Bacteriophages of the Pakpunavirus genus exhibit a broad host range and potent bacteriolytic activity, making them promising candidates for clinical use. Here, we present a structural atlas of the therapeutic phage Pakpunavirus P7-1, a component of a phage cocktail targeting Pseudomonas aeruginosa that has undergone Phase 1/2 clinical trials. We determine the near-atomic structure of the extended virion and obtain a medium-resolution reconstruction of the contracted tail. Atomic models are presented for 20 structural proteins comprising the icosahedral capsid, neck, contractile tail, and baseplate. We identify six upward-pointing Short Tail Fibers that stabilize the extended sheath and six highly flexible Long Tail Fibers likely involved in host recognition. Ordered fragments of the Tape Measure Protein reveal six copies inside the tail tube, forming a 3-helix cork at the tail tip. Sheath contraction repositions the baseplate, projecting all twelve tail fibers outward, yet contraction alone is insufficient to trigger genome ejection.

Existing methods of grading atelectasis are typically subjective and not scalable. We aimed to develop an automated, deep learning-based framework to quantify and grade postoperative atelectasis. We retrospectively included all patients who underwent RULobectomy from 2008 to 2023. We trained three nnU-Net v2 segmentation models for preoperative and postoperative lobes and airways with volumetric quantification of the right middle lobe (RML), right lower lobe (RLL), and total lung volume. Atelectasis severity in the RML was independently graded using a 5-point radiological scale (none, minimal, subsegmental, segmental, lobar). The association between volume metrics with atelectasis severity and clinical outcomes was evaluated. 236 patients comprised the study cohort. Median(IQR) RML volume loss progressively increased with higher atelectasis grades, from -4.6 mL (-78.5, 59.0) in grade 0 to -317.8 mL (-440.7, -194.8) in grade 4 atelectasis (p < 0.001). Normalized RML/right lung (RL) and RML/total lung (TL) volume ratios showed statistically significant differences across the pooled atelectasis grades (p < 0.001). Normalized RLL volumes increased with worsening RML atelectasis (p < 0.001), suggesting compensatory hyperinflation. A higher ΔRML/RL [OR(95%CI): 0.89 (0.81-0.98), p = 0.01] and ΔRML/TL [0.80 (0.65-0.98), p = 0.03] were associated with reduced 1-year need for bronchoscopy. We demonstrate the feasibility and clinical relevance of deep learning-based volumetric assessment of atelectasis after RULobectomy.

This study investigated the effects of eccentric exercise-induced delayed onset muscle soreness (DOMS) on neck extensor muscle behaviour and force output, examining force steadiness and the spatial distribution of splenius capitis (SCap) and upper trapezius (UT) muscle activity. Twenty healthy individuals completed three laboratory sessions (baseline, 24 h and 48 h post-exercise), where participants performed submaximal isometric neck extension and flexion tasks (20%, 50%, and 70% of their maximum voluntary contraction). High-density surface electromyography was used to examine bilateral SCap and UT muscle activity, and force steadiness was evaluated using the absolute and relative amplitude of force fluctuations. Neck muscle soreness significantly increased 24 h and 48 h post-exercise compared with baseline (p < 0.001), along with significant reductions in pressure pain thresholds over suboccipital and C4 regions (p < 0.001). Caudal shifts of SCap and UT muscle activity were observed during neck extension contractions in the presence of DOMS (p < 0.01, p < 0.001, respectively), and entropy values were significantly higher at 24 h and 48 h for the SCap (p < 0.001). The absolute amplitude of force fluctuations during the neck extension contractions improved across sessions (p < 0.05). These findings suggest that acute neck muscle soreness induces a redistribution of neck muscle activity; this is likely to be adaptive to protect painful muscle regions.

Gingivobuccal defects are one of the most challenging defects for the reconstructive surgeon. Great strides have been made to improve the reconstructive outcomes and quality of life of the patient with a combination of more sophisticated surgical techniques and more advanced technology. New methods provide better accuracy, shorter surgical times, better functional results, lesser complication rates, and overall better quality of life. This article provides a brief overview of the advances that have been made in the field of reconstruction and rehabilitation postoncological resections of the gingivobuccal complex and provides a glimpse of what the future holds.

Inflammatory and neoplastic conditions of the pediatric airway can result in significant respiratory and vocal impairment. The pediatric airway is inherently small; thus, even minor obstruction results in an exponential increase in resistance to airflow and can quickly lead to life-threatening airway compromise. The broad range of severity and symptom manifestation requires comprehensive history, examination, and endoscopic evaluation to accurately diagnose these conditions. Surgical intervention is often required for diagnosis and management; however, advances in nonsurgical therapies have greatly enhanced outcomes and reduced the need for operative intervention. This article reviews nonsurgical management strategies for several key airway conditions.

Cervical spine injury occurs in 1-2% of paediatric trauma cases. Differences in anatomy, size and injury patterns compared with adult patients can make the assessment of cervical spine injuries in children challenging. This article provides an overview of the approach to be taken when assessing a potential cervical spine injury. It also covers the range of available clinical decision aids to help clinicians diagnose cervical spine injuries while safely avoiding unnecessary radiation as much as possible.

In 2011, a unilateral accessory C1 to C2 articular facet was described for the first time. We report an uncommon case of a right-sided accessory C1 to C2 articular facet causing cervical spinal cord compression. A 41-year-old man presented with neck pain radiating to the trapezius muscles for 8 months. Two months later, he developed impaired fine motor skills. Physical examination revealed tenderness on palpation of the cervical paravertebral muscles, more pronounced on the right side. Cervical imaging studies demonstrated a right-sided accessory C1 to C2 facet causing significant compression of the cervical spinal cord. The patient underwent a right-sided C2 laminectomy followed by complete arthrectomy of the compressive accessory facet using a bone cutter to achieve spinal cord decompression. At outpatient follow-up 2 months after surgery, he showed complete resolution of the fine motor impairment. This case highlights the importance of considering atypical anatomical causes in the differential diagnosis of common spinal symptoms, such as neck pain, and contributes additional information on a spinal pathology that remains poorly represented in the literature.