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<b> Neuropathic pain induction</b>
<br>
<br>
<!-- Select Basic --><div class="form-group"><label class="col-md-4 control-label" for="selectbasic"><b>1.</b> Procedure label: What is the type of neuropathic pain model? </label>
<div class="col-md-4"><select id="selectbasic" name="selectbasic" class="form-control">
<option value="1">SNI/Spared Nerve Injury- Decosterd_Woolf_2000</option>
<option value="2">PSL or PSNL/ Partial Sciatic Nerve Ligation</option>
<option value="3">CCI/Chronic Constriction Injury (all variants)</option>
</select><em><span class="help-block">List the disease or injury that is being modelled; Provide a label to uniquely identify a disease model induction procedure within the study </span></em></div>
</div><br>
<!-- Select Basic -->
<div class="form-group"><label class="col-md-4 control-label" for="selectbasic"><b>2.</b> Was one of the following anaesthetics used? </label>
<div class="col-md-4"><select id="selectbasic" name="selectbasic" class="form-control">
<option value="1">Isoflurane</option>
<option value="2">KetamineL</option>
<option value="3">Ketamine/Xylazine</option>
<option value="4">Others</option>
<option value="5">Not reported</option>
</select>
</div>
</div
<!-- Text input-->
<ul style="list-style-type:NONE"><li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>2.1</b> If others, please specify the substance from the study text</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <em><span class="help-block"></span></em></div>
</div></li></ul>
<br>
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<div class="form-group"><label class="col-md-4 control-label" for="radios"><b>3.</b> Was pre-operative analgesia administered?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label> <em><span class="help-block"> </span></em></div>
</div>
<!-- Text input-->
<ul style = "list-style-type:NONE">
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>3.1</b> If yes, which analgesic drug was used?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <em><span class="help-block">Please specify the substance from the study text </span></em></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>3.2</b> If yes, at which dosage (in mg/kg bodyweight) was the analgesic administered?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>3.3</b> If yes, how many times was the analgesic drug administered?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Multiple Radios (inline) -->
<li><div class="form-group"><label class="col-md-4 control-label" for="radios"><b>3.4</b> If yes, which drug application route was used?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> i.p. </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> i.v. </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> s.c. </label> <label class="radio-inline" for="radios-3"> <input type="radio" name="radios" id="radios-3" value="4" /> i.t. </label> <label class="radio-inline" for="radios-4"> <input type="radio" name="radios" id="radios-4" value="5" /> Others </label></div>
</div></li>
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<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>3.5</b> If others, please specify the route from the study text</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <em><span class="help-block">Please specify the route from the study text </span></em></div>
</div></li>
</ul>
<br>
<div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>4.</b> Was peri-operative analgesia administered?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label> <em><span class="help-block"> </span></em></div>
</div></li>
<ul style="list-style-type:NONE">
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>4.1</b> If yes, Which analgesic drug was used?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <em><span class="help-block">Please specify the substance from the study text </span></em></div>
</div></li>
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<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>4.2</b> If yes, at which dosage (in mg/kg bodyweight) was the analgesic administered?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>4.3</b> If yes, How many times was the analgesic drug administered?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Multiple Radios (inline) -->
<li><div class="form-group"><label class="col-md-4 control-label" for="radios"><b>4.4</b> If yes, Which drug application route was used?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> i.p. </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> i.v. </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> s.c. </label> <label class="radio-inline" for="radios-3"> <input type="radio" name="radios" id="radios-3" value="4" /> i.t. </label> <label class="radio-inline" for="radios-4"> <input type="radio" name="radios" id="radios-4" value="5" /> Others </label></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>4.5</b> If others, please specify the route from the study text</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /></div>
</div></li></ul>
<br>
<!-- Multiple Radios (inline) -->
<div class="form-group"><label class="col-md-4 control-label" for="radios"><b>5.</b> Was post-operative analgesia administered?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label> </div>
</div>
<ul style="list-style-type:NONE">
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput">
<b>5.1</b> If yes, What analgesic drug was used?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <em><span class="help-block">Please specify the substance from the study text </span></em></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>5.2</b> If yes, at which dosage (in mg/kg bodyweight) was the analgesic administered?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>5.3</b> If yes, How many times was the analgesic drug administered?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Multiple Radios (inline) -->
<li><div class="form-group"><label class="col-md-4 control-label" for="radios"><b>5.4</b> If yes, Which drug application route was used?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> i.p. </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> i.v. </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> s.c. </label> <label class="radio-inline" for="radios-3"> <input type="radio" name="radios" id="radios-3" value="4" /> i.t. </label> <label class="radio-inline" for="radios-4"> <input type="radio" name="radios" id="radios-4" value="5" /> Others </label></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>5.5</b> If others, please specify the route from the study text</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <em><span class="help-block">Please specify the route from the study text </span></em></div>
</div></li>
</ul>
<br>
<!-- Multiple Radios (inline) -->
<div class="form-group"><label class="col-md-4 control-label" for="radios"><b>6.</b> Was antibiotica administered peri-operatively or post-operatively?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label> <em><span class="help-block"></span></em></div>
</div>
<ul style="list-style-type:NONE">
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>6.1</b> If yes, Which antibiotica was used?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <em><span class="help-block">Please specify the anitbiotica from the study text </span></em></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>6.2</b> If yes, at which dosage (in mg/kg bodyweight) was the analgesic administered?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>6.3</b> If yes, How many times was the antibiotica administered?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Multiple Radios (inline) -->
<li><div class="form-group"><label class="col-md-4 control-label" for="radios"><b>6.4</b> If yes, Which application route was used?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> i.p. </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> i.v. </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> s.c. </label> <label class="radio-inline" for="radios-3"> <input type="radio" name="radios" id="radios-3" value="4" /> i.t. </label> <label class="radio-inline" for="radios-4"> <input type="radio" name="radios" id="radios-4" value="5" /> Others </label></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>6.5</b> If others, please specify the route from the study text</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <em><span class="help-block">Please specify the route from the study text </span></em></div>
</div></li>
</ul>
<br>
<!-- Multiple Radios (inline) -->
<div class="form-group"><label class="col-md-4 control-label" for="radios"><b>7.</b> Did the authors specify how many ligations were made in the CCI model?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label> <em><span class="help-block">The number does not matter. </span></em></div>
</div>
<ul style="list-style-type:NONE">
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>7.1</b> If yes, How many ligatures were added to the CCI model?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
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<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>7.2</b> If yes, which material was used for the ligatures?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
</ul>
<!-- Multiple Radios (inline) -->
<br>
<div class="form-group"><label class="col-md-4 control-label" for="radios"><b>8.</b> Was the the skin incision dimension described in cm?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div>
<ul style="list-style-type:NONE">
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>8.1</b> If yes, How long was the skin incision in cm?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" />
</div>
</div>
</li>
</ul>
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<div class="form-group"><label class="col-md-4 control-label" for="radios"><b>9.</b> Was the tissue closure procedure described?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div>
<ul style="list-style-type:NONE">
<!-- Multiple Radios (inline) -->
<li><div class="form-group"><label class="col-md-4 control-label" for="radios"><b>9.1</b> If yes, Was the muscular layer closed?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<ul style="list-style-type:NONE">
<!-- Select Basic -->
<li><div class="form-group"><label class="col-md-4 control-label" for="selectbasic"><b>9.1.1</b> If yes, what suture material was used to close the muscle layer? </label>
<div class="col-md-4"><select id="selectbasic" name="selectbasic" class="form-control">
<option value="1">Resorbable suture</option>
<option value="2">Non-absorbable suture</option>
<option value="3">Others</option>
</select><em><span class="help-block"> </span></em></div>
</div></li>
</ul>
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<li><div class="form-group"><label class="col-md-4 control-label" for="radios"><b>9.2</b> If yes, Was the skin layer closed?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div>
<ul style="list-style-type:NONE">
<!-- Select Basic -->
<li><div class="form-group"><label class="col-md-4 control-label" for="selectbasic"><b>9.2.1</b> If yes, what suture material was used to close the muscle layer? </label>
<div class="col-md-4"><select id="selectbasic" name="selectbasic" class="form-control">
<option value="1">Resorbable suture</option>
<option value="2">Non-absorbable suture</option>
<option value="3">Tissue glue</option>
<option value="4">Staples</option>
<option value="5">Others</option>
</select><em><span class="help-block"> </span></em></div>
</div></li>
</ul>
<br>
</li>
</ul>
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<div class="form-group"><label class="col-md-4 control-label" for="radios"><b>10.</b> Were the skin sutures removed?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div>
<ul style="list-style-type:NONE"><!-- Multiple Radios (inline) -->
<li><div class="form-group"><label class="col-md-4 control-label" for="radios"><b>10.1</b> If yes, were an anaesthic given?</label>
<div class="col-md-4"><label class="radio-inline" for="radios-0"> <input type="radio" name="radios" id="radios-0" value="1" checked="checked" /> Yes </label> <label class="radio-inline" for="radios-1"> <input type="radio" name="radios" id="radios-1" value="2" /> No </label> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<!-- Text input-->
<li><div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>10.2</b> On which postoperative day were the sutures removed?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div></li>
<br>
</ul>
<br>
<!-- Text input-->
<div class="form-group"><label class="col-md-4 control-label" for="textinput"><b>11.</b>How long was the operative experience of the surgeon <b>in months</b>?</label>
<div class="col-md-4"><input id="textinput" name="textinput" type="text" placeholder=" " class="form-control input-md" /> <label class="radio-inline" for="radios-2"> <input type="radio" name="radios" id="radios-2" value="3" /> Not reported </label></div>
</div>
