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A man in his 70s was referred to the endocrine surgery department after incidental finding of hypercalcaemia during preoperative work-up for abdominal aortic aneurysm repair. The patient reported severe fatigue and malaise with no previous history of nephrolithiasis or osteoporosis. After biochemical confirmation of primary hyperparathyroidism, localisation studies suggested multiple gland disease. Intraoperatively, three enlarged parathyroid adenomas were found and excised. Histopathological and immunohistochemical examination revealed triple water clear cell (WCC) parathyroid adenomas. Adenomas being entirely composed of WCCs are rare. In addition, triple adenomas are so rare that their existence is disputed by some authors. The present paper reports on an extremely rare case of a patient suffering from triple parathyroid adenomas composed entirely of WCCs. To our knowledge, this is the first such reported case in the English language literature.

The definition of the mandibular angle profile is a common challenge for oral and maxillofacial surgeons. Accurate diagnosis and treatment planning are mandatory in order to properly manage soft and hard tissues. The use of several biomaterials is described in the literature. The present paper reports the treatment of a defect in the right mandibular angle in otomandibular syndrome sequelae by positioning polyetheretherketone (PEEK) patient-specific implants (PSI) in a 25-year-old patient who previously underwent orthognathic surgery. Satisfactory aesthetic results were achieved with no complications 12 months after surgery. Considering its advantageous physical properties and the low rate of postoperative complications reported in the literature, PEEK can increase the treatment options for recontouring not only the upper third and the middle third of the face, but also of the lower third, in particular in cases of large three-dimensional defects.

A man in his twenties with a history of recurrent sinusitis was urgently referred to the emergency department (ED) by an out-of-hours general practitioner following a 2-day history of increasing right eye pain, redness and swelling after a week of coryzal symptoms. He denied visual impairment and any history of recent dental pain or procedures. Initial assessment in ED noted fever, tachycardia and hypotension. Video consultation with ophthalmologist in the ED identified proptosis, periorbital erythema and chemosis with full eye movement solely affecting the right eye. Visual acuity of 6/6 was confirmed in both eyes. After review by the ear, nose and throat (ENT) team, a diagnosis of sinogenic right orbital cellulitis was made, empirical antibiotics started and care transferred to the ENT team for immediate surgical intervention. 48 hours postoperatively, the patient acutely deteriorated, developing ophthalmoplegia and visual acuity of 6/95 in the right eye. Repeat imaging demonstrated a deteriorating picture and urgent surgery was organised at a neighbouring hospital’s specialist ENT unit combined with a change to his antibiotics. On day 4, 1 day following transfer, an anaerobic bacterium,Eggerthia catenaformis,was isolated from blood cultures collected on admission. The patient improved clinically following the second surgery and targeted antimicrobial therapy, eventually being discharged 10 days after initial presentation. In addition toE. catenaformis, the Anaerobic Reference Unit (Cardiff) identified two further anaerobic bacteria,Parvimonas micraandDialister pneumosintes. This paper presents the first documented case of polymicrobial anaerobic orbital cellulitis secondary to acute bacterial sinusitis. Moreover, this case underpins the importance of broad empirical antibiotics coupled with surgical source control to effectively manage a rare but sight-threatening and life-threatening disease.

How are abstract concepts such as ‘freedom' and ‘democracy' represented in the mind? One prominent proposal suggests that abstract concepts are grounded in emotion. Supporting this ‘affective embodiment' account, abstract concepts are rated to be more strongly positive or more strongly negative than concrete concepts. This paper demonstrates that this finding generalizes across languages by synthesizing rating data from Cantonese, Mandarin Chinese, Croatian, Dutch, French, German, Indonesian, Italian, Polish and Spanish. However, a deeper look at the same data suggests that the idea of emotional grounding only characterizes a small subset of abstract concepts. Moreover, when the concreteness/abstractness dimension is not operationalized using concreteness ratings, it is actually found that concrete concepts are rated as more emotional than abstract ones. Altogether, these results suggest limitations to the idea that emotion is an important factor in the grounding of abstract concepts. This article is part of the theme issue ‘Concepts in interaction: social engagement and inner experiences’.

Lipomas are benign tumours of mesenchymal origin, representing one of the most common tumours of the body. They are often observed between the fourth and the sixth decade of life and in 13% of the cases they occur in the head and neck region. In case of symptoms, surgical removal is the treatment of choice; when the formation involves the temporal region, the surgical approach is often challenging due to the presence of the neurovascular structures, such as the temporalis branch of the facial nerve and their potential extension to the nearby structures under the zygomatic arch to either the infratemporal fossa or the buccal region. Recurrence can occur frequently only if there is incomplete removal of lipoma. In this paper, the authors discuss surgical pitfalls of a very rare case of a large-sized symptomatic lipoma extended to the infratemporal and pterygomaxillary fossa, surgically removed via trans-zygomatic hemicoronal approach.

Cooperative networks are essential features of human society. Evolutionary theory hypothesizes that networks are used differently by men and women, yet the bulk of evidence supporting this hypothesis is based on studies conducted in a limited range of contexts and on few domains of cooperation. In this paper, we compare individual-level cooperative networks from two communities in Southwest China that differ systematically in kinship norms and institutions—one matrilineal and one patrilineal—while sharing an ethnic identity. Specifically, we investigate whether network structures differ based on prevailing kinship norms and type of gendered cooperative activity, one woman-centred (preparation of community meals) and one man-centred (farm equipment lending). Our descriptive results show a mixture of ‘feminine’ and ‘masculine’ features in all four networks. The matrilineal meals network stands out in terms of high degree skew. Exponential random graph models reveal a stronger role for geographical proximity in patriliny and a limited role of affinal relatedness across all networks. Our results point to the need to consider domains of cooperative activity alongside gender and cultural context to fully understand variation in how women and men leverage social relationships toward different ends.This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.

Humans rely on both kin and non-kin social ties for a wide range of support. In patrilocal societies that practice village exogamy, women can face the challenge of building new supportive networks when they move to their husband's village and leave many genetic kin behind. In this paper, we track how women from 10 diverse communities in rural Bangladesh build supportive networks after migrating to their husband's village, comparing their trajectories with women who remained in their childhood village (Bengali: n = 317, Santal: n = 36, Hajong: n = 39, Mandi: n = 36). Women who migrated for marriage started with almost no adult close kin (mean 0.1) compared to women who remained in their childhood village (mean 2.4). However, immigrants compensated for the lack of genetic kin by a combination of close affinal kin and close friends. By their late 20s, immigrants reported substantially more non-kin friends than did non-immigrants (mean 1.4 versus 1.1) and a comparable number of supportive partners in several domains. These findings raise questions about the functions and quality of these different social ties and how different composition of supportive networks may provide different opportunities for women in these settings. This article is part of the theme issue ‘Cooperation among women: evolutionary and cross-cultural perspectives’.

We investigate the value of a two-armed Bayesian response adaptive randomization (RAR) design to investigate early preterm birth rates of high versus low dose of docosahexaenoic acid during pregnancy. Unexpectedly, the COVID-19 pandemic forced recruitment to pause at 1100 participants rather than the planned 1355. The difference in power between number of participants at the pause and planned was 87% and 90% respectively. We decided to stop the study. This paper describes how the RAR was used to execute the study. The value of RAR in two-armed studies is quite high and their use in the future is promising.

In this paper, we provide an overview of the evolution of the definition of hyperglycemia during the past century and the alterations in glucose dynamics that cause fasting and postprandial hyperglycemia. We discuss how extensive mechanistic, physiological research into the factors and pathways that regulate the appearance of glucose in the circulation and its uptake and metabolism by tissues and organs has contributed knowledge that has advanced our understanding of different types of hyperglycemia, namely prediabetes and diabetes and their subtypes (impaired fasting plasma glucose, impaired glucose tolerance, combined impaired fasting plasma glucose, impaired glucose tolerance, type 1 diabetes, type 2 diabetes, gestational diabetes mellitus), their relationships with medical complications, and how to prevent and treat hyperglycemia.