Double Medial Circumflex Femoral Artery Perforator Flaps for Unilateral Breast Reconstruction-A Case Report.

Thigh-based free flaps are a common second-line options in autologous breast reconstruction when the abdominal donor site is unavailable. While the profunda artery perforator (PAP) flap and gracilis-based flaps are most commonly utilized in this scenario, certain anatomic variations may favor alternative flap selection. One such option is the medial circumflex femoral artery perforator flap (MCFLAP).

Current and future applications of artificial intelligence in surgery: implications for clinical practice and research.

Surgeons are skilled at making complex decisions over invasive procedures that can save lives and alleviate pain and avoid complications in patients. The knowledge to make these decisions is accumulated over years of schooling and practice. Their experience is in turn shared with others, also via peer-reviewed articles, which get published in larger and larger amounts every year.

Navigating the Ethical Landmines of ChatGPT: Implications of Intelligent Chatbots in Plastic Surgery Clinical Practice.

ChatGPT is a cutting-edge language model developed by OpenAI with the potential to impact all facets of plastic surgery from research to clinical practice. New applications for ChatGPT are emerging at a rapid pace in both the scientific literature and popular media. It is important for clinicians to understand the capabilities and limitations of these tools before patient-facing implementation.

Air or Saline? A Propensity Score-Matched Analysis on the Effect of Tissue Expander Fill on Complications in Immediate Breast Reconstruction.

Background: Tissue expander fill medium and volume have implications for the pressure exerted on mastectomy skin flaps. This study evaluated the influence of initial fill medium (air vs. saline) on complications in immediate breast reconstruction within a propensity score-matched cohort.

Two Thumbs Down: A 10-Year Analysis of Crossbow-Related Hand and Digit Injuries in the United States.

Background: Modern crossbow is a popular weapon used throughout the United States for outdoor recreation. Crossbow mechanics place the hand and digits at significant risk of injury while shooting or handling these weapons; however, injury patterns have been poorly documented. In this study, the authors use a national database to assess patterns of crossbow-related injuries of the hand and digits.

Consequences and Predictors of Prolonged Tissue Expander Duration in Breast Reconstruction.

Background:  Tissue expanders (TEs) are temporary devices used in breast reconstruction, which are generally removed within 1 year. There is a paucity of data regarding the potential consequences when TEs have longer indwelling times. Thus, we aim to determine whether prolonged TE implantation length is associated with TE-related complications.

Variations in Incidence of Trigger Finger and Response to Corticosteroid Injection after Aromatase Inhibitor Therapy for Breast Cancer.

Background: Aromatase inhibitors (AIs), such as letrozole and anastrozole, have been demonstrated to have significant musculoskeletal symptoms in patients. The purpose of this study was to evaluate the effect of specific AI medications on the incidence of trigger finger and independent factors affecting treatment outcomes within this population.

Methods: A retrospective chart review was performed at the authors' institution between the years 2014 and 2018 in patients with the diagnosis of breast cancer.

Predicting Final Implant Volume in Two-stage Prepectoral Breast Reconstruction.

Unlabelled: Two-stage implant-based breast reconstruction remains the most commonly performed reconstructive modality following mastectomy. Although prior studies have explored the relationship between tissue expander (TE) features and permanent implant (PI) size in subpectoral reconstruction, no such study exists in prepectoral reconstruction. This study aims to identify pertinent TE characteristics and evaluate their correlations with PI size for prepectoral implant-based reconstruction.

Ethical, Legal, and Financial Considerations of Artificial Intelligence in Surgery.

Machine learning systems have become integrated into some of the most vital decision-making aspects of humanity, including hiring decisions, loan applications, and automobile safety, to name just a few. As applications increase in both gravity and complexity, the data quality and algorithmic interpretability of the systems must rise to meet those challenges. This is especially vital for navigating the nuances of health care, particularly among the high stakes of surgical operations.

New Frontiers of Natural Language Processing in Surgery.

The vast and ever-growing volume of electronic health records (EHR) have generated a wealth of information-rich data. Traditional, non-machine learning data extraction techniques are error-prone and laborious, hindering the analytical potential of these massive data sources. Equipped with natural language processing (NLP) tools, surgeons are better able to automate, and customize their review to investigate and implement surgical solutions.

Deep Learning Applications in Surgery: Current Uses and Future Directions.

Deep learning (DL) is a subset of machine learning that is rapidly gaining traction in surgical fields. Its tremendous capacity for powerful data-driven problem-solving has generated computational breakthroughs in many realms, with the fields of medicine and surgery becoming increasingly prominent avenues. Through its multi-layer architecture of interconnected neural networks, DL enables feature extraction and pattern recognition of highly complex and large-volume data.

Comparative Effectiveness of Behavioral Interventions on Quality of Life for Older Adults With Mild Cognitive Impairment: A Randomized Clinical Trial.

Importance: Recommendations to engage in behavioral strategies to combat clinically significant cognitive and behavioral symptoms are routinely given to persons with mild cognitive impairment (MCI). The comparative effectiveness of these behavioral interventions is not well understood.

Objective: To compare the incremental effects of combinations of 5 behavioral interventions on outcomes of highest importance to patients with MCI.

Physical exercise and cognitive engagement outcomes for mild neurocognitive disorder: a group-randomized pilot trial.

Background: Amnestic mild cognitive impairment (aMCI) is considered a risk state for the development of dementia due to Alzheimer's disease. It is also a period in which interventions may be most effective in slowing progression to dementia. Computerized cognitive training and increased physical activity have shown to be among the most promising interventions.

Behavioral Interventions to Prevent or Delay Dementia: Protocol for a Randomized Comparative Effectiveness Study.

Background: Currently, people at risk for dementia and their caregivers are confronted with confusing choices about what behavioral interventions are most effective.

Objective: The objective of this study is to determine which empirically supported behavioral interventions most impact the outcomes highly valued by patients with mild cognitive impairment and their partners.

Methods: This protocol describes a comparative effectiveness trial targeting 300 participants with mild cognitive impairment and their study partners.

Out of Arabia-the settlement of island Soqotra as revealed by mitochondrial and Y chromosome genetic diversity.

The Soqotra archipelago is one of the most isolated landmasses in the world, situated at the mouth of the Gulf of Aden between the Horn of Africa and southern Arabia. The main island of Soqotra lies not far from the proposed southern migration route of anatomically modern humans out of Africa approximately 60,000 years ago (kya), suggesting the island may harbor traces of that first dispersal. Nothing is known about the timing and origin of the first Soqotri settlers.

Peritraumatic responses and their relationship to perceptions of threat in female crime victims.

Peritraumatic responses, aside from dissociation, have been understudied in acute trauma populations. Participants were 172 female rape, 68 assault, and 80 robbery victims recruited through formal reporting agencies and assessed 1 month after the crime. Despite substantial overlap across crimes, rape victims reported more emotional responses reflecting fear, detachment, shame, and more nonactive behavioral responses.