Choice Of Procedure Research Articles

TRANSLATION OF CULTURAL ASPECTS FROM ENGLISH INTO ARABIC: A CASE STUDY OF A DANCE OF THE FORESTS

Culture is about the mode of life and activity, way of thinking, and artifacts, which are associated with particular communities and the language which serves as a vehicle for meanings. This paper is aimed at describing cultural challenges and their translation procedures from English into Arabic; it also investigates choices of translation procedures that can be used to overcome cultural aspects problems. This study limits itself to cultural factors. It follows Newmark’s approach (1988) on culture translation. The corpus of this study is a play entitled A Dance of The Forests written by Wole Soyinka. The study is a qualitative study and cultural occurrences are analyzed and their translations are rated by raters who are native speakers of Arabic. The research reveals that translating a literary work like a play requires the use of strategies and procedures like domestication and oblique translation procedures, which are found to be vital in translating drama text from English into Arabic.

First, do no harm, second, say sorry? Investigating the impact of a new tort reform

Abstract We investigate the effect of so-called “apology laws” on physician procedure choice and birth outcomes. Advocates believe they may reduce litigation since a harmed person who receives an apology or explanation may be less likely to sue, all else equal. In the medical context, this could translate into a reduction in defensive medicine practiced. To investigate this possibility, we examine the impact of these laws on the use of C-sections, a common measure for gauging the practice of defensive medicine by OB/GYN physicians. We find consistent evidence that “partial” versions actually increase the use of C-sections, contrary to the intention of these laws. More specifically, we find it is older, presumably more established physicians who respond the most. Moreover, we also find some evidence that these particular laws also reduced the rate of preventable pregnancy complications, which suggests that the extra C-sections induced may not just represent defensive medicine (JEL I10, I18, K13).

Surgical management of odontogenic myxomas: A case series

IntroductionOdontogenic myxoma is a relatively rare bone tumor involving exclusively the jaws. Despite its benign nature, odontogenic myxoma can exhibit aggressive, locally invasiveness and has a high potential of recurrence. Surgical treatment can be conservative of radical. The choice of surgical procedure is controversial, and there are no established guidelines. Case series presentationWe present a case series of three cases of odontogenic myxomas. This case series illustrates the variability of the radioclinical presentation of odontogenic myxoma and the resulting surgical management, ranging from simple enucleation to mandibular interruptive resection surgery with free flap reconstruction. Discussion and conclusionThrough this case series, we highlighted and described decision criteria contributing to treatment choice and summarized this in an algorithm. Radiological tumor characteristics and also patient specific factors such as age need to be considered to make a personalized decision to each patient.

Poly(ethylene imine)-chitosan carbon dots: study of its physical–chemical properties and biological in vitro performance

Carbon dots (CDs) have been quickly extended for nanomedicine uses because of their multiple applications, such as bioimaging, sensors, and drug delivery. However, the interest in increasing their photoluminescence properties is not always accompanied by cytocompatibility. Thus, a knowledge gap exists regarding their interactions with biological systems linked to the selected formulations and synthesis methods. In this work, we have developed carbon dots (CDs) based on poly (ethylene imine) (PEI) and chitosan (CS) by using microwave irradiation, hydrothermal synthesis, and a combination of both, and further characterized them by physicochemical and biological means. Our results indicate that synthesized CDs have sizes between 1 and 5 nm, a high presence of amine groups on the surface, and increased positive ζ potential values. Further, it is established that the choice and use of different synthesis procedures can contribute to a different answer to the CDs regarding their optical and biological properties. In this regard, PEI-only CDs showed the longest photoluminescent emission lifetime, non-hemolytic activity, and high toxicity against fibroblast. On the other hand, CS-only CDs have higher PL emission, non-cytotoxicity associated with fibroblast, and high hemolytic activity. Interestingly, their combination using the proposed methodologies allow a synergic effect in their CDs properties. Therefore, this work contributes to developing and characterizing CD formulations based on PEI and CS and better understanding the CD’s properties and biological interaction.

Socioeconomic disparities in procedural choice and outcomes after aortic valve replacement

ObjectiveTo identify potential socioeconomic disparities in the procedural choice of patients undergoing surgical aortic valve replacement (SAVR) versus transcatheter aortic valve replacement (TAVR) and in readmission outcomes after SAVR or TAVR. MethodsThe Nationwide Readmissions Database was queried to identify a total of 243,691 patients who underwent isolated SAVR and TAVR between January 2016 and December 2018. Patients were stratified according to a tiered socioeconomic status (SES) metric comprising patient factors including education, literacy, housing, employment, insurance status, and neighborhood median income. Multivariable analyses were used to assess the effect of SES on procedural choice and risk-adjusted readmission outcomes. ResultsSAVR (41.4%; 100,833 of 243,619) was performed less frequently than TAVR (58.6%; 142,786 of 243,619). Lower SES was more frequent among patients undergoing SAVR (20.2% [20,379 of 100,833] vs 19.4% [27,791 of 142,786]; P < .001). Along with such variables as small hospital size, drug abuse, arrhythmia, and obesity, lower SES was independently associated with SAVR relative to TAVR (adjusted odds ratio [aOR], 1.17; 95% confidence interval [CI], 1.11 to 1.24). After SAVR, but not after TAVR, lower SES was independently associated with increased readmission at 30 days (aOR, 1.19; 95% CI, 1.07-1.32), 90 days (aOR, 1.27; 95% CI, 1.15-1.41), and 1 year (adjusted hazard ratio, 1.19; 95% CI, 1.11 to 1.28; P < .05 for all). ConclusionsOur study findings indicate that socioeconomic disparities exist in the procedural choice for patients undergoing AVR. Patients with lower SES had increased odds of undergoing SAVR, as well as increased odds of readmission after SAVR, but not after TAVR, supporting that health inequities exist in the surgical care of socioeconomically disadvantaged patients.

The Comparative Efficacy of Conventional and Crown-Down Root Canal Preparation Techniques in Relation to the Extrusion of Apical Debris

Numerous scientific investigations have been undertaken to assess the efficacy of standard root canal preparation methods and the crown-down procedure in mitigating the ejection of apical debris. The aforementioned research examines multiple facets, encompassing the efficacy of canal cleaning, the potential for debris extrusion, and their influence on the outcome of root canal therapy. The objective of this study is to evaluate the efficacy of conventional and crown-down root canal preparation methods in relation to the extrusion of apical debris. The literature search used a lot of different databases, like PubMed, Web of Sciences, EMBASE, Cochrane Libraries, and Google Scholar, to look into how well traditional and crown-down root canal preparation methods work for getting debris out of the root canal. Traditional methods of root canal preparation have been extensively employed in the field of endodontics. While root canal cleaning and shaping techniques have demonstrated efficacy, there is still a potential danger of apical debris extrusion. Several factors contribute to the level of risk involved in dental procedures. These factors encompass the use of instruments, the amount of pressure applied during preparation, the effectiveness of irrigation, and the level of experience possessed by the dentist. In conclusion, the efficacy of both methodologies is contingent upon various aspects, including the level of expertise possessed by the dentist, the specific instruments employed, the irrigation technique employed, and the thoroughness of the case examination. The particulars of each case and the dentist's personal preference should guide the choice of either procedure.

Surgical treatment options of lower urinary tract symptoms due to benign prostatic obstruction : The German S2e guideline 2023-part3

Lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO) are one of the most common diagnoses in clinical practice. Bothersome LUTS impact considerably quality of life of men and may cause severe complications without treatment. According to the diagnostic assessment every patient should be treated with an adequate therapy. Management comprises aconservative approach, medication, novel minimally invasive options, and surgical procedures with the aim to remove the obstructing adenoma. The German guideline panel has updated the German guidelines on diagnostic evaluation and management of LUTS due to BPO. Evidence-based recommendations of surgical treatment options of LUTS due to BPO are evaluated. Chapters 11.1.1 and 11.2 of the updated German S2e guideline on the management of LUTS due to BPO are summarized as a review article. Atreatment algorithm based on current evidence has been proposed. It is considered to provide guidance for the selection of the best procedure according to the needs of the patient. Anatomic features of the prostate, the patients' morbidity, and the preservation of ejaculatory function are taken into account for the choice of the best procedures. These surgical options can be divided into techniques with direct, delayed or no removal of the adenoma, procedures with suprapubic access, and embolizing approaches. The updated German S2e guideline on the management of LUTS due to BPO provides evidence-based recommendations for the selection of the best procedure according to the needs of the individual patient.

Fatigue life prediction using critical distance on aluminum alloy wire containing indentation produced marks

The present study aims to predict fatigue life in aluminum alloy 6201-T81 wires containing defects produced by hardness indentation procedures. The wires tested were obtained from a 900 MCM All Aluminum Alloy Conductor (AAAC 900 MCM) used in power transmission lines. The stress field in the vicinity of the defect and the determination of the crack initiation site (hotspot) were obtained by applying elastic–plastic simulations via the Finite Element Method (FEM). Such a simulation considered both the indentation process, and the fatigue loading on the wire. The Smith-Watson-Topper multiaxial fatigue criterion applied to an equivalent stress computed by the Volume Method (MV) was used to estimate life. Challenges presented by the incorporation of the residual stress field and the choice of the best calibration procedures were addressed. Comparison between stress gradients in simulations and failures observed in fractographic analyses of specimens subjected to fatigue testing suggested similar potential crack propagation regions. A new and wide experimental campaign showed that presence of indentation defects reduced the fatigue life of the wires. 84% of the lives computed by the proposed methodology were within a factor of 3 compared with tests, being the worst estimate within a factor of 5 .

External rectal prolapse: Which operation and Why?

Background: External rectal prolapse is a rare condition and the only treatment option is surgery. In 10- 50% of patients (women) co-exist other anatomical and functional pelvic floor disorders and eventual should be corrected in the same time, requiring complex rectal and pelvic operations by a multidisciplinary team. Material and methods: A review of the literature based in Google Scholar and PubMed medical database was performed. The predominant surgical procedures in the literature were identified and the associated functional and anatomical pelvic floor disorders coexisting with the external rectal prolapse, the usefulness of preoperative examinations and the final surgical treatment were reviewed. Cross-references of the published articles were used to accomplish this review stud Results: There is a great variety of proposed surgical procedures for external full-thickness rectal prolapse. There is no surgical “gold standard” and the approaches vary. The procedures can be categorized into two main broad groups, abdominal and perineal ones. An important distinguishing factor is the potential use of prosthetic mesh which is popular but also involved in some rare but serious complications. The presence of comorbidities and individual patient characteristics makes the choice of procedure particularly complex. The input of pelvic floor multi-disciplinary team is required when prolapse of middle and anterior pelvic compartments is present. The number and variation of surgical options makes the process of the patient informed consent very important for the restoration of normal quality of life. Conclusions: External rectal prolapse is a condition which requires meticulous assessment and the surgical procedure of choice needs to be individualized according to the patient requirements.

Comparative study between 1-year patency of brachiobasilic arteriovenous fistula versus brachial to basilic forearm loop graft in patients with end-stage renal disease

Background The most preferred method of vascular access is the autogenous arteriovenous fistula (AVF). When ready for dialysis, autogenous AVF outperforms arteriovenous grafts (AVG) in terms of patency and survival. An alternate method of vascular access for such individuals is the transposed AVF or AVG. Aim The goal of this trial is to evaluate and contrast the results of those who were treated with a brachiobasilic (BB) AVF to those who were treated with a polytetrafluoroethylene brachial to basilic forearm loop graft. Primary endpoints Assisted primary patency, primary patency also secondary patency. Secondary endpoints: postoperative complications (wound infection, bleeding, steal syndrome, and procedure-related mortality), functional maturity. Patients and methods This is a prospective cohort observational trial performed at the Vascular Surgery Department, Faculty of Medicine, Ain Shams University. Data about patients who had forearm loop grafts or BB AVFs during the period from January 2021 to January 2022 were collected according to the study inclusion criteria. There was a total of 50 individuals included (25 patients in each group). The first group included cases who had BB AVF with basilic vein transposition (BB tAVF) whereas the second group included patients who had brachial-basilic forearm loop graft (BB AVG). Results Regarding age and sex distribution or risks of cardiovascular events, there was not a statistically significant distinction among the two study groups. The fistula group required statistically significant longer time to achieve functional maturity mean±SD (BB tAVF=9.64±2.29 vs .BB AVG=6.6±2 assisted and secondary patencies at 3, 6, 12, and 18 months). No statistically significant variation existed among groups regarding postoperative bleeding, infection, and procedure-related mortality. Conclusion Both BB AVF and polytetrafluoroethylene brachial to basilic forearm loop graft can be considered as viable options for vascular access in this patient population. The choice of procedure may depend on individual patient factors, possible risks of prolonged central venous catheter (CVC) use, as well as the risks of infection and thrombosis, which should be carefully evaluated.

20-Gauge vs. 23-Gauge Vitrectomy, in Terms of Surgically Induced Astigmatism

OBJECTIVES To compare the post-operative (post-op) surgically induced mean astigmatism in patients undergoing 20-gauge- and 23-gauge vitrectomy. METHODOLOGY Sixty patients were enrolled. Relevant information was recorded in a Performa for each patient. Patients were randomly grouped into A (20-gauge) and B (23-gauge) groups. Astigmatism was recorded by a single technician using the same keratometer for all patients. A single surgeon operated on all patients. Post-operatively, all patients were re-examined after 1 week and 6 weeks, and their surgically induced astigmatism was recorded. RESULTSOf 60 patients, 58.6% were males, and 41.4% were females, with a mean age of 53.77 ± 9.63 years. The post-operative astigmatism difference between the two vitrectomy procedures was investigated. In the 20-gauge group, with 30 patients, the mean post-operative astigmatism difference was 2.21 D (±0.66 SD), with a standard error mean of 0.12. In the 23-gauge group, with 30 patients, the mean post-operative astigmatism difference was 0.74 D (±0.44 SD), with a standard error mean of 0.08. The degrees of freedom (df) were 58, and the standard error of the difference was 0.145. The t-value was calculated at 10.1504, and the p-value was found to be 0.001, indicating a significant difference. CONCLUSION The observation that the 20-gauge group displayed a notably higher mean difference in astigmatism than the 23-gauge group suggests a potential association between the choice of vitrectomy procedure and the extent of astigmatism alteration in post-operative outcomes.

Current and future utility of ultrasound imaging in upper extremity musculoskeletal rehabilitation: A scoping review

Study DesignThis study was a scoping review. BackgroundContinued advances in musculoskeletal sonography technology and access have increased the feasibility of point-of-care use to support day-to-day clinical care and decision-making. Sonography can help improve therapeutic outcomes in upper extremity (UE) rehabilitation by enabling clinicians to visualize underlying structures during treatment. Purpose of the StudyThis study aimed to (1) evaluate the growth, range, extent, and composition of sonography literature supporting UE rehabilitation; (2) identify trends, gaps, and opportunities with regard to anatomic areas and diagnoses examined and ultrasound techniques used; and (3) evaluate potential research and practice utility. MethodsSearches were completed in PubMed, CINAHL, SPORTDiscus, PsycINFO, and BIOSIS. We included data-driven articles using ultrasound imaging for upper extremity structures in rehabilitation-related conditions. Articles directly applicable to UE rehabilitation were labeled direct articles, while those requiring translation were labeled indirect articles. Articles were further categorized by ultrasound imaging purpose. Article content between the two groups was descriptively compared, and direct articles underwent an evaluation of evidence levels and narrative synthesis to explore potential clinical utility. ResultsAverage publication rates for the final included articles (n = 337) steadily increased. Indirect articles (n = 288) used sonography to explore condition etiology, assess measurement properties, inform medical procedure choice, and grade condition severity. Direct articles (n = 49) used sonography to assess outcomes, inform clinical reasoning, and aid intervention delivery. Acute UE conditions and emerging sonography technology were rarely examined, while tendon, muscle, and soft tissue conditions and grayscale imaging were common. Rheumatic and peripheral nerve conditions and Doppler imaging were more prevalent in indirect than direct articles. Among reported sonography service providers, there was a high proportion of nonradiologist clinicians. ConclusionSonography literature for UE rehabilitation demonstrates potential utility in evaluating outcomes, informing clinical reasoning, and assisting intervention delivery. A large peripheral knowledge base provides opportunities for clinical applications; however, further research is needed to determine clinical efficacy and impact for specific applications.

An Experimental Analysis of the Prize-Probability Tradeoff in Stopping Problems

Abstract We experimentally examine how individuals commit to a cutoff stopping rule when facing a sequence of independent lotteries. We identify two main behavior patterns: (1) a small share of participants consistently choose stopping rules whose gain bound (i.e., the accumulated gain at which the sequence stops) is larger than the loss bound, and (2) a larger share of participants consistently choose rules whose loss bound is larger than the gain bound. We introduce a procedural choice model that accounts for these patterns and show that the behavior of most of our participants is inconsistent with prominent theories of decision under risk.

Impact of local delivery of allogeneic chondrocytes on the biological response and healing of the sternum bones after sternotomy

Median sternotomy is the surgical method of choice for many procedures where one of the main problems is the long post-operative wound healing process leading to sternal dehiscence and the development of infection. This leads to prolonged hospital stay and increased mortality due to post-operative complications. A promising solution seems to be the use of allogeneic chondrocytes for wound treatment, whose properties in the field of cartilage reconstruction are widely used in medicine, mainly in orthopedics. In the present study, we investigated the effect of local delivery of allogeneic chondrocytes on the biological response and healing of the sternum after sternotomy. We optimized the culture conditions for the isolated chondrocytes, which were then applied to the sternal incision wound. Chondrocytes in the culture were assessed on the basis of the presence of chondrocyte-specific genes: Sox9, Aggrecan and Collagen II. In turn, the histopathological and immunohistochemical evaluation was used to assess the safety of implantation. In our work, we demonstrated the possibility of obtaining a viable culture of chondrocytes, which were successfully introduced into the sternal wound after sternotomy. Importantly, implantation of allogeneic chondrocytes showed no significant side effects. The obtained results open new possibilities for research on the use of allogeneic chondrocytes in the process of accelerating wound healing after median sternotomy.

Comparative study of video recordings of non-medical devices in laparoscopic surgery: a cross-sectional study.

Laparoscopic surgery is the approach of choice for multiple procedures, being laparoscopic cholecystectomy one of the most frequently performed surgeries. Likewise, video recording of these surgeries has become widespread. Currently, the market offers medical recording devices (MRD) with an approximate cost of 2000 USD, and alternative non-medical recording devices (NMRD) with a cost ranging from 120 to 200 USD. To our knowledge, no comparative studies between the available recording devices have been done. We aim to compare the perception of the quality of videos recorded by MRD and NMRD in a group of surgeons and surgical residents. A cross-sectional study was conducted using an online survey to compare recordings from three NMRDs (Elgato 30fps, AverMedia 60fps, Hauppauge 30fps) and one MRD (MediCap 20fps) during a laparoscopic cholecystectomy. The survey assessed: definition of anatomical structures (DA), fluidity of movements (FM), similarity with the operating room screen (ORsim), and overall quality (OQ). Descriptive and nonparametric analytical statistics tests were applied. Results were analyzed using JMP-15 software. Forty surveys were collected (80% surgeons, 20% residents). NMRDs scored significantly higher than MRD in DA (p = 0.003), FM (p < 0.001), ORsim (p < 0.001), and OQ (p < 0.001). One NMRD was chosen as the highest quality device (70%), and MRD as the poorest (78%). No significant differences were found when analyzing by surgical experience. In terms of recording laparoscopic procedures, non-medical video recording devices (NMRDs) outperformed medical-grade recording device (MRD) with a higher overall score. This suggests that NMRDs could serve as a cost-effective alternative with superior video quality for recording laparoscopic surgeries.

Analysis of disease composition and primary surgical procedures in pediatric secondary glaucoma inpatients: a single-center study

Objective: To analyze the disease composition and primary surgical procedures in pediatric inpatients with secondary glaucoma. Methods: A retrospective case series study was conducted. Clinical data of children aged≤16 years with secondary glaucoma who were admitted to the Zhongshan Ophthalmic Center, Sun Yat-sen University, between January 1, 2017, and December 31, 2021, were included. The patients were classified according to the Childhood Glaucoma Research Network (CGRN) classification system, and their diagnoses, underlying factors, gender, age of onset, affected eye(s), age and type of initial surgery, and ophthalmic examination data were analyzed. Statistical analysis was performed using Kruskal-Wallis rank sum test and χ2 test. Results: A total of 540 patients (744 eyes) were included in this study, comprising 319 males (59.1%) and 221 females (40.9%). Unilateral disease was observed in 336 cases (62.2%), while bilateral involvement was present in 204 cases (37.8%). The age of onset was 4.0 (0.0, 9.0) years, and the median age of the first anti-glaucoma surgery was 5.0 (0.7, 10.0) years. Among them, there were 195 cases (36.1%) of secondary glaucoma associated with non-acquired ocular anomalies (SCG-O), with a median age of onset of 0.0 (0.0, 4.0) years, and 97 of these cases (49.7%) were male. secondary glaucoma associated with non-acquired systemic disease or syndrome (SCG-S) were observed in 68 cases (12.6%), with a median age of glaucoma onset of 0.1 (0.0, 4.0) years, and 47 of these cases (69.1%) were male. Secondary glaucoma associated with acquired conditions (SCG-A) accounted for 192 cases (35.6%), with a median age of onset of 9.0 (5.0, 13.0) years, and 125 of these cases (65.1%) were male. There were 85 cases (15.7%) of secondary glaucoma following cataract surgery (SCG-C), with a median age of onset of 3.0 (0.8, 7.0) years, and 50 of these cases (58.8%) were male. Male patients were predominant in SCG-S and SCG-A, with 47 cases (69.1%) and 125 cases (65.1%), respectively (χ2=9.94, 17.52; P=0.002,<0.001). Except for SCG-O, all other types of pediatric secondary glaucoma predominantly affected only one eye: SCG-S in 52 cases (76.5%), SCG-A in 128 cases (66.7%), and SCG-C in 54 cases (63.5%) (χ2=19.06, 21.33, 6.22; all P<0.05). The highest proportion of SCG-O was attributed to congenital ectropion uveae (46 cases, 23.6%). Sturge-Weber syndrome was the most common SCG-S (45 cases, 66.3%), while SCG-A mostly resulted from trauma (59 cases, 30.8%) and corticosteroid use (56 cases, 29.2%). Trabeculectomy (211 eyes, 30.8%) and glaucoma drainage device implantation (197 eyes, 28.7%) were the most frequently performed primary surgical procedures. Conclusions: SCG-O and SCG-A were found to be common types of pediatric secondary glaucoma. The age of onset and the choice of primary anti-glaucoma surgical procedures varied among different types of pediatric secondary glaucoma. However, overall, trabeculectomy and glaucoma drainage device implantation were the primary surgical procedures predominantly employed.

Vitreoretinopathy-Associated Pediatric Retinal Detachment Treatment Outcomes: IRIS® Registry (Intelligent Research in Sight) Analysis.

To determine the treatment patterns and outcomes of pediatric retinal detachments (RDs) associated with hereditary vitreoretinopathies. Retrospective cohort analysis using IRIS® Registry (Intelligent Research in Sight) database. Patients < 18 years old with a rhegmatogenous RD and a systemic disorder associated with vitreoretinal degeneration (e.g., Stickler syndrome) or other malformation of the vitreous from 2013-2019. Cases were identified using International Classification of Diseases, Ninth and Tenth Revisions (ICD-9, ICD-10) diagnostic codes from the IRIS® Registry cohort. Other hereditary vitreoretinopathies that are not encoded by specific ICD code(s) were captured by text search. Nonspecific vitreous abnormality ICD codes were also included. Exclusion criteria included traumatic retinal detachments using ICD codes for ocular trauma and serous or exudative retinal detachment. Surgical procedures were identified using Current Procedural Terminology (CPT) codes for repair of retinal detachment. Baseline demographic information collected included age, gender, race/ethnicity, geographic region of the provider location, and health insurance status. Main outcomes measured in this study were average time to first surgery, number of eyes presenting with bilateral detachments, and choice of initial surgical procedure. A total of 2115 eyes of 1722 patients were identified (mean age, 10.4 years; 58% male). The median time to first surgery was 7 days (interquartile range, 40 days). One thousand four hundred seven eyes of 1134 patients had ≥ 1 year of follow-up, with 506 eyes (36%) developing a fellow eye RD. Thirty-three percent of patients presenting with bilateral detachments, and 349 eyes had initial RD surgery within 1 year of the index date documented by CPT code. Fellow eye detachment occurred a mean of 32 days after initial presentation. The mean number of surgeries per eye within 1 year was 1.68. Best-corrected visual acuity did not improve from a baseline 20/54 to 20/62. The initial procedure was most commonly complex RD repair (n = 176), followed by scleral buckle (n = 102), pars plana vitrectomy (n = 89), laser (n = 59), cryotherapy (n = 5), and pneumatic retinopexy (n = 5). There were 51 new diagnoses of glaucoma and 37 new diagnoses of aphakia within 1 year after the surgical procedure. IRIS Registry data provide insight into rare pediatric vitreoretinopathy-associated RDs, which have a high rate of reoperation and fellow eye involvement. Proprietary or commercial disclosure may be found after the references.

Application of the decisional regret scale (DRS) in men undergoing anti-incontinence procedures for stress urinary incontinence.

Decisional regret (DR) has previously been applied to other urologic issues (hypospadias, prostate cancer). The present study seeks to evaluate certain patient factors that directly correlate to high DR scores in anti-incontinence procedures. Medical records for 119 patients undergoing anti-incontinence procedures between 2009 and 2020 were retrospectively reviewed. Forty-one patients were accessible for telephone follow-up and provided a Decisional Regret Scale (DRS) questionnaire. If patients had both a sling and an artificial urinary sphincter (AUS) placed, questionnaires were administered for each. DRS score was quantified in accordance with prior literature, with scores ranging 0-100. We subdivided patients based on demographics and surgical data, correlating this with DRS score. In 41 patients, 46 procedures (13 slings, 33 AUS) were performed. Thirty-nine (95.1%) men underwent robotic-assisted laparoscopic prostatectomy, and 11 (26.8%) men reported prior pelvic radiation. Post-procedural continence, irrespective of procedure, yielded an average 2±1.56 pads per day (PPD). Mean DRS score across the cohort was 29.78. DRS score was subdivided into mild, moderate, and severe, with majority noting "none to mild" regret (63%), 15.2% reporting moderate and 21.7% severe. Predictors of higher regret included history of radiation (P=0.056), choice of anti-incontinence procedure (P=0.011), and need for surgical revision (P=0.00042). DR was unrelated to race, complete continence, and time to follow-up. DRS has recently been applied to anti-incontinence procedures for male stress incontinence; our study highlights novel findings not previously assessed. Majority of men had minimal regret with a subset that had significant regret-history of radiation, multiple revisions/explant, and those who elected for sling upfront. These results highlight the importance of patient selection and pre-operative counselling.

Ultrasound-guided procedures for the management of chronic thoracic back pain: a technical review.

Pain arising from the thoracic region has been reported to be potentially as debilitating as cervical or lumbar back pain, and may stem from a vast number of spinal sources, including zygapophysial, costovertebral and costotransverse joints, intervertebral discs, ligaments, fascia, muscles, and nerve roots. Over the last two decades, the use of ultrasound in interventional spinal procedures has been rapidly evolving, due to the ultrasound capabilities of visualizing soft tissues, including muscle layers, pleura, nerves, and blood vessels, allowing for real-time needle tracking, while also reducing radiation exposure to both patient and physician, when compared to traditional fluoroscopy guidance. However, its limitations still preclude it from being the imaging modality of choice for some thoracic spinal procedures, notably epidural (interlaminar and transforaminal approaches) and intradiscal injections. In this technical review, we provide an overview of five thoracic spinal injections that are amenable to ultrasound guidance. We start by discussing their clinical utility, followed by the relevant topographic anatomy, and then provide an illustrated technical description of each of the procedures discussed: (1) erector spinae plane block; (2) intra-articular thoracic zygapophyseal (facet) joint injection; (3) thoracic medial branch block; (4) costotransverse joint injection; and (5) costovertebral joint injection.

Toward global and national toxicity footprints

AbstractEstimating comprehensive toxicity footprints, encompassing potential impacts of toxic releases from consumption on human health and ecosystems, remains challenging due to the absence of complete emission inventories and disaggregation in global economic sectors. This study proposes an integrative approach to evaluate the global toxicity footprint by combining multiple databases, inventorying methods gap‐filling/extrapolation techniques, and environmentally extended multi‐region input–output models. We incorporated industrial, residential, and agricultural emissions of 693 chemicals into air, water, and soil, assessing the toxicity footprints of 49 countries and regions and revealing the displacement of toxic impacts across regions and nations. Our results emphasize the significant sensitivity of emission inventories and toxicity footprints to the choice of extrapolation procedures in regionalized chemical inventory development. Despite considerable progress in consolidating emission data, major gaps persist in publicly available datasets, impeding accurate extrapolation of global pollutant releases and comprehensive analysis of toxicity footprints. Primary data require refinement, harmonization, and expansion to enhance toxicity footprints' accuracy, particularly concerning pesticide emissions and national Pollutant Release and Transfer Registers initiatives. This study offers crucial insights for national and regional policymakers, facilitating the creation of targeted regulations and incentives to mitigate toxic substances' environmental impact. Future research should prioritize developing input–output table projections, deriving forward‐looking time series of national emission inventories, and establishing absolute thresholds for toxic impacts within the framework of environmentally sustainable societies.