Search

More than 20 papers about COVID-19 have been retracted at the time of this writing. It is premature, however, to conclude that such work is being retracted at higher rates than the rest of the literature.

Previous studies have shown that sodium bicarbonate ingestion may enhance intense exercise performance, but may also cause severe gastrointestinal distress. The purpose of this study was to determine whether a modified sodium bicarbonate (SB) ingestion protocol would elevate serum bicarbonate concentration more than previous methods without causing gastrointestinal distress. In randomized order, seven (5 men, 2 women) elite middle-distance runners ingested either placebo, Modified SB (600 mg·kg− 1 over 19.5 h), or Acute SB (300 mg·kg− 1) in opaque gelatin capsules. Baseline and post-ingestion blood samples were analyzed for bicarbonate, pH, sodium, hematocrit, and lactate. Repeated measures ANOVA (2 time points × 3 conditions) were analyzed to determine differences in serum bicarbonate, lactate, sodium, blood pH, and hematocrit. Gastrointestinal distress was assessed via self-report on a Likert scale of 1–10. Simple (condition) and repeated (time) within-participant contrasts were used to determine the location of any statistically significant main and interaction effects (p ≤ 0.05). Both Modified SB (7.6 mmol·L− 1, p

In biomedical science, most papers that lead to retractions don9t threaten anyone9s life. But a troubling exception arose after investigators found fabrication and other misconduct in nearly 100 papers co-authored by German anesthesiologist Joachim Boldt. Many of those studies supported the effectiveness of intravenous solutions containing hydroxyethyl starch, or hetastarch, to stabilize the blood pressure of patients during and after surgery or trauma. U.K. medical societies relied on four of Boldt9s papers in issuing guidelines about the treatments; many patients may have been put at risk by his findings. A meta-analysis that excluded them found that such fluids posed modest but statistically significantly greater risks of kidney damage and death.

OBJECT Over the last decade, image guidance systems have been widely adopted in neurosurgery. Nonetheless, the evidence supporting the use of these systems in surgery remains limited. The aim of this study was to compare simultaneously the effectiveness and safety of various image guidance systems against that of standard surgery. METHODS In this preclinical, randomized study, 50 novice surgeons were allocated to one of the following groups: 1) no image guidance, 2) triplanar display, 3) always-on solid overlay, 4) always-on wire mesh overlay, and 5) on-demand inverse realism overlay. Each participant was asked to identify a basilar tip aneurysm in a validated model head. The primary outcomes were time to task completion (in seconds) and tool path length (in mm). The secondary outcomes were recognition of an unexpected finding (i.e., a surgical clip) and subjective depth perception using a Likert scale. RESULTS The time to task completion and tool path length were significantly lower when using any form of image guidance compared with no image guidance (p < 0.001 and p = 0.003, respectively). The tool path distance was also lower in groups using augmented reality compared with triplanar display (p = 0.010). Always-on solid overlay resulted in the greatest inattentional blindness (20% recognition of unexpected finding). Wire mesh and on-demand overlays mitigated, but did not negate, inattentional blindness and were comparable to triplanar display (40% recognition of unexpected finding in all groups). Wire mesh and inverse realism overlays also resulted in better subjective depth perception than always-on solid overlay (p = 0.031 and p = 0.008, respectively). CONCLUSIONS New augmented reality platforms may improve performance in less-experienced surgeons. However, all image display modalities, including existing triplanar displays, carry a risk of inattentional blindness.

ObjectivesIn managing a patient with glioblastoma multiforme (GBM), a surgeon must weigh up whether sufficient tumour can be removed so that the patient can enjoy the benefits of decompression and cytoreduction, without impacting on the patient’s neurological status. In a previous study we identified the five most important anatomical features on a pre-operative MRI that are predictive of surgical resectability and used them to develop a grading system. The aim of this study was to apply an artificial neural network (ANN) to improve the prediction of surgical resectability.MethodsA prospectively maintained database was searched between February and August 2017 to identify all adult patients with supratentorial GBM that underwent resection. Pre-operative MRI scans were scored using the aforementioned grading system and post-operative scans assessed to determine the extent of resection. Performance of the standard grading system and ANN were then evaluated by analysing their Receiver Operator Characteristic curves; Area Under Curve (AUC) and accuracy were calculated and compared using the t-­test with a value of pResultsIn all, 47 patients were included, of which 18 (38.3%) were found to have complete excision. The AUC and accuracy were significantly greater using the ANN compared to the standard grading system (0.87 vs. 0.79 and 0.81 vs. 0.77 respectively; pConclusionsAn ANN allows for improved prediction of surgical resectability in patients with GBM.

The objective was to determine the likelihood of conceiving spontaneously following cessation of IVF/ICSI; how long does it take and what factors are associated with conception? The design was an internet-based survey. All registered users of www.ivf-infertility.com received an electronic questionnaire addressing issues relating to the duration and cause of infertility, number of IVF/ICSI cycles and outcome, whether they conceived following cessation of IVF/ICSI and the time taken to conceive and outcome. Four hundred and eighty four patients responded of whom 403 met the study criteria. The overall cumulative live birth rate over a 6-year period following cessation of IVF/ICSI was 29%. Eighty-two percent of conceptions occurred within 2 years. Positive factors associated with spontaneous conception were unexplained infertility (p = 0.02), ovulation dysfunction (p = 0.01), infertility less than four years prior to IVF/ICSI (p = 0.045) and 2 years or less since discontinuation of IVF/ICSI (p 0.001) and up to four attempts at IVF/ICSI (p = 0.02). In conclusion, 29% of couples conceived spontaneously over a 6-year period following the cessation of IVF/ICSI. The findings of this study can be used to counsel and reassure women following IVF/ICSI.

Over the past decade, public health specialist Donald Morisky of the University of California, Los Angeles, has moved aggressively to enforce his copyright on a questionnaire he developed that examines how likely it is that a patient will adhere to a recommended drug regimen. Together with a colleague, he has demanded payments of as much as tens of thousands of dollars each from hundreds of researchers who have used Morisky9s scale, and threatened to force the retraction of papers if the alleged infringers don9t pay. Morisky is well within his legal rights to seek the payments. But observers say Morisky9s vigorous enforcement and the size of his demands stand out. At least two teams have withdrawn papers rather than pay. Other authors have resisted, questioning the ethics and legality of the requests, which one researcher has called "absurd and predatory." But Morisky says he is just trying to make sure the tool is used properly, and notes that he has allowed researchers to administer the survey more than 1 million times for free.

Many factors have been suggested that influence a couple's decision to stop infertility treatment despite not achieving their goal of having a baby. This Internet-based questionnaire study aims to shed light on these reasons by surveying patients who have received treatment from a variety of different centres.Registered users of an independent infertility website were invited to participate in the survey by filling in a structured questionnaire.Eighty users completed the questionnaire. Fifty-eight percent of patients received treatment in just one centre. Seventy-eight percent of the patients paid for the treatment themselves. Forty-two percent of couples intended to have only one treatment cycle and 60% of couples reported undergoing more cycles than they had originally intended. Ten percent of patients regretted not stopping their treatment earlier. The most common reasons why patients opted against further treatment cycles were financial constraints (46%), emotional burden (35%), poor response to treatment (29%) and poor egg quality (19%).The decision to stop treatment despite poor outcomes is a difficult one and unique to the couple. The findings of this study are consistent with the widely held belief that in vitro fertilization is a stressful, expensive process, given that almost all women cited these as reasons to stop treatment.

BACKGROUND: Over the past decade image guidance systems have been widely adopted in specialties such as neurosurgery and otorhinolaryngology. Nonetheless, the evidence supporting the use of image guidance systems in surgery remains limited. New augmented reality systems offer the possibility of enhanced operating room workflow compared with existing triplanar image displays, but recent studies have highlighted several concerns, particularly the risk of inattentional blindness and impaired depth perception. The aim of this study was to compare simultaneously the effectiveness and safety of various image guidance systems against standard surgery. METHODS: In this preclinical randomised study design 50 novice surgeons were allocated to no image guidance, triplanar display, always-on solid overlay, always-on wire mesh overlay, or on-demand inverse realism overlay. Each participant was asked to identify a basilar tip aneurysm in a validated model head. The primary outcomes were time to task completion, and tool path length. The secondary outcomes were recognition of an unexpected finding (a surgical clip) and subjective depth perception (using a Likert scale). FINDINGS: Surgeons' time to task completion and tool path length were significantly lower in groups using any form of image guidance than in groups with no image guidance (p