This research explores how dimensions of family well-being influence individual well-being among workers in Guatemala, measured through self-esteem, emotional control, and decision-making. Using the Poverty Stoplight methodology and a dataset of approximately 3,600 observations, we model subjective well-being as a latent construct capturing key psychological capacities.The results show that financial security (particularly stable income and savings), social connectedness, and access to basic services are the strongest predictors of individual well-being. In contrast, some infrastructural and educational indicators display weaker or non-significant associations, suggesting that not all dimensions of family well-being translate equally into psychological functioning.These findings provide a more nuanced understanding of how social, economic, and relational factors shape subjective well-being at both the individual and household levels. The study contributes to the literature by linking multidimensional family conditions with individual psychological outcomes, highlighting the central role of relational and financial stability in contexts characterized by structural constraints.
Introduction Cranioplasty following decompressive craniectomy restores cranial integrity and may promote neurological recovery by restoring cerebral physiology. Although autologous bone and synthetic implants have been widely compared, their relative effects on functional recovery remain unclear. Objective To compare functional and surgical outcomes following autologous bone versus synthetic implant-based cranioplasty after decompressive craniectomy. Methods A PRISMA-guided systematic review and meta-analysis searched PubMed/MEDLINE, Embase, and the Cochrane Library through April 2026. Comparative studies of autologous bone versus synthetic implant-based cranioplasty were included. The primary outcome was functional improvement. Secondary outcomes included postoperative infection, hematoma or hemorrhage, and revision surgery. Random-effects meta-analyses used odds ratios (ORs) with 95% confidence intervals (CIs). Results Five retrospective comparative cohort studies including 958 patients met the inclusion criteria; 701 underwent autologous bone cranioplasty and 257 synthetic reconstruction. Three studies reported functional outcomes suitable for meta-analysis. Functional improvement did not differ between autologous and synthetic cranioplasty (OR 1.01, 95% CI 0.59–1.72; p = 0.98; I² = 0%). Postoperative infection was also similar (OR 1.00, 95% CI 0.59–1.71; p = 0.99; I² = 0%). Autologous cranioplasty showed a nonsignificant trend toward lower postoperative hematoma or hemorrhage (OR 0.46, 95% CI 0.14–1.47; p = 0.12; I² = 0%) and higher revision rates (OR 1.42, 95% CI 0.74–2.73; p = 0.18; I² = 0%). Neurocognitive and quality-of-life outcomes could not be pooled because of inconsistent reporting. Conclusions Current evidence shows no significant differences between autologous bone and synthetic implant-based cranioplasty in functional recovery, postoperative infection, hematoma, or revision surgery. Material selection should be individualized based on patient, surgical, and resource factors. Prospective comparative studies should standardize reporting of functional, neurocognitive, and quality-of-life outcomes to clarify whether reconstructive material influences long-term neurological recovery.
ABSTRACT Autoaggressive nail disorders involve a spectrum of self-inflicted conditions resulting from repetitive behaviors directed at the nail, commonly secondary to impaired emotional regulation. These disorders fall within the category of body-focused repetitive behaviors and frequently overlap with psychiatry and dermatology. Common disorders include onychophagia, onychotillomania, habit-tic deformity, Heller’s median canaliform nail dystrophy, onycholysis semilunaris, and onychodaknomania. Complications may range from paronychia, melanonychia, to permanent nail bed damage, and in severe cases, loss of the terminal phalanx. Diagnosis is based on clinical evaluation and recognition of behavioral patterns. Management requires patient education, behavioral modification therapy, and psychiatric intervention. Increased awareness of these disorders is essential to avoid misdiagnosis, provide timely treatment, and improve patient outcomes. Key words: Autoaggressive nail disorders, Body-focused repetitive behaviors, Onychophagia, Onychotillomania, Habit-tic deformity
Access to obstetric ultrasound is often limited in low-resource settings, particularly in rural areas of low- and middle-income countries. This work proposes a human-in-the-loop artificial intelligence (AI) system designed to assist midwives in acquiring diagnostically relevant fetal images using blind sweep protocols. The system incorporates a classification model along with a web-based platform for asynchronous specialist reviews. By identifying key frames in blind sweep studies, the AI system allows specialists to concentrate on interpretation rather than having to review entire videos. To evaluate its performance, blind sweep videos captured by a small group of soft-trained midwives using a low-cost Point-of-Care Ultrasound (POCUS) device were analyzed. The system demonstrated promising results in identifying standard fetal planes from sweeps made by non-experts. A field evaluation indicated good usability and a low cognitive workload, suggesting that it has the potential to expand access to prenatal imaging in underserved regions.
CASE:A 19-year-old woman had 4 years of right-wrist pain, weakness, and limited motion. No syndromic stigmata or family history. Radiographs showed isolated unilateral Madelung deformity with negative ulnar variance. Planning required radial shortening; a modified double-cut dome osteotomy with segmental resection was performed, with Vickers ligament release and volar plate fixation. At 12 months, union was achieved with restored alignment and neutral ulnar variance; she reported complete pain relief and full function. Wrist motion and grip strength normalized. CONCLUSION:This modified double-cut dome osteotomy permits intentional resection for radial shortening while preserving multiplanar correction in atypical negative ulnar variance. LEVEL OF EVIDENCE:IV.
