Reconstruction Period Research Articles

Volunteering and fake volunteering in Ukraine: a new research direction through the prism of informal institutions

This study delves into the emergence of fake voluntarism, a novel form of deception observed in Ukraine following the onset of the Russo-Ukrainian war. The full-scale Russian aggression not only spurred the expansion of the volunteer movement but also fostered the proliferation of spurious volunteerism, primarily motivated by the pursuit of personal gain. We conceptualize these contrasting social practices as informal institutions, diverging in their functions. While traditional volunteering falls into the category of ‘complementary’ informal institutions, following G. Helmke and S. Levitsky's typology, fake volunteering represents ‘competing’ institutions that not only diminish the efficacy of formal institutions but also erode the credibility of genuine volunteer efforts. This research aims to expand the scope of study of informal institutions in wartime conditions, in particular, to contribute to the discussion on the reasons for Ukraine's resilience during the war and the challenges of overcoming internal threats. While volunteerism in various forms is an essential element of state resilience, fake volunteerism, along with other corrosive institutions, undermines it from within. Drawing on the open-source data, we extract distinctive attributes that enable the differentiation between these phenomena. Additionally, we delve into the structural factors that foster opportunities for fake volunteering in wartime Ukraine, including inadequate legal oversight, the persistence of personal exchanges, and a high level of trust in volunteers. These conditions, exacerbated by escalating economic pressures and social uncertainties, collectively contribute to the emergence of pseudo-volunteering. Our proposed model of fake volunteering allows for a better understanding of this institution's underlying nature. The research offers a novel perspective in explaining new social practices arising from wartime conditions and offering practical insights for establishing legal and social safeguards against fraud during periods of war and post-war reconstruction.

Suture Packaging as a Marker for Intraoperative Image Alignment in Augmented Reality on Mobile Devices.

Preoperative vascular imaging has become standard practice in the planning of microsurgical breast reconstruction. Currently, translating perforator locations from radiological findings to a patient's abdomen is often not easy or intuitive. Techniques using three-dimensional printing or patient-specific guides have been introduced to superimpose anatomy onto the abdomen for reference. Augmented and mixed reality is currently actively investigated for perforator mapping by superimposing virtual models directly onto the patient. Most techniques have found only limited adoption due to complexity and price. Additionally, a critical step is aligning virtual models to patients. We propose repurposing suture packaging as an image tracking marker. Tracking markers allow quick and easy alignment of virtual models to the individual patient's anatomy. Current techniques are often complicated or expensive and limit intraoperative use of augmented reality models. Suture packs are sterile, readily available, and can be used to align abdominal models on the patients. Using an iPad, the augmented reality models automatically align in the correct position by using a suture pack as a tracking marker. Given the ubiquity of iPads, the combination of these devices with readily available suture packs will predictably lower the barrier to entry and utilization of this technology. Here, our workflow is presented along with its intraoperative utilization. Additionally, we investigated the accuracy of this technology.

Reconstructive plastic surgery in combined treatment of breast cancer: Predictive risk factors of complications and reconstruction failure.

e12594 Background: Breast reconstruction after mastectomy must consider potential complications from surgical techniques as well as additional complications of oncologic treatment such as radiation or systemic therapy. But the consensus is lacking regarding the optimal reconstruction plan for patients requiring adjuvant radiation therapy. Objective: To determine the impact of risk factors on the development complications of breast reconstruction for postmastectomy radiotherapy. Methods: This study included patients diagnosed with breast cancer who received combination treatment from 2016 to 2021 at the FSBI “N.N. Petrov National Medical Research Center of Oncology” of the Russian Ministry of Health. The patients were divided into 3 groups: immediate reconstruction (158 people), immediate-delayed (210 people) and delayed (98 people). Results: Every fourth patient (24.0%, 112/466) may encounter a complication after mastectomy with reconstruction and adjuvant radiation therapy. According to the analyzed data, there was no correlation between potential risk factors depending on the general status of patients (age, obesity, diabetes mellitus, hypertension, history of smoking) and the occurrence of complications after combination treatment. Conclusions: The analysis of complications and reconstructive failures showed that immediate breast reconstruction at the FSBI "N.N. Petrov National Medical Research Center of Oncology" of the Ministry of Health of Russia is the safest method of reconstruction in the combined treatment of breast cancer with the lowest incidence of severe complications (9.5%, 15/158, z>1.96), which plays a key role in the development of reconstructive failures (Pearson Correlation=0.861, p<0.001). However, these surgeries are associated with a significant number of capsular contractures (15.2%, 24/158, z>1.96, Pearson Correlation=0.230, p<0.001), which requires finding ways to minimize these risks to optimize treatment in each individual case in short and long term results.

Interactive 360° media for the dissemination of endangered world heritage sites: the ancient city of Palmyra in Syria

Since the onset of conflict in Syria in 2011, several heritage sites have suffered partial or complete destruction. The ancient city of Palmyra, a UNESCO World Heritage Site since 1980, was placed on the List of World Heritage in Danger in 2013, alongside five other Syrian heritage sites. Between 2015 and 2017, Palmyra experienced the loss of nearly 40% of its historic buildings and landmarks. The site’s remote location and ongoing armed conflict pose additional challenges in accessing and preserving it.This paper introduces an interactive online platform employing 360° media to document and disseminate information about the world heritage site of Palmyra. The platform contributes to the safeguarding process of Palmyra, facilitating public engagement and interaction with the site. It also has potential applications for other sites in Syria and beyond. The platform allows users to explore both archival and current information of damaged historical monuments and buildings, revealing their layered histories before and after demolition. Employing interactive 360° media, similar to applications like Google Street View, the platform offers a reality-based digital environment. Users can virtually move into different buildings or follow specific pathways within the site, accessing archival information and documentation about particular monuments and buildings along their journey.This project serves as a unique informational resource for decision-makers and policy planners, aiding in the understanding of the site and the development of relevant strategies and recommendations. It also proves beneficial as an educational tool. The collective understanding fostered by this platform is expected to positively influence post-conflict restoration and reconstruction plans, making it an invaluable asset for research and educational purposes.

Computer-Assisted Surgery in Mandible Reconstruction.

Computer-assisted surgery is the most significant recent advancement in osseous head and neck reconstruction. Computer-aided design (CAD) software allows computerized planning of resection and reconstruction. Computer-aided manufacturing (CAM) can be used to create models, cutting guides, and patient-specific plates. Several studies have shown that these techniques are more accurate and result in decreased flap ischemia times compared with conventional techniques. CAD also facilitates the immediate placement of dental implants. The most useful application of computer-assisted surgery is delayed reconstruction, in which soft tissue contraction and the absence of a specimen as a reference make accurate estimation of the defect challenging. The drawbacks of CAD/CAM are lack of intraoperative flexibility and cost. Some centers have created in-house CAD/CAM processes using open-source software and commercially available three-dimensional printers.

Between Freedom and Order: Evolution logic of urban-rural population mobility Policy from the perspective of historical institutionalism

Urban-rural population flow is the key element and important driving force for urban-rural integration development and rural revitalization. The pattern of urban-rural population flow in China is restricted and guided by policies. From the perspective of historical institutionalism, this paper analyzes the evolution context, structural logic and dynamic mechanism of the change of urban and rural population mobility policy. The urban and rural population mobility policy has gone through five historical stages: the order reconstruction period at the beginning of the founding of New China, the political call period after the Great Leap Forward Movement, the free flow period after the reform and opening up, the period of making the best use of the situation under the economic system reform and the accelerated integration period under the background of the new era. The institutional choice under different paths, the institutional evolution under the key nodes and the institutional continuation under the path dependence constitute the structural logic of the policy change of urban-rural population mobility. The situation coupling under the action of exogenous variables, the value coupling promoted by the change of ideas, and the subject coupling under the interaction of actors’ game constitute the dynamic mechanism of policy change, which promotes the historical change and realistic development of policy.

Computer Patient-Specific 3D Modeling and Custom-Made Guides for Revision ACL Surgery.

Revision anterior cruciate ligament reconstruction (ACLR) is a challenging surgery occurring in 3 to 24% of primary reconstructions. A meticulous planning to study the precise size and location of both femoral and tibial bone tunnels is mandatory. The aim of the study was to evaluate the intra- and interoperator differences in the decision-making process between experienced surgeons after they were asked to make preoperative planning for ACL revision reconstruction with the use of both the computed tomography (CT) scan and a three-dimensional (3D)-printed model of the knee. Data collected from 23 consecutive patients undergoing revision of ACLR for graft failure at a single institute between September 2018 and February 2020 were prospectively reviewed. The double-blinded collected data were presented to three board-certificate attending surgeons. Surgeons were asked to decide whether to perform one-stage or two-stage revision ACLR based on the evaluation of the CT scan images and the 3D-printed custom-made models at two different rounds, T0 and T1, respectively, 7 days apart one from the other. Interoperator consensus following technical mistake was 52% at T0 and 56% at T1 using the CT scans, meanwhile concordance was 95% at T0 and 94% at T1 using the 3D models. Concordance between surgeons following new knee injury was 66% at T0 and 70% at T1 using CT scans, while concordance was 96% both at T0 and T1 using 3D models. Intraoperative variability using 3D models was extremely low: concordance at T0 and T1 was 98%. McNemar test showed a statistical significance in the use of 3D model for preoperative planning (p < 0.005). 3D-printed model reliability resulted to be higher compared with CT as intraoperator surgery technique selection was not modified throughout time from T0 to T1 (p < 0.005). The use of 3D-printed models had the most impact when evaluating femoral and tibial tunnels, resulting to be a useful instrument during preoperative planning of revision ACLR between attending surgeons with medium-high workflow.

Neuroplastic Surgery Principles of Computerized Surgical Planning in Complex Cranioplasty Reconstruction.

This article explores the evolution and implementation of three-dimensional (3D) models and Computerized Surgical Planning (CSP) for complex cranioplasty reconstruction and the advances in neuroplastic surgery principles for improved surgical outcomes. Over recent years, CSP has revolutionized the field by employing detailed medical imaging to enhance the accuracy and efficacy of 3D models and for the creation of customized cranial implants (CCIs). The study discusses the advancements of solid alloplastic implants to the future of implants with sophisticated and integrated neurotechnology to treat or enhance patient outcomes. CSP can be used to identify and mitigate complications that can occur within cranioplasty reconstruction and to create CCIs to address the postoperative challenge of temporal hollowing. Despite the promising advancements, the article acknowledges the current limitations of CSP, including cost and technological accessibility, and proposes future directions for research and development. The findings suggest that with further improvements in imaging, biomaterials, and manufacturing techniques, CSP in neuroplastic surgery and other specialties will continue to significantly enhance the precision and personalized care of cranioplasty reconstruction.

Preoperative evaluation of the persistent urogenital sinus in cases with congenital adrenal hyperplasia

BackgroundCongenital adrenal hyperplasia (CAH) is a common cause of urogenital sinus (UGS) anomalies. Delineating the abnormal anatomy of the UGS is crucial prior to the operative repair. Genitography and cystourethroscopy are commonly used by most surgeons to plan for reconstruction. We aim at this study to evaluate the role of these modalities and to compare their accuracy in delineating the abnormal anatomy.MethodsWe did a prospective study of 30 female paediatric patients with persistent UGS secondary to CAH. All cases were evaluated with genitography and cystourethroscopy. We compared the accuracy of each modality in delineating the confluence. The confluence depth, the urethral length proximal to the confluence, the vaginal dimensions, and the depth of the bladder neck were measured in the genitograms.ResultsCystourethroscopy showed the abnormal anatomy in all 30 cases (100%). The genitogram showed the site of confluence in 24 cases out of 30 cases (80%). According to the site of the vaginal opening in relation to the external urethral sphincter in the genitogram, we had 2 groups: the low confluence group (N = 14) and the high confluence group (N = 16). The mean confluence depth in the low group was 9.8 mm vs. 20.5 mm in the high group (p-value < 0.001). To find a cutoff point to differentiate low from high groups, we used the values that resulted from dividing the length of the urethra proximal to the confluence over the depth of the bladder neck. By using the ROC curve, the cutoff point was 0.63 mm (< 0.63 mm high, > / = 0.63 mm low) (p-value < .001).ConclusionWe recommend using both cystourethroscopy and genitography for preoperative evaluation. Cystourethroscopy is superior in identifying the abnormal anatomy, but it lacks precision in taking measurements. Genitography can avoid this drawback and can precisely measure the confluence depth, vaginal dimensions, and length of the proximal urethra. We suggest using this formula (length of the urethra proximal to the confluence/depth of bladder neck) to classify persistent UGS as low (> / = 0.63 mm) and high (< 0.63 mm).

A Sustainable Approach to Reconstruction: Historical Roof Structure Interventions

The reconstruction of structural subassemblies in historic buildings is a widely debated topic that often arises throughout a building’s lifespan. The most vulnerable structures and, consequently, the most frequently modified are roofs, due to the materials used, which render them susceptible to biological decay or fire. This paper aims to analyse roof reconstructions across various historical periods and under different circumstances depending on the necessity for construction or reconstruction. Several exceptional reconstructions from Europe are examined, where the final solution was determined based on sustainability criteria from the construction period. Wood in roof trusses is often replaced with alternative materials such as metal or reinforced concrete. In the case of the Evangelical Church in Bistrița, destroyed by fire for the second time in 2008, the solution of replication using wood was adopted, and the wooden elements were calculated for fire resistance, according to the Eurocodes. Another important aspect to consider when constructing new roofs is the need for protective or temporary roof structures, where sustainability and reusability are fundamental requirements. The principles used to choose the covering method were different depending on the reconstruction period. Three analysis criteria were defined to compare historical solutions with current sustainability principles in the reconstruction and construction of new roofs for existing buildings.

Transformative Narratives: Generational Gaps in Post-War Japan Through the Cinematic Lens of Tokyo Monogatari and Ohayo

The research delves into the profound generational divides depicted in Yasujir Ozu's Tokyo Monogatari and Ohayo, providing a captivating cinematic exploration of post-war Japans transformative landscape. Through an intricate synthesis of cinematic narratives and history analysis, it meticulously examines the contrasting attitudes towards material fulfillment, evolving social norms, and shifting patriarchal dynamics portrayed in these masterpieces. Yasujir Ozu, widely regarded as one of Japans most influential filmmakers, captured the complexities of generational dynamics and societal transformation during the tumultuous era of reconstruction in the 1950s in Japan. By scrutinizing these themes in depth, the essay offers profound insights into the complexities of post-war Japanese identity, shedding light on the intricate interplay between tradition and modernity during the pivotal era of reconstruction in the 1950s. Through its nuanced examination of these multifaceted themes, the essay provides a comprehensive understanding of the enduring generational gaps that emerged in Japanese society during the 1950s, inviting readers to contemplate the intricate dynamics shaping the nations narrative during a crucial juncture in its history.

Why modification of the ECLAC methodology for Bangladesh is important? Observation from housing, commerce and transport sector in cyclone Mora in Teknaf Upazila, Cox's Bazar, Bangladesh

An immediate and precise Damage and Loss Assessment (DaLA) is necessary after the occurrence of any disaster to bounce back to its previous stage perceiving the recovery needs. Since the ECLAC (Economic Commission for Latin America and the Caribbean) methodology has been identified as the most consistent and comprehensive one worldwide for DaLA, this research aims to apply and modify the ECLAC for the housing, commerce, and transportation sectors in the context of Bangladesh as it needs to incorporate both its formal and informal economies in DaLA. An immediate field visit was performed in Teknaf Upazila after the occurrence of cyclone Mora in 2017 following 12 Key Informant Interviews (KIIs) and 135 individual surveys for the above mentioned sectors. This study considers alternative sources for baseline data because of its unavailability and a constant Likert scale throughout the assessment. While applying the ECLAC, several adjustments have been obtained depending on the local characteristics that create differences in the estimation of modified DaLA from the conventional ECLAC. In the case of the housing sector, all three damage, loss, and additional cost estimations are modified. On the other hand, the damage and especially the loss have been revised for the commerce sector. Also the loss and additional cost estimation for the transportation sector have been separated and modifications have been adopted. This study may help to estimate avoiding the over and under-estimation of damage and loss and can be applied in future disasters in Bangladesh and other developing countries. The researchers can develop a complete ECLAC methodology examining the other sectors and the government can take initiatives to apply the revised ECLAC methodology for a proper reconstruction and recovery planning.

Contralateral Autologous Augmentation in DIEP Flap Reconstruction: Employing CT Angiography & Volumetric Analysis for Preoperative Planning.

Autologous reconstruction accounts for approximately 20% of all breast reconstruction. In cases of unilateral reconstruction, contralateral breast augmentation using autologous tissue can be performed to improve symmetry and is a viable option for patients interested in having more volume relative to their current size without the use of implants. CT scans have been used for preoperative planning for autologous reconstruction to evaluate available perforators. In this study, we report our experience using CT angiography for preoperative volumetric assessment for autologous contralateral breast augmentation in the setting of unilateral autologous breast reconstruction. Twelve patients underwent autologous augmentation during the study period. The average reconstruction flap weight was 561.2±253.6 grams, while the average augmentation flap weight was 218.0±133.7 grams. No patients experienced flap loss and we demonstrate that the predicted volumes for the augmented and reconstructed breasts were comparable to the actual respective flap volumes. Additionally, post-operative patient-reported outcome measures demonstrate high levels of satisfaction across multiple BREAST-Q subscales. This study demonstrates the utility of using CT angiography to estimate reconstructive volumes to help preoperative planning and achieve predictable postoperative breast volumes. It also supports that contralateral autologous augmentation is a good option for patients who would like to avoid implants and are interested in a small to moderate increase in size.

Integrated Strategic Analytical Framework for Analysing and Improving A Bank’s Market Performance during Periods of Disruptive Competition

As the Caribbean financial market becomes increasingly competitive as a result of the increasingly more innovative fintech companies and other revolutionary traditional banks’ activities, a critical analysis of the internal and external variables and changes that can undermine a bank’s effective market performance is essential for discerning the improvement strategies that must be adopted. However, the challenge has often arisen from lack of the accurate approach for accomplishing such internal and external analysis. To fill such a gap, this study uses integrative review as one of the techniques of qualitative-content analysis to evaluate different banking performance improvement strategies and strategic management theories. Through such analysis, the study aimed to discern the integrated strategic analytical framework that can be extracted and suggested to the banking executives for analysing and improving a bank’s market performance during periods of disruptive competition. To improve a bank’s effective market performance during periods of enormous disruptions, social construction and re-construction of the merging findings imply that the accurate analysis and response to the unfolding changes in the external trends will require the banking executives to use the three frameworks’ strategic analysis to inform the competitive course of directions that the bank can undertake. The Three-Frameworks’ Strategic Analysis will require the banking executives to evaluate the stage of its industry growth stages in conjunction with the use of Porter’s “Five Forces of Industry Analysis” and Porter’s “Four Corners of Competitors’ Analysis”. Following the accurate understanding of the industry and market dynamics, findings suggest the bank executives can then craft and apply the strategies for leveraging their competitiveness whilst also countering disrupters. Such strategies would require increasing the investment in R&amp;D to introduce novel digital banking technologies as well as the introduction of novel digital financial products/services that respond or even exceed the unfolding customer expectations. Other critical strategies would require the assimilation or nurturing and integrating the most disruptive fintech companies as part of the essential business partners. Once these strategies are being executed, it is essential the banking executives must also analyse the impacts of such strategies on the improvement of a bank’s liquidity and profitability. Basing on such insights, the study enriches the existing theories by offering the Integrated Strategic Analytical Framework that the contemporary banking executives can adopt for analysing and improving a bank’s market performance during periods of disruptive competition. However, future research can still explore how improving employees’ creativity bolsters a bank’s innovativeness to catalyse its effective market performance during periods of disruptive competition.

Comparison of the recovery characteristics for canine corneal ulcer treated with corneoconjunctival transposition or conjunctival autografts

Corneal ulceration induced by Staphylococcus pseudintermedius (S. pseudintermedius) is a common clinical eye disease. Antibiotics combined with corneoconjunctival transposition (CCT) or conjunctival autografts (CA) are often used, but the recovery characteristics are still unknown. In this experiment, canine corneal ulcer models induced by S. pseudintermedius and treated with levofloxacin eye drops (LED) were created. The models were used to compare the recovery characteristics of CCT and CA, combined with LED, by clinical observation, histopathology, and cytokine expression detected by qRT-PCR analysis. The results showed that the ulcerative cornea with only LED treatment perforated after 48 h. The mRNA expression of TLR2, IL-1β, IL-6, IL-8, and TNF-α genes was significantly elevated on 14, 28, and 35 days after the surgery compared to normal (p < 0.01). On day 42, the inflammatory damage had resolved, but the corneal transparency and arrangement of collagen fibrils in the CCT group were higher than those in the CA group. The mRNA expression of EGF, FGF, TGF-β1 and VEGF genes increased significantly (p < 0.01), mostly until day 42, proving that CCT and CA surgery contributed to the corneal recovery, and relieved the inflammatory reaction, with the elimination of corneal cicatrices needing a period of reconstruction. Therefore, this study has provided, for the first time, the method for establishing a canine corneal ulcer model induced by S. pseudintermedius. More importantly, the recovery of canine ulcerative corneas with CCT or CA surgery is reported for the first time.

Postoperative Cosmetic Scores and Revision Rates After Nasal Mohs Reconstructive Surgery.

Few studies have examined the impact of preoperative and surgical factors on the change in cosmetic survey scores after nasal Mohs reconstruction using a subset of the 10-item Standardized Cosmesis and Health Nasal Outcomes Survey-Cosmesis (SCHNOS-C). We aim to determine preoperative and surgical factors that impact cosmetic outcomes following Mohs nasal reconstruction. Retrospective analysis. Nasal Mohs reconstruction patients at a tertiary medical center. All patients receiving Mohs reconstruction of any nasal subunit at a tertiary medical center were analyzed. Variables collected included demographic and Mohs defect/reconstruction characteristics. Primary outcomes were changes in cosmetic (SCHNOS-C) scores and revision rates. Multivariable analysis was used to identify independent predictors of cosmetic scores/revision. We included 296 patients for analysis. On multivariable logistic regression, factors contributing to better final cosmetic scores were receiving a skin/composite graft (odds ratio [OR]: 0.22, 95% confidence interval:0.06-0.68, P = .014) compared to a local flaps. Women were more likely to have worsening cosmetic scores (OR: 2.27, 1.06-4.99, P = .037). Only initial cosmetic scores independently predicted receiving any revision (OR: 1.11, 1.03-1.20, P = .006). Average SCHNOS-C scores after nasal reconstruction of Mohs defects are low. Only worse patient reported SCHNOS-C scores predicted revision. It is important to understand preoperative and surgical factors that affect cosmetic outcomes to optimize patient counseling and reconstructive planning. Patient perception is a key factor in predicting revisions.

Evaluation of Three-Dimensional Reconstruction Technology in Precision Hepatectomy for Primary Liver Cancer

Abstract Background Primary Liver Cancer has become a potent threat to the world due to its high morbidity and mortality rate. Up till now, Liver transplantation is the most suggested treatment but it is not feasible owing to the unavailability of donors and high cost. Hepatectomy provides an alternative treatment to this deadliest disease. Precision hepatectomy is performed with the aid of traditional 2 dimensional technology and image processing such as CT scan and Magnetic Resonance Imaging. However, it requires extensive expertise and pose challenges to the young doctors in decision making. Modern imaging and computer technology has opened the new avenues in medical field with the advent of 3 dimensional Reconstruction and visualization methods. Material and Methods We conducted a cohort retrospective study. In this study, we tried to evaluate the efficacy an impacts of 3 dimensional reconstruction on the preoperative planning of hepatectomy, intraoperative conditions and postoperative complications. We took 95 patients and divided them in two groups A and B. Group A has 67 patients who underwent hepatectomy before the application of 3 dimensional reconstruction and 28 patients on whom hepatectomy was performed according to the planning and methods of 3dimensional reconstruction and results were evaluated. Results Our study found that 3 dimensional reconstruction can help in better diagnosis, resection planning and reduce the postoperative complication. Results were not significant difference p &gt; 0.05 on the incidence of postoperative complication between group A and B. Results were significant p &lt; 0.05 for the intraoperative blood loss, optimal surgery time and postoperative hospitalization. Conclusion Hence, 3 dimensional reconstruction is a landmark discovery in medical sciences for the accurate evaluation and resection of complex liver cancers.

Digitalization in Cranial Reconstruction: Revolutionizing Precision and Innovation.

Cranioplasty for cranial defects can be complex and challenging in composite defects. The intricate 3D structure of the craniofacial skeleton poses various difficulties encountered in surgical reconstruction. The continuous progress in computer-aided design and computer-aided manufacturing design, and fabrication technology has led to a growing array of applications for visual analog scale and 3D printing in craniofacial surgery, encompassing preoperative assessment, the creation of cutting guides, and the development of custom implants and stereolithographic models. Within this review, the authors detail the present and developing applications of virtual surgical planning, 3D bioprinting, augmented reality, and virtual reality in craniofacial reconstruction.

Evaluating the Ability of Brachial Plexus-Injured Patients to Control an Externally Powered (Myoelectric) Hand Prosthesis.

Restoration of hand function after traumatic brachial plexus injury (BPI) remains a formidable challenge. Traditional methods such as nerve or free muscle transfers yield suboptimal results. Advancements in myoelectric prostheses, characterized by novel signal acquisition and improved material technology, show promise in restoring functional grasp. This study evaluated the ability of adults with a BPI injury to control an externally powered prosthetic hand using nonintuitive signals, simulating the restoration of grasp with a myoelectric prosthesis. It also assessed the effectiveness of a comprehensive multidisciplinary evaluation in guiding treatment decisions. A multidisciplinary brachial plexus team assessed adults with compromised hand function due to BPI. The feasibility of amputation coupled with fitting of a myoelectric prosthesis for grasp reconstruction was evaluated. Participants' ability to control a virtual or model prosthetic hand using surface electromyography (EMG) as well as with contralateral shoulder motion-activated linear transducer signals was tested. The patient's input and injury type, along with the information from the prosthetic evaluation, were used to determine the reconstructive plan. The study also reviewed the number of participants opting for amputation and a myoelectric prosthetic hand for grasp restoration, and a follow-up survey was conducted to assess the impact of the initial evaluation on decision-making. Of 58 subjects evaluated, 47 (81%) had pan-plexus BPI and 42 (72%) received their initial assessment within 1 year post-injury. Forty-seven patients (81%) could control the virtual or model prosthetic hand using nonintuitive surface EMG signals, and all 58 could control it with contralateral uniscapular motion via a linear transducer and harness. Thirty patients (52%) chose and pursued amputation, and 20 (34%) actively used a myoelectric prosthesis for grasp. The initial evaluation was informative and beneficial for the majority of the patients, especially in demonstrating the functionality of the myoelectric prosthesis. The study indicates that adults with traumatic BPI can effectively operate a virtual or model myoelectric prosthesis using nonintuitive control signals. The simulation and multidisciplinary evaluation influenced informed treatment choices, with a high percentage of patients continuing to use the myoelectric prostheses post-amputation, highlighting its long-term acceptance and viability. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Investigating Post-Disaster Reconstruction since the 2011 Great East Japan Earthquake: A Study on the Ōtsuchi-chō, Iwate Prefecture through Timelines

Since the 2011 Great East Japan Earthquake, 13 years have passed, and many areas have completed post-disaster reconstruction. Therefore, it is necessary to further summarise and analyse the experiences gained from this post-disaster reconstruction. This study conducted door-to-door interviews with residents of Ōtsuchi-chō, Iwate Prefecture, in the 13 years following the earthquake. It recorded the residents’ perspectives on post-disaster reconstruction and its shortcomings. By collecting locally published materials like newspapers, and local government records and integrating them with interview records, the first “Great East Japan Earthquake Timeline” for Ōtsuchi-chō was compiled. We primarily divided this timeline into the following three phases: the disaster and early reconstruction period (2011), the mid-reconstruction period (2012–2015), and the late reconstruction period (2016–Present). This timeline has yielded the following results: firstly, some issues have arisen during this prolonged reconstruction process. For example, continuous relocation hinders community rebuilding, especially in the context of an ageing society. Secondly, the “Ōtsuchi-chō Reconstruction Timeline” was created, which can be used for post-disaster reconstruction in contemporary Japanese villages facing severe ageing. This timeline provides a clear understanding of how disaster-affected areas can rebuild housing and infrastructure, and recover economically. It offers guidance for the reconstruction of Japanese villages after a disaster. Therefore, post-disaster reconstruction in the region should accelerate infrastructure development and continuously listen to residents’ voices, providing corresponding services to make reconstruction comprehensive and specific. At the same time, it also contributes to the post-disaster reconstruction of villages in other developed countries.