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Diagnosis and management of postoperative wound infections in the head and neck region

“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]” Credit: 2023 Barbarewicz…



“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]”

Credit: 2023 Barbarewicz et al.

“The majority of wound infections often manifest themselves immediately postoperatively, so close followup should take place […]”

BUFFALO, NY- October 20, 2023 – A new research perspective was published in Oncoscience (Volume 10) on October 4, 2023, entitled, “Diagnosis and management of postoperative wound infections in the head and neck region.”

In everyday clinical practice at a department for oral and maxillofacial surgery, a large number of surgical procedures in the head and neck region take place under both outpatient and inpatient conditions. The basis of every surgical intervention is the patient’s consent to the respective procedure. Particular attention is drawn to the general and operation-specific risks. 

Particularly in the case of soft tissue procedures in the facial region, bleeding, secondary bleeding, scarring and infection of the surgical area are among the most common complications/risks, depending on the respective procedure. In their new perspective, researchers Filip Barbarewicz, Kai-Olaf Henkel and Florian Dudde from Army Hospital Hamburg in Germany discuss the diagnosis and management of postoperative infections in the head and neck region.

“In order to minimize the wound infections/surgical site infections, aseptic operating conditions with maximum sterility are required.”

Furthermore, depending on the extent of the surgical procedure and the patient‘s previous illnesses, peri- and/or postoperative antibiotics should be considered in order to avoid postoperative surgical site infection. Abscesses, cellulitis, phlegmone and (depending on the location of the procedure) empyema are among the most common postoperative infections in the respective surgical area. The main pathogens of these infections are staphylococci, although mixed (germ) patterns are also possible. 

“Risk factors for the development of a postoperative surgical site infection include, in particular, increased age, smoking, multiple comorbidities and/or systemic diseases (e.g., diabetes mellitus type II) as well as congenital and/ or acquired immune deficiency [10, 11].”


Continue reading the paper: DOI: 

Correspondence to: Florian Dudde


Keywords: surgical site infection, head and neck surgery


About Oncoscience

Oncoscience is a peer-reviewed, open-access, traditional journal covering the rapidly growing field of cancer research, especially emergent topics not currently covered by other journals. This journal has a special mission: Freeing oncology from publication cost. It is free for the readers and the authors.

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Delivering aid during war is tricky − here’s what to know about what Gaza relief operations may face

The politics of delivering aid in war zones are messy, the ethics fraught and the logistics daunting. But getting everything right is essential − and…




Palestinians on the outskirts of Gaza City walk by buildings destroyed by Israeli bombardment on Oct. 20, 2023. AP Photo/Ali Mahmoud

The 2.2 million people who live in Gaza are facing economic isolation and experiencing incessant bombardment. Their supplies of essential resources, including food and water, are quickly dwindling.

In response, U.S. President Joe Biden has pledged US$100 million in humanitarian assistance for the citizens of Gaza.

As a scholar of peace and conflict economics who served as a World Bank consultant during the 2014 war between Hamas and Israel, I believe that Biden’s promise raises fundamental questions regarding the delivery of humanitarian aid in a war zone. Political constraints, ethical quandaries and the need to protect the security of aid workers and local communities always make it a logistical nightmare.

In this specific predicament, U.S. officials have to choose a strategy to deliver the aid without the perception of benefiting Hamas, a group the U.S. and Israel both classify as a terrorist organization.


When aiding people in war zones, you can’t just send money, a development strategy called “cash transfers” that has become increasingly popular due to its efficiency. Sending money can boost the supply of locally produced goods and services and help people on the ground pay for what they need most. But injecting cash into an economy so completely cut off from the world would only stoke inflation.

So the aid must consist of goods that have to be brought into Gaza, and services provided by people working as part of an aid mission. Humanitarian aid can include food and water; health, sanitation and hygiene supplies and services; and tents and other materials for shelter and settlement.

Due to the closure of the border with Israel, aid can arrive in Gaza only via the Rafah crossing on the Egyptian border.

The U.S. Agency for International Development, or USAID, will likely turn to its longtime partner on the ground, the United Nations Relief and Works Agency, or UNRWA, to serve as supply depots and distribute goods. That agency, originally founded in 1949 as a temporary measure until a two-state solution could be found, serves in effect as a parallel yet unelected government for Palestinian refugees.

USAID will likely want to tap into UNRWA’s network of 284 schools – many of which are now transformed into humanitarian shelters housing two-thirds of the estimated 1 million people displaced by Israeli airstrikes – and 22 hospitals to expedite distribution.

Map of Gaza and its neighbors
Gaza is a self-governing Palestinian territory. The narrow piece of land is located on the coast of the Mediterranean Sea, bordered by Israel and Egypt. PeterHermesFurian/iStock via Getty Images Plus


Prior to the Trump administration, the U.S. was typically the largest single provider of aid to the West Bank and Gaza. USAID administers the lion’s share of it.

Since Biden took office, total yearly U.S. assistance for the Palestinian territories has totaled around $150 million, restored from just $8 million in 2020 under the Trump administration. During the Obama administration, however, the U.S. was providing more aid to the territories than it is now, with $1 billion disbursed in the 2013 fiscal year.

But the White House needs Congress to approve this assistance – a process that requires the House of Representatives to elect a new speaker and then for lawmakers to approve aid to Gaza once that happens.


The United Nations Relief and Works Agency is a U.N. organization. It’s not run by Hamas, unlike, for instance, the Gaza Ministry of Health. However, Hamas has frequently undermined UNRWA’s efforts and diverted international aid for military purposes.

Hamas has repeatedly used UNRWA schools as rocket depots. They have repeatedly tunneled beneath UNRWA schools. They have dismantled European Union-funded water pipes to use as rocket fuselages. And even since the most recent violence broke out, the UNRWA has accused Hamas of stealing fuel and food from its Gaza premises.

Humanitarian aid professionals regularly have to contend with these trade-offs when deciding to what extent they can work with governments and local authorities that commit violent acts. They need to do so in exchange for the access required to help civilians under their control.

Similarly, Biden has had to make concessions to Israel while brokering for the freedom to send humanitarian aid to Gaza. For example, he has assured Israel that if any of the aid is diverted by Hamas, the operation will cease.

This promise may have been politically necessary. But if Biden already believes Hamas to be uncaring about civilian welfare, he may not expect the group to refrain from taking what they can.

Security best practices

What can be done to protect the security of humanitarian aid operations that take place in the midst of dangerous conflicts?

Under International Humanitarian Law, local authorities have the primary responsibility for ensuring the delivery of aid – even when they aren’t carrying out that task. To increase the chances that the local authorities will not attack them, aid groups can give “humanitarian notification” and voluntarily alert the local government as to where they will be operating.

Hamas has repeatedly flouted international norms and laws. So the question of if and how the aid convoy will be protected looms large.

Under the current agreement between the U.S., Israel and Egypt, the convoy will raise the U.N. flag. International inspectors will make sure no weapons are on board the vehicles before crossing over from Arish, Egypt, to Rafah, a city located on the Gaza Strip’s border with Egypt.

The aid convoy will likely cross without militarized security. This puts it at some danger of diversion once inside Gaza. But whether the aid convoy is attacked, seized or left alone, the Biden administration will have demonstrated its willingness to attempt a humanitarian relief operation. In this sense, a relatively small first convoy bearing water, medical supplies and food, among other items, serves as a test balloon for a sustained operation to follow soon after.

If the U.S. were to provide the humanitarian convoy a military escort, by contrast, Hamas could see its presence as a provocation. Washington’s support for Israel is so strong that the U.S. could potentially be judged as a party in the conflict between Israel and Hamas.

In that case, the presence of U.S. armed forces might provoke attacks on Gaza-bound aid convoys by Hamas and Islamic jihad fighters that otherwise would not have occurred. Combined with the mobilization of two U.S. Navy carrier groups in the eastern Mediterranean Sea, I’d be concerned that such a move might also stoke regional anger. It would undermine the Biden administration’s attempts to cool the situation.

On U.N.-approved missions, aid delivery may be secured by third-party peacekeepers – meaning, in this case, personnel who are neither Israeli nor Palestinian – with the U.N. Security Council’s blessing. In this case, tragically, it’s unlikely that such a resolution could conceivably pass such a vote, much less quickly enough to make a difference.

Topher L. McDougal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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G77 Nations, China, Push Back On U.S. “Loss And Damage” Climate Fund In Days Leading Up To UN Summit

G77 Nations, China, Push Back On U.S. "Loss And Damage" Climate Fund In Days Leading Up To UN Summit

As was the case in primary school with…



G77 Nations, China, Push Back On U.S. "Loss And Damage" Climate Fund In Days Leading Up To UN Summit

As was the case in primary school with bringing in presents, make sure you bring enough for the rest of the class, otherwise people get ornery...

This age old rule looks like it could be rearing its head in the days leading up to the UN COP 28 climate summit, set to take place in the United Arab Emirates in about six weeks. 

At the prior UN COP 27, which took place in Egypt last year, the U.S. pushed an idea for a new World Bank "loss and damage" climate slush fund to help poor countries with climate change. But the G77 nations plus China, including many developing countries, are pushing back on the idea, according to a new report from the Financial Times

The goal was to arrange how the fund would operate and where the money would come from for the "particularly vulnerable" nations who would have access to it prior to the upcoming summit in UAE.

But as FT notes, Pedro Luis Pedroso Cuesta, the Cuban chair of the G77 plus China group, has said that talks about these details were instead "deadlocked" over issues of - you guessed it - where the money is going and the governance of the fund.

The U.S.'s proposal for the fund to be governed by the World Bank has been rejected by the G77 after "extensive" discussions, the report says. Cuesta has said that the nations seek to have the fund managed elsewhere, but that the U.S. wasn't open to such arrangements. 

Cuesta said: “We have been confronted with an elephant in the room, and that elephant is the US. We have been faced with a very closed position that it is [the World Bank] or nothing.”

Christina Chan, a senior adviser to US climate envoy John Kerry, responded: “We have been working diligently at every turn to address concerns, problem-solve, and find landing zones.” She said the U.S. has been "clear and consistent" in their messaging on the need for the fund. 

Cuesta contends that the World Bank, known for lending to less affluent nations, lacks a "climate culture" and often delays decision-making, hindering quick responses to climate emergencies like Pakistan's recent severe flooding.

The G77 coalition voiced concerns about the World Bank's legal framework potentially limiting the fund's ability to accept diverse funding sources like philanthropic donations or to access capital markets.

With just days left before the UN COP 28 summit, the World Bank insists that combating climate change is integral to its mission and vows to collaborate on structuring the fund.

Tyler Durden Fri, 10/20/2023 - 15:45

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Guest Contribution: “Exchange Rate Elasticities and Product Sophistication”

Today, we’re fortunate to have Willem Thorbecke, Senior Fellow at Japan’s Research Institute of Economy, Trade and Industry (RIETI) as a guest contributor….



Today, we’re fortunate to have Willem Thorbecke, Senior Fellow at Japan’s Research Institute of Economy, Trade and Industry (RIETI) as a guest contributor. The views expressed represent those of the author himself, and do not necessarily represent those of RIETI, or any other institutions the author is affiliated with.

Large Exchange Rate Appreciations

Exchange rates can appreciate substantially.  The U.S. real effective exchange rate (REER) appreciated 34% between July 2011 and September 2023 (see Figure 1).[1]  The Swiss REER appreciated 36% between October 2007 and September 2011.  The Japanese REER appreciated 38% between July 2007 and January 2012.  The British REER appreciated 27% between January 2009 and August 2015.

Figure 1: U.S. Real Effective Exchange Rate.  Source: Bank for International Settlements. 

Large appreciations erode the price competitiveness of exports and cause dislocation.  The Swiss National Bank responded to the appreciation in September 2011 by setting a floor for the Swiss franc relative to the euro.  The yen appreciation decimated the Japanese electronics industry.  The pound appreciation crowded out the British manufacturing sector (see Krugman, 2016 and Mody, 2016).


Exchange Rate Elasticities and Product Complexity

How can countries protect themselves from the harmful effects of appreciations on exports?  One way would be to produce goods that are less sensitive to exchange rates. Abiad et al. (2018) and Asia Development Bank  (2018) noted that sophisticated goods are harder to produce. There will thus be fewer substitutes for these goods and customers will need to spend more time and effort to find replacements. When there are fewer substitutes, microeconomic theory teaches us that price elasticities will be lower.  Thus exports of complex products may be less sensitive to exchange rates.

Abiad et al.(2018) and Asia Development Bank (2018) recommended measuring product complexity using the methods of Hidalgo and Hausmann (2009).  Hidalgo and Hausmann employed the method of reflections to calculate a product’s complexity. This approach takes account of how ubiquitous a good is, as measured by the number of countries that have a revealed comparative advantage in exporting the good. This method also takes account of how diversified an economy is, as measured by the number of goods that the economy exports with revealed comparative advantage. Hidalgo and Hausmann used an iterative process involving product ubiquity and economy diversification to derive a product complexity index (PCI) for more than 1,200 products disaggregated at the Harmonized System (HS) 4-digit level.

Arbatli and Hong (2016) employed Hidalgo and Hausmann’s  (2009) PCI to investigate whether more sophisticated exports from Singapore have lower exchange rate elasticities. They used annual data disaggregated at the HS 4-digit level over the 1989 to 2013 period.  They also used a mean group estimator and found that products that are more complex are less responsive to exchange rates.

Sauré (2015) investigated how exchange rates impact Switzerland’s trade in pharmaceutical and non-pharmaceutical goods.  Pharmaceutical goods are sophisticated and require extensive research and development.  He employed annual panel data on Switzerland’s trade with 24 partners over the 1988–2007 period.  He used Arellano-Bond estimation and reported that an appreciation of the Swiss franc had no impact on Switzerland’s trade balance in pharmaceutical goods but lowered Switzerland’s trade balance in non-pharmaceutical goods.

Baiardi et al. (2015) examined price elasticities for clothing.  Clothing is a low-technology good produced by many countries.  They used annual data over the 1992-2011 period on clothing exports from 12 countries disaggregated into 4-digit Standard Industrial Trade Classification categories.  They measured relative prices as the ratio of the country’s export unit value for each 4-digit clothing category to the average export unit value for the other 11 exporters of the same good. They employed system generalized method of moments techniques and found that price increases decreased exports for 11 of the 12 countries.  On average, a 10% increase in relative prices for these countries would reduce clothing exports by 7.5%.

Previous research thus indicates that sophisticated exports such as pharmaceuticals are not affected by exchange rates and while basic products such as clothing are.  In recent work (Thorbecke et al., 2021 and Chen et al., 2023), we investigated the relationship between product complexity as measured by  Hidalgo and Hausmann’s (2009) method and exchange rate elasticities for China, the world’s leading exporter. We used Bénassy-Quéré et al.’s (2021) approach to estimate exchange rate elasticities.  Thorbecke et al. examined China’s exports of 960 manufactured goods disaggregated at the HS 4-digit level to 190 partners over the 1995-2018 period. They reported that a 10% appreciation of the Chinese yuan causes a fall in exports of 2.5% for the most sophisticated exports, 4.5% for medium-high sophisticated exports, 6.8% for medium sophisticated exports, 8.5% for medium-low sophisticated exports, and 12.4% for the least sophisticated exports (see Figure 2). Chen et al. examined China’s exports of 1,242 goods disaggregated at the HS 4-digit level to 190 partners over the 1995-2018 period.  They found that appreciations significantly reduced exports during the 1990s and early 2000s. However, as China has upgraded its production capabilities and exported more technologically advanced products, its exchange rate elasticities have fallen.

Figure 2: The Relationship between Exchange Rate Elasticities and Product Complexity for China’s Exports. Notes: Real exchange rate elasticities are estimated for China’s exports of 960 manufacturing goods disaggregated at the Harmonized System 4-digit level to 190 countries over the 1995-2018 period. The 960 categories are sorted into five levels of complexity using the methodology of Hidalgo and Hausmann (2009). The exchange rate is interacted with dummy variables for complexity levels.  The regressors also include real GDP in the importing countries and importer-product and time fixed effects. Source: Calculations by the authors.

Lessons for the U.S.

For the appreciations mentioned in the opening paragraph, exchange rates subsequently depreciated for Switzerland, Japan, and Britain.  The U.S. REER, however, remains strong.  Recent estimates suggest that a strong U.S. dollar keeps steady state U.S. exports lower and the steady state U.S. trade deficit higher.

The Atlas of Economic Complexity reported that the ranking of the U.S. economy in terms of complexity has fallen eight places between 2000 and 2021 while the ranking of the Chinese economy has risen 21 places over this period. According to the Atlas, Japan, South Korea, and Singapore ranked among the top five most complex economies in the world in 2021. Historically the success of East Asian economies at climbing the technology ladder and producing sophisticated goods was driven by factors such as entrepreneurs who face appropriate incentives, workers who are hardworking and well-educated, fiscal policy that is disciplined, national saving rates that are high, infrastructure that is world class, and exchange rates that are not too strong. The U.S., to increase the complexity of its exports and to better weather periods of strong exchange rates, should take a page out of Asia’s playbook.  It should also avoid policy mixes such as expansionary fiscal policy and contractionary monetary policy that produce large dollar appreciations.



Abiad, A., Baris, K., Bertulfo, D., Camingue-Romance, S., Feliciano, P., Mariasingham, J., Mercer-Blackman, V., and Bernabe, J. 2018. The Impact of Trade Conflict on Developing Asia. (Working Paper No. 566). Manila: Asian Development Bank.

Arbatli, E., and Hong, G. H. 2016. Singapore’s Export Elasticities: A Disaggregated Look into the Role of Global Value Chains and Economic Complexity (Working Paper No. 16–52). Washington, DC: International Monetary Fund.

Asian Development Bank. 2018. Asian Development Outlook Update: Maintaining Stability Amid Heightened Uncertainty. Manila: Asian Development Bank.

Baiardi, D., Bianchi, C., and Lorenzini, E.. 2015. The Price and Income Elasticities of the Top Clothing Exporters: Evidence from a Panel Data Analysis. Journal of Asian Economics 38: 14–30.

Bénassy-Quéré, A., Bussière, M., and Wibaux, P. 2021. Trade and Currency Weapons. Review of International Economics, 29: 487-510.

Chen, C., Salike, N., and Thorbecke, W. 2023. Exchange Rate Effects on China’s Exports: Product Sophistication and Exchange Rate Elasticity. Forthcoming in the Asian Economic Journal,

Hidalgo, C.A,and Hausmann, R. 2009. The Building Blocks of Economic  Complexity. Proceedings of the National Academy of Sciences of the United States of America 106 (26): 10570–75.

Krugman, P. 2016. Notes on Brexit and the Pound. The Conscience of a Liberal Weblog, 11 October.

Mody, A. 2016. Don’t Believe What You’ve Read: The Plummeting Pound Sterling is Good News for Britain. Independent, 10 October.

Sauré, P. 2015. The Resilient Trade Surplus, the Pharmaceutical Sector, and Exchange Rate Assessments in Switzerland. (Working Papers No. 15-11). Washington DC: Peterson Institute for International Economics.

Thorbecke, W., Chen, C., and Salike, N. 2021. The Relationship between Product Complexity and Exchange Rate Elasticities: Evidence from the People’s Republic of China’s Manufacturing Industries. Asian Development Review, 38: 189-212.

[1] REER data come from the Bank for International Settlements.

This post written byby Willem Thorbecke.

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