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PurposeTo assess whether transcutaneous retrobulbar amphotericin B injections (TRAMB) reduce exenteration rate without increasing mortality in rhino-orbital-cerebral mucormycosis (ROCM).MethodsIn this retrospective case-control study, 46 patients (51 eyes) with biopsy-proven ROCM were evaluated at 9 tertiary care institutions from 1998 to 2021. Patients were stratified by radiographic evidence of local orbital versus extensive involvement at presentation. Extensive involvement was defined by MRI or CT evidence of abnormal or loss of contrast enhancement of the orbital apex with or without cavernous sinus, bilateral orbital, or intracranial extension. Cases (+TRAMB) received TRAMB as adjunctive therapy while controls (-TRAMB) did not. Patient survival, globe survival, and vision/motility loss were compared between +TRAMB and -TRAMB groups. A generalized linear mixed effects model including demographic and clinical covariates was used to evaluate the impact of TRAMB on orbital exenteration and disease-specific mortality.ResultsAmong eyes with local orbital involvement, exenteration was significantly lower in the +TRAMB group (1/8) versus -TRAMB (8/14) (p = 0.04). No significant difference in mortality was observed between the ±TRAMB groups. Among eyes with extensive involvement, there was no significant difference in exenteration or mortality rates between the ±TRAMB groups. Across all eyes, the number of TRAMB injections correlated with a statistically significant decreased rate of exenteration (p = 0.048); there was no correlation with mortality.ConclusionsPatients with ROCM with local orbital involvement treated with adjunctive TRAMB demonstrated a lower exenteration rate and no increased risk of mortality. For extensive involvement, adjunctive TRAMB does not improve or worsen these outcomes.

A right-hand-dominant female presented 5 weeks following a right middle finger intralesional cantharidin injection for a common wart by a dermatologist. The patient experienced progressive stiffness, blistering, swelling, pain, and ultimately, full-thickness skin necrosis surrounding the injection site. Careful debridement followed by a full-thickness skin graft was performed with no evidence of involvement of the germinal matrix or terminal extensor tendon. At the 7-month postoperative mark, the patient's graft exhibited favorable healing and improved functionality that did not require further follow-up. Intralesional injection of cantharidin solutions for digital warts leads to progressive skin necrosis. Our case required prompt debridement and defect coverage. Involvement of the underlying anatomical structures was also a concern. Dermatologists and hand surgeons should be familiar with this complication as intralesional cantharidin injections are contraindicated.

This work aims to assess the possibility of using packaging industry waste to modify polypropylene products (PPs). The products were made in the form of extruded foil and injected samples. The products were produced using regranulate made of polypropylene cast foil. Maleic anhydride-modified polypropylene (MAPP) and polyolefin elastomer (POE) with a glycidyl ester functional group were used to modify the polypropylene. The samples were produced based on 50% foil waste reground and 50% pure PP. The rheological properties of the blends were assessed using the melt mass flow rate (MFR) technique; thermal properties using the differential scanning calorimetry method (DSC). The products manufactured using the injection molding method were subjected to an analysis of mechanical properties, such as tensile strength and impact strength. Also, in the case of film samples, tensile strength was assessed. Color-change assessments with CIE L*a*b* were carried out for all materials. Injection-molded products based on recycled metallized cast foil showed favorable mechanical properties such as tensile strength (1 MAPP = 26.7 MPa; 2 MAPP = 27.1 MPa), which was higher than the original material (cPP = 20.7 MPa). Also, for the films produced from regrind, the tensile strength was at a level similar (1 MAPP = 24.6 MPa; 2 MAPP/POE = 25.1 MPa) to the films extruded from virgin materials (cPP = 24.9 MPa). The introduction of a POE additive to the blends resulted in increased impact strength (1 MAPP/POE = 31 kJ/mol; 2MAPP/POE = 18 kJ/mol; 3 MAPP/POE = 11 kJ/mol) in relation to unmodified samples (cPP = 7 kJ/mol). The introduction of a POE additive to the tested mixtures improved the impact strength of the injected products by almost 4 times for sample 1 MAPP/POE and 2.5 times for sample 2 MAPP/POE in comparison to virgin cPP. These studies confirmed that foil waste can be successfully used to modify polypropylene products shaped both in the injection and extrusion processes. [ABSTRACT FROM AUTHOR]

Background: Platelet-rich plasma (PRP) is increasingly used for the injection treatment of knee osteoarthritis (OA). However, the role of leukocytes contained in PRP is controversial, with some preclinical studies suggesting detrimental effects and others emphasizing their contribution in secreting bioactive molecules. Purpose: To compare the safety and effectiveness of leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP) for the treatment of knee OA. Hypothesis: That leukocytes could influence results both in terms of adverse events and clinical outcomes. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: This double-blind randomized controlled trial included 132 patients with Kellgren-Lawrence grade 1-3 knee OA who were randomized to a 3-injection cycle of either LR-PRP or LP-PRP. Patients were prospectively assessed at baseline and at 2, 6, and 12 months with subjective evaluations comprising the International Knee Documentation Committee (IKDC) subjective score, the KOOS (Knee injury and Osteoarthritis Outcome Score), the WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), the visual analog scale for pain, the EuroQol–visual analog scale, the EuroQol–5 dimensions, and the Tegner activity scale. Objective evaluations consisted of the IKDC objective score, active/passive range of motion, and circumference of the index and contralateral knees. Patient judgment of the treatment was recorded as well as adverse reactions and failures. Results: An overall improvement in subjective and objective outcomes was documented, with no differences between the 2 groups, except for the improvement in the IKDC subjective score at 2 months, which was greater for the LR-PRP group compared with the LP-PRP group (14.8 ± 14.8 vs 8.6 ± 13.3, respectively; P =.046), as well as for active (P =.021) and passive (P =.040) ROM of the index knee at 6 months, showing statistically significant higher values in the LP-PRP group; and for quadriceps circumference of the index (P =.042) and contralateral (P =.045) knees at 12 months, which were significantly greater in the LR-PRP group. The IKDC subjective score improved from 42.5 ± 17.6 at baseline to 55.6 ± 21.4 at 12 months for the LR-PRP group (P <.0005) and from 45.7 ± 16.4 to 55.3 ± 20.4 for the LP-PRP group (P =.001). No differences in terms of patient treatment judgment were observed at all follow-up time points. No severe adverse events related to the treatment were reported, but some mild adverse events related to the treatment were observed: 16 in the LR-PRP group and 17 in the LP-PRP group. Treatment failed in 5 patients in the LR-PRP group and 2 in the LP-PRP group. Conclusion: This double-blind randomized controlled trial demonstrated that leukocytes did not affect the safety and efficacy of intra-articular PRP injections for the treatment of patients with knee OA. Both LR-PRP and LP-PRP demonstrated comparable clinical outcomes at all follow-up time points, without showing differences in subjective and objective outcomes or in adverse events and treatment failures. Registration: NCT04187183 (ClinicalTrials.gov). [ABSTRACT FROM AUTHOR]

Purpose: Aim of this systematic review of preclinical evidence was to determine the effects of intra‐articular corticosteroid (CS) injections in joints affected by osteoarthritis (OA). Methods: A systematic review was performed on animal studies evaluating intra‐articular CS injections for OA joints. The search was performed on PubMed, Cochrane, and Web of Science databases. A synthesis of the results was performed investigating CS effects by evaluating studies comparing CS with control groups. Morphological, histological, immunohistochemistry evaluations, clinical outcomes, biomarkers and imaging results were evaluated. The risk of bias was assessed according to the Systematic Review Centre for Laboratory Animal Experimentation's tool. Results: Thirty‐two articles analysing CS effects in OA animal models were included (1079 joints), 18 studies on small and 14 on large animals. CS injections showed overall positive effects in at least one of the outcomes in 68% of the studies, while 16% reported a deleterious effect. CS improved cartilage and synovial outcomes in 68% and 60% of the studies, but detrimental effects were documented in 11% and 20% of the studies, respectively. Clinical parameters evaluated in terms of pain, lameness or joint swelling improved in 63% of the studies but deteriorated in 13%. Evidence is limited on imaging and biomarkers results, as well as on the best CS type, dose, formulation and injection protocol. The risk of bias assessment revealed a 28% low and an 18% high risk of bias. Conclusion: Intra‐articular CS injections induced a wide range of results on OA joints in experimental animal models, from disease‐modifying and positive effects on pain and joint function at short‐term evaluation to the lack of benefit or even negative effects. This underlines the need to identify more specific indications and treatment modalities to avoid possible detrimental effects while maximising the anti‐inflammatory properties and the benefits of intra‐articular CS in OA joints. Level of Evidence: Level II. [ABSTRACT FROM AUTHOR]

Adherence and treatment continuation rates of the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) semaglutide for both oral (O‐SEMA) and subcutaneous injection (SEMA‐SC) remain unknown in real‐world clinical practice. This retrospective observational study compared the 12 month adherence and treatment discontinuation of O‐SEMA and once‐weekly SEMA‐SC in patients with type 2 diabetes using a real‐world claims database. SEMA‐SC initiators were 1:1 propensity score‐matched to O‐SEMA initiators. Non‐adherence was defined as <0.8 of the proportion of days covered. SEMA‐SC had a significantly higher odds ratio (OR) for non‐adherence than O‐SEMA (OR: 1.39). The hazard ratio for treatment discontinuation, using O‐SEMA as the reference, was 1.45 for SEMA‐SC, although the discontinuation rate of O‐SEMA was higher during the early stage. O‐SEMA initiators showed significantly higher adherence and greater persistence in therapy than SEMA‐SC initiators at 12 months, which could lead to earlier initiation of GLP‐1RA treatment. [ABSTRACT FROM AUTHOR]

Neuropathy of the lateral cutaneous branch of the iliohypogastric nerve (LCBIN) may represent a differential diagnosis for greater trochanteric pain syndrome (GTPS). Ultrasound-guided neural blockade of the LCBIN may lead to diagnosis of this neuropathy. The aim of this study was to evaluate the accuracy of ultrasound-guided nerve block in cadavers and to present a first clinical case series of patients with neuropathy of the LCBIN where the workup for GTPS remained unremarkable. Ultrasound-guided nerve block led to pain relief in these patients, indicating LCBIN neuropathy. First, ultrasound-guided injections at the LCBIN were performed bilaterally in 24 fresh, non-frozen, non-embalmed body donors. Accuracy and nerve localization were validated by anatomic dissection. Second, a clinical case series of nine patients with suspected GTPS who underwent ultrasound-guided diagnostic LCBIN blockade was retrospectively analyzed. Ultrasound-guided injections at the LCBIN yielded 91.7% accuracy (95% confidence interval: 0.80–0.98). On the right side the nerve was found within a range of 3–14 cm from the anterior superior iliac spine, and within a range of 7–15 cm on the left side. This clinical case series indicates that ultrasound-guided blockade at the LCBIN provides temporary pain relief and indicates the presence of LCBIN neuropathy. Ultrasound has demonstrated high accuracy for localization and injection guidance in the examination of LCBIN. Ultrasound-guided injection of local anesthetics may help to identify LCBIN neuropathy as a differential diagnosis in patients with suspected GTPS. [ABSTRACT FROM AUTHOR]

Introduction: Spinal and non-spinal pathologies can cause low back pain. Non-spinal sources of low back pain include the sacroiliac joint (SIJ) and the hip. SIJ pain can be treated either conservatively or surgically. Current strategies for managing sacroiliac joint pain are debated, and limited evidence exists. Areas covered: The present expert opinion updates current evidence on conservative and surgical modalities for SIJ pain Expert opinion: Surgical management for SIJ pain is effective. However, it exposes patients to surgery and, therefore, related complications. Conservative management may be implemented in patients with moderate SIJ pain, with less than six months of symptoms, or not eligible for surgery. Several noninvasive modalities are available, mostly centered on intra-articular injections. Corticosteroids, platelet-rich plasma, and stem cells have only midterm lasting effects, at most for nine months. Radiofrequency ablation is another methodology for pain relief. Both continuous and pulsatile radiofrequency ablation are associated with good outcomes. SIJ fusion can be performed using different techniques; however, a clear recommendation on the most appropriate modality for the management of SIJ pain is still debated. [ABSTRACT FROM AUTHOR]

Objectives: Evaluating the effectiveness and safety of repeated high‐dose intradetrusor abobotulinumtoxin A (Dysport®) injections for the treatment of pediatric neurogenic bladders refractory to medications. Design: Retrospective interventional study. Participants: The cohort included 37 children (22 boys and 15 girls) of median age 9.2 years. Inclusion criteria were diagnosis of neurogenic bladder and failure to respond to medical treatment. Exclusion criteria were augmented bladder, insufficient data, and interval of > 11 months between video‐urodynamic study and Dysport injection. Interventions: All participants were treated with an intra‐detrusor injection of Dysport 30 IU/kg (up to 1000 IU) under general anesthesia. Repeated (second and third) injections were scheduled (6–12 months) in patients who demonstrated an improvement in cystometric parameters. All participants underwent video urodynamic testing before onset of treatment and 4–5 months after subsequent injection. Main Outcome Measures: Success of treatment was defined as a decrease in end filling pressure (EFP) to < 40 cm H2O and/or a 20% increase in maximal cystometric capacity (MCC). These parameters along with initial bladder features were evaluated for ability to predict treatment success. Results: No side effects of Dysport were observed or reported. The overall success rate was 62%. MCC increased by a median of 30% (IQR 200–300, p < 0.001), 37% (IQR 197–310, p = 0.001) and 45% (IQR 245–300, p = 0.025) after the first, second and third injections, respectively. Median EFP decreased from 45 cm H2O to 34 cm H2O (IQR 20–45, p = 0.029), 23 cm H2O (IQR 20–37, p = 0.004), and 20 cm H2O (IQR 12–32, p = 0.049) after the first, second, and third injections, respectively. No predicting factor of success of treatment were found; However, three of five cases of "end stage" bladder showed improvement. Conclusions: High‐dose Dysport injection is safe and effective for the treatment of neurogenic bladder. Studies with larger cohort and a control group would further elucidate which bladders would benefit most. At present, we recommend treating also bladders with "end stage" features with botulinum toxin before considering augmentation. [ABSTRACT FROM AUTHOR]

Objective: To investigate the utility of preprocedural paracetamol on reducing pain scores post office‐based laryngeal procedures. Study Design: Prospective, controlled before‐after comparative study. Setting: Controlled prospective before‐after study. Methods: A retrospective analysis was performed of 100 patients who underwent office‐based laryngeal procedures without preprocedural analgesia at our center to establish a control group. Age, sex, procedure type, and amount of substance used were documented as well as postprocedural pain score. Pain scores were recorded every 5 minutes for 30 minutes following office‐based laryngeal procedures. A prospective arm of this study was then performed in which every patient undergoing office‐based laryngeal procedures at our center between September 2019 and December 2020 was administered 1000 mg of paracetamol prior to their procedure. The postprocedure pain scores of the 2 groups were then compared. Results: A hundred patients were included in the retrospective arm and 75 patients were included in the prospective arm, receiving 1000 mg of paracetamol a median of 45 (interquartile range: 30‐53) minutes prior to their procedure. The 2 groups were matched for age, sex, and type of laryngeal procedure. Both nonanalgesia and analgesia groups demonstrated a similar proportion of patients who experienced any pain (47% and 48%, respectively) postprocedurally. The prospective arm of this study however reported a statistically significant reduction in the magnitude of their pain scores at all points postprocedurally (P =.005). Conclusion: Paracetamol preprocedurally reduces the severity of pain in office‐based laryngeal procedures and would be a useful consideration for patients who are likely to experience significant postprocedural pain. Level of Evidence: Level 3. [ABSTRACT FROM AUTHOR]

A new design of plasma-assisted injector to ignite or stabilize combustion is presented. This design is intended to produce discharges that penetrate the combustion chamber instead of staying at the wall. This plasma-assisted injector, simple and robust, allows compact designs for a weakly intrusive implementation in engines, and is compatible with either air or fuel, depending on the process or application. A prototype was manufactured, implemented and tested with quasi-DC discharges on the LAPCAT2 Dual Mode Ramjet combustor at LAERTE facility in ONERA. Combustion tests showed earlier ignition and increased pressure when the plasma was turned on with a measured plasma power of 1.4 kW. • Presentation of the design and principle of a new plasma assisted injector. • Demonstration of its ability to generate discharges penetrating the flow. • Characterization of the discharge dynamics and its interaction with the gas flow. • Comparison of the discharge behavior in hydrogen vs air. • Ability of the plasma assistance to enhance supersonic combustion. [ABSTRACT FROM AUTHOR]

Background: Rhipicephalus sanguineus sensu lato (s.l.) and Ctenocephalides felis are among the most important year-round ectoparasites of dogs. The persistent efficacy of one treatment with fluralaner injectable suspension (Bravecto® 150 mg/ml powder and solvent for suspension for dogs, referred to as Bravecto® injectable) was investigated in a negative-controlled, randomised, partially blinded 12-month laboratory study. Methods: A total of 20 dogs were randomly allocated to two equal groups (treatment and control). Treatment-group dogs were injected subcutaneously on study day 0 with the investigational veterinary product at the recommended dose of 15 mg fluralaner/kg body weight (0.1 mL/kg), whereas the control group dogs received saline solution (0.1 mL/kg). Each dog was infested with 50 (25 female, 25 male) adult R. sanguineus s.l. and 100 adult C. felis 2 days before treatment, 5 and 28 days after treatment, and then once monthly for a 12-month period. Live tick and flea counts were performed 48 h after treatment or subsequent infestation, respectively. Efficacy was determined by comparing arithmetic means of the treatment group tick and flea counts with those of the control group. Infestation was considered adequate if at least 25.0% of ticks and 40.0% of fleas were recovered from at least six dogs in the control group at the respective assessment times. Results: Adequate R. sanguineus s.l. and C. felis infestations of control group dogs were observed at each time point. Arithmetic mean treatment group values were significantly lower than those of the control group at all time points. The immediate efficacy when treating existing infestations of R. sanguineus s.l. and C. felis (infestation 2 days before treatment), was 49.7% and 89.7%, respectively. The persistent efficacy against post-treatment re-infestations was 94.4–100% against R. sanguineus s.l. and 92.2–100% against C. felis. Seven dogs in the control group developed flea allergy dermatitis due to the repeated re-infestations over the study period, whereas no dogs in the treatment group were affected. No clinically relevant side effects were observed over the entire study period. Conclusions: The fluralaner injectable suspension (Bravecto® injectable) provides 1 year of efficacy against R. sanguineus s.l. and C. felis infestations in dogs following a single treatment, allowing once-yearly treatment, which can significantly improve owner compliance with year-round protection of dogs. [ABSTRACT FROM AUTHOR]

Calcium hydroxide injection desulfurization has attracted extensive attention because of its low cost and recyclable characteristics. The modified calcium hydroxide was prepared on the basis of the digestion of calcium lignosulfonate (wood calcium) aqueous solution with ethanol and used in the pilot test of flue gas injection desulfurization of the coke oven. The injection desulfurization experiment was carried out with calcium hydroxide modified by 50% ethanol and 20% ethanol+0.5% wood calcium. It was found that the injection desulfurization efficiency of the two modified calcium hydroxide was better than that of the unmodified calcium hydroxide under the same injection conditions. The desulfurization efficiency of 20% ethanol+0.5% calcium hydroxide modified by wood calcium can reach more than 93.7% under the condition of 2 and 5 times calcium to sulfur ratio. The XRF analysis of desulfurization product showed that the content of S element in unreturned desulfurization ash was only 1.28%, which increased to 4.46% after 5 times of return. BET results showed that the specific surface area of the returned desulfurization ash decreased from 35.115m2/g to 10.256m2/g and the pore volume decreased from 0.103cm3/g to 0.0433cm3/g. [ABSTRACT FROM AUTHOR]

Introduction: People who inject drugs (PWID) are a key population at risk of HIV in Iran. We measured the prevalence and covariates of HIV-related risk behaviours among PWID in Iran. Methods: We conducted a respondent-driven bio-behavioural surveillance survey among PWID from July 2019 to March 2020 in 11 major cities. We assessed PWID's recent (i.e., last three months) HIV-related risk behaviours using a four-level categorical variable: Only unsafe injection (i.e., sharing needles/syringes or injecting equipment), only unsafe sex (i.e., unprotected sex), dual HIV risk (i.e., both unsafe injection and unprotected sex), and safe injection and sex. Data were summarized using RDS-weighted analysis. Multinomial logistic regression models were built to characterize HIV-related risk behaviours and relative risk ratio (RRR) with 95% confidence interval (CI) were reported. Results: Overall, 2562 men who inject drugs (MWID) were included in the regression analysis. The RDS-weighted prevalence of dual HIV risk was 1.3% (95% CI: 0.8, 1.9), only unsafe injection was 4.5%, and only unsafe sex was 11.8%. Compared to the safe injection and sex group, dual HIV risk was significantly and positively associated with multiple partnership (RRR = 15.06; 3.30, 68.73). Only unsafe injection was significantly associated with homelessness in the last 12 months (RRR: 3.02; 95% CI: 1.34, 6.80). Only unsafe sex was significantly associated with multiple partnership (RRR = 6.66; 4.27, 10.38), receiving free condoms (RRR = 1.71; 1.01, 2.89), receiving free needles (RRR = 2.18; 1.22, 3.90), and self-received risk for HIV (RRR = 2.51; 1.36, 4.66). Moreover, history of HIV-testing in the last three months was significantly associated with only unsafe injection (RRR = 2.71; 1.84, 3.80). Among the 90 women who injected drugs, none reported dual HIV risk behaviours. Discussion and conclusions: While the low prevalence of dual HIV risk among PWID is encouraging, unprotected sexual practices among PWID is concerning. Expanding sexual health education and care services as well as tailored interventions aimed at reducing high-risk sexual activities among PWID are warranted. Additionally, tackling potential misperceptions about risk of HIV transmission among PWID in Iran is warranted. [ABSTRACT FROM AUTHOR]

In this study, we developed an injectable DNA vaccine targeting the aopB gene of Aeromonas hydrophila, encapsulated within poly(lactic‐co‐glycolic acid) (PLGA) nanoparticles, for use in common carp. Juvenile common carp were divided into six groups with three replicates each. Groups A and B received intramuscular injections of the plasmid containing the target gene (pCDNA3.1‐aopB) with or without encapsulation, respectively. Groups C and D received the plasmid lacking the target gene via the same route. Group E received PLGA, while Group F (control) received phosphate‐buffered saline. Sampling occurred on days 0, 30, and 60, and hematological and immunological indices were compared among the groups. On day 60, all groups were challenged with Aeromonas hydrophila, and cumulative mortality rates were assessed. Our results indicated successful detection of the target gene in various tissues of vaccinated fish. Notably, vaccinated groups exhibited a significant decrease in cumulative mortality (p < 0.05). Immunological indices, such as serum antibody titer and nonspecific immune responses, significantly improved in vaccinated groups, particularly those receiving the DNA vaccine with PLGA encapsulation (p < 0.05). Overall, the DNA vaccine, especially when nanoencapsulated with PLGA, demonstrated efficacy and immunogenicity against A. Hydrophila in common carp, suggesting its potential as a vaccination strategy against this infection. Further research could optimize its effectiveness and applicability. [ABSTRACT FROM AUTHOR]

The intricate geological characteristics of tight oil reservoirs, characterized by extremely low porosity and permeability as well as pronounced heterogeneity, have led to a decline in reservoir pressure, substantial gas expulsion, an accelerated decrease in oil production rates, and the inadequacy of traditional water injection methods for enhancing oil recovery. As a result, operators encounter heightened operational costs and prolonged timelines necessary to achieve optimal production levels. This situation underscores the increasing demand for advanced techniques specifically designed for tight oil reservoirs. An internal evaluation is presented, focusing on the application of molecular deposition film techniques for enhanced oil recovery from tight oil reservoirs, with the aim of elucidating the underlying mechanisms of this approach. The research addresses fluid flow resistance by employing aqueous solutions as transmission media and leverages electrostatic interactions to generate nanometer-thin films that enhance the surface properties of the reservoir while modifying the interaction dynamics between oil and rock. This facilitates the more efficient displacement of injected fluids to replace oil during pore flushing processes, thereby achieving enhanced oil recovery objectives. The experimental results indicate that an improvement in oil displacement efficiency is attained by increasing the concentration of the molecular deposition film agent, with 400 mg/L identified as the optimal concentration from an economic perspective. It is advisable to commence with a concentration of 500 mg/L before transitioning to 400 mg/L, considering the adsorption effects near the well zone and dilution phenomena within the reservoir. Molecular deposition films can effectively reduce injection pressure, enhance injection capacity, and lower initiation pressure. These improvements significantly optimize flow conditions within the reservoir and increase core permeability, resulting in a 7.82% enhancement in oil recovery. This molecular deposition film oil recovery technology presents a promising innovative approach for enhanced oil recovery, serving as a viable alternative to conventional water flooding methods. [ABSTRACT FROM AUTHOR]

Objective: To review and validate a questionnaire on knowledge of injectable insulin management (JH-SEFAC) by patients with diabetes for use in community pharmacies. Methods: Study design: cross-sectional observational in Spanish community pharmacies during the first half of 2023. Inclusion criteria: patients with diabetes, of legal age, on insulin treatment. Questionnaire design: a nominal group of community pharmacist reviewed and piloted the initial questionnaire to determine its feasibility. It was approved by the CEIC of Aragón (PI22/375). Content validation: by a multidisciplinary group of experts in diabetes, using an ad hoc evaluation questionnaire of 10 questions (Likert scale of 1-5). Reliability: by means of the internal consistency index (Cronbach's alpha) and the intraclass correlation coefficient (ICC). Reproducibility (test/retest): the results of the questionnaire administered twice 2-3 weeks apart to the group of patients were compared. Pharmacists members of the SEFAC Diabetes Working Group collaborated. Sample: calculated in 127 subjects (95% CI and precision of 10%). Results: 20 community pharmacies from 13 autonomous communities included 131 patients. The expert assessment was 4.52 out of 5 (90.4%). The Keiser-Meyer-Olkin test was 0.626 and Bartlett's test was significant (p<0.001). The Cronbach's alpha of the global questionnaire was 0.804 and the ICC was 0.902. The mean score of the questionnaire was 15.98 out of 31 points. Conclusions: The JH-SEFAC questionnaire was validated to evaluate the management of insulin injectables, providing community pharmacists with a valuable tool for therapeutic education. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been growing interest in the use of hyaluronic acid (HA) for the treatment of premature ejaculation (PE). The efficacy of this treatment is quite controversial. Aim: This study intended to evaluate the efficacy and safety of glans penis augmentation with HA gel for PE. Methods: This systematic review includes randomized controlled trials (RCTs), primary clinical trials, prospective and retrospective studies, case series, and case reports. Searches in Embase, PubMed, Cochrane, Web of Knowledge, and ClinicalTrials.gov were performed blindly by 2 reviewers. Outcomes: Intravaginal ejaculation latency time (IELT), questionnaires about PE, glans circumference (millimeters), and adverse events. Results: Thirteen studies were included in the evaluation: 4 RCTs, 8 prospective observational studies, and 1 restrospective study. The number of patients who received HA gel on the glans penis was 706. According to the results of 2 placebo-controlled RCTs, HA gel treatment significantly improved IELT at the end of the first month (mean difference [MD], 65.44 seconds). In the first month after the HA gel injection procedure, IELT increased vs before the procedure (MD, 176.18 [95% CI, 146.89-205.48]; P <.001, I2 = 83%). When the IELT values ​​were compared at 6 months after HA gel application, IELT improved vs before the procedure (MD, 143.93 [95% CI, 124.78-163.09]; P <.001, I2 = 82). The glans circumference expanded by approximately 1.5 cm after the procedure (MD, 14.82 mm [95% CI, 12.75-16.90]; P <.001, I2 = 65%). When the side effect profile of other studies was examined, side effects were observed in 91 patients after HA gel injection applied to 598 patients (15.22%). Among these side effects, the most common were pain (n = 46, 7.69%), bulla/nodule formation (n = 25, 4.18%), and ecchymosis (n = 20, 3.34%). Conclusion: While HA shows promise as a therapeutic option for PE, ongoing research is essential to elucidate its clinical utility, mechanisms of action, and comparative efficacy. [ABSTRACT FROM AUTHOR]

Background and Aims: Low back pain is a common problem and a major burden to society. Transforaminal epidural steroid injection is one of the most effective treatment modalities for back pain. We aim to objectively quantify pain relief of lumbosacral radicular pain post transforaminal steroid injection by correlating perfusion index (PI), reflecting real‑time peripheral blood flow change at the site of monitoring, controlled by sympathetic system with Numerical rate score (NRS) and SLRT improvement. Material and Methods: A prospective observational study, conducted at K.S Hegde Medical Academy, Mangaluru, from June 2021 to June 2022 as a time‑bound study. After IEC clearance (IEC certificate number) for the procedure and study, patients undergoing transforaminal epidural steroid injection for lumbosacral radicular pain were enrolled, excluding those meeting the exclusion criteria. PI change and NRS score improvement were noted at 0, 5, 10, 15, and 30 minutes along with pre and post‑procedure SLRT. Results were analyzed. Results: A total of 40 patients were analyzed. PI change at 30 minutes was 2.113 from a baseline of 0.217. Median NRS of 5, improved to 0 and the mean SLRT of 45.17 to 61.45 at the end of 30 minutes. All changes are statistically significant with P (<0.01). correlation between the PI change with NRS is mild (‑0.312). Conclusion: PI change ratio shows an overall improvement in pain levels objectively, in a non‑invasive, easy, and reliable way. Simultaneous improvement in both NRS and SLRT is clinically significant but cannot predict a correlated quantitative measure of pain relief. [ABSTRACT FROM AUTHOR]

This study focused on the physicochemical properties and tenderness of vacuum‐packaged beef M. semitendinosus as affected by various dilution ratios (DRs, 1:4, 1:2, and 1:1) of green kiwifruit juice extract (GKJE) with phosphate buffer during storage at 4°C for 7 days. In addition, the formation of peptides with antioxidant activity for GKJE ability to hydrolyze proteins present in beef was evaluated at different steps of in vitro digestion. Beef with GKJE showed higher tenderness than control (CTL, beef with brine solution alone) during storage, and the increased DR increased tenderness as compared to lower DRs. The addition of GKJE increased protein digestibility during in vitro digestion. To increase the antioxidant activity in the body, GKJE having a DR of 1:2 and 1:1 should be applied to the beef muscle with effective antioxidant activity. These results suggest that DRs of phosphate buffer and kiwifruit juice of 1:1 and 1:2 have the potential to be used as a meat‐tenderizing agent and could increase the digestibility of meat as well as the antioxidant capability of bioactive peptides. Practical Application: The dilution ratio of kiwi juice with phosphate buffer at 1:1 has the potential to be used as a meat‐tenderizing agent during refrigerated storage and also increase the digestibility of beef. [ABSTRACT FROM AUTHOR]

Background: Nonsurgical cosmetic procedures, particularly the use of hyaluronic acid (HA)‐based soft tissue fillers, are becoming increasingly popular. This trend has catalyzed the development of a plethora of HA‐based products differing in product characteristics, thereby catering to an ever‐widening spectrum of aesthetic applications. However, complications rise concomitant with the increasing number of procedures. Among the strategies to manage such adverse events is the enzymatic breakdown with hyaluronidase. Objective: To analyze the response of different HA‐based soft tissue filler materials to hyaluronidase injections. Methods: A total of 11 different HA‐based soft tissue fillers were evaluated using noninvasive ultrasound imaging to assess their behavior in response to hyaluronidase injections. The HA‐based soft tissue fillers were categorized according to their product characteristics into a structuring, volumizing, and lip volumizing group. Standardized injections of 0.2 cc were performed in chicken breast to simulate human tissue. Ultrasound measurements of width, height, and calculated volume were performed immediately after filler injection, 1 h and 24 h following hyaluronidase injection. Results: Regardless of the soft tissue filler analyzed, the most significant volume reduction occurred within the first h after applying hyaluronidase, with a 64.1% decrease from the initial volume. After 24 h, the total volume reduction reached 81.7%. No statistically significant differences were found when comparing the three groups at each follow‐up time period, except for the height measurement after 1 h. While width was statistically significant in all groups between the investigated follow‐up groups, the volume reduction was only statistically significant in the groups with the highest and second highest G' values (i.e., Group 1—structuring, Group 2—volumizing). Conclusion: The effectiveness of hyaluronidase in dissolving HA‐based fillers is initially independent of product characteristics of HA‐based fillers such as G‐prime, with increased efficacy in fillers with higher G‐prime values, as evidenced by significant volume reductions in such groups. [ABSTRACT FROM AUTHOR]

We present an earthquake simulator, Quake-DFN, which allows simulating sequences of earthquakes in a 3D discrete fault network governed by rate and state friction. The simulator is quasi-dynamic, with inertial effects being approximated by radiation damping and a lumped mass. The lumped mass term allows for accounting for inertial overshoot and, in addition, makes the computation more effective. Quake-DFN is compared against three publicly available simulation results: (1) the rupture of a planar fault with uniform prestress (SEAS BP5-QD), (2) the propagation of a rupture across a stepover separating two parallel planar faults (RSQSim and FaultMod), and (3) a branch fault system with a secondary fault splaying from a main fault (FaultMod). Examples of injection-induced earthquake simulations are shown for three different fault geometries: (1) a planar fault with a wide range of initial stresses, (2) a branching fault system with varying fault angles and principal stress orientations, and (3) a fault network similar to the one that was activated during the 2011 Prague, Oklahoma, earthquake sequence. The simulations produce realistic earthquake sequences. The time and magnitude of the induced earthquakes observed in these simulations depend on the difference between the initial friction and the residual friction μi -- μf, the value of which quantifies the potential for runaway ruptures (ruptures that can extend beyond the zone of stress perturbation due to the injection). The discrete fault simulations show that our simulator correctly accounts for the effect of fault geometry and regional stress tensor orientation and shape. These examples show that Quake-DFN can be used to simulate earthquake sequences and, most importantly, magnitudes, possibly induced or triggered by a fluid injection near a known fault system. [ABSTRACT FROM AUTHOR]

Background: In recent years, soft tissue materials have been applied as forehead fillers. Some filling materials need to be removed or refilled in a timely manner in certain situations; therefore, it is important to develop a method to identify the location and type of filling materials. This study summarizes the imaging findings of different filling materials under high-frequency ultrasound, providing a reference for clinical treatment. Methods: We screened facial ultrasound images performed at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from April 2015 to July 2023 and classified and summarized the types of frontal filling materials and their imaging results. Results: This study included ultrasound imaging results from 114 patients, including 39 with hyaluronic acid (HA) filling, 45 with polyacrylamide hydrogel (PAG) filling, 14 who received autologous fat transplantation, 2 who received prosthesis implantation, 2 who received both HA and PAG filling, and 12 who received silicone oil filling. HA mainly manifests as an anechoic zone on ultrasonography, with images divisible into four types. PAG primarily presents as fine punctate echoes, divisible into five types. Fat transplantation presents as a low-echo area with uneven density, divisible into five types. Finally, the silicone oil-filling material appears as a cloud-like high echo on the forehead, visible throughout the entire skin layer, and unclear imaging in deep tissues. Conclusion: High-frequency ultrasound is a safe and reliable method to evaluate the type and position of forehead filling materials, which can be easily applied in clinical practice. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

From May 2022 to June 2023, 42 patients used the same material and different types of needles were retrospectively analyzed. Twenty-one patients were in blunt needle group and 21 patients in sharp needle group. The injection pain, congestion and postoperative satisfaction of the two groups were evaluated. Results There was no significant difference in intraoperative and postoperative pain between the two groups (P>0.05). The intraoperative and postoperative incidences of congestion of blunt needle group were lower than those of sharp needle group, and the difference was statistically significant (P<0.05). There was no significant difference in postoperative satisfaction between the two groups (P>0.05). Conclusion Both groups achieved satisfactory results in intraoperative and postoperative pain and postoperative satisfaction, and the blunt needle was better than the sharp needle in preventing congestion. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the outcomes of total coccygectomy compared with steroid injection and rectal manipulation in patients with persistent idiopathic coccydynia. Methods: This retrospective study analyzed patients who underwent either total coccygectomy or rectal manipulation with fluoroscopy-guided steroid injection between 2018 and 2021 at two medical centers. The patients were divided into two groups: Group A, consisting of 13 patients who underwent total coccygectomy, and group B, consisting of 16 patients who received rectal manipulation and fluoroscopy-guided steroid injection. Results: There were no significant differences in visual analog scale (VAS) scores between the groups before treatment. However, 10 days after treatment, group B exhibited a significantly lower VAS score [1 (0-4)] than group A [3.7 (2-7)]. There were no significant differences in VAS scores between group A and group B at the one-month, three-month, and six-month follow-up assessments after treatment. Conclusion: Total coccygectomy and steroid injection with rectal manipulation are effective treatment options for idiopathic coccydynia. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to explore factors affecting the progression of neovascular age‐related macular degeneration (nAMD) and identify predictive factors that can estimate the duration of intravitreal treatments. Methods: This retrospective real‐world study included 421 nAMD patients treated at the Kuopio University Hospital during years 2007–2021. The collected data included background demographics, treatment history, visual acuity and retinal biomarker analysis. Impact of baseline factors on age at diagnosis, treatment duration, received treatment intensity and visual acuity gains were analysed. Results: Heavy smoking and high body mass index (BMI) were associated with an earlier onset, while the use of anticoagulation and anti‐aggregation medication were associated with a later onset of nAMD. A low number of injections during the first year of treatment and the presence of intraretinal fluid (IRF) at baseline were associated with shorter treatment duration. Interestingly, when IRF only patients were compared to subretinal fluid (SRF) only patients, IRF patients showed higher occurrences of subretinal drusenoid deposits (43.5% vs. 15%, p = 0.04). In addition, when all patients with IRF were compared to SRF only patients, more hyperreflective foci (HRF) and complete RPE and outer retinal atrophy (cRORA; 20.7% vs. 5%, p = 0.02) were observed in patients with IRF. Conclusions: Our results reveal that heavy smoking and high BMI are accelerating factors for earlier emergence of nAMD, while the presence of IRF results in a fast‐progressing disease. More intriguingly, the link between IRF and appearance of subretinal drusenoid deposits, HRF, and increased retinal atrophy was observed. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to determine if ultrasound (US) allows a precise assessment of the paratenon (PT) of the Achilles calcaneal tendon (AT), and to anatomically describe the US-guided paratendinous injection technique. Methods: This study was initially conducted on eight cadaveric specimens using high-resolution ultrasound (HRUS) to examine the PT appearance, thickness, and its relationships with the AT, plantaris tendon (PLT), Kager's fat pad (KFP), sural nerve (SN), and fascia cruris (FC). US-guided paratendinous injection of China ink was performed in all specimens, followed by anatomical dissection to assess injectate distribution. Then, HRUS study of the PT was carried out bilaterally in twenty asymptomatic volunteers (40 legs). Two musculoskeletal radiologists recorded all data in consensus except PT thickness in volunteers which was recorded independently in order to calculate intra and inter-observer reliability. Results: The PT was consistently identified with HRUS along its entire course in both cadaveric specimens (8/8) and volunteers (40/40). The mean PT thickness was 0.54 mm in cadavers and 0.39 mm in vivo, without any correlation with the AT thickness. Intra- and inter observer reliability were respectively excellent and good for PT thickness. All eight (100%) ex vivo China ink injections were accurate, demonstrating a circumferential distribution of the injectate between the PT and the AT, associated with an anterior spread to the KFP. Conclusion: HRUS allows visualization of the PT along its entire length, and assessment of its relationships to adjacent structures. US-guided paratendinous injections can accurately and safely deliver injectates in the paratendinous sheath. [ABSTRACT FROM AUTHOR]

Searching for new alternatives to commercialize pork from entire male pigs that could be affected by a boar taint sensory defect would be adequate. In this study, two different marinade mixtures (additives, salt, white wine plus different spices for mixture 1 and 2) were injected into pork loin pieces from castrated (C1 and C2) and entire male pigs (E1 and E2) with a high boar taint level (5.51 µg.g−1 AND and 0.73 µg.g−1 SKA) to evaluate their effect on the physicochemical and sensory quality of pork, and to assess their boar taint masking properties. To achieve this, physicochemical and sensory analyses with trained panellists were carried out. Marinated meat showed some differences in colour and a reduction in cooking losses. Mixture 2 achieved the best boar taint masking effect, due to spices content mainly nutmeg and ginger, and other ingredients such as white wine. In conclusion, marinating pork from entire male pigs can contribute to achieving an acceptable quality standard. [ABSTRACT FROM AUTHOR]

Introduction: Anti-vascular endothelial growth factor (VEGF) agents have been the standard treatment for retinal diseases for almost two decades. These treatments are administered via intravitreal injection using single-use vials or prefilled syringes (PFS). In this systematic review, we evaluate health care resource use and clinical outcomes and experiences with PFS for intravitreal injection of anti-VEGF treatments. Methods: MEDLINE, EMBASE, and The Cochrane Library were searched from January 1, 2015 to February 8, 2024 to identify literature reporting outcomes regarding procedural efficiency, health care resource use, patient and clinician experiences, and safety for currently approved anti-VEGFs (ranibizumab, aflibercept, brolucizumab) administered using PFS. Comparators were vial-based injections of the same anti-VEGFs. Results: A total of 36 publications met the criteria for inclusion in the systematic literature review; the majority were non-randomized studies, with a small number of reviews, case series, survey studies, and opinion articles. Publications reported that preparation times were significantly shorter for PFS (40.3–57.9 s) versus vials (ranibizumab, 62.8–98.0 s; aflibercept, 71.9–79.5 s), with no differences in product stability between PFS and vials. Clinicians expressed a preference for PFS and thought PFS were faster, easier to use, and had increased safety versus vials. Publications consistently reported significantly lower rates of endophthalmitis per injection with PFS versus vials (ranibizumab PFS, 0–0.02%; aflibercept PFS, 0.01–0.02%; ranibizumab vial, 0.02–0.05%; aflibercept vial, 0.02–0.06%). Four publications reported increased rates of transient vision loss after aflibercept PFS injection versus vial-based injection. No publications reported outcomes regarding health care resource use or patient experiences. Conclusion: The available literature supports the increased procedural efficiency of PFS versus vial-based intravitreal injection of anti-VEGFs. PFS are positively perceived by clinicians and have a safety benefit in the form of a decreased risk of endophthalmitis versus vials. Plain Language Summary: Anti-vascular endothelial growth factor (VEGF) drugs, given by injection into the eye, are commonly used to treat diseases that affect the back of the eye (the retina). Anti-VEGF drugs are provided in small containers (vials) or in syringes that are already filled with the drug (prefilled syringes). When someone is treated with an anti-VEGF drug from a vial, the drug must first be taken from the vial using a needle and syringe, and then injected. When someone is treated with an anti-VEGF drug from a prefilled syringe, the drug is injected directly from the prefilled syringe, i.e., there are fewer steps involved when a prefilled syringe is used. We searched the medical literature to see if there were differences in clinical outcomes and experiences between prefilled syringes and vials when used to inject anti-VEGF drugs. Clinicians spent about 50% less time getting ready for injections when prefilled syringes were used than when vials were used. Clinicians also preferred to use prefilled syringes than vials for injecting anti-VEGF drugs. Clinicians reported that prefilled syringes were easier to use, faster, and safer than vials. Patients who were given injections from prefilled syringes had a lower rate of infection of the inside of the eye (endophthalmitis) than patients who were given injections from vials. These results indicate that using prefilled syringes for injecting drugs into the eye can improve efficiency at ophthalmology clinics and improve safety for patients. [ABSTRACT FROM AUTHOR]

The steel industry accounts, according to the International Energy Agency, for ~6.7% of global CO2 emissions, and the major portion of its contribution is from steelmaking via the blast furnace (BF) route. In the short term, a significant reduction in fossil CO2 emissions can be achieved through the introduction of bio-coal into the BF as part of cold bonded briquettes, by injection, or as part of coke. The use of bio-coal-containing residue briquettes was previously demonstrated in industrial trials in Sweden, whereas bio-coal injection was only tested on a pilot scale or in one-tuyere tests. Therefore, industrial trials replacing part of the pulverized coal (PC) were conducted. It was concluded that the grinding, conveying, and injection of up to 10% of charcoal (CC) with PC can be safely achieved without negative impacts on PC injection plant or BF operational conditions and without losses of CC with the dust. From a process point of view, higher addition is possible, but it must be verified that grinding and conveying is feasible. Through an experimentally validated computational fluid flow model, it was shown that a high moisture content and the presence of oversized particles delay devolatilization and ignition, lowering the combustion efficiency. By using CC with similar heating value to PC, compositional variations in the injected blend are not critical. [ABSTRACT FROM AUTHOR]

Intra-articular injection-based therapy is often used aside conservative treatment and lifestyle modifications to manage knee osteoarthritis (KO) patients. Conventional injections contain steroids and hyaluronic acid, while more recently multipotential adult stem cell, platelet-rich plasma (PRP), and platelet lysate (PL) injections have been used to promote cartilage regeneration or repair. The aim of the current study is to analyse current evidence on PL injections for the treatment of KO and to determine if these are effective and how these perform compared to other injection regimens. The databases of Scopus, Embase, PubMed, Web of Science, and Cochrane Library were searched on 30 June 2023. Risk of bias was assessed using the SYRCLE tool for animal studies and Cochrane RoB 2 as well as ROBINS-I tool for human studies. Studies were included if these were in English, any year, and regarded animals with osteoarthritis (OA) or human adult patients with OA. In vitro trials and non-adult human studies were excluded. Results on OA symptom stage and severity, and pain were recorded. The research retrieved three human studies (n = 48, n = 25, n = 58) and four animal studies: one rabbit, two studies, and one rat study. PL was found to decrease KO symptoms at follow-up ≤ 1 year with respect to baseline levels and when compared to hyaluronic acid or platelet-rich plasma. Symptoms returned 6 months–1 year after the final administration, with studies showing peak efficacy at approximately 6 months. Animal studies showed clinical improvements, reduction of lameness, and partial effect on the cartilage regeneration of the seven studies, two had a high risk of bias, four were associated to some concerns, and one had low risk. A major source of bias in these studies was the use of questionnaires and scoring that could be subject to interpretation. Overall, PL was well-tolerated and showed efficacy comparable to PRP; when pain control was assessed, it showed similar efficacy compared to hyaluronic acid. These findings may support its use in clinical trials to confirm these initial findings; future research should also focus on the comparison with other non-surgical treatments, on a more detail of the potential regenerative properties, and to optimise the treatment schedule. [ABSTRACT FROM AUTHOR]

Abstract Adherence and treatment continuation rates of the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) semaglutide for both oral (O‐SEMA) and subcutaneous injection (SEMA‐SC) remain unknown in real‐world clinical practice. This retrospective observational study compared the 12 month adherence and treatment discontinuation of O‐SEMA and once‐weekly SEMA‐SC in patients with type 2 diabetes using a real‐world claims database. SEMA‐SC initiators were 1:1 propensity score‐matched to O‐SEMA initiators. Non‐adherence was defined as

Background and Aims: Low back pain is a common problem and a major burden to society. Transforaminal epidural steroid injection is one of the most effective treatment modalities for back pain. We aim to objectively quantify pain relief of lumbosacral radicular pain post transforaminal steroid injection by correlating perfusion index (PI), reflecting real-time peripheral blood flow change at the site of monitoring, controlled by sympathetic system with Numerical rate score (NRS) and SLRT improvement. Material and Methods: A prospective observational study, conducted at K.S Hegde Medical Academy, Mangaluru, from June 2021 to June 2022 as a time-bound study. After IEC clearance (IEC certificate number) for the procedure and study, patients undergoing transforaminal epidural steroid injection for lumbosacral radicular pain were enrolled, excluding those meeting the exclusion criteria. PI change and NRS score improvement were noted at 0, 5, 10, 15, and 30 minutes along with pre and post-procedure SLRT. Results were analyzed. Results: A total of 40 patients were analyzed. PI change at 30 minutes was 2.113 from a baseline of 0.217. Median NRS of 5, improved to 0 and the mean SLRT of 45.17 to 61.45 at the end of 30 minutes. All changes are statistically significant with P (

Abstract Background Rhipicephalus sanguineus sensu lato (s.l.) and Ctenocephalides felis are among the most important year-round ectoparasites of dogs. The persistent efficacy of one treatment with fluralaner injectable suspension (Bravecto® 150 mg/ml powder and solvent for suspension for dogs, referred to as Bravecto® injectable) was investigated in a negative-controlled, randomised, partially blinded 12-month laboratory study. Methods A total of 20 dogs were randomly allocated to two equal groups (treatment and control). Treatment-group dogs were injected subcutaneously on study day 0 with the investigational veterinary product at the recommended dose of 15 mg fluralaner/kg body weight (0.1 mL/kg), whereas the control group dogs received saline solution (0.1 mL/kg). Each dog was infested with 50 (25 female, 25 male) adult R. sanguineus s.l. and 100 adult C. felis 2 days before treatment, 5 and 28 days after treatment, and then once monthly for a 12-month period. Live tick and flea counts were performed 48 h after treatment or subsequent infestation, respectively. Efficacy was determined by comparing arithmetic means of the treatment group tick and flea counts with those of the control group. Infestation was considered adequate if at least 25.0% of ticks and 40.0% of fleas were recovered from at least six dogs in the control group at the respective assessment times. Results Adequate R. sanguineus s.l. and C. felis infestations of control group dogs were observed at each time point. Arithmetic mean treatment group values were significantly lower than those of the control group at all time points. The immediate efficacy when treating existing infestations of R. sanguineus s.l. and C. felis (infestation 2 days before treatment), was 49.7% and 89.7%, respectively. The persistent efficacy against post-treatment re-infestations was 94.4–100% against R. sanguineus s.l. and 92.2–100% against C. felis. Seven dogs in the control group developed flea allergy dermatitis due to the repeated re-infestations over the study period, whereas no dogs in the treatment group were affected. No clinically relevant side effects were observed over the entire study period. Conclusions The fluralaner injectable suspension (Bravecto® injectable) provides 1 year of efficacy against R. sanguineus s.l. and C. felis infestations in dogs following a single treatment, allowing once-yearly treatment, which can significantly improve owner compliance with year-round protection of dogs. Graphical Abstract

Abstract Introduction People who inject drugs (PWID) are a key population at risk of HIV in Iran. We measured the prevalence and covariates of HIV-related risk behaviours among PWID in Iran. Methods We conducted a respondent-driven bio-behavioural surveillance survey among PWID from July 2019 to March 2020 in 11 major cities. We assessed PWID’s recent (i.e., last three months) HIV-related risk behaviours using a four-level categorical variable: Only unsafe injection (i.e., sharing needles/syringes or injecting equipment), only unsafe sex (i.e., unprotected sex), dual HIV risk (i.e., both unsafe injection and unprotected sex), and safe injection and sex. Data were summarized using RDS-weighted analysis. Multinomial logistic regression models were built to characterize HIV-related risk behaviours and relative risk ratio (RRR) with 95% confidence interval (CI) were reported. Results Overall, 2562 men who inject drugs (MWID) were included in the regression analysis. The RDS-weighted prevalence of dual HIV risk was 1.3% (95% CI: 0.8, 1.9), only unsafe injection was 4.5%, and only unsafe sex was 11.8%. Compared to the safe injection and sex group, dual HIV risk was significantly and positively associated with multiple partnership (RRR = 15.06; 3.30, 68.73). Only unsafe injection was significantly associated with homelessness in the last 12 months (RRR: 3.02; 95% CI: 1.34, 6.80). Only unsafe sex was significantly associated with multiple partnership (RRR = 6.66; 4.27, 10.38), receiving free condoms (RRR = 1.71; 1.01, 2.89), receiving free needles (RRR = 2.18; 1.22, 3.90), and self-received risk for HIV (RRR = 2.51; 1.36, 4.66). Moreover, history of HIV-testing in the last three months was significantly associated with only unsafe injection (RRR = 2.71; 1.84, 3.80). Among the 90 women who injected drugs, none reported dual HIV risk behaviours. Discussion and conclusions While the low prevalence of dual HIV risk among PWID is encouraging, unprotected sexual practices among PWID is concerning. Expanding sexual health education and care services as well as tailored interventions aimed at reducing high-risk sexual activities among PWID are warranted. Additionally, tackling potential misperceptions about risk of HIV transmission among PWID in Iran is warranted.

Abstract Background Besides the high prevalence of HIV and HCV infections, people who inject drugs (PWID) have a cumulative risk of acquiring skin and soft tissue infections (SSTI) from, among other things, social precariousness, homelessness/unstable housing, and unhygienic injecting practices. We propose to evaluate whether a two-component educational hand hygiene intervention which combines training in hand-washing with the supply of a single-use alcohol-based hand rub, called MONO-RUB, is effective in reducing injection-related abscesses in the PWID population. Specifically, we shall implement a nationwide, two-arm, multi-centre, cluster randomised controlled trial to evaluate the effectiveness and cost-effectiveness of this intervention in PWID. Methods HAWA is a community-based participatory research study to be conducted in 22 harm reduction centres (HR) in France (not yet recruiting); the latter will be randomised into two clusters: centres providing standard HR services and the intervention (i.e., intervention group) and those providing standard HR services only (i.e., control group). After randomization, each cluster will include 220 PWID, with an inclusion period of 12 months and an individual follow-up period of 6 months. For each participant, we will collect data at M0, M3 and M6 from photos of injection sites on the participant’s body, a face-to-face injection-related SSTI questionnaire, and a CATI questionnaire. The primary outcome is the reduction in abscess prevalence between M0 and M6, which will be compared between the control and intervention arms, and measured from observed (photographs) and self-declared (SSTI questionnaire) data. We will also assess the cost-effectiveness of the intervention. Discussion The HAWA trial will be the first cluster randomized controlled trial to improve hand hygiene among PWID with a view to reducing SSTI. If effective and cost-effective, the intervention combined with the distribution of MONO-RUBs (or a similar cleaning product) may prove to be an important HR tool, helping to reduce the enormous burden of infection-related deaths and diseases in PWID. Trial Registration NCT06131788, received on 2 January 2024.

Aims: Steroid injections are used for subacromial pain syndrome and can be administered via the anterolateral or posterior approach to the subacromial space. It is not currently known which approach is superior in terms of improving clinical symptoms and function. This is the protocol for a randomized controlled trial (RCT) to compare the clinical effectiveness of a steroid injection given via the anterolateral or the posterior approach to the subacromial space. Methods: The Subacromial Approach Injection Trial (SAInT) study is a single-centre, parallel, two-arm RCT. Participants will be allocated on a 1:1 basis to a subacromial steroid injection via either the anterolateral or the posterior approach to the subacromial space. Participants in both trial arms will then receive physiotherapy as standard of care for subacromial pain syndrome. The primary analysis will compare the change in Oxford Shoulder Score (OSS) at three months after injection. Secondary outcomes include the change in OSS at six and 12 months, as well as the Pain Numeric Rating Scale (0 = no pain, 10 = worst pain), Disabilities of Arm, Shoulder and Hand questionnaire (DASH), and 36-Item Short-Form Health Survey (SF-36) (RAND) at three months, six months, and one year after injection. Assessment of pain experienced during the injection will also be determined. A minimum of 86 patients will be recruited to obtain an 80% power to detect a minimally important difference of six points on the OSS change between the groups at three months after injection. Conclusion: The results of this trial will demonstrate if there is a difference in shoulder pain and function after a subacromial space steroid injection between the anterolateral versus posterior approach in patients with subacromial pain syndrome. This will help to guide treatment for patients with subacromial pain syndrome. Cite this article: Bone Jt Open 2024;5(9):729–735.

Background: Nail psoriasis remains a challenging condition with limited satisfaction from current treatments. An increasing number of neuropeptides were reported in psoriatic tissue. Objective: To compare the efficacy of botulinum toxin A (BoNT-A) injection, triamcinolone acetonide (TA) injection, topical combination of vitamin D/steroid (VitD/steroid) and placebo in improving nail psoriasis. Methods: A 24-week randomized intraindividual comparative-controlled study involved participants with at least 4 psoriatic fingernails, each with a total target nail psoriasis severity index (NAPSI) score of at least 3 points. Nails were randomly received different treatments; intralesional BoNT-A injection at baseline, intralesional TA at baseline and eighth week, daily topical VitD/steroid application for 16 weeks and placebo. Results: Evaluation of 64 psoriatic fingernails showed a 40% reduction in the total target NAPSI score at 24 weeks following BoNT-A injection (P = .001). BoNT-A significantly improved nail bed lesions more than TA and topical VitD/steroid (P = .038), with no reported serious adverse effects. Limitations: Relatively small sample size; hand hygiene during the COVID-19 pandemic may interfere NAPSI score evaluation. Conclusions: BoNT-A injection emerges as a promising and effective therapy for nail psoriasis, providing sustained efficacy lasting up to 6 months with a single injection.

This study is important for the fields of pharmaceutical nano-drug suspension, biomedical engineering, pressure surges and food processing systems. The slip condition is necessary for polishing internal cavities and artificial heart valves in a variety of manufactured objects, micro- or nano-channels, and applications. Low Reynolds number (Re → 0) and long wavelength (δ ≪ 1) considerations are used in the formulation of the mathematical model at low non-Newtonian parameter values, nonlinear boundary conditions and the governing nonlinear equation are analytically solved using the perturbation method. The graphs of frictional force, pressure rise, velocity, pressure gradient, and streamline graphs are done using Wolfram MATHEMATICA software. In this paper, we compared the results of the total slip condition with those of the first-order slip condition and the absence of any slip effects. It has been noticed that increasing the suction and injection parameters leads to a decrease the pressure rate with complete slip effects, partial slip effects and no slip effects. We show that an increase in the third grade fluid parameter Γ increases the magnitude of axial velocity. From a physical perspective, it shows the shear thinning characteristic, which causes a decrease in viscosity and an increase in fluid velocity. Frictional force behaves differently when compared to pressure rate. In other words, the pressure gradient acts as an obstacle to the peristalsis-driven flow. The objective of the study is to find the impact of the peristaltic flow phenomena and the impact of peristaltic on third-grade non-Newtonian fluid where the suction and injection are prevailing which is similar to the thing in biomechanical devices, like blood vessels, etc. there is a change of oxygen and carbon dioxide from the tissue layer to the fluid within the blood vessel. [ABSTRACT FROM AUTHOR]

Contracture and thickening of the coracohumeral ligament (CHL) occur in patients with adhesive capsulitis. This adversely affects the movement and function of the shoulder joint. There is limited evidence that explores the effectiveness of an isolated steroid injection into the CHL in combination with physical therapy. This prospective randomized control trial aimed to evaluate the clinical effects of ultrasonography-guided corticosteroid injection compared to a sham injection into the CHL in subjects with adhesive capsulitis. Forty patients (23 males, 52.2 ± 8 years of age) with unilateral adhesive capsulitis (with 5.4 ± 2 months' mean duration of symptoms) were randomly assigned to either the experimental or control group. Both groups received ultrasonography-guided injections into the CHL. The experimental group (n = 20) received corticosteroids and the control group (n = 20) received a sham lidocaine injection. All subjects underwent supervised conventional physical therapy 3 times a week for 3 months. Subjects were evaluated for improvements in pain, range of motion, and disability at 6 and 12 weeks compared with preinjection baseline measurements. Data were compared statistically across groups and times at P <.05. The CHL thickness was compared at baseline across sides using paired t tests. The experimental group showed statistically greater improvements in pain, functional scores, flexion, abduction, and internal and external rotation range of motion at 12 weeks compared with the control group. Pain reduction was observed in both groups at 6 and 12 weeks, but the experimental group exhibited significantly greater reductions. The CHL was significantly thicker on the affected side than on the unaffected side (P <.001). This study partially supported the hypothesis. Notably, significant improvements in pain, range of motion, and functional scores were observed at 12 weeks in the experimental group. The greater improvements in pain and external rotation may have resulted in lower disability scores in the experimental group. The results emphasize the importance of targeted intervention into the CHL. [ABSTRACT FROM AUTHOR]

Corticosteroid injections (CSIs) are commonly used for the treatment of shoulder pain in patients with osteoarthritis and rotator cuff arthropathy. These injections may increase the risk of infection following eventual shoulder arthroplasty. The purpose of this study was to perform a systematic review and meta-analysis of existing data to explore the relationship between preoperative CSI's and postoperative periprosthetic joint infection (PJI) following shoulder arthroplasty. A literature search was performed on PubMed, Embase, and Web of Science databases through September 29, 2023. Of the 4221 retrieved, 7 studies including 136,233 patients were included for qualitative analysis. Studies describing patients receiving CSI prior to shoulder arthroplasty and the effect on postoperative infection risk were included in the systematic review and subsequent meta-analysis. Assessment of risk of bias was performed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Receiving a CSI prior to shoulder arthroplasty was found to have a statistically significant association with increased risk for PJI (odds ratio [OR]: 1.13; 95% confidence interval [CI]: 1.06-1.19; P <.0001). The rate of PJI increased when injections were given closer to the time of surgery. Patients who received an injection at any time point before surgery had a 5.4% risk of PJI compared to 7.9% and 9.0% in patients receiving an injection within 3 months and 1 month of surgery, respectively. This time dependent association however did not reach statistical significance: 1 month OR 1.48; 95% Cl: 0.86-2.53; P =.16, 3 months OR 1.95; 95% Cl: 0.95-4.00; P =.07. The results of this systematic review and meta-analysis demonstrate that patients receiving corticosteroid shoulder injections prior to shoulder arthroplasty may be at an increased risk for PJI postoperatively. While time dependent stratification did not reach statistical significance, our findings indicate a clear trend of increased risk for patients receiving injections closer to surgery. [ABSTRACT FROM AUTHOR]

Aims: The primary aim of this study was to assess the feasibility of recruiting and retaining patients to a patient-blinded randomized controlled trial comparing corticosteroid injection (CSI) to autologous protein solution (APS) injection for the treatment of subacromial shoulder pain in a community care setting. The study focused on recruitment rates and retention of participants throughout, and collected data on the interventions’ safety and efficacy. Methods: Participants were recruited from two community musculoskeletal treatment centres in the UK. Patients were eligible if aged 18 years or older, and had a clinical diagnosis of subacromial impingement syndrome which the treating clinician thought was suitable for treatment with a subacromial injection. Consenting patients were randomly allocated 1:1 to a patient-blinded subacromial injection of CSI (standard care) or APS. The primary outcome measures of this study relate to rates of recruitment, retention, and compliance with intervention and follow-up to determine feasibility. Secondary outcome measures relate to the safety and efficacy of the interventions. Results: A total of 53 patients were deemed eligible, and 50 patients (94%) recruited between April 2022 and October 2022. Overall, 49 patients (98%) complied with treatment. Outcome data were collected in 100% of participants at three months and 94% at six months. There were no significant adverse events. Both groups demonstrated improvement in patient-reported outcome measures over the six-month period. Conclusion: Our study shows that it is feasible to recruit to a patient-blinded randomized controlled trial comparing APS and CSI for subacromial pain in terms of clinical outcomes and health-resource use in the UK. Safety and efficacy data are presented. Cite this article: Bone Jt Open 2024;5(7):534–542.

Abstract Introduction Anti-vascular endothelial growth factor (VEGF) agents have been the standard treatment for retinal diseases for almost two decades. These treatments are administered via intravitreal injection using single-use vials or prefilled syringes (PFS). In this systematic review, we evaluate health care resource use and clinical outcomes and experiences with PFS for intravitreal injection of anti-VEGF treatments. Methods MEDLINE, EMBASE, and The Cochrane Library were searched from January 1, 2015 to February 8, 2024 to identify literature reporting outcomes regarding procedural efficiency, health care resource use, patient and clinician experiences, and safety for currently approved anti-VEGFs (ranibizumab, aflibercept, brolucizumab) administered using PFS. Comparators were vial-based injections of the same anti-VEGFs. Results A total of 36 publications met the criteria for inclusion in the systematic literature review; the majority were non-randomized studies, with a small number of reviews, case series, survey studies, and opinion articles. Publications reported that preparation times were significantly shorter for PFS (40.3–57.9 s) versus vials (ranibizumab, 62.8–98.0 s; aflibercept, 71.9–79.5 s), with no differences in product stability between PFS and vials. Clinicians expressed a preference for PFS and thought PFS were faster, easier to use, and had increased safety versus vials. Publications consistently reported significantly lower rates of endophthalmitis per injection with PFS versus vials (ranibizumab PFS, 0–0.02%; aflibercept PFS, 0.01–0.02%; ranibizumab vial, 0.02–0.05%; aflibercept vial, 0.02–0.06%). Four publications reported increased rates of transient vision loss after aflibercept PFS injection versus vial-based injection. No publications reported outcomes regarding health care resource use or patient experiences. Conclusion The available literature supports the increased procedural efficiency of PFS versus vial-based intravitreal injection of anti-VEGFs. PFS are positively perceived by clinicians and have a safety benefit in the form of a decreased risk of endophthalmitis versus vials.

Abstract Background Corticosteroid injections are commonly used for the treatment of plantar fasciitis. In recent years, ultrasound-guided multipuncture treatment of the fascia has been described in the literature. Our study aimed to compare the effectiveness of these two techniques in the treatment of plantar fasciitis. Methods The outcomes achieved over 120 days following the use of these techniques to treat plantar fasciitis were examined. A total of 81 patients were randomly selected for the study; 41 were treated with ultrasound-guided multipuncture and 40 with ultrasound-guided corticosteroid injection. Clinical examinations and ultrasound assessments were performed before treatment and at 30, 60 and 120 days post-treatment. Clinical assessments included the use of a visual analog scale (VAS) to record pain and the Foot Function Index (FFI) to evaluate function. Ultrasound was used to measure the thickness of the plantar fascia. Results Both the ultrasound-guided multipuncture and corticosteroid injection techniques were associated with significant functional and echographic improvements at 4 months post-treatment (P

Abstract Trigger finger (TF) is a disorder characterized by snapping or locking a finger. It has a prevalence of greater than 3% in the general population; however, this estimate could be increased to 5% up to 20% in diabetic patients. Some unreal ambiguity about definition, pathophysiology, site of lesion, and etiology are found among researchers and clinicians, leading to a lack of understanding of all aspects of the disease and improper management as many clinicians proceed to anti-inflammatory medications or steroids injection without in-depth patient evaluation. Original articles cited up to 2022, found through a Google search using the specified keywords, have been used in this review. Close-access articles were accessed through our researcher account with the Egyptian Knowledge Bank. In this review, we will focus on pathophysiology to present all possible findings and etiology to represent all risk factors and associated diseases to assess and confirm a diagnosis and the exact location of pathology hence better treatment modalities and reducing the recurrence of the pathology.

Min Cheol Chang,1 Seoyon Yang2 1Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea; 2Department of Rehabilitation Medicine, School of Medicine, Ewha Woman’s University Seoul Hospital, Seoul, Republic of KoreaCorrespondence: Seoyon Yang, Department of Rehabilitation Medicine, School of Medicine, Ewha Woman’s University Seoul Hospital, 260 Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea, Tel +82-10-2787-2052, Fax +82-50-4225-2052, Email seoyonyang@gmail.comObjective: Bone single-photon emission computed tomography (SPECT) preferentially localizes areas exhibiting greater bone remodeling and enhanced perfusion, which helps identify areas of pain and inflammation in the lumbar facet joints (LFJs). Herein, we investigated the treatment outcome of intraarticular (IA) corticosteroid injection in patients with LFJ-origin lower back pain (LBP) depending on the presence of increased LFJ uptake on bone SPECT.Methods: We retrospectively recruited 38 patients with LFJ-origin LBP. Of the 38 patients, 22 patients showed increased uptake on bone SPECT (SPECT+ group), and 16 patients did not show increased uptake on bone SPECT (SPECT- group). A numeric rating scale (NRS) was used to assess pain reduction 1 month after treatment with a corticosteroid injection. Treatment was considered successful when the posttreatment NRS score was ≥ 50% lower than the pretreatment NRS score.Results: The NRS scores of the SPECT+ group at the 1-month follow-up were significantly lower than those of the SPECT- group. Additionally, the degree of change in the NRS scores was larger in the SPECT+ group than that in the SPECT- group. In addition, 18 of the 22 patients (81.8%) in the SPECT+ group underwent successful treatment. Eight of the 16 patients (50%) in the SPECT- group underwent successful treatment. The ratio of successful treatment was significantly higher in the SPECT+ group than in the SPECT- group.Discussion: Bone SPECT could help predict the therapeutic outcome after IA LFJ corticosteroid injection and determine the treatment plan for patients with LFJ-origin LBP.Keywords: facet joint, lumbar spine, corticosteroid, injection, single-photon emission computed tomography, pain

The experiment was conducted for the period from (9/16/2023 to 11/18/2023), with the aim of studying the effect of injecting eggs with different levels of organic selenium and spirulina algae extract on the hatchability characteristics, productive performance of broiler chickens. The experiment of injection and hatching of chicks was conducted in the Lailani hatchery located in the Lailan area. (600) hybrid eggs (Ross 308) from a flock of 33-week-old mothers imported from Republic of Turkey were used, with average egg weight 58 g. They were randomly distributed among (6) treatments with (100) eggs for each treatment and placed in BROODTECH incubator drawers until the age of (18 days), after which the eggs were injected and the drawers were transferred to the hatchery until the chicks emerged at the age of (21 days), which were: T1 = no negative control injection, T2 = injection of 0.5 ml of deionized distilled water per egg (positive control), T3 = injection of 0.5 ml/egg containing a concentration of 10 micrograms of organic selenium, T4 = 0.5 ml/egg injection containing a concentration of 20 micrograms of organic selenium, T5 = 0.5 ml/egg injection containing 1.5 mg of spirulina algae extract, T6= 0.5 ml/egg injection containing 3 mg of spirulina algae extract. The data were subjected to statistical analysis by applying one-way ANOVA using SAS software. Differences between treatments were tested using Duncan's multiple comparison test, at a significance level of P ≤0. 05. The study conducted that inject the egg with organic selenium were enhance the bird weight and the weight gain, moreover, the both of organic selenium and the spirulina extract affected significantly on the hatching rate, feed intake and FCR.

Purpose: Knee osteoarthritis (KOA) is a very common cartilage disorder affecting millions of people globally and is characterized by pain, stiffness, swelling, loss of articular cartilage, and osteophyte formation, resulting in disability. The presently available treatments for KOA are palliative. Hence, there is a need to explore a non-surgical treatment portfolio. Bone marrow aspirate concentrate (BMAC) is one of the predominant attention-drawing managements/treatments for KOA in recent times due to its potential advantages of disease-modifying and regeneration capacities. Principle: This study aimed to evaluate the role of single-injection autologous BMAC as a therapeutic option in the treatment of KOA and evaluate the functional and clinical outcomes of KOA patients. In this study, 132 patients with KOA (Kellgren and Lawrence (KL) grade II and III) were included as per the inclusion criteria. Autologous bone marrow was aspirated and separated, and concentrated bone marrow aspirate was administered into the knee joint of the affected individual. Results: At the end of the 12th month (end of the follow-up period), 95% of patients showed complete pain relief and improvement in joint function, which shows that the results were promising and encouraging. Unpaired t-test results also indicated that the two-tailed p-value is less than 0.0001, and the difference is extremely statistically significant. No adverse effects were observed in the study patients. Conclusions: BMAC therapy has potential, with satisfactory, efficient, and durable results in KL grades II and III in KOA patients. This can be a safe alternative therapy in the treatment of KOA, especially in the early grades of OA. In summary, to the best of our knowledge, this is the first study from India that evaluated BMAC efficacy both subjectively and objectively in KOA (KL-II and KL-III) patients.

In this work the mechanism of current flow during illumination with hν≥Eg in the temperature range of 77÷300 K is considered. It is established that in the PtSi – Si-M structure in the temperature range of 77÷270 K the regime of space charge limited currents (SCLC) is realized. The current-voltage characteristics of the structures show areas of linear and quadratic dependences of current on voltage, as well as areas of a sharp increase in current. These features of the current-voltage characteristic are explained by the presence of deep level structures and sticking levels for charge carriers in the base region. From the temperature dependence of the SCLC, the concentration of adhesion levels was determined to be equal to (1.8÷3) 1015 cm-3 and the adhesion factor to be equal to 6.32·10-2. In the temperature range 77÷115 K at voltages 0.2÷1 V, the current-voltage characteristic obeys the law J ~ Un(n=3÷4), and above U – the law J ~ U6, followed by a transition to the quadratic law.

This study aimed to investigate the utility of intensive triamcinolone acetonide (TA) injections after extensive esophageal endoscopic submucosal dissection (ESD). This retrospective study included 27 lesions in 27 consecutive patients who underwent ESD (ulcers encompassing ≥3/4 of the esophageal circumference) and received TA injections without oral steroid administration. Groups A and B included patients undergoing ESD with and without complete circumferential resection, respectively. All patients received TA injections (100 mg/session) immediately after ESD. In Group A, weekly based TA injections were performed until near-complete ulcer epithelialization. In Group B, patients did not receive additional injections or received weekly or biweekly TA injections. The primary outcome was stricture rate, and the secondary outcomes were the proportion of patients requiring endoscopic balloon dilation (EBD) and the number of TA injections. Group A included 7 lesions, and Group B included 20 lesions. The median (range) tumor lengths were 40 (30–90) and 45 (30–110) mm in Groups A and B, respectively. In Group A, the median circumferential resection diameter was 40 (20–80) mm. The stricture rate and the proportion of patients requiring EBD were 0 (0%) in Group A and 1 (5.0%) in Group B. The number of TA injection sessions was significantly higher in Group A than in Group B (8 [5–25] vs 1.5 [1–3]; p < 0.001). Intensive weekly or biweekly based TA injections might aid in preventing post-ESD stricture and the need for EBD in patients undergoing extensive resection involving the entire esophageal circumference. [ABSTRACT FROM AUTHOR]