Focus on assessing the likelihood of harms, including the risk of committing criminal offences, has tended to be on negative events or characteristics, but promotive factors-positive events/characteristics-and protective factors-developmental features that may facilitate management of the negative-may be just as important. Stages of moral and cognitive agency development are among the latter. To determine whether moral and/or cognitive agency helps prevent offending in adulthood among adolescents at risk of becoming offenders after parental maltreatment. The hypothesis was that adolescents at such risk who had stronger moral judgement and cognitive control skills would be less likely to become adult offenders than those with lower moral and cognitive skills. Data were from the longitudinal, prospective, USA-based Future of Families and Child Wellbeing Study. Data used here were from 2669 participants (1267 males and 1402 females) assessed when 14-19 years old and when 21-26 years old. In the earlier data collection wave, information included one parent's account of parental maltreatment during the previous year and measures of the adolescent's moral judgement and cognitive control skills. Data for the second wave included the young person's reports of any criminal charge between the ages of 18 and 22. A statistically significant association between parental maltreatment and a later criminal charge was confirmed, even after controlling for fixed variables, including sex and ethnicity. Regression analysis revealed that moral agency moderated the relationship between parental maltreatment and subsequent charges, but cognitive agency did not. Moral agency as an adolescent reduced the likelihood of future adult offending in youth exposed to high parental maltreatment. Adverse experiences as an adolescent are linked to later offending, but not inevitably so. Recognition that adolescent moral agency is protective may help direct scarce resources into more effective prevention strategies.
Arts-based interventions create meaningful opportunities for emotional expression, strengthening personal competencies that can enhance prison social climate and support reintegration. This study examined the perceived feasibility and acceptability of RadioACTIVITY, a co-creative arts-based program combining radio theatre production with participatory practices (RadioLAB, RadioSTUDIO, RadioDIFFUSION), implemented across three 10-month editions in a Portuguese prison. Twenty-eight incarcerated individuals (53.6% female; 46.4% male) participated in focus groups. Thematic analysis indicated that feasibility was supported by sustained engagement facilitated through non-judgmental facilitation, collaborative processes, and dynamic sessions. Acceptability was reflected in positive evaluations of the program as meaningful and appropriate, alongside interest in its continuation. Participants also reported intrapersonal (e.g., self-regulation, language skills) and interpersonal (e.g., empathy) gains, as well as perceived social impacts, including reduced stigma. Findings highlight the potential of arts-based approaches to foster rehabilitation and more constructive prison environments. A Participant-Led Radio Program in Prison: What Worked and WhyCreative arts programs can help people in prison express their thoughts and emotions, build personal skills, and improve relationships with others. These benefits may also contribute to a more positive prison environment and support successful reintegration into society. This study explored how people in prison experienced RadioACTIVITY, an innovative arts-based program that uses radio theatre and collaborative creative activities. RadioACTIVITY was implemented over three editions (i.e., three groups of participants), each lasting 10 months, in a Portuguese prison. The program involved three main stages: experimenting with ideas and voices (RadioLAB), creating radio productions together (RadioSTUDIO), and sharing the final content with others (RadioDIFFUSION). A total of 28 incarcerated participants (men and women) took part in group discussions to share their views about the program. Overall, participants found the program easy to engage with and highly meaningful. They highlighted the importance of facilitators who showed respect, listened without judgment, and worked collaboratively with the group. The creative and varied structure of the sessions also helped maintain motivation and interest. Participants reported several personal benefits. On an individual level, they described improvements in emotional control, self-discipline, and language skills. On a social level, they noted better understanding of others, increased empathy, and more positive interactions. Beyond personal change, participants felt the program had a wider impact by helping to challenge negative stereotypes about people in prison and by creating content that could be shared with other prisons. These findings suggest that arts-based programs like RadioACTIVITY can play an important role in rehabilitation by fostering personal growth, improving relationships, and contributing to healthier and more constructive prison environments.
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) encounter a range of difficulties in daily life. Guided by previous studies and theories, this pilot study examined whether distinct subgroups of children with ADHD could be identified based on their appraisals of the causes of their symptoms and the strategies they use to manage them. A further aim was to investigate associations between appraisals, management strategies, and psychological stress. Based on theory, we expected that appraisals attributing symptoms to external or controllable factors would be associated with lower stress levels. Ninety-six children with ADHD, aged 9-16 years, completed questionnaires. The Children's Appraisals and Management of ADHD (CAM-ADHD) questionnaire-developed for this study-measured appraisals of symptom causes and management strategies. Psychological stress was assessed using the Stress in Children questionnaire. Analyses focused on identifying underlying factors and examining correlations. Three types of appraisals were identified: "ADHD is caused by biology/brain," "ADHD is caused by the environment," and "ADHD is part of personality." Two types of management strategies emerged: "Attempting to exert self-control" and "Asking for teachers' help." Children who attributed their symptoms to environmental causes reported lower stress. Medication use was associated with greater use of self-control strategies and reduced reliance on teachers' help. Children with ADHD differ in how they understand the causes of their symptoms and in the strategies they use to manage them. These differences are meaningfully related to psychological stress and medication use, underscoring the importance of considering children's own appraisals in assessment and intervention.
Investigating the genetic attributes of indigenous goat breeds is crucial for their conservation and breeding. The Matou goat, a valued native breed of Southern China, is characterized by high meat quality and reproductive efficiency, representing an important genetic resource for livestock production. Its genetic basis underlying productive traits remains unclear at the whole-genome level. Therefore, this study aimed to elucidate its genomic diversity and selection signatures with whole-genome sequencing (WGS), in order to provide a basis for its future conservation and breeding. Population structure analyses, including principal component analysis, phylogenetic tree construction, and admixture analysis, revealed that the 128 sampled individuals could be divided into two subgroups. One subgroup exhibited greater genetic diversity, as reflected by higher heterozygosity and lower inbreeding coefficients, along with a higher frequency of private alleles indicative of a more closed breeding history. The slower linkage disequilibrium decay observed in this subgroup suggests it has undergone stronger selection. By integrating Fst, XP‑CLR, and XP‑EHH analyses, we identified 215 genes within 306 candidate regions under selection. Several of these genes (ARHGAP31, CHURC1, ITGA11, and GFOD1) harbor variants that overlap with QTLs and are associated with production traits in livestock. These findings provide a basis for conservation and breeding of the Matou goat. The Matou goat is a valuable local breed in China, known for its good meat and high reproductive rate. However, its population and quality have been declining, and we lack a deep understanding of its genetic characteristics. To help protect and improve this breed, we studied the genetic makeup of 128 Matou goats by analyzing their entire genome. We found that the goats could be divided into two subgroups. One subgroup showed signs of crossbreeding and had higher genetic diversity. By comparing these subgroups, we identified key genetic regions that have been selected for traits important to farmers. Several genes we found are linked to body size, meat quality, and reproduction. Our findings provide a genetic guide for breeding better Matou goats, which can help farmers increase productivity and ensure the long-term survival of this important breed.
This study aims to systematically investigate the motivations behind orthognathic surgery in dentofacial deformity patients using Q methodology, thereby providing valuable insights for clinical decision-making in dentofacial deformity treatment. Additionally, the research seeks to evaluate the efficacy of Q methodology in subjective opinion surveys within this specific medical context. This exploratory, cross-sectional Q-methodology study (without pre-specified hypotheses) was conducted at the Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, China Medical University, Shenyang, China, from December 2020 to December 30, 2021. Q methodology was employed to interview patients with dentofacial deformities to explore their motivations for surgery. The Q methodology comprises five main steps: 1. Q Statement Collection: Initially, the subject was defined, followed by the collection of motivation-related statements through literature reviews and interviews with patients with dentofacial deformities and orthognathic surgeons. 2. Q sample construction: Two professors of orthognathic surgery discussed and identified a Q sample, then tested it by a pre-experiment. 3. P sample selection: The quantity of the P sample depends on the Q sample and follows the principles of Q methodology. 4. Q-Sort: The P sample ranked the statements on an 11-point distribution grid ranging from "most agree" to "most disagree". 5. Statistical analysis: Data processing and analysis were performed using the PQMethod2.35 program, and principal component analysis and factor analysis were carried out. Through factor analysis, three distinct motivational viewpoints were identified, accounting for 67.5% of the total variance: Type 1, appearance-driven (27.5%); Type 2, occlusal function-dominant (17.5%); and Type 3, combined facial shape and occlusal function-driven (22.5%). Patients' explanations of their motivations for orthognathic surgery revealed that orthodontists' advice significantly influenced their decision to proceed with surgery. In this study, three distinct motivational profiles were identified among patients seeking orthognathic surgery: appearance-oriented, occlusal function-dominant, and a combined type. Awareness of these profiles may facilitate patient-centered communication and help align clinical discussions with patient expectations. Orthodontists' recommendations played an important role in patients' decision-making. These findings suggest that Q methodology represents a promising approach for investigating patient motivations in clinical settings.
Ex vivo normothermic perfusion (EVNP) allows for comprehensive functional assessment; however, current scoring systems are validated only for short perfusion durations. This study investigates the utility of the EVNP quality assessment score for a 6-h period to predict viability in discarded human kidneys. Twenty human kidneys from marginal donors, previously declined for transplantation, underwent 6-h EVNP. Functional parameters (renal blood flow, resistance index, urine output), perfusate biochemistry, tissue injury biomarkers, and histology were assessed. Kidneys were stratified by EVNP score: group A (1-2), group B (3), and group C (4-5). Group A demonstrated significantly higher renal blood flow (median 213.5 versus 145.1 [B] versus 81.7 mL/min [C], P < 0.0001), lower resistance index (0.32 versus 0.41 [B] versus 0.86 mL/min/mm Hg [C], P < 0.0001), greater urine output (241.1 versus 97.9 [B] versus 10.9 mL [C], P < 0.0001), and more favorable perfusate profiles (lactate: 14.2 versus 15.7 [B] versus 19.9 mg/dL [C], P = 0.02). Histological scores did not correlate with EVNP score groups at baseline or after perfusion. EVNP during 6 h showed trends consistent with functional graft performance, suggesting it may help inform decisions to reduce organ discard. The EVNP score may assist in identifying kidneys with potential for transplantation despite suboptimal histology, which could contribute to reducing the underutilization of marginal grafts.
The synthesis of 1-(3-methylphenyl)-2-(4-nitrophenyl)-4,5-diphenyl-1H-imidazole, C28H21N3O2, has been efficiently achieved in a one-pot procedure from simple materials. Its structure was analysed with the help of a full set of spectroscopic techniques, X-ray crystallographic studies and computational calculations, suggesting that the compound shows some potential for being used in nonlinear optical (NLO) devices. Despite being a sterically demanding tetrasubstituted imidazole, this compound can form a stable crystal structure based on the combination of a large set of weak interactions. With four aryl substituents, displaced and tilted edge-to-face and face-to-face aromatic-aromatic interactions are responsible of many of the short contacts identified, representing the major contribution as determined with the use of Hirshfeld surfaces. The nitro groups also play a key role, being responsible of the polarization of the molecule with the formation of antiparallel assemblies, leading to well-defined stacks. Antiparallel N...O pairs are also present at relatively short distances, together with short H...O contacts (16.9% contribution), indicating the presence of weak hydrogen bonds of the O atoms with weakly acidic H atoms in the polarized structure.
There are practical limitations to using comorbidities alone in predicting the need for admission to the intensive care unit (ICU). We compared the classification performance of a deep learning/artificial intelligence (DL/AI) model on chest X-ray radiography (CXR) for predicting admission of a patient to the ICU to using two common comorbidity indices, using data collected during the COVID-19 pandemic as a use case. CXR imaging studies and clinical data of patients who tested positive for COVID-19 between February 2020 and January 2022 were retrospectively collected, yielding 8357 CXR imaging studies from 5046 patients. Classification performance by a DL/AI model in the task of predicting ICU admission within 24 h of imaging was compared to (a) the Charlson comorbidity index (CCI) and (b) the age-adjusted version of the Charlson comorbidity index (ACCI) using the area under the receiver operating characteristic curve (AUC). The AUC from each comorbidity index was compared with the DL/AI model, with a Bonferroni-corrected significance level of P = 0.025 . The prediction of ICU admission using the DL/AI model (median AUC [95% CI]: 0.78, [0.74, 0.81]) demonstrated statistical superiority to using the CCI and ACCI comorbidity indices with improvements in AUC of 0.16 ( P < 0.001 ) and 0.12 ( P < 0.001 ), respectively. A DL/AI model on CXR for predicting ICU admission within 24 h of imaging obtained superior performance compared with two clinical comorbidity indices in a use case. This work serves as a use case to demonstrate the potential for some medical imaging deep learning models to help improve patient care and resource planning for ICU departments.
Return-to-sport decision-making is a central responsibility in sports physiotherapy, yet athletes may appear clinically recovered while remaining underprepared for the physical, psychological, and contextual demands of sport. This critical narrative review synthesizes key considerations relevant to return-to-sport decision-making and proposes a practical four-domain framework integrating functional performance, load tolerance, psychological readiness, and contextual sport demands. The framework describes an iterative process beginning with minimum clinical readiness, followed by development of a domain-based readiness profile, action-oriented interpretation, shared progression decision-making, and reassessment over time. It is intended to help clinicians identify readiness gaps, communicate progression decisions, and select graded progression strategies. Rather than serving as a validated prediction model, the framework is presented as a clinical reasoning aid to support individualized and context-sensitive return-to-sport decisions. Future research should evaluate its feasibility, reliability, and clinical utility across different sports, injury types, competitive levels, and resource settings.
Cancer is a major stressor leading to a wide range of emotions. Emotions, also negative emotions, are essentially adaptive, in the sense that they help patients cope with cancer. Emotions can also be maladaptive, if they are disproportionately severe or persistent, or interfere with functioning. Our overall goal was to explore whether disturbance of life goals provides a fruitful framework for developing indicators that can distinguish between adaptive and maladaptive emotions. To test the hypotheses that (1) goal disturbance and emotional symptoms are reciprocally and positively associated to each other; and (2) the association between goal disturbance and emotional symptoms is stronger in patients with maladaptive emotions as compared to patients with adaptive emotions. Patients with (non)metastasized disease who recently started systemic treatment (n = 132) filled out Ecological Momentary Assessments 5 times per day for 14 consecutive days in which emotional symptoms and activities related to life goals were documented. The importance of life goals in six domains was assessed with an interview (work/study, disease-related health, lifestyle health, social activities, religious, spiritual and intellectual activities, and leisure). Patients were grouped as having adaptive or maladaptive emotions based on a reference standard (a psychiatric diagnostic assessment, or the subjective need for professional mental healthcare). Linear mixed models were built in R, with either goal disturbance or negative emotional symptoms as dependent variable. Goal disturbance for social activities and leisure activities was significantly associated with more emotional symptoms. Goal disturbance for disease-related health activities was significantly associated with less emotional symptoms. No significant association was found for other activities (with one exception). With negative emotions as outcome variable, goal disturbance was more strongly associated with more emotional symptoms in patients with maladaptive emotions than patients with adaptive emotions for social, leisure and lifestyle health activities. Further research is warranted to develop an indicator of maladaptive emotions in patients with cancer based on the extent of goal disturbance of social, leisure and lifestyle health activities.
Drug-induced acute pancreatitis (DIAP) is a rare cause of acute pancreatitis, accounting for approximately 3-5% of cases, and reports of chemotherapy-induced pancreatitis remain limited. Herein, we present the case of a 68-year-old man who developed DIAP during adjuvant chemotherapy with S-1 plus docetaxel and later with capecitabine plus oxaliplatin following surgery for gastric cancer. A drug-induced lymphocyte stimulation test (DLST) was conducted to identify the suspected agents, yielding positive results for S-1 and capecitabine, whereas docetaxel and oxaliplatin were negative. Unexpectedly, the DLST result for 5-fluorouracil was negative. Based on these findings, adjuvant chemotherapy was switched to 5-fluorouracil plus leucovorin, which was successfully continued without recurrence of pancreatitis. Shortly thereafter, the patient was diagnosed with recurrent gastric cancer. However, palliative chemotherapy with a 5-fluorouracil-based regimen was safely continued. Although DIAP can be fatal, the DLST may help identify the suspected causative drug and contribute to decision-making in important clinical situations such as cancer treatment.
Pestivirus infection in camels has been insufficiently studied, particularly in Saudi Arabia. In the current work, the seroprevalence of pestivirus infection in camels' sera (n = 180) in Rafha in northern Saudi Arabia was screened using Enzyme Linked Immuno-Sorbent Assay (ELISA). Data on age, sex and breed were analysed statistically. Pestivirus seroprevalence was 11.1. It was higher in adults (22.2%) than in young animals (10.5%), higher in females (33.3%) than in males (10.7%) and higher in the Mjahim breed (23.8%) compared to the Magater breed (9.4%). Chi-square analysis revealed a significant correlation between pestivirus infection and breed (p = 0.015), whereas no significant associations were noted with age (p = 0.123) or sex (p = 0.432). Wald statistics indicated that breed (p = 0.005) and sex (p = 0.048) were significant predictors of pestivirus infection.Contribution: To our knowledge, this is the first study to report the risk factors associated with pestivirus infection in camels in northern Saudi Arabia. The results can help explore epidemiological parameters and aid in control, while future research should include larger samples and molecular techniques to verify active infection.
Non-thyroidal illness syndrome (NTIS), historically termed euthyroid sick syndrome, is characterized by reduced serum triiodothyronine (T3), variable thyroxine (T4), and typically normal or suppressed thyroid-stimulating hormone (TSH) in the absence of intrinsic thyroid disease. Traditionally viewed as an adaptive response to acute illness that does not require intervention, NTIS is increasingly being recognized within broader contexts of metabolic adaptation, including aging, caloric restriction, and pharmacologically induced weight loss. This narrative review reexamines NTIS as a context-dependent metabolic reprogramming response that may represent an evolutionarily conserved survival and longevity mechanism. Evidence from critical care endocrinology, mitochondrial biology, aging research, caloric restriction studies, and emerging data on glucagon-like peptide-1 (GLP-1) receptor agonists is synthesized to explore the mechanistic and clinical implications of low T3 states. During acute physiologic stress, including infection, trauma, and starvation, reduced peripheral T4-to-T3 conversion and increased reverse T3 production appear to promote metabolic downshifting through decreased mitochondrial oxygen consumption, reduced anabolic signaling, and the redistribution of energy toward immune defense and cellular repair. These adaptations parallel pathways associated with enhanced metabolic efficiency and longevity. Similar thyroid hormone changes are increasingly observed in individuals undergoing significant weight loss, sustained caloric restriction, or GLP-1 receptor agonist therapy. While transient reductions in T3 may reflect adaptive energy conservation, persistent low T3 states in the setting of chronic inflammation, cardiometabolic disease, sarcopenia, or advanced aging may contribute to impaired mitochondrial function, reduced metabolic flexibility, and loss of physiologic resilience. NTIS may therefore represent a spectrum of adaptive and maladaptive responses influenced by physiologic context, duration, and inflammatory burden. A systems-based, longevity-oriented framework may improve the interpretation of low T3 states and help guide future research aimed at distinguishing beneficial metabolic adaptation from pathologic endocrine suppression.
Psychologists have long known that contact with and exposure to so-called outgroup members can help overcome separation, including those resulting from entrenched conflicts. Getting to know each other facilitates understanding and fosters tolerance, whether we think of national, religious, cultural, socio-economic or age divides. Thus, we here expand the concept of Environmental Peacebuilding to Environmental Bridgebuilding, because sharing knowledge and practices around nature conservation objectives offers opportunities to find common ground for individuals and groups. With Environmental Bridgebuilding, we are emphasising the connectivity effects of nature conservation planning and implementation. Due to our shared experiences, we take our work with the barn owl, Tyto alba, as an example to discuss Environmental Bridgebuilding. This choice does not limit Environmental Bridgebuilding to this species, on the contrary. Moreover, we discuss psychological factors in addition to between-subgroup and intergroup challenges that might impact the success of socially engaging nature conservation initiatives, as well as the need for the combined expertise from various professions, such as biologists, psychologists, farmers and economists. Ecology and science more generally can be an inspiring source to bring together people that life has divided.
Children growing up in low-resource settings are at greater risk for lifelong psychiatric problems. They are both more likely to have risk factors for early psychopathology and to be less likely to seek help and engage support for these problems. Resource-oriented therapeutic models-those that emphasise strengths of individuals and harness positive personal and social resources-may be particularly crucial in reducing the lifelong health inequalities that could arise amongst children growing up in socially deprived areas. We used network analysis to investigate the use of personal (different emotion regulation (ER) strategies) and social (social connectedness, religion, recreational activities) resources of children living in East London (N = 867, M age = 8.76 (0.95), 49% female) and their mental health outcomes using self- and teacher-reported questionnaires (data collected November 2022-2023). We found that family, peer, and school connectedness were the most central elements of the network, whilst negative ER strategies seemed to be a part of the cluster of anxiety and depression symptoms. Our findings highlight the importance of harnessing both internal strengths and positive social resources when thinking about intervention programmes for symptoms of emotional disorders in children growing up in deprived areas. Identifying strategies for nurturing social connectedness in children's closest environment is also crucial.
Anatomical variations in the arterial supply to the right colon are clinically relevant in patients undergoing laparoscopic and robotic colectomy, as misidentification of the vessels may lead to inadequate lymphadenectomy or bowel ischemia. A common trunk formed by the ileocolic artery (ICA) and middle colic artery (MCA), arising from the superior mesenteric artery (SMA), is an uncommon vascular configuration that may complicate surgical decision-making. A 73-year-old man presented with constipation and abdominal pain. Colonoscopy revealed a circumferential type 2 tumor in the ascending colon, causing luminal stenosis. Histopathological examination of a biopsy confirmed moderately differentiated adenocarcinoma. Using contrast-enhanced computed tomography, wall thickening without distant metastasis was detected. Three-dimensional computed tomography angiography revealed a rare vascular anomaly in which the ICA and MCA originated from a common trunk arising from the SMA, accompanied by the absence of the right colic artery. The patient underwent an elective robot-assisted right hemicolectomy using the da Vinci Si® system. The postoperative course was uneventful; the patient was discharged on postoperative day 8. The pathological diagnosis was pT3N0M0, stage IIa adenocarcinoma. No recurrence has been observed during the 3-year follow-up. Preoperative three-dimensional vascular imaging is useful for identifying uncommon vascular variants and translating findings into a safe intraoperative strategy. The robotic approach allows precise vascular handling in such cases. Awareness of such anatomical configurations may help prevent intraoperative misinterpretation and support meticulous preoperative planning, particularly in minimally invasive and robotic right colectomy.
Endoscopic bilioduodenal double stenting is sometimes necessary for patients with malignant bilioduodenal obstruction (MBDO). The patency of biliary stents is important for preventing cholangitis and continuing treatment. However, the factors that influence recurrent biliary obstruction (RBO) in patients with MBDO are not well known. This study aimed to identify the factors associated with RBO in patients who underwent endoscopic bilioduodenal double stenting. Patient characteristics, device use, and endoscopic treatment procedures were evaluated as possible risk factors for RBO. Overall, 55 patients with MBDO underwent endoscopic bilioduodenal double stenting (transpapillary drainage, n = 35; endoscopic ultrasound-guided biliary drainage, n = 20). Multivariate analysis using a Fine and Gray competing risk model revealed that biliary stenting on the oral side of the duodenal stricture (HR 2.98; 95% CI 1.16-7.68; p = 0.023) and chemotherapy (HR 3.74; 95% CI 1.25-11.22; p = 0.018) were significantly associated with RBO. Biliary stenting on the oral side of the duodenal stricture was associated with RBO during duodenal stenting in patients with MBDO. Although chemotherapy was also associated with RBO in the multivariable competing risk analysis, this finding should be interpreted cautiously. Careful treatment selection, including consideration of gastrojejunostomy in patients with oral-side biliary stenting, may help reduce the incidence of RBO.
Survivorship considerations have gained increasing importance in patients with early breast cancer. Every surgical procedure poses a risk of complications and a potential negative impact on patient-reported outcomes (PROs), thereby driving growing interest in de-escalation strategies in breast cancer surgery. In this context, we aimed to assess complication rates, the potential role of physiatric rehabilitation in managing these complications, and the impact of axillary surgery on PROs. This retrospective single-center cohort study included breast cancer patients who underwent surgery between January 2022 and March 2023 at the Breast Unit of Policlinico Umberto I, Rome. Among 164 patients operated on during the study period, 71 who underwent axillary surgery and received postoperative physiatric evaluation according to the institutional care pathway (PDTA) were included. The Disability of the Arm, Shoulder and Hand (DASH) questionnaire was administered to evaluate PROs. Among the included patients (n = 71), SLNB was performed in 71.83% and ALND in 21.13%. A total of 34/71 patients (47.89%) developed complications requiring rehabilitative treatment and were classified as cases, while the remaining patients constituted the control group. Overall, shoulder painful mobility limitation (56.34%) (SPML), motor deficit (54.93%) (MD), and sensory deficit (46.48%) (SD) were the most frequent complications, whereas lymphedema (LE) and scapular winging (SW) occurred in 4.23% each. More extensive axillary procedures were associated with a higher number of lymph nodes removed (p < 0.0001). Cases had significantly more lymph nodes removed than controls (p = 0.0003). Patients requiring rehabilitation were younger on average than controls. Recovery time differed significantly between cases and controls (p < 0.0001), with most patients recovering within 3 months from the first physiatric visit. DASH scores were significantly worse in patients requiring rehabilitative treatment than in controls (p < 0.0001). The mean DASH score was 14%. Higher DASH values were associated with postoperative complications requiring rehabilitation and delayed or absent recovery, particularly SPML, DM, DS, and SW. Functional impairment of the upper limb remained frequent and may affect patients' daily activities. These findings support the importance of integrating surgical management with early physiatric evaluation and rehabilitation to optimize functional recovery. Systematic assessment using patient-reported outcome measures (PROMs), such as the DASH questionnaire, may help identify disability early and support patient follow-up.
Ovarian cysts in prepubertal girls are uncommon and often raise concerns about torsion or malignancy. Severe primary hypothyroidism can cause ovarian enlargement and cyst formation as part of Van Wyk-Grumbach syndrome. A 7-year-old prepubertal girl presented with acute lower abdominal pain. Imaging revealed a large, mildly complex left ovarian cyst, a smaller contralateral cyst, preserved vascularity, and no torsion. Laboratory evaluation showed profound primary hypothyroidism, elevated prolactin and estradiol levels, and delayed bone age. Due to the symptoms, cyst size, and mildly complex imaging findings, laparoscopic cyst excision was performed, confirming a benign cyst without torsion or malignancy. Following thyroid replacement therapy, endocrine parameters normalized, and the contralateral cyst regressed. Although many ovarian cysts related to Van Wyk-Grumbach syndrome regress with levothyroxine alone, this case highlights the management dilemma when the presentation is acute and imaging raises concerns about complications. Hypothyroidism should be included in the differential diagnosis of ovarian cysts in prepubertal girls. Routine thyroid function testing may guide early diagnosis, enable conservative management when appropriate, and help avoid unnecessary surgery.
Luminescent metal-organic frameworks (LMOFs), a subclass of MOFs integrating metal clusters with organic linkers, exhibit intrinsic photoluminescence alongside high porosity and structural tunability. Compared to conventional MOFs, LMOFs offer superior photo stability, rapid response, and strong host-guest interactions, making them ideal for sensing applications. Functionalization with amide groups via pre- or post-synthetic modification introduces specific binding sites that enhance selectivity toward a diverse range of analytes, including metal ions, anions, biomolecules, explosives, gases, and small solvent molecules. This review summarizes recent advances in the synthesis and sensing performance of amide-functionalized LMOFs. Amide-functionalized LMOFs offer enhanced sensitivity and selectivity for chemical sensing.Pre- and post-synthetic strategies enable precise amide integration within MOF architectures.Sensors exhibit excellent photostability, framework robustness, and rapid response behavior.Effective for detecting metal ions, anions, explosives, VOCs, and biological targets.Prospective ideas for the future that could help advance the field of amide-decorated MOF are explored.