Insights Into Ocular Resilience: Unraveling the Epidemiology, Prognostic Factors, and Visual Triumphs of Open Globe Injuries in the COVID-19 Era at a Leading Tertiary Care Centre of Western Rajasthan, India.

INTRODUCTION: This study was conducted to describe the epidemiology, prognostic factors, and visual outcomes of open globe injuries (OGIs) at a tertiary care centre in Western Rajasthan, India. METHODS: Data of OGI patients treated at the Department of Ophthalmology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, from March 2019 to December 2021 were reviewed retrospectively. Demographic details including age, gender, place of injury, wound characteristics (i.e., cause, mechanism, location, and size), visual acuity (VA), and associated ocular injuries were recorded. The Ocular Trauma Classification System (OTCS) and the Birmingham Eye Trauma Terminology (BETT) were used to categorize OGIs. All the data was entered into a Microsoft Excel sheet (Microsoft Corporation, Redmond, Washington, United States) and analyzed with IBM SPSS Statistics for Windows, Version 23.0 (Released 2015; IBM Corp., Armonk, New York, United States). RESULTS: A total of 40 patients with OGIs were included. OGI was discovered to be four times higher in males and 47.5% of the total cases were observed in patients aged 0-15 years, followed by patients aged 16-30 (27.5%). The rupture injury showed a higher incidence rate (32.5%) than the penetrating injury (62.5%). Of all OGIs, 75% were grade 4 injuries, with zone 1 being the most often affected zone and wood stick injury being the most prevalent aetiology. A significant difference was noted (p<0.001) in comparing presenting VA with final VA with paired sample t-test. A negative Spearman correlation was noted between age and final VA (r = 0.53, p = 0.000), and the grade of injury and final VA (r = 0.51, p = 0.001.) Conclusion: Young males were the most susceptible group to sustain OGIs due to their more physical activities. Health education and safety in the workplace and during sports are crucial to reduce the incidence of OGI.

Infection Rates of an Intraoral Versus Extraoral Approach to Mandibular Fracture Repairs are Equal: A Systematic Review and Meta-Analysis.

PURPOSE: This study investigates whether the intraoral approach to mandibular open reduction and internal fixation, through exposure to the oral cavity's microbiome, results in higher infection rates compared to the extraoral approach, thus addressing a critical public health concern, potentially offering an opportunity to reduce health-care costs, and aiming to guide effective clinical practice. METHODS: In this systematic review with meta-analyses, a review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A comprehensive literature search was conducted using Embase and PubMed for articles published between 1989 and 2023. Inclusion criteria targeted studies on open reduction and internal fixation mandibular fractures comparing intraoral and extraoral approaches and reporting infection rates. Exclusion criteria eliminated non-English articles, case reports, and studies with insufficient approach-specific data. The primary outcome was the postoperative infection rate, with surgical approach as the predictor. Covariates such as age, sex, diabetes, and smoking status were included when reported. Data were analyzed using R software, employing random-effects models due to anticipated heterogeneity (I2 statistics). RESULTS: From 61 studies, 11 provided direct comparisons involving 1,317 patients-937 intraoral and 380 extraoral. Infection rates were 5.9% for intraoral and 10% for extraoral approaches. Pooled relative risk was 0.94 [95% confidence interval, 0.63, 1.39], suggesting no significant risk difference. Prevalence of infections was estimated at 9% for intraoral and 6.1% for extraoral procedures, with significant heterogeneity (I2 = 84% for intraoral and 56% for extraoral). CONCLUSION: Our meta-analysis found no significant difference in infection rates between the two approaches. There is opportunity to expand on reporting complication rates comparing the various approaches to mandibular fixation. Until these data are presented, surgeon preference may dictate the operative approach to expose the mandible for reduction and fixation.

Recurrence of membranous nephropathy after kidney transplantation: A multicenter retrospective cohort study.

Membranous nephropathy (MN) is a leading cause of kidney failure worldwide and frequently recurs after transplant. Available data originated from small retrospective cohort studies or registry analyses; therefore, uncertainties remain on risk factors for MN recurrence and response to therapy. Within the Post-Transplant Glomerular Disease Consortium, we conducted a retrospective multicenter cohort study examining the MN recurrence rate, risk factors, and response to treatment. This study screened 22,921 patients across 3 continents and included 194 patients who underwent a kidney transplant due to biopsy-proven MN. The cumulative incidence of MN recurrence was 31% at 10 years posttransplant. Patients with a faster progression toward end-stage kidney disease were at higher risk of developing recurrent MN (hazard ratio [HR], 0.55 per decade; 95% confidence interval [CI], 0.35-0.88). Moreover, elevated pretransplant levels of anti-phospholipase A2 receptor (PLA2R) antibodies were strongly associated with recurrence (HR, 18.58; 95% CI, 5.37-64.27). Patients receiving rituximab for MN recurrence had a higher likelihood of achieving remission than patients receiving renin-angiotensin-aldosterone system inhibition alone. In sum, MN recurs in one-third of patients posttransplant, and measurement of serum anti-PLA2R antibody levels shortly before transplant could aid in risk-stratifying patients for MN recurrence. Moreover, patients receiving rituximab had a higher rate of treatment response.

Epidemiology of distal radius fractures: Elucidating mechanisms, comorbidities, and fracture classification using the national trauma data bank.

BACKGROUND: An update on the epidemiology of distal radius fractures in the United States is necessary, particularly as the elderly population grows. Additionally, age and frailty have been associated with complications following surgical fixation of DRFs. Herein, we utilize the National Trauma Data Bank, a robust nationwide resource, to investigate the relationship between demographics, comorbidities, injury and fracture characteristics, and admission details. METHODS: Patients with isolated distal radius fractures were identified from the National Trauma Data Bank (2016-2019) according to ICD-10 codes. Univariate and multivariate regressions were conducted to determine independent risk factors for bilateral fractures, displaced fractures, open fractures, as well as length of hospital stay and adverse discharge disposition for patients undergoing inpatient surgical fixation. RESULTS: The incidence of DRFs was 3.6/1,000 trauma-related emergency department visits and 10.8/1,000 upper extremity traumas. Trauma mechanism was significantly associated with displaced and open fractures. Age (OR 1.01, 95% CI 1.01-1.01), BMI (OR 1.02, 95% CI 1.01-1.02), smoking (OR 1.34, 95% CI 1.15-1.57), and alcohol level (trace: OR 2.18, 95% CI 1.41-3.29; intoxicated: OR 2.20, 95% CI 1.63-2.95) were significantly associated with open fractures. Machinery (ß=2.04, 95% CI 1.00-3.08) and MVT (ß=0.39, 95% CI 0.08-0.69) mechanisms were independent risk factors for longer length of stay. mFI-5 was an independent risk factor, in a stepwise fashion, for both length of stay and adverse discharge disposition. CONCLUSIONS: High-energy mechanisms and risk factors for poor skin quality were significantly associated with open fractures. mFI-5 was an independent risk factor for longer length of stay and non-routine discharges in patients of all ages, despite controlling for other comorbidities, unrelated complications, and mechanism of injury. Trauma mechanism was an independent risk factor for prolonged length of stay only, particularly in patients younger than 65 years of age.

Nature of Overcharging and Charge Inversion in Electrical Double Layers.

Understanding overcharging and charge inversion is one of the long-standing challenges in soft matter and biophysics. To study these phenomena, we employ the modified Gaussian renormalized fluctuation theory, which allows for the self-consistent accounting of spatially varying ionic strength as well as the spatial variations in dielectric permittivity and excluded volume effects. The underlying dependence of overcharging on the electrostatic coupling is elucidated by varying the surface charge, counterion valency, and dielectric contrast. Consistent with simulations, three characteristic regimes corresponding to weak, moderate, and strong coupling are identified. Important features like the inversion of zeta potential, crowding, and ionic layering at the surface are successfully captured. For weak coupling, there is no overcharging. In the moderate coupling regime, overcharging increases with the surface charge. Finally, in the strong coupling regime, ionic crowding and saturation in overcharging are observed. Our theory predicts a nonmonotonic dependence of charge inversion on multivalent salt concentration as well as the addition of monovalent salt, in quantitative agreement with experiments.

Development and Validation of a Multiclass Model Defining Molecular Archetypes of Kidney Transplant Rejection: A Large Cohort Study of the Banff Human Organ Transplant Gene Expression Panel.

Gene expression profiling from formalin-fixed paraffin-embedded (FFPE) renal allograft biopsies is a promising approach for feasibly providing a molecular diagnosis of rejection. However, large-scale studies evaluating the performance of models using NanoString platform data to define molecular archetypes of rejection are lacking. We tested a diverse retrospective cohort of over 1400 FFPE biopsy specimens, rescored according to Banff 2019 criteria and representing 10 of 11 United Network of Organ Sharing regions, using the Banff Human Organ Transplant panel from NanoString and developed a multiclass model from the gene expression data to assign relative probabilities of 4 molecular archetypes: No Rejection, Antibody-Mediated Rejection, T Cell-Mediated Rejection, and Mixed Rejection. Using Least Absolute Shrinkage and Selection Operator regularized regression with 10-fold cross-validation fitted to 1050 biopsies in the discovery cohort and technically validated on an additional 345 biopsies, our model achieved overall accuracy of 85% in the discovery cohort and 80% in the validation cohort, with ≥75% positive predictive value for each class, except for the Mixed Rejection class in the validation cohort (positive predictive value, 53%). This study represents the technical validation of the first model built from a large and diverse sample of diagnostic FFPE biopsy specimens to define and classify molecular archetypes of histologically defined diagnoses as derived from Banff Human Organ Transplant panel gene expression profiling data.

Detergent induced structural perturbations in peanut agglutinin: insights from spectroscopic and molecular dynamic simulation studies.

The three dimensional structure of a protein is very important for its structure. Studies relating to protein structure have been numerous and the effect of denaturants on proteins can help understand the process of protein folding and misfolding. Detergents are important denaturants and play important roles in various fields. Here we explored the effect of sodium dodecyl sulphate (SDS) and cetyltrimethylammonium bromide (CTAB) on the structure of peanut agglutinin (PNA). The protein was purified from its natural source and impact of SDS and CTAB was studied by circular dichroism, intrinsic fluorescence, 8-anilino-1-napthalenesulfonic acid, molecular docking and molecular dynamics simulation. Pure peanut agglutinin showed a trough at 220 nm and positive ellipticity peak at 195 nm, specific for lectins. Results from the experimental and simulation studies suggest how oppositely charged detergents can interact differently and lead to varied structural perturbations in PNA. Both the surfactants induce all α protein-like circular dichroism in the protein, above its critical micelle concentrations, with significant change in accessible surface area that became more hydrophobic upon the treatment. Major interactions between the surfactants and protein, resulting in PNA conformational rearrangement, are electrostatic and van der Waals interactions. However, CTAB, a cationic surfactant, has similar effects as anionic surfactant (SDS) but at significantly very low concentration. Though the effects followed same pattern in both the surfactant treatment, i.e. above respective CMC, the surfactants were inducing all α protein-like conformation in PNA.Communicated by Ramaswamy H. Sarma.

Ion correlation-driven like-charge attraction in multivalent salt solutions.

The electrostatic double layer force is key to determining the stability and self-assembly of charged colloids and many other soft matter systems. Fully understanding the attractive force between two like-charged surfaces remains a great challenge. Here, we apply the modified Gaussian renormalized fluctuation theory to study ion correlation-driven like-charge attraction in multivalent salt solutions. The effects of spatially varying ion correlations on the structure of overlapping double layers and their free energy are self-consistently accounted for. In the presence of multivalent salts, increasing surface charge or counterion valency leads to a short-range attraction. We demonstrate that although both overcharging and like-charge attraction are outcomes of ion correlation, there is no causal relationship between them. Our theory also captures the non-monotonic dependence of like-charge attraction on multivalent salt concentration. The reduction of attraction at high salt concentrations could be a contributing factor toward the reentrant stability of charged colloidal suspensions. Our theoretical predictions are consistent with the observations reported in experiments and simulations.

Investigating the Effects of the POPC-POPG Lipid Bilayer Composition on PAP248-286 Binding Using CG Molecular Dynamics Simulations.

PAP248-286 is a fusogenic peptide derived from prostatic acid phosphatase, commonly found in human semen, and is known to mediate HIV fusion with cell membranes. In this study, we performed 120 independent coarse-grained molecular dynamics simulations to investigate the spontaneous binding of PAP248-286 monomers, considering both charged and neutral histidine (His) residues, to membrane bilayers composed of different lipid compositions: 100% POPC, 70% POPC-30% POPG, and 50% POPC-50% POPG. Our simulations revealed that PAP248-286 displayed spontaneous binding to the membrane, with increased binding observed in the presence of anionic lipid POPG. Specifically, in systems containing 30% and 50% POPG lipids, monomer residues, particularly in the systems containing charged histidine (His) residues, exhibited prolonged binding with the membrane. Furthermore, our simulations indicated that PAP248-286 adopted a parallel orientation with the membrane, exposing its positively charged residues to the lipid bilayer. Interestingly, systems containing charged His residues showed a higher lipid occupancy around the peptide. These findings are consistent with previous experimental data, suggesting that PAP248-286 binding is enhanced in membranes with charged His residues, resembling the conditions found in the acidic vaginal pH environment. The results of our study provide further insights into the molecular mechanisms underlying the membrane binding of PAP248-286, contributing to our understanding of its potential role in HIV fusion and infection.

Association of TGF-ß1 Polymorphism and TGF-ß1 Levels With Chronic Hepatitis C and Cirrhosis: A Systematic Review and Meta-Analysis.

Despite the extensive research conducted on the relationship between transforming growth factor-beta 1 (TGF-ß1) polymorphisms and levels and the onset and development of liver disease, there are still certain gaps that need to be addressed. To address these gaps and provide a comprehensive overview of the current knowledge, this review aimed to identify relevant published research on TGF-ß1/TGF-ß1 polymorphism, TGF-ß1/TGF-ß1 levels, and their associations with cirrhosis and hepatitis C. The synthesis of available data was performed to further enhance our understanding in this area. Adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a search strategy was implemented across several online databases to search for relevant articles as per the defined selection criterion. Eight studies were selected after the completion of the search strategy. Of the eight studies, five revealed a considerably high level of TGF-ß1 in patients who had hepatitis C virus (HCV) and liver cirrhosis caused by hepatocellular carcinoma (HCC). The forest plot analysis showed a statistically significant impact of TGF-ß1 polymorphism and levels on the incidence of hepatic cirrhosis and hepatitis C, with an odds ratio (OR) of 0.65 and a risk ratio (RR) of 0.76. The heterogeneity test showed a high level of heterogeneity at 94% and 95% for OR and RR, respectively, but the overall effect was significant with P < 0.01 for both measures. According to the results obtained, the authors concluded that TGF-ß1 polymorphism and its associated levels should be taken into account while developing preventive and therapeutic approaches for hepatic cirrhosis and hepatitis C.

A Systematic Review of the Impact of Patient Factors on BREAST-Q Outcomes After Reduction Mammoplasty.

BACKGROUND: As reduction mammoplasty rises in popularity, it will become increasingly important to understand the patient-reported outcome measurements associated with a successful operation. There has been a growing body of literature on BREAST-Q outcomes for patients undergoing reduction mammoplasty, but meta-analyses of patient factors and BREAST-Q Reduction Module scores are lacking. This study sought to ascertain which patient factors were associated with improvements in BREAST-Q scores compared with preoperative levels. METHODS: A literature review through August 6, 2021, was conducted using the PubMed database to select publications using the BREAST-Q questionnaire to evaluate outcomes after reduction mammoplasty. Studies examining breast reconstruction, breast augmentation, oncoplastic reduction, or breast cancer patients were excluded. BREAST-Q data were stratified by comorbidities, age, body mass index (BMI), complication rate, and resection weight. RESULTS: Among 14 articles and 1816 patients, the mean age ranged from 15.8 to 55 years, mean BMI ranged from 22.5 to 32.4 kg/m2, and bilateral mean resected weight ranged from 323 to 1845.96 g. Overall complication rate was 19.9%. On average, satisfaction with breasts improved by 52.1 ± 0.9 points (P < 0.0001), psychosocial well-being improved by 43.0 ± 1.0 points (P < 0.0001), sexual well-being improved by 38.2 ± 1.2 points (P < 0.0001), and physical well-being improved by 27.9 ± 0.8 points (P < 0.0001). The mean age was positively correlated with preoperative sexual well-being (Spearman rank correlation coefficient [SRCC]: 0.61, P < 0.05). Body mass index was negatively correlated with preoperative physical well-being (SRCC: -0.78, P < 0.01) and positively correlated with postoperative satisfaction with breasts (SRCC: 0.53, P < 0.05). The mean bilateral resected weight was significantly positively correlated with postoperative satisfaction with breasts (SRCC: 0.61, P < 0.05). No significant correlations were observed between complication rate and preoperative, postoperative, or mean change in BREAST-Q scores. CONCLUSIONS: Reduction mammoplasty improves patient satisfaction and quality of life as reflected by the BREAST-Q. Although preoperative or postoperative BREAST-Q scores may be individually influenced by age and BMI, these variables demonstrated no statistically significant effect on the average change between these scores. This literature review suggests that reduction mammoplasty delivers high satisfaction across a diverse range of patient populations, and additional prospective cohort or comparative studies gathering robust data on other patient factors would benefit this area of research.

A coarse-grained molecular dynamics investigation on spontaneous binding of Aß1-40 fibrils with cholesterol-mixed DPPC bilayers.

Alzheimer's disease is the most common form of dementia. Its aetiology is characterized by the misfolding and aggregation of amyloid-ß (Aß) peptides into ß-sheet-rich Aß oligomers/fibrils. Although multiple experimental studies have suggested that Aß oligomers/fibrils interact with the cell membranes and perturb their structures and dynamics, the molecular mechanism of this interaction is still not fully understood. In the present work, we have performed a total of 120 µs-long simulations to investigate the interaction between trimeric or hexameric Aß1-40 fibrils with either a 100% DPPC bilayer, a 70% DPPC-30% cholesterol bilayer or a 50% DPPC-50% cholesterol bilayer. Our simulation data capture the spontaneous binding of the aqueous Aß1-40 fibrils with the membranes and show that the central hydrophobic amino acid cluster, the lysine residue adjacent to it and the C-terminal hydrophobic residues are all involved in the process. Moreover, our data show that while the Aß1-40 fibril does not bind to the 100% DPPC bilayer, its binding affinity for the membrane increases with the amount of cholesterol. Overall, our data suggest that two clusters of hydrophobic residues and one lysine help Aß1-40 fibrils establish stable interactions with a cholesterol-rich DPPC bilayer. These residues are likely to represent potential target regions for the design of inhibitors, thus opening new avenues in structure-based drug design against Aß oligomer/fibril-membrane interaction.

High-Throughput Ultra Performance Liquid Chromatography-Tandem Mass Spectrometry Method Validation for the Estimation of Atorvastatin and Active Metabolites in Human Plasma.

A highly selective, sensitive, rugged, and rapid ultra high-performance liquid chromatography-tandem mass spectrometry method (UPLC-MS/MS) is optimized and validated for reliable quantification of atorvastatin (ATR) and its active metabolites, 2-hydroxy atorvastatin (2-ATR) and 4-hydroxy atorvastatin (4-ATR) in human plasma using atorvastatin-D5 (ATR-D5), 2-hydroxy atorvastatin-D5 (2-ATR-D5), and 4-hydroxy atorvastatin-D5 (4-ATR-D5) as deuterium-labeled internal standards (ISTDs), respectively. Isocratic mode chromatographic separation was used with a reverse-phase C18 Symmetry Shield (150 × 4.6 mm, 5.0 µm) column and a mobile phase of acetonitrile:2 mM ammonium formate (pH-3.0) [65:35%v/v] at a flow rate of 0.7 mL/min. Electrospray ionization technique with positive ion mode polarity was applied to achieve the best signal intensity and stable response. Solid-phase extraction by direct elution method was applied to extract the drugs from the plasma sample. The calibration curve range was validated from a concentration range of 0.500-250 ng/mL for ATR and 2-ATR and 0.200-20 ng/mL for 4-ATR. The within-batch and between-batch precision and accuracy were found to be consistent and reproducible for all the analytes across the validation. Extraction recoveries were >80% for all analytes and ISTDs. All peaks of analytes and the respective ISTDs were eluted within 5.2 min. In this validated method, selective multivariate analytical approaches were utilized such as best fit linearity range for different strength formulations, preventive measures for in vivo and ex vivo autodegradation of metabolites, and shorter analysis time. This validated method can be useful for challenging quantification of ATR and its active metabolites for therapeutic drug monitoring and in high-throughput clinical study sample analysis.

Natural Plasmodium falciparum Infection Stimulates Human Antibodies to MSP1 Epitopes Identified in Mice Infection Models upon Non-Natural Modified Peptidomimetic Vaccination.

(1) Background: Malaria, a vector-borne infectious disease, is caused by parasites of the Plasmodium genus, responsible for increased extreme morbidity and mortality rates. Despite advances in approved vaccines, full protection has not yet been achieved upon vaccination, thus the development of more potent and safe immuno-stimulating agents for malaria prevention is a goal to be urgently accomplished. We have focused our research on a strategy to identify Plasmodium spp. epitopes by naturally acquired human antibodies and rodent malaria infection models immunized with site-directed non-natural antigens. (2) Methods: Some predictive algorithms and bioinformatics tools resembling different biological environments, such as phagosome-lysosome proteolytic degradation, affinity, and the high frequency of malaria-resistant and -sensitive HLA-II alleles were regarded for the proper selection of epitopes and potential testing. Each epitope's binding profile to both host cells and HLA-II molecules was considered for such initial screening. (3) Results: Once selected, we define each epitope-peptide to be synthesized in terms of size and hydrophobicity, and introduced peptide-bond surrogates and non-natural amino acids in a site-directed fashion, and then they were produced by solid-phase peptide synthesis. Molecules were then tested by their antigenic and immunogenic properties compared to human sera from Colombian malaria-endemic areas. The antigenicity and protective capacity of each epitope-peptide in a rodent infection model were examined. The ability of vaccinated mice after being challenged with P. berghei ANKA and P. yoelii 17XL to control malaria led to the determination of an immune stimulation involving Th1 and Th1/Th2 mechanisms. In silico molecular dynamics and modeling provided some interactions insights, leading to possible explanations for protection due to immunization. (4) Conclusions: We have found evidence for proposing MSP1-modified epitopes to be considered as neutralizing antibody stimulators that are useful as probes for the detection of Plasmodium parasites, as well as for sub-unit components of a site-directed designed malaria vaccine candidate.

Are Surgical Approaches Correlated With BREAST-Q Score Improvements After Reduction Mammoplasty? A Systematic Review.

BACKGROUND: Despite the commonly recognized benefits and drawbacks of each surgical technique for reduction mammoplasty, data on the influence of each surgical approach on patient quality of life and satisfaction remains limited. Our study aims to evaluate the association between surgical factors and BREAST-Q scores for reduction mammoplasty patients. METHODS: A literature review through August 6, 2021, was conducted using the PubMed database to select publications that used the BREAST-Q questionnaire to evaluate outcomes after reduction mammoplasty. Studies examining breast reconstruction, breast augmentation, oncoplastic reduction, or breast cancer patients were excluded. The BREAST-Q data were stratified by incision pattern and pedicle type. RESULTS: We identified 14 articles that met selection criteria. Among 1816 patients, the mean age ranged from 15.8 to 55 years, mean body mass index ranged from 22.5 to 32.4 kg/m 2 , and bilateral mean resected weight ranged from 323 to 1845.96 g. Overall complication rate was 19.9%. On average, satisfaction with breasts improved by 52.1 ± 0.9 points ( P < 0.0001), psychosocial well-being improved by 43.0 ± 1.0 points ( P < 0.0001), sexual well-being improved by 38.2 ± 1.2 points ( P < 0.0001), and physical well-being improved by 27.9 ± 0.8 points ( P < 0.0001). No significant correlations were observed when mean difference was modeled against complication rates or prevalence of superomedial pedicle use, inferior pedicle use, Wise pattern incision, or vertical pattern incision. Complication rates were not correlated with preoperative, postoperative, or mean change in BREAST-Q scores. A negative correlation was noted between the prevalence of superomedial pedicle use and postoperative physical well-being (Spearman rank correlation coefficient [SRCC], -0.66742; P < 0.05). The prevalence of Wise pattern incision was negatively correlated with postoperative sexual well-being (SRCC, -0.66233; P < 0.05) and physical well-being (SRCC, -0.69521; P < 0.05). CONCLUSIONS: Although either preoperative or postoperative BREAST-Q scores may be individually influenced by pedicle or incision type, there was no statistically significant effect of surgical approach or complication rates on the average change of these scores, and overall satisfaction and well-being scores improved. This review suggests that any of the main surgical approaches to reduction mammoplasty provide equally substantial improvements in patient-reported satisfaction and quality of life, but more robust comparative studies would strengthen this area of research.

Self-Consistent Description of Vapor-Liquid Interface in Ionic Fluids.

Inhomogeneity of ion correlation widely exists in many physicochemical, soft matter, and biological systems. Here, we apply the modified Gaussian renormalized fluctuation theory to study the classic example of the vapor-liquid interface of ionic fluids. The ion correlation is decomposed into a short-range contribution associated with the local electrostatic environment and a long-range contribution accounting for the spatially varying ionic strength and dielectric permittivity. For symmetric salt, both the coexistence curve and the interfacial tension predicted by our theory are in quantitative agreement with simulation data reported in the literature. Furthermore, we provide the first theoretical prediction of interfacial structure for asymmetric salt, highlighting the importance of capturing local charge separation.

Correction to Pyramid-Shaped PEG-PCL-PEG Polymeric-Based Model Systems for Site-Specific Drug Delivery of Vancomycin with Enhance Antibacterial Efficacy.

[This corrects the article DOI: 10.1021/acsomega.9b04064.].

The Potential of Transexamic Acid Use for Wide Awake Local Anesthesia No Tourniquet.

Tranexamic acid (TXA) is a drug commonly used to decrease intraoperative bleeding. Its use in various types of surgery is well defined; however, its use in plastic surgery and even more so, hand surgery is not as well researched. Concurrently, the use of wide-awake local anesthesia no tourniquet (WALANT) procedures has increased in popularity. As the use of WALANT increases, it comes to question whether TXA could be used as an alternative to epinephrine during WALANT procedures. This case involves a 33-year-old woman status-post motor vehicle collision. On examination, the patient sustained transection of the flexor digitorum profundus on both her left middle and ring fingers along with absent sensation to her left middle finger. Due to the surgical preference for vascular monitoring, TXA was used alternatively to epinephrine to control intraoperative bleeding during the tendon repairs. It was observed that TXA allowed for controlled bleeding, preservation of the surgical visual field, successful tendon repair, and postoperative success. The successful use of TXA in this case prompts further investigation as to whether TXA could be used as an alternative to epinephrine in WALANT procedures.

Electrostatic Correlation Induced Ion Condensation and Charge Inversion in Multivalent Electrolytes.

The study of the electrical double layer lies at the heart of colloidal and interfacial science. The standard mean-field Poisson-Boltzmann (PB) theory is incapable of modeling many phenomena originating from ion correlation. An important example is charge inversion or overcharging of electrical double layers in multivalent electrolyte solutions. Existing theories aiming to include correlations cannot capture the non-monotonic dependence of charge inversion on salt concentration because they have not systematically accounted for the inhomogeneous nature of correlations from surface to the bulk and the excluded volume effect of ions and solvent molecules. In this work, we modify the Gaussian renormalized fluctuation theory by including the excluded volume effect to study ion condensation and charge inversion. A boundary layer approach is developed to accurately model the giant difference in ion correlations between the condensed layer near the surface and the diffuse layer outside. The theory is used to study charge inversion in multivalent electrolytes and their mixtures. We predict a surface charge induced formation of a three-dimensional condensed layer, which is necessary but not sufficient for charge inversion. The value of the effective surface potential is found to depend non-monotonically on the bulk salt concentration. Our results also show a non-monotonic reduction in charge inversion in monovalent and multivalent electrolyte mixtures. Our work is the first to qualitatively reproduce experimental and simulation observations and explains the underlying physics.