Functional Results Research Articles

Bosworth fracture: Pathoanatomy, Complications, and Medium-term Results of Treatment.

Bosworth fractures (BFs) with entrapment of a fibular fragment behind the posterior malleolus (PM) are rare but potentially serious injuries to the ankle. Despite an increased awareness through a more regular use of computed tomography (CT) scanning, there is still a scarcity of clinical outcome studies. Over a course of 25 years, data on 23 patients treated for BF at our institutions (mean age 44 years) were collected prospectively. Of those, 16 patients had a Weber type B fracture with displacement of the proximal fibular fragment and 7 patients Weber type C fractures with displacement of the distal fibular fragment behind PM. All but 1 patient, who refused operative treatment, were treated with open reduction and internal fixation. A total of 21 patients were followed up for an average of 66 (range, 18-204) months. The PM was fractured in 96% and the Tillaux-Chaput tubercle in 13% of cases. In 80% of patients with preoperative CT scans, the fibular fragment was entrapped between the posterior aspect of the distal tibia and the displaced PM fragment. An initial attempt at closed reduction was successful in 4 of 7 Weber type C fractures and in none of 16 Weber type B fractures. The overall complication rate was 22%. Eighty-one percent of patients rated their results as good or excellent. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score at the final follow-up averaged 84.1 (range, 45-100). Risk factors for postoperative osteoarthritis and poor functional results included unsuccessful closed reduction, inadequate open reduction, and avascular necrosis of the talus. Clinical and radiographic results were correlated. Unsuccessful initial reduction and failure to achieve anatomic open reduction were associated with posttraumatic arthritis whereas open anatomic reduction and internal fixation resulted in favorable functional and radiographic results in the medium to long term.

Can robotic arm-assisted total knee arthroplasty be applied to valgus deformity.

Total knee arthroplasty (TKA) in valgus knees is challenging. Optimal ligament balance, implant neutral or moderate valgus alignment are crucial but conventional instrumentations usually lead to outliers. Robotic arm assisted TKA (RATKA) advantages could answer this challenge. Objectives were to assess RATKA frontal alignment accuracy for valgus knees, rotational femoral component reliability, revision surgery rate and functional outcomes for this population. This study is based on a continuous series of 454 RATKA. Implants were positioned according to a patient-specific alignment and postero-stabilised inserts were used. Valgus values, range of motion, KOOS and revision surgery rates were assessed at one-year postoperative. Femoral component rotation was analysed intraoperatively. MAKO navigation system confirmed valgus preoperative deformity for 34 patients. Mean postoperative valgus value was - 1.5°±1.53 (range, -5 to 1), 85% patients had a residual valgus between 0 and - 3°, 97% of patients had a difference < 3° between valgus planned and valgus measured at one year postoperatively. Mean femoral rotation was + 2.65°±1.87 (range, 0 to 6.8°) of external rotation related to posterior condylar angle. No revision surgery has been performed. Mean KOOS value at one year was 80.79. 76% of patients (n = 26) had a good (70-80) or excellent (> 80) KOOS score. Mean flexion value was 133°±12 (range, 100 to 140). RATKA can be applicable in valgus knee, offering high precision in component positioning with very few outliers. It also facilitates component rotation positioning, providing excellent functional results and ROM.

An analysis of heavy silicone oil treatment for inferior proliferative vitreoretinopathy

PurposeProliferative vitreoretinopathy (PVR) is a complication of retinal detachment which requires multiple vitreoretinal surgical interventions and frequent use of oil endotamponade. In this study, we conducted an in-depth analysis of complications associated with the use of heavy silicone oil in the management of inferior PVR.MethodsA retrospective cohort study of 20 eyes that underwent vitrectomy for inferior PVR with use of heavy silicone oil (Densiron 68) between March 2021 and October 2022 at Oxford Eye Hospital. Complications were classified into major categories relating to intraocular pressure, inflammation, lens, and oil emulsification/migration. Visual outcomes and surgical success rate were also evaluated.ResultsFill-induced pressure spikes (> 30 mmHg) within 14 days post-surgery were common after Densiron tamponade, especially in patients previously on glaucoma drops. The number of glaucoma drugs were increased in 45% of patients during Densiron tamponade. In 20% of cases, an increased medication was continued long-term after Densiron removal. Significant cataract progression occurred in all phakic patients. In 25% of pseudophakic cases, posterior capsule opacification was noted. Inflammatory complications, such as anterior uveitis, were rare and any cystoid macular oedema was transient. No unexplained acute loss of vision following Densiron removal was encountered. The anatomical success rate at 30 days after Densiron removal was 70%. The mean (± SD) best-corrected visual acuities were 1.04 (± 0.79), 0.85 (± 0.62) and 0.50 (± 0.51) logMAR prior, during and after Densiron tamponade, respectively.ConclusionThe outcomes in this cohort treated with Densiron 68 were comparable to previously reported anatomical and functional results in cases with inferior PVR. IOP and lens-related complications require additional treatment during or after Densiron tamponade. Inflammatory complications rarely occurred over tamponade durations of around three months.Trial registrationAnalyses were conducted as an internal quality improvement audit and as such did not require external IRB review.

Ultrasound-guided release of carpal tunnel syndrome - anterograde technique.

Compression of the median nerve in the carpal tunnel is a frequent pathology with severe functional impact. An ultrasound-guided technique was developed to preserve structures, diminish scar fibrosis and enable fast return to full activity. Its advantages are safety and low additional cost. Ultrasound-guided carpal tunnel release is indicated in moderate and severe carpal tunnel syndrome persisting after conservative treatment. A preoperative ultrasound scan is recommended to evaluate anatomy. Recurrent carpal tunnel syndrome, secondary carpal tunnel syndrome and anatomic variants compromising the safety of transverse carpal ligament division are contraindications. The procedure is performed under local anesthesia without tourniquet. The entry point is a short transverse incision proximal to the wrist crease. The transverse carpal ligament is divided anterogradely, using a dedicated blade under ultrasound control, making sure no nerves, tendons or blood vessels are injured. The final step is to check that the division is complete. Early return to use of the hand is permitted. Reports of similar techniques demonstrated early symptomatic relieve, favorable patient-reported outcome measures from within 1 week after surgery to 2 years' follow-up, with early return to normal daily activity and work. The complications rate is low: many series showed no complications. Comparative studies between ultrasound-guided carpal tunnel release and the mini-open technique reported similar or greater and quicker symptom relief, less scar pain and better strength. Final functional results tend to be similar.

Retrospective cross-sectional study on bronchiectasis in adult Aboriginal Australians: disease characteristics and comparison with ethnically diverse global bronchiectasis registry cohorts

BackgroundGlobally, adult Indigenous people, including Aboriginal Australians, have a high burden of chronic respiratory disorders, and bronchiectasis is no exception. However, literature detailing bronchiectasis disease characteristics among adult Indigenous people...

Impact of Female Genital Self-Image on sexual function and associated risk factors

Female sexual function results of complex interactions between biological and non-biological factors. Assess the influence of genital self-image on sexual function in women. A cross-sectional online survey was conducted among Portuguese women aged ≥18 years between 4th of April and 22nd of June 2023. Demographic information, medical history, sexual behavior, Female Genital Self-Image Scale (FGSIS) and Female Sexual Function Index-6 (FSFI-6) were featured in the questionnaire. We included 482 participants; 40.6% (n = 191) were uncomfortable with their genital image (FGSIS < 22 points). In general, 20.3% were not satisfied with sexual life (n = 96) and 19.5% (n = 80) met the criteria for female sexual dysfunction (FSFI-6 score ≤ 19). Women with negative genital self-image had lower FSFI-6 scores than women comfortable with genital appearance (24.0 versus 26.0; p < 0.01), presenting higher rates of female sexual dysfunction (24.5% versus 16.0%; p = 0.039). Subscales of desire, arousal, satisfaction and pain were all worse in the negative genital self-image group. Genital appearance dissatisfaction increases the risk of female sexual dysfunction by 1.5 times. Post-menopausal women had higher rates of negative genital self-image (37.9% versus 65.9%; p < 0.001) and female sexual dysfunction (38.2% versus 17.4%; p = 0.006). Depression and endometriosis were associated with higher rates of genital dissatisfaction and sexual dysfunction. A history of unwanted sexual experiences was associated with negative genital self-image (51.9% versus 38.9%; p = 0.077). Genital self-image has an important impact in female sexual function, and it is a risk factor for female sexual dysfunction. Menopause, depression, endometriosis and unwanted sexual contacts may be risk factors for a negative perception of the genital image.

Functional Outcome and Balance Compensation in Patients with Unilateral Vestibular Schwannoma After Surgical Treatment-Short- and Medium-Term Observation.

Objective: The aim was to evaluate vestibular function in patients with unilateral vestibular schwannoma before and in the short and medium term after surgical treatment to analyze vestibular compensation. The identification of the prognostic factors determining incomplete and slower balance recovery was assessed. Methods: Forty-five patients with unilateral vestibular schwannoma treated surgically through the middle cranial fossa and translabyrinthine approach were enrolled in this study. The data were collected in the period between April 2022 and August 2023. The clinical data, vestibular tests (video head impulse test, sensory organization test) and the dizziness handicap inventory (DHI) before and after surgery were evaluated. Results: One month after surgery, a temporary deterioration in the DHI results occurred (DHI total score before surgery 24.36 vs. one month after surgery 31.64); however, a significant increase was found only by analyzing the functional subscale (p = 0.0395) for the DHI functional, emotional and physical subscale results; in addition, the total score before and three months after the surgery did not differ significantly. No statistically significant differences between the preoperative sensory organization test and the test one month after the surgery were found, while a significant improvement in the vestibular parameters was observed three months after the surgery compared to the preoperative results (C5 0.0306, C6 0.0002, VEST 0.0294, COMP 0.0023). A negative correlation was found between the DHI total score and C5 (-0.3198, -0.3266), C6 (-0.3448, -0.46379), VEST (-0.3100, -0.3252) and COMP (-0.4018, -0.4854) one and three months after the surgery, respectively. A significant deterioration was found between the LSC gain results on the tumor side (p < 0.001) and on the healthy side before the surgery vs. one month afterwards (p = 0.0079) and before the surgery vs. three months afterwards (p = 0.0419). The middle cranial fossa or translabyrinthine approach had no influence on the postoperative results. Conclusions: In the postoperative period, vestibular compensation occurs spontaneously. The results show that the functional level deteriorates one month after surgery but then improves significantly three months after the surgery, which confirms that compensation occurs gradually. The DHI functional subscale results before surgery and three months afterwards did not differ significantly, which demonstrates that functional recovery after vestibular denervation should take place within that time. In the present study, no predictive factors for unsatisfactory functional postoperative outcomes were found.

Robotic hiatus hernia surgery: learning curve and lessons learned

New procedures like the robotic approach require proficiency to ensure patient safety and satisfactory functional results. Hiatal hernia surgery serves as a suitable training procedure for upper gastrointestinal tract surgeons transitioning to the robotic approach. This study aims to evaluate the outcomes of implementing the robotic approach in hiatal hernia surgery at a tertiary hospital and to assess the associated learning curve. A retrospective review was conducted on 54 patients (58 surgeries) between June 2019 and March 2024, including both primary and revision robotic antireflux surgeries. The study focused on perioperative outcomes, symptom resolution, and the surgical learning curve, assessed using Cumulative Sum analysis. The results showed that global surgical time averaged 124 ± 57 (54–350) min, 127 ± 38 (116–139) for Primary Surgery and 164 ± 84 (115–212) min for Revisional Surgery. There were no conversions to laparoscopic or open approach. The global median of hospital stay was 2 days (2 for Primary Surgery and 3 for Revisional Surgery) and three patients required readmission (2 for Primary Surgery and 1 for Revisional Surgery). Postoperative complications occurred in 3 patients. Symptom resolution was achieved in 90% of Primary Surgery group and 85.7% of Revisional Surgery group. Learning curve described three phases: 1-training (case 1 to 14), 2-plateau (15 to 25) and 3-expertise phase (25 onwards). The robotic approach in hiatal hernia surgery is feasible with minimal morbidity, short hospital stays, and excellent functional results. With previous experience in laparoscopic approach and esophagogastric surgery the learning curve can be reduced to 14 procedures.

Irradiated Homologous Costal Cartilage Grafts in Complex Functional Septorhinoplasty.

Optimal results in complex nasal reconstruction, particularly in the context of post-traumatic and revision septorhinoplasty, often require the use of cartilage grafts to provide additional structural support to the nose. While autologous costal cartilage (ACC) has been traditionally used, this can be limited by donor site morbidity, increased operative time, and in some cases, lack of suitable cartilage for grafting. There has been a trend towards using irradiated homologous costal cartilage (IHCC) as an alternative source of graft material. We review our departmental experience of using IHCC in functional septorhinoplasty surgery. We performed a retrospective review of electronic medical records of all patients who underwent septorhinoplasty using IHCC at a tertiary referral center between May 1, 2022, and April 30, 2024. Demographic data, surgical details, and postoperative outcomes, including rates of infection, resorption, warping, and revision were recorded and analyzed. Fifty-seven patients (34 males, 23 females) with a mean age of 41.0 years (range: 18-65 years) were included. Forty-one were revision septorhinoplasty operations, while 16 were primary cases. Almost all were performed via an open approach (98.2%). Three patients developed postoperative infection (5.3%) while one developed columellar dehiscence needing further revision surgery (1.8%). Functional and aesthetic results were otherwise satisfactory in all patients. We observed no cases of warping, resorption, or extrusion. The median length of follow-up was 279 days (interquartile range: 171-527 days). We present the largest United Kingdom series to date on the use of IHCC in septorhinoplasty surgery. Our findings support its use as a safe and effective graft material and a viable alternative to autologous sources, offering the benefits of a robust reconstructive material and shortened operative time, without the risk of donor site complications. A longer follow-up period is ideally required to evaluate its long-term structural stability.

Evidence for the extent and oncological benefit of lymphadenectomy for esophageal cancer

The prognosis for esophageal cancer is determined in particular by the depth of infiltration (Tstage) and lymph node metastasis (Nstatus). In patients with locally advanced tumors, surgical resection is the current standard. The extent of the lymphadenectomy depends on the localization of the tumor, analogous to the choice of surgical technique. For adequate tumor staging and achievement of pN0 status, seven lymph nodes without tumor metastases are necessary by definition but the current guidelines recommend 20lymph nodes as abenchmark in an expert consensus. Despite the importance of the lymph node status for the prognosis of the patient and the already standardized use of targeted imaging of sentinel lymph nodes in other oncological disciplines, there is neither avalidated method nor sufficient evidence for the benefit of lymph node mapping in esophageal cancer. The discussion about the prognostic advantage of lymphadenectomy is particularly interesting in T1 early stage cancer. Due to the technical advances of interventional endoscopy in recent years, organ preservation using endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) has not only become possible but also safe to carry out and thus established as the standard with better functional results; however, if one or more risk factors are present, endoscopic ablation is no longer defined as curative and should be supplemented by further treatment, usually non-organ-preserving resection. The step from organ-preserving interventional treatment with alow complication rate to asurgical procedure with significant mortality and morbidity as well as functional limitations seems immense and requires optimization, especially in view of the technical developments of surgery in recent years. This can either aim to identify the risk of lymph node metastases more precisely or to minimize the morbidity/mortality and functional limitations of additive treatment procedures. Approaches to this are currently the subject of research and have already been safely applied in individual pilot projects.

Open Partial Horizontal Laryngectomy in the Elderly: Oncological and Functional Outcomes.

The aim of the present study was to investigate the oncological and functional prognostic implication of perioperative risk factors in the elderly patient who underwent open partial horizontal laryngectomy (OPHL). A single institution, retrospective case-cohort study. The present study retrospectively reviewed the clinical charts of a cohort of 100 elderly laryngeal squamous cell carcinoma (LSCC) patients who underwent OPHL at our institution. Oncological and functional results were evaluated through univariate analysis. The overall recurrence rate was 19%. The 2 years overall and disease-specific survivals were 72% and 90%, respectively. No perioperative deaths were reported. A postoperative complication was reported in 20 cases (20%). Fifty-four patients (54%) were decannulated during the hospitalization. A percutaneous endoscopic gastrostomy procedure was performed in 12 patients (12%) due to persistent dysphagia. Twenty-six patients experienced postoperative late sequelae (26%), in terms of postoperative laryngeal obstruction (POLO) in 17 cases. A total of 80 patients (80%) were finally successfully decannulated. A functional total laryngectomy was performed in 6 cases. The indication to OPHL should be carefully evaluated in the elderly. In appropriately selected patient, OPHL represents a safe and effective therapeutic option. Cervical positive nodes and an incomplete resection of the tumor with positive surgical margins remain in such population the main prognostic factors for the oncological outcome, these factors have a negative impact on the functional outcome too, due to the need for adjuvant treatment. Hence, OPHL should be offered as a single-modality treatment especially in the elderly. 4 Laryngoscope, 2025.

Total joint arthroplasty of the thumb CMC joint.

Rhizarthrosis-osteoarthritis of the thumb carpometacarpal (CMC) joint is usually a primary idiopathic disease. Total joint arthroplasty (TJA) is one of the surgical treatment options for symptomatic advanced thumb CMC arthritis. This retrospective study aims to evaluate the mid-term functional and radiological results of TJA with the minimum follow-up period of 3 years after the surgery. Presented are the results of 136 total trapeziometacarpal joint replacements in the group of 105 patients consisted of 96 women and 9 men. Used prostheses were ELiS® implant (27 cases), Ivory® implant (42 cases), Touch® Dual mobility (67 cases). The follow-up period was minimally 3 years postoperatively. In all the patients, along with range of motion and radiologic evaluation of implant position, the function and pain of operated joint were evaluated using DASH and VAS score at regular intervals pre- and postoperatively. At a mean of 85months (range 38-126months) post-operatively, patients in 116 cases (85%) reported full satisfaction and absence of symptoms and difficulties. In 12 cases (9%) some slight residual post-exercise pain was reported. In eight cases (6%) patients suffered from episodic rest-pain, but with a lower intensity than in the preoperative period. Postoperatively, the patients declared subjective improvement in hand function. The total DASH score and VAS score decreased in all patients, while ROM increased. The course of all of TJA surgeries was complication-free. Five patients needed revision surgery. In two patients a dislocation has occurred and in three cases a loosening of the cup's implant was reported. The most frequent postoperative complication was the occurrence of transient paraesthesias of the thumb in eight cases (6%). TJA is the method of choice in management of advanced symptomatic osteoarthritis of the thumb CMC joint. Mastering surgical technique, TJA represents safe and effective treatment method in advanced degenerative changes of the thumb CMC joint and it's benefits exceed possible perioperative and postoperative risks.

Results of functioning of the Federal databank of radiation doses to the population of the Russian Federation due to natural sources of ionizing radiation in 2022–2024

Results of functioning of the Federal databank of radiation doses to the population of the Russian Federation due to natural sources of ionizing radiation in 2022–2024

Cystocele and rectocele repair with native tissue layers: definition of the technique.

To investigate the outcomes of central cystocele and rectocele repair using natural tissue layers. To describe a novel technique (Dogan technique). This is a retrospective cohort study. Between January 2021 and January 2023, patients who had central cystocele and rectocele higher than stage1 were included in the study. The Pelvic Organ Prolapse Quantification (POP-Q) score was used to determine the degree of the prolapsus. All cystocele and rectocele repair surgeries were performed by the same physician. The patients' voiding habits were assessed using ICIQ-SF and OAB-V8. Sexual function results were assessed with FSFI questionnaire before and after the operation. Transperineal ultrasonography was performed to examine mobility of the anterior and posterior compartments. Total of 36 patients were diagnosed with grade 2 and above central cystocele (19, 52%) and rectocele (n = 17, 48%). After the operation the anatomical cure of anterior and posterior compartments was achieved for all patients in the two-years follow-up. According to voiding habits before the surgery, there were symptoms of stress urinary incontinence (SUI),urge urinary incontinence (URGE), both SUI and URGE, and no incontinence at the patients; 7 (36.8%), 14 (73.7%), 5 (26.3%), 3 (15.7%) respectively. Of those URGE patients (n = 5/14, 35.7%) incontinence symptoms were mixed-type. After the cystocele operation, significant improvement was seen in their voiding problems according to the ICIQ-SF and OAB-V8 questionnaires (p < 0.05). As well as significant improvement was found in sexual function according to the FSFI questionnaire (p < 0.05).

Accuracy of Guided Dual Technique in Esthetic Crown Lengthening: A Prospective Case-Series Study.

This study aimed to evaluate the efficacy and safety of a digitally guided dual technique during esthetic crown lengthening surgery. In addition, patient satisfaction and patient-reported outcomes were assessed. A prospective case series study was conducted. Cone-beam computed tomography and intraoral scans were used to design surgical guides, which were manufactured via 3D printing. The primary outcome was surgical accuracy, assessed by measuring the distance between the planned and final gingival margin positions using overlapping intraoral scans. Secondary outcomes included clinical crown length, gingival margin stability, pain, and patient satisfaction. Statistical analyses were performed using multilevel linear regression models, with significance set at p < 0.05. Ten participants (87 teeth) were treated without complications. The mean duration of surgery was 66.5 min. The overall absolute deviation was 0.56 mm (95% CI: 0.48 to 0.65) at 6 months postoperatively. Clinical crown length increased significantly from baseline to the end of surgery (p < 0.001), with minimal reduction at 6 months (p = 0.479). Patient-reported outcomes indicated mild postoperative pain and high satisfaction with esthetic results. The digitally guided dual technique for esthetic crown lengthening surgery is safe and effective, providing highly accurate outcomes. The technique also results in excellent patient satisfaction. The use of digitally guided dual techniques for ACL surgery enhances precision and safety, leading to highly accurate outcomes and improved patient satisfaction. This approach could be beneficial in clinical settings to ensure better esthetic and functional results.

Ionizable Cholesterol Analogs as the Fifth Component of Lipid Nanoparticles for Selective Targeting Delivery of mRNA.

Lipid nanoparticles (LNP) have shown great promise in clinical applications for delivering mRNA. Targeted delivery of mRNA to particular tissues or organs is essential for precise therapeutic outcomes and minimized side effects in various disease models. However, achieving targeted delivery beyond the liver is a challenge based on current LNP formulations. In this report, we synthesized four ionizable cholesterol analogs by attaching two tertiary amine groups onto the head of a cholesterol-like structure and incorporated them as a fifth component into conventional commercial LNPs based on ALC-0315 or SM-102. Selective targeting delivery of mRNA is achieved by adjusting the proportion of the fifth component in the LNP. Specifically, a spleen-targeted 0315-Ergo-40% formulation demonstrated an impressive 95% delivery efficiency, while a lung-targeted 102-Sito-40% formulation achieved up to 78%. Moreover, when this strategy is applied to a self-developed ionizable lipid named U-101 instead of ALC-0315 or SM-102, the targeting delivery efficiencies to the spleen and lungs reach 96 and 71%, respectively. Multiple assessments suggest that inclusion of the fifth component does not compromise LNP stability, as indicated by consistent particle size, polydispersity index (PDI), and encapsulation efficiency. Furthermore, the test results of liver and kidney function and immunogenicity reveal no increase of toxicity in vivo following the introduction of the fifth component. Additional studies on in vitro cytotoxicity, lysosomal escape, and cellular transfection efficiency confirm that the fifth component does not diminish delivery performance. Taken together, the incorporation of ionizable cholesterol analogs leads to targeting of LNP delivery, which features strong organ selectivity, high safety, and suitability for further evaluation.

PARAMETER ESTIMATION OF LOGNORMAL AND PARETO TYPE I DISTRIBUTIONS USING FREQUENTIST AND BAYESIAN INFERENCES

Extreme events are events that rarely occur but they cause substantial losses. Insurance companies need to take extreme events into account in risk management because extreme events can have a negative impact on the company's financial health. As a result, insurance companies need an appropriate loss model that matches the empirical data from these extreme events. A distribution that is heavy-tailed and skewed to the right is a good distribution for modeling the magnitude of losses from extreme events. In this paper, two distributions with heavy tails and skew to the right will be used to model the magnitude of losses from extreme events, namely the lognormal distribution and the Pareto distribution type I. The parameters of these distributions are estimated using two inferences, namely the frequentist and Bayesian inferences. In the frequentist inference, two methods are applied, namely the moment method and maximum likelihood. On Bayesian inference, two prior distributions are used, namely uniform and Jeffrey. Test model suitability is carried out by visually comparing the model distribution function with the empirical distribution function, as well as by comparing the Root Mean Square Error (RMSE) value. The visualization results of the distribution function and RMSE values ​​show that in general, the Bayesian inference is better at estimating parameters than the frequentist inference. In the frequentist inference, the maximum likelihood method can provide better estimated values ​​than the moment method. In the Bayesian inference, the two prior distributions show a relatively similar fit to the data and tend to be better than the frequentist inference.

Realization of p-type MA-based perovskite solar cells based on exposure of the (002) facet

The crystallographic orientation of perovskite crystals significantly influences their photoelectric performance and associated photovoltaic devices. The classic perovskite (MAPbI3) films based on solution processing usually suffer from chaotic orientations. The impact of preferential crystallographic orientation of MAPbI3 thin films on the carrier transport is still far from being well understood. In comparison with the (011) and (111) facets, our density functional theory results revealed that the hole carrier in the (001) facet exhibits superior carrier transport properties. Herein, the highly oriented (001) FAPbI3 could serve as growth templates and promote the (002) orientations of MAPbI3 perovskite. Furthermore, the p-type doping in MAPbI3 was obtained by controlling the amount of MAI. The (002)-dominated MAPbI3 perovskite with p-type characteristics exhibits exceptional carrier transport properties, thereby enhancing device performance.

Anatomical and functional results of patients with late-stage age-related macular degeneration 6 months after smaller-incision new-generation implantable miniature telescope (SING IMT™) implantation.

The aim of the study was to evaluate anatomical and functional outcomes of the Smaller-Incision New Generation Implantable Miniature Telescope (SING IMT™) in patients with bilateral advanced age-related macular degeneration (AMD). This non-comparative retrospective single-surgeon interventional case series included patients with bilateral late-stage AMD who underwent cataract surgery and SING IMT™ implantation at the Sant'Anna University Hospital, University of Ferrara, Italy. The main outcome measures included corrected distance (CDVA) and near visual acuity (CNVA), endothelial cell loss (ECL), and incidence of complications. 11 eyes of 11 patients were included. The mean follow-up duration was 6.5 ± 2.4 months. After surgery, CDVA significantly improved (from 17.00 ± 9.74 to 26.00 ± 8.53) letters (P = 0.008). Significant improvement of CNVA was also observed (from 12.27 ± 4.36 to 8 ± 2.61 Jaeger levels; P = 0.004). Mean ECL was 4.8 ± 5.5% at 3 months. No intraoperative complications were observed, while postoperative complications included iris incarceration (9.1%), pigment deposition on the device (9.1%), and transient corneal oedema (27.3%). Nevertheless, 10 of 11 patients (90.9%) began to complain of blurred or hazy vision within 3 months of surgery. The device was ultimately explanted in 3 patients (27.3%) because of this symptom. Although SING IMT™ implantation is associated with promising objective results, unexplained blurred or hazy vision represents common postoperative complaints which may lead to patient dissatisfaction. Further studies including patient-reported outcomes are warranted to evaluate the effect of the intervention on patients' visual function and quality of life.

Interposition Arthroplasty with Meniscal Allograft for the Treatment of Sternoclavicular Joint Pathology; The SC Calamari Technique.

Painful degeneration of the sternoclavicular joint refractory to nonoperative treatment has historically been managed with resection of the degenerative segment of the medial clavicle. Although this has produced good results with improvement in symptoms, recurrent pain necessitating revision surgery is not an infrequently encountered outcome. To reduce the occurrence of recurrent postoperative pain, a novel technique to reconstruct the intra-articular disc at the time of medial clavicle resection was developed. 10 patients whom underwent medial clavicle excision and interposition arthroplasty with a lateral meniscus allograft were retrospectively reviewed. Functional results were based on VAS pain scores and subjective shoulder scores. VAS pain score improved from 7.5 (5-10) preoperatively to 1.2 (0-2; p = .005, W-value = 0) postoperatively, with an average improvement of 6.3. The mean preoperative SSV score improved from 54.5 (25-70) preoperatively to 88.5% (80-95%; p = .005; W-value = 0) postoperatively, with a mean increase of 34 percentage points. No patients experienced a complication and or recurrence of pain at most recent follow-up. Minimal excision of the medial clavicle and interposition arthroplasty with lateral meniscal allograft successfully reduces pain and restores stability and function for the treatment of painful degeneration of the SC joint.