Mutational analysis of cytoplasmic domain of integrin subunit alpha-1 and its association with periapical wound healing after surgical endodontic treatment.

BACKGROUND: Numerous studies reported that the healing after surgical endodontic retreatment is influenced by multiple factors which include the genetic profile of the patient, epigenetics, and immune responses. The genes which are primarily responsible for the healing potential in different individuals are those which are involved in the regulation of the cytoskeleton and cellular adhesion which subsequently affects bone deposition and healing. Integrins are cell-surface molecules, possess a key role in the cytoskeleton and cellular adhesion. Integrin Subunit Alpha 1 (ITGA1) is one among the integrin family and helps in regulating the Epidermal Growth Factor receptor (EGFR) pathway, consequently affects proliferation and healing. The objectives of the study were to identify mutations in the cytoplasmic domain of Integrin Subunit Alpha 1 (ITGA1), to assess the expression of activated EGFR, EGFRPhospho and TC-PTP in the periapical wound and to correlate these mutations and expression patterns with periapical wound healing. METHODS AND FINDINGS: Thirty-seven patients between ages 18-60 years reported chronic apical periodontitis of single-rooted anterior teeth with periapical radiolucency, equal or greater than 4 mm or periapical lesion in an open apex of single-rooted teeth due to trauma were included in the study from 01st June 2018 till 31st October 2019. Patients with persistent radiolucency after primary root canal treatment and endodontic retreatment were kept on follow-up for 3-4 months surgical endodontic treatment was performed in cases with persistent periapical lesions of 4mm or more in diameter. Periapical lesion sample was collected and used for (1) histo-pathological analysis after Hematoxylin & Eosin staining, (2) total DNA extraction for ITGA1 cytoplasmic domain mutational analysis and immunohistochemistry for EGFR and TCPTP. A positive correlation was observed between the expression levels of EGFRPhospho and the healing of periapical lesions. Moreover, a negative weak correlation was observed between the expression levels of EGFR and TCPTP and the healing of periapical lesions. Out of nine sequences of cytoplasmic domain of ITGA1 which were analyzed, none of them was detected with SNP. CONCLUSION: Higher expression levels of EGFRPhospho and lower expression levels of EGFR and TCPTP were associated with patients with good healing potential in periapical area. However, immunohistochemistry scores were statistically insignificant to draw any conclusion.

Assessment of imposter syndrome among postgraduate residents using Clance imposter phenomenon scale: a multicentric, cross-sectional study.

BACKGROUND: Imposter syndrome develops when high-achieving individuals, despite external measurements of achievement, have a chronic sense of self-doubt paired with a fear of being exposed as a hoax. This endangers one's mental health and well-being. The objective of the study was to determine the prevalence and severity of imposter syndrome among postgraduate residents and to identify the risk factors associated with imposter syndrome. METHODS: This is a cross-sectional study conducted among the postgraduate trainees working in four different training hospitals in Pakistan. Imposter syndrome was assessed using the Clance Imposter Phenomenon Scale. RESULTS: A total of 146 postgraduate residents participated in this study. The majority had significant imposter syndrome, with females more suffered than males. Trainees of the pediatrics department were affected the most while of the dentistry were least to be affected. Multiple factors including marital status, number of children, working hours, extracurricular activities, and private practice have been shown to affect the prevalence of imposter syndrome. CONCLUSION: Imposter syndrome is a prevalent phenomenon among the residents of Pakistan. Efforts to identify and establish a proper relationship between general demographics and imposter syndrome are required for the healthy work experience of the trainees.

Evaluating the Necessity of Routine Histopathology in Sleeve Gastrectomy Specimens: A Five-Year Analysis.

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is a widely performed bariatric surgery that involves the removal of a portion of the stomach. Routinely, the resected gastric tissue is sent for histopathological examination to screen for malignancies or other significant pathological findings. However, the necessity of this routine practice remains uncertain. This study aims to evaluate the histopathological outcomes of LSG specimens over a five-year period at our institution. METHODS: We conducted a retrospective analysis of 203 patients who underwent LSG between January 2017 and December 2022 at Heartlands Hospital, University Hospitals Birmingham. Data collected included patient demographics, body mass index (BMI), use of preoperative oesophagogastroduodenoscopy (OGD), and histopathological findings. Patients with incomplete records or those who underwent Roux-en-Y gastric bypass were excluded from the study. RESULTS: Data were extracted for 310 patients, of whom 107 were excluded. The majority of the 203 patients analyzed were female (83%), with a mean age of 45.7 years and a mean BMI of 45.4 ± 7.3. Preoperative OGD was performed in only 0.5% of cases. Histopathological examination revealed that 81.3% (n=165) of patients had normal gastric mucosa, while 14.3% (n=29) had chronic gastritis. Clinically significant findings were rare, with only 1% (n=2) of patients showing gastrointestinal stromal tumors (GISTs) or focal intestinal metaplasia. None of the patients required additional treatment or follow-up based on these histopathological findings. CONCLUSION: Most LSG specimens in our study showed normal or non-significant histopathological findings, raising questions about the routine use of histopathological examination in LSG procedures. It remains unclear whether histopathology is necessary following sleeve gastrectomy. While no patients in our cohort required further treatment or surveillance, there are reports in the literature where surveillance or further treatment was necessary, though the incidence remains low. Given the low incidence of clinically significant pathology, further studies with larger sample sizes and multi-center data are needed to establish clear guidelines on this issue.

Comprehensive identification of GASA genes in sunflower and expression profiling in response to drought.

Drought stress poses a critical threat to global crop yields and sustainable agriculture. The GASA genes are recognized for their pivotal role in stress tolerance and plant growth, but little is known about how they function in sunflowers. The investigation aimed to identify and elucidate the role of HaGASA genes in conferring sunflowers with drought tolerance. Twenty-seven different HaGASA gene family members were found in this study that were inconsistently located across eleven sunflower chromosomes. Phylogeny analysis revealed that the sunflower HaGASA genes were divided into five subgroups by comparing GASA genes with those from Arabidopsis, peanut, and soybean, with members within each subgroup displaying similar conserved motifs and gene structures. In-silico evaluation of cis-regulatory elements indicated the existence of specific elements associated with stress-responsiveness being the most abundant, followed by hormone, light, and growth-responsive elements. Transcriptomic data from the NCBI database was utilized to assess the HaGASA genes expression profile in different sunflower varieties under drought conditions. The HaGASA genes expression across ten sunflower genotypes under drought stress, revealed 14 differentially expressed HaGASA genes, implying their active role in the plant's stress response. The expression in different organs revealed that HaGASA2, HaGASA11, HaGASA17, HaGASA19, HaGASA21 and HaGASA26 displayed maximum expression in the stem. Our findings implicate HaGASA genes in mediating sunflower growth maintenance and adaptation to abiotic stress, particularly drought. The findings, taken together, provided a basic understanding of the structure and potential functions of HaGASA genes, setting the framework for further functional investigations into their roles in drought stress mitigation and crop improvement strategies.

Piloting a Novel Computational Framework for Identifying Prosthesis-Specific Contributions to Gait Deviations.

This paper introduces a novel computational framework for evaluating above-knee prostheses, addressing a major challenge in gait deviation studies: distinguishing between prosthesis-specific and patient-specific contributions to gait deviations. This innovative approach utilizes three separate computational models to quantify the changes in gait dynamics necessary to achieve a set of ideal gait kinematics across different prosthesis designs. The pilot study presented here employs a simple two-dimensional swing-phase model to conceptually demonstrate how the outcomes of this three-model framework can assess the extent to which prosthesis design impacts a user's ability to replicate the dynamics of able-bodied gait. Furthermore, this framework offers potential for optimizing passive prosthetic devices for individual patients, thereby reducing the need for real-life experiments, clinic visits, and overcoming rehabilitation challenges.

Atogepant for migraine prevention: a meta-analysis of safety and efficacy in adults.

Background: Migraine is a neurological condition marked by frequent headaches, which tends to be accompanied by nausea and vomiting in severe instances. Injectable therapies for migraine, such as monoclonal antibodies that target calcitonin gene-related peptide (CGRP), have proven to be effective and safe. While various oral drugs are available, none have been developed for migraines. Patients prefer oral therapies because they are easier to use, making atogepant, an orally accessible small-molecule CGRP receptor antagonist, a possible alternative. Objectives: This systematic review and meta-analysis compared the safety and effectiveness of atogepant with placebo in treating migraine. Methods: Adhering to the PRISMA guidelines, we meticulously gathered randomized controlled trials (RCTs) from databases including the Cochrane Library, PubMed, Science Direct, and ClinicalTrials.gov. Studies comparing atogepant with placebo and reporting monthly migraine days (MMDs) as the primary outcome along with secondary outcomes such as monthly headache days and acute medication use days were included. Two independent reviewers conducted the data extraction and quality assessment. Statistical analyses were carried out using RevMan, utilizing risk ratios for dichotomous outcomes and mean differences for continuous outcomes, and a random-effects model. Results: Our primary outcome was the change in MMDs over 12 weeks, which showed a significant reduction with atogepant at dosages of 10, 30, and 60 mg. Secondary outcomes, such as monthly headache days, proportion of patients achieving a ≥ 50% reduction in MMDs, acute medication use days, and patient-reported outcomes, consistently showed that atogepant outperformed placebo, highlighting its effectiveness in reducing the migraine burden. Conclusion: Higher doses of atogepant are more effective in lowering migraine and headache-related days and increasing quality of life metrics. However, this is accompanied by an increased incidence of adverse events, suggesting the need for careful dose optimization to balance the benefits and risks. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=563395. Unique Identifier: CRD42024563395.

Protective effects of the exogenous application of salicylic acid and chitosan on chromium-induced photosynthetic capacity and osmotic adjustment in Aconitum napellus.

Chitosan (CTS) is recognized for enhancing a plant's resilience to various environmental stresses, such as salinity and drought. Moreover, salicylic acid (SA) is acknowledged as a growth regulator involved in addressing metal toxicity. However, the effectiveness of both compounds in mitigating Cr-induced stress has remained relatively unexplored, especially in the case of Aconitum napellus, a medicinally and floricultural important plant. Therefore, the primary objective of this study was to investigate the potential of CTS and SA in alleviating chromium (Cr)-induced stress in A. napellus. To address these research questions, we conducted a controlled experiment using potted plants to evaluate the individual and combined impacts of CTS and SA on plants exposed to Cr stress. Foliar application of CTS (0.4 g/L) or SA (0.25 mmol/L) led to significant improvements in the growth, chlorophyll content, fluorescence, and photosynthetic traits of A. napellus plants under Cr stress. The most notable effects were observed with the combined application of CTS and SA, resulting in increases in various morphological parameters, such as shoot length (2.89% and 7.02%) and root length (27.75% and 3.36%) under the Cr 1 and Cr 2 treatments, respectively. Additionally, several physiological parameters, such as chlorophyll a (762.5% and 145.56%), chlorophyll b (762.5% and 145.56%), carotenoid (17.03% and 28.57%), and anthocyanin (112.01% and 47.96%) contents, were notably improved under the Cr 1 and Cr 2 treatments, respectively. Moreover, the combined treatment of CTS and SA improved the fluorescence parameters while decreasing the levels of enzymatic antioxidants such as catalase (27.59% and 43.79%, respectively). The application also notably increased osmoprotectant parameters, such as the total protein content (54.11% and 20.07%) and the total soluble sugar content (78.17% and 49.82%) in the leaves of A. napellus in the Cr 1 and 2 treatments, respectively. In summary, these results strongly suggest that the simultaneous use of exogenous CTS and SA is an effective strategy for alleviating the detrimental effects of Cr stress on A. napellus. This integrated approach opens promising avenues for further exploration and potential implementation within agricultural production systems.

Green synthesized iron oxide nanoparticles as a potential regulator of callus growth, plant physiology, antioxidative and microbial contamination in Oryza sativa L.

In tissue culture, efficient nutrient availability and effective control of callus contamination are crucial for successful plantlet regeneration. This study was aimed to enhance callogenesis, callus regeneration, control callus contamination, and substitute iron (Fe) source with FeO-NPs in Murashige and Skoog (MS) media. Nanogreen iron oxide (FeO-NPs) were synthesized and well characterized with sizes ranging from 2 to 7.5 nm. FeO-NPs as a supplement in MS media at 15 ppm, significantly controlled callus contamination by (80%). Results indicated that FeCl3-based FeO-NPs induced fast callus induction (72%) and regeneration (43%), in contrast FeSO4-based FeO-NPs resulted in increased callus weight (516%), diameter (300%), number of shoots (200%), and roots (114%). Modified media with FeO-NPs as the Fe source induced fast callogenesis and regeneration compared to normal MS media. FeO-NPs, when applied foliar spray, increased Plant fresh biomass by 133% and spike weight by 350%. Plant height increased by 54% and 33%, the number of spikes by 50% and 265%, and Chlorophyll content by 51% and 34% in IRRI-6 and Kissan Basmati, respectively. Additionally, APX (Ascorbate peroxidase), SOD (Superoxide dismutase), POD (peroxidase), and CAT (catalase) increased in IRRI-6 by 27%, 29%, 283%, 62%, while in Kissan Basmati, APX increased by 70%, SOD decreased by 28%, and POD and CAT increased by 89% and 98%, respectively. Finally, FeO-NPs effectively substituted Fe source in MS media, shorten the plant life cycle, and increase chlorophyll content as well as APX, SOD, POD, and CAT activities. This protocol is applicable for tissue culture in other cereal crops as well.

Unconventional Radical and Radical-Hole Site-Based Interactions in Halogen-Bearing Dimers and Trimers: A Comparative Study.

Radical (R•) and R•-hole site-based interactions are comparatively studied, for the first time, using ab initio methods. In this regard, R•-bearing molecules •XO3 (where X = Cl, Br, and I) were subjected to direct interaction with NH3 within dimeric and trimeric forms in the form of NH3···â€¢XO3/•XO3···NH3 and NH3···â€¢XO3···NH3 complexes, respectively. As confirmed by electrostatic potential analysis, the studied R•-bearing molecules •XO3 had the outstanding potentiality to interact as Lewis acid centers via two positive sites dubbed as R• and R•-hole sites. Such an observation proposed the potentiality of the considered •XO3 molecules to engage in unconventional R• and well-established R•-hole site-based interactions with Lewis bases. This was confirmed by negative interaction (E int) energies, ranging from -4.93 to -19.89 kcal/mol, with higher favorability for R• site-based interactions over the R•-hole site-based ones. MP2 energetic features furnished higher preferability for the R• site-based interactions than the R•-hole site-based ones in the case of chlorine- and bromine-bearing complexes, and the reverse was true for the iodine-bearing complexes. Moreover, elevated E int values were recorded for the NH3···â€¢XO3···NH3 trimers over the NH3···â€¢XO3 and •XO3···NH3 dimers, outlining the higher preference of the •XO3 molecules to engage in R• and R•-hole site-based interactions in the trimeric form over the dimeric one. These results might be considered a requisite linchpin for numerous forthcoming supramolecular chemistry and crystal engineering studies.

Kawasaki disease with profound systemic vascular involvements: An insightful pediatric case.

Key Clinical Message: Kawasaki disease (KD), a self-limiting vasculitis, can present with a broader spectrum of vascular involvements, necessitating early recognition and prompt management. This case exemplifies the importance of involving multiple teams on board in managing complex presentations of KD. It also highlights the importance of close monitoring for the progression of the disease spectrum as well as family education to ensure favorable outcomes. The case also emphasizes the importance of long-term follow-up and further research to understand the prognosis, early screening tools, and possible complications due to multi-organ involvement in KD along with their management strategies. Abstract: Kawasaki disease (KD) is a multisystem vascular inflammatory syndrome, which predominantly affects the small and medium vessels in children within the age group of less than 5 years. The most threatened complication is the development of coronary artery aneurysms (CAAs). We present an extremely rare case of KD in a 2-month, 21-day-old male infant with extensive vascular involvement, expanding the disease spectrum beyond the involvement of coronary arteries. These included aneurysmal dilatations of both internal carotid arteries, the descending aorta, bilateral multilevel intercostal arteries, coeliac artery, superior mesenteric artery, and both renal arteries. Implementing a multidisciplinary approach with early treatment via intravenous immunoglobulin (IVIG) and dexamethasone proved to be most effective in the patient's management. Despite unique challenges such as severe coronary dilation and pseudomonas sepsis during the special care, the patient was stabilized and discharged after 11 days of hospital stay, highlighting the importance of early prompt management and a centered approach to evaluate in a broader spectrum. This case emphasizes the importance of long-term follow-up and further research to understand the prognosis, early screening tools, and possible complications due to multi-organ involvement in KD along with their management strategies.

Off-pump vs. on-pump coronary artery bypass grafting in patients with chronic kidney disease: an updated systematic review and meta-analysis.

BACKGROUND: In patients with chronic kidney disease (CKD), cardiovascular disease is found to be the primary cause of mortality, and after coronary artery bypass grafting (CABG), their prognosis deteriorates. METHODS: We conducted a meta-analysis comparing off-pump CABG versus on-pump CABG in CKD patients. We searched electronic databases, including PubMed, Cochrane, and Google Scholar, using relevant keywords. We included studies comparing off-pump CABG with on-pump CABG in patients with chronic kidney disease, which was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m2. Effect estimates were synthesized using a random-effects model and expressed as risk ratios (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, with corresponding 95% confidence intervals (CIs). Our primary outcome was short-term mortality. RESULTS: A total of 25 studies, of which 23 were observational and 2 were RCTs, were included in this meta-analysis, comprising 234,585 patients (66,591 in the off-pump group and 167,994 in the on-pump group). Our meta-analysis showed that there was a significantly higher mortality rate in the on-pump CABG group as compared to the off-pump CABG group (RR: 0.73, 95% CI [0.61, 0.88]; P = 0.0006, I2 = 60%). CONCLUSION: Compared with OPCAB, short-term mortality was significantly higher in ONCAB.

Optimization of the determination of volatile organic compounds in plant tissue and soil samples: Untargeted metabolomics of main active compounds.

This review critically assesses the determination of low molecular weight volatiles by different methods, providing context for the development of suitable techniques to determine volatile content in plant tissue and soil samples as well as the associated analytical challenges. Although sensitive analytical methods have been reported in recent decades, studies on their application in modern investigative techniques are lacking. Herein, the latest sampling methods in volatile biochemistry, current advancements in the understanding of these analytes, and the significance of these findings for other types of volatiles are summarized. Gas chromatography, high-performance liquid chromatography, ion chromatography, thin-film microextraction, and real-time monitoring techniques are discussed and critically determined. This review concerns the methods most suitable for future research in this area.

Acute type A aortic dissection in patients with non-prior cardiac surgery vs. prior cardiac surgery: a systematic review and meta-analysis.

Background: Patients with prior cardiac surgery undergoing acute type A aortic dissection (ATAAD) are thought to have worse clinical outcomes as compared to the patients without prior cardiac surgery. Aim: To compare the safety and efficacy of ATAAD in patients with prior cardiac surgery. Methods: We systematically searched PubMed, Cochrane Library and Google Scholar from database inception until April 2024. We included nine studies which consisted of a population of 524 in the prior surgery group and 5,249 in the non-prior surgery group. Our primary outcome was mortality. Secondary outcomes included reoperation for bleeding, myocardial infarction, stroke, renal failure, sternal wound infection, cardiopulmonary bypass (CPB) time, cross-clamp time, hospital stay, and ICU stay. Results: Our pooled estimate shows a significantly lower rate of mortality in the non-prior cardiac surgery group compared to the prior cardiac surgery group (RR = 0.60, 95% CI = 0.48-0.74). Among the secondary outcomes, the rate of reoperation for bleeding was significantly lower in the non-prior cardiac surgery group (RR = 0.66, 95% CI = 0.50-0.88). Additionally, the non-prior cardiac surgery group had significantly shorter CPB time (MD = -31.06, 95% CI = -52.20 to -9.93) and cross-clamp time (MD = -21.95, 95% CI = -42.65 to -1.24). All other secondary outcomes were statistically insignificant. Conclusion: Patients with prior cardiac surgery have a higher mortality rate as compared to patients who have not undergone cardiac surgery previously. Patients with prior cardiac surgery have higher mortality and longer CPB and cross-clamp times. Tailored strategies are needed to improve outcomes in this high-risk group.

Assessing the shade matching accuracy among dental students through visual and instrumental methods.

Objectives: To evaluate the shade selection accuracy of male dental students according to the three dimensions of color: value, hue, and chroma, using visual and instrumental shade selection methods under different lighting conditions. Methods: This comparative cross-sectional study was instigated amongst 70 male 4th, 5th, and 6th years BDS students of the Dental Clinics Complex at King Faisal University, Saudi Arabia for a duration of two months. First, the principal investigator determined the shade of tooth 11 and 46 on patient utilizing the spectrophotometer after calibration. In the next step, students were asked to select the shade of same tooth 11 and 46 using VITA 3D-Master shade guide under clinic lightening condition and corrected light. The characteristics of the color such as hue, chroma and value were recorded. The Kruskal-Wallis test was applied to find the significant difference in shade selection between visual and instrumental methods with respect to academic years. Results: The mean of the value of instrumental shade selection of tooth # 46 was slightly higher among 4th year students (4.41±0.73), than that of 5th year (3.72±1.02), and 6th year students (3.83±0.83), with a statistically significant difference among them (p= 0.024), indicating 6th year students selected darker shades. Additionally, a statistically significant relationship was noticed among 4th, 5th, and 6th year students with respect to the means of the chroma of 2.18 ±1.29, 2.92±1.11, and 3.13±1.10, respectively (p= 0.025). Conclusion: The selection of posterior teeth shades was notably influenced by academic years, employing both instrumental and visual methods, while considering color parameters.

Postoperative sensitivity of composites using novel Bacillus subtilis nanofortified adhesives: a triple-blind study.

NANOTECHNOLOGY: is the art and science of dealing with nanoscale particles. This has transformed contemporary dental practices through myriad contributions to biomaterial science. Titanium dioxide nanoparticles procured from Bacillus subtilis, an eco-friendly and biogenic source, can significantly magnify the physiochemical attributes of dental materials. However, postoperative sensitivity is a major drawback of composite restorations. The incorporation of these nanoparticles into dental adhesives can greatly benefit clinical dentistry by resolving this issue. This trial aimed to evaluate the effectiveness of a novel titanium dioxide nanofortified adhesive on the postoperative sensitivity of composite restorations. METHODS: This triple-blind, parallel-group randomized controlled trial was conducted at the Department of Operative Dentistry and Endodontics, School of Dentistry, Islamabad, from May 15, 2023, to November 25, 2023. Participants (n = 60) with Class I and II primary carious lesions with a minimum cavity depth of 3-5 mm were randomly assigned to two groups (n = 30). After obtaining informed consent, the restorative procedure was accomplished using a minimally invasive approach and etch-and-rinse adhesive strategy. In group A, a nanofortified adhesive was used for composite restoration, whereas in group B, an adhesive without nanoparticles was used. Postoperative sensitivity was evaluated using the Visual Analog Scale (VAS) score at follow-up periods: of one day, one week, two weeks and one month. A Chi-square test was used to compare postoperative sensitivity between the two groups. The level of significance was set at p < 0.05. RESULTS: A noteworthy association was observed between sensitivity and the group variable at all four evaluation periods: after one day (p = 0.002), 1 week (p = 0.002), 2 weeks (p = 0.007) and one month. In conclusion, participants who underwent restorative intervention using titanium dioxide nanoreinforced adhesives reported a notable reduction in sensitivity at all time intervals. Hence, the occurrence and severity of postoperative sensitivity are significantly reduced using Bacillus subtilis-procured nanofortified adhesives as compared to conventional adhesives without nanoparticles. TRIAL REGISTRATION: This trial was retrospectively registered at ClinicalTrials.gov (ID: NCT06242184) on 03/02/2024. All procedures involving human participants were performed in conformance with this protocol.

"Evaluating wound closure innovations in spinal surgery: impacts on efficiency and patient outcomes".

This study evaluates contemporary wound closure techniques in spinal surgery, focusing on the efficacy of barbed sutures, skin staples, and negative-pressure wound therapy (NPWT), compared to traditional methods. Barbed sutures, like STRATAFIX™ Symmetric, and skin staples demonstrate significant advantages, including reduced wound closure time, lower infection rates, and improved surgical outcomes, particularly in multilevel or revisional procedures. In contrast, plastic surgery closures do not show a substantial reduction in postoperative complications despite being used in more complex cases. NPWT is highlighted as an effective adjunct therapy for managing surgical site infections and reducing the need for hardware removal. The findings suggest that while modern techniques offer clear benefits, traditional methods remain valuable in specific contexts. The review advocates for further research through large-scale, long-term studies and emphasizes the need for personalized wound closure strategies based on individual patient risk factors.

"Biomarkers in severe traumatic brain injury: enhancing prognostic accuracy and therapeutic strategies".

This study examines the emerging role of biomarkers in the prognosis and management of severe traumatic brain injury (sTBI). Key findings highlight the significance of serum RIP-3, STC1, Nrf2, and cerebrospinal fluid galectin-3 and cytokines in predicting disease severity, mortality, and functional outcomes in sTBI patients. Elevated levels of RIP-3 and STC1 were linked to poor prognosis and increased mortality, with RIP-3 associated with necroptosis and inflammation, and STC1 with neuroprotective properties. Nrf2 was found to correlate with oxidative stress and adverse outcomes, while elevated CSF galectin-3 and IL-6 indicated neuroinflammation and neurodegeneration. These biomarkers show promise not only as prognostic tools but also as potential therapeutic targets. The study suggests further validation through multicenter research to enhance clinical applications and improve treatment strategies for sTBI.