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Background: Prenatal exposure to persistent organic pollutants (POPs) has been linked to adverse pregnancy outcomes. Existing disparities in exposure across populations highlight the need for identifying modifiable risk factors. Here, we investigated the determinants of serum levels of polybrominated diphenyl ethers (PBDEs) and organochlorine pesticides (OCPs) in pregnant African American women (N = 54)., Methods: Concentrations of 2,2'4,4'-tetrabromodiphenyl ether (BDE-47), 2,2',4,4',5-pentabromodiphenyl ethe (BDE-99), 2,2',4,4',6-pentabromodiphenyl ether (BDE-100), hexachlorobenzene (HCB), and p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE) were measured in first trimester maternal serum from a subset of women enrolled in the Atlanta African American Maternal Child Cohort. Home characteristics, cleaning behaviors, diet, and demographic information were collected via survey questionnaires. Associations between individual determinants and individual PBDE and OCP concentrations were assessed using linear regression., Results: Pregnant women who frequently ate red meat, cheese, milk, or yogurt had elevated levels of HCB and p,p'-DDE compared to those who ate these products less frequently (e.g., red meat: β=0.21; 95% CI=-0.07, 0.48 for p,p'-DDE), while pregnant women who reported living in apartments, homes ≥10 years old, or had couches ≥5 years old, had increased levels of PBDEs compared to reference groups. Pregnant women who vacuumed and cleaned their home more frequently showed decreased levels of PBDEs relative to reference groups (e.g., vacuuming: BDE-100 β= -0.81, 95% CI= -1.55, -0.06)., Conclusions: Our results illustrate modifiable determinants of PBDE and OCP exposures in pregnant women and emphasize the potential to reduce the body burden of these POPs both directly, by changing diet, residence, or home furnishings, and indirectly through cleaning methods., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Dorothy Nakiwala reports was provided by 1Center for Lifecourse Epidemiology of Adiposity and Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA. Dorothy Nakiwala reports financial support was provided by National Institutes of Health. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: The radial forearm free flap (RFFF) is widely used in head and neck reconstruction and serves as a versatile option for complex soft tissue eyelid and orbital socket reconstruction, particularly following orbital exenteration. This study evaluated the success and complication rates of RFFF in these contexts., Methods: A literature search of the PubMed, Dynamed, DARE, EMBASE, Cochrane and British Medical Journal electronic databases was conducted (PROSPERO registration number CRD42024584536)., Results: Twenty-two studies met the inclusion criteria, reporting 40 RFFF procedures in 40 patients (ages: 21-93, M:F 2.1:1). Of these, 65% (n=26) of the RFFFs were used for orbital socket reconstruction, with 75.7% (n=28) performed after cancer resection. The pooled success rate of the RFFFs in orbital and eyelid reconstruction was 92.8% (95% CI, 83.25 to 100, P = 0.39, I² = 5%) and the pooled complication rate was 8.62% (95% CI, 0% to 24.98%, P<0.01, I² = 78%). Flap failure occurred in 10% (n=4) of cases, primarily due to wound dehiscence (n=2)., Conclusions: RFFFs demonstrate success and complication rates comparable to traditional flaps used in eyelid and orbital reconstruction, such as the anterolateral thigh, rectus abdominis and latissimus dorsi flaps. It offers functional and cosmetic benefits, particularly for reconstruction after orbital exenteration. The RFFF is a reliable option for complex orbital and eyelid reconstructions and should be considered when local options are unavailable. Standardised reporting and further research are needed to validate long-term outcomes and minimise donor site complications., (Copyright © 2025 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

The proposed study sought to investigate whether maternal experiences of racial discrimination and gendered racial stress are associated with offspring executive functioning. Total 266 Black mother-child pairs in the United States were assessed from pregnancy through child age of 4 years. We hypothesized that children whose mothers reported higher rates of perceived gendered racial stress during pregnancy and racial discrimination throughout their lifetime would have lower scores on executive functioning assessments. Furthermore, we hypothesized that low maternal education and income would act as risk moderators whereas social support would act as a protective moderator in the associations between maternal experiences of discrimination (EOD) and child executive functioning. Main effect findings support our hypothesis of an intergenerational association between maternal EOD and gendered racial stress and lower child executive functioning scores. Income was a significant moderator. As hypothesized, the association between mothers reports of lifetime discrimination and lower child executive functioning scores was stronger at lower levels of income. In contrast, however, the association between maternal prenatal reports of gendered racial stress and lower child executive functioning scores was stronger at higher levels of maternal education and income. Social support did not have a significant moderating effect on any of the association., (© 2025 Michigan Association for Infant Mental Health.)

Background: The facial artery musculomucosal (FAMM) flap is a versatile flap based on the facial artery. It can be used to reconstruct the floor of the mouth, palate, tongue and alveolar ridge. The flap can be designed in various orientations and modified as an islanded or tunnelised flap. This study aimed to review the application of FAMM flap in the reconstruction of defects of the tongue and oral cavity, with specific focus on success rates and total complications., Methods: A literature search was conducted by 2 independent reviewers on PubMed, Dynamed, DARE, EMBASE, Cochrane and British Medical Journal (BMJ) electronic databases (Registry CRD42024529989)., Results: Twenty-seven studies fulfilled the search criteria and data on 407 FAMM flaps performed on 402 patients were extracted for analysis. Overall, 1.7% (n=7) of flaps failed because of total necrosis (n=3), partial necrosis requiring surgical intervention and flap abandonment (n=2), total failure (n=1) and fistula formation (n=1). Overall, 26.0% (n=106) of patients experienced non-functional complications. The most reported complications were partial necrosis (n=23, 5.7%), wound dehiscence (n=18, 4.4%) and venous congestion (n=13, 3.2%). The pooled success rate in all studies using FAMM flaps for oral cavity and tongue reconstruction was 99.47% (95% CI, 98.26 to 100.00, P = 1.00; I 2 = 0%;). Pooled total complication rates were 30.18% (95% CI, 16.97 to 43.38, P < 0.01; I 2 = 91%). Only 35 flaps required re-operation., Conclusions: With low complication and failure rates, FAMM flaps are a safe and versatile option to consider in oral cavity and tongue reconstruction., (Copyright © 2025 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Aim: The British Thyroid Association (BTA) Guidelines for the Management of Thyroid Cancer advocate for fine-needle aspiration cytology for all thyroid nodules graded indeterminate (U3) at ultrasound assessment. This approach raises concerns regarding potential over-diagnosis of low-risk lesions. Conversely, equivalent Thyroid Imaging Reporting and Data Systems (TIRADS) guidelines permit surveillance or discharge of indeterminate thyroid nodules of certain sizes. This service analysis analyses how guideline choice impacts the fine-needle aspiration cytology rate and subsequent surgical management of indeterminate thyroid nodules., Materials and Methods: All patients with an indeterminate (U3) thyroid nodule identified on ultrasound over a 12-month period were included. Indeterminate thyroid nodules were retrospectively rescored using three equivalent TIRADS classifications by three independent reviewers, blinded to the histopathology. Hypothetical differences in fine-needle aspiration cytology rates and surgical activity were then compared., Results: Ninety-six nodules were identified. Retrospective application of TIRADS guidelines resulted in a hypothetical 44.8-55.2% reduction in fine-needle aspiration cytology performed for indeterminate thyroid nodules compared to BTA. A statistically significant increase in rates of surgical activity for indeterminate thyroid nodules was observed between BTA guidance and all retrospectively applied TIRADS guidelines (p < 0.001). Of four confirmed thyroid cancers, three would have been unanimously removed., Conclusion: Under BTA guidance, increased fine-needle aspiration cytology rates for indeterminate thyroid nodules resulted in significantly increased surgical activity in our cohort compared to retrospectively applied TIRADS guidelines., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)