Short Recovery Period Research Articles

Protective Effect of Allergen Immunotherapy in Patients With Allergic Rhinitis and Asthma Against COVID-19 Infection: Observational, Nationwide, and Multicenter Study.

Allergic diseases are associated with an increased susceptibility to respiratory tract infections. Although allergen immunotherapy (AIT) alters the course of allergies, there is limited evidence from clinical practice demonstrating its ability to enhance the host defense against pathogens. The aim of this study was to investigate the protective effect of AIT against viral infection in patients with allergic rhinitis (AR) and allergic asthma (AS) based on clinical evidence. A multicenter, questionnaire-based survey was conducted during a tremendous surge in COVID-19 cases between February 10, 2023, and March 15, 2023, in 81 centers across China recruiting healthy volunteers and patients with AR and AS to investigate the clinical outcomes of COVID-19 infection. Of 10,151 participants recruited in the survey, 3654 patients and 2192 healthy volunteers who tested positive for COVID-19 were included in this analysis after screening. Overall, no significant differences in COVID-19 outcomes were observed between patients and healthy volunteers. An additional 451 patients were excluded due to their use of biologics as the sole add-on treatment, leaving 3203 patients in the further analysis. Of them, 1752 were undergoing routine medication treatment (RMT; the RMT group), whereas 1057 and 394 were receiving AIT and a combination of AIT and omalizumab (OMA) as adjunct therapies to RMT, respectively (AIT+RMT and AIT+OMA+RMT groups). The AIT group showed milder COVID-19 symptoms, shorter recovery periods, and a lower likelihood of hospitalization or emergency department visits than the RMT group (all P<.05). After adjusting for confounding factors, including demographic characteristics and COVID-19 vaccination, AIT remained a significant protective factor associated with shorter recovery time (adjusted odds ratio [OR] 0.62, 95% CI 0.52-0.75; adjusted P<.001) and a lower incidence of hospitalization or emergency department visits (adjusted OR 0.73, 95% CI 0.54-0.98; adjusted P=.03). Furthermore, the AIT+OMA+RMT group showed greater protection with a shorter recovery time (adjusted OR 0.51, 95% CI 0.34-0.74; adjusted P<.001) than the AIT+RMT group. Our multicenter observational study provides valuable clinical evidence supporting the protective effect of AIT against COVID-19 infection in patients with AR and AS.

Response of cool‐season turfgrass monocultures and two‐way mixtures to sequential acute drought periods

AbstractTurfgrass seeds are often sold as mixtures of several species to increase the probability of positive responses toward abiotic and biotic stresses, a response to drought being one of these. Several species of turfgrass are already thought to be better suited for drought, such as hard fescue (Festuca brevipila Tracey) and tall fescue [Schedonorus arundinaceus (Schreb.) Dumort]. However, little is known about the benefit of these species in mixtures with drought‐intolerant and/or drought‐avoiding species during drought. Understanding species mixture composition during establishment, before and after drought stress periods, could help develop more resilient mixtures for this stress condition. We compared monocultures and mixtures of hard fescue, Kentucky bluegrass (Poa pratensis L.), and perennial ryegrass (Lolium perenne L.) during sequential short drought and recovery periods in controlled conditions. We observed that the composition of most mixtures remained similar during drought and recovery periods; however, perennial ryegrass was often less prevalent after drought stress. We found that hard fescue monocultures had better green leaf coverage than Kentucky bluegrass and perennial ryegrass during drought stress. However, the presence of hard fescue in mixtures was not an indicator of greater drought tolerance, and variable fluorescence to maximal fluorescence data indicated that hard fescue was just as physiologically stressed as perennial ryegrass and Kentucky bluegrass during the drought periods. These results indicate that while hard fescue seems visually drought tolerant, it is still physiologically stressed and improved drought tolerance could be achieved through focusing on physiological indicators of stress in this species rather than visual indicators.

In vivo tetraploid induction of mono-embryonic citrus genotypes by colchicine treatment

Polyploid holds great significance in citrus breeding, to produce dwarf tetraploid rootstocks with wide adaptability and triploid scion varieties bearing seedless fruits. In citrus, tetraploids have been generated through somatic hybridization and autonomous chromosome doubling of nucellar embryos. However, most tetraploids were recovered from poly-embryonic (apomictic) citrus, while tetraploids of mono-embryonic (non-apomictic) citrus were seldomly reported. Herein, we developed an in vivo tetraploid induction method by colchicine treatment, which is especially high-efficient in mono-embryonic citrus. The epicotyl of citrus seedling was decapitated and incubated in dark for different time durations (0–15 d) to induce callus formation on the epicotyl wound. The callus on wound was then immersed in different concentrations (0.0125 %-0.100 %) of colchicine for 2 h, enabling regeneration of tetraploid shoots. We achieved high tetraploid induction rate (20.69 %) but low mixoploid induction rate (1.72 %), when 0.025 % colchicine was applied on wound cultured in dark for 9 d By using this method, 147 tetraploids were recovered from mono-embryonic mandarin, tangerine, sweet orange, pummelo and citron. Our method exhibited high tetraploid induction efficiency (14.28 %-20.69 %), low rate of mixoploid (1.72 %-5.30 %), short recovery period (45 d), and no need of tissue culture. The majority (75 %-100 %) of the recovered tetraploids maintained stable ploidy during subsequent growth, and the mono-embryonic nature of the tetraploids was identified by InDel marker analysis. The mono-embryonic tetraploids obtained herein enriched polyploid germplasm pool for citrus breeding.

Evaluating the protective effectiveness and risk factors of ursodeoxycholic acid on COVID-19 among outpatients.

Objective: This study aimed to assess the chemopreventive effect of ursodeoxycholic acid (UDCA) against COVID-19 and to analyze infection risk factors, symptoms, and recovery in outpatients with UDCA exposure. Methods: The study enrolled outpatients prescribed UDCA from the Second Affiliated Hospital of Chongqing Medical University, China, between 01 July 2022, and 31 December 2022. Data on demographics, comorbidities, and drug combinations were collected using electronic medical records. COVID-19 infection, symptoms, severity, prognosis, vaccinations, and UDCA administration were surveyed by telephone interviews. UDCA non-users served as controls and were matched in a 1:2 ratio with UDCA users using propensity score matching with the nearest neighbor algorithm. Infection rates, symptomatology, severity, and prognosis were compared between matched and control cohorts, and risk factors and infection and recovery symptoms were analyzed in UDCA-exposed outpatients. Results: UDCA-exposed outpatients (n = 778, 74.8%) and matched UDCA users (n = 95, 74.2%) showed significantly lower SARS-CoV-2 infection rates than control patients (n = 59, 92.2%) (p < 0.05). The matched UDCA group exhibited substantially lower fever, cough, sore throat, and fatigue rates than controls (p < 0.05). Participants with UDCA exposure generally experienced mild symptoms, while those without UDCA had moderate symptoms. The matched UDCA group also had significantly shorter durations of fever and cough (p < 0.05). Risk factors such as age over 60, less than 1month of UDCA administration, diabetes mellitus, and coronary artery disease significantly increased SARS-CoV-2 infection rates (p < 0.05), while smoking led to a decrease (p < 0.05). Hypertension was associated with a prolonged COVID-19 recovery (p < 0.05), while smoking, vaccination, and fatty liver disease were associated with shorter recovery periods (p < 0.05). The main symptoms in the full UDCA cohort were fever, cough, and sore throat, with fatigue, cough, and hyposthenia being the most persistent. Conclusion: UDCA demonstrated chemopreventive effect against SARS-CoV-2 in outpatients by significantly reducing infection incidence and mitigating COVID-19 symptoms, severity, and recovery duration. Old age, short UDCA course, and comorbidities such as diabetes mellitus and CAD increased infection rates, while hypertension prolonged recovery. Smoking, vaccination, and fatty liver disease reduced infection rates and shortened recovery. UDCA had minimal impact on symptom types. Larger and longer-term clinical studies are needed further to assess UDCA's effectiveness in COVID-19 prevention or treatment.

Multicenter, randomized, controlled comparative-effectiveness study comparing virtual reality to sedation and standard local anesthetic for pain and anxiety during epidural steroid injections

BackgroundThe main objective of this study was to determine whether virtual reality (VR) reduces procedure-related pain and other outcomes for epidural steroid injections (ESI). Randomized controlled study was undertaken in academic centers in the U.S. and Thailand where 146 patients with lumbosacral radiculopathy undergoing an ESI were allocated to immersive VR with local anesthetic, sedation with midazolam and fentanyl + local anesthetic, or local anesthetic alone.The primary outcome was procedure-related pain recorded on a 0-10 scale. Other immediate-term outcome measures were pain from a standardized subcutaneous skin wheal, procedure-related anxiety, ability to communicate, satisfaction, and time to discharge. Intermediate-term outcome measures at 4 weeks included back and leg pain scores, function, and success defined as a >2-point decrease in average leg pain coupled with a score >5/7 on a Patient Global Impression of Change scale. FindingsProcedure-related pain scores with both VR (mean 3·7 (SD 2·5)) and sedation (mean 3·2 (SD 3·0)) were lower compared to control (mean 5·2 (SD 3·1); mean differences -1.5 (-2.7, -0.4) and -2.1 (-3.3, -0.9), respectively), but VR and sedation scores did not significantly differ (mean difference 0.5 (-0.6, 1.7)). Among secondary outcomes, communication was decreased in the sedation group (mean 3·7 (SD 0·9)) compared to the VR group (mean 4·1 (SD 0·5); mean difference 0.4 (0.1, 0.6)), but neither VR nor sedation was different than control. The trends favoring sedation and VR over control for procedure-related anxiety and satisfaction were not statistically significant. Post-procedural recovery time was longer for the sedation group compared to both VR and control groups. There were no meaningful intermediate-term differences between groups except that medication reduction was lowest in the control group. InterpretationVR provides comparable benefit to sedation for procedure-related pain, anxiety and satisfaction, but with fewer side effects, superior communication and a shorter recovery period. FundingFunded in part by grants from MIRROR, Uniformed Services University of the Health Sciences, U.S. Dept. of Defense, grant # HU00011920011. Equipment was provided by Harvard MedTech, Las Vegas, NV

The first experience of applying microwave ablation in primary hyperparathyroidism

The OBJECTIVE of this article was to present a clinical demonstration of the successful experience of using minimally invasive surgical treatment of a patient with primary hyperparathyroidism (PHPT) by percutaneous microwave ablation (MWA) of parathyroid adenoma, under ultrasound guidance. This method provides maximum effectiveness with minimal invasiveness, a shorter recovery period after surgery, and a better cosmetic effect. After the minimally invasive intervention, the patient had complaints related to hypocalcemia, which develops practically after any form of radical PHPT treatment. No other complications were observed. Further dynamic observation was carried out by an endocrinologist at the place of residence. The obtained positive results demonstrated a good perspective of PHPT treatment by using MWA.

Extracorporeal shock wave lithotripsy versus laser lithotripsy in the treatment of post-SWL steinstrasse: a randomized comparative study.

To compare the efficacy of Holmium laser lithotripsy with that of extracorporeal shock lithotripsy (SWL) for post-SWL ureteral steinstrasse. From January 2022 to July 2023, 36 patients with post-SWL ureteral steinstrasse were randomly divided into laser lithotripsy and SWL groups. Patients with pain, moderate to marked hydronephrosis, large leading stone fragments, and showing no spontaneous resolution within 3-4weeks after medical expulsive therapy were included. Patients with sepsis were excluded. The success rate was the primary outcome. We compared the perioperative data between the groups. The success rate was higher in the ureteroscopy group than in the SWL group (p = 0.034). SWL was a significantly longer operation, and the fluoroscopy time was significantly longer in the SWL group than in the URS group (p = 0.027). Auxiliary procedures were more frequently performed in the SWL group than in the URS group (p = 0.02). JJ stents were inserted in 100% of patients in the URS group. Three patients (16.7%) underwent conversion to laser ureteroscopy after the second SWL session failed. No significant difference in the incidence of postoperative complications was observed between the groups, but the incidence of postoperative LUT was high in the ureteroscopy group. The mean hospital stay was 30h in the ureteroscopy group. SWL was performed without the need for hospital admission. Ureteroscopic laser lithotripsy for steinstrasse was safe and effective, with a higher success rate, shorter fluoroscopy time, and shorter recovery period than SWL.

Efficacy of Laser Treatment in Pilonidal Disease: A Single-Arm Meta-Analysis.

Objective: This study aimed to collate all published studies on laser therapy for pilonidal disease and demonstrate the safety and effectiveness of minimally invasive techniques. Methods: A comprehensive literature search, with no language limitations, was performed using PubMed, Embase, and Web of Science from inception to April 23, 2023. Two reviewers independently screened the literature according to the inclusion and exclusion criteria and evaluated the bias risk of included studies. Meta-analysis was performed using RevMan software (version 5.4). (PROSPERO Registration ID Number CRD42023420803). Results: The analysis included 1214 patients from 13 studies, who fulfilled the pre-defined inclusion criteria. With a median follow-up of 12 (range, 7.8-25) months, 1000 (84.4%) patients achieved healing after primary laser treatment. The mean complication and recurrence rates were 12.7% and 7.6%, respectively. Conclusions: Laser ablation for pilonidal sinus disease is a new minimally invasive technique with good treatment efficacy, low postoperative recovery, and shorter recovery periods following employment.

Hypoxia impairs cellular energy allocation in the juvenile horseshoe crab Tachypleus tridentatus

Although hypoxia is a serious environmental concern for marine ecosystems globally, its biological effects on the benthic biota remain mostly unclear for some endangered species. To provide an deep understanding of the possible effects of hypoxia on the tri-spine horseshoe crab Tachypleus tridentatus, the cellular energy allocation (CEA) approach was utilized to examine the cellular responses and adaption potential of horseshoe crabs. We examined the energetic responses of T. tridentatus under low dissolved oxygen level (2 mg O2/L). The horseshoe crabs first experienced 14 days of hypoxic stress, and then recovered in a normal dissolved oxygen environment for 7 days. On the 7th and 14th day of hypoxic exposure, the levels of available energy, electron transport system activity, protein, lipids, and carbohydrates were decreased in T. tridentatus (p < 0.05). All measured parameters in the hypoxic group partially or completely recovered after seven days of re‑oxygenation, reaching a level that was significantly up-regulated (p < 0.05) compared with the 14th day and non-significantly different from the 0th day exposure (p ˃ 0.05). In conclusion, hypoxic stress has adverse effects on the energy balance of juvenile T. tridentatus, but these adverse effects can be alleviated in a short recovery period. As a result, our findings provide novel perspectives on the physiology of T. tridentatus under hypoxia acclimation, which is essential information for establishing ideal conditions for the cultivation of this endangered species.

Results of Modified Stenströms Technique Otoplasty and Patients' Satisfaction at King Fahad Armed Forces Hospital (KFAFH).

Background Globally, the prevalence of protruding ears is relatively frequent. Ear deformities manifest due to underdevelopment of the antihelical fold, conchal hypertrophy, and/or an obtuse conchoscaphal angle. The availability of multiple approaches proves that there isn't a single optimal accepted procedure. The Modified Stenström otoplasty technique supports the surgeon in the management of underdeveloped antihelix fold, conchal hypertrophy, and obtuse conchoscaphal angle among other deformities. We are the first to evaluate the clinical effects and measure the satisfaction rate post-otoplasty using the modified Stenström technique with a case series study. Methods Six patients were included in the study with a total of 12 ears operated on between February 2021 and July 2022. Utilizing the modified Stenström technique for bilateral protruding ears. All patients had six postoperative follow-up visits with fixed intervals; one week, three weeks, six weeks, three months, six months, and one year. During their one-year postoperative follow-up appointment, all patients completed thesatisfaction survey questions. Results Six individuals were studied, three males and three females with a mean age of 23.1 (range, 7-53 years old). There were no complications or recurrences observed. Based on the responses we collected, all patients reported a high satisfaction rate at one-year postoperative follow-up. Conclusion The modified Stenström technique yields good naturally appearing ears. It is an easy and safe technique to apply. It has a short recovery period, and no hospital stay is required. All contribute to a high satisfaction rate among studied patients.

Effectiveness of erector spinae plane block in children with pectus excavatum deformity during minimally invasive thoracoplasty with osteosynthesis of the sternocostal complex: a prospective randomized comparative study

BACKGROUND: Despite the widespread use of regional blocks in children, ensuring adequate perioperative pain control during minimally invasive thoracoplasty with osteosynthesis of the sternocostal complex remains a problem. The introduction of ultrasound navigation has allowed specialists to increasingly give preference to peripheral blockades; paravertebral anesthesia has proven to be effective in thoracic surgery. However, safer interfascial blocks, including erector spinae plane block, are rarely used in pediatrics, and there is no evidence base for the effectiveness of the method. OBJECTIVE: Our aim was to compare the effectiveness of erector spinae plane block with paravertebral blockade during minimally invasive thoracoplasty with osteosynthesis of the sternocostal complex in children. MATERIALS AND METHODS: A prospective randomized comparative study of children who underwent minimally invasive thoracoplasty with osteosynthesis of the sternocostal complex was conducted from September 2022 to April 2023. According to the inclusion criteria, the selected 39 children were divided into groups: I — paravertebral blockade, and II — erector spinae plane block. The mean arterial pressure, heart rate during the perioperative period stages, postanesthesia recovery by Aldrete scale and pain intensity by the Wong–Baker scale, and stress response markers (cortisol and lactate) were assessed. RESULTS: No significant differences were observed in the study groups when comparing mean arterial pressure and heart rate at any of the measurement points of the perioperative period (p 0.05). Further, no significant differences were noted between the groups when comparing cortisol and lactate levels (p 0.05). The awakening level was characterized by a short recovery period and did not differ between the groups (p 0.05). The intensity of pain during the observation period did not exceed 5 points on the verbal rating scale in both groups, and the severity of pain was significantly higher in the group with blockade of the erector spinae plane block only 2 hours after surgery (p 0.05).Postoperative nausea and vomiting were more common in children with erector spinae plane block (p 0.05). No other adverse events were recorded. CONCLUSION: Erector spinae plane block is an effective and simple method of regional anesthesia for minimally invasive thoracoplasty with osteosynthesis of the sternocostal complex and can be used as an alternative to paravertebral blockade in children.

Cutting-Edge Innovations in Minimally Invasive Techniques for Skin Cancer Treatment

Skin cancer is a common and possibly deadly disease that requires immediate and efficient treatment. Conventional surgical methods, although successful, frequently lead to the formation of scars and extended periods of recuperation. In recent years, there have been significant developments in minimally invasive treatments for treating skin cancer. These techniques provide patients with alternative options that result in better cosmetic outcomes and shorter recovery periods. This article is a comprehensive summary of state-of-the-art advancements in minimally invasive procedures, including as laser therapy, cryotherapy, electrochemotherapy, and radiofrequency ablation. We analyze the benefits of these procedures, including minimized scarring, improved cosmetic outcomes, and faster healing periods, while also examining the difficulties and factors involved in their application. We showcase the concrete advantages that patients receive when they undergo minimally invasive therapy for skin cancer, using case studies and success stories as evidence. In addition, we examine potential future paths in research and development, anticipating a favorable outlook for the ongoing use of minimally invasive methods in the treatment of skin cancer. The global prevalence of skin cancer is a substantial health issue, leading to continuous progress in treatment strategies aimed at enhancing patient results. Conventional surgical techniques, however efficient, can lead to conspicuous scarring and extended recuperation periods. Recent advancements in minimally invasive procedures have significantly transformed the treatment of skin cancer, providing patients with alternative options that yield better esthetic results and shorter recovery periods. This article offers a comprehensive analysis of state-of-the-art advancements in minimally invasive procedures, encompassing laser therapy, cryotherapy, electrochemotherapy, and radiofrequency ablation. We use case studies and success stories to demonstrate the concrete advantages that patients gain from these operations, such as minimized scarring and improved cosmetic outcomes. In addition, we explore the difficulties and factors to take into account when putting these methods into practice, along with potential areas for further investigation and advancement. Our goal is to emphasize the hopeful future of minimally invasive treatments in skin cancer care, which will ultimately enhance patient experiences and outcomes.

The temporal expression pattern of classical MHC class I in sleep-restricted mice: Generalizations and broader implications

The intricate relationship between sleep and leukocyte trafficking has garnered intense attention, particularly their homing dynamics to secondary lymphoid organs under normal and restricted sleep (SR). Considering the scarcity of information regarding circadian rhythms in major histocompatibility class I (MHC-I) expression in SR, we designed a study that assessed the temporal expression of MHC-I in murine lymph nodes and spleen and the subsequent effects of sleep recovery. Male C57BL/6, housed in 12:12 light/dark cycle, were grouped into control (C) and SR. SR was carried for one week before lymphoid tissues were sampled at selected time points and assessed for leukocyte number and MHC-I expression.SR resulted in 21% decrease in granulocyte and 24% increase in agranulocyte numbers.In C, MHC-I expression pattern in lymph nodes was bimodal and relatively higher than splenocytes during the animal’s active phase (110.2 ± 1.8 vs 81.9 ± 3.8, respectively; p = 0.002). Splenocytes; however, showed a bimodal pattern upon SR, with higher protein levels during the rest than the activity period (154.6 + 36.2 vs 99.5 + 15.9, respectively; p = 0.002), suggesting preparedness for a potential infection. Furthermore, SR caused a significant drop in MHC-I expression at the onset of rest with 57% and 30% reduction in lymph nodes and splenocytes, respectively. However, the overall protein expression collectively taken from both lymphoid tissues remained stable, emphasizing its indispensable role in immunological homeostasis. This stability coincided with the restoration of protein levels to baseline after a short sleep recovery period, resembling a reset for MHC-I antigen presentation following a week of SR.Understanding the interplay between MHC-I expression and contextual factors could enhance treatment protocols, refining the efficacy and time precision of glucocorticoid-based therapies in immune modulation.

Retroceso del glaciar del Carihuairazo y sus implicaciones en la comunidad de Cunucyacu

The retreat of glaciers is a reality throughout the Andes Mountain range, especially in low-altitude mountains. One of these cases is the loss of the remaining ice mass in Carihuairazo (Tungurahua, Ecuador), which in recent years has experienced a considerable retreat. This research aims to characterize the retreat of this glacier and its implications for the nearby community (Cunucyacu) through the application of a multi-source methodology, which includes the collection of glacier aerial photographs, data from nearby meteorological stations, the use of global climate reanalysis data, interviews with community members, and mountaineers who work and frequent the area. To characterize the glacier’s mass evolution, a hydroglaciological model was applied, using input data from meteorological series, and its parameters were calibrated with the photographic record of the glacier’s outline. The results show a glacier loss of 99% of its surface in 1956 (0.34 ) by 2021. The model successfully simulates the glacier area variation over 67 years, revealing a continuous decrease since 1978, with short periods of recovery and equilibrium, where temperature is the variable that best explains the glacier’s retreat. However, the model fails to consider the effect of external factors, such as the eruption of the Tungurahua volcano that could enhance the glacier retreat. The Carihuairazo glacier is in a situation of inevitable disappearance, highlighting the vulnerabilities of communities facing this phenomenon as a consequence of climate change.

Unveiling the unique properties of carbon nitride (C6N8) monolayer as a novel flexible sensor for hydrogen cyanide and hydrogen fluoride: A DFT study

Surge for the advancement of sensor that accurately and selectively detect toxic materials particularly cyanides and fluorides, is expanding every day. Herein, we analyze the sensing ability of carbon nitride (C6N8) monolayer for precise detection of hydrogen cyanide (HCN) and hydrogen fluoride (HF) using DFT approach. Interaction energy analysis reveals that HF binds strongly to C6N8 monolayer which is probably due to chemical bond formation whereas, HCN adsorbed to the surface by weak van der Waals forces. The atom in molecules (AIM), the density of states (DOS), non-covalent interaction (NCI), molecular electrostatic potential (MEP), electron localization function (ELF), frontier molecular orbitals (FMO), and QNBO were used to gain a thorough understanding of the complexation of HCN and HF with monolayer. HCN and HF analytes with C6N8 monolayer exhibit slight variations in band gap energy in FMO analysis (4.206 to 4.267 eV) indicating weak NCIs. Furthermore, MEP map demonstrate that more charge transfer is occurred from the C6N8 monolayer towards HF@C6N8 resulting in a strong ionic bonding. In addition, the existence of non-covalent interactions among complexes confirmed by NCI-RDG and QTAIM analysis. A short recovery period for HCN@C6N8 (1.677 × 10−7 s) makes desorption process simpler. Appreciable selectivity of monolayer towards analytes and prospects of all findings will provide an experimentalist with practical suggestions to build highly sensitive sensors for HCN and HF using C6N8 monolayer.

Early Return to Work after Carpal Tunnel Release with Ultrasound Guidance.

The duration of postoperative leave varies by the carpal tunnel release (CTR) technique. This study aimed to determine the time to return to work (RTW) after CTR with ultrasound (CTR-US) guidance and identify factors contributing to this duration. This was a multicenter postmarket registry of patients treated with CTR-US. Time to RTW was analyzed with Kaplan-Meier methods. Logistic regression identified the association of patient, work, and procedural factors with the probability of RTW within 5 days (a standard work week) after CTR-US. A total of 544 employed patients (655 hands) from 24 centers were treated with CTR-US between November 2019 and August 2022. The mean patient age was 50 years, 62% were women, and most (76%) were full-time employees, where work activities were desk-based (49%), light manual (28%), or heavy manual (23%). The complication rate was 0.8%. After CTR-US, the median RTW was 3 days (interquartile range: 1-6 days), with 74.6% returning by 5 days, 87.8% by 10 days, and 97.1% by 30 days. Work activity (desk-based versus heavy manual: odds ratio = 2.93, 95% confidence interval: 1.70-5.04, P < 0.001) and sex (man versus woman: odds ratio = 1.85, 95% confidence interval: 1.15-2.98, P = 0.01) were associated with higher probability of RTW within 5 days. The median RTW ranged from 2 to 4 days in all patient subgroups, including heavy manual laborers (median 4 days) and women (median 3 days). CTR-US offers an efficient approach to treating CTS, enabling most patients to RTW with minimal delay. The short recovery periods observed across diverse patient and work characteristic subgroups compare favorably to other CTR techniques.

Micro-face-lift: A novel biplanar, composite, less-invasive procedure.

Facial rejuvenation procedures have been in existence for over a century. Since its first introduction, it improved anatomical understanding and clinical implications and gave rise to numerous techniques and re-ideations of the original face-lift. The increase in popularity of face-lift procedures attracts patients of various ages and with different medical comorbidities. In this paper, we describe the less-invasive facelift procedure, termed the "Micro-Face-lift," with minimal complications, a short recovery period, and few contraindications. The authors retrospectively analyzed the medical files of 51 patients who underwent the "Micro-Face-lift" procedure between 2014 and 2019 by three independent surgeons. Fifty-one patients met the inclusion criteria for the procedure. Forty-nine patients were women (96.1%) and the remainder were men (3.9%). The mean age at the time of the procedure was 60.8 years (range 45-87). Complications were encountered in five patients (9.8%): two hypertrophic scars (3.8%), one hematoma (2%), one surgical wound infection (2%), and one edema (2%), persistent for more than 2 weeks postoperatively. All complications resolved within 6 weeks of postoperatively. Thirty-five patients (68.6%) underwent additional procedures to maximize the aesthetic outcome. Thirty patients (58.8%) underwent submental liposuction and five patients (9.8%) underwent mid-face lipo-filling. The average satisfaction score on the self-reported "Likert" scale was 4.27 (range 1-5). All patients were followed for a minimum period of 18 months. The "Micro-Face-lift" is a less-invasive procedure that can be performed under local anesthesia and sedation in the outpatient setting. Complication rates and mortality are low, contraindications are rare, and the recovery period is short. In our experience, patient satisfaction is high with the Micro-Face-lift procedure, and the learning curve for the experienced practitioner is short.

A Randomized Trial Investigating the Laparoscopic Transabdominal Preperitoneal Approach for Recurrent Inguinal Hernia Repair

Background: Repairing a recurrent hernia is a challenging endeavor due to the pre-existing weakened tissues and altered anatomy. Among the available approaches, the open posterior preperitoneal approach has demonstrated significantly better outcomes compared to the anterior approach. Additionally, the laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair represents an evolving technique with the advantages of minimally invasive surgery. The objective of our study is to perform a comparative analysis of these three approaches for the repair of recurrent inguinal hernias, focusing on complications and the occurrence of early recurrences. This research aims to provide valuable insights into the most effective and safe approach for managing this challenging surgical condition. Methods: In our study, we conducted a randomized allocation of 200 patients into three equal groups: Group A, Group B, and Group C. Patients in Group A underwent the open posterior preperitoneal approach, while those in Group B received transinguinal anterior tension-free repair. Group C patients underwent the laparoscopic transabdominal preperitoneal (TAPP) procedure. The primary endpoint of our study was to assess the recurrence of inguinal hernias following the respective surgical approaches. Results: Our study yielded several noteworthy findings. The mean hospital stay, time to return to work, and time off from work were all shorter in Group C when compared to Groups A and B. Chronic postoperative pain was observed in 13.33% of patients in Group A, 30% of patients in Group B, and 10% of patients in Group C. Notably, the overall complication rate was lower in both Groups A and C at 19.7%, while Group B had a higher complication rate of 34.36%. Conclusion: In the context of recurrent inguinal hernia repair, our study findings suggest that the laparoscopic and open posterior approaches are equally effective in terms of operative outcomes. The open preperitoneal hernia repair stands out as a cost-effective option with a low recurrence rate. Patients undergoing this procedure experience a relatively short postoperative recovery period and report minimal postoperative pain. This approach has demonstrated significantly better outcomes compared to the commonly used anterior approach.

Soil depth and recovery interval mediate soil water repellency under different forest types and fire intensity levels in China: Evidence for ecosystem resiliency

Soil water repellency (SWR) is a physical phenomenon whereby the surface of soil particles cannot be, or resists being, moistened by water. The recovery process of fire-induced SWR can provide important evidence for ecosystem resilience, but most existing studies ignored this process. Prescribed burning is a widely used method to reduce the risk of fire and fuel. However, prescribed fires can increase SWR, reducing infiltration and increasing overland flow and subsequent soil erosion. In order to understand the ecosystem resilience process from fire-induced SWR, soil samples were collected before and after prescribed burning. Four different forest types in the Hunan province of China were studied. Soil samples at four different soil depths (0–5, 6–10, 11–15, and >15 cm) and four time intervals (3, 30, 180, and 360 d) after burning at different intensities were collected. No significant difference in SWR was found among the four forest types, but the SWR of soil in plantations was stronger than that in secondary forests before fire. Most soil samples showed slightly increased SWR after burning, SWR increasing with fire intensity. Surface soil (0–5 cm) SWR showed greater sensitivity to fire disturbance than subsurface soil (>5 cm). SWR had a smaller scope of influence and shorter recovery period in burned secondary forests. Although SWR recovered over time, recovery was slower with increasing fire intensity. SWR always recovered to pre-fire levels given sufficient time. Our study revealed the recovery process of SWR, and explored the temporal and spatial mechanisms of forest ecosystem recovery after prescribed burning.

The effect of T-lysine cream on the wound healing process

Background and objective: Wound healing is a dynamic process that can be compromised in patients with chronic and metabolic conditions or unhealthy lifestyles. Objectives of study is to demonstrate a hyaluronate-containing supramolecular structure which enhances repalysYAL®cream effectiveness, sodium chloride with thymine (T-LysYal®); 1) notable progress in the healing of wounds. 2) the production of minuscule collagen strands 3) a shorter recovery period. Methods: Case study, the test group received standard treatment followed by lysine cream to indicate the size and depth ulcer from the 1st week to the 3rd week. Our patients were a 1-year child and 29 years old male who presented with a second degree of total body surface area (TBSA) burn and skin grafts at the burn center of Rozhawa Hospital/ Hawler/Iraq. The observations were approved by the Ethics committee college of pharmacy in compliance with the ethical standard. Initially assessed as superficial partial-thickness in-depth, the wounds were treated conservatively with dressings and repalysYAL® cream 2-3 times per day; however, represents the healing process in short-term individual therapy. Results: In case 1; The patient had been exposed to flash deep burn to the right palm (thermal injury) mainly of superficial partial thickness; any necrotic tissue present needs to be removed to take full advantage of the product’s potential. When (repalysYAL®) cream is used, there will be a physiological increase in the exudate, which will have to be managed to avoid maceration. While in case 2;The patient presented surgical wound dehiscence in the inner compartment of the left foot with leakage of purulent material and signs of necrotizing fasciitis. with using (repalysYAL®) cream, the wound reduces scar formation due to 90% and increase fibroblast by 30% when a blood vessel is formed to which blood is supplied, the cells are cultivated and divided to form new tissue and an organ. Conclusion: Signaling pathways that induce cellular and tissue responses after injury, which may be impeded during chronic wound healing, were greatly improved using lysine cream as a therapy.