Purpose Factors influencing the results of radial nerve to triceps to axillary nerve transfers remain poorly defined. Therefore, the goal of this study is to compare radial to axillary nerve transfer outcomes by age, and to determine if age is a reliable predictor of outcome. Methods A single center retrospective cohort study was conducted between 2015 and 2025. Exclusions included patients younger than 18 years, less than 1 year follow-up, or lack of MRC strength documented after surgery. Patients were subanalyzed by age: 18–39 years, 40–59 years, and ≥60 years. The primary outcome was recovery of M4 strength or greater. Subgroup analysis was performed to compare demographic, intraoperative variables, and postoperative outcomes. Results Fifty-three patients (n = 20 aged 18–39 years, n = 16 aged 40–59 years, n = 17 aged ≥60 years) were included with a median follow-up time of 16.7 months. There were no differences in lesion location, BMI, smoking status, or preoperative MRC grade between groups. Younger patients were more likely to sustain high-energy injuries (85% in patients aged 18–39 years, 43.8% in patients aged 40–59 years, 17.6% in patients aged ≥60 years, P = .001). 62.3 % of the cohort underwent end-to-end nerve transfer (75% in patients aged 18–39 years, 68.8% in patients aged 40–59 years, 47.1% in patients aged ≥60 years, P = .214). Postoperative clinical improvement was demonstrated in every age group. Overall, 77.4% of patients had a preoperative deltoid M0 strength and 66.0% of patients achieved at least M4 strength after surgery (75% in patients aged 18–39 years, 68.8% in patients aged 40–59 years, 52.9% in patients aged ≥60 years, P = .304). After surgery, there was no difference between groups for donor site morbidity, reoperation rate, or wound complications. Conclusions Meaningful M4–M5 recovery was achieved across all age cohorts, with a nonsignificant trend toward lower recovery rates in older patients (P = .746). Although not significant (P = .260), ETE trended toward being more common in younger patients versus ETS in older patients, likely reflecting injury severity. Patients that had therapeutic stimulation were 2.75 times more likely to reach M4–M5 compared to those that did not. Type of study/level of evidence Prognostic III.
This review examines the unique cardiovascular disease patterns in older women, focusing on sex and age-specific pathophysiology, diagnostic challenges, and disparities in management. We aim to clarify how aging and hormonal transitions influence disease presentation and outcomes among women, and to identify gaps in cardiovascular care. Emerging data demonstrate that older women are disproportionately affected by HFpEF, coronary microvascular dysfunction, atrial fibrillation, and valvular heart disease. These conditions are influenced by vascular stiffness, myocardial remodeling, and systemic inflammation and often present with atypical symptoms leading to diagnosis delays. Contemporary studies highlight persistent gaps in timely diagnosis, referral for advanced therapies, and representation in clinical trials. Increasing attention is being directed toward frailty, multimorbidity, and patient-centered care models in this population. Recognizing age and sex-specific characteristics, increasing representation of older women in clinical trials, improving equitable access to diagnostic and therapeutic resources, and aligning treatment decisions with patient priorities are critical to narrowing existing gaps and improving long-term outcomes for older women with cardiovascular disease.
This study examines mental health status of patients with complex hypospadias, which include proximal (penoscrotal, scrotal or perineal) hypospadias or hypospadias of any degree with additional urogenital anomalies. Eligible patients of different ages (24
Innovation in psychiatry relies on laboratory-based neuroscience research using experimental animal models. How to best train and support investigators remains a critical question for the field. We examined how training background, operationalized as MD, PhD, or MD/PhD degree, is associated with National Institutes of Health (NIH) K-to-R01 transition, a key career benchmark. Understanding how clinical and research training impact early research success will inform strategies in medical education and physician-scientist training in psychiatry. This preregistered study used NIH RePORTER to identify recipients of NIH mentored-career-development K01 and K08 awards from neuroscience-focused NIH institutes. Projects using animal models to address a neuroscience question were identified by title-and-abstract review. R01 awards (1997–2024) were identified and linked to prior K awardees (1997–2016) to determine conversion rates. Among 758 awards (243 K01, 515 K08), 51
Amortized Bayesian inference (ABI) has emerged as a powerful simulation-based approach for estimating complex mechanistic models, offering fast posterior sampling via generative neural networks. However, extending ABI to hierarchical models, a cornerstone of modern Bayesian analysis, remains a major challenge due to the need to simulate massive data sets and estimate thousands of parameters. In this work, we build on compositional score matching (CSM), a divide-and-conquer strategy for Bayesian updating using diffusion models. To address existing stability issues of CSM in dealing with large data sets, we couple adaptive solvers with a novel, error-damping compositional estimator. Our estimator remains stable even with hundreds of thousands of data points and parameters. We validate our approach on a controlled toy example, a high-dimensional autoregressive model, and a real-world advanced microscopy application involving over 750,000 parameters.
