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Clinical Evidence on Allogeneic Blood-Derived Eye Drops in Ocular Surface and Corneal Diseases
No full textPurposeTo systematically review clinical studies on allogeneic blood-derived eye drops in ocular surface and corneal diseases.MethodsA PRISMA-guided search of PubMed, Google Scholar, Scopus, Web of Science, and Embase (1985–September 2025) identified eligible clinical studies on allogeneic eye drops for ocular surface and corneal diseases. Two reviewers independently extracted data and assessed study quality using Joanna Briggs Institute tools.ResultsSixty studies (1733 participants; 2374 eyes) met inclusion criteria, with 1423 patients (1738 eyes) receiving allogeneic eye drops. The cohort included 929 females (53.6%), 562 males (32.4%), and 242 unspecified (14.0%), with a mean age of 42.3 ± 21.8 years.Indications were dry eye disease (30.0%), mixed ocular surface disorders (21.7%), ligneous conjunctivitis (20.0%), persistent epithelial defects, erosions, and ulcers (18.3%), neurotrophic keratopathy (5.0%), and chemical or toxin-related injuries (5.0%).Treatments comprised allogeneic serum (47.4%), umbilical cord serum (43.2%), cord blood platelet lysate (10.1%), platelet-poor plasma/fresh frozen plasma (6.0%), plasma rich in growth factors (2.1%), and platelet-rich plasma (0.5%).Across 1738 treated eyes, reported outcomes were generally consistent, with improvements observed in patient-reported symptoms, epithelial healing, visual outcomes, and adverse events reported in <2% of cases. In dry eye disease, the largest relative improvements were reported for symptom scores (28.3%) and epithelial healing (24.9%), with smaller gains in tear-based measures (14–17%). Mixed ocular surface disorders showed symptom relief (28.5%), epithelial healing (16.9%), and BCVA improvement (7.7%). Ligneous conjunctivitis achieved complete/near remission in 1.5%, persistent epithelial defects healed in 10.2% with 0.5% recurrence, neurotrophic keratopathy showed 2.1% resolution with improved sensitivity, and chemical burns achieved 2.0% complete closure with better clarity and vision. Overall, patient-reported symptoms and epithelial healing emerged as the most consistently responsive outcomes, while reported safety profiles remained favorable. While many studies demonstrated acceptable methodological quality within their respective designs, the overall evidence base was predominantly composed of observational and non-comparative studies, which limits overall certainty.ConclusionAllogeneic blood-derived eye drops are associated with meaningful clinical improvement across ocular surface diseases and demonstrate favorable short-to mid-term safety. Further controlled studies with standardized protocols, longer follow-up, and cost-effectiveness analyses are needed
Impact of varying degree of donor-recipient weight mismatch on survival outcomes in pediatric heart transplantation
No full textObjectives : Body weight is still the most common metric used for donor-recipient matching in Pediatric Heart Transplantation (PHTX) and its impact on long-term outcomes remains unclear from variable definition and conflicting evidence. In this study, the outcomes of varying weight mismatch on PHTX was analysed. Methods : The United Network for Organ Sharing (UNOS) database (1984-2025) was retrospectively analysed. Size mismatch as a percentage donor-recipient weight difference was categorized as Mild ( 30%), and stratified as undersizing or oversizing. Demographics, clinical characteristics, and post-transplant outcomes were compared. One-year and 15-year mortality were analysed using multivariable logistic and Cox regression, respectively. Results : Oversizing (80%, 9,175/11,583) was more common than undersizing (20%, 2,408/11,583). With increasing oversizing, the recipients were younger, had congenital heart disease (CHD) diagnosis, and elevated pulmonary vascular resistance but with shorter wait-list times. Oversizing had no impact on 30-day, 1-year, or 15-years survival. With increasing undersizing, recipient age was similar, had less restrictive cardiomyopathy diagnosis, and had female donor but with shorter wait-list times. Undersizing had inferior survival till 5-years but not at 15-years. However, on multivariable analysis, undersizing was not predictive of inferior survival anytime as was congenital heart disease diagnosis, Extracorporeal Membrane Oxygenation (ECMO) bridge, elevated pulmonary-vascular resistance, transplantation era, and post-transplant rejection, stroke, and dialysis use. Conclusions : Oversizing is more likely than undersizing in PHTX. While oversizing had no overall survival impact, undersizing had negative mid-term but not long-term survival impact which disappeared when adjusted for underlying cardiac diagnosis, elevated pulmonary vascular resistance, transplantation era and occurrence of post-transplant complications
Artificial Intelligence Versus Human Perception of Power: A Craniofacial Analysis of Female U.S. Senators
No full textImpact of facial appearance on success has been well-established. For women, specifically, there is a complex interplay between perceived attractiveness, competence, and power. As artificial intelligence (AI) is rapidly being used for facial analysis, it is critical to evaluate whether AI-derived facial assessments align with or diverge from human perception in systematic and potentially biased ways. Official government portraits of White, female United States (U.S.) senators (n=20) were anonymized and analyzed. Five facial measurements (eyebrow elongation, facial elongation, facial width-to-height ratio, mandibular angle, and chin size) were quantified using an image analysis software. Human participants (n=47) and ChatGPT-5 rated the perceived power of the portraits on a 7-point scale. Statistical analyses were performed to understand which craniofacial metrics were associated with perceived power in both human and AI raters. Across portraits, AI systematically assigned higher power ratings than humans (p<0.001). Rankings showed moderate-to-strong alignment (r=0.533, p=0.015). Both humans and AI associated greater facial elongation and higher fWHR with reduced power. Notably, only AI judgments were disproportionately driven by elongation in multivariate models. AI systems have many human heuristics but may amplify specific features and inflate trait ratings. This raises important considerations for their clinical integration. In plastic surgery, where AI is increasingly informing aesthetic counseling, reliance on biased outputs risks oversimplifying patient assessment. Diverse training datasets and clinician oversight are essential to ensure AI functions as an adjunct, rather than a substitute, for human judgment
Consensus recommendations in the management of jaw (gnathic) osteosarcoma
No full textGnathic osteosarcoma (OS), which includes mandibular and maxillary jaw OSs, account for 6%-9% of OS. Single-institutional and multi-institutional retrospective studies, as well as population-level databases, suggest that clinical differences exist among gnathic OS and OS of other sides, including other craniofacial OS. To date, no specific prospective studies of gnathic OS have been reported, and aspects of clinical management are controversial. Some elements of care are aligned with extragnathic OS, e.g., margin negative (R0) surgery, whereas others, such as chemotherapy and radiation, are not clearly defined. The authors reviewed the available literature for the diagnosis, treatment, and supportive/survivorship care patients with gnathic OS and offer consensus statements for the comprehensive management of this rare disease
Evaluating ChatGPT in Pediatric Craniofacial Surgery Counseling: A Vignette-Based Assessment of Educational Quality, Specificity, Readability, and Emotional Content
No full textLarge language models (LLMs) like ChatGPT have the potential to improve patient education. Their role in pediatric plastic surgery counseling remains underexplored. This study evaluated ChatGPT-4o's responses to common parent questions across 4 pediatric craniofacial procedures using 5 metrics: DISCERN, specificity, Flesch-Kincaid Grade Level (FKGL), emotion scoring, and Patient Education Materials Assessment (PEMAT).
Twelve standardized vignettes were developed for cleft lip and palate, craniosynostosis, facial trauma from a dog bite, and otoplasty. Each case featured prompts on surgical risks, recovery, and procedure-specific concerns. All were submitted on the same day using the same ChatGPT-4o profile. DISCERN scores were rated by 2 board-certified plastic surgeons. Specificity and emotion were rated on a 5-point Likert scale by 2 medical students. Readability was calculated with FKGL. PEMAT was used to assess understandability and actionability.
Mean DISCERN score was 43.7/75 (reliability 23.8/40, treatment quality 20.3/35). Mean specificity ranged from 1.7 (craniosynostosis) to 3.0 (otoplasty and dog bite). Average FKGL was 9.5 (10th-grade level). Mean emotion score was 3.1. PEMAT scores averaged 62% for understandability and 27% for actionability. Facial trauma demonstrated the highest in both domains.
ChatGPT-4o produced organized, accessible responses, but underperformed in reliability, quality, specificity, and actionability. Reading level exceeds recommended patient education standards of sixth to eighth grade. Emotional tone was moderate but not consistently tailored to sensitive pediatric contexts. These findings suggest ChatGPT is insufficient for unsupervised use. With refinement, LLMs may serve as support, but not replace, physician-led counseling in pediatric craniofacial surgery
Neurosurgical leadership in neuro-oncology clinical trials: A nationwide study
No full textDespite therapeutic advances, central nervous system (CNS) tumors such as glioblastoma and brain metastases remain highly lethal. Neurosurgeons have historically driven innovation in neuro-oncology but may be underrepresented as principal investigators (PIs) in clinical research. We analyzed all 525 U.S.-based neuro-oncology trials listed on ClinicalTrials.gov as of October 2024 to evaluate trends in neurosurgeon-led research, stratified by phase, funding source, and institutional characteristics. Oncologists led 34.8% of trials, whereas neurosurgeons led 21.5%. When normalized to the number of board-certified specialists, neurosurgeons demonstrated greater per-capita leadership than oncologists. Neurosurgeon-led studies were primarily early-phase (36.7% phase I; 5.1% phase III/IV), underscoring their role in translational and first-in-human investigations. At the state level, neurosurgical leadership correlated strongly with the number of neurosurgical residency programs (R² = 0.4835, p < 0.001) and aggregated departmental NIH funding (R² = 0.6146, p < 0.001), with states possessing greater training infrastructure and research resources demonstrating higher rates of neurosurgeon-led clinical trials. Nevertheless, 55.3% of neurosurgeon PIs lacked direct NIH support, highlighting persistent funding barriers. Notably, women were nearly twice as likely as men (1.8×) to serve as PIs, suggesting emerging gender diversity in neurosurgical research leadership. Neurosurgeons maintain a significant presence in neuro-oncology clinical trials, particularly in early translational work. However, their limited representation in NIH-sponsored and late-phase studies reflects enduring structural and funding challenges. Strengthening research mentorship, expanding grant access, and fostering interdisciplinary collaboration may enhance neurosurgical leadership and accelerate therapeutic innovation in neuro-oncology
Integrated Immune and Molecular Profiling Identifies Prognostic Subgroups and Therapeutic Targets in Chondrosarcoma
No full textChondrosarcoma (ChS) is a rare bone malignancy with heterogeneous behavior, the molecular and immunological background of which remains unknown. No effective systemic treatment for advanced ChS patients is available. The aim of this study was to develop an immune-mutational classification of ChS and to search for novel prognostic factors and molecular targets. We performed an immunological-molecular profiling of 99 patients diagnosed with primary ChS G1-G3 and dedifferentiated ChS. An expression of 20 immune response markers was assessed by IHC and targeted the next-generation sequencing of 409 genes was performed. Immunological and mutational profiles were correlated with overall survival using a multivariate LASSO-penalized Cox model. Three immunophenotypes were described-"cold" (IMP1), "hot" (IMP2), and "intermediate" (IMP3). IMP1 was the most prevalent in G1 cases, while IMP2 was the most prevalent in dedifferentiated cases.
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mutations were associated with high-grade ChS (FDR < 0.05). IMP2 was characterized by a higher number of immune infiltrates in the central region of the tumor (HR: 3.3; CI: 1.13-9.8;
< 0.05).
mutations were present most often in IMP2 cases (HR: 3.8; CI: 1.75-8.1;
< 0.001). Tumor size, dedifferentiated subtype,
mutation and the presence of IMP2 were identified as independent negative prognostic survival factors in ChS. An immune-mutational classification system for ChS patients was proposed, which may be used to identify those potentially suited for immunotherapy combined with IDH-mutant inhibitors in future research
Determination of Binary CO 2 /CH 4 Adsorption Isotherms and Kinetics over Hierarchical Activated Carbons via the Zero-Length Column Technique
No full textCurrent adsorption processes generally rely on unary adsorption isotherms to assess the efficacy of adsorbent materials suitable for a particular separation. While unary adsorption isotherms provide important information about the adsorbent’s affinities toward adsorbates of interest, they fail to accurately determine the real response of adsorbents in multicomponent systems. This is mainly due to cooperative and competitive adsorption phenomena that often take place in complex environments. As such, it is essential to obtain binary/multicomponent equilibrium data to have a realistic assessment of adsorption materials. In this work, we utilized the zero-length column (ZLC) technique to obtain binary adsorption isotherms of CO2 and CH4 over two hierarchical microporous-mesoporous carbons, namely, Br-318 and Nuchar. The ZLC generated low-pressure equilibrium isotherms of pure CO2 and CH4 closely resembled the volumetric isotherms, and the trend revealed by the experimental data of binary adsorption isotherms was qualitatively consistent with that obtained from the theoretical model, confirming the alignment between the two equilibrium data acquisition methods, as well as the theoretical and experimental approaches. The kinetic analysis of the ZLC profiles in the binary mixture indicated 55 and 66% reductions in diffusion of CO2 through Br-318 and Nuchar, respectively, in the presence of CH4 relative to the pure system. The findings of this investigation highlight the efficacy of the ZLC method in accurately determining the binary adsorption data
