Jose Manuel

Abstract Introduction Candidozyma auris (formerly Candida auris ) is an emerging yeast that causes bloodstream infections, especially

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After treatment failure in psoriatic arthritis (PsA), choosing the next therapy involves more than simply cycling within a drug class or switching to another.

Abstract: Standard automation ROI misses four categories of systemic risk -- tacit knowledge erosion, resilience reduction, regulatory exposure, and

Robotic surgery is increasingly integrated into general surgical practice, creating a need for standardized training methods that objectively assess technical skill acquisition. Current robotic simulation curricula often rely on psychomotor tasks that may not reflect clinically relevant reconstructive procedures. Enterotomy repair requires precise tissue handling and suturing and may serve as a practical benchmark for robotic training. This study evaluated whether a standardized robotic enterotomy repair task could demonstrate reproducible skill acquisition among junior residents. A prospective longitudinal study was conducted involving PGY-1 and PGY-2 general surgery residents performing a standardized two-layer robotic enterotomy repair on a porcine small bowel model using the da Vinci Xi platform. Participants completed three sessions spaced 1–2 weeks apart. The primary outcome was time to task completion. Secondary outcomes included leak testing, technical errors, and exploratory comparisons by postgraduate year and prior robotic training. Changes in performance across sessions were analyzed using a linear mixed-effects model accounting for repeated measures. Thirty-eight residents participated, with 30 completing all three sessions. Mean completion time decreased from 18.47 ± 4.87 min in session 1 to 14.90 ± 6.00 min in session 2 and 13.20 ± 5.60 min in session 3 (p < 0.001). Leak rates declined from 26.3% in session 1 to 20.0% in session 3. Logistic regression analysis accounting for repeated observations demonstrated no significant association between completion time and leak occurrence (OR 1.0003, 95% CI 0.9988–1.0019; p = 0.671). PGY-1 residents demonstrated greater improvement, with convergence between PGY levels by the final session. Residents with prior robotic training demonstrated numerically faster repair times, though differences were not statistically significant. A short, standardized robotic suturing curriculum using a procedure-based enterotomy repair task produces reproducible improvements in technical efficiency among junior surgical residents without compromising repair integrity. This model provides an objective and practical framework for assessing robotic skill acquisition early in surgical training.

Introduction In adult cochlear implant users, conventional frequency (CF) mapping is standard practice. Tonotopic fitting (TF) refers to a programming strategy in which the frequency allocation of the speech processor is matched as closely as possible to the natural tonotopic organization of the cochlea. Whether TF mapping improves outcomes over CF remains uncertain. Methods We searched PubMed, Embase, and Cochrane for randomized controlled trials comparing tonotopic versus conventional mapping in adult cochlear implant users. Random-effects meta-analysis was performed using RevMan 5.4. Continuous outcomes were analyzed using standardized mean difference (SMD) with 95% confidence intervals (CIs), and heterogeneity was assessed with I2. A two-tailed P-value < 0.05 was considered statistically significant. We created an effect-direction plot for selected outcomes to provide a visual summary of the direction and consistency of effects across studies. Results A total of five publications were included, representing four trials (n = 109). There was no significant difference between TF and CF mapping in speech understanding in quiet (SMD = -0.07; 95% CI -0.82, 0.68; P = 0.86; I2 = 79%) and in noise (SMD = 0.51; 95% CI -0.44,1.46; P = 0.30; I2 = 93%). The sensitivity analysis for speech understanding in noise favored TF. Also music perception favored TF on the effect direction plot, while sound quality showed variable outcomes. Conclusion TF mapping may have potential benefits over CF mapping for speech understanding in noise and music perception. Larger randomized trials are needed to establish the clinical significance of TF mapping.

Tahimy Fuentes-Alvarez Carlos Ordóñez Ricardo García-Herrera David Barriopedro and Jose Manuel Garrido-Perez

by and Service of Ophthalmology and IDIS, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain

Department of Mechanical Engineering, Faculty of Engineering, University of Porto, R. Dr. Roberto Frias, 4200-465 Porto, Portugal

Purpose of Review Pornography consumption has become increasingly prevalent in digital environments, with a subset of individuals developing problematic pornography use (PPU). Despite growing research interest, limited attention has been given to the role of empathy and interpersonal sensitivity in this context. This narrative review aims to synthesize the available evidence on the relationship between pornography use, PPU, and socio-emotional processes, particularly empathy and interpersonal sensitivity. Recent Findings Across seven empirical studies, convergent evidence from cross-sectional, longitudinal, and experimental studies suggests that pornography exposure, especially when involving violent content, is associated with reduced empathy and increased emotional desensitization. Experimental studies suggest that exposure to sexually violent pornographic material is associated with lower empathic responses and greater acceptance of rape myths, whereas correlational and clinical studies link lower empathy to higher exposure to violent pornographic content and greater likelihood of coercive sexual behaviors. Early exposure to pornography, particularly when combined with adverse developmental experiences, may be associated with more pronounced socio-emotional effects. Emerging neurobiological evidence also points to alterations in oxytocin–vasopressin systems among individuals with PPU, raising the possibility of biopsychosocial mechanisms that could be linked to lower empathic functioning. Summary Overall, the available evidence indicates that pornography use may be associated with diminished empathy and increased objectification, particularly under conditions of high exposure to pornography or violent content. However, evidence specifically addressing interpersonal sensitivity remains limited and indirect. Nonetheless, methodological limitations, including the predominance of cross-sectional designs and heterogeneous measures, constrain causal interpretation. Future research should prioritize longitudinal and experimental designs, incorporate diverse samples, and integrate psychosocial and neurobiological measures. These findings also suggest that preventive and educational interventions focused on empathy and media literacy may mitigate potential adverse outcomes associated with pornography use and PPU.