bluuebunny/crossref_metadata_2025 huggingface dataset:
In Supracondylar Humerus Fractures With Nerve Injury, Does Time to Surgery Impact Recovery?
Authors: Wahlig Brian D. , Sullivan Mikaela H. , Broida Samuel E. , Larson A. Noelle , Shaughnessy William J. , Stans Anthony A. , Grigoriou Emmanouil , Milbrandt Todd A.
Published: October 2024

Background:

Supracondylar humerus (SCH) fractures are common and present with associated nerve injuries in 11% to 42% of cases. Historically, SCH fractures with neurological compromise warranted urgent surgical intervention. A recent study showed that treatment delay is acceptable in patients with isolated anterior interosseous nerve (AIN) injury. Though indications for urgent treatment are relaxing, no studies have evaluated the need for urgent surgical treatment for other nerve injuries associated with SCH fractures. The aim of this study was to determine if the timing of surgical intervention is related to the timing of neurological recovery in SCH fractures associated with any nerve injury.

Methods:

A retrospective review of 64 patients with surgically managed SCH fractures and concomitant neurological deficit on presentation was conducted at a single level 1 pediatric trauma hospital from 1997 to 2022. The relationship between the time to surgical intervention and the time to partial and complete nerve recovery was analyzed using linear regression.

Results:

Sixty-four patients with an average age of 6.9±2.0 years and an average time to surgery of 9.8±5.6 hours were analyzed. Sixty-two patients (97%) were followed to partial neurological recovery and 36 (56%) were followed to full neurological recovery. Neurological deficit included median [n=41 (64%)], radial [n=22 (34%)], and ulnar [n=15 (23%)]. Ten patients (16%) had isolated AIN injury. The average time to partial neurological recovery was 20±23 days and the time to full recovery was 93±83 days. There was a statistically significant relationship between time to partial neurological recovery and time to surgical intervention (P=0.02). There was no relationship between time to full neurological recovery and time to surgery (P=0.8).

Conclusion:

Earlier time to surgical intervention in pediatric SCH fractures with isolated nerve injury was associated with earlier partial recovery but not full neurological recovery. Prioritizing urgent surgery in these patients did not improve their ultimate neurological recovery.

Level of Evidence:

Therapeutic level III.
Updates in palliative care of gynecologic oncology patients
Authors: Khoo Teresa , Karlin Daniel , Pietras Christopher
Published: October 2024

Purpose of review

This review assesses the impact of early integration of palliative care and the disparities that exist among patients with gynecologic malignancies. It also highlights the recent advances in symptom management, goals of care communication, and end of life care.

Recent findings

Although palliative care has been utilized earlier, there are still barriers to its integration both nationally and worldwide, manifesting as predominantly late hospice referrals and aggressive care at the end of life. However, there are increasing efforts to promote earlier integration and discussion around goals of care through multidisciplinary approaches. Apart from symptom burdens, patients with gynecologic malignancies experience financial toxicity that impact various aspects of their lives, leading to potentially harmful choices to mitigate costs. A growing area of interest in palliative care is the realm of psychedelic-assisted therapy, which has shown benefits in treating advanced cancer patients with depression.

While significant strides have been made in incorporating palliative care earlier, continued research in palliative care is needed to address symptomatic and psychosocial suffering worldwide.
A Meta-analysis Comparing Deep Inferior Epigastric Perforator Flaps and Latissimus Dorsi Flaps in Breast Reconstruction
Authors: Tanas Yousef , Tanas Julie , Swed Sarya , Spiegel Aldona J.
Published: October 2024

Background:

Deep inferior epigastric perforator (DIEP) flaps and latissimus dorsi (LD) flaps are two widely used breast reconstruction techniques, each with distinct advantages and limitations. This meta-analysis aims to compare patient satisfaction and incidence of complications between these two techniques to inform clinical decision-making.

Methods:

PubMed, Scopus, and Web of Science were searched for relevant studies. We included studies with data comparing DIEP and LD flaps, BREAST-Q patient satisfaction, and complications. Statistical analyses were performed using RevMan 5.4.

Results:

The search yielded 788 studies, of which 13 were included in the meta-analysis. A total of 2128 patients were analyzed, with 1378 undergoing DIEP flap reconstruction and 750 receiving LD flap reconstruction. The analysis showed greater improvement with DIEP flaps in breast satisfaction [mean difference (MD) = 9.48, 95% confidence interval (CI) = 6.90–12.05, P < 0.00001], physical well-being (MD = 5.95, 95% CI = 2.98–8.92, P < 0.0001), and satisfaction with outcome (MD = 9.36, 95% CI = 3.01–15.71, P = 0.004). Nonetheless, DIEP flaps had higher rates of skin flap necrosis [risk ratio (RR) = 4.27, 95% CI = 2.44 to 7.46, P < 0.00001], wound dehiscence (RR = 5.12, 95% CI = 2.53–10.35, P < 0.00001), and reoperation (RR = 2.24, 95% CI = 1.58 -3.16, P < 0.00001) but lower seroma rates (RR = 0.27, 95% CI = 0.10–0.74, P = 0.01).

Conclusions:

DIEP flap reconstruction offers superior patient satisfaction compared with LD flap reconstruction, despite a higher incidence of certain complications.
Midface Skeletal Sexual Dimorphism: Lessons Learned from Advanced Three-dimensional Imaging in the White Population
Authors: Abushehab Abdallah , Rames Jess D. , Hussein Sara M. , Meira Pazelli Alexandre , Sears Tori A. , Wentworth Adam J. , Morris Jonathan M. , Sharaf Basel A.
Published: October 2024

Background:

Facial shape is significantly influenced by the underlying facial bony skeleton. Sexual dimorphisms in these structures are crucial for craniofacial, aesthetic, and gender-affirming surgery. Previous studies have examined the orbits and upper face, but less is known about the midface. This study aimed to elucidate the sexual dimorphism in the midface region, focusing on the maxilla and zygomatic bones.

Methods:

A retrospective review was conducted using facial computed tomography scans from 101 White patients aged 20–79 years, using Materialise Mimics and 3-Matics for segmentation and 3D reconstruction. Measurements and statistical shape modeling of the midfacial skeleton were performed.

Results:

Our results show a distinct sexual dimorphism in the midfacial skeletal structure across all age groups. Women typically had a narrower bizygomatic width by 1.5 mm (P = 0.04), a shallower maxillary depth by 1.6 mm (P < 0.01), and a midfacial vertical height that was 4 mm shorter than that of men (P = 0.018). In contrast, men exhibited a greater distance between the frontozygomatic sutures by 5.4 mm (P < 0.01), a 3-mm greater interorbitale distance (P < 0.01), and a 2.1-mm wider infraorbital foramina distance (P = 0.007). There were no significant differences in the pyriform and maxillary angles (P = 0.15 and P = 0.52, respectively).

Conclusions:

Our analysis of midfacial skeletal anatomy revealed sexual dimorphism differences. Men exhibited more pronounced facial features than women, with a broader horizontal midfacial skeleton, a longer midfacial vertical height, and greater maxillary depths compared with women.
Racial Disparities in Plastic Surgery Outcomes: A Systematic Literature Review and Meta-Analysis
Authors: Skorochod Ron , Wolf Yoram
Published: October 2024

Background:

Racial disparities in surgical outcomes have been shown to lead to subpar results in various patients. Variability and contradictions in the current literature highlight the need for a crucial evaluation of the matter in studies focusing on plastic and reconstructive surgery. Investigating the matter is a pivotal step toward effective guidelines that mitigate factors contributing to racial disparities in outcomes and improve our perception of a patient-centered health-care system. The study aimed to identify whether racial disparities exist in plastic and reconstructive surgery procedures.

Methods:

Systematic review of the literature as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to find relevant articles assessing the impact of race on surgical outcomes. PubMed, Embase, MEDLINE, and Cochrane library were screened by both authors, and relevant articles were identified. Prevalence of complications were extracted from included studies, and odds ratio (OR) with 95% confidence interval (CI) was calculated and grouped for a statistical analysis.

Results:

Meta-analysis of 13 studies, with a mean of 8059 patients per study, demonstrated a pooled OR of 1.21 (95% CI: 1.00–1.46), indicating an insignificant association between non-White race and postoperative complications. Subanalysis comparing African American patients to White patients (10 studies) showed an OR of 1.36 (95% CI: 1.06–1.74), signifying a statistically significant risk for African Americans. No publication bias was observed, but substantial heterogeneity (73% and 79%) suggested varied study factors influencing outcomes.

Conclusions:

Racial disparities exist in plastic and reconstructive outcomes. Physicians and medical staff should focus on patients’ sociodemographic background, accessibility to care, support cycles, and language proficiency, while determining the surgical plan and postoperative care.
Technical Strategies and Learning Curve in Robotic-assisted Peripheral Nerve Surgery
Authors: Aman Martin , Struebing Felix , Weigel Jonathan , Bigdeli Amir K. , Gazyakan Emre , Kneser Ulrich , Harhaus Leila , Boecker Arne H.
Published: October 2024

Background:

Robotic-assisted peripheral nerve surgery (RASPN) has emerged as a promising advancement in microsurgery, offering enhanced precision and tremor reduction for nerve coaptations. This study investigated the largest published patient collective in RASPN and provided specific technical aspects, operative setups, and a learning curve.

Methods:

Data collection involved creating a prospective database that recorded surgical details such as surgery type, duration, nerve coaptation time, and number of stitches. The experienced surgeon first underwent a 12-hour training program utilizing the Symani robot system in combination with optical magnification tools before using the system clinically.

Results:

The study included 19 patients who underwent robot-assisted peripheral nerve reconstruction. The cohort included six men (31.6%) and 13 women (68.4%), with an average age of 53.8 ± 18.4 years. The procedures included nerve transfers, targeted muscle reinnervation, neurotized free flaps, and autologous nerve grafts. Learning curve analysis revealed no significant reduction in time per stitch over the initial nine coaptations (4.9 ± 0.5 min) compared with the last 10 coaptations (5.5 ± 1.5 min).

Conclusions:

The learning curve for RASPN was compared with early experiences with other surgical robots, emphasizing the importance of surgical proficiency and assistant training. Obstacles such as instrument grip strength and blood clot formation were highlighted, and suggestions for future advancements were proposed. RASPN presents an exciting opportunity to enhance precision; however, ongoing research and optimization are necessary to fully harness its benefits.
A Unique Advantage of a 24-hour Surgical Delay in Autologous Breast Reconstruction
Authors: Melancon Devin M. , Yoo Daniel , Stern-Buchbinder Zachary , Morin Samantha , St. Hilaire Hugo , Allen Robert J.
Published: October 2024

The surgical delay technique can be used effectively in autologous breast reconstruction when there is unfavorable flap vascular anatomy or when the reconstruction necessitates a larger volume of donor tissue to obtain optimal results. The length of time between surgically delaying the flap to pedicle division and inset of the flap often varies based on surgeon preference but is typically approximately a week or longer. The authors present a case in which a 24-hour surgical delay was successfully used to augment deep inferior epigastric perforator flaps for autologous reconstruction. This technique is beneficial as it does not allow time for scarring and adhesions to develop between stages and allows for both stages to be performed in the same hospital admission.
Vulvar Reconstruction with Freestyle Perforator Flap from the Medial Thigh Using Color Doppler Ultrasound
Authors: Landau Madeleine B. , Imbrescia Kory , Smith Christopher
Published: October 2024

Vulvoperineal defects mount significant functional and aesthetic challenges for reconstructive surgeons, often followed by postoperative complications. Ideal flap creation and perforator selection is vital for proper healing, especially in those with comorbid health concerns. This report details an innovative approach to vulvar reconstruction using a freestyle perforator flap from the medial thigh, identified by color flow Doppler ultrasound (CDU). This noninvasive imaging technique made possible the exact identification and confirmation of a well-vascularized pedicle, giving rise to a tailored flap for enhanced postoperative recovery and healing. The flap was designed based on real-time vascular mapping by CDU and validated through indocyanine green angiography, ensuring robust perfusion. The case of this patient demonstrated the successful application of portable CDU to navigate the intricate vessel network of the medial thigh, which would not have been possible with traditional imaging modalities such as computed tomography alone. The lack of postoperative complications following reconstruction demonstrates how this strategy for addressing vulvoperineal defects is advantageous due to meticulous perforator selection based on the patient’s unique anatomy. CDU is therefore an important tool for achieving optimal outcomes related to form and function, all while reducing the risks of donor site morbidity.
RELATIONSHIP BETWEEN THE HEIGHT OF WIDE AND NARROW PRIMARY MACULAR STAPHYLOMA AND MYOPIC MACULAR RETINOSCHISIS
Authors: García-Ben Antonio , Fernández Martín Marta , Olivier Pascual Nuria , Arroyo Castillo Rosa , Rubio Cid Sara , Ortigueira Espinosa Rafael , Álvarez Díaz María Dolores
Published: October 2024

Purpose:

To investigate the relationship between the depth of wide and narrow primary macular staphyloma and myopic macular retinoschisis.

Methods:

Sixty-nine highly myopic eyes with wide and narrow primary macular staphyloma were included in this cross-sectional study and classified into two groups according to the presence or absence of myopic macular retinoschisis on swept-source optical coherence tomography. All patients received a complete ophthalmologic examination with determination of macular staphyloma depth by ocular ultrasonography (B-scan).

Results:

Nine eyes (9/69, 13.04%) present myopic macular retinoschisis on swept-source optical coherence tomography. Eyes with vitreomacular tractions, arteriolar traction, and greater macular staphyloma depth were more likely to develop myopic macular retinoschisis (odds ratio, 11.32; P = 0.001; odds ratio, 6.23; P = 0.039; and odds ratio, 3.37; P = 0.01, respectively). We did not observe statistically significant differences regarding best-corrected visual acuity between eyes with and without myopic macular retinoschisis (P = 0.39).

Conclusion:

The depth of the wide and narrow primary macular staphyloma appears to be a new and an important factor in the development of myopic macular retinoschisis.
Visual and anatomical outcomes following vitrectomy with subretinal tPA injection in patients with submacular haemorrhages secondary to wet AMD
Authors: Gallagher David , Hurley Daire , O’Brien Luke , Petronzi Vincenzo , Connell Paul , Dooley Ian
Published: October 2024

Purpose:

Submacular haemorrhages (SMHs) are most commonly associated with wet age-related macular degeneration (AMD) and their size and duration are strong prognostic factors for visual outcome. The aim of this audit was to evaluate outcomes of direct injection of submacular tissue plasminogen activator (t-PA) into these lesions during pars plana vitrectomy (PPV).

Methods:

All patients presenting to the Mater Misericordiae Hospital from January 2017 to December 2019 with large SMHs secondary to wet AMD who underwent this treatment were included for review. All ten patients underwent complete PPV, injection of 0.2ml (50µg) subretinal t-PA and air tamponade. Pre-operative and post-operative evaluations included visual acuity testing (VA), optical coherence tomography (OCT) and slit lamp examination.

Results:

Eight patients (80%) showed improvement of their VA, with 4 patients achieving a VA of ≤0.4 LogMAR (20/50). Six patients had a total clearing of the macular haemorrhage, with a further 2 having sub-total clearance. One patient subsequently developed a retinal detachment requiring oil tamponade.

Conclusions:

SMH secondary to wet AMD is a sight threatening event with a varied prognosis but in most cases, vitrectomy with subretinal t-PA injection results in improved anatomical and visual outcomes.
Comparative Analysis of the Intrinsic Disorder Within the Layers of the Human Cornea
Authors: Djulbegovic Mak B. , Antonietti Michael , Taylor Gonzalez David J. , Mattes Robby , Kim Colin , Uversky Vladimir N. , Martinez Jaime D. , Karp Carol L.
Published: October 2024

Purpose:

The human cornea is essential for vision, providing structural integrity and refractive power to the eye. Recent advancements have deepened our understanding of the corneal molecular composition, yet the role of intrinsically disordered proteins within the cornea is unexplored.

Methods:

We analyzed 3,250 corneal proteins identified by Dyrlund et al, focusing on the epithelium, stroma, and endothelium layers. We performed a bioinformatics analysis to characterize the amino acid composition, the propensity for intrinsic protein disorder, and the distribution of protein types in 3 corneal layer proteome.

Results:

Our study demonstrates that each corneal layer exhibited unique patterns in amino acid composition related to protein disorder. Order-promoting amino acids were generally depleted except for leucine, whereas disorder-promoting amino acids like arginine and glutamic acid were enriched across all layers. Significant variations were observed in the levels of intrinsic disorder among the different corneal layers, with substantial proportions of highly disordered proteins present in each. Analysis of protein class type in each layers revealed that no significant differences were detected in the distribution of protein classifications across the layers, suggesting a consistent population of the protein types across all corneal layers.

Conclusions:

Our findings reveal a sophisticated landscape of protein structures where intrinsic disorder varies across layers, suggesting an adaptation of the corneal proteome to the unique physiological demands of each layer. These structural variations may reflect the intricate requirements for corneal transparency, biomechanical stability, and environmental responsiveness.
Acquired Ankyloblepharon Correction Using Ocular Surface and Tarsal Mucous Membrane Grafting in Cicatrizing Ocular Surface Diseases
Authors: Patil Gaurav , Shanbhag Swapna S. , Basu Sayan , Singh Swati
Published: October 2024

Purpose:

To report the long-term surgical outcomes of acquired ankyloblepharon correction using mucous membrane graft.

Methods:

Five eyes of 4 patients (median age, 19 years) with acquired ankyloblepharon were managed using eyelid splitting and mucous membrane graft anchored to the recti muscles on the bulbar surface in the respective quadrant and onto the bare tarsal surface. Outcome measures include a change in the palpebral fissure width, ability to fit scleral contact lenses, visual acuity, and cosmesis.

Results:

The underlying etiologies of ankyloblepharon were chronic Stevens-Johnson syndrome (n = 3), and chemical injury (n = 2). All 5 eyes had conjunctival shortening, and 3 had severe dry eyes (median Schirmer 4.5 mm). Four eyes had limbal stem cell deficiency. The median horizontal palpebral fissure width improved to 22 mm from 8 mm. This single-staged surgical technique allowed for fornix formation and prosthetic replacement of the ocular surface ecosystem lens fitting in all 5 eyes. Median logMAR visual acuity improved from 2.1 to 0.7 following ankyloblepharon release, prosthetic replacement of the ocular surface ecosystem lens fitting in 4 eyes, and keratoprosthesis in 1 eye. Repeat mucous membrane graft for recurrent symblepharon in 1 quadrant was required in 2 eyes where complete 360 degrees bulbar and tarsal conjunctiva loss were present preoperatively. At the median follow-up period of 27 months, all patients reported better cosmesis and had no symblepharon recurrence following repeat surgery in 2 eyes and single surgery in 3 eyes. The donor site healed well without any complications. No mitomycin C or symblepharon ring was used.

Conclusion:

Ocular surface and adnexal reconstruction using bulbar and tarsal mucous membrane grafts help visually rehabilitate patients with acquired ankyloblepharon secondary to cicatrizing ocular surface disorders.
Microscopic Anatomy of Orbital Septum
Authors: Gouigoux Stefano , Vaidya Aric , Naito Munekazu , Takahashi Yasuhiro , Kakizaki Hirohiko
Published: October 2024

Purpose:

To study the microscopic anatomy of the orbital septum and evaluate its relationships with the adjoined structures.

Methods:

Histological evaluation of 11 upper eyelids (5 right, 6 left) from 10 Japanese cadavers (age range: 36–94-year-old, average: 71.1) was performed. The specimens were fixed in 10% formalin and stained with Elastica Van Gieson. Specimens were microscopically analyzed using different magnifications (20×, 40×, and 100×).

Results:

The orbital septum was the single fibrous layer in all the specimens, anteriorly separated from the retro-orbicularis fat pad capsule and posteriorly from the preaponeurotic fat pad capsule. At the junction of the orbital septum with the levator aponeurosis, the orbital septum proceeded towards the tarsal plate, and the preaponeurotic fat pad capsule reflected posteriorly.

Conclusions:

The orbital septum is constituted of a single layer of fibrous tissue anteriorly separated from the retro-orbicularis fat pad capsule and posteriorly from the preaponeurotic fat pad capsule by the corresponding virtual spaces.
Endophthalmitis rates after secondary intraocular lens surgeries: 11-year Medicare fee-for-service analysis
Authors: Kerrison Caroline H. , Chang David F. , Dun Chen , Sabharwal Jasdeep , Woreta Fasika A.
Published: October 2024

Purpose:

To assess postoperative endophthalmitis (POE) rates and risk factors after secondary intraocular lens (IOL) implantation for preoperative aphakia and IOL exchange combined with or without vitrectomy.

Setting:

Medicare fee-for-service (FFS) beneficiaries, United States.

Design:

Retrospective study.

Methods:

Medicare FFS beneficiaries who underwent IOL exchange or secondary IOL implantation for preoperative aphakia between January 1, 2011, and November 19, 2022, were identified. POE rates were calculated overall and separately for each surgical category—secondary IOL for aphakia vs IOL exchange, with subsets for concurrent anterior or posterior vitrectomy. Multivariate analysis of potential risk factors was implemented.

Results:

97 152 patients were included. The 42-day POE rates for secondary IOL implantation for aphakia and for IOL exchange were 0.35% and 0.28% overall, 0.31% and 0.30% when combined with posterior vitrectomy, and 0.84% and 0.42% with anterior vitrectomy, respectively. The risk of POE increased when secondary IOL surgery was combined with anterior vitrectomy compared with no vitrectomy (adjusted odds ratio [aOR], 1.849; P < .001) and with higher Charlson Comorbidity Indexes compared with 0: 1 to 2 (aOR, 1.495; P = .01), 3 to 4 (aOR, 1.591; P = .01), 5 to 6 (aOR, 1.617; P = .046), and ≥7 (aOR, 3.290; P < .001). Risk was decreased for IOL exchange compared with secondary IOL implantation for preoperative aphakia (aOR, 0.783; P = .04).

Conclusions:

The overall POE rate for all secondary IOL surgeries was 0.31% during the 11-year period. We hypothesize that the absence of the posterior capsular barrier would explain the higher POE rates compared with cataract surgery, especially if a concurrent vitrectomy was performed with the secondary IOL procedure.
Comparing visual outcomes of keratorefractive lenticule extraction, PRK, and LASIK procedures in the military population
Authors: Evangelista Charisma B. , Harris Justin P. , Trinh Toan M. , Kohler Paul D. , Mackie Ryan , Turovets Sergei , Aden James K. , Capo-Aponte Jose E.
Published: October 2024

Purpose:

To assess the 6-month visual and refractive outcomes of keratorefractive lenticule extraction (KLEx) as compared with laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) in a military population at a Joint Warfighter Refractive Surgery Center.

Setting:

Joint Warfighter Refractive Surgery Center (JWRSC), Lackland Air Force Base, San Antonio, Texas.

Design:

Retrospective study.

Methods:

Patients who underwent KLEx, PRK, or LASIK between 2019 and 2022 were included. Anonymized data collected included demographics, preoperative and postoperative uncorrected and corrected visual acuity, and manifest refraction.

Results:

Of the 4466 treated eyes, 737 (16.5%) underwent the KLEx, 2801 (62.7%) underwent PRK, and 928 (20.8%) underwent LASIK treatment. Regarding efficacy, there was no statistically significant difference at postoperative month (POM) 6 between the percentage of eyes reaching an uncorrected distance visual acuity of 20/20 or better between the 3 procedures. At POM1 (P < .001) and POM3 (P < .001), there were a greater number of eyes in the KLEx group that achieved the same or 1 line better of distance visual acuity than the PRK group. The efficacy indices of KLEx, PRK, and LASIK at POM6 were 1.09, 1.10, and 0.97, respectively. The safety indices for KLEx, PRK, and LASIK at POM6 were 0.96, 1.01, and 0.81, respectively.

Conclusions:

After the initial recovery period, KLEx demonstrates comparable outcomes in efficacy, safety, and accuracy as compared with LASIK and PRK.
Child maltreatment elevated the risk of late-life chronic pain: a biopsychosocial framework from the UK Biobank cohort
Authors: Zhao Wenhui , Lu Xuejing , Tu Yiheng
Published: October 2024

Understanding the development of chronic pain (CP) is challenging due to its multifactorial etiology. Child maltreatment (CM), encompassing various types of neglect and abuse affecting more than one-third of the population, is a critical aspect of early-life adversity with long-lasting impacts. It is increasingly recognized for its role in altering biopsychosocial processes, potentially increasing vulnerability to CP. However, the exact path connecting CM to CP is not fully elucidated, primarily attributable to limitations in prior research, including insufficient sample sizes, inadequate consideration of comprehensive mediative variables, and a lack of longitudinal data. To address these gaps, our study utilizes a large-scale dataset (n = 150,989) comprising both cross-sectional and longitudinal data, along with an extensive range of biopsychosocial variables. Our findings reveal that all types of CMs, except physical neglect, significantly increase the risk of CP, and all types of CPs, except headache, were affected by CM. Furthermore, we demonstrate that individuals with CM histories are more predisposed to comorbid CP conditions. Importantly, biopsychosocial factors are found to explain over 60% of the association between CM and CP, with psychological factors playing a key role. This study not only characterizes the relationship between CM and CP but also underscores the influence of psychosocial elements in this dynamic interplay. These findings offer important insights into the long-term impacts of CM and provide a foundation for developing targeted therapeutic and preventive strategies for CP.
Slack potassium channels in spinal dorsal horn neurons control neuropathic pain and acute itch
Authors: Zhou Fangyuan , Engel Patrick , Ruth Peter , Lukowski Robert , Schmidtko Achim , Lu Ruirui
Published: October 2024

The sodium-activated potassium channel Slack (KNa1.1, Kcnt1) plays a critical role in tuning neuronal excitability. Previous studies have revealed that Slack is expressed in neurons of the superficial dorsal horn of the spinal cord. However, the precise role of Slack in spinal dorsal horn neurons is unclear. In this study, we used mice in which Slack is conditionally ablated in spinal dorsal horn neurons (Lbx1-Slack−/− mice) and analyzed their behaviors in various models of pain and itch. Lbx1-Slack−/− mice exhibited increased neuropathic pain behavior after peripheral nerve injury but normal responses in a model of inflammatory pain. Unexpectedly, Lbx1-Slack−/− mice demonstrated increased scratching after intradermal injection of chloroquine, LY344864, and histamine. Moreover, neuromedin B receptors are coexpressed with Slack in the dorsal horn, and scratching after intrathecal delivery of neuromedin B was increased in Lbx1-Slack−/− mice. Our study provides in vivo evidence that Slack expressed in spinal dorsal horn neurons inhibits nerve injury–induced allodynia and acute itch induced by various pruritogens.
Tracheal transplantation: lessons learned that may apply to lung transplantation
Authors: Genden Eric M. , Chen Ya-Wen
Published: October 2024

Purpose of review

The purpose of this review is to explore the lessons learned from experimental and human tracheal transplantation to determine if this information may be applied to lung transplantation.

Recent findings

Experimental work in animal models and the recent human tracheal transplantation suggests that a robust tracheal vascular supply prevents anastomotic complications. Further, this work demonstrates that tracheal allografts undergo a progressive chimerism as recipient epithelium repopulates the allograft. In contrast to most vascularized composite allografts such as hand and face transplantation that experience high rates of rejection, the tracheal allograft did not demonstrate rejection. This may suggest that tissue chimerism plays a role in evading immune-mediated allograft rejection.

While anastomotic complications and chronic allograft rejection are the most common complications related to lung transplantation, the findings associated with tracheal transplantation may have implications for both reducing complications associated with lung transplantation.
Advancements in Imaging for the Diagnosis of Wake-up Stroke
Authors: Li Yang , Ma Chun-Hui
Published: October 2024

Background:

The concept of wake-up stroke (WUS) as a distinct subtype of acute ischaemic stroke, characterized by an uncertain onset time, traditionally resulted in the exclusion of patients from intravenous thrombolysis treatment.

Review Summary:

Advancements in neuroimaging have prompted a shift in the approach to intravenous thrombolysis treatment, moving away from a strict focus on the onset time window toward consideration of the tissue time window. This paradigm shift has expanded the opportunity for a larger cohort of patients with WUS to receive timely and effective treatment, ultimately leading to improved prognosis.

Conclusions:

This study reviews the WUS pathogenesis and the progress of various imaging diagnostic techniques to clarify the WUS onset time and select the optimal treatment plan.
Bone density changes in young women in Uganda using tenofovir-based HIV preexposure prophylaxis and depot medroxyprogesterone acetate contraception
Authors: Heffron Renee , Muwonge Timothy R. , Thomas Katherine K. , Zewdie Kidist , Ssebuliba Timothy , Stein Gabrielle , Morrison Susan , Badaru Josephine , Nakyanzi Agnes , Bambia Felix , Mugwanya Kenneth , Wyatt Christina , Matovu Flavia , Yin Michael T. , Mujugira Andrew
Published: October 2024

Background:

Injectable depot medroxyprogesterone acetate (DMPA) is the most common contraceptive choice among young women in Uganda, where HIV burden is high and HIV preexposure prophylaxis (PrEP) may be offered. For young women who choose to use both agents concurrently, it is unknown whether they will experience declines in bone mineral density (BMD) beyond those elicited by either product singly.

Methods:

From 2018 to 2022, we conducted a 2-year prospective study with women ages 16–25 years in Kampala, Uganda desiring pregnancy and HIV prevention. Women were provided condoms, injectable DMPA, and/or FTC/TDF, according to their choices and underwent annual dual X-ray absorptiometry (DXA) scans. We used tenofovir-diphosphate (TFV-DP) quantification in dried blood spots and DMPA injection dates to classify exposure. Linear regression models estimated the difference in percent BMD change from baseline to month 12 for women using FTC/TDF and DMPA versus women using neither product.

Results:

Of 499 enrolled women, discontinuation and re-starting of contraception and PrEP was common. Women consistently using neither product (n = 39) experienced BMD increases. Women with consistent use of both products during 1 year (n = 22) experienced an average BMD loss of 1.04% at lumbar spine and hip and 1.77% at femoral neck. These losses were different relative to women who used neither agent: lumbar spine −3.35% (95% CI −5.13 to −1.56%, P = 0.001), total hip −2.24% (95% CI −3.87 to −0.60%, P = 0.009), and femoral neck −1.71% (95% CI −3.73 to 0.31%, P = 0.102).

Conclusion:

We observed a trend for women with concurrent DMPA and FTC/TDF PrEP use to have 1–3% lower BMD than unexposed women after 12 months.
Three-dimensional Morphometric Analysis of the Effectiveness of Kinesio Taping on Postoperative Discomfort Following Mandibular Third Molar Surgery: A Prospective Randomized Split-mouth Study
Authors: Russo Diana , Mariani Pierluigi , Bifulco Luca , Ferrara Simone , Cicciù Marco , Laino Luigi
Published: October 2024

This study investigates the efficacy of Kinesio taping (KT) in reducing postoperative discomfort, including edema, trismus, and pain, following mandibular third molar extraction. A prospective randomized split-mouth design was employed, involving 7 patients with impacted mandibular third molars. KT was applied immediately postsurgery, and outcomes were assessed on the third and seventh postoperative days using a Visual Analog Scale (VAS) for pain, 3D morphometric analysis for swelling, and caliper measurements for trismus. Results showed significant reductions in pain, swelling, and trismus on the KT-treated side compared with the control side. The most notable differences were observed on day 7, where KT demonstrated superior effectiveness in alleviating symptoms. The control group showed improvement over time, but the KT-treated group experienced faster and more pronounced recovery. In conclusion, KT proved to be a safe and effective method for improving postoperative recovery following mandibular third molar surgery, offering a low-cost, accessible option to enhance patient comfort and quality of life.
Suicide in prison in the North of Italy (1993–2022): a case-control study examining differences between suicides inside and outside prison
Authors: Calati Raffaella , Tambuzzi Stefano , Gravagnuolo Rosa , Muscatiello Livio , Magrin Maria Elena , Crippa Franca , Madeddu Fabio , Zoja Riccardo , Gentile Guendalina
Published: October 2024

Prisoners constitute a group at suicide risk, showing higher relative rates of suicides than the general population. However, there is limited knowledge about the characteristics of those who die by suicide in Italian prisons. Based on the total sample of suicides of the Institute of Forensic Medicine of Milan (1993–2022), suicides in prison (N = 120) were matched by age and gender with cases that occurred outside prison (N = 300) and compared with them. The considered variables were sociodemographic, clinical, and suicide-related. Univariate analyses and logistic regression model were performed. In univariate analyses, suicides in prison showed higher rates of ethnicity different from white Caucasian, lower rates of depression, higher rates of alcoholism, addiction, respiratory system diseases, hepatitis, and amyotrophic lateral sclerosis, lower use of any medication, and in particular psychotropic medications, and a higher percentage of violent suicide method versus nonviolent compared to suicides outside prison. In the logistic regression model, ethnicity, depression, and addiction were the only features differentiating suicides in prison from ones outside prison. Particular attention should be paid to inmates with non-white ethnicity and those with addiction. Ensuring adequate access to psychiatric care and implementing comprehensive suicide prevention strategies within Italian prisons is crucial.
Investigations into the occurrence of polycyclic aromatic hydrocarbons in surface waters of the Narok and Bomet counties of Kenya
Authors: Chaka Bakari , Osano Aloys M. , Nyaigoti Omwoyo Wesley , Forbes Patricia B. C.
Published: October 2024

Polycyclic aromatic hydrocarbons (PAHs) are a group of emerging chemical pollutants that pose severe health challenges and toxicity to people and aquatic organisms exposed to these pollutants. This study sought to assess the types and levels of PAHs and their eco-toxicity indices in surface waters of Narok and Bomet counties of Kenya, which have witnessed an increase in charcoal-burning activities and vehicular emissions near water bodies. Sampling was done in eight regions of the two counties based on their proximity to PAH sources. Extraction of the water samples was done via a solid-phase mmethod. Seven US Environmental Protection Agency (US EPA) priority PAHs were detected. The concentrations of these PAHs varied from below the limits of detection up to 31.42 µg l
−1
for dibenzo[
a,h
]anthracene. The majority of the PAHs from Narok County were pyrogenic, while those from Bomet were petrogenic based on PAH diagnostic ratios. The surface waters were significantly polluted with dibenzo[
a,h
]anthracene, with risk quotients above 1.0 in the surface waters, and were found to be hazardous, with hazard quotients above 10.0, thus indicating potential environmental risks. The findings indicate the need for stringent measures to be put in place to mitigate the risks posed by these PAHs.
Flower/FLWR-1 regulates neuronal activityviathe plasma membrane Ca2+-ATPase to promote recycling of synaptic vesicles
Authors: Seidenthal Marius , Redzovic Jasmina , Liewald Jana F. , Rentsch Dennis , Shapiguzov Stepan , Schuh Noah , Rosenkranz Nils , Eimer Stefan , Gottschalk Alexander
Published: October 2024

The Flower protein was suggested to couple the fusion of synaptic vesicles (SVs) to their recycling in different model organisms. It is supposed to trigger activity-dependent bulk endocytosis by conducting Ca2+at endocytic sites. However, this mode of action is debated. Here, we investigated the role of theCaenorhabditis eleganshomolog FLWR-1 in neurotransmission. Our results confirm that FLWR-1 facilitates the recycling of SVs at the neuromuscular junction (NMJ). Ultrastructural analysis of synaptic boutons after hyperstimulation revealed an accumulation of large endocytic structures inflwr-1mutants. These findings do not support a role of FLWR-1 in the formation of bulk endosomes but rather a function in their breakdown. Unexpectedly, loss of FLWR-1 led to increased neuronal Ca2+levels in axon terminals during stimulation, particularly in GABAergic motor neurons, causing excitation-inhibition imbalance. We found that this increased NMJ transmission might be caused by deregulation of MCA-3, the nematode orthologue of the plasma membrane Ca2+ATPase (PMCA).In vivomolecular interactions indicated that FLWR-1 may be a positive regulator of the PMCA and might influence its recycling through modification of plasma membrane levels of PI(4,5)P2.
Consumer privacy decision-making in digital era: an integrative review and taxonomy
Authors: Sun Zhuo , Pan Gaofeng , Yang Ruixian , Zang Guoquan , Zhou Jinghong
Published: October 2024

Purpose

In the digital age, personalized services and accurate recommendations enhance the customer experience and streamline shopping. However, increasing concerns about personal privacy have led to resistance from consumers, necessitating a balance between providing high-quality online services and safeguarding personal data. The aim of this paper is to offer a comprehensive review of the fragmented literature on consumer privacy decision-making and to identify key issues worth exploring in future research.

Design/methodology/approach

Although previous studies have analyzed the antecedents and outcomes of privacy decisions, they have often been conducted in a fragmented manner. There remains a lack of a holistic understanding of the factors influencing privacy decisions, including their boundaries. Therefore, we build on the Theory of Planned Behavior to combine consumer privacy decision-making with a graphically conceptual framework used in a similar scoping methodology. We attempt to dissect the antecedent, moderator and outcome variables that influence consumer privacy decision-making, ultimately providing a comprehensive framework for understanding these dynamics.

Findings

Based on the Theory of Planned Behavior, we analyze the entire process of consumer privacy decision-making in terms of antecedent, moderating and outcome variables. The results indicate that consumer privacy decision-making is not an isolated behavior or a single choice but a complex, multi-level dynamic process. The factors influencing consumer privacy decisions primarily encompass five aspects: individual characteristics, information, organization, platform and interaction management, leading to various outcomes in both behavioral and perceptual dimensions. Furthermore, the process is constrained by multiple moderating variables, such as information sensitivity, platform knowledge and prior experience.

Originality/value

We build on the Theory of Planned Behavior to combine consumer privacy decision-making with a graphically conceptual framework used in a similar scoping methodology. We dissect the antecedent, moderator and outcome variables that influence consumer privacy decision-making, aiming to provide a comprehensive framework for understanding these processes.
Artificial intelligence in corporate communications: determinants of acceptance and transformative processes
Authors: Kelm Karolin , Johann Michael
Published: October 2024

Purpose

This study investigates the determinants of artificial intelligence (AI) acceptance in and AI-driven transformations of corporate communications. From a technology adoption perspective, the study explores the dual influence of individual and organizational factors on AI acceptance.

Design/methodology/approach

Employing a qualitative research design, this study conducted semi-structured interviews with 19 AI experts in large-scale companies in Germany.

Findings

The study reveals micro-level determinants of AI acceptance related to AI’s perceived usefulness and ease of use. It also identifies macro-level determinants, including organizational awareness and frameworks. Corporate communications is expected to gain relevance due to the organizational integration of AI.

Research limitations/implications

The proposed model integrates crucial factors influencing AI adoption and offers a starting point for quantitative validation. The study serves as a benchmark for future research, particularly given its timing right before the extensive adoption of ChatGPT.

Practical implications

Organizations are encouraged to develop strategies that enhance both individual and organizational AI readiness. By reflecting both micro- and macro-level determinants of AI acceptance, a more holistic understanding of effective change management initiatives related to AI integration can be fostered.

Originality/value

By proposing an extension to the technology acceptance model, which incorporates both micro- and meso-level determinants, this study provides a novel framework for holistically understanding AI acceptance in corporate communications.
Digitalization of construction-phase information management by project owners: qualitative analysis of potential benefits and probable factors
Authors: Jahanger Qais K.
Published: October 2024

Purpose

The US construction industry has been relatively slow to employ digital information technologies. The lack of adoption by project owners is a result of them not having a solid understanding of probable factors (PFs) that could influence the implementation of such systems and potential benefits (PBs) that can serve as key motivators and an assessment instrument. Thus, this article aims to study PBs of digital construction-phase information management (DCIM) systems for project owners and PFs that could influence the implementation of such systems by project owners.

Design/methodology/approach

Qualitative data collection and analysis methods were followed to conduct the research. The qualitative data (information) regarding PBs and PFs were collected using a survey to subject matter experts and the content analysis method was used to analyze the data.

Findings

Findings show that almost all the qualitative data regarding PBs of DCIM systems are positive, and these data support 10 of 18 PBs with which they were compared. The qualitative data that is negative does not support one PB. Findings also show that all the qualitative data regarding the PFs are confirmatory, and these data support 14 of 28 PFs with which they were compared. The most supported PB is improvement in the efficiency of documentation within the organization and the most supported PF is upper management support.

Originality/value

The primary contribution of this research is in increasing project owners’ understanding of PBs of DCIM systems and PFs that could influence the implementation of such systems.
Understanding human–technology interaction: evolving boundaries
Authors: Magliocca Pierpaolo , Canestrino Rossella , Carayannis Elias G. , Gagliardi Anna Roberta
Published: October 2024

Purpose

This paper explores the intricate evolution of human–machine interaction within the framework of Society 5.0, highlighting how technological advancements influence human behavior and societal progress.

Design/methodology/approach

A multidimensional framework is developed through a qualitative approach to analyze the evolution of human–technology interaction. This innovative conceptual model provides a comprehensive understanding of these dynamics.

Findings

The proposed model unveils a significant shift from perceiving technology as a mere tool to acknowledging its profound influence on daily routines and potential enhancements. This revelation underscores the critical role of human-centric strategies, enlightening us about the evolving nature of technology.

Research limitations/implications

The study synthesizes existing research to present a comprehensive framework for understanding human–machine interaction, providing insights that can inform future research and theory development.

Practical implications

This study equips policymakers, researchers and practitioners with actionable strategies to enhance technology use. By incorporating human-centric approaches, addressing issues such as technostress and promoting effective digital knowledge management, this research empowers the audience with practical solutions.

Social implications

The paper underscores the broader impact of technology on societal progress. It emphasizes the importance of incorporating human-centric strategies in technology implementation to promote fairness, inclusivity and overall societal well-being.

Originality/value

This paper introduces an innovative conceptual model based on a multidimensional framework to analyze the complex evolution of human–technology interaction. It enriches the ongoing debate by highlighting the nuanced relationship between humans and technology, addressing significant gaps in existing literature and offering an original interpretative perspective.