Search Results (41,189)

Background: Osteoporosis has a rising global incidence and social burden. Serum uric acid’s dual roles in oxidative stress and inflammation may influence bone health, but findings are inconsistent and require further research. This study aimed to evaluate the relationship between SUA levels and osteoporosis in a multicenter cohort obtained from different regions of Türkiye. Methods: This multi-center retrospective study included 3280 individuals, postmenopausal women and men aged 45 and older, from 16 centers in Türkiye. Individuals were excluded if they recently consumed alcohol, had severe renal dysfunction, certain hormonal or mineral disorders, specific medications, or certain menopausal statuses. Bone mineral density (BMD) at the hip and lumbar spine was measured using dual-energy X-ray absorptiometry (DXA), and participants were classified as normal or having osteopenia or osteoporosis based on T-score thresholds. Results: Overall, 34.8% were male, and 65.2% were female. For the lumbar spine, 36.8% had osteopenia, and 13.5% had osteoporosis; similarly, for the total hip, 40.8% had osteopenia, and 7.9% had osteoporosis. ROC analysis identified a threshold of 3.9 mg/dL serum uric acid (SUA) (AUC 0.374; p < 0.001), which was positively associated with both lumbar and total hip BMD. Osteoporosis rates were higher in patients with SUA < 3.9 mg/dL compared to those with SUA ≥ 3.9 mg/dL at the lumbar spine (29.1% vs. 14.2%, p < 0.001) and total hip sites (23.6% vs. 15.9%, p = 0.003). After adjustment for potential confounders, SUA was a significant independent predictor of osteoporosis in the lumbar spine (OR 0.70; p < 0.001) and the hip (OR 0.80; p < 0.001). Conclusions: Serum uric acid levels are inversely linked to bone mineral density and osteoporosis risk, indicating a potential role in bone health. However, due to study limitations, causal relationships remain unproven, and further research is needed. Full article

Background/Objectives: The objective of this study was to evaluate, for the first time, the effectiveness and safety of 4% icodextrin solution by detecting the incidence of adhesion-related morbidities (adhesion-related hospital readmissions, including reoperations) when used as an adhesion prophylactic agent during laparoscopic gynecologic surgery. Methods: The study was a single-arm, two-center, retrospective study. The incidence of hospital readmissions that were directly or possibly related to adhesions following the use of 4% icodextrin in laparoscopic gynecologic surgery, 2 years from the date of index surgery, was assessed either via chart review alone or, when found necessary, in combination with patient-completed questionnaires. Patient safety was evaluated through reported adverse events. The relationship between clinical events and the use of 4% icodextrin was assessed by investigators based on patient-level data. Results: After 149 patients were screened, the study finally included 123 patients; 4 (3.3%; 95% CI: 0.89%, 8.12%) had at least one reoperation or readmission that was directly or possibly related to adhesion within 2 years of index surgery. In the supplemental analysis (67 patients using chart and questionnaire data), this incidence rate was 10.4% (95% CI: 4.30%, 20.35%). No adverse events related to the use of 4% icodextrin were reported. Conclusions: This is the first study ever evaluating hospital readmission/reoperation rates after application of a specific adhesion prophylactic agent. The results indicate that 4% icodextrin is safe and effective when used as an intraperitoneal instillate for reduction in adhesions in gynecological laparoscopic procedures. It has a lower readmission and reoperation rate compared to meta-analysis data in the international literature. Full article

Background/Objectives: To compare the five-year efficacy and safety of the 63 µm (XEN63) vs. 45 µm (XEN45) XEN^® Gel Stent in patients with open-angle glaucoma (OAG). Methods: This retrospective matched (1:1) cohort study included adults with OAG who underwent standalone ab interno implantation of the XEN63 or the XEN45 between 2014 and 2021 at a tertiary referral center in Belgium. The primary outcome was IOP at five years. The secondary outcomes included surgical success, topical medication use, postoperative hypotony, complications and interventions. Results: Thirty eyes of 30 patients (15 XEN63 and 15 XEN45) were analyzed. The baseline characteristics were comparable. At five years, the mean IOP did not differ between the XEN63 and the XEN45 (11.5 vs. 11.0 mmHg; p = 0.54). The XEN63 demonstrated higher complete success rates than the XEN45 for both the IOP < 18 mmHg (10 vs. four eyes; p = 0.016) and <15 mmHg criteria (10 vs. three eyes; p = 0.003). The topical medication use was low and comparable (0.6 vs. 0.9 medications; p = 0.57). The numerical (13 vs. five eyes; p = 0.008) and symptomatic (six vs. two eyes; p = 0.2) hypotony were more frequent after the XEN63 implantation. The two eyes with XEN63 and none with XEN45 experienced clinically significant hypotony. The needling procedures and secondary glaucoma surgeries were more frequent after the XEN45. Conclusions: The XEN63 implantation was associated with higher long-term success rates and also with a higher incidence of early postoperative hypotony. These findings indicate a trade-off between efficacy and safety and suggest that careful patient selection and postoperative management are essential when considering larger lumen subconjunctival drainage devices. Full article

Background: The incidence and mortality rates of cancer among females aged 65 years or older in the Republic of Korea are increasing; however, the national cancer screening rate (50.4%) remains low. Therefore, this study aimed to identify predictors of participation in the National Cancer Screening Program (NCSP) among women aged 65 years or older using data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII, 2019–2021). Methods: This cross-sectional study utilized data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII, 2019–2021). Study variables were selected based on Andersen’s healthcare utilization model. Participation in the National Cancer Screening Program (NCSP) was defined as the dependent variable, and independent variables included predisposing, enabling, and need factors. Descriptive analyses were conducted to examine participants’ characteristics. Chi-square tests were used to assess differences in NCSP participation according to participant characteristics. Multivariable logistic regression analysis was conducted to identify factors associated with participation, with all independent variables simultaneously included in the model to adjust for potential confounding. A p-value of <0.05 was considered statistically significant. Results: A total of 2105 women aged 65 years or older were included in the analysis. Of the 2105 women aged 65 years or older, 1429 (67.9%) reported participation in cancer screening within the past two years. NCSP participation was significantly associated with being married (OR = 1.540; 95% CI: 1.263–1.879), being a middle school (OR = 1.357; 95% CI: 1.022–1.801) or college graduate or higher (OR = 2.012; 95% CI: 1.199–3.378), having private insurance (OR = 1.930; 95% CI: 1.573–2.368), average subjective health (OR = 1.332; 95% CI: 1.004–1.766), dyslipidemia (OR = 1.347; 95% CI: 1.110–1.636), and physical activity participation (OR = 1.252; 95% CI: 1.029–1.524). In contrast, urban residence, income level, being employed, medical coverage type, hypertension, diabetes, monthly drinking status and current smoking status were not statistically significantly correlated with NCSP participation. Conclusions: These findings highlight the need for tailored outreach strategies and health education programs targeting women aged 65 years and older to enhance participation in the NCSP and ultimately improve public health outcomes. Full article

Background/Objectives: Bond reliability is essential in orthodontic treatment, as temperature fluctuations in the oral environment can weaken adhesive interfaces and increase the risk of bracket failure. However, direct comparison of the long-term durability of commonly used orthodontic resin cements under thermocycling conditions is limited. Therefore, the present study aimed to evaluate and compare the shear bond strength (SBS) and failure modes of Transbond™ XT and Orthomite™ LC before and after thermal cycling (Tc). Methods: A total of 60 bovine enamel specimens were used in this study. Specimens were bonded with either Transbond XT or Orthomite LC under standardized conditions. SBS was measured at 24 h (Tc0) and after 5000 thermal cycles (Tc5000). Failure modes were classified as adhesive (A), enamel cohesive (B), or bracket cohesive (C) failure. Statistical analyses included the Mann–Whitney U test for SBS and Fisher’s exact test for failure mode distribution. Results: At Tc0, there was no significant difference in SBS between the two cements (p > 0.05). After Tc5000, Orthomite LC showed significantly higher SBS than Transbond XT (p = 0.00368). Failure mode analysis revealed that, after Tc, Transbond XT exhibited a higher incidence of adhesive failures (A), whereas Orthomite LC predominantly demonstrated bracket cohesive failures (C) (p = 0.00020). Conclusions: Orthomite LC demonstrated greater resistance to thermal cycling–induced bond degradation compared with Transbond XT, likely due to differences in resin monomer composition and interface stability. Full article

Transcatheter aortic valve implantation (TAVI) has become the preferred treatment for patients with symptomatic severe aortic valve stenosis. Newer-generation devices, increased operator experience, and improved patient selection have contributed to a reduction in complication rates. However, the occurrence of new-onset left bundle branch block (LBBB) after TAVI remains high, and currently it is the most common complication associated with the procedure. This review discusses the current understanding of new-onset LBBB, including its causes, incidence, clinical outcomes, and management strategies. Full article

City-scale augmented reality (AR) learning paths are outdoor, multi-stop educational routes delivered through mobile devices in public space. This paper examines the Art Nouveau Path, a mobile AR game (MARG) route in Aveiro, Portugal, as a deployable learning service. The focus is on implementation requirements and traceability rather than learning outcomes. The analysis combined profiling of eight points of interest (POIs) and 36 tasks, group-session logs from 118 sessions, and teacher-facing evidence from a validation workshop (T1-VAL, N = 30) and on-site observation (T2-OBS, N = 24). Open-text responses were segmented into meaning units and coded with an eight-determinant taxonomy, with good intercoder reliability (Krippendorff’s alpha = 0.83). Logs and the post-path questionnaire (S2-POST, N = 439) were used only to describe enactment feasibility and data integrity. The strongest determinants concerned onboarding and legibility, marker robustness and recovery, and curriculum alignment, together with safety and fallback needs. These signals were translated into 18 testable requirements linked to six transfer artefacts for enactment, maintenance, incident handling, and fallback. Overall, the study provides an implementation-oriented specification to support auditability, replication, and transfer in city-scale AR learning services. Full article

Background and Objectives: Patients with rheumatoid arthritis (RA) are found to have a higher risk of dental diseases. Although herbal medicines (HMs) have long been used to treat various conditions, few studies focus on its impact on dental diseases. In this longitudinal cohort study, we assessed the correlation between HM use and risk of dental diseases in RA groups. Materials and Methods: A total of 2359 persons with RA aged 20–80 who were free of dental diseases between 2001 and 2010 were retrospectively enrolled from nationwide register-based data. They were then classified into HMs and non-HMs groups based on whether they ever used combined HMs after RA onset. Incidence rate and hazard ratios (HRs) of dental diseases were estimated for both groups by the end of 2013 via fitting Cox proportional hazards model. Results: Incidence rate of dental disease was reported to be lower in the HMs group than in the non-HMs group (90.21 per 1000 person-years versus 106.94 per 1000 person-years, respectively). RA individuals treated with HMs showed a significantly lower risk of dental diseases, especially dental caries, pulpitis, periodontitis, and stomatitis. Among commonly prescribed formulas, eleven herbal products significantly associated with a lower risk of dental diseases, such as Hai-Piao-Xiao, Yan-Hu-Suo, Chuan-Niu-Xi, Mo-Yao, Olibanum, Bei-Mu, Mu-Gua, Gui-Zhi-Shao-Yao-Zhi-Mu-Tang, Shao-Yao-Gan-Cao-Tang, Xue-Fu-Zhu-Yu-Tang, and Ping-Wei-San. Conclusions: The addition of HMs treatment may have advantages to proactively prevent sequent risk of dental disorders for persons with rheumatic diseases. A deeper exploration focusing on pharmacological action is needed to provide more reliable evidence for the improvement of susceptible individuals’ oral hygiene. Full article

Photovoltaic systems deployed on large floating platforms in nearshore waters are strongly influenced by hydroelastic effects, nonlinear shallow-water waves, and variable bathymetry. This study develops a time-domain hydroelastic framework that couples the fully nonlinear non-hydrostatic wave model NHWAVE with a Rankine-source potential-flow solver and a discrete-module Cummins formulation. The wave model provides incident pressures and kinematics over uneven seabeds, while the potential-flow solver evaluates radiation and diffraction effects and transfers the resulting hydrodynamic coefficients into the time domain. Numerical simulations are carried out for a 600 m modular floating structure under regular waves over flat and sloped bathymetries with $tan\alpha =0.0133$, wave periods of 4–6 s, and wave heights of 0.3–1.0 m. The results show that bathymetric variation intensifies shoaling-induced excitation, modifies added-mass and damping distributions, increases the spatial non-uniformity of hydroelastic motions, and amplifies bending-moment RMS responses relative to the flat-bottom case. Additional comparisons between rigid-body and hydroelastic models show clear period-dependent redistribution of motions and bending demand. These results demonstrate that both local bathymetry and structural elasticity must be considered for the reliable analysis and design of nearshore floating photovoltaic systems and other large floating structures. Full article

Volatile organic compounds (VOCs) pose significant health risks. Photocatalytic oxidation offers a promising route for VOC purification under ambient conditions. Based on a review of over 80 studies, this article critically evaluates research progress on four semiconductor photocatalyst systems (TiO₂-based, g-C₃N₄-based, bismuth-based oxides, and MOFs) for VOC degradation. Unlike traditional descriptive reviews, this work establishes a quality-based filtering framework to distinguish studies reporting standardized photochemical parameters from those that do not. The analysis reveals a fundamental problem: the vast majority of reviewed studies lack essential parameters (incident photon flux, apparent quantum yield, or rigorous dark adsorption equilibrium), rendering cross-study comparisons invalid. Most literature relies on non-standardized metrics such as conversion percentages or rate constants per catalyst mass. While some high-quality studies report AQY, these remain a small fraction of the literature. Within individual studies under identical conditions, modification strategies enhance activity relative to controls, but relative efficiency (ζr) values are meaningful only within the same study and cannot be compared across setups. This review thus serves a dual purpose: to summarize modification strategies and to critically expose the lack of standardization. Future research must adopt unified reporting standards (photon flux, AQY, benchmarks under identical conditions) to transform the field into a reproducible, cumulative science. Full article

Context: In numerous low- and middle-income nations, malaria remains a significant issue due to the challenges associated with diagnosing it through thin blood smears. The appearance of images can vary significantly depending on the microscope type, magnification, lighting conditions, slide preparation methods, and staining techniques. Due to the delicate morphology of parasites, false negatives might adversely affect patient care. Objective: To achieve optimal outcomes from validation, it is essential to construct a robust and easily replicable process. This pipeline should integrate the optimal elements of classical machine learning and end-to-end deep learning, enhance reliability by pairwise ensembling, and select ensemble weights in a logical, data-driven manner. Method: To achieve our objective, we propose two tracks. The initial track encompasses real-time augmentation, convolution-based feature extraction, and the training of calibrated classical classifiers. The second module focuses on training many convolutional networks from inception to completion. Subsequently, we construct paired ensembles and employ a hybrid methodology to select convex weights for combining the findings. This method initially evaluates a set of candidate weights and then refines them to maximise validation accuracy. Results: The precision of the two-track architecture consistently improves, transitioning from conventional baselines to end-to-end models. Optimal and consistent enhancements are achieved through weighted ensembling. Utilising optimised fusion reduces the incidence of false negatives for subtle parasites and false positives caused by staining artefacts. This yields an accuracy of 96.35% on the reserved data and reduced variance across folds. Conclusions: The integration of augmentation, multiple modelling tracks, and optimal pairwise ensembling yields the highest accuracy in categorising malaria smears. It facilitates further enhancements by incorporating supplementary models, multi-class extensions, and operating-point calibration. Full article

Background/Objectives: Duodenal lymphomas (DLs) are a rare subset of gastrointestinal lymphomas with incompletely characterized clinicopathological features due to low incidence and diagnostic challenges. This study assessed DL survival outcomes, characterized clinical/endoscopic features, and identified prognostic factors. Methods: This was a retrospective observational study of patients undergoing endoscopic examinations between 1 November 2002 and 1 November 2022 at Peking Union Medical College Hospital, with a subsequent histopathological diagnosis of DL. The primary outcome was overall survival (OS), and Cox proportional hazards modeling was used for survival analyses. Results: Sixteen patients (32%) had indolent B-cell lymphoma, 20 (40%) had aggressive B-cell lymphoma, and 14 (28%) had T-cell lymphoma. Diarrhea and weight loss were more common in patients with T-cell lymphoma. The most common endoscopic appearance was mucosal granularity, and 40% of patients had mass lesions. The median OS was 24.1 (95% CI: 13.3–117) months, with 1- and 5-year survival rates of 68.0% (95% CI: 56.2–82.2%) and 33.8% (95% CI: 22.3–51.44%), respectively. In multivariable analysis, a granular appearance (HR: 0.33, 95% CI: 0.11–0.99, and p = 0.049) and taking chemotherapy (HR: 0.22, 95% CI: 0.07–0.69, and p = 0.01) were associated with better OS, while T-cell lymphoma (HR: 9.19, 95% CI: 2.12–32.83, and p = 0.003) and stage IV lymphoma (HR: 12.76, 95% CI: 1.70–95.66, and p = 0.013) were associated with worse OS. Conclusions: This first integrated study provides new information on the clinical, endoscopic, and prognostic features of DL. While no specific clinical or endoscopic feature is diagnostic of DL, DL must remain in the differential diagnosis of any patient presenting with nonspecific gastrointestinal symptoms. Full article

Laser-induced microjet-assisted ablation is an emerging technology in the field of laser processing. However, the influence of solid boundaries on jet behavior and the associated material removal mechanism remains unclear after observing and analyzing the ablation process. To address this, the present study systematically investigates the effect of the incidence angle on the processing efficiency and material removal mechanism in laser-induced microjet ablation. By controlling the laser power and liquid layer thickness, the dynamic behavior of the microjet, material removal performance, and surface morphology evolution under different inclination angles were explored. Based on video analysis and OpenCV processing, the regulation of jet morphology and impact mode by the incidence angle was revealed. Combined with white light interferometry and ultra-depth-of-field three-dimensional microscopy, the ablation depth and material removal rate were quantitatively characterized. The results showed that under normal incidence, the maximum material removal rate of 0.092 mm³/s was achieved at 9 W, while further increases in power led to a decrease in removal rate due to bubble aggregation. When the sample was tilted to 15°, the material removal rate reached 0.163 mm³/s, representing a 106.30% improvement compared to that at 0°, and the ablation depth also peaked with an average maximum depth of 12.32 ± 0.58 μm and a single-point maximum of 54.36 μm. Furthermore, scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) were employed to elucidate the microstructural features and elemental distribution under different process parameters. Through multi-parameter experiments, this study achieved process parameter optimization and clarified the material removal mechanism influenced by different incidence angles, providing both a process reference and theoretical basis for efficient micro-machining of aerospace materials. Full article

Background/Objectives: Microtia, a congenital ear malformation ranging from mild anomalies to anotia, imposes a psychosocial burden, yet its link to pediatric psychiatric disorders in population-based settings is understudied. Methods: This study included 6048 patients with microtia and a control cohort of 120,960 age- and sex-matched participants from the Korean National Health Insurance database. The incidence of overall psychiatric disorder events was compared between the microtia and control cohorts. Results: Compared with the control cohort, the incidence rate ratio (IRR) in patients with microtia was 1.16 (95% CI, 1.05–1.29) for overall psychiatric disorders, 5.35 (95% CI, 4.56–6.27) for hyperkinetic disorder (HKD), and 9.67 (95% CI, 5.49–17.03) for autism. After adjusting for age group, sex, and socioeconomic status, microtia was associated with an increased risk of overall psychiatric disorders, HKD, and autism. Subgroup analyses revealed an elevated risk of overall psychiatric disorders among individuals aged 5 to 14 years, males, and those with low or high socioeconomic status. Ear reconstruction surgery was associated with a lower risk of HKD among patients aged 10 to 14 years, females, and those with low socioeconomic status. The observed association between ear reconstruction surgery and lower HKD risk in these specific subgroups warrants further investigation using study designs capable of establishing causal inference. Conclusions: Microtia is associated with an increased risk of psychiatric disorders in pediatric and adolescent populations, with particularly pronounced risks for HKD and childhood autism. These findings underscore the importance of early psychiatric screening in children with microtia. Full article