Purpose: Intrathecal dexmedetomidine (DEX) has been used to improve the quality and duration of spinal anesthesia. The aim of this meta-analysis is to evaluate whether intrathecal DEX could prolong the duration of sensory and motor block during spinal anesthesia. Methods: We searched PubMed, EMBASE, Web of Science, and the Cochrane Library for randomized controlled trials that investigated the facilitatory effects of intrathecal administration of DEX compared with those of a placebo on spinal anesthesia from inception to April 2019. Sensory and motor block durations, sensory and motor block onset times, time to first analgesic request, and DEXrelated adverse effects were evaluated. Results were combined using fixed-effects or random effects modeling when appropriate. Findings: A total of 1478 patients from 25 clinical studies were included in the analysis. Compared with placebo, intrathecal DEX significantly prolonged the durations of both sensory block (weighted mean difference [WMD] ¼ 134.42 min; 95% CI, 109.71e159.13 min; P < 0.001) and motor block (WMD ¼ 114.27 min; 95% CI, 93.18e135.35 min; P < 0.001). It also hastened the onset of sensory block (WMD ¼ −0.80 min; 95% CI, −1.21 to −0.40; P < 0.001) and motor block (WMD ¼ −1.03 min; 95% CI, −1.51 to −0.56 min; P < 0.001). Furthermore, it delayed the time to first analgesic request (WMD ¼ 216.90 min; 95% CI, 178.90e254.90 min; P < 0.001) and reduced the incidence of shivering (risk ratio [RR] ¼ 0.39; 95% CI, 0.27e0.55; P < 0.001). DEX was associated with increased risk of transient bradycardia (RR ¼ 1.59; 95% CI, 1.07e2.37; P ¼ 0.022) and hypotension (RR ¼ 1.40; 95% CI, 1.04e1.89; P ¼ 0.026) but did not increase the incidence of postoperative nausea and vomiting (RR ¼ 0.87; 95% CI, 0.62e1.24; P ¼ 0.45). Implications: Intrathecal DEX can prolong the duration of sensory block, the duration of motor block, and the time to first analgesic request associated with spinal anesthesia.

Background: Patients with cancer are at increased risk of severe outcomes from COVID-19. Understanding the impact of SARS-CoV-2 infection and vaccination induced-immunity is an area of unmet need.Methods: CAPTURE (NCT03226886) is a prospective longitudinal cohort study of COVID-19 vaccine or SARS-CoV-2 infection-induced immunity. SARS-CoV-2 infections were confirmed by RT-PCR and ELISA. Neutralising antibody titres (NAbT) against wildtype (WT) SARS-CoV-2 and variants of concern (VOC; Alpha, Beta, Delta) and SARS-CoV-2 specific T-cells (SsT-cells) were quantified.Results: 118 patients (89% solid malignancy, [SM]) were SARS-CoV-2-positive (median follow-up: 154 days). 85% patients were symptomatic; 2 died of COVID-19. 82% had S1-reactive antibodies, of whom 89% had neutralising antibodies (NAbs); NAbT were lower against all VOCs. While S1-reactive antibody levels declined over time, NAbT remained stable up to 329 days. Most patients had detectable SsT-cells (76% CD4+, 52% CD8+). Haematological malignancy (HM) patients had impaired immune responses that were disease and treatment-specific (anti-CD20), but with evidence suggestive of compensation from T-cells. 585 patients were evaluated following 2 doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after 2 doses were 85% and 54% in patients with SM and HM, respectively. A lower proportion of patients had detectable NAbs against SARS-CoV-2 VOC (Alpha 62%, Beta 54%, Delta 49%) vs WT (84%), with corresponding significantly lower NAbT. Patients with HM were more likely to have an undetectable NAb and had lower NAbT vs solid malignancies to both WT and VOCs. Seroconversion showed poor concordance with NAbTs against VOCs. Prior SARS-CoV-2 infection boosted NAbT including against VOCs. Anti-CD20 treatment was associated with severely diminished NAbTs. Vaccine-induced T-cell responses were detected in 80% of patients, with no differences between vaccines or cancer types.Conclusions: Patients with HM had blunted humoural responses to infection and vaccination, particularly against VOCs, but preserved cellular responses might contribute to protection. Our results lend support to prioritisation of all cancer patients for further booster vaccination.Clinical trial identification: NCT03226886.

AbstractThe intelligent poly N,N-dimethylacrylamide hydrogel material system with high mechanical strength and the 3D printable property was prepared via in situ free radical polymerization under vacuum successfully. With the increase in nanofibrillated cellulose (NFC) content, stress and strain of hydrogels increased gradually. As the effective reinforcement, NFC enhanced the crosslinking density, which realized the controllable regulation of rheology behaviors including viscosity, storage modulus, and loss modulus of hydrogels. Combined with the swelling rate and the existence of the gel–sol transition point, a hydrogel with 10 mg/mL NFC was treated as the 3D printing ink of hydrogel actuators. Variation of printing parameters significantly affected self-driven deformations. The hydrogel actuators with 90°/0° and 45°/135° configurations owned bending and spiral deformations, respectively. Actuators with a larger length–width ratio owned a lower pitch value. The precise anisotropic swelling property of the printed bilayer structure was the self-driven deformation mechanism of hydrogel actuators, which provided material candidates for the preparation of soft robots and actuators.

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Background Dietary guidelines typically recommend limiting the intake of fresh red meat, yet evidence linking red meat consumption with adverse health outcomes is inconsistent. Objective To assess the level of evidence from existing systematic reviews and meta-analyses and analyze the association between high consumption of red meat and cancer risk and adverse health outcomes. Methods Eight databases were searched to collect systematic reviews and meta-analyses from database inception to December 2022. Two independent reviewers screened and extracted data and used the AMSTAR 2 tool to evaluate methodological quality of the included studies. Meta-analysis was conducted using STATA 17.0. Results A total of 18 studies were included, of which 5 were rated as high quality, 4 as medium quality, 6 as low quality, and 3 as extremely low quality. Of the 9 SRs/MAs included, primary studies with overlap were identified, and 14 studies were eventually included. The meta-analysis results showed that compared with the lowest intake of red meat, the highest intake of red meat was associated with an increased risk of colorectal cancer (OR 1.21, 95% CI 1.07-1.37), gastric cancer (OR 1.37, 95% CI 1.18-1.59), non-Hodgkin&#039;s lymphoma (OR 1.10.95% CI 1.02-1.19), stroke (RR 1.11, 95% CI 1.03-1.20), type 2 diabetes (RR 1.19 95% CI 1.04-1.37), and ischemic heart disease (RR 1.09, 95% CI 1.06-1.12), as well as a negative effect on total cholesterol (WMD 0.264, 95% CI 0.144-0.383), triglycerides (WMD -0.181, 95% CI -0.349 to -0.013), low-density lipoprotein (WMD 0.198, 95% CI 0.065-0.330), and high-density lipoprotein (WMD -0.065, 95% CI -0.109 to -0.020). However, the associations with breast cancer (RR 1.05 95% CI 1.00-1.11), glycemic control (WMD 0.040, 95% CI 0.049-0.129), and changes in body weight status [overweight (β 0.89, 95% CI 0.48-1.64); obesity (β 1.06, 95% CI 0.30-3.71)] were not significant. Conclusions This comprehensive umbrella review suggests that high consumption of red meat may increase the risk of colorectal cancer, gastric cancer, non-Hodgkin lymphoma, stroke, type 2 diabetes, and cardiovascular disease, and that reducing red meat intake is a key modifiable dietary factor for reducing risk. However, there was no significant correlation with breast cancer, kidney stones, age-related eye disease or changes in body weight.