Combined single-stage approach for repair of extensive aortic pathologies - our initial experience.

Management of aortic pathologies affecting the arch and proximal descending thoracic aorta, with complex anatomical features, remains a formidable clinical challenge. We report our surgical experience using a single-stage combined approach for such repairs using a simultaneous anterolateral thoracotomy and midline sternotomy and its benefits. This is a retrospective, single-centre experience of 17 patients from January 2021 to September 2023.

Gender Affirming Revision Vaginoplasty Utilizing Decellularized Fish Skin Xenograft: Surgical Technique and Outcomes.

Purpose: Tissue availability for revision vaginoplasty in trans feminine individuals is often limited, creating challenges in cases with prior surgery or inadequate local tissue. While not yet extensively studied in genital reconstruction, Kerecis SurgiClose®, a decellularized fish skin xenograft, has shown promise as a skin substitute in other surgical contexts, including burn care and chronic wound management. This study aims to describe the surgical technique and evaluate the short-term clinical outcomes of revision vaginoplasty using decellularized fish skin xenograft (FSXRV) in trans feminine individuals.

Diagnostic Accuracy of Spleen-dedicated 100 Hz Transient Elastography to Predict High-risk Esophageal Varices.

Introduction: The Baveno VII consensus suggested different SSM cut-offs to predict High-Risk Esophageal Varices (HREV) and Clinically Significant Portal Hypertension (CSPH) in patients with cirrhosis. Few studies have validated these cut-offs using spleen-dedicated 100 Hz TE. We have assessed the diagnostic performance of SSM in predicting HREV and CSPH using a spleen-dedicated 100 Hz TE and compared it with other noninvasive algorithms.

Biomechanical characterization of cadaveric thigh skin for development of biofidelic simulants.

Background: Simulants that accurately replicate the mechanical properties of human skin are essential for biomechanical testing, especially for skin prosthetics and grafting. Although there has been a plethora of research related to the testing of skin samples of several locations, particularly the thigh region remains yet to be extensively explored. Previous studies involving thigh skin lack the testing at varying strain rates which could be helpful to develop simulants and improve high-expansion skin grafts.

Role of prehabilitative gastrostomy tube feeding to bridge severely malnourished surgically unfit achalasia patients to per-oral endoscopic myotomy.

Background And Aim: Achalasia cardia may be associated with a risk of severe malnutrition, causing unique challenges in nutritional and definitive management. This study aims to evaluate a novel nutrition strategy in severely malnourished, surgically unfit patients, using percutaneous endoscopic gastrostomy (PEG) tube feeding to improve nutrition followed by per-oral endoscopic myotomy (POEM).

Methods: We conducted a prospective study of achalasia cardia patients from September 2023 to September 2024 at a tertiary care centre.

Three-Dimensional Assessment of Mandibular Morphology Across Vertical Facial Growth Patterns Using Cone-Beam Computed Tomography: A Cross-Sectional Study.

Introduction: Mandibular morphology exhibits significant variation across vertical facial growth patterns. A clear understanding of these variations is essential for precise orthodontic diagnosis, treatment planning, and the prediction of growth trends. This study aimed to compare the mandibular morphological characteristics among individuals with normodivergent, hypodivergent, and hyperdivergent growth patterns using cone-beam computed tomography (CBCT), focusing on parameters such as condylar dimensions, ramus morphology, symphysis measurements, and mandibular notch features.

Ensemble mutation and multi-population-driven differential evolution for numerical optimization and feature selection of breast cancer.

Breast cancer stands as a critical health challenge for women worldwide, whose numbers continue to increase because of multiple complicating elements. The distribution of high-dimensional medical datasets creates an essential challenge for breast cancer diagnosis because it leads to reduced predictive model efficiency. This research develops an advanced version of the differential evolution (DE), named ensemble mutation and multi-population-driven differential evolution (EMMDE), for optimal feature selection.

Real-world evidence on effectiveness and safety of granulocyte transfusion (GT) during pre-engraftment phase in hematopoietic stem cell transplant patients: A single-centre study from north India, with mini-review of Indian studies on GT.

Introduction: Pre-engraftment phase of hematopoietic stem cell transplant (HSCT) (<3 weeks after transplant) is a crucial period with chances of early complications like febrile neutropenia. Granulocyte transfusion (GT) is a temporary bridge therapy to recover such patients till engraftment.

Methods: This was a retrospective observational study conducted by the department of Transfusion Medicine at a large tertiary care hospital in North India from January 2020 to June 2023.

Vasopressin as a postoperative management strategy in Fontan procedure: a comparative study.

Purpose: The Fontan procedure is crucial for managing univentricular heart conditions but can lead to prolonged pleural effusions, affecting recovery and hospital stays. This study evaluated the effectiveness of vasopressin in reducing pleural effusion and improving recovery outcomes following Fontan procedure.

Methods: This comparative observational study reviewed patient records from October 2021 to September 2023.

Internal Hernia: A Rare Cause of Bowel Ischemia and Infarction.

Internal abdominal hernias are uncommon causes of intestinal obstruction and are difficult to detect preoperatively due to their imprecise clinical manifestations and complicated anatomic appearance. Paraduodenal hernias represent the most common subset of all internal hernias (IHs). The symptoms are nonspecific and range from persistent abdominal discomfort to acute abdomen.

Sexual satisfaction and function (SatisFunction) survey post-vaginoplasty for transgender and gender diverse individuals: preliminary development and content validity for future clinical use.

Background: Transgender and gender diverse individuals (TGDIs) are people whose gender identity is not in line with their sex assigned at birth, but current surveys used for cisgender patients addressing sexual satisfaction and function (SFS) do not fit the needs of this unique population.

Aim: The authors of this project sought to create and validate a new comprehensive survey in North American English that differs from the current options for TGDI post-vaginoplasty.

Materials And Methods: Using the current literature on SFS as a foundation, a 26-item survey was created and distributed to 16 TGDI at least 3 months post-vaginoplasty.

AutoSAFT: Autofocusing for extended depth of imaging in scanning acoustic microscopy.

In the scanning acoustic microscopy (SAM) imaging, it is essential to address the diminished lateral resolution in the out-of-focus region, as image quality correlates with the ultrasound propagation distance either above or below the focal plane. To focus the scanned image, a refocusing technique called synthetic aperture focusing technique (SAFT) is widely used, which improves the resolution by extending the depth of focus manually. In SAM, refocusing the image accurately is challenging without prior defocusing information.

Influence of internal electrostatics on reduction potentials in amine-ligated bimetallic copper complexes.

The electrostatic modulation of redox potentials of molecular electrocatalysts is a promising strategy to minimize overpotentials without compromising their catalytic activity given their intrinsic correlation. While the introduction of s-block cations to modulate the redox potential of single-site transition metal catalysts is known, the prevalence and nature of such electrostatic interactions in bimetallic complexes deserves further attention. In this work, using density functional theory and electrostatic charged sphere models, we quantify the influence of distance-dependent electrostatic effects on the reduction potentials of a bimetallic Cu(II) model system with a dipicolylamine (DPA) ligand, wherein the Cu(II) centers are bridged by an aliphatic diamine (NH-(CH)-NH) linker of varying chain lengths ( = 0 to 10).

Future directions in transfeminine genital gender-affirming surgery: tissue substitutes and transplant.

Purpose Of Review: The present study reviews contemporary literature focused on uterine transplantation and tissue substitutes for the purposes of transfeminine genital gender affirming surgery (GAS). Additional background is provided for both topics to provide a more comprehensive understanding of the modern applications.

Recent Findings: Uterine transplant remains an experimental procedure in cisgender patients who wish to avoid surrogacy.

Congestive myelopathy secondary to epidural venous engorgement and venous congestion in a patient with Budd-Chiari syndrome and its management through inferior vena cava stenting.

Budd-Chiari syndrome with obstruction in the inferior vena cava causes increased venous pressure in the azygous-hemiazygous system and paravertebral venous plexus, which is transmitted to the epidural venous plexus, devoid of the valves. It causes epidural venous plexus engorgement and venous congestion and may present rarely with low back pain or radiating pain. However, patients developing lower limb weakness as a complication of Budd-Chiari syndrome is an infrequent and severe presentation.

The impact of gender-affirming interventions on eating disorder diagnosis risk among transgender and gender-diverse individuals.

Background: The objective of this study is to evaluate the risk of being diagnosed with an eating disorder among transgender and gender-diverse (TGD) individuals, specifically examining how this risk differs following gender-affirming medical therapy (GAMT).

Methods: The study utilizes electronic medical record (EMR) data from the TriNetX database. A total of 90,955 TGD individuals were identified in the TriNetX database.

Exciton-Polaron in a Quasi-One-Dimensional Chain of Hexyl-Diammonium-BiI Octahedra.

Lower-dimensional organic-inorganic hybrid perovskite materials promise to revolutionize the optoelectronics industry due to the tremendous possibilities of exotic control on excitonic properties driven via quantum confinement. Flexible organic cations acting as spacers and stabilizers enhance electron-phonon couplings, further amplifying the potential for modular light-matter interactions in these materials. Herein we unravel the nature of excitons in a quasi-1D chain of corner-sharing bismuth iodide octahedra with an intrinsic quantum well structure stabilized by a hexyl-diammonium cation.

Investigating the psychometric properties of pathological concern questionnaire in Indian emerging adults.

Background: The Pathological Concern Questionnaire (PCQ) measures thoughts, emotions, and actions based on attitudes, including repression of personal needs and overinvestment in satisfaction of others' needs. The PCQ is widely used in the literature, but its psychometric properties are not well-established in the Indian population.

Aim: The current study aimed to examine the reliability and validity of PCQ among emerging adults in India.