Social relationships shape human health and mortality via behavioral, psychosocial, and physiological mechanisms, including inflammatory and immune responses. Though not tested in human studies, recent primate studies indicate that the gut microbiome may also be a biological mechanism linking relationships to health. Integrating microbiota data into the 60-year-old Wisconsin Longitudinal Study, we found that socialness with family and friends is associated with differences in the human fecal microbiota. Analysis of spouse (N = 94) and sibling pairs (N = 83) further revealed that spouses have more similar microbiota and more bacterial taxa in common than siblings, with no observed differences between sibling and unrelated pairs. These differences held even after accounting for dietary factors. The differences between unrelated individuals and married couples was driven entirely by couples who reported close relationships; there were no differences in similarity between couples reporting somewhat close relationships and unrelated individuals. Moreover, married individuals harbor microbial communities of greater diversity and richness relative to those living alone, with the greatest diversity among couples reporting close relationships, which is notable given decades of research documenting the health benefits of marriage. These results suggest that human interactions, especially sustained, close marital relationships, influence the gut microbiota.

The authors sought to assess the safety and early efficacy of the pCONUS Bifurcation Aneurysm Implants in a meaningful number of patients; we performed a systematic review and meta-analysis for the treatment of 203 intracranial aneurysms. A literature search was performed by a reference librarian, and after screening nine case series were included in this analysis. We estimated from each study the cumulative incidence (event rate) and 95% confidence interval (CI) for each outcome. Event rates were pooled in a meta-analysis across studies using the random-effects model; descriptive statistics were reported when relevant. The pCONUS devices can be used with a technical success rate of 100% (95% CI: 0.98-1.00) and a technical complication rate of 0% (95% CI: 0.00-0.02). Perioperative morbidity and mortality rates were 7% (95% CI: 0.03-0.11) and 0% (95% CI: 0.00-0.01), respectively. Perioperative hemorrhage rate was 0% (95% CI: 0.00-0.02); rate of treatment-related long-term neurological deficit was 2% (95% CI: 0.00-0.06). The long-term complete occlusion rate was 60% (95% CI: 0.52-0.69) and retreatment rate was 14% (95% CI: 0.06-0.22). The pCONUS devices are an additional tool for the treatment of wide-necked intracranial aneurysms with high rates of technical success and sufficiently low rates of morbidity and mortality. Comparative studies with longer-term follow-up are needed to clarify the role of this device in the management of challenging aneurysms.

Objective Twitter is a popular social media platform among physicians. Neurointerventionalists frequently document their lifesaving mechanical thrombectomy cases on Twitter with very favorable results. We fear that there may be some social media publication bias to tweeted mechanical thrombectomy cases with neurointerventionalists being more likely to tweet cases with favorable outcomes. We used these publicly documented cases to analyze post-intervention Twitter-reported outcomes and compared these outcomes with the data provided in the gold standard literature. Methods Two reviewers performed a search of Twitter for tweeted cases of acute ischemic strokes treated with mechanical thrombectomy. Data were abstracted from each tweet regarding baseline characteristics and outcomes. Twitter-reported outcomes were compared with the Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke (HERMES) trial individual patient meta-analysis. Results When comparing the tweeted results to HERMES, tweeted cases had a higher post-intervention rate of modified Thrombolysis In Cerebral Infarction (mTICI) scale score of 2c/3 (94% vs 71%, respectively; p<0.0001) and rate of National Institutes of Health Stroke Scale (NIHSS) score ≤2 (81% vs 21%, respectively; p<0.0001). There were no reported complications; thus, tweeted cases also had significantly lower rates of complications, including symptomatic intracerebral hemorrhage (0% vs 4.4%, respectively; p<0.0001), type 2 parenchymal hemorrhage (0% vs 5.1%, respectively; p<0.0001), and mortality (0% vs 15.3%, respectively; p<0.0001). Conclusions There is a significant difference between social media and reality even within the ‘MedTwitter’ sphere, which is likely due to a strong publication bias in Twitter-reported cases. Content on ‘MedTwitter’, as with most social media, should be accepted cautiously.

Study Design: Cross-sectional study Objective: Childhood participation in boxing and martial arts has increased over the past decade, and these activities are well-known causes of traumatic injury. We hypothesized that the face is frequently injured in the setting of pediatric boxing and martial arts trauma in the United States and that there are identifiable injury patterns. Methods: We performed a cross-sectional study of consecutive pediatric patients in the National Electronic Injury Surveillance System (NEISS) from January 1, 2010 to December 31, 2019. Patients were included in our study if they were younger than 18 years of age and evaluated in the emergency department (ED) after boxing or martial arts trauma. Primary outcome was facial injury. Other variables of interest include age, sex, ED disposition, type and location of injury. Descriptive and univariate statistics of the primary outcome were computed with these variables. Results: There were 4,978 total pediatric patients injured due to boxing and martial arts trauma reported by NEISS-participating EDs during the study period, and 264 patients experienced injury to the face (264/4978; 5.3%). Over 20% (n = 60) of reported facial injuries were fractures; the most fractured structure was the nose (42/60; 70), orbit (11/60; 18.3%), and mandible (6/60; 10%). Almost 20% (11/60%) of pediatric facial fractures due to boxing and martial arts trauma involved fighting a family member or friend, and a punch was the most common mode of fracture (42/58; 72.4%). Conclusions: Facial injuries comprise about 5% of injuries after boxing and martial arts trauma and 22% of these facial injuries are fractures. If children choose to participate, parents, coaches, trainers, officials, and community leaders should make the greatest effort possible to minimize risk, including the mandatory use of head and face protective gear and elimination of training fighting, or “sparring.”