Comparative Efficacy of Flow Diverter Devices in the Treatment of Carotid Sidewall Intracranial Aneurysms: a Retrospective, Multicenter Study.

BACKGROUND: The comparative efficacy and safety of first-generation flow diverters (FDs), Pipeline Embolization Device (PED) (Medtronic, Irvine, California), Silk (Balt Extrusion, Montmorency, France), Flow Re-direction Endoluminal Device (FRED) (Microvention, Tustin, California), and Surpass Streamline (Stryker Neurovascular, Fremont, California), is not directly established and largely inferred. PURPOSE: This study aimed to compare the efficacy of different FDs in treating sidewall ICA intracranial aneurysms. METHODS: We conducted a retrospective review of prospectively maintained databases from eighteen academic institutions from 2009-2016, comprising 444 patients treated with one of four devices for sidewall ICA aneurysms. Data on demographics, aneurysm characteristics, treatment outcomes, and complications were analyzed. Angiographic and clinical outcomes were assessed using various imaging modalities and modified Rankin Scale (mRS). Propensity score weighting was employed to balance confounding variables. The data analysis used Kaplan-Meier curves, logistic regression, and Cox proportional-hazards regression. RESULTS: While there were no significant differences in retreatment rates, functional outcomes (mRS 0-1), and thromboembolic complications between the four devices, the probability of achieving adequate occlusion at the last follow-up was highest in Surpass device (HR: 4.59; CI: 2.75-7.66, p < 0.001), followed by FRED (HR: 2.23; CI: 1.44-3.46, p < 0.001), PED (HR: 1.72; CI: 1.10-2.70, p = 0.018), and Silk (HR: 1.0 ref. standard). The only hemorrhagic complications were with Surpass (1%). CONCLUSION: All the first-generation devices achieved good clinical outcomes and retreatment rates in treating ICA sidewall aneurysms. Prospective studies are needed to explore the nuanced differences between these devices in the long term.

The associations of pre-pregnancy BMI and gestational weight gain with maternal gut microbiota.

Previous studies reporting the association between gut microbiota dysbiosis and maternal obesity were mostly confined at the phylum level or at postpartum period. This study aimed to investigate the dynamic changes in gut microbial communities associated with maternal obesity at different time points of pregnancy. We performed 16S rRNA gene V3-V4 amplicon sequencing on stool samples from 110 women in all three trimesters and 1-month postpartum. Maternal gut microbial communities associated with maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) were explored. The influence of maternal obesity on gut microbiota trajectories was determined based on longitudinal shifts in community clusters across the trimesters. The richness index of alpha diversity decreased with the progression of pregnancy, particularly in women with excessive GWG. The evenness index in 2nd trimester was found inversely associated with GWG. Various taxonomic differences in 1st trimester were associated with excessive GWG, whereas limited taxonomic differences in 2nd and 3rd trimesters were associated with pre-pregnancy BMI or GWG. Meanwhile, the gut microbiota trajectory with especially depleted genus Faecalibacterium in 1st trimester was associated with excessive GWG (adjusted odds ratio 5.7, 95% confidence interval 1.2-28.1). Moreover, the longitudinal abundances of genus Lachnospiraceae ND3007 group across gestations were depleted in women with overweight/obese pre-pregnancy BMI, while genus Bifidobacterium enriched in women with excessive GWG. Our study shows that dysbiosis of the gut microbiota in early pregnancy may have a significant impact on excess GWG. The abundance of the genus Faecalibacterium in 1st trimester may be a potential risk factor. Clinical trial number: NCT03785093 (https://classic.clinicaltrials.gov/ct2/show/NCT03785093).

A three-component hydrogen bonded framework.

A porous three-component hydrogen bonded framework, 1⋅biphen⋅TP, was prepared from a tetra-amidinium component (14+) and two different dianions, benzene-1,4-dicarboxylate (terephthalate, TP2-) and biphenyl-4,4'-dicarboxylate (biphen2-). Interestingly, when the framework was prepared in ethanol/water, 1⋅biphen⋅TP forms even when an excess of either dicarboxylate is present. However, when only water is used as solvent, only two-component frameworks are formed.

Scanning electron microscopic analysis of 5% glycolic acid as a novel alternative to 17% ethylenediaminetetraacetic acid in root biomodification: An in vitro study.

Background: Nonsurgical periodontal therapy results in the formation of a smear layer which inhibits tissue regeneration. Root biomodification (RB) using various agents has been tried for the enhancement of new attachment formation. However, no substantial therapeutic advantages of currently available root conditioning agents have been reported emphasizing the need for additional biologically acceptable agents. Glycolic acid (GA) due to its antimicrobial nature and ability of initiation and proliferation of fibroblasts may potentially modify root surface enabling regeneration. Materials and Methods: Eighty specimens from 40 single-rooted teeth were treated with 17% ethylenediaminetetraacetic acid (EDTA) and 5% GA and scanning electron microscopy analysis was done. The micrographs were examined for the evaluation of smear layer removal, total number of dentinal tubules, total number of patent dentinal tubules, mean diameter and surface area of dentinal tubules, and dentin erosion. Statistical analysis was done using unpaired t-test for intergroup comparison. Results: The efficacy of smear layer removal (P = 0.01) and dentin erosion (P = 0.042) was significantly better in the GA group. Both the groups showed no difference in dentinal tubule-related parameters. Conclusion: GA showed improved RB with greater smear layer removal and lesser dentin erosion, indicating its use as a potent alternative to the conventional EDTA root conditioning.

Trametinib restores the central conducting lymphatic flow in a premature infant with Noonan syndrome.

We describe a premature hydropic infant with Noonan syndrome and a therapy refractory chylothorax. This was shown to be due to a central conducting lymphatic anomaly. After therapy with a MEK-inhibitor the infant recovered clinically and radiologically completely, possibly by restoring lymphatic valve function.

Artificial intelligence in colorectal multidisciplinary team meetings. What are the medicolegal implications?

AIM: To give an insight into areas for future development and suggestions in the complexities of incorporation of AI into human colorectal cancer (CRC) care while bringing into focus the importance of clinicians' roles in patient care. METHODS: Existing literature around AI use in CRC care is reviewed and potential regulatory issues and medicolegal implications around its implementation in CRC multidisciplinary team meetings (MDTs) are identified. RESULTS: Challenges with patient privacy and confidentiality, patient consent, inequity and bias, patient autonomy, as well as AI system transparency and the liability and accountability issues arising from complications that arise from AI-aided clinical decisions are important focusses associated with the use of AI in CRC MDTs. CONCLUSION: Consideration of various medicolegal aspects of the use of AI in CRC MDTs is warranted to ensure its safe and smooth incorporation into CRC MDTs. AI function as a clinical decision support system and does not replace professional expertise.

The impact of health on labour outcomes among middle-aged and elderly: Insights from India.

The impact of ill-health on labour force participation is a well-recognized concern in both developed and developing countries. However, previous studies have often overlooked age differentials in this relationship, assuming uniform effects across age groups. This study aims to fill this gap by examining how ill-health affects labour outcomes among different age segments in India. Utilizing data from the Longitudinal Ageing Study in India (LASI) Wave 1, which covers over 72,000 individuals aged 45 and above, this research investigates the linkage between health and labour force outcomes. The labour outcomes in this study includes labour force participation, labour earnings and hours worked. Present study used instrumental variable approach to mitigate endogeneity issues and establish causal relationships between health and labour outcomes. The Heckman selection model is utilized to address selection bias in analysing wage and hours worked. The study reveals several key findings. Firstly, ill-health consistently leads to a decline in labour force participation among both middle-aged (28 percent) and elderly (36 percent) individuals in India. This underscores the pervasive impact of health on workforce engagement, particularly in a context with limited social security measures. Secondly, the research identifies significant variations in the effects of ill-health on wages and hours worked based on age. Among elderly individuals, there is a pronounced reduction in both wages and hours worked due to ill-health. However, this effect is less pronounced among middle-aged adults. Furthermore, socioeconomic factors play a pivotal role in shaping how ill-health influences labour outcomes among different age groups. This study underscores the importance of considering age differentials in the impact of ill-health on labour outcomes, offering valuable insights for policymakers, practitioners, and researchers seeking to address this critical issue in India's dynamic socio-economic landscape.

Assessment of smoking care by stroke specialists in patients with recent TIA and minor stroke: an international prospective registry-based cohort study.

OBJECTIVES: The objectives are to assess smoking abstinence and its effects on vascular risk and to report tobacco-cessation counselling and pharmacotherapy use in patients who had a recent minor stroke or transient ischaemic attack (TIA). DESIGN AND SETTING: The TIA registry.org project is a prospective, observational registry of patients with TIA and minor stroke that occurred in the previous 7 days with a 5-year follow-up, involving 61 sites with stroke specialists in 21 countries (Europe, Asia, Latin America and Middle East). Of those, 42 sites had 5-year follow-up data on more than 50% of their patients and were included in the present study. PARTICIPANTS: From June 2009 through December 2011, 3847 patients were eligible for the study (80% of the initial cohort). OUTCOMES: Tobacco counselling and smoking-cessation pharmacotherapy use in smoking patients were reported at discharge. Association between 3-month smoking status and risk of a major cardiovascular event (MACE) was analysed with multivariable Cox regression model. RESULTS: Among 3801 patients included, 835 (22%) were smokers. At discharge, only 35.2% have been advised to quit and 12.5% had smoking-cessation pharmacotherapy prescription. At 3 months, 383/835 (46.9%) baseline smokers were continuers. Living alone and alcohol abuse were associated with persistent smoking; high level of education, aphasia and dyslipidaemia with quitting. The adjusted HRs for MACE at 5 years were 1.13 (95% CI 0.90 to 1.43) in former smokers, 1.31 (95% CI 0.93 to 1.84) in quitters and 1.31 (95% CI 0.94 to 1.83) in continuers. Using time-varying analysis, current smoking at the time of MACE non-significantly increased the risk of MACE (HR 1.31 (95% CI 0.97 to 1.78); p=0.080). CONCLUSION: In the TIAregistry.org, smoking-cessation intervention was used in a minority of patients. Surprisingly, in this population in which, at 5 years, other vascular risk factors were well controlled and antithrombotic treatment maintained, smoking cessation non-significantly decreased the risk of MACE.

Non-adiabatic electronic relaxation of tetracene from its brightest singlet excited state.

The ultrafast relaxation dynamics of tetracene following UV excitation to the bright singlet state S6 has been studied with time-resolved photoelectron spectroscopy. With the help of high-level ab initio multireference perturbation theory calculations, we assign photoelectron signals to intermediate dark electronic states S3, S4, and S5 as well as to a low-lying electronic state S2. The energetic structure of these dark states has not been determined experimentally previously. The time-dependent photoelectron yields assigned to the states S6, S5, and S4 have been analyzed and reveal the depopulation of S6 within 60 fs, while S5 and S4 are populated with delays of about 50 and 80 fs. The dynamics of the lower-lying states S3 and S2 seem to agree with a delayed population coinciding with the depopulation of the higher-lying states S4-S6 but could not be elucidated in full detail due to the low signal levels of the corresponding two-photon ionization probe processes.

Glaucoma Rehabilitation using ElectricAI Transcranial Stimulation (GREAT)-study protocol for randomized controlled trial using combined perceptual learning and transcranial electrical stimulation for vision enhancement.

BACKGROUND: Glaucoma patients with irreversible visual field loss often experience decreased quality of life, impaired mobility, and mental health challenges. Perceptual learning (PL) and transcranial electrical stimulation (tES) have emerged as promising interventions for vision rehabilitation, showing potential in restoring residual visual functions. The Glaucoma Rehabilitation using ElectricAI Transcranial stimulation (GREAT) project aims to investigate whether combining PL and tES is more effective than using either method alone in maximizing the visual function of glaucoma patients. Additionally, the study will assess the impact of these interventions on brain neural activity, blood biomarkers, mobility, mental health, quality of life, and fear of falling. METHODS: The study employs a three-arm, double-blind, randomized, superiority-controlled design. Participants are randomly allocated in a 1:1:1 ratio to one of three groups receiving: (1) real PL and real tES, (2) real PL and sham tES, and (3) placebo PL and sham tES. Each participant undergoes 10 sessions per block (~ 1 h each), with a total of three blocks. Assessments are conducted at six time points: baseline, interim 1, interim 2, post-intervention, 1-month post-intervention, and 2-month post-intervention. The primary outcome is the mean deviation of the 24-2 visual field measured by the Humphrey visual field analyzer. Secondary outcomes include detection rate in the suprathreshold visual field, balance and gait functions, and electrophysiological and biological responses. This study also investigates changes in neurotransmitter metabolism, biomarkers, self-perceived quality of life, and psychological status before and after the intervention. DISCUSSION: The GREAT project is the first study to assess the effectiveness of PL and tES in the rehabilitation of glaucoma. Our findings will offer comprehensive assessments of the impact of these treatments on a wide range of brain and vision-related metrics including visual field, neural activity, biomarkers, mobility, mental health, fear of falling, and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT05874258 . Registered on May 15, 2023.

Investigating a role for PUB17 and PUB16 in the self-incompatibility signaling pathway in transgenic Arabidopsis thaliana.

In Brassicaceae self-incompatibility (SI), self-pollen rejection is initiated by the S-haplotype specific interactions between the pollen S cysteine-rich/S-locus protein 11 (SCR/SP11) ligands and the stigma S receptor kinases (SRK). In Brassica SI, a member of the Plant U-Box (PUB) E3 ubiquitin ligases, ARM-repeat containing 1 (ARC1), is then activated by SRK in this stigma and cellular events downstream of this cause SI pollen rejection by inhibiting pollen hydration and pollen tube growth. During the transition to selfing, Arabidopsis thaliana lost the SI components, SCR, SRK, and ARC1. However, this trait can be reintroduced into A. thaliana by adding back functional copies of these genes from closely related SI species. Both SCR and SRK are required for this, though the degree of SI pollen rejection varies between A. thaliana accessions, and ARC1 is not always needed to produce a strong SI response. For the A. thaliana C24 accession, only transforming with Arabidopsis lyrata SCR and SRK confers a strong SI trait (SI-C24), and so here, we investigated if ARC1-related PUBs were involved in the SI pathway in the transgenic A. thaliana SI-C24 line. Two close ARC1 homologs, PUB17 and PUB16, were selected, and (Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) technology was used to generate pub17 and pub16 mutations in the C24 accession. These mutants were then crossed into the transgenic A. thaliana SI-C24 line and their potential impact on SI pollen rejection was investigated. Overall, we did not observe any significant differences in SI responses to implicate PUB17 and PUB16 functioning in the transgenic A. thaliana SI-C24 stigma to reject SI pollen.

Protein stability prediction by fine-tuning a protein language model on a mega-scale dataset.

Protein stability plays a crucial role in a variety of applications, such as food processing, therapeutics, and the identification of pathogenic mutations. Engineering campaigns commonly seek to improve protein stability, and there is a strong interest in streamlining these processes to enable rapid optimization of highly stabilized proteins with fewer iterations. In this work, we explore utilizing a mega-scale dataset to develop a protein language model optimized for stability prediction. ESMtherm is trained on the folding stability of 528k natural and de novo sequences derived from 461 protein domains and can accommodate deletions, insertions, and multiple-point mutations. We show that a protein language model can be fine-tuned to predict folding stability. ESMtherm performs reasonably on small protein domains and generalizes to sequences distal from the training set. Lastly, we discuss our model's limitations compared to other state-of-the-art methods in generalizing to larger protein scaffolds. Our results highlight the need for large-scale stability measurements on a diverse dataset that mirrors the distribution of sequence lengths commonly observed in nature.

Interhospital Transfer for Endovascular Stroke Treatment in Canada: Results From the OPTIMISE Registry.

BACKGROUND: Interhospital transfer for patients with stroke due to large vessel occlusion for endovascular thrombectomy (EVT) has been associated with treatment delays. METHODS: We analyzed data from Optimizing Patient Treatment in Major Ischemic Stroke With EVT, a quality improvement registry to support EVT implementation in Canada. We assessed for unadjusted differences in baseline characteristics, time metrics, and procedural outcomes between patients with large vessel occlusion transferred for EVT and those directly admitted to an EVT-capable center. RESULTS: Between January 1, 2018, and December 31, 2021, a total of 6803 patients received EVT at 20 participating centers (median age, 73 years; 50% women; and 50% treated with intravenous thrombolysis). Patients transferred for EVT (n=3376) had lower rates of M2 occlusion (22% versus 27%) and higher rates of basilar occlusion (9% versus 5%) compared with those patients presenting directly at an EVT-capable center (n=3373). Door-to-needle times were shorter in patients receiving intravenous thrombolysis before transfer compared with those presenting directly to an EVT center (32 versus 36 minutes). Patients transferred for EVT had shorter door-to-arterial access times (37 versus 87 minutes) but longer last seen normal-to-arterial access times (322 versus 181 minutes) compared with those presenting directly to an EVT-capable center. No differences in arterial access-to-reperfusion times, successful reperfusion rates (85% versus 86%), or adverse periprocedural events were found between the 2 groups. Patients transferred to EVT centers had a similar likelihood for good functional outcome (modified Rankin Scale score, 0-2; 41% versus 43%; risk ratio, 0.95 [95% CI, 0.88-1.01]; adjusted risk ratio, 0.98 [95% CI, 0.91-1.05]) and a higher risk for all-cause mortality at 90 days (29% versus 25%; risk ratio, 1.15 [95% CI, 1.05-1.27]; adjusted risk ratio, 1.14 [95% CI, 1.03-1.28]) compared with patients presenting directly to an EVT center. CONCLUSIONS: Patients transferred for EVT experience significant delays from the time they were last seen normal to the initiation of EVT.

Reversible Hydrophobic Deep Eutectic Solvent-Based Uranyl-Sensing Optode Film in Aqueous Streams: Color Transformation and Reusability.

A hydrophobic deep eutectic solvent (HDES)-based optode was designed for the preconcentration and determination of the UO22+ ion in aqueous media using spectroscopic techniques [energy-dispersive X-ray fluorescence (EDXRF) and solid-state absorption]. The optode was developed by incorporation of HDES (tri-n-octyl phosphine oxide and decanoic acid in an equimolar ratio), tri-(2-ethylhexyl) phosphate, and 2-(5-bromo-2-pyridylazo)-5-diethylaminophenol into a cellulose triacetate matrix. Characterization studies were carried out using different techniques to understand the roles of HDES as a plasticizer, UO22+ extractant, and Br-PADAP immobilizer. Uptake studies revealed that the optimal pH was 3 and sorption followed the type II adsorption isotherm. Uranium in the U-sorbed optode can be directly analyzed over a large concentration range of 0.021 × 10-3-2.1 × 10-3 Mol L-1 using EDXRF. The optode film exhibited a linear dynamic range of 0.84 × 10-6-84 × 10-6 Mol L-1 for uranium, with a lowest limit of detection of 0.084 × 10-6 Mol L-1 by colorimetric analysis. This optode-based method was employed for seawater analysis for its UO22+ concentration without any matrix separation, and the concentration was found to be 1.30 ± 0.06 × 10-8 Mol L-1. The optode exhibited better selectivity for UO22+ in the presence of various cations including Sr2+ and Cs+ in an aqueous medium. Compared to other prevailing optical sensors, this optode performed better in terms of key factors like pH, equilibration time, reusability, and detection limit.

Countering stereotypes: Exploring the characteristics of Aboriginal Australians who do not drink alcohol in a community representative sample.

INTRODUCTION: Contrary to stereotypes, Aboriginal and Torres Strait Islander Australians are more likely to abstain from drinking than other Australians. We explored characteristics and experiences of Aboriginal and Torres Strait Islander Australians who do not drink alcohol. METHOD: We conducted a cross-sectional, representative survey of 775 Aboriginal and Torres Strait Islander Australians (16+ years) in remote and urban South Australia. We explore correlates of not drinking alcohol using multi-level logistic regression. We describe reasons for non-drinking and harms participants experienced in past 12 months from others' drinking. RESULTS: Non-drinking participants were more likely to be older (OR 1.35 [95% CI 1.21, 1.50] per decade) and unemployed (OR 2.72 [95% CI 1.77, 4.20]). Participants who spoke Aboriginal Australian languages at home were three times more likely to be lifetime abstainers from drinking (OR 3.07 [95% CI 1.52, 6.21]). Common reasons for not drinking alcohol were health and family. Most did not report harms from others' alcohol consumption (79.6%, 76.9%, urban and remote respectively). Stress from others' alcohol consumption was the most reported harm by non-drinkers (14.5% and 23.1%, urban and remote, respectively). DISCUSSION AND CONCLUSIONS: Culture such as speaking Aboriginal Australian languages might have protective effects that promote abstaining but was rarely explicitly cited as a reason for not drinking. A greater understanding of local values held by people who do not drink alcohol could help inform health messaging and other interventions to reduce alcohol-related harms. Understanding local reasons for abstaining can help tailor health messaging to suit local contexts.

Wastewater Surveillance to Confirm Differences in Influenza A Infection between Michigan, USA, and Ontario, Canada, September 2022-March 2023.

Wastewater surveillance is an effective way to track the prevalence of infectious agents within a community and, potentially, the spread of pathogens between jurisdictions. We conducted a retrospective wastewater surveillance study of the 2022-23 influenza season in 2 communities, Detroit, Michigan, USA, and Windsor-Essex, Ontario, Canada, that form North America's largest cross-border conurbation. We observed a positive relationship between influenza-related hospitalizations and the influenza A virus (IAV) wastewater signal in Windsor-Essex (ρ = 0.785; p<0.001) and an association between influenza-related hospitalizations in Michigan and the IAV wastewater signal for Detroit (ρ = 0.769; p<0.001). Time-lagged cross correlation and qualitative examination of wastewater signal in the monitored sewersheds showed the peak of the IAV season in Detroit was delayed behind Windsor-Essex by 3 weeks. Wastewater surveillance for IAV reflects regional differences in infection dynamics which may be influenced by many factors, including the timing of vaccine administration between jurisdictions.

Prospective Study to Evaluate the Role of Dual Point Contrast-enhanced Magnetic Resonance Imaging in Differentiation of Brain Tumoral from Nontumoral Tissue: A Magnetic Resonance/PET Study.

Background and Purpose: Follow-up imaging of gliomas is crucial to look for residual or recurrence and to differentiate them from nontumoral tissue. Positron emission tomography (PET)-magnetic resonance imaging (MRI) is the problem-solving tool in such cases. We investigated the role of dual point contrast (DPC)-enhanced MRI to discriminate tumoral from the nontumoral tissue compared to PET-MRI taken as the gold standard. Materials and Methods: The institutional ethics committee approved the study, and consent was obtained from all the patients included in the study. We prospectively did immediate and 75-min delayed contrast MRI in glioma cases who came for follow-up as a part of PET-MRI study in our institute. Subtracted images were obtained using immediate and 75-min delayed contrast images. Color-coded subtracted images were compared with PET-MRI images. 75-min delayed contrast MRI and diffusion-weighted imaging (DWI) images with Gray Scale inversion were compared with PET attenuation-corrected images. Results: We included 23 PET MRI cases done with different radiotracers in our study. Overall, we found PET-DPC correlation in (20/20 ~ 100%) cases of enhancing tumors. In two cases (DOPA and fluorodeoxyglucose), since they were nonenhancing low-grade gliomas and the other one was melanoma with intrinsic T1 hyperintensity and the DPC technique could not be used. DWI-PET correlated in 17/19 (~89.4%) cases, and perfusion-weighted imaging (PWI)-PET dynamic susceptibility contrast (DSC)/ASL correlated in 14/18 (~77.7%) cases after cases with hemorrhage were excluded. Conclusion: DPC MRI showed a good correlation with PET MRI in discriminating tumoral from the nontumoral tissue. DPC MRI can act as a potential alternative to PET MRI in peripheral hospitals where PET is not available. However, the DPC technique is limited in low-grade nonenhancing gliomas.

A Rare Presentation of Extrahepatic Biliary Neuroendocrine Tumor Diagnosed using 68Ga-DOTA-TOC Imaging, But Undetectable on 68Ga-FAPI Imaging.

Neuroendocrine tumors (NETs) are commonly seen in the small intestine and rarely found within the bile ducts. This low incidence is due to a smaller number of Kulchitsky cells in the extrahepatic biliary tree, which predisposes to the disease. The diagnosis of biliary tree carcinoid preoperatively is very rare, with most cases in the literature being incidentally diagnosed during surgery or being identified on the histopathology report postoperatively. Here, we present an interesting case of an extrahepatic biliary NET which was diagnosed preoperatively.

Navigating the Web of Influence: A Bibliometric Analysis of Social Media Addiction.

Social media addiction is a behavioral dependency characterized by excessive and compulsive use of social media platforms, leading to negative impacts on various aspects of an individual's life. Bibliometric analysis is a research method used to quantitatively analyze academic literature, such as articles, books, and conference papers. It involves the application of statistical and mathematical tools to study the patterns and trends in scientific publications. This bibliometric study provides a comprehensive analysis of the literature on social media addiction, revealing patterns and dynamics within the field. Utilizing Web of Science for bibliographic data, the study employs advanced bibliometric tools like Biblioshiny and CiteSpace to map the scientific landscape. Annual scientific production, top contributing authors, key sources, trending topics, and thematic maps were identified using Biblioshiny. Additionally, network visualizations, such as co-citation networks of authors, time zone network visualizations of keyword co-occurrence, and timeline network visualizations of country collaborations, were created using CiteSpace. Our findings present an increasing trend in publications over the years, highlighting a growing recognition of social media addiction's significance. We detail the most relevant authors and sources, pinpointing key contributors and influential journals that shape the discourse. Trend topics analysis uncovers the prevalent themes, with "internet addiction" and "adolescents" at the forefront, reflecting the field's concentration on the younger population. The thematic map categorizes the research into motor themes (driving research areas), basic themes (fundamental and well-established areas), and niche themes (specialized and emerging topics), providing insight into the central and evolving topics. The study also delves into the co-occurrence of all keywords and the co-citation of authors, illustrating the interconnected nature of the research community. A timeline network visualization of country collaborations underscores the global scope of research efforts. Importantly, the study identifies critical research gaps such as underexplored demographics and emerging digital concerns and discusses practical implications, including the need for targeted intervention programs and informed policy-making. Collectively, this study charts the trajectory of social media addiction research and lays a foundation for future explorations to address identified lacunae.

[Surgical treatment of traumatic arteriovenous fistulas of extremities]. / Osobennosti khirurgicheskogo lecheniya travmaticheskikh arteriovenoznykh fistul konechnostei.

The number of victims with damage to the great vessels has increased in recent years due to escalation of armed conflicts. Vascular damages comprise 3% of traumatic injuries in peacetime, and their incidence increases to 15% during hostilities. False aneurysms and traumatic arteriovenous fistulas follow vascular injury in 48.9-68.7% of cases. We present open surgical treatment of traumatic arteriovenous fistulas. The issues of diagnosis, surgical tactics, algorithm of intervention and options for successful treatment are described.