Search Results (4,143)

Gut-derived uremic toxins may play a key role in neurodevelopmental conditions such as autism spectrum disorder (ASD) via host-microbe metabolic interactions. We evaluated five uremic toxins—p-cresyl sulfate (PCS), indoxyl sulfate (IS), trimethylamine N-oxide (TMAO), asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA)—in urine samples of 97 children with ASD and 71 neurotypical controls, stratified by Bristol Stool Chart (BSC) consistency types. Four of these toxins (PCS, IS, TMAO, ADMA) were integrated into a novel composite biomarker called the Metabolic Index of Gut Dysfunction (MIGD), while SDMA was measured as a complementary renal function marker. While individual metabolite levels showed no statistically significant differences, group-wise analysis by stool phenotype revealed distinct trends. ASD children with hard stools (BSC 1–2) showed elevated PCS levels and the MIGD score (median 555.3), reflecting phenolic fermentation dominance with reduced indolic detoxification. In contrast, children with loose stools (BSC 6–7) had the lowest MIGD values (median 109.8), driven by higher IS and lower ADMA concentrations, suggestive of enhanced indole metabolism. These findings indicate that MIGD may serve as a novel biomarker to stratify metabolic phenotypes in ASD, linking urinary metabolite patterns to gut function. Further validation in larger and longitudinal cohorts is warranted to confirm its potential utility in precision microbiota-targeted interventions. Full article

Background: While TSH suppression is essential in patients with differentiated thyroid cancer (DTC) to reduce the risk of recurrence, it has also been linked to side effects, particularly a reduction in bone mineral density that may contribute to osteoporosis. However, previous studies investigating this association have yielded inconsistent results. This study aimed to evaluate bone density using Hounsfield units from PET/CT scans in a longitudinal analysis including both sexes. Methods: Patients with DTC under continuous TSH suppression who underwent two PET/CT scans were included. Hounsfield units were measured for each lumbar vertebra (L1–L5) in the CT by placing an elliptical region of interest (ROI) in the center of the vertebra, avoiding hyperdense edges. Laboratory parameters were also collected. Results: A total of 50 patients were included in the study (25 male, 25 female), with a mean age of 57.2 (±15.3) years at the time of the first scan. The mean duration of TSH suppression before the first scan was 3.7 ± 3.9 years, and the mean interval between both scans was 4.4 ± 4.0 years. At the follow-up scan, bone density was significantly lower compared with baseline for all lumbar vertebrae (L1–L5 combined and individually) (all p < 0.05). Subgroup analysis revealed a significant decline in women at L1, L2, L4, and L5 and for overall lumbar bone density, while men showed nonsignificant trends. Conclusions: Our study suggests a sustained reduction in vertebral bone density during TSH suppression. The results support routine monitoring in both sexes, risk stratification by age and duration of suppression, and, when oncologically appropriate, consideration of lower suppression intensity or initiation of bone-protective therapy in high-risk patients. Full article

Objective: To evaluate the degree of current evidence through a systematic review and meta-analysis on the association between podoplanin overexpression and the malignant transformation of oral potentially malignant disorders (OPMDs). Methods: A systematic search was performed in the MEDLINE (through PubMed), Embase, Scopus, and Web of Science databases for primary-level research published before December 2024, strictly designed as longitudinal cohorts with follow up data, and no restrictions by language or publication date. The Quality in Prognosis Studies QUIPS tool (developed by the Cochrane Prognosis Methods Group) was applied in order to assess the methodological quality and risk of bias. Meta-analyses, subgroup meta-analyses, sensitivity, and small-study effects analyses were performed. Results: Twelve primary-level studies met the eligibility criteria and were included, which followed up 857 OPMDs patients over time. Podoplanin overexpression was significantly associated with an increased risk of the malignant transformation of OPMDs (RR = 3.64, 95% CI = 2.18–6.10, p < 0.001). Podoplanin also proved to be a valuable biomarker in the malignant transformation of all investigated OPMDs (oral leukoplakia: p < 0.001; erythroplakia: p = 0.05; oral lichen planus: p = 0.02; discoid lupus erythematosus: p = 0.009). In addition, podoplanin overexpression was significantly associated with an increased risk of cancer development in several study subgroups with methodological implications (anti-podoplanin D2-40 antibody: p < 0.001; membrane and cytoplasm staining: p < 0.001; antibody dilution at 1:100: p < 0.001; overnight incubation: p < 0.001; 4 °C incubation: p < 0.001; cut-off point > 1%: p < 0.001; low risk of bias: p < 0.001). Conclusions: This systematic review and meta-analysis, on the basis of the evidence, indicates that podoplanin overexpression is a predictor of an increased risk of malignant transformation in OPMDs, singularly in oral leukoplakias. Its evaluation using immunohistochemical methods would be advisable in pathology laboratories. Full article

Background/Objectives: Hearing loss constitutes a modifiable risk factor for dementia. Auditory rehabilitation with devices such as cochlear implants (CIs) has been reported to prevent cognitive decline in older adults. However, post-implant cognitive effects remain highly heterogeneous across studies. Thus, the aim of this review is to synthesize the evidence on cognitive outcomes and their interplay with speech perception, quality of life (QoL), and psychological status. Methods: A bibliographic search was conducted following PRISMA guidelines from January 2015 to July 2025. Studies were eligible if they included adult CI candidates who completed cognitive and audiometric assessments. In total, 43 studies, including longitudinal and cross-sectional designs, were reviewed. Several studies also assessed hearing aid (HA) users and normal-hearing (NH) controls. Principal results were identified and analyzed across cognitive domains, audiological performance, QoL, and psychological outcomes. Results: CIs significantly improved cognition across longitudinal studies, with a higher number of assessments reporting gains in memory (61%), global cognition (57%), and executive function (46%); while attention, language, and visuospatial skills were less frequently evaluated. Though findings are not fully consistent, interactions between speech intelligibility and cognitive subdomains have also been found in several studies: global cognition (25%), executive function (22%), visuospatial skills (20%), attention (21%), language (17%), and memory (12%). Improvements in QoL, social engagement, depression, and anxiety are frequently observed. Conclusions: The lack of unified and adapted neurocognitive tools may prevent the observation of consistent outcomes across studies. Further research and multimodal data are still needed to fully understand the interaction between cognition, speech intelligibility, and QoL in CI users. Full article

Background/Objective: The sequelae of COVID-19 on geriatric health is profound, yet its consequences on mental well-being remain insufficiently elucidated, particularly in older adults with musculoskeletal conditions. This study aimed to explore the interrelationships and magnitude of the effects of fear of COVID-19, fear of falls, physical activity, and social frailty on depressive symptoms in this population. Methods: Purposive sampling was applied to recruit 292 older adults with musculoskeletal conditions. Data were collected through structured interviews (face-to-face and telephone) using standard questionnaires. Path analysis with Satorra–Bentler correction examined the relationships in the proposed model of depressive symptoms. The model fit indices were evaluated using the chi-square (χ²), the goodness-of-fit test was assessed with standard criteria of the comparative fit index (CFI ≥ 0.95), the Tucker–Lewis index (TLI ≥ 0.95), the root mean squared error of approximation (RMSEA < 0.08), and the standardized root mean square residual (SRMR < 0.05). Results: Mean participant age was 70.30 ± 6.56 years, with 74.3% female. The path analysis model demonstrated an excellent fit indicating χ² = 0.007 (p = 0.933), CFI and TLI = 1.000, RMSEA = 0.000, SRMR = 0.001. Fear of COVID-19 negatively indirectly impacted depressive symptoms (β = −0.07, p = 0.017), while physical activity had a positive direct effect (β = 0.16, p = 0.004). Fear of COVID-19 directly influenced social frailty (β = 0.18, p = 0.003) but had a negative direct impact on physical activity (β = −0.37, p = 0.000). However, fear of falling did not show a significant relationship with the other study variables. Conclusions: Depressive symptoms entail physical and psychosocial consequences. Physical activity has a positive effect on depressive symptoms. Fear of COVID-19 increases social frailty, while increasing physical activity reduces this fear. Future research should evaluate longitudinal effects and investigate evidence-based public health interventions or tailored cognitive–behavioral interventions to reduce pandemic-related fear and prevent mental health sequelae. Full article

The LRRK2+ SAA− cohort of Parkinson’s disease (PD), characterized by the absence of hallmark α-synuclein pathology, remains under-explored. This limits opportunities for early detection and targeted intervention. This study analyzes data from this under-characterized subgroup and compares it with the LRRK2+ SAA+ cohort using longitudinal data from the Parkinson’s Progression Markers Initiative (PPMI). The PPMI dataset includes 115 LRRK2+ patients (70 SAA+, 45 SAA−) across 52 features encompassing clinical assessments, cognitive scores, DaTScan SPECT imaging, and motor severity. DaTScan binding ratios were selected as imaging-based indicators of early dopaminergic loss, while NP3TOT (MDS-UPDRS Part III total score) was used as a gold-standard clinical measure of motor symptom severity. Linear mixed-effects models were then applied to evaluate longitudinal predictors of DaTScan decline and NP3TOT progression, and statistical analyses of group comparisons revealed distinct drivers of symptoms differentiating SAA− from SAA+ patients. In SAA− patients, a decline in DaTScan was significantly associated with thermoregulatory impairment (p-value = 0.019), while NP3TOT progression was predicted by constipation (p-value = 0.030), sleep disturbances (p-value = 0.046), and longitudinal time effects (p-value = 0.043). In contrast, SAA+ patients showed significantly lower DaTScan values compared to SAA− (p-value = 0.0004) and stronger coupling with classical motor impairments, including freezing of gait (p-value = 0.016), rising from a chair (p-value = 0.007), and turning in bed (p-value = 0.016), along with cognitive decline (MoCA clock-hands test, p-value = 0.037). These findings support the hypothesis that LRRK2+ SAA− patients follow a distinct pathophysiological course, where progression is influenced more by autonomic and non-motor symptoms than by typical motor dysfunction. This study establishes a robust, multimodal modeling framework for examining heterogeneity in genetic PD and highlights the utility of combining DaTScan, NP3TOT, and symptom-specific features for early subtype differentiation. These findings have direct clinical implications, as stratifying LRRK2 carriers by SAA status may enhance patient monitoring, improve prognostic accuracy, and guide the design of targeted clinical trials for disease-modifying therapies. Full article

The aim of this paper is to evaluate the correlation between the coronary calcium score (CCS) and coronary artery disease (CAD), patients underwent coronary CT angiography (CTA). Four hundred and five patients who underwent a coronary CT with CCS analysis were considered for this retrospective study. Coronary CTA was performed using a dual-source (256-slice) CT scanner (SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). Before injecting the contrast medium, non-contrasted cardiac CT was performed in a longitudinal scan field from the tracheal carina down to the diaphragm. The corresponding images for calcium scoring were reconstructed with a slice width of 1.5 mm and a slice interval of 1 mm, and the tube voltage was 120 kVp. The total calcium score was calculated using dedicated software. The calcium score based on the Agatston method was defined as the presence of a lesion with an area greater than 1 mm² and peak intensity greater than 130 Hounsfield Units, which was automatically identified and marked with color by the software. From the radiological report, the degree of coronary stenosis was retrieved. A score of 1 corresponds to the absence of stenosis, a score of 2 to mild stenosis (<50%), and a score of 3 to moderate/severe stenosis (>50%). The total coronary gravity score (CGS) for each patient was calculated by summing the score of each coronary artery. The Spearman test was used for correlation. Out of the 405 patients, 217 were male. The mean and standard deviation age was 72 ± 11 years. The overall amount of calcium was an Agatston score of 393 ± 709. A positive correlation between CCS and CGS was found (r = 0.835 and p < 0.001). A ROC curve with AUC 0.917 (p ≤ 0.001) was obtained. The optimal cutoff point of the calcium score for discriminating CGS < 2 was 112, yielding sensitivity of 90% and specificity of 81%. This study confirms the important relationship between the coronary artery calcium score and the presence and extension of coronary artery disease. Full article

This study investigates the influence of ball burnishing (BB) path strategies on the surface integrity and functional performance of laser-cladded Inconel 718. Three BB strategies—(1) BB-Longitudinal, (2) BB-Transverse, and (3) BB-Crosshatch—relative to the laser scan trajectory were evaluated and compared against ground surfaces as a baseline. Post-processing BB treatment were demonstrated to be effective in modifying the subsurface layer of the cladded Inconel 718 material, extending to depths of up to 100 µm, increasing dislocation density by over 2.5 times, and enhancing hardness from 260 HV5 (ground) to as high as 461 HV5. These microstructural improvements led to significant gains in corrosion and impact resistance, despite a rise in surface roughness from Ra 0.35 µm (ground) to up to 2.38 µm for BB-Longitudinal surfaces. Impact testing revealed up to 35% reduction in indentation volume, particularly with BB-Transverse and BB-Crosshatch strategies. Nonetheless, sliding wear tests did not confirm improvements in wear resistance, as wear depths exceeded the hardened layer and abrasive wear remained dominant. Electrochemical testing in 3.5 wt.% NaCl solution showed a positive shift in corrosion potential (E_corr) exceeding 200 mV compared to the ground condition, indicating reduced corrosion susceptibility for BB-Longitudinal condition. Among the tested strategies, BB-Transverse offered the most balanced enhancements, highlighting the complex interplay between laser cladding heterogeneities and post-processing response in optimizing surface and mechanical properties of Inconel 718 claddings. Full article

Suspended monorail systems are increasingly adopted in urban rail transit due to their small land requirements and environmental benefits. However, welded details in track beams are prone to fatigue cracking under repeated service loads, posing risks to long-term structural safety. This study investigates the fatigue performance of suspended monorail track beams through 1:4 scaled fatigue experiments and finite element (FE) simulations. Critical fatigue-sensitive locations were identified at the mid-span longitudinal stiffener–bottom flange weld toe and the mid-span web–bottom flange weld toe. Under the most unfavorable operating condition (train speed of 30 km/h), the corresponding hot-spot stresses were 28.48 MPa and 27.54 MPa, respectively. Stress deviations between scaled and full-scale models were within 7%, verifying the feasibility of using scaled models for fatigue studies. Fatigue life predictions based on the IIW hot-spot stress method and Eurocode S–N curves showed that the critical details exceeded the 100-year design requirement, with estimated fatigue lives of 2.39 × 10⁸ and 5.95 × 10⁸ cycles. Furthermore, a modified damage equivalent coefficient method that accounts for traffic volume and train speed was proposed, yielding coefficients of 2.54 and 3.06 for the two fatigue-prone locations. The results provide a theoretical basis and practical reference for fatigue life evaluation, design optimization, and code development of suspended monorail track beam structures. Full article

Background/Objectives: Perfectionism is a personality trait characterised by the setting of extremely high and unrealistic personal standards, accompanied by critical self-evaluations. The literature indicates that perfectionism may develop as a learned behaviour, shaped by parent–child interactions, highlighting the influence of parental, individual and environmental factors. This quantitative study examines how parental perfectionism/practices and child temperament contribute to early perfectionism. Methods: The sample comprised 32 first-grade children (9 girls) from Faro district, aged between five and seven, and their parental figures. Parental perfectionism was assessed using self-report questionnaires, while children’s characteristics were evaluated through a combination of parent-report measures, direct observation, and interview-based methods. Results: Children self-rated higher perfectionism than parents attributed, with modest cross-informant agreement for socially prescribed and negligible agreement for Self-Oriented Perfectionism. Direct parent–child associations were small and method-dependent. Coercive/intrusive parenting corresponded to higher child Socially Prescribed Perfectionism, with convergence between observed intrusiveness and self-reported coercive practices. Temperament showed modest, patterned covariation with parenting and child perfectionism. Notably, Effortful Control attenuated the association between parental and child Socially Prescribed Perfectionism, whereas Surgency/Extraversion and Negative Affect did not; no temperament dimension moderated Self-Oriented Perfectionism. Conclusions: Findings indicate a complex interplay between dispositional and environmental factors in early childhood and underscore the value of multi-informant, multi-method assessment. As a pilot study, these findings provide initial insights into the intergenerational transmission of perfectionism in small children and serve as a basis for generating hypotheses and guiding future research, emphasising longitudinal designs and diverse samples to strengthen validity and clarify intergenerational processes. Full article

Background/Objectives: The prison environment presents a unique context for examining the impact of addiction on physical and psychological functioning. Individuals with substance use disorders (SUDs) are overrepresented in correctional facilities and often experience greater emotional difficulties and impaired physical capacity. This study aimed to conduct a comparative analysis of psychological and functional profiles between addicted and non-addicted male inmates in a semi-open correctional facility. Methods: The study included 47 male prisoners (19 addicted, 28 non-addicted). Physical performance was assessed using the Countermovement Jump (CMJ), handgrip strength, the Functional Movement Screen (FMS), and the FitLight reaction time test. Psychological functioning was evaluated using six standardized questionnaires: problem-focused, emotion-focused, and avoidant coping strategies, depression (PHQ-9), perceived stress (PSS-10), and self-compassion (SCS). Results: No statistically significant differences (p > 0.05) were found between addicted and non-addicted inmates in physical performance parameters. Addicted individuals demonstrated slightly higher handgrip strength with lower variability, while non-addicted inmates showed slightly better lower-body power in the CMJ test. Functional movement quality and reaction speed were similar between groups. Psychological assessments also revealed no significant differences between the groups. Coping styles, depressive symptoms, perceived stress levels, and self-criticism scores were comparable in both populations. In the addicted group, deeper squats correlated with lower stress (rho = −0.46, p = 0.047), and better hurdle step performance correlated with emotion-focused coping (rho = 0.46, p = 0.048). Conclusions: Although no statistically significant differences were found between addicted and non-addicted male inmates in the assessed physical and psychological outcomes, the limited sample size and context-specific nature of this pilot study suggest that these findings should be viewed as preliminary and interpreted with caution. Nonetheless, the observed associations between physical performance and psychological variables indicate subtle interconnections between motor capacity, stress perception, and coping mechanisms that merit further investigation in larger, longitudinal studies. Full article

Background/Objectives: Fibromyalgia (FM) is a nociplastic pain disorder marked by altered central nervous system processing and abnormal sensory modulation. Diagnosis remains largely symptom-based and lacks objective biomarkers. Sensory modulation disorder (SMD)—impaired regulation of responses to non-noxious input—may represent a clinically relevant diagnostic dimension. This study aimed to estimate the prevalence/diagnostic value of SMD in FM, examine links with symptom severity and stress, and assess its potential for patient stratification. Methods: In this cross-sectional study, 182 adults were enrolled (104 FM; 78 controls). Standardized instruments included the Adolescent/Adult Sensory Profile (AASP), Fibromyalgia Impact Questionnaire (FIQ), and Perceived Stress Scale (PSS). Group comparisons, regression, and discriminant analyses evaluated SMD profiles. Results: Compared with controls, FM adults showed higher sensory sensitivity and avoidance (both p < 0.001), lower sensation seeking (p = 0.002), and modestly higher low registration (p = 0.027). Elevated SMD correlated with greater symptom severity and perceived stress. Stress significantly predicted FM’s impact (β = 0.57, p < 0.001). A discriminant model achieved 84% apparent in-sample accuracy for classifying FM severity from sensory/stress profiles. Conclusions: Sensory modulation abnormalities are highly prevalent in FM and show meaningful associations with symptom severity and stress, suggesting that SMD could represent a potential diagnostic dimension and stratification aid. These findings should be interpreted within an exploratory, cross-sectional design. Incorporating sensory modulation assessment into FM evaluation may improve diagnostic precision, reduce delays, and guide individualized management. Confirmation in larger longitudinal studies is warranted. Full article

Background/Objectives: This proof-of-concept study evaluated whether optical coherence tomography angiography (OCTA) can non-invasively capture micro-vascular alterations in non-melanoma skin cancer (NMSC) lesions during and after superficial orthovoltage radiotherapy (RT) using radiomics and vascular features analysis. Methods: Eight patients (13 NMSC lesions) received 36–50 Gy in 6–20 fractions. High-resolution swept-source OCTA volumes (1.1 × 10 × 10 mm³) were acquired from each lesion at three time points: pre-RT, immediately post-RT, and three months post-RT. Additionally, healthy skin baseline was scanned. After artifact suppression and region-of-interest cropping, (i) first-order and texture radiomics and (ii) skeleton-based vascular features were extracted. Selected features after LASSO (least absolute shrinkage and selection operator) were explored with principal-component analysis. An XGBoost model was trained to classify time points with 100 bootstrap out-of-bag validations. Kruskal–Wallis tests with Benjamini–Hochberg correction assessed longitudinal changes in the 20 most influential features. Results: Sixty-one OCTA volumes were analyzable. LASSO retained 47 of 103 features. The first two principal components explained 63% of the variance, revealing a visible drift of lesions from pre- to three-month post-RT clusters. XGBoost achieved a macro-averaged AUC of 0.68 ± 0.07. Six features (3 texture, 2 first order, 1 vascular) changed significantly across time points (adjusted p < 0.05), indicating dose-dependent reductions in signal heterogeneity and micro-vascular complexity as early as treatment completion, which deepened by three months. Conclusions: OCTA-derived radiomic and vascular signatures tracked RT-induced micro-vascular remodeling in NMSC. The approach is entirely non-invasive, label-free, and feasible at the point of care. As an exploratory proof-of-concept, this study helps to refine scanning and analysis protocols and generates knowledge to support future integration of OCTA into adaptive skin-cancer radiotherapy workflows. Full article

Background and Objectives: Cardiac injury caused by cancer therapy can be detected early using high-sensitivity cardiac troponins (hs-cTns), and this is crucial for preventing irreversible consequences. Clinically relevant issues regarding hs-cTns in oncologic settings—such as reliable cut-off values, the optimal assessment timeframe, factors influencing their levels, and their prognostic ability in relation to functional echocardiographic parameters—require further investigation. In this study, we aimed to examine the determinants of hs-cTnT variations during cancer therapy and the relationship between the biomarker and functional conventional echocardiographic parameters. Materials and Methods: We prospectively evaluated adult patients scheduled for chemotherapy for either breast or gastrointestinal cancers, excluding those with pulmonary and cardiac disorders. We enrolled 40 patients who underwent a minimum of one cycle of potentially cardiotoxic regimens containing at least one of the following agents: anthracyclines, cyclophosphamide, taxanes, 5-fluorouracil, platinum compounds, trastuzumab, or bevacizumab. We observed two-dimensional and tissue Doppler echocardiographic parameters and hs-cTnT levels for a median of 360 days (IQR 162, 478) following the start of chemotherapy. Results: The generalised estimating equation (GEE) analysis revealed significant elevations in hs-cTnT levels at three months (β = 1.2; p = 0.005) and six months (β = 2.3; p = 0.02) from baseline, influenced by anthracycline treatment (p = 0.009), renal function (p = 0.003), and increased cardiotoxicity risk (high: p = 0.013; medium: p < 0.001). Elevated hs-cTnT levels independently predicted the deterioration of the LV longitudinal myocardial function, measured by the systolic tissue velocities, according to the GEE analysis. The receiver operating characteristic curve-derived hs-cTnT thresholds—of 8.23 ng/L and 8.08 ng/L—had a high negative predictive value for identifying Average and Lateral LVS′ decreases, respectively. Conclusions: Our research supports the use of baseline and continuing hs-cTnT testing in cancer patients, showing the dependence of the biomarker on renal function, cardiovascular toxicity risk level, and anthracycline treatment. The hs-cTnT cut-off value of approximately 8 ng/L may suggest a low probability of longitudinal myocardial function impairment and this observation needs further validation in larger cohorts. Full article

Background and Objectives: Infantile colic affects 15–40% of infants ≤ 5 months, burdening families and health systems. While the effects of intrapartum oxytocin on neonatal outcomes have been widely investigated, its potential link with infantile colic remains poorly understood. We evaluated whether synthetic oxytocin is associated with infantile colic during the first five months of life and explored neonatal head circumference, feeding type and epidural anesthesia as additional factors. Materials and Methods: Prospective 1:1 matched case–control study in three Spanish pediatric outpatient clinics. Parents of 76 term infants aged 0–5 months (38 cases, 38 controls) completed face-to-face structured interviews documenting synthetic oxytocin and epidural use, infant anthropometry and feeding pattern. Infantile colic was diagnosed by Rome IV criteria. Associations were estimated with conditional logistic regression, producing adjusted odds ratios and 95% confidence intervals. Results: Synthetic oxytocin was used in 57.9% of deliveries and epidural anesthesia in 81.6%. Synthetic oxytocin showed no association with infantile colic (aOR 1.24; 95% CI 0.50–3.09). Epidural strongly predicted synthetic oxytocin exposure (aOR 4.55; 95% CI 1.28–16.20) but had no independent link to infantile colic. Infants with colic had a smaller mean head circumference at birth, although this difference did not remain significant after adjusting for gestational age, likely reflecting limited sample size. Synthetic oxytocin was not associated with breastfeeding status. Conclusions: In this cohort, intrapartum synthetic oxytocin was not related to infantile colic or to feeding difficulties. Smaller head circumference among colic cases may warrant further investigation as a potential risk marker. The high co-use of synthetic oxytocin and epidural underscores the need for larger longitudinal studies to clarify their peripartum–neonatal interactions. Full article