Sustainability in Reconstructive Breast Surgery: An Eco-audit of the Deep Inferior Epigastric Perforator Flap Pathway.

Background: The deep inferior epigastric perforator (DIEP) flap provides an effective and popular means for autologous breast reconstruction. However, with the complexity of the pathway, the environmental impact of the pathway has yet to be evaluated.

Methods: A retrospective analysis of 42 unilateral DIEPs at a single reconstructive center was performed.

Collaboration between clinicians and vision-language models in radiology report generation.

Automated radiology report generation has the potential to improve patient care and reduce the workload of radiologists. However, the path toward real-world adoption has been stymied by the challenge of evaluating the clinical quality of artificial intelligence (AI)-generated reports. We build a state-of-the-art report generation system for chest radiographs, called Flamingo-CXR, and perform an expert evaluation of AI-generated reports by engaging a panel of board-certified radiologists.

Patient satisfaction using wide-awake local anaesthesia no tourniquet (WALANT) in adults undergoing elective hand surgery: A systematic review and meta-analysis.

Background: Wide-awake local anaesthesia no tourniquet (WALANT) is increasing in popularity within hand surgery. However, evidence is unclear on patient satisfaction rates when WALANT is compared against more traditional anaesthetic techniques where pneumatic tourniquets are used. The present study aimed to evaluate the satisfaction rates of patient with the WALANT technique.

Scalable watermarking for identifying large language model outputs.

Large language models (LLMs) have enabled the generation of high-quality synthetic text, often indistinguishable from human-written content, at a scale that can markedly affect the nature of the information ecosystem. Watermarking can help identify synthetic text and limit accidental or deliberate misuse, but has not been adopted in production systems owing to stringent quality, detectability and computational efficiency requirements. Here we describe SynthID-Text, a production-ready text watermarking scheme that preserves text quality and enables high detection accuracy, with minimal latency overhead.

Altered trace elements, antioxidant vitamin C, and malondialdehyde levels are associated with the pathophysiology and development of pre-hepatic jaundice: A case-control study.

Objectives: Pre-hepatic jaundice results from an imbalance between bilirubin production and clearance, often linked to hemoglobinopathies. Antioxidant vitamin C, malondialdehyde, and trace elements play roles in jaundice, yet their specific associations remain unclear. The objective is to assess and compare these biomarkers in pre-hepatic jaundice patients and healthy controls, aiming to identify potential diagnostic markers and understand distinctive characteristics related to the disease's pathogenesis.

Radiation-induced Esophagitis in Breast Cancer Patients Treated With Supraclavicular Field Irradiation.

Background/aim: The objective of this research was to assess the frequency and intensity of radiation-induced esophagitis in breast cancer patients treated with supraclavicular radiotherapy field irradiation.

Patients And Methods: This study involved 100 patients with positive lymph nodes receiving radiotherapy to the breast or chest wall along with supraclavicular field irradiation, with toxicity levels assessed weekly. Treatment utilized the 3D conformal technique, and variables, such as mean and maximum dose to the cervical esophagus, mean dose to the entire esophagus, and length of the esophagus within the treated area were recorded.

Do autistic adults spontaneously reason about belief? A detailed exploration of alternative explanations.

Southgate 's (Southgate 2007 18, 587-92 (doi:10.1111/j.1467-9280.

ALT in combination with triple-rolled TFL for reconstruction of a complex tendoachilles defect: technical details and rehabilitation regime.

A fit man in his 60s presented with an infected Achilles tendon (AT) following two failed repairs for a traumatic rupture. Initial debridement of necrotic tissue resulted in a large soft tissue defect requiring robust coverage. Following aggressive wound management, an anterolateral thigh flap was elevated with tensor fasciae latae (TFL) which was triple-rolled to provide soft tissue coverage and tendon reconstruction.

Thrombotic Thrombocytopenic Purpura due to Varicella-Zoster Virus Meningoencephalitis in an Immunocompetent Patient.

Varicella-zoster virus (VZV) can cause variable disease states in individuals with intact and compromised immune systems. Both meningoencephalitis and thrombotic thrombocytopenic purpura (TTP) are uncommon, life-threatening entities associated with VZV. There are few reported cases of TTP due to VZV and this may be the first case of TTP due to VZV meningoencephalitis confirmed through lumbar puncture.

Graphene oxide nanosheets augment silk fibroin aerogels for enhanced water stability and oil adsorption.

Nanocomposite aerogels exhibit high porosity and large interfacial surface areas, enabling enhanced chemical transport and reactivity. Such mesoporous architectures can be prepared by freeze-casting naturally-derived biopolymers such as silk fibroin, but often form mechanically weak structures that degrade in water, which limits their performance under ambient conditions. Adding 2D material fillers such as graphene oxide (GO) or transition metal carbides ( MXene) could potentially reinforce these aerogels stronger intermolecular interactions with the polymeric binder.

Prolonged operative time is a risk factor for adverse postoperative outcomes in the unilateral deep inferior epigastric perforator (DIEP) flap surgery: A retrospective cohort study.

Background: Currently, one published study documented operative time (OT) as a predictor for postoperative outcomes in bilateral deep inferior epigastric perforator (DIEP) flap breast reconstructions. No literature has investigated this in unilateral DIEP flaps. We aimed to determine the relationship between unilateral OT, postoperative complications, unplanned reoperations (UR), and extended length-of-stay (eLOS).

Increasing Chemotherapeutic Efficacy Using pH-Modulating and Doxorubicin-Releasing Injectable Chitosan-Poly(ethylene glycol) Hydrogels.

Modulation of pH is crucial to maintaining the chemical homeostasis of biological environments. The irregular metabolic pathways exhibited by cancer cells result in the production of acidic byproducts that are excreted and accumulate in the extracellular tumor microenvironment, reducing the pH. As a consequence of the lower pH in tumors, cancer cells increase the expression of metastatic phenotypes and chemotherapeutic resistance.

Pressure injury incidence and impact on patients treated with prone positioning for COVID-19 ARDS.

Objective: To determine the incidence of pressure injuries (PIs) and their impact on clinical outcomes in patients treated with prone positioning for COVID-19 acute respiratory distress syndrome (ARDS).

Method: All patients with COVID-19 ARDS who were treated with prone positioning were categorised as cases and those who were not treated with prone positioning were categorised as controls. Demographics, clinical data and confounding variables affecting outcomes were recorded.

Health Coaching for Weight Loss Among Overweight and Obese Individuals in Saudi Arabia: A Retrospective Analysis.

Background Health coaching is an increasingly used strategy to help in adopting lifestyle changes for weight loss. While Saudi Arabia has one of the highest obesity prevalences worldwide, research on lifestyle interventions for weight loss is limited. Aim We aimed to investigate the effectiveness of health coaching for weight loss among the Saudi population in real-world primary healthcare settings.

Enhancing the reliability and accuracy of AI-enabled diagnosis via complementarity-driven deferral to clinicians.

Predictive artificial intelligence (AI) systems based on deep learning have been shown to achieve expert-level identification of diseases in multiple medical imaging settings, but can make errors in cases accurately diagnosed by clinicians and vice versa. We developed Complementarity-Driven Deferral to Clinical Workflow (CoDoC), a system that can learn to decide between the opinion of a predictive AI model and a clinical workflow. CoDoC enhances accuracy relative to clinician-only or AI-only baselines in clinical workflows that screen for breast cancer or tuberculosis (TB).

A Single-center Comparison of Unipedicled and Bipedicled Diep Flap Early Outcomes in 98 Patients.

Unlabelled: The deep inferior epigastric perforator (DIEP) flap is the gold standard for autologous breast reconstruction. One or two pedicles may be used. Our study is the first to compare unipedicled and bipedicled DIEP flaps on donor and recipient site outcomes in the same patient cohort.

Put you in the problem: Effects of self-pronouns on mathematical problem-solving.

Self-cues such as personal pronouns are known to elicit processing biases, such as attention capture and prioritisation in working memory. This may impact the performance of tasks that have a high attentional load like mathematical problem-solving. Here, we compared the speed and accuracy with which children solved numerical problems that included either the self-cue "you," or a different character name.

Action on the social determinants for advancing health equity in the time of COVID-19: perspectives of actors engaged in a WHO Special Initiative.

Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in 'Pathfinder' countries.

From working in emergency to working for peace: leveraging health to build peace in the Eastern Mediterranean Region.

The World Health Organization has noted the important synergies between health and peace since its very inception, both in its foundational document and in its work globally. The WHO Constitution remarks that the "health of all peoples is fundamental to the attainment of peace and security and is dependent on the fullest co-operation of individuals and States". In addition, peace is noted as being one of the fundamental conditions to promote health in the Ottawa Charter for Health Promotion in 1986.

SARS-CoV-2 Testing in the Community: Testing Positive Samples with the TaqMan SARS-CoV-2 Mutation Panel To Find Variants in Real Time.

Genome sequencing is a powerful tool for identifying SARS-CoV-2 variant lineages; however, there can be limitations due to sequence dropout when used to identify specific key mutations. Recently, ThermoFisher Scientific has developed genotyping assays to help bridge the gap between testing capacity and sequencing capability to generate real-time genotyping results based on specific variants. Over a 6-week period during the months of April and May 2021, we set out to assess the ThermoFisher TaqMan mutation panel genotyping assay, initially for three mutations of concern and then for an additional two mutations of concern, against SARS-CoV-2-positive clinical samples and the corresponding COVID-19 Genomics UK Consortium (COG-UK) sequencing data.

Diseased Filum Terminale as a Cause of Tethered Cord Syndrome in Ehlers-Danlos Syndrome: Histopathology, Biomechanics, Clinical Presentation, and Outcome of Filum Excision.

Background: Patients with hypermobile Ehlers-Danlos syndrome (hEDS), a heritable connective tissue disorder, present frequently with symptoms of tethered cord syndrome (TCS) but without a low-lying conus. Currently, surgical treatment of such cases is controversial. Because connective tissue disorder affects fibrous structures, we hypothesized that a diseased filum terminale (FT) might cause TCS in hEDS, justifying surgical transection for treatment.