extensively used in consumer products, especially in infant formulas. However, there is a lack of statistical data about the levels of mineral oil in tropical oils, including saturated hydrocarbons (MOSH) and aromatic hydrocarbons (MOAH). In this study, we reported a survey of MOSH/MOAH in tropical oils. Meanwhile, we provided an effective strategy to reduce the content of MOSH/MOAH. A total of 708 tropical plant oils were collected from five tropical countries for this survey. The highest quantifiable MOSH and MOAH concentrations were up to 455.99 mg kg-1 and 78.87 mg kg-1, respectively. Thereinto, MOSH was ubiquitous in almost all the tested samples. The distribution of sub-fractions for MOSH was centered at C25-C35 and C35-C40 for most crude and refined oils. After distillation, the MOH sub-fraction ≤C40 could be removed effectively, but there was no effect on the sub-fraction >C40.

Introduction Otoscopy is a key clinical skill which following the introduction of the Medical Licensing Assessment all newly qualified doctors in the United Kingdom will be required to be able to perform independently. At present there is no consensus on a standardised method for objectively assessing otoscopy skills. Methods Prospective mixed methods study comparing face, content and construct validity of three different platforms for otoscopy skills assessment, using a traditional otoscope with manikin, digital otoscope (Tympahealth) with manikin, and traditional otoscope with a low-cost model ear (SimEar). Skills were assessed using a standardised mark scheme, and five expert assessors and twelve participants who rotated through three Objective Structured Clinical Examination (OSCE) stations representing each model. Assessors numerically ranked validity of each model, and participated in a semi-structured interview of opinion. Results Each platform differed in face, construct and content validity scores, with no one platform consistently outperforming others. Three main themes were identified during thematic analysis of expert assessor interviews: ability to assess what is seen, anatomical reality, and ease of use. The low-cost model showed greatest potential, where modification to include a silicone ear could lead to high validity with marginal increase in cost. Conclusion Several modalities for assessing otoscopy skills exist, each with advantages and disadvantages. Modifications to a low-cost model, for use with either a traditional or digital otoscope, could prove to be the best model.

Introduction: Coronary artery bypass graft (CABG) surgery is a common therapeutic intervention performed in patients with coronary artery disease. However, this operation has several postoperative complications; One of the most common complications after CABG surgery is right ventricular dysfunction. Therefore, the aim of this study is to evaluate RV deformations indices after CABG surgery. Methods: This cross-sectional study was performed from 2019 to 2020 in the cardiac surgery ward of Farshchian Hospital in Hamadan. 40 patients with cardiac ischemia were studied as single vessel disease (SVD), two vessels disease (2VD) and three vessels disease (3VD) who were candidates for CABG surgery. All patients underwent color and tissue Doppler echocardiography and Strain RV imaging, before and one month after CABG. Data analysis was performed using SPSS version 21 and a p-value less than 0.05 was considered statistically significant. Results: Among 40 patients (32 males and 8 female), the average age was 65.17 (SD 7.87) and average body mass index was 25.59 (SD 3.20). 4 patients underwent off-pump CABG surgery. Mean LVEF, SPAP, and RV diameter one month after CABG significantly increased compared with pre-surgery and TDI (SM), Strain RV (GLS), FAC, MPI RV, and TAPSE were decreased, which was less in the group B (3VD) than the first group (P <0.001). There was no significant difference between RVDD and LVDD before and one month after CABG (P> 0.05). No significant correlation coefficient was observed between Strain RV changes and pump time. Conclusion: Changing the right ventricular geometry after CABG, leads to reduction of Longitudinal deformation while maintaining overall RV function. Therefore, it is recommended to consider lower normal values ​​for these indices after CABG to be taken.

BJOG mini-commentary on BJOG-22-0097This manuscript by McCall et al reports that UK and France have very different approaches to managing women with PAS. More women in France received a uterus conserving approach. Major haemorrhage was more common in the UK series. The authors speculate that this may be related to treatment modality. The ACOG/SMFM committee opinion (Obstet Gynecol 2018;132:e259–75) recommends caesarean hysterectomy as the most generally accepted approach. Does this report imply that we should stop offering hysterectomies and recommend conservative treatment?Before we make up our mind, it is important to consider what else was different in the two cohorts. The case definitions used by UK OSS and PACCRETA investigators were different. However, the authors of the current report have included only those cases that satisfied a harmonised definition. UK prevalence (1.7/10 000) was significantly lower as compared to that from France (4.2/10 000). This raises the question: Is UK under-reporting or is France over-reporting? Screening studies may give some idea about the ‘true’ prevalence. A prevalence of 5.8/10 000 (Panaiotova et al, Ultrasound Obstet Gynecol 2019; 53: 101–106) was reported with screening for Caesarean scar pregnancies. Coutinho et al (Ultrasound Obstet Gynecol 2021; 57: 91–96) reported a prevalence of 3.8/10 000 with screening for PAS in late pregnancy. In both these reports all women had either placenta previa or a low-lying placenta. In contrast, placenta previa was present in 64% and 63% of women from UK and France, respectively. In this light, one would expect a higher, rather than lower prevalence of PAS as compared to the two screening studies. One explanation could be increasing Caesarean section rate and better awareness with time.A systematic review reported high (>90%) sensitivity for the detection of PAS using ultrasound in women at high risk of PAS (D’Antonio et al, Ultrasound Obstet Gynecol 2013; 42: 509–517). The prenatal detection was disappointingly low at < 50% in both UK and France. Before we begin to berate ourselves, it is noteworthy that these are 7-12 year-old data. The current study took place between May 2010 - April 2011(UK) and November 2013 - October 2015(France).What about the differences in median blood loss? Manual removal of the placenta was attempted in fewer women in France. Even then, unplanned hysterectomy was more common in the French group. The blood loss may be lower with conservative management, but this advantage should be weighed against the uncertainty about the possibility and timing of developing major haemorrhage in the post-operative period. Moreover, it is possible that the UK series had particularly severe cases as compared to the French cohort given the significantly lower prevalence. A head-to-head comparison of the two treatment modalities has never been reported. This will necessitate a unified definition and accurate prenatal detection. Such a study would be extremely challenging given the strong views of women regarding fertility preservation and of physicians regarding ongoing uncertainty with complications and personal experience. The jury is still out on this one.

We report seventeen-year-old twins which suffering from gender dysphoria. The first pair twin despite having similar characteristics of gender dysphoria, had apposite temperament. While temperament has been considered to be genetically inherited, the incidence of gender dysphoria in our cases with different temperament raises the question about this paradox.

Sustainable city growth necessitates sound political decisions. Owing to ineffective policies, the land price increments have had a significant impact on immigration settlements. Scholars have studied city immigrant settlements without mentioning rising land prices as a major driver of illegal settlements. This study explores the influence of the long-term increase in land prices on immigrant settlement, by employing a panel cointegration model and the city-level panel data of Abomey-Calavi from 1992 to 2012. Increments in land prices are found to be correlated with both internal and external immigrants. Rising land prices hamper formal immigrant settlement. City growth may suffer significantly as the number of immigrants may double by 2030. However, implementing a novel land banking policy in urban planning, may help control land price spikes and limit illegal settlements. The findings advocate for a discussion on affordable land prices at the Sustainable Development Goals (SDG11) summit.

Aim: Residual neuromuscular blockade is a common complication after general anaesthesia. Sugammadex can reverse the action of aminosteroid neuromuscular blockers. Our study aimed to explore sugammadex safety issues in the real world and determine the spectrum of adverse reactions. Methods: All sugammadex-related adverse events reported in VigiBase between 2010 and 2019 were classified by group queries according to the Medical Dictionary for Regulatory Activities. A disproportionality analysis of data was performed using the information component (IC); positive IC values were deemed significant. Results: Overall, 16,219,410 adverse events were reported, and 2032 were associated with sugammadex. The most frequent reactions were recurrence of neuromuscular blockade (n = 54, IC: 6.74, 95% credibility interval [CI]: 6.33–7.10), laryngospasm (n = 53, IC: 6.05, IC025:5.64), bronchospasm (n = 119, IC: 5.63 , IC025:5.36), and bradycardia (n = 169, IC: 5.13, IC025:4.90). Fatal cases were more likely with cardiac disorders, especially in patients over 65 years. In addition, the common adverse drug reactions (ADRs) differed between different age groups (P < 0.01). The ADRs were higher between 0–17 years than in other age groups. The onset time of common ADRs was typically within one day, and 68.9% occurred within half an hour after sugammadex administration. Conclusions: Anaesthesiologists should carefully monitor the anaesthesia recovery period to correct the adverse drug reactions caused by sugammadex and recommend monitoring neuromuscular function throughout the anaesthesia process. Sugammadex should be used carefully in patients with cardiovascular diseases, and ECG and hemodynamic changes monitored after medication.

Background: Consequences of lung injury and inflammation in preterm infants with bronchopulmonary dysplasia (BPD) contribute to prolonged oxygen requirements. We aim to identify the median age of home oxygen discontinuation and the factors that might predict longer use of home oxygen therapy. Methods: All preterm (≤36 weeks’ gestation) infants diagnosed BPD who required home oxygen therapy in Ramathibodi hospital during January 2000 – December 2019 were recruited in this retrospective study. Timing of home oxygen withdrawal were identified as the primary outcome. Demographic data, severity of BPD, history of respiratory support, procedures, prenatal history, comorbidities, and complications were recorded and analyzed as the associated factors of home oxygen withdrawal. Results: Of the 40 infants, 18 (45%) successfully weaned oxygen within 12 months. The median corrected age (CA) of oxygen withdrawal was 13.8 months (8.5, 22.1). Longer duration of total respiratory support, longer length of hospital stay, and poor weight gain were associated with longer duration of oxygen use. Infants who gained higher weight at oxygen withdrawal were associated with shorter duration of home oxygen use at 12 months CA (adjusted OR, 1.97; 95% CI, 1.13-3.23; p = 0.015) and 15 months CA (adjusted OR, 1.98; 95% CI, 1.20-3.27; p = 0.007). Conclusions: The median corrected age of oxygen withdrawal in Thai BPD infants was 13.8 months. Factors associated with prolonged home oxygen use included longer duration of respiratory support, length of hospital stay, severe BPD, and poor weight gain.