Transperineal ultrasonography (TUS) is increasingly recognized for evaluating labor progression, but its contribution to delivery outcomes, particularly in forceps delivery, remains uncertain. This prospective cohort study investigated whether TUS-assisted examination improves maternal and neonatal outcomes in forceps deliveries. We included term singleton pregnancies undergoing trial of forceps at a tertiary perinatal center in Japan between 2019 and 2022. Participants were divided into two groups based on whether TUS was performed before delivery. The maternal composite outcome comprised cesarean section after failed forceps, ≥ 3 tractions required, third- or fourth-degree perineal tear, or postpartum hemorrhage > 1500 mL. The neonatal composite outcome included umbilical artery pH < 7.0, base excess < - 12, 5-minute Apgar score < 7, trauma, or NICU admission. Propensity-score matching (1:1) was applied to balance covariates. Among 403 eligible patients, 216 matched cases were analyzed. Both maternal (relative risk [RR] 0.53, 95% CI 0.29-0.97; number needed to treat [NNT] 8.9; p = 0.03) and neonatal (RR 0.47, 95% CI 0.22-0.99; NNT 10.7; p = 0.04) composite outcomes were significantly lower in the TUS group, with fewer cases requiring ≥ 3 tractions (p = 0.01). TUS-assisted examination prior to forceps delivery may improve both maternal and neonatal safety.

Burn injuries remain a major public health concern, often resulting in extensive tissue damage and life-threatening complications. Among these, burn wound infections are the leading cause of mortality in patients with extensive surface area involvement. This study aimed to compare the wound-healing efficacy of silver sulfadiazine (SSD) cream and povidone-iodine in patients with second- and third-degree burns involving 30 to 50% of total body surface area (TBSA). The primary outcome was wound healing rate (time to graft preparation), while secondary outcomes included pain intensity and the frequency of required dressing changes. In this double-blind clinical trial, 80 patients with second- or third-degree burns involving 30 to 50% TBSA were enrolled and randomly assigned to receive either SSD cream or povidone-iodine (PI). The sample size was determined using a formal power calculation (α = 0.05, power = 80%), resulting in 40 patients per group. Wound healing was assessed based on healing rate, tissue appearance, pain intensity, inflammatory response, and overall recovery, using weekly clinical examinations and photographic documentation. Among the 80 participants (51.2% female and 48.8% male; mean age, 38.1 ± 14 years), the PI group required significantly more frequent dressing changes (P = 0.001) and reported higher pain intensity (P < 0.001). Interestingly, no significant between-group differences were observed in healing rate, number of surgical interventions, or length of hospital stay (P > 0.05). Logistic regression identified pain intensity as the only variable significantly associated with treatment type (P = 0.014). SSD demonstrated superior clinical performance in reducing pain and dressing frequency among patients with moderate-to-severe burns, although overall healing rates were comparable between groups. Larger multicenter studies are recommended to validate these findings and to assess long-term outcomes.Clinical trial registration Iranian Registry of Clinical Trials (IRCT), IRCT20240126060819N1, registered on April 10, 2024.

In interpersonal communication, white lies are often used to consider the feelings of others or to avoid the negative consequences of telling the truth. Understanding the relationship between children's empathic ability and white lie cognition cannot only help to comprehend the development process of children's white lies and deepen the research in children's moral development and social cognition, but also provide a theoretical basis for educating children on white lie cognition and fostering prosocial behavior. Although white lie cognition is well-documented in children with typical development, the role of empathic ability in this process remains under-researched in neurodiverse populations. This study examined the influence of empathic ability on white lie cognition in children with autism spectrum disorder and children with intellectual disability. A white lie cognition task and an empathy continuum test were administered to assess the performance and differences among children with typical development, ASD, and ID across various dimensions of white lie cognition and empathic ability. Results: (1) Significant differences in cognitive empathy, emotional empathy, and evaluations of both the degree and morality of white lies were observed among autism spectrum disorder, children with intellectual disabilities, and children with typical development. The stronger a child's cognitive and emotional empathy, the easier it was to evaluate the degree of white lie and its moral implications. (2) Autism spectrum disorder demonstrated significantly lower empathic ability and white lie cognition compared with those with intellectual disabilities. Moreover, greater empathic ability in these children was associated with improved white lie cognition. (3) Across children with typical development, autism spectrum disorder, and children with intellectual disabilities, when empathic ability scores were higher, cognitive empathy and emotional empathy could positively predict all aspects of white lie cognition. These results indicate that the empathic ability of autism spectrum disorder and children with intellectual disabilities can directly affect their white lie cognition. In these children, higher empathic ability is associated with improved cognition of white lies and promotes accurate evaluations of both the degree and morality of white lies.

Patients with large total body surface area (TBSA) burns face significantly elevated risks of morbidity and mortality. Achieving rapid, durable wound closure with minimal risk of infection or systemic compromise is critical to reducing mortality. Biodegradable Temporizing Matrix (BTM) (PolyNovo, Victoria, Australia) offers a synthetic alternative to biological dermal substitutes, providing temporal wound closure and a scaffold for neodermis generation. A 68-year-old woman presented with third-degree flame burns covering 25% TBSA across the right trunk and upper limb following a domestic syncopal episode. After initial stabilization, the patient underwent a 2-stage reconstruction. Stage I (postburn day 4) involved surgical excision to the fascia and immediate application of BTM. Stage II (postburn day 39) involved the delamination of the sealing layer and coverage of the vascularized neodermis using split-thickness skin grafts, meshed at a ratio of 1:1.5. BTM was successfully integrated within 35 days, exhibiting the characteristic uniform pink color of vascular network formation. Complete epithelialization was documented by postburn day 75, with no clinical signs of infection observed throughout the treatment course. Follow-up at postburn day 377 demonstrated satisfactory functional recovery and favorable long-term scar quality, with minimal secondary contracture. BTM provided temporal closure that was less prone to infection, which proved invaluable in managing this extensive burn in a high-risk patient. Successful neodermis regeneration improves the split-thickness skin graft coverage characteristics and supports the use of BTM as an effective reconstructive modality for deep, large-TBSA burns, where minimizing risk of infection and fluid loss is paramount, while simultaneously allowing for improved functional and aesthetic outcomes.