搜索结果：Hands

Background Muscle strength is a key factor determining metabolic health, physical performance, and morbidity. Although body mass index (BMI) is used widely to assess obesity, it does not assess body composition adequately. Percentage body fat (PBF) could provide a better estimate of adiposity and its association with muscle strength, particularly in Asian populations with higher body fat at lower BMI levels. We aimed to evaluate the associations of BMI and PBF with HGS and lower limb muscle strength among North Indian adults and to compare the independent associations of BMI and PBF with HGS. Methodology This cross-sectional study included 1,513 apparently healthy adults aged 18 to 60 years. Anthropometric measurements, BMI, and PBF were measured using bioelectrical impedance analysis. HGS was measured using a Jamar hydraulic dynamometer, and lower limb muscle strength was tested using a handheld dynamometer. Correlation and multiple regression analyses were performed to assess the association of BMI and PBF with muscle strength. Results The average age of the participants was 38.25 &#xb1; 9.76 years, and 54.5% were males. PBF showed a significant inverse association with HGS for both hands. For the right HGS, the regression coefficient B was -0.619 with an R&#xb2; of 0.331, while for the left HGS, B was -0.594 with an R&#xb2; of 0.336 (p < 0.001 for both). However, BMI showed a comparatively weaker association with HGS, explaining less than 2% of the variation. Higher BMI was significantly associated with greater lower limb muscle strength (p < 0.001), while no significant association was found between BMI categories and HGS. Multivariable regression analysis further showed that PBF remained independently associated with HGS (p-value < 0.001 for both hands). Conclusions According to our study, PBF demonstrated a stronger association with muscle strength than BMI. These findings show that relying on BMI alone is insufficient and suggest including body composition assessment to identify individuals at risk of reduced muscle strength and related health complications.

Brachydactyly type E is a rare skeletal disorder characterized by variable shortening of the metacarpals and/or metatarsals. Heterozygous pathogenic variants in PTHLH, which encodes parathyroid hormone-related protein, are an established cause of autosomal dominant brachydactyly type E and are variably associated with short stature. We report a mother-son pair with brachydactyly type E and short stature caused by a novel heterozygous nonsense variant in PTHLH. The proband, a boy aged 7 years and 8 months, presented with short stature, brachydactyly involving both hands and feet, mild global developmental delay, and subtle craniofacial features. Radiographs showed generalized shortening of the metacarpals, metatarsals, and phalanges, premature epiphyseal fusion, and metaphyseal widening. His mother had marked adult short stature and brachydactyly, with more prominent shortening of the third to fifth digits. Biochemical and endocrine evaluation revealed no evidence of hormone resistance or major metabolic abnormalities. Trio whole-exome sequencing identified a novel heterozygous nonsense variant in PTHLH(NM_198965.2) c.82G>T, p.(Glu28Ter), and Sanger sequencing confirmed segregation with the affected mother. Our pooled descriptive review of previously published individual-level cases showed that short stature is common but incompletely penetrant in PTHLH-associated brachydactyly type E. Predicted loss-of-function variants, especially early truncating, frameshift, and signal peptide/initiation-region variants, were more often reported with growth impairment, whereas recurrent variants and familial cases showed marked inter- and intrafamilial variability. This report expands the mutational spectrum of PTHLH and supports the role of PTHLH haploinsufficiency in impaired skeletal growth. This family further illustrates that PTHLH-associated brachydactyly type E can present with generalized involvement of the metacarpals, metatarsals, and phalanges. Variant consequence and protein location may help clinical risk stratification but are insufficient for reliable individual-level prediction of short stature. The molecular diagnosis also informed management by supporting longitudinal growth monitoring rather than recombinant growth hormone therapy in the absence of GH-IGF-1 axis abnormalities. Recognition of brachydactyly with short stature and normal biochemical findings should prompt consideration of PTHLH-related disease and molecular testing.

The Caffeinated Coli Educational Module brings inquiry-driven learning to high schools, introducing students to scientific research, synthetic biology, and genetic engineering. The module focuses on the exploration of a genetically engineered strain of E. coli modified to grow exclusively on caffeine and, as such, can be used as a measurement device to determine the amount of caffeine in a liquid or beverage. Students conduct two bioassay experiments using these bacteria. During this process, they learn to create cultures and then measure bacterial growth followed by calculating the caffeine concentrations of unknown samples using their own data. This flexible module contains five weeks of original lectures and student learning materials that follow Next Generation Science Standards (NGSS), allowing the content to be adapted for basic, intermediate, or advanced biology courses. Upon completion of the module, students and teachers expressed that the most memorable aspects of the module include collaboration with peers, hands-on learning of content, and the opportunity to interact with the professor/mentors through office hours. Already implemented in 8 Texas high schools over the past two academic years, our module inspires STEM learning while bringing 21 st century biology research to new audiences.

Split-hand/foot malformation (SHFM) is a group of congenital birth defects affecting the hands and feet, significantly impairing patients quality of life. The TP63 gene encodes the p63 protein, heterozygous TP63 variants can cause SHFM. The aim of this study was to identify TP63 gene variants in three Chinese families with SHFM. Three Chinese families with SHFM enrolled in this study. Proband 1 and Proband two had familial history of SHFM, whereas Proband 3 was a sporadic case of this disease. Peripheral blood was collected from the proband and their available family members for genomic DNA extraction. Candidate pathogenic variants were identified through whole exome sequencing (WES), validated using PCR-based Sanger sequencing and bioinformatic analysis. We found three different missense variants in the TP63 gene: c.2032G>C (p.Glu678Gln), c.956G>A (p.Arg319His), and c.689T>A (p.Val230Asp). Among them, c.689T>A (p.Val230Asp) is novel variant. In the present work, three TP63 gene variants were found in the families with SHFM, which expanded the variant spectrum of TP63. These findings not only provide further evidence for their heterogeneous role in limb and non-limb malformations but also broaden the genetic spectrum of associated disorders. These insights pave the way for improved prenatal genetic diagnosis and informed counseling.

Migratory birds act as important dispersal hosts for parasitic mites, facilitating their spread over long geographic distances and potentially contributing to the emergence of infestations in previously unaffected areas. This study investigates an unprecedented outbreak of mite infestation among residents of two villages in northwestern Iran, in July 2025. This outbreak coincided with the arrival and nesting of migratory rosy starlings (Sturnus roseus) within or near human dwellings. A comprehensive survey and clinical examination of the affected villagers revealed that 37.6% of residents in Ebrahim Khesar and 26.3% of residents in ZavehKuh presented with skin lesions consistent with mite parasitism, with housewives representing the most affected occupational group. All itching and skin irritation occurs during the day and mainly involved the trunk and hands. The mean age of affected individuals did not differ significantly between the two villages (35.7&#x202f;&#xb1;&#x202f;23.1 vs. 41.0&#x202f;&#xb1;&#x202f;25.8 years; t&#x202f;=&#x202f;-1.111, df = 100, P&#x202f;=&#x202f;0.269; 95% CI: -15.0-4.2). Mites were collected from live birds and their carcasses and identified as Ornithonyssus sylviarum using morphological criteria. The close association between nesting rosy starlings and human settlements facilitated direct transmission of mites to humans, resulting in widespread symptoms of pruritus and dermatitis, but no systemic disease. This study found rosy starlings introduced bird mites (O. sylviarum) to homes, causing human infestations. Successful control depends on identifying the mite species, bird/nest management, education, and surveillance. A better understanding of the factors driving these outbreaks is essential for informing prevention strategies and reducing the impact of mite infestations on vulnerable populations.

This case report describes guided pulpal regeneration (GPR) of two immature permanent molar teeth with chronic apical abscess, thin dentinal walls, and open apices. Both teeth were treated with an identical protocol in two sessions, with minimum instrumentation with hand files, irrigation with 1.5% sodium hypochlorite (NaOCl), and application of 1:1 mixture of ciprofloxacin and metronidazole as an intracanal medicament, blood clot as a scaffold, and mineral trioxide aggregate (MTA) as the capping material. At the one-year follow-up, both treated teeth were asymptomatic. However, the root development procedure was different even in different roots of the same tooth, varying from only an increased thickness of dentinal walls to complete closure of the apex along with an increase in root length and dentinal wall thickness. It is concluded that the outcome of GPR is not completely predictable, and may vary among teeth with similar initial conditions and treatment approaches.

Hypothyroidism is a common condition that can have serious consequences if left untreated. Adrenal insufficiency, on the other hand, is a rare condition that can be life-threatening if left untreated. Early initiation of treatment with L-thyroxine and hydrocortisone supplementation helps restore quality of life by eliminating the risks associated with these deficiencies. Managing this type of hormonal imbalance in patients with short bowel syndrome is a rare situation, and there are few clear guidelines regarding its treatment.

OBJECTIVE: The primary aim was to quantify changes in structural and functional nerve parameters following carpal tunnel release. The secondary aims were to describe recovery trajectories and describe the regenerative capacity of the median nerve. DESIGN: Prognosis systematic review with meta-analysis. LITERATURE SEARCH AND SELECTION CRITERIA: Six databases were searched from inception to June 2024 for studies reporting at least 1 of the following outcomes: electrodiagnostic measures, quantitative sensory testing, grip/pinch strength, 2-point discrimination, Semmes-Weinstein monofilament, intraepidermal nerve fiber density, autonomic measures, brain function/structure, or Boston Carpal Tunnel Questionnaire. DATA SYNTHESIS: Outcomes were categorized by time post surgery: <2, 2 to 4, 5 to 7, 8 to 12, and >12 months. Randomized and observational studies were included, with quality assessed using the RoB 2 tool (revised Cochrane Risk of Bias tool for randomized trials) and the Newcastle-Ottawa Scale, respectively. RESULTS: A total of 199 studies comprising 15 636 patients and 578 healthy controls were included. We observed significant, time-dependent improvement in most outcomes. Grip and pinch strength did not show marked recovery until 5 to 7 months postoperatively. Compared to healthy controls, patients had persistent deficits in several electrodiagnostic measures even 1 year after surgery. Impairments in warm, vibration, and mechanical detection thresholds persisted up to 6 months postoperatively. CONCLUSION: Carpal tunnel release led to gradual improvement in median nerve function and structure. Key measures-including electrodiagnostics, detection thresholds, and intraepidermal nerve fiber density-often remained below normal levels after surgery. J Orthop Sports Phys Ther 2026;56(8):482-529. Epub 19 May 2026. doi:10.2519/jospt.2026.13846.

Neurophysiological assessments might advance the understanding of nonspecific chronic low back pain (nsCLBP) by quantifying altered pain processing and associated autonomic responses. Contact heat-evoked potentials (CHEPs) and sympathetic skin responses (SSRs) were compared between nsCLBP patients and healthy controls (HCs), and their relationships with experimental and clinical pain ratings were explored. A total of 56 nsCLBP patients and 40 age- and sex-matched HCs were included in this study. All participants underwent simultaneous recordings of CHEPs and SSRs in response to two blocks of 15 heat stimuli applied at the back (i.e., the patients' clinical pain area) and the hand (nonpainful control area). Participants rated the perceived pain intensity of each contact heat stimulus using a numerical rating scale (0-10). The change of pain ratings, CHEP, and SSR amplitudes between blocks was calculated as habituation index. SSR latencies were prolonged in patients compared to HCs (F&#x2009;=&#x2009;9.5, p&#x2009;=&#x2009;0.003) and were shorter after back stimulation compared to hand stimulation (F&#x2009;=&#x2009;9.6, p&#x2009;<&#x2009;0.001). No other group differences were observed. Clinical pain intensities in patients correlated (1) with contact heat pain ratings in both areas (back: rho&#x2009;=&#x2009;0.27, p&#x2009;=&#x2009;0.041, control area: rho&#x2009;=&#x2009;0.272, p&#x2009;=&#x2009;0.042) and (2) inversely with CHEP P2 latencies after hand stimulation (current pain: rho&#x2009;=&#x2009;-0.324, p&#x2009;=&#x2009;0.019; average 4&#x2009;weeks: rho&#x2009;=&#x2009;-0.320, p&#x2009;=&#x2009;0.022). Prolonged SSR latencies in nsCLBP might indicate a dysregulated pain-autonomic response. Clinicaltrials.gov_identifier: NCT04433299.

This study describes a standardized ultrasound-guided double-needle lavage technique for acute calcific periarthritis of the hand and reports its technical feasibility and preliminary clinical outcomes. Five consecutive patients underwent ultrasound-guided percutaneous lavage. Clinical characteristics, affected joint, calcification size, sonographic features, complications, and visual analog scale (VAS) scores at baseline, 1&#xa0;week, and 1&#xa0;month were recorded. Four cases involved the&#xa0;metacarpophalangeal joints,&#xa0;whereas one involved the interphalangeal joint. Mean calcification size was 14.4&#x2009;&#xb1;&#x2009;6.0&#xa0;mm. All deposits were mature and showed no posterior acoustic shadowing. Mean VAS decreased from 8.8&#x2009;&#xb1;&#x2009;1.8 at baseline to 0.4&#x2009;&#xb1;&#x2009;0.5 at 1&#xa0;week and 0.2&#x2009;&#xb1;&#x2009;0.4 at 1&#xa0;month, corresponding to mean pain reductions of 94.2% and 96.7%, respectively. No complications occurred. Ultrasound-guided lavage appears feasible, safe, and minimally invasive, providing rapid and substantial pain relief. Larger prospective studies are needed to confirm these preliminary findings.

Speed Breeding (SB) has become an essential tool for rapid breeding pipeline. However, the practical implementation of existing wheat (Triticum aestivum L.) SB protocols is largely constrained by a dependence on specialized plant care facilities. This study provides detailed instructions for growing wheat under SB conditions that can be implemented by institutions lacking dedicated technical support departments. The first Central Asian SB facility was established at Zhetysu University named after Iliyas Zhansugurov. For the identification of an effective plant growing substrate, sixteen treatments were developed. The nutrient management of the most suitable potting mix included two steps: i) identification of the importance of Nitrogen-Phosphorus-Potassium (NPK) supplementation, and ii) identification of optimal timing and nutrient dosage. Fertilizers were supplied at 4 different time intervals. Plants were supplemented with a foliar spray of calcium nitrate and copper and were hand-watered once a day. The plant material included seven wheat genotypes. Developmental dynamics and grain yield were evaluated under two, 1.5-and 2.0-meter, light-to-bench distances. A germination test was conducted at different time points after flowering. In this study, we report the establishment of the first SB facility in Central Asia. The developed cost-effective potting mix contained 65% FFPM, 18% perlite, 12% sand, and 7% bio humus per L-1. An additional NPK supplementation under the 21d_L time interval significantly increased effective tiller number (ETN, p=1x10-5), number of kernels per plant (NKP, p=1x10-8) and grain weight per plant (GWP, p=2x10-5) compared to non-fertilized control (NF). The ETN of plants grown under the 1.5&#xa0;m treatment was significantly higher (p=3x10-4) than that of in 2.0&#xa0;m condition. This resulted in an 83.3% increase in ETN (p=2x10-4), 145% in NKP (p=8x10-3) and 127% in GWP (p=6x10-3) without compromising thousand grain weight (TGW, p=8x10-1), highlighting a potential positive effect of proximity to a 1.5&#xa0;m light-bench under SB conditions. The light intensities in the range of 500-700, depending on the developmental stage, supported healthy wheat growth under SB conditions. This study findings support sustainable regional and global wheat breeding programs aiming to incorporate the speed breeding technique into their breeding schemes, specifically in underrepresented regions.

Undernutrition remains a significant public health challenge in the Democratic Republic of Congo (DRC). This study aims to identify dietary and non-dietary factors associated with undernutrition among children aged 6-23 months using the Composite Index of Anthropometric Failure. The secondary analysis was conducted using data from the 2023 National Nutrition Survey, a nationally representative cross-sectional study. The final analytical sample consisted of 5396 children, stratified into two age bands 6-11 months (n=1792) and 12-23 months (n=3604). Bivariate analysis (p<0.2), Multivariable logistic and stepwise regression models (p<0.05) were used to identify factors associated with undernutrition. The overall prevalence of undernutrition was 47.4%, rising significantly from 37.4% in infants aged 6-11 months to 52.6% in children aged 12-23 months. Stepwise logistic regression identified distinct risk profiles: for the 6-11&#x2009;month group, male sex (adjusted OR (aOR)=1.7; 95%&#x2009;CI 1.3 to 2.1)&#x2009;and larger households with >2 children (aOR=1.3; 95%&#x2009;CI 1.1 to 1.6) increased the undernutrition, while acceptable minimum meal frequency (MMF) was the primary protective factor (aOR=0.12; 95%&#x2009;CI 0.08 to 0.19). Among the 12-23&#x2009;month, high dietary diversity (aOR=0.5; 95%&#x2009;CI 0.4 to 0.7), acceptable MMF (aOR=0.6; 95%&#x2009;CI 0.5 to 0.8) and maternal education significantly reduced undernutrition. Conversely, rural residency, recent diarrhoea (aOR=1.4; 95%&#x2009;CI 1.2 to 1.7) and poor hand hygiene remained major factors associated with undernutrition. Traditional indices significantly underestimate the true nutritional burden in the DRC. These findings underscore the need for a National Nutrition Programme to implement multisectoral interventions that prioritise maternal literacy and the integration of Water, Sanitation and Hygiene protocols to address the diverse drivers of undernutrition.

Maternal immune adaptation during pregnancy is orchestrated by dynamic signals from the uterine microenvironment, including placental extracellular vesicles (pEVs) released into maternal circulation. EVs have emerged as key mediators of this crosstalk; however, their role in sex-specific immune modulation remains incompletely defined. Here, we investigated whether pEVs derived from term placentas induce sex-dependent changes in the phenotype, metabolism, and function of human monocytes. pEVs were isolated from 13 term uncomplicated placentas (six male-derived, M-pEVs, and seven female-derived, F-pEVs) and characterized by complementary approaches, revealing similar size distributions and concentrations, with differences in physicochemical properties and molecular cargo. Circulating monocytes from 17 non-pregnant female donors were exposed to M-pEVs or F-pEVs and analyzed for phenotypic, metabolic, and functional responses. pEVs induced distinct activation profiles depending on fetal sex. F-pEVs reduced CD11b and CD11c expression while increasing CD14, CD39 and IL-10 production. On the other hand, M-pEVs increased CD14 expression and enhanced IL-1&#x3b2; secretion. Both nanovesicles populations increased IL-10 and CXCL8 release and promoted a shift toward classical monocytes (CD14+CD16-) with a reduction in the intermediate subsets. Metabolic analyses revealed divergent immunometabolic programs: M-pEVs promoted lactate and reactive oxygen species production, whereas F-pEVs enhanced lactate production, fatty acid uptake, lipid droplet accumulation, and mitochondrial activity without increasing ROS. Functionally, both pEV populations increased efferocytosis, with a distinct sensitivity to metabolic inhibitors. These findings demonstrate that pEVs differentially modulate circulating monocytes according to fetal sex and support a role for fetal sex in shaping maternal immunometabolic responses.

Objectives: Proximal enamel stripping is one way to create space in orthodontic treatments that leaves grooves on the enamel surface and predispose teeth to caries. The aim of this study was to compare the two common stripping systems and the effect of polishing after the stripping process on the level of surface roughness. Materials and Methods: Twenty-five extracted teeth were randomly divided into five groups:untreated control (C), mechanical stripping (Sn), mechanical stripping and polishing (Sp), manual stripping (Dn), manual stripping and polishing (Dp). Mechanical stripping used a SWISS denta care Quality oscillating system, manual stripping used Dentaurum hand tapes, and polishing used Soflex disks. Teeth underwent pH-cycling and the amount of released calcium was measured by spectrometry. Samples were examined under atomic force microscopy (AFM) before and after demineralization. Baseline and post-demineralization surface roughness values (Ra, Rq, Rz) were calculated. Finally, scanning electron microscopy (SEM) images were obtained from two samples of each group. data analysis was done by One-way ANOVA. P-value<0.05 was considered statistically significant. Results: There was no significant difference between the stripping methods in terms of surface roughness parameters, but there was a significant difference between the polished and unpolished groups (P<0.05). Calcium release was significantly lower in the Sp group compared to the other groups (P<0.05). In SEM images, the least amount enamel damage was related to the Sp group. Conclusion: Unlike stripping systems, polishing is considerably useful in decreasing enamel roughness. Totally, mechanical stripping and polishing has shown the best consequences on enamel structure.

Uric acid is the end product of purine metabolism and plays a dichotomous role in the human body. On one hand, it exerts antioxidant and neuroprotective effects; on the other hand, chronic hyperuricemia has been strongly associated with diseases beyond gout, affecting the cardiovascular, renal, metabolic, autoimmune, and central nervous systems (CNS). Excess uric acid promotes oxidative stress, endothelial damage, neurodegeneration, inflammasome activation, and impairs energy metabolism. It exacerbates autoimmune diseases, such as Systemic Lupus Erythematosus (SLE) and antiphospholipid syndrome (APS), by increasing inflammatory and oxidative damage, leading to greater end-organ damage. The British Society for Rheumatology, European League Against Rheumatism, American College of Rheumatology, and National Institute for Health and Care Excellence (NICE) have all established a "treat-to-target" approach for hyperuricemia with serum urate levels below 6 mg/dL and below 5 mg/dL in severe cases. Allopurinol and Febuxostat, xanthine oxidase inhibitors, are used as first-line pharmacological therapies for the treatment of hyperuricemia, whereas uricosurics and Interleukin-1 (IL-1) inhibitors are preferred in cases of refractory hyperuricemia. Lifestyle modifications, such as the Dietary Approaches to Stop Hypertension (DASH) diet, weight reduction, and smoking cessation, are also recommended for the long-term management of the disease. Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors, selective urate transport inhibitors, and plant-derived anti-inflammatory compounds have emerged as new treatments with promising responses. This review synthesizes the current literature on the multifaceted role of uric acid and emphasizes its systemic implications in chronic diseases. It also outlines the already established management options and new innovative therapies for managing this disease. Understanding this dichotomous role is essential for adopting a precise management approach that balances the protective and pathological effects of uric acid.

This study aimed to develop consensual definitions and semiquantitative scoring for structural damage on ultrasound and to test the reliability of individual components of a global Outcome Measures in Rheumatology ultrasound joint damage score (GLODS) in rheumatoid arthritis (RA). A Delphi survey including statements on normal ultrasound appearance of joint features, scanning technique, new definitions, and scoring systems for 3 components of structural damage (bone erosions, cartilage change, and joint malalignment) was circulated among task force members. After agreement (&#x2265;75% of grades 4-5 on a 1-5 Likert scale) was achieved on the statements, datasets of ultrasound images representing various grades of the above-mentioned structural damage components were created and used in 2 web-based exercises. Finally, the metacarpophalangeal joints 1 to 5 of 7 patients with RA were scanned with ultrasound, twice on the same day by 7 task force members for detecting and scoring the 3 components using the consensus-based semiquantitative GLODS. Intraobserver and interobserver reliability of the new scoring system was measured by weighted kappa. Agreement on a total of 9 statements was reached in 4 Delphi rounds. Intraobserver and interobserver reliability for the individual components ranged from good to excellent in both the web-based (0.72-0.97) and the live exercises (0.68-0.89). Intraobserver and interobserver reliability of the total GLODS was shown to be excellent (0.92) and good (0.69), respectively. Ultrasound is a reliable tool for evaluating bone erosions, cartilage change, and joint malalignment in the hand joints of patients with RA. These features can be reliably integrated into a global ultrasound score.

Accurate detection and characterizstion of wrist fractures are essential for optimal management of wrist trauma. This study aimed to evaluate the diagnostic performance of a computed tomography (CT)-like 3D-multiecho fast field echo (mFFE) magnetic resonance imaging (MRI) sequence for the detection and morphological characterisation of traumatic wrist fractures compared with cone-beam computed tomography (CBCT). This retrospective study included 66 patients with recent wrist trauma and suspected fracture between October 2022 and September 2023. Two musculoskeletal radiologists (R1 and R2) independently reviewed CBCT and 3D-mFFE CT-like MRI images. The diagnostic performance of the 3D-mFFE sequence for detecting and characterising traumatic bone injuries was assessed using a consensus interpretation by a third radiologist (R3) as the reference standard. Sixty-three traumatic bone injuries were identified in 38 of the 66 patients (58%). For injury detection with the 3D-mFFE sequence, sensitivity, specificity, and accuracy were 0.62, 0.99, and 0.96 for R1 and 0.60, 1.00, and 0.96 for R2. For CBCT, sensitivity, specificity, and accuracy were 0.68, 1.00, and 0.97 for R1 and 0.70, 1.00, and 0.97 for R2. Agreement between the 3D-mFFE sequence and the reference standard for fracture characterisation was strong to near perfect for both comminution (&#x3ba; = 0.69-0.87) and displacement (&#x3ba; = 0.63-0.92). The CT-like 3D-mFFE MRI sequence demonstrated diagnostic performance comparable to CBCT for the morphological assessment of wrist fractures. When incorporated into a standard MRI protocol, this sequence may allow both detection and characterisation of traumatic bone injuries within a single, radiation-free examination.

Distal transradial access (dTRA) is an alternative to proximal transradial access (pTRA) for neuroangiography, but comparative real-world data and evidence on its early learning curve remain limited. We compared procedural performance and access-site complications between dTRA and pTRA and evaluated the early learning curve of dTRA. We retrospectively analyzed 470 diagnostic cerebral angiography procedures, representing 421 unique patients, performed via radial access at a single center between January 2025 and February 2026, including 237 dTRA and 233 pTRA procedures. Baseline characteristics, including age, sex, body mass index (BMI) category, aortic arch type, and antiplatelet/anticoagulant use, procedural performance, and clinically assessed access-site events were compared between groups. Radial artery occlusion (RAO) was assessed by postoperative bedside pulse examination and confirmed with Doppler ultrasound when clinical findings were uncertain. Multivariable logistic regression was used to evaluate predictors of RAO, persistent bleeding or repeated compression, hand edema, and a composite access-site event endpoint. Because repeated procedures occurred in a subset of patients and event counts were limited, first-procedure sensitivity analysis and analyses of infrequent outcomes were interpreted cautiously. The dTRA learning process was assessed in the first 100 dTRA cases performed by a single operator using multivariable regression, cumulative sum (CUSUM) analysis, segmented trend analysis, and phase-based comparisons. Baseline characteristics were comparable between groups, including age, male sex, BMI category, aortic arch type, and antiplatelet/anticoagulant use. Compared with pTRA, dTRA was associated with more puncture attempts (3.0 [2.0-4.0] vs 2.0 [1.0-3.0], P&#xa0;<&#xa0;0.001), longer puncture time (2.0 [1.0-5.0] vs 2.0 [1.0-3.0] min, P&#xa0;=&#xa0;0.003), lower first-pass success (19.4% vs 35.2%, P&#xa0;<&#xa0;0.001), and a higher crossover rate (11.4% vs 6.0%, P&#xa0;=&#xa0;0.037). However, dTRA was associated with a lower clinically assessed RAO rate (2.5% vs 7.7%, P&#xa0;=&#xa0;0.011). On multivariable analysis, pTRA was independently associated with higher odds of RAO (OR 3.27, 95% CI 1.26-8.49, P&#xa0;=&#xa0;0.015) and the composite access-site event endpoint (OR 3.12, 95% CI 1.55-6.28, P&#xa0;=&#xa0;0.001). Similar findings were observed in a sensitivity analysis restricted to the first procedure per patient. In the first 100 dTRA cases, cumulative dTRA experience was independently associated with shorter total procedure time (beta&#xa0;=&#xa0;-0.074&#xa0;min/case, P&#xa0;=&#xa0;0.009), while CUSUM and moving-average analyses suggested that the major learning effect occurred within approximately the first 10-15 cases. In this retrospective single-operator cohort, dTRA was associated with lower clinically assessed RAO than pTRA despite greater access difficulty. The early learning effect was mainly reflected in shorter total procedure time. These findings support the feasibility of dTRA but should be interpreted cautiously given the study's observational design and limited anatomical data.

Chronic subdural hematoma (cSDH) is predicted to become the most common neurosurgical pathology by 2030. Surgical evacuation is a critical component of cSDH management, and postoperative monitoring is important given high recurrence rates and concerns related to restarting anticoagulation. Given issues related to cost, radiation exposure, and time for computerized tomography (CT) and magnetic resonance imaging examinations, we developed a novel technique to detect, assess, and quantify residual and/or recurrent subdural hematoma with point-of-care, hand-held ultrasound and sonolucent burr-hole covers placed during the initial surgery. We prospectively collected and retrospectively analyzed clinical and radiographical data for cSDH patients treated with burr-hole evacuation and implanted sonolucent burr-hole covers. Postoperative outpatient follow-up included direct comparison of point-of-care ultrasound (US) and head CT as the gold standard. Implant-to-cortical distance and absolute hematoma thickness were measured using ImageJ and Unity PACS on follow-up scans. Nine patients underwent burr-hole evacuation of cSDH with placement of a sonolucent cover. Hematoma thickness and cover-to-septum pellucidum distance did not differ between the two techniques. Both US and CT detected recurrent subdural hematoma in one of the nine patients. US and CT showed resolution of cSDH for the remaining seven subjects at follow-up, demonstrating 100% concordance between the US and CT methods. No immediate or short-term complications and infections related to the use of the sonolucent cover were noted in this cohort. Ultrasound-based assessment using a sonolucent burr-hole cover showed good concordance with CT for detecting and ruling out recurrent cSDH in a small cohort of patients. Point-of-care US could become a supplemental imaging modality for postoperative evaluation of cSDH.