New and Emerging Biological Therapies for Myasthenia Gravis: A Focussed Review for Clinical Decision-Making.

Myasthenia gravis (MG) is a rare autoimmune disease characterised by exertion-induced muscle weakness that can lead to potentially life-threatening myasthenic crises. Detectable antibodies are directed against specific postsynaptic structures of the neuromuscular junction. MG is a chronic condition that can be improved through therapies, but to date, not cured.

Innovative technique of corking the lumen of an intraoperatively decompressed turgid gall bladder with surgical gauze to prevent gall bladder stone/bile spillage during a laparoscopic cholecystectomy.

Technical difficulties are often encountered in a laparoscopic cholecystectomy where a tense/distended/ turgid gall bladder prevents the surgeon from grasping the gall bladder properly which therefore necessitates the decompression of the turgid gall bladder. However, even if intraoperative decompression is done, the spillage of remnant stones, bile or fluid from the gall bladder is a possibility which can lead to undue complications. This is where following the simple technique of using a gauze piece with a radio-opaque marker to occlude the decompression puncture site helps in performing a safe decompression thereby preventing bile, fluid or stone spillage.

Self-sovereign management scheme of personal health record with personal data store and decentralized identifier.

Conventional personal health record (PHR) management systems are centralized, making them vulnerable to privacy breaches and single points of failure. Despite progress in standardizing healthcare data with the FHIR format, hospitals often lack efficient platforms for transferring PHRs, leading to redundant tests and delayed treatments. To address these challenges, we propose a decentralized PHR management system leveraging Personal Data Stores (PDS) and Decentralized Identifiers (DIDs) in line with the Web 3.

Risk Factors for Positive Resection Margins Following Breast-Conserving Surgery.

Background The incidence of margin re-excision following breast conserving surgery (BCS) is a quality measure in the National Health Service. The threshold is less than 20% of all BCS procedures. Despite three decades of studies and a wealth of literature identifying multiple factors associated with increased risk for margin involvement, an accepted threshold rate affecting one in five procedures remains high.

Developing affordable and efficient heating devices for enhanced live cell imaging in confocal microscopy.

Temperature control is crucial for live cell imaging, particularly in studies involving plant responses to high ambient temperatures and thermal stress. This study presents the design, development, and testing of two cost-effective heating devices tailored for confocal microscopy applications: an aluminum heat plate and a wireless mini-heater. The aluminum heat plate, engineered to integrate seamlessly with the standard 160 mm × 110 mm microscope stage, supports temperatures up to 36°C, suitable for studies in the range of non-stressful warm temperatures (e.

Keyhole Mini-Pterional Craniotomy for Clipping of Bilateral Middle Cerebral Artery Aneurysms.

Middle cerebral artery (MCA) aneurysms remain excellent candidates for microsurgical treatment, despite proliferation of new endovascular tools. Nonetheless, patients desire less invasive options for permanent, durable treatment of their aneurysms; this is particularly the case for those presenting without subarachnoid hemorrhage, and those with multiple aneurysms that may require several surgical approaches. Keyhole craniotomies, when properly utilized in well-selected patients, allow for minimally invasive treatment of both ruptured and unruptured cerebral aneurysms, including those harboring bilateral aneurysms which may be treated from a single approach.

Adjusting on-scene CPR duration based on transport time interval in out-of-hospital cardiac arrest: a nationwide multicenter study.

The optimal duration of on-scene cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients remains uncertain. Determining this critical time period requires outweighing the potential risks associated with intra-arrest transport while minimizing delays in accessing definitive hospital-based treatments. This study evaluated the association between on-scene CPR duration and 30-day neurologically favorable survival based on the transport time interval (TTI) in patients with OHCA.

Abortion provision and characteristics of abortion patients in an academic medical center in Washington state before and after Dobbs.

Objective: To examine abortion care in the largest academic medical center in Washington, a state protective of abortion rights, before and after the Supreme Court Dobbs decision.

Methods: This retrospective cohort study evaluated abortion provision at the University of Washington between January 1, 2022 and October 31, 2023. Data on patient sociodemographic and clinical characteristics were extracted from electronic medical records.

SEPO-FI: Deep-learning based software to calculate fusion index of muscle cells.

The fusion index is a critical metric for quantitatively assessing the transformation of in vitro muscle cells into myotubes in the biological and medical fields. Traditional methods for calculating this index manually involve the labor-intensive counting of numerous muscle cell nuclei in images, which necessitates determining whether each nucleus is located inside or outside the myotubes, leading to significant inter-observer variation. To address these challenges, this study proposes a three-stage process that integrates the strengths of pattern recognition and deep-learning to automatically calculate the fusion index.

Implementation of the I-DECIDED tool for PIVC assessment and decision making: discussion paper.

Highlights: PIVCs often cause pain, irritation, or infection. Regular and careful catheter checks can decrease complications and improve patient outcomes. Implementation of the I-DECIDED® tool led to fewer idle catheters and complications.

"When People Reach Out that is When They're Desperate": Understanding Informal and Formal Help-Seeking Practices for Gambling among Aboriginal Peoples in the Northern Territory, Australia.

This study provides an in-depth qualitative exploration of Aboriginal peoples' experiences with seeking help for gambling-related issues in the Northern Territory (NT), Australia. Through semi-structured interviews with 29 participants, including regular and occasional gamblers as well as those affected by others' gambling, the research highlights key barriers to seeking formal help. These barriers included the normalisation of gambling within Aboriginal communities, denial of gambling problems, feelings of shame, privacy concerns, and a lack of trust in mainstream services.

High-Performance Optical Fiber Displacement Sensor with Extended Linear Range and Sensitivity.

Optical Fiber Displacement Sensors (OFDSs) provide several advantages over conventional sensors, including their compact size, flexibility, and immunity to electromagnetic interference. These features make OFDSs ideal for use in confined spaces, such as turbines, where direct laser access is impossible. A critical aspect of OFDS performance is the geometry of the fiber bundle, which influences key parameters such as sensitivity, range, and dead zones.

Clinical Whole-Body Gait Characterization Using a Single RGB-D Sensor.

Instrumented gait analysis is widely used in clinical settings for the early detection of neurological disorders, monitoring disease progression, and evaluating fall risk. However, the gold-standard marker-based 3D motion analysis is limited by high time and personnel demands. Advances in computer vision now enable markerless whole-body tracking with high accuracy.

Strategies for Optimizing Acute Burn Wound Therapy: A Comprehensive Review.

Recent advancements in acute burn wound therapy are transforming the management of burn injuries, with a focus on improving healing times, graft integration, and minimizing complications. However, current clinical treatments face significant challenges, including the difficulty of accurately assessing wound depth and tissue viability, which can lead to suboptimal treatment planning. Traditional closure methods often struggle with issues such as delayed wound closure, limited graft survival, inadequate tissue regeneration, and insufficient vascularization.

Sex Determination in Reptiles: A Review.

Reptile biodiversity is rapidly declining, with over 11,733 recognized species across 1226 genera being documented, many of which are endangered. Captive breeding programs play a crucial role in conservation; however, effective management requires accurate sex determination, especially due to the fact that many reptile species exhibit minimal or no sexual dimorphism. When present, sexual dimorphism manifests as differences such as size, coloration, and morphological features influenced by evolutionary pressures and hormones.

Prenatal labor analgesia education program on outcomes for primiparas: study protocol for a randomized controlled trial.

Background: A significant number of primiparous women lack awareness of labor epidural analgesia, resulting in lower acceptance of labor epidural analgesia. Additional prenatal education may help primiparas understand labor epidural analgesia and increase labor epidural analgesia rates. This randomized controlled trial (RCT) will evaluate the effects of an online and offline prenatal labor epidural analgesia education program for primiparas to improve their labor epidural analgesia rate and to reduce their misunderstanding of labor epidural analgesia and fear of birth.

Development, implementation, and evaluation of an innovative clinical trial operations training program for Africa (ClinOps).

Background: Africa's involvement in clinical trials remains very low. Although the crucial role of training initiatives in building clinical trial capacity in Africa has been documented, current efforts fall short as they lack alignment with local contexts. This study aimed to design, develop, implement, and evaluate an innovative clinical trial operations training program for Africa.

Dissipation Alters Modes of Information Encoding in Small Quantum Reservoirs near Criticality.

Quantum reservoir computing (QRC) has emerged as a promising paradigm for harnessing near-term quantum devices to tackle temporal machine learning tasks. Yet, identifying the mechanisms that underlie enhanced performance remains challenging, particularly in many-body open systems where nonlinear interactions and dissipation intertwine in complex ways. Here, we investigate a minimal model of a driven-dissipative quantum reservoir described by two coupled Kerr-nonlinear oscillators, an experimentally realizable platform that features controllable coupling, intrinsic nonlinearity, and tunable photon loss.

Robotic Surgery from a Gynaecological Oncology Perspective: A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study (GO SOAR3).

Background/objectives: For healthcare institutions developing a robotic programme, delivering value for patients, clinicians, and payers is key. However, the impact on the surgeon, training pathways, and logistics are often overlooked. We conducted a study on the impact of robotic surgery on surgeons, access to robotic surgical training, and factors associated with developing a successful robotic programme.

3D-Printing of Artificial Aortic Heart Valve Using UV-Cured Silicone: Design and Performance Analysis.

The advancement of medical 3D printing technology includes several enhancements, such as decreasing the length of surgical procedures and minimizing anesthesia exposure, improving preoperative planning, creating personalized replicas of tissues and bones specific to individual patients, bioprinting, and providing alternatives to human organ transplants. The range of materials accessible for 3D printing within the healthcare industry is significantly narrower when compared with conventional manufacturing techniques. Liquid silicone rubber (LSR) is characterized by its remarkable stability, outstanding biocompatibility, and significant flexibility, thus presenting substantial opportunities for manufacturers of medical devices who are engaged in 3D printing.

Edge-AI Enabled Wearable Device for Non-Invasive Type 1 Diabetes Detection Using ECG Signals.

Diabetes is a chronic condition, and traditional monitoring methods are invasive, significantly reducing the quality of life of the patients. This study proposes the design of an innovative system based on a microcontroller that performs real-time ECG acquisition and evaluates the presence of diabetes using an Edge-AI solution. A spectrogram-based preprocessing method is combined with a 1-Dimensional Convolutional Neural Network (1D-CNN) to analyze the ECG signals directly on the device.

Breaking Barriers: Addressing Gender Disparities in Hip Resurfacing Surgery Access in the United States.

Second-generation large-diameter head hip resurfacing (HR) arthroplasty has gained popularity in terms of its potential for minimal wear and the preservation of proximal femoral bone stock. HR faces challenges, such as increased hip fracture rates and adverse reactions to metal detritus, despite the fact that over one million metal-on-metal (MoM) arthroplasties have been performed globally. FDA issued warnings in 2011 and 2016 regarding higher failure rates in women and categorized MoM implants as high-risk, influencing U.

Comparison of an AI-based mobile pupillometry system and NPi-200 for pupillary light reflex and correlation with glaucoma-related markers.

Introduction: Glaucoma is a leading cause of blindness, often progressing asymptomatically until significant vision loss occurs. Early detection is crucial for preventing irreversible damage. The pupillary light reflex (PLR) has proven useful in glaucoma diagnosis, and mobile technologies like the AI-based smartphone pupillometer (AI Pupillometer) offer a promising solution for accessible screening.

A nomogram for predicting neonatal acute respiratory distress syndrome in patients with neonatal pneumonia after 34 weeks of gestation.

Objective: To establish a prediction nomogram for early prediction of neonatal acute respiratory distress syndrome (NARDS).

Methods: This is a retrospective cross-sectional study conducted between January 2021 and December 2023. Clinical characteristics and laboratory results of cases with neonatal pneumonia were compared in terms of presence of NARDS diagnosis based on the Montreux Definition.

Dominant Occipital Sinus: A Rare Anatomical Variant With Potentially Catastrophic Consequences if Unrecognized Preoperatively.

The occipital sinus is often thought of as a redundant vestigial structure in adults. However, in rare cases, it can form the dominant route of intracerebral venous drainage, with a risk of significant surgical morbidity if unrecognised. We present an illustrative case describing this anatomical variant and tailoring of a midline suboccipital craniotomy to allow resection of a fourth ventricular epidermoid tumour with preservation of a dominant occipital sinus, and a review of the published literature.