This is a case report of a 14-year-old girl with a Blauth Type IIIc hypoplastic thumb who underwent metacarpal reconstruction with a medial femoral condyle flap to preserve a five-digit hand. At the patient's 9-month follow-up, imaging demonstrated complete bone healing at both the first metacarpal recipient site and the donor site. At 17 months after surgery, the patient is satisfied with the appearance and improved function as she now has a stable post with a small amount of thumb abduction and adduction, with minimal donor site morbidity. The patient has elected not to undergo the planned second stage of opposition transfer, first webspace deepening, and tendon transfer for the time being, although these procedures may increase her function further. This case presents a novel application of the MFC flap to preserve a five-digit hand in a patient with congenital thumb hypoplasia, with minimal donor site morbidity.

Objective: Childhood peer abuse is a developmentally salient form of interpersonal adversity, yet its role in shaping links between peripheral biological stress markers and brain structure remains poorly understood. The present cross-sectional study examined whether retrospectively reported childhood peer verbal and physical abuse moderated associations of systemic inflammatory burden and hair cortisol with subcortical brain volume.Methods: Participants from a community sample completed the Maltreatment and Abuse Chronology of Exposure scale and structural magnetic resonance imaging. Inflammatory burden was indexed by a composite of standardised IL-6, IL-8, TNF-alpha, and C-reactive protein values (n = 292), and hair cortisol was available in a subsample (n = 172). Bilateral amygdala, hippocampus, putamen, and caudate volumes were extracted from FreeSurfer segmentation. Linear regression models adjusted for gender, age, parental education, and estimated total intracranial volume; false discovery rate correction was applied across the four ROI tests within each marker-by-moderator family.Results: Peer verbal abuse moderated associations of inflammatory burden with bilateral amygdala volume (β = -.095, pFDR = .032) and bilateral putamen volume (β = -.115, pFDR = .017). Peer physical abuse moderated the association between hair cortisol and bilateral amygdala volume (β = .227, pFDR = .035). Caudate models did not survive correction. Core findings remained significant after sensitivity adjustment for broader childhood adversity and current depression/anxiety symptoms.Conclusions: Associations differed across brain regions, biological markers, and peer-abuse subtypes. These findings identify peer adversity as an important interpersonal context for understanding stress-related brain differences.

Differentiating generated and human-written content is increasingly difficult. We examine how incentives to convey humanness and task characteristics shape perceptions of textual content across five studies. In Studies 1-2, humans and GPT-4 write relationship advice or relationship descriptions with or without instructions to appear human. New participants judge each text's source. Instructions to appear human increase perceived humanness only for GPT-4, reducing the human advantage. Study 3 shows that these effects persist under instructions to avoid sounding like an AI model and replicate across GPT-4 and GPT-4o. Study 4 demonstrates that GPT models can produce empathy without humanness and humanness without empathy. Study 5 shows that GPT-4 increases perceived humanness by adopting informal, conversational language and other surface-level stylistic cues, whereas human writers show little adjustment. Together, the findings indicate that perceived humanness depends on incentives to appear human and the context in which writing is produced.

Child sexual abuse (CSA) most often occurs inside private residential settings, yet little is known about how the presence of others or physical barriers such as closed doors meaningfully influence whether abuse occurs or can be detected. Despite the common assumption that CSA requires complete isolation, situational crime prevention (SCP) predicts that the presence of others should reduce opportunity for abuse, yet the extent to which this holds in practice remains poorly understood. This study, conducted in the United States, examined whether this assumption holds true in private homes by integrating perspectives from both survivors and individuals who perpetrated CSA. Using semi-structured interviews of CSA survivors (n = 61) and individuals incarcerated for CSA (n = 47), we explored whether others were present in the home during the CSA and whether physical barriers limited the possibility of observation. Someone else was home during the CSA in 64.7% of cases, and in more than half (52.6%) others were usually or always present. Where the location of that person was recorded, just over one in ten (11.5%) were in the same room as the abuse. In approximately half of the cases (50.5%), no physical barrier would have prevented observation of the CSA. These findings challenge the assumption that CSA within private homes depends upon complete isolation and highlight the need to reconsider how opportunity, visibility, and household dynamics are addressed in both prevention efforts and prosecutorial strategies.

The mass kidnapping of 251 individuals by Hamas on October 7, 2023, created a collective ambiguous loss for Israeli society, marked by prolonged uncertainty over the hostages' fate. While ambiguous loss is typically studied in families, its population-level health associations during continuous armed conflict are unknown. This study provides the first longitudinal evidence of this experience. Israeli adults were surveyed at three (T1; N = 740), six (T2; N = 336), and eighteen (T3; N = 254) months post-kidnapping; a representative subsample (N = 220) completed all waves. We assessed general psychological distress (DASS), abduction-related separation distress (ALI+-SD), and boundary ambiguity (BAS). Within-subject mixed-effects models indicated significant reductions in DASS and BAS scores from T1 to T2 (B = 1.04 and B = 1.28, respectively; ps < 0.01), followed by a plateau thereafter. Separation distress declined significantly only at T3 (B = -1.58, p < 0.01). ALI+-SD and BAS each significantly predicted DASS beyond time effects, with multilevel mediation indicating that ALI+-SD mediated the BAS-DASS association. In the longitudinal sample, ALI+-SD and BAS together explained 44% (T1), 34% (T2), and 41% (T3) of the variance in general distress. The findings suggest that ongoing collective ambiguous loss constitutes a substantial public health concern during war. Unresolved uncertainty surrounding the hostages stalls societal recovery, creating a state of collective limbo and posing a barrier to collective healing. Therefore, ambiguous loss following mass hostage-taking should be considered a widespread societal stressor with consequences extending far beyond directly affected families.

Idiopathic intracranial hypertension (IIH) is characterized by elevated intracranial pressure without an identifiable mass lesion, hydrocephalus, cerebral venous sinus thrombosis, or abnormal cerebrospinal fluid composition. Diagnosis during pregnancy can be challenging because headache and visual symptoms overlap with several neurologic and obstetric disorders. We report a previously healthy 20-year-old primigravida with a body mass index of approximately 33 kg/m[2] who presented at 17 weeks' gestation with intermittent headache, photophobia, blurred vision, horizontal diplopia, nasal deviation of the left eye, and absent left-eye abduction. Visual acuity was 6/6 bilaterally, with mild bilateral optic disc swelling, greater on the left. The initial brain magnetic resonance imaging report described subtle paired diffusion-weighted signal abnormalities in the region of the medial longitudinal fasciculi, interpreted as possible mild cytotoxic edema related to a potentially reversible ischemic event. These findings were not anatomically concordant with the documented isolated left abduction deficit, and subsequent informal radiologic review raised the possibility that they were artifactual; no formal radiology addendum was available. Magnetic resonance angiography showed no significant intracranial arterial abnormality, and magnetic resonance venography excluded cerebral venous sinus thrombosis. Lumbar puncture in the lateral decubitus position demonstrated an opening pressure of 31 cmH2O with normal cerebrospinal fluid constituents, followed by resolution of her symptoms and abducens palsy after drainage. Symptoms recurred at 20 weeks, when repeat opening pressure was 42 cmH2O; and they again improved after drainage. Acetazolamide was commenced at 250 mg twice daily and increased to 500 mg twice daily at 33 weeks because of persistent optic disc swelling. The patient underwent cesarean delivery at 36 weeks; the specific clinical rationale for the mode of delivery was unavailable in the records reviewed. The neonate weighed 2.6 kg, had Apgar scores of seven and eight, and had no documented neonatal complications. Acetazolamide was continued postpartum. At telephone review approximately six months after delivery, the patient remained clinically well, reported adherence to her prescribed acetazolamide, and denied recurrent headache, blurred vision, diplopia, or ocular deviation. Final objective ophthalmologic resolution could not be confirmed because she did not attend her most recent scheduled ophthalmology follow-up. This case emphasizes the need to integrate clinical examination, cerebrospinal fluid findings, and neuroimaging when evaluating intracranial hypertension during pregnancy.