Comprehensive Assessment of Labiaplasty Techniques and Tools, Satisfaction Rates, and Risk Factors: A Systematic Review and Meta-analysis.

BACKGROUND: Various surgical techniques have been devised for the surgical cosmetic enhancement of female outer genitalia. The selection of an optimal method should be based on satisfaction rates and safety; however, a comprehensive, contemporary systematic assessment of these factors in has been limited in the literature. OBJECTIVES: Our aim was to conduct a comprehensive systematic review and meta-analysis to evaluate the overall satisfaction rates and risk factors associated with various labiaplasty techniques and tools. METHODS: The authors performed a systematic literature search in three medical databases: PubMed, Elsevier and Cochrane Library (CENTRAL) with the closing date of October 2023. Original articles with quantitative satisfaction rates and frequencies of most common complications (hematoma, dehiscence, swelling, bleeding and infection) were included. RESULTS: Systematic search provided a total of 3954 records. After selection and review of the articles, 86 eligible, peer-reviewed studies were identified, of which 53 provided quantitative data. High overall satisfaction rate was found for all methods (Prop: 94%; CI: 93-95%), with highest satisfaction for deepithelization (Prop: 97%; CI: 85%-99%). Complications were generally rare, with elevated incidences for some techniques (wedge resection - dehiscence: Prop: 8%; CI: 5%-13% and composite reduction - swelling: Prop: 13%; CI: 2%-54%). Scalpel has significantly higher incidence of complications than laser, namely for bleeding, swelling and hematoma. CONCLUSIONS: Labiaplasty can be considered a generally effective approach to outer female genitalia beautification, with low associated risks. Surgeons must tailor their approach to the patients' needs and anatomy to achieve maximal satisfaction, given the differences in the frequency of complications for each method.

Evolutionarily stable payoff matrix in hawk-dove games.

BACKGROUND: Classical matrix game models aim to find the endpoint of behavioural evolution for a set of fixed possible interaction outcomes. Here, we introduce an evolutionary model in which not only the players' strategies but also the payoff matrix evolves according to natural selection. RESULTS: We start out from the hawk-dove matrix game and, in a way that is consistent with the monomorphic model setup of Maynard Smith and Price, introduce an evolving phenotypic trait that quantifies fighting ability and determines the probability of winning and the cost of losing escalated hawk-hawk fights. We define evolutionarily stable phenotypes as consisting of an evolutionarily stable strategy and an evolutionarily stable trait, which in turn describes a corresponding evolutionarily stable payoff matrix. CONCLUSIONS: We find that the maximal possible cost of escalating fights remains constant during evolution assuming a separation in the time scales of fast behavioural and slow trait selection, despite the fact that the final evolutionarily stable phenotype maximizes the payoff of hawk-hawk fights. Our results mirror the dual nature of Darwinian evolution whereby the criteria of evolutionary success, as well as the successful phenotypes themselves, are a product of natural selection.

Spring buds of European woody plants have old 14C age.

Trees and shrubs maintain carbon reserves to support their functions during periods when metabolic demand exceeds carbon supply, such as during the dormant season. To gain a better understanding of carbon storage and utilisation dynamics of eight woody plant species in temperate Central Europe, bud scale and leaf samples were collected to determine the radiocarbon age of fresh sprouts in trees and shrubs, at three background sites avoiding local emissions that may influence affect the observed 14C/12C ratio. The accelerator mass spectrometry-based bomb-radiocarbon approach, to determine the age of the mobilized carbon in the plant bud samples from storage, was complemented by stable carbon isotope measurements. The bomb-radiocarbon dating technique was used to determine the age of the samples, while a northern hemispheric atmosphere 14CO2 dataset was used to calibrate the radiocarbon ages of the plant samples. The youngest observed calibrated radiocarbon age of the buds was over 4 years, and the oldest was even 9 years old. There was no significant difference between the ages of bud scales and embryonal leaf laminas. Our results show that there is a considerable amount of stored older carbon in the woody stems that can be used to produce buds in spring, which is a complex mixture of stored carbon of different ages, but there is no relationship between the radiocarbon age and the stable carbon isotope composition. The observed results show that not only the tree species, but shrubs also can store and use significantly older carbon pools, the carbon storage intensity is similar for trees with trunks and short-stemmed shrubs branching directly above the ground, i.e. carbon storage starts in young twigs and continues in ageing branches.

[The application of negative pressure wound therapy (NPWT) in potentially lethal conditions]. / A negatív nyomással végzett sebkezelés (NPWT) alkalmazása potenciálisan letális állapotokban.

Bemutatásra kerülo esetünkben egy 47 éves, generalizált septicus állapotú férfi beteg komplex terápiás megoldást igénylo kezelését ismertetjük, negatív nyomásterápia segítségével (NPWT). A páciens kezeletlen diabéteszes láb szindróma talaján kialakult szepszis, fasciitis necrotisans klinikai-radiomorfológiai képével került osztályunkra, akinél sürgosséggel feltárást, az alsó végtag valamennyi kompartmentjét érinto fasciotomiát végeztünk, NPWT-kezelést indítottunk. Kezelése során a beteg állapotát súlyosbító szövodmények léptek fel: Curling-fekély, toxicus epidermalis necrolysis (TEN). A fascitis kapcsán kialakult kb. 6% TBSA (total body surface area) kiterjedésu hámhiányt a TEN-szindróma további epidermális állományvesztéssel tovább súlyosbította. Állapotstabilizálást, kezdeti lokalis kontroll biztosítását követoen a hámhiányos felület csökkentése érdekében a sebeket szukítettük, a feltisztult sebalapok fedése 1:3 arányban hálósított félvastag bor transzplantációjával történt. Az NPWT-kezelést a transzplantációt követoen is folytattuk. A beteg három hónapos intenzív osztályos és sebészeti kezelést követoen sebészi szempontból meggyógyult. A negatív nyomásterápia korai - a kórlefolyásnak megfelelo - adekvát üzemmódban és fedési technikával történo alkalmazása a végtagvesztéssel és életveszéllyel járó nagy fokú hámhiány esetében hatékony eszköznek bizonyult. A multidiszciplináris terápiának köszönhetoen betegünk sebészeti alapbetegségét sikeresen gyógyítottuk, azonban az évtizedes tartamú kezeletlen cukorbetegsége, SARS-Covid peumoniája, a relabáló septicus állapota során fellépo szövodmények következtében felépülni már nem tudott.

Characterisation of urban aerosol size distribution by radiocarbon and PIXE analyses in a middle-European urban environment for source identification: a pilot study.

This study, conducted in Debrecen, Hungary, aimed to analyse atmospheric particulate matter (APM or PM) through radiocarbon and PIXE analyses during the winter smog (23-25 January) and spring (15-18 May) seasons. The information presented in this pilot study aims to provide insight into the importance of utilising detailed characteristics of the mass size distributions of fossil carbon (ff) and contemporary carbon (fC) content. Additionally, it seeks to compare these characteristics with the size distributions of various elements to enable even more accurate PM source identification. In winter, APM concentrations were 86.27 µg/m3 (total), 17.07 µg/m3 (fC) and 10.4 µg/m3 (ff). In spring, these values changed to 29.5 µg/m3, 2.64 µg/m3 and 7.01 µg/m3, respectively. Notably, differences in mass size distribution patterns were observed between the two seasons, suggesting varied sources for contemporary carbon. Biomass burning emerged as a crucial source during the smog period, supported by similar MMAD (Mass Median Aerodynamic Diameter) values and a strong correlation (r = 0.95, p < 0.01) between potassium and fC. In spring, a significant change in the concentration and distribution of fC occurred, with a broad, coarse mode and a less prominent accumulation mode. Ff was found to have similar distributions as PM, with nearly the same MMADs, during both periods. Finally, a comprehensive comparison of modal characteristics identified specific sources for the various components, including biomass burning, vehicle exhaust, coal and oil combustion, vehicle non-exhaust, road dust, tyre abrasion, mineral dust and biogenic emission. This study showcases how using radiocarbon and PIXE analysis in size distribution data can enhance our understanding of the sources of PM and their effects on different size fractions of PM.

Isotopic study of honey documents widespread plant uptake of old carbon in North America.

A comprehensive understanding of carbon cycling pathways in the soil-plant system is needed to develop models that accurately predict global carbon reservoir responses to anthropogenic perturbations. Honey is a carbon-rich natural food produced by wild and managed pollinating insects all over the world; the composition of a single sample is a function of millions of pollinator-plant interactions. We studied the 13C/12C and Δ14C of 121 honey samples sourced from the United States, and found a significant older carbon contribution. The effect is observed from 25 to 45° latitude, not correlated with 13C/12C, and consistent with a previously published study on European honeys. In specific cases, the measured values were up to 20 ‰ (Δ14C) higher than the expected atmospheric 14CO2 value for the given year, which shows a significant older carbon contribution. We hypothesize that the older carbon is from plant liquids derived in part from soil carbon or stored nonstructural carbohydrates from plants, which shifts the calibrated age of the sample by 5 years or more. Our work is the first to describe the widespread occurrence of older carbon in honey and shows that radiocarbon measurements can be a powerful tool to trace carbon allocations in terrestrial food webs and detect the atmosphere-soil-plant carbon cycle contributions.