Equinovarus is a prevalent and debilitating foot deformity requiring surgical intervention when conservative management fails. We performed triple arthrodesis using a modified Lambrinudi combined with X-shaped plate internal fixation to correct deformity, improve gait, and restore walking function, with the primary goal of enhancing the patient's quality of life. This retrospective consecutive case series of 14 patients (mean age, 41.9 ± 15.7 years) aimed to describe clinical/radiographic outcomes and the feasibility of X‑shaped plate fixation within a modified Lambrinudi triple arthrodesis. The patient cohort comprised 4 males and 10 females, with underlying etiologies including poliomyelitis, cerebral palsy, post-traumatic sequelae, and Charcot-Marie-Tooth disease. All patients underwent modified Lambrinudi triple arthrodesis combined with soft tissue procedures. Outcomes were assessed through radiographic evaluation (including the talar-calcaneal angle, talus-first metatarsal angle, and calcaneal-fifth metatarsal angle, all measured on anteroposterior radiographs, along with the lateral talus-first metatarsal angle) and clinical investigations: MOS 36-Item Short-Form Health Survey (SF-36) score, visual analog scale (VAS), and International Clubfoot Study Group (ICFSG) Outcome Evaluation Score. Mean follow-up time was 46.1 ± 14.8 months (range, 24-69). Radiographic assessment demonstrated bony union in all patients at 6 months following triple arthrodesis. Postsurgical improvements in foot morphology and function occurred at varying levels across the cohort. At last follow-up, marked increases in SF-36 scores were observed in both physical and mental domains, whereas the VAS score decreased from 6.7 to 1.4 (P < .001) and ICFSG score decreased from 37.7 to 8.1 (P < .001), with an excellent-to-good rate of 93%. Patients' quality of life improved. Satisfactory fusion rates, favorable clinical outcomes, simple internal fixation requirements were all associated with the modified Lambrinudi procedure with X-shaped plate fixation for triple arthrodesis. This internal fixation is reliable.

Nasal base depression is a frequent aesthetic concern in rhinoplasty, particularly in patients with midfacial retrusion. This study introduces a fascia transplantation technique to correct alar base (paranasal) depression and restore nasal-facial harmony through structural support of the alar base. A retrospective analysis was conducted on 52 patients who underwent fascia grafting during open rhinoplasty. Fascia placement was performed primarily for alar base/paranasal augmentation; changes in tip projection or nasolabial angle, when present, were not direct surgical targets of the fascia graft. Fascia was harvested from postauricular or rectus abdominis regions, depending on the cartilage source. Nasal morphology was evaluated pre- and postoperatively using standardized anthropometric measurements. Alar base depression was quantitatively assessed through grayscale image analysis using ImageJ. Patient satisfaction was measured with a modified Rhinoplasty Outcome Evaluation (ROE) scale. Complications were monitored via clinical examination, standardized photography, and a structured questionnaire addressing symptoms such as foreign-body sensation, graft displacement, and local discomfort. Following fascia-based nasal base augmentation, significant aesthetic improvements were observed. Alar width and base width changes were minimal and statistically insignificant. Postoperative grayscale analysis showed a significant decrease in values (from 0.720 to 0.583, P < 0.05), indicating reduced alar base depression following fascia grafting. The mean postoperative ROE score increased notably, with no major complications such as foreign-body sensation or graft displacement reported. Fascia transplantation provides stable augmentation of the alar base/paranasal region with a favorable safety profile; any observed changes in tip projection or nasolabial angle should be interpreted as secondary (indirect) effects rather than direct targets of fascia placement. It represents a safe and effective autologous option for achieving durable, harmonious aesthetic outcomes in rhinoplasty. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Accurate stent positioning in aorto-ostial lesions remains challenging due to complex three-dimensional anatomy, lack of optimal fluoroscopic projections, and high rates of geographic miss. Stent overhang impairs guide catheter re-engagement and complicates future revascularization. Despite its frequency, no standardized approach exists for managing excessive stent protrusions. This study systematically evaluated management strategies for excessive aorto-ostial stent protrusion, integrating comprehensive bench testing with clinical case experience, and assessed the feasibility, mechanics, and outcomes of the Side Flap technique. Bench experiments assessed multiple corrective strategies in two scenarios, guidewire crossing through the central stent lumen and through a side cell, across contemporary DES platforms. Mechanical feasibility, force transmission, stent deformation and expansion, and structural integrity were evaluated using high-pressure ballooning, catheter-assisted maneuvers, and intracoronary imaging. A retrospective multicenter series provided complementary real-world clinical outcomes of the Side Flap technique. Longitudinal stent compression using guide catheters, large balloons, or telescoping maneuvers proved mechanically ineffective and frequently produced severe stent deformation or malapposition. In contrast, intentional side-cell recrossing with creation of a neo-lumen was consistently feasible, structurally stable, and reproducible. All DES platforms tolerated large-diameter side-cell expansion without strut fracture, yielding circular neo-lumens with excellent apposition on OCT. Clinically, the Side Flap technique achieved high procedural success with no technique-related adverse events during follow-up. The Side Flap technique offers a controlled and reproducible alternative strategy when true-lumen access is not achievable or fails, and represents a valuable addition to the interventional armamentarium. Longitudinal stent crush techniques are unreliable for managing excessive aorto-ostial protrusion.

BACKGROUND: This study emphasis on effectiveness of various non-pharmacological methods and nursing interventional care and its evaluation among post-caesarean women in selected hospitals in India and other countries. Nursing intervention basically refers to standard post-operative care delivered to women undergone lower segment caesarean section to plummet post-surgery complications, reduce negative experience of the mother, and improve outcome of C-section post operation care and speedy healing of the women. OBJECTIVE: To identify studies regarding rate and incidence of C-sections and to identify studies which had included standard nursing interventional care and their effectiveness in the maternal outcome among post caesarean women at selected hospitals. METHODS: Online database browsed from PubMed, Google scholar, Sodhganga, Medline, research gate, Scopus, WoS by using keywords rate of caesarean section, post -operative care, nursing intervention, maternal outcome after C-section. RESULT: 12 articles were included in this review study reflecting maternal recovery regarding non-pharmacological interventions delivered to post- caesarean mothers. Difference in maternal and foetal outcome between routine nursing care and planned interventional nursing care. Significant recovery has been recorded in all therapeutic studies with positive maternal and foetal outcome. CONCLUSION: To summarise the review study that unveiled the positive maternal outcome which can be attained after caesarean section, by implementing various nursing interventional approaches among post-caesarean women that includes standardized post-operative outcome evaluation. Keywords: Rate and incidence of C-section, post-operative care, caesarean mother, nursing intervention, early ambulation

ABSTRACT It is increasingly evident that the second Trump administration (Trump II) has made tariffs its strategic weapon of choice, even as it advances a narrative of national economic and societal renewal. An interim evaluation of policy outcomes suggests that Western economic warfare has achieved, at best, poor results in modifying Putin’s behavior of geopolitical aggression. As regards Russia’s attack on Ukraine and escalatory political warfare against Europe and the United States, these actions have proven catastrophic, magnifying Putin’s self-created security dilemma that now drives NATO expansion, modernization, and forward deployment; propels Western nations towards integrated counter-hybrid warfare strategies; and increases Russian dependence on China. What remains uncertain is whether Trump II’s egregious affinity for the Russian aggressor will ultimately promote new policies that snatch defeat from the jaws of victory and further embolden the West’s authoritarian adversaries.

Each year, physical traumas affect over one billion people worldwide, generating a substantial burden in terms of mortality, disability and productivity loss. The period following hospital discharge, encompassing the transition to home, short-term stays in rehabilitation facilities, as well as outpatient and community-based follow-up care, represents a critical phase in the recovery process for trauma injury patients. Yet, this phase remains poorly documented. We aim to (1) Map data on assessment strategies for various outcomes among trauma survivors after hospital discharge, including the tools used and how they are administered, as well as the resources required, and the barriers and facilitators to their implementation, and (2) Compare the feasibility of implementing the assessment strategies while considering response rates, resource use, costs and sustainability. We will conduct a scoping review using the Joanna Briggs Institute methodology. We will search MEDLINE, Embase, CINAHL, Scopus and PsycINFO for studies published since 1990 to reflect the evolution of contemporary follow-up practices, including the emergence of Patient-Reported Outcome Measures and digital tools. There will be no language restrictions. We will consider all studies involving trauma survivors, focusing on the evaluation of postdischarge health outcomes. Two independent reviewers will screen studies and extract data on population characteristics, assessment strategies and feasibility. Results will be analysed thematically and presented narratively. We will present counts and percentages for each assessment strategy, along with its characteristics and associated barriers and facilitators. Subgroup analyses will also be conducted based on clinical and social determinants and contextual factors. Ethics approval is not required for this review. The results of this scoping review will be shared through publication in a peer-reviewed journal, conference presentations and our network of knowledge users. DOI 10.17605/OSF.IO/KZHS4.

The mortality among patients admitted with sepsis remains high and varies depending on the site of infection. The impact of hypercapnia and acidemia on clinical outcomes in mechanically ventilated patients with sepsis is not well understood. Multicenter, binational, retrospective study assessed the association of compensated hypercapnia, hypercapnic acidemia, and nonrespiratory acidemia, in mechanically ventilated patients with mortality in sepsis. Data were extracted from the "Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation adult patient" database over a 17-year period (from January 2006 to December 2022) from 201 ICUs. Patients were classified into four mutually exclusive groups based on a combination of arterial pH and arterial Co2 recorded during the first 24 hours of ICU stay: normocapnia with normal pH, fully compensated hypercapnia, hypercapnic acidemia, and nonrespiratory acidemia. Logistic regression and Cox proportional hazards regression were used to examine the association of compensated hypercapnia, hypercapnic, and nonrespiratory academia to hospital mortality. None. Fifty-two thousand four hundred five patients were included. Overall compensated hypercapnia (odds ratio [OR], 1.39; 95% CI, 1.24-1.55; p < 0.001), hypercapnic acidemia (OR, 1.68; 95% CI, 1.57-1.80; p < 0.001), and nonrespiratory acidemia (OR, 1.75; 95% CI, 1.61-1.90; p < 0.001) was associated with increased risk of hospital mortality as compared with patients with normocapnia and normal pH. The risk of increased hospital mortality associated with hypercapnic and nonrespiratory acidemia persisted in all prespecified diagnostic subgroups when compared with patients who had normal pH and normocapnia. Compensated hypercapnia was associated with increased mortality risk in neurologic and unspecified subgroups of sepsis. Hypercapnic acidemia and nonrespiratory acidemia within the first 24 hours of ICU admission are associated with increased risk of hospital mortality in mechanically ventilated patients with sepsis. This association remains consistent in all diagnostic subgroups of sepsis.

Evaluation of the clinical outcomes and factors affecting the prognosis of endodontic microsurgery using cone-beam computed tomography: a retrospective cohort study.

INTRODUCTION. Evaluation of endodontic treatment outcomes through radiographic assessment is subject to interobserver variability and depends heavily on clinician experience. Artificial intelligence (AI) platforms offer potential for standardized, objective assessment of periapical healing. MATERIALS AND METHODS. This retrospective study analyzed 400 panoramic radiographs from patients who underwent root canal treatment between January 2023 and December 2024. An AI platform developed using TensorFlow and Keras, with model training in PyTorch and validation in MATLAB Deep Learning Toolbox, was employed. Three blinded expert endodontists independently assessed all radiographs, with consensus serving as the gold standard. Outcomes were classified as healed, healing, or diseased based on periapical index criteria. Diagnostic performance metrics including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated. RESULTS. The AI platform demonstrated overall accuracy of 89.8% in classifying treatment outcomes. For detecting healed cases, sensitivity was 92.3%, specificity 87.6%, PPV 88.9%, and NPV 91.5%. For diseased / persistent pathology detection, sensitivity was 88.7%, specificity 93.2%, PPV 84.3%, and NPV 95.1%. Agreement between AI and expert consensus was substantial (Cohen’s κ = 0.834, p &lt; 0.001). AI performance was superior in anterior teeth (93.2% accuracy) compared to molars (86.4% accuracy, p = 0.008). Processing time per radiograph averaged 2.3 ± 0.4 seconds. CONCLUSIONS. The AI-driven platform demonstrated high diagnostic accuracy comparable to expert assessment, with potential for standardized, rapid evaluation of endodontic treatment outcomes. Further prospective validation and clinical integration studies are warranted.

Safewards implementation in residential aged care: a pilot and feasibility study.

Evaluation of early surgical outcomes for posterior fossa lesions using the far lateral approach: Single-surgeon series from Vietnam

To compare complication rates and visual outcomes of cataract surgery performed by trainees vs independent surgeons. 8 UK clinical centers. Retrospective multicenter clinical database study. 15-year data of 35 558 cataract surgeries undertaken by trainees and 77 131 by independent surgeons were evaluated for the rate of operative complications with emphasis on posterior capsule rupture (PCR) and logMAR distance visual acuity (VA) (defined as best available value of uncorrected or corrected VA) at 4 to 12 weeks. Recording of intraoperative complications was robust using a predetermined list of cataract surgery complications in the electronic medical record. Trainees operated on less complex eyes, with lower rates of advanced cataracts and poor pupillary dilation ( P < .001). Trainee surgeries had a significantly higher rate of PCR (2.4% vs 1.3%) compared with independent surgeons. Junior trainees had the highest PCR rate at 3.87%, compared with senior trainees at 2.12%. Using the funnel plot methodology, most surgeons seemed to approach the overall mean of PCR, 1.9%, at a surgical volume of approximately 150 cases. At 4 to 12 weeks postoperatively, there was no significant difference in the mean logMAR VA between both groups (0.197 vs 0.200, Snellen equivalent ∼20/30, P = .095). PCR should be the primary metric for assessing the quality of trainee-performed cataract surgery rather than VA outcomes. Funnel plot representation of PCR provides an equitable approach for monitoring trainees' surgical progress and peer-to-peer comparisons.

Introduction: Coronavirus Disease 2019 (COVID-19) infection has been difficult to control despite advancements in medical science. Many short and long-term complications following COVID-19 infection are still being observed. The hypoxaemia episodes occurring in the first trimester of pregnant women and their potential role in causing congenital malformations in newborns remain unclear. Limited information is available regarding the effects of Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) during the first trimester of pregnancy and its association with the risk of developing Major Congenital Malformations (MCMs). Aim: To compare the development of congenital malformations in pregnant women who tested SARS-CoV-2 positive and those who tested negative during the first trimester of pregnancy. Materials and Methods: A prospective cohort study was conducted in a small town in the Hooghly district of West Bengal between January 2021 and December 2021. Two nursing homes were selected for sample collection, with approximately 100 patients per centre. The study included 100 pregnant women in their first trimester who tested SARS-CoV-2 positive and another 100 pregnant women in their first trimester who tested negative. An unpaired t-test was performed to analyse the association between the development of MCMs in both groups. Results: The mean maternal age was comparable between the COVID-19-exposed group (24.6 years) and the nonexposed group (25.2 years). The proportions of primigravida and multigravida women were also similar in both groups (62% vs. 64% primigravida, respectively). The odds ratio for MCMs in the COVID-19-exposed group was 0.49, indicating a lower likelihood compared to the non-exposed group. The average Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability/response), Activity (muscle tone), and Respiration (breathing effort) (APGAR) scores at 1 and 5 minutes were slightly higher in the exposed group (7.01 and 7.45) than in the non-exposed group (6.8 and 7.28), though the differences were not statistically significant (p=0.28 and p=0.50, respectively). Conclusion: The present study concludes that there is no evidence of increased risk of MCMs associated with firsttrimester maternal SARS-CoV-2 infection. Overall, the findings do not support any major teratogenic effects resulting from maternal COVID-19 infection in early pregnancy.

A0649 Trial in progress: Evaluation of urinary minimal residual disease and outcomes in high-risk non-muscle invasive bladder cancer surveilled with blue light compared to white light cystoscopy

Infection with respiratory syncytial virus (RSV) represents a substantial burden of disease, especially in children. While one vaccine (RSVpreF) has been recommended for administration in pregnant women, another one (RSVPreF3-Mat) has been discontinued in a Phase 3 study due to an increased incidence of preterm births in the study group. When comparing the studies related to these two vaccine candidates, the differences in preterm birth rates appear inconsistent. For a more differentiated evaluation of birth outcomes associated with maternal RSV vaccination, we recommend introducing the previously described concept of "small and vulnerable newborns."

Buccinator myomucosal flap with rotational flap in repair of midline and distal palatal Fistulas: A comparative study of 30 cases with speech outcome evaluation.

Perceived effectiveness of agricultural clusters and the behavioral pathways to climate smart agriculture adoption: Evidence from Ethiopia.

Expert consensus-derived evaluation criteria for orthodontic treatment outcomes using a novel ranking method: A retrospective dental cast analysis study.

To determine the prevalence of potentially inappropriate prescribing (PIP), potentially inappropriate medication (PIM), potential prescription omission (PPO), potentially harmful drug-drug interactions (PDDI) and identify associated factors among older Ethiopians. Systematic review and meta-analysis DATA SOURCE: We searched PubMed, HINARI, Scopus and Web of Science databases to identify eligible studies published up to 31 October 2025. Observational studies reported the prevalence of PIP, PIM, PPO and PDDI among older adults from any healthcare settings were screened. Two independent reviewers selected studies, extracted data and assessed the risk of bias. The quality and risk of bias of the studies were assessed using the Newcastle-Ottawa scale and Hoy risk of bias tool, respectively, while the certainty of evidence of outcomes was assessed using Grading of Recommendations, Assessment, Development and Evaluation based on Cochrane recommendations. We used a random-effects model for analyses to estimate the pooled prevalence and associated factors. All data analyses were done using Stata V.17 software. The national prevalence of PIP, PIM, PPO and PDDI was estimated as main outcomes. Variations were estimated based on regions, age groups, outcome evaluation tool, disease type and healthcare setting. The review included 25 studies (n=5662 participants) for PIP or PIM, 14 studies (n=2706 participants) for PDDI and 6 studies (n=1342 participants) for PPO. The pooled prevalence estimate was 41% (95% CI 33% to 48%), I2=96.87% for PIP, 37% (95% CI 31% to 44%), I2=96.33% for PIM, 55% (95% CI 36% to 73%), I2=99.00% for PDDI and 14% (95% CI 6% to 24%), I2=95.07% for PPO. The majority of the studies have very good quality (very good=13, good=1, satisfactory=11 for PIP and PIM; very good=11, satisfactory=3 for PDDI; very good=6 for PPO) and low risk of bias (low risk=18, moderate risk=7 for PIP and PIM; low risk=12, moderate risk=2 for PDDI and low risk=6 for PPO), while all studies for each outcome have low certainty of evidence. Subgroup analyses revealed significant regional and contextual variations. Polypharmacy was significantly associated with PIP (OR=3.72, 95% CI 2.53 to 5.46, p<0.01, I2=69.56%), PIM (OR=4.20, 95% CI 2.91 to 6.06, p<0.01, I2=57.83%) and PDDI (OR=4.51, 95% CI 3.05 to 6.69, p<0.01, I2=0.00%), while hypertension (OR=2.46, 95% CI 1.38 to 4.36, p<0.01 I2=0.00%) was associated with PIP. This review found a high prevalence of PIP, PIM, PDDI and PPO among older adults in Ethiopia, with notable heterogeneity across regions. Polypharmacy was associated with PIP, PIM and PDDI, while hypertension showed association with PIP. Despite generally good study quality, the certainty of evidence was low for the included studies due to the cross-sectional design nature, with high heterogeneity. Therefore, these findings should be interpreted cautiously. This study indicates a high burden of inappropriate medication prescribing and its associated factors, underscoring the importance of further robust studies to clarify prescribing practices and associated factors. CRD42024556744.

Soft tissue augmentation around dental implants is essential for long-term peri-implant health, yet the comparative efficacy of different soft tissue techniques remains unclear. Therefore, it is of interest to evaluate changes in keratinized tissue width (KTW), soft tissue thickness (STT) and peri-implant health parameters at 1, 3 and 6 months post-surgery. Results show that FGG significantly outperforms XCM in enhancing keratinized tissue (KT) and improving clinical outcomes such as probing depth (PD) and bleeding on probing (BOP). Both techniques demonstrate effectiveness, but FGG remains the preferred option for achieving optimal peri-implant tissue health. This study advances knowledge by highlighting the superior effectiveness of FGG in soft tissue management around implants.