Search Results (783)

Background and Objectives: To evaluate the magnitude, axis and age-related changes in corneal astigmatism in patients before cataract surgery. Materials and Methods: In this retrospective, cross-sectional, and observational study, data from 2152 eyes that underwent phacoemulsification were evaluated. Keratometric values were obtained using the IOL Master 500 device. The frequency, magnitude and axis of corneal astigmatism were determined. The astigmatism axis was categorized as with the rule (WTR), against the rule (ATR), and oblique astigmatism. Quantitative analysis was performed using the power vector method (J0 and J45). The distribution and characteristics of corneal astigmatism data according to age were analyzed. Results: The mean age of the patients was 70.56 ± 8.88 years (range 40–94 years) and 1010 (46.9%) were males. Mean corneal astigmatism, J0 and J45 values were 0.96 ± 0.72, 0.05 ± 0.51, 0.01 ± 0.30 diopters (D), respectively. The most common range of magnitudes was 0.50–0.99 D with 38.8%, followed by <0.50 D (25.3%), 1.00–1.49 D (20.3%), and 1.50–1.99 D (8.7%). The cubic regression curve showed a U-shaped nonlinear relationship between age and corneal astigmatism (p < 0.001). The most common type of astigmatism was WTR with 43.4%, followed by ATR with 37.5% and oblique astigmatism with 19.1%. With the increase in age, the astigmatism axis gradually changed from WTR to ATR. There was a linear trend in the rate of these types of astigmatism across age groups (p < 0.05). Additionally, in patients under 65 years of age, WTR astigmatism was negatively correlated with age, while in patients 65 years of age and older, ATR astigmatism was positively correlated with age (r = −0.217, p < 0.001; r = 0.153, p < 0.001, respectively). Linear regression analyses revealed that the J0 value decreased significantly with age, whereas J45 showed no significant relationship. Specifically, J0 decreased by 0.014 D per year of age (95% confidence interval [CI], 0.011–0.016; p < 0.001). Conclusions: The results obtained in this study may provide information to guide surgeons in the management of astigmatism and the choice of toric intraocular lens in cataract surgery. Full article

Background/Objectives: Youth with type 1 diabetes (T1DM) face unique challenges in balancing dietary choices, physical health outcomes, and social–emotional well-being in school settings. This cross-sectional exploratory pilot study examined the associations of diet with physical health and teacher-reported social–emotional functioning in students with T1DM. Methods: Students with T1DM (mean age = 13.42; 47 female, 50 male; 50% White, Non-Hispanic, 50% minority) self-reported their nutritional habits using the KBlock Dietary Screener for Children when school was in session. Teacher-rated school-related behaviors were assessed through the Behavior Assessment Scale for Children-2nd Edition (BASC-2). Canonical correlation analysis was conducted to determine whether the variable sets (diet with physical health and school-related behavioral health) shared a significant multivariate relationship. Results: Youth with lower glycemic loads and consuming more sugar, dairy, and meat/poultry/fish but fewer legumes, fruit, and less saturated fat exhibited fewer externalizing symptoms and higher BMI. Diet uniquely accounted for modest variance in combined social–emotional and physical health, controlling for demographics and T1DM duration. Findings support increasing the availability of whole, nutrient-rich foods, integrating comprehensive nutrition education into curricula, and ensuring access for all students, regardless of socioeconomic status. Conclusions: Comprehensive dietary assessments and school-based randomized control trials are needed to enact more evidence-based dietary recommendations or interventions for youth, aiming for a balanced approach that addresses both mental and physical health outcomes. Full article

Background: Temporomandibular disorders (TMD) and bruxism are prevalent conditions managed by dentists. However, treatment choices—especially concerning botulinum toxin (BTX)—often lack consistency. This study aimed to develop and assess a structured clinical decision-making algorithm for BTX use in patients with TMD and bruxism. Methods: A treatment algorithm was designed through a qualitative analysis of the literature and aligned with German S3 guidelines. A total of 227 dentists assessed three clinical case vignettes reflecting routine clinical practice. Each vignette was evaluated first without and subsequently with the algorithm, focusing on typical indications for botulinum toxin treatment. Data were collected via online survey (SurveyMonkey) and analyzed using Microsoft Excel. Participants were stratified by gender and clinical experience (≤5 years vs. >5 years). Results: Of the 227 dentists contacted, 103 responded, and 56 completed the survey (57.1% male; mean age: 34.5 ± 10.6 years). BTX decision accuracy significantly improved for Case 1 (62.5% → 87.5%, p = 0.0013) and Case 2 (14.3% → 87.5%, p < 0.0001), but not for Case 3 (44.6% → 46.4%, p = 1.000). Confidence increased, and uncertainty decreased, particularly among less experienced dentists. The algorithm also significantly influenced both first- and second-line treatment choices, aligning them more closely with guideline-based therapy. Usefulness was confirmed by 78.6% of respondents, with no significant differences based on gender or experience. Conclusions: The proposed algorithm significantly improved diagnostic accuracy, treatment consistency, and confidence in the use of BTX for TMD and bruxism. It facilitates evidence-based, experience-independent decision-making and potentially represents a useful clinical tool in dental practice. Full article

The reproductive behavior and nest-building activity of the sand-dwelling goby Hazeus ammophilus were investigated to examine its nesting characteristics and to determine how and why this species builds radial structures around its nests. Field observations revealed that males spawned with multiple females in open muddy-sand bottoms, using bivalve shells or fallen leaves as spawning substrates. Males cared for eggs after spawning and repeatedly mated with multiple females, suggesting a male-territory-visiting polygamous mating system. A distinctive feature of this species was the presence of radial ditches extending from the nest. These ditches developed through repeated male behaviors of digging from the nest toward the surrounding area and sweeping accumulated sand out of the nest, resulting in a crater-like structure around the nest. These behaviors may contribute to cleaning and stabilizing the spawning substrate, and the resulting structures themselves may also be involved in female mate choice. Taken together, these findings indicate that H. ammophilus has evolved a flexible reproductive strategy, and nest-building behavior possibly adapted to unstable open sandy environments, highlighting the behavioral diversity and ecological plasticity within gobiid fishes. Full article

The circadian cycle regulates metabolism in response to external stimuli, such as light exposure, sleep schedules, and eating patterns. However, misalignment between internal biological rhythms and social demands can compromise food choices, potentially leading to overweight and obesity. This research aimed to assess how a person’s chronotype links to social jet lag (SJL), which in turn would relate to their nutritional status and food consumption patterns as a university student. 617 students from a State University located in the State of Paraná, Brazil, completed a cross-sectional research study that collected sociodemographic information/anthropometrics by means of an online survey. It included self-reported height/weight data and dietary habits. The Munich Chronotype Questionnaire (MCTQ) was utilized to determine each participant’s chronotype classification and SJL calculation. Researchers found that nearly half of the students (49.3%) displayed an Intermediate Chronotype, which is associated with a diet that contained elements of the “Mixed” Diet, meaning there are equal portions of healthy food (Fresh Fruits, Beans, etc.) and unhealthy foods (Sweetened Beverages). The multivariate logistic regression analyses identified age as a significant predictor of obesity risk (OR: 1.15, p < 0.001), while dietary habits such as fruit consumption played a protective role. Additionally, having a breakfast protected them from being classified as obese compared to those who did not eat breakfast (OR = 0.59). Contrary to expectations, late-night supper was not a statistically significant predictor in the adjusted model. Predictors of an Intermediate chronotype included being male and eating morning snacks regularly. The results of this study suggest that students with an intermediate chronotype will predictably have skewed eating patterns, such as skipping breakfast and eating late—both of which affect obesity risks. Nutritional strategies for university students should focus on promoting circadian regularity and optimizing meal timing. Full article

Host odour may be affected by symbiotic microbes that produce metabolites. As a result, chemical signal production may be influenced. Few studies to date have assessed how symbiotic microbes influence variation in geography of animal chemical signals. This is important because chemical signal divergence can affect mate choice, species recognition, and ultimately speciation in a broad range of animals. However, the underlying driving forces of chemical signal divergence are still rather poorly understood. To study chemical signals, bats provide a good model system because they are such social mammals. Because males roost in dark spaces during the daytime, they rely on chemical and acoustic signals. We identified three colonies across a large geographic area and collected male forehead gland secretions from Pratt’s leaf-nosed bats (Hipposideros pratti). We examined the role symbiotic microbes played in potential variation in the geography of chemical signals. We observed significant colony-level differences in compound categories and in the amount of specific compounds. We also found significant colony-level differences in forehead gland microbiota. However, there was no significant relationship between bat-gland bacterial community composition and variation in chemical composition across colonies. These results suggest that bacterial communities may fail to shape the chemical signalling profiles of the different colonies in Pratt’s leaf-nosed bats. Full article

Background/Objectives: Managing large midline olfactory groove meningiomas is especially difficult in elderly patients who have limited physiological reserves. Here we describe a unique and dangerous geriatric case where we used new quantifiable anatomical measurements and developed a structured multidisciplinary preoperative and postoperative protocol to assist in all aspects of surgery. Case Presentation: A 68-year-old male with fronto-lobe syndrome and disability (astasia-abasia; Tinetti Balance Score of 4/16 and Gait Score of 0/12) as well as cognitive dysfunction (MoCA score of 12/30) and blindness bilaterally. Imaging prior to surgery demonstrated a very large olfactory groove meningioma which severely compressed both optic pathways at the level of the optic canals (up to 71% reduction in cross-sectional area of the optic nerves) and had complex vascular relationships with the anterior cerebral artery complex (210° contact surface). Due to significant cardiovascular disease and liver disease, his care followed a coordinated optimization protocol for the perioperative period. He underwent bifrontal craniotomy, initial early devascularization and then staged ultrasonic internal decompression (approximately 70% reduction in tumor volume) and finally microsurgical dissection of the tumor under multi-modal monitoring of neurophysiology. Discussion: We analyzed his imaging data prior to surgery using a standardized measurement protocol to provide quantitative measures of the degree of compression of the optic pathways (traction-stretch index = 1.93; optic angulation = 47.3°). These quantitative measures allowed us to make a risk-based evaluation of the anatomy and to guide our choices of corridors through which to dissect and remove the tumor. Following surgery, imaging studies demonstrated complete removal of the tumor with significant relief of the frontal lobe and optic apparatus from compression. His pathology showed that he had a WHO Grade I meningioma with an AKT1(E17K) mutation identified on molecular profiling. Conclusions: This case is intended to demonstrate the feasibility of integrating quantitative anatomical measurements into a multidisciplinary, protocol-based perioperative pathway to maximize the safety and effectiveness of the surgical removal of a complex and high-risk skull-base tumor. While the proposed quantitative indices are experimental and require additional validation, the use of a systematic approach such as this may serve as a useful paradigm for other complex skull-base cases. Full article

Caffeine is widely used to enhance cognitive performance, but its efficacy may vary with the administration route and circadian timing. This study compared the acute effects of caffeine capsule ingestion and caffeine mouth rinsing on cognitive performance across morning, midday, and evening sessions in well-trained, adolescent male volleyball players. Twenty-four athletes completed three randomized, double-blind, crossover trials involving a caffeine capsule (3 mg·kg⁻¹), a caffeine mouth rinse of the same dose (expectorated), and a placebo. Cognitive performance was assessed using simple and choice reaction time tests and the Stroop task, alongside a side-effects questionnaire. Both caffeine forms improved performance versus the placebo, with the greatest enhancements occurring at midday and moderate benefits evident in the morning. Capsule ingestion produced the most consistent improvements across reaction speed and executive control, whereas mouth rinsing elicited smaller, task-dependent effects, particularly at midday. No consistent or practically relevant benefits were observed for either caffeine condition in the evening, when cognitive performance was naturally highest. Side effects were mild and infrequent, with occasional headaches after capsule ingestion. These findings indicate that caffeine capsules most effectively enhance cognitive performance when baseline alertness is suboptimal, while caffeine mouth rinsing represents a practical ingestion-free alternative with moderate efficacy. Full article

Symptomatic male hypogonadism, defined by low serum testosterone with associated clinical symptoms, is increasingly treated with testosterone replacement therapy. Traditional oral formulations were limited by hepatotoxicity and poor bioavailability, leading to reliance on injectable and transdermal routes. Recent advances in oral testosterone undecanoate formulations have introduced safer and more effective options. This review compares Jatenzo, Tlando, and Kyzatrex, highlighting their pharmacology, efficacy, safety, and clinical utility. Clinical trial data demonstrate restoration of eugonadal testosterone levels in most patients (80–88%), with shared risks including hypertension, polycythemia, and lipid changes. Differences in dosing regimens, titration requirements, and insurance coverage influence choice of therapy and patient adherence. Kyzatrex offers flexible titration and self-pay access, Tlando provides a fixed-dose regimen, and Jatenzo combines titratability with established clinical data. Collectively, these agents expand the therapeutic landscape of hypogonadism, offering effective, non-invasive alternatives that support individualized treatment strategies. Full article

The study’s aim was to compare the unplanned admission rates and nutrition outcomes in patients with head and neck squamous cell cancer (HNSCC) receiving chemoradiotherapy at two different hospitals with different nutrition support approaches. Hospital Site A used prophylactic tube feeding and Site B used reactive tube feeding. Consecutive HNSCC patients receiving chemoradiotherapy with curative intent over six months in 2015 were eligible for this prospective comparative cohort study. Only patients who were classified as at high nutrition risk using validated guidelines were included. Patients’ weight was recorded at the start, end, and 4–6 weeks post treatment to determine percentage weight loss outcomes. Unplanned hospital admissions (for medical or nutrition related reasons) and associated length of stay (LOS) were collected throughout and up to 1-month post treatment. In total, 88 patients were included in the study (site A n = 58; site B n = 30). The mean age was 60 years, 86–90% were male, and predominantly had oropharyngeal cancer. There was no statistical difference between the groups for percentage weight loss at any timepoint, rates of unplanned nutrition related admissions, or LOS. Stepwise logistic analysis showed that being of an older age was predictive of having an unplanned nutrition-related admission. In summary, there was no difference in the rate of unplanned admissions or percentage weight loss for patients with HNSCC managed under the prophylactic versus reactive tube feeding approach. Decision making regarding the choice of feeding tube should be made in consultation with the patient and the multidisciplinary team. Full article

What people consume for breakfast and why they do so have not been widely studied, especially in developing-economy countries. This study aimed to determine the breakfast food habits and their drivers of adults in South Africa, a multiethnic middle-income country. An online cross-sectional survey was conducted among 1000 representative consumers of moderate to higher living standard (Living Standard Measure [LSM] range ≥ 5). Data from 842 respondents (mean age 41 years, 51.7% females and 48.3% males) was analyzed. Of 21 different food types in descending order, the most frequently consumed were bread, ready-to-eat (RTE) cereals, fruits/nuts, high-fibre cereal, yoghurt, and leftovers, all consumed weekly by 42–65% of respondents. Principal component analysis revealed that three components had eigenvalues > 1 characterized as “On-the-go”, “Traditional”, and “Ready-to-eat and functional cereals”. They explained 49% of the data. Decision tree analysis revealed that, for example, Black respondents were more likely to consume foods in the “traditional” category. Quick-and-easy options, notably bread, RTE cereals, fruits/nuts, and leftovers, were dominant, especially among lower LSM respondents. Tasty and filling, and value for money, as exemplified by leftovers and vetkoek (fried dough), were important considerations, particularly among these respondents. These drivers can lead to unhealthy choices, a major concern in South Africa with its high level of diet-related diseases. This study, however, indicates that South African consumers, irrespective of age, ethnicity, and living standard, rated healthfulness and nutritional value highly as a benefit, the highest for choosing 13 of the 21 foods. Additionally, aspects of wellness, e.g., feeling energized/recharged, rated very highly. Thus, it is concluded that the opportunity exists to support consumer needs of nutrition and wellness together with affordability, taste, and satiety. Full article

Background/Objectives: Single-sided deafness (SSD) treatment options include Contralateral Routing of Signal (CROS) or Bilateral Routing of Signal (BiCROS) systems, bone conduction devices, cochlear implants (CIs) and no intervention. Aligning treatment recommendations with patient motivations is fundamental for satisfaction and successful outcomes. At our institution, a structured telehealth consultation precedes formal testing and includes treatment motivation exploration and comprehensive review of all interventions. This study examined SSD treatment motivations and their association with pursuing cochlear implantation. Methods: Adults who completed a pre-treatment SSD telehealth consultation over a four-year period were identified. Charts were retrospectively reviewed for demographics, SSD characteristics, treatment motivations, treatment choice, and CI outcomes. Results: A total of 122 adults were evaluated. Mean age was 56.3 (±13.0) years, and 59.8% were male. Mean SSD duration was 10.8 (±15.8) years. The most common etiology was sudden sensorineural hearing loss. The top primary motivations were improving overall hearing (23.0%), restoring hearing to the deaf ear (22.1%), and improving hearing in noise (21.3%). Most patients (45.1%) opted for a hearing aid, CROS or BiCROS system; 38.5% chose CI; and 14.8% declined treatment. Only 57.4% of those who selected CI had the implant, primarily due to surgery avoidance (31.5%) and insurance limitations (10.5%). Motivation did not predict treatment choice or CI receipt. Among CI recipients (n = 27), those motivated by hearing restoration demonstrated poorer speech outcomes and datalogging. Conclusions: Improving overall hearing and restoring hearing to the deaf ear were the most common motivations for seeking SSD treatment. Adult CI recipients had similar motivations to those who chose non-surgical options. Full article

Background/Objectives: Endovascular therapy (EVT) is the treatment of choice for femoropopliteal artery (FPA) disease manifesting as critical limb-threatening ischemia (CLTI) or intermittent claudication (IC). This study aimed to compare the clinical outcomes of patients with CLTI with those of patients with IC after EVT in a real-world setting. Methods: In total, 1924 patients with FPA disease (CLTI: n = 812, IC: n = 1112) from the K-VIS ELLA (Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases) registry who underwent EVT between 2006 and 2021 were analyzed. The primary endpoint was defined as target limb amputation or clinically driven (CD) target extremity revascularization (TER) 2 years after the procedure. Results: The incidence of the primary endpoint after inverse probability of treatment weighting (IPTW) was significantly higher in the CLTI group (hazard ratio [HR], 1.314; 95% confidence interval [CI], 1.105–1.561; p = 0.002). The incidences of loss of clinical patency, major adverse limb events (MALEs), and all-cause mortality were also higher in the CLTI group (hazard ratio [HR], 1.312; 95% confidence interval [CI], 1.157–1.488; p < 0.001). However, the risk of repeat percutaneous transluminal angioplasty (PTA) was similar between the groups (HR, 1.014; 95% CI, 0.833–1.234; p = 0.920). The use of drug-coated balloons (DCBs) was associated with favorable primary outcomes in both groups, particularly in patients with IC (HR: 0.429, 95% CI: 0.25–0.734; p = 0.002). Conclusions: Patients with CLTI undergoing EVT for FPA disease experienced worse clinical outcomes than those with IC, although the repeat PTA rates were similar. The use of DCBs showed promising results in both groups. Full article

Background/Objectives: Pathological tooth loss resulting from poor oral hygiene or systemic diseases can lead to partial edentulism, affecting patients both psychologically and physically. These consequences include facial height reduction, temporomandibular dysfunction, and impaired phonetics and mastication. Immediate complete dentures are often an effective provisional solution during the transition to full edentulism; however, establishing the occlusal plane can be challenging when remaining teeth prevent a conventional wax try-in. This clinical case aims to present a qualitative clinical case study of a single patient, illustrating the use of the Broadrick Occlusal Plane Analyzer (BOPA) for the establishment of an occlusal plane in harmony with the anterior and condylar guidance. Methods: A 51-year-old male patient presented to the Department of Prosthodontics at the School of Dentistry, Autonomous University of Guadalajara, with partial edentulism, periodontal disease, and generalized Grade III tooth mobility. Immediate maxillary and mandibular complete dentures were selected as the treatment of choice. Due to the presence of remaining teeth that hindered clinical determination of the occlusal plane, the BOPA was used during the denture design process. Results: Anatomical landmarks were combined with BOPA tracing to establish an occlusal plane harmonious with anterior and condylar guidance. The center of the curve was modified to accommodate anatomic variability in anteroposterior reference points. Conclusions: The use of the Broadrick Occlusal Plane Analyzer facilitated the accurate determination of the occlusal plane for the fabrication of immediate complete dentures in a patient where clinical assessment was limited. This modification allowed the establishment of a bilateral balanced occlusal scheme, contributing to functional and acceptable provisional oral rehabilitation during postoperative alveolar healing. Full article

Purpureocillium lilacinum is an emerging pathogen that can cause severe ocular infections. This study aimed to investigate the risk factors, clinical manifestations, antifungal susceptibilities, and outcomes of ocular infections caused by P. lilacinum at a large ophthalmic center in Southern China. This retrospective study reviewed the medical records of 34 patients with culture-proven P. lilacinum oculomycosis treated at the Zhongshan Ophthalmic Center from January 2020 to December 2024. The study included 34 patients (17 males, 17 females). The most common risk factor was ocular trauma (38.2%). In vitro susceptibility testing revealed high resistance to fluconazole and caspofungin, but general susceptibility to voriconazole (median MIC 0.25 mg/L). Despite 97.1% of patients receiving voriconazole therapy, outcomes were generally poor, with 54.5% of patients experiencing a poor outcome (vision worse than counting fingers). A significantly shorter time to microbiological diagnosis was associated with a favorable outcome (median 26 days vs. 65 days, p = 0.007). In conclusion, the visual outcomes of this infection remain generally poor, with the major clinical challenge being the delay in diagnosis. Therefore, prompt microbiological investigation is recommended for patients with suspected intraocular infection. Voriconazole remains the first-line therapeutic choice, the therapeutic potential of newer triazoles warrants further investigation. Full article