Search Results (4,508)

Recent studies have focused on the detrimental effects of global economic policy uncertainty (EPU) on firm profitability. Nevertheless, none of these studies has focused on a developing economy like Nigeria. To understand this, the study conducted a host of regression analyses using the Driscoll and Kraay fixed-effect estimator and the two-step system generalised method of moments to examine the effects of global crude oil prices and domestic and global economic policy uncertainty on firm profitability in Nigeria from 2005 to 2024. The findings indicate that while global EPU had a minimal impact on firm profitability, domestic EPU had a substantial negative impact. The findings remain consistent even across the sub-samples, sensitivity, and robustness analyses. Furthermore, the findings showed that firm size and capital are significant determinants of profitability for Nigerian firms. At the same time, oil prices and their interactions do not affect firm profitability in Nigeria. The study suggests that regulators in the Nigerian business environment can contribute to building a more resilient environment by implementing systems to monitor critical economic indicators and ensure timely responses to emerging challenges. Systematic evaluations of economic uncertainties, including business sentiment, inflation rates, exchange rates, interest rates, and economic growth, can provide valuable insights for policy formulation and interventions aimed at enhancing the profitability of Nigerian firms. Full article

Background: Psychological distress is increasingly recognized as an important determinant of health-related quality of life (HRQoL) in adults with diabetes mellitus (DM). However, data quantifying this burden in Eastern European populations remains limited. Objectives: This study aimed to assess psychological distress—defined as anxiety, depressive symptoms, or perceived stress—and HRQoL among Romanian adults with DM compared with healthy controls, and to explore potential differences between diabetes subtypes. Methods: A cross-sectional study was conducted, including 400 adults (201 with DM and 199 healthy controls). Psychological distress was evaluated using the State–Trait Anxiety Inventory (STAI-Y1, STAI-Y2), Beck Depression Inventory (BDI), and Holmes–Rahe Stress Scale, while HRQoL was assessed using the EQ-5D Visual Analogue Scale. Group comparisons were performed using appropriate parametric or non-parametric tests, with additional multivariable analyses adjusting for age, sex, and body mass index. Results: Adults with diabetes exhibited significantly higher levels of anxiety, depressive symptoms, and perceived stress, and lower HRQoL, compared with controls (all p < 0.001). These differences remained statistically significant after adjustment for age, sex, and body mass index. Exploratory analyses revealed no statistically significant differences between diabetes subtypes, although subgroup comparisons were limited by sample size. Conclusions: Psychological distress is highly prevalent among Romanian adults with DM and is associated with poorer self-perceived health-related quality of life. The results support the relevance of incorporating systematic psychosocial assessment into routine diabetes care. Full article

Two Gram-negative aerobic halophilic bacteria, designated KMM 9989^T and KMM 9879, were isolated from a bottom sediment sample of the Okhotsk Sea, Russia. The novel strains grew in 0.5–4% NaCl, at 5–35 °C and pH 5.5–10.0. Phylogenetic analyses based on 16S rRNA gene and whole genome sequences placed strains KMM 9989^T and KMM 9879 within the family Roseobacteraceae, where they were clustered with their closest relative Marinovum algicola KCTC 22095^T. The average nucleotide identity (ANI) between strain KMM 9989^T and Marinovum algicola KCTC 22095^T was 81.4%. The level of digital DNA–DNA hybridization (dDDH) between the novel isolates KMM 9989^T and KMM 9879 was 97%, while between strain KMM 9989^T and Marinovum algicola KCTC 22095^T, it was 27%. Strains KMM 9989^T and KMM 9879 contained Q-10 as the predominant ubiquinone and C_18:1ω7c as the major fatty acid. The polar lipids were phosphatidylcholine, phosphatidylglycerol, phosphatidylethanolamine, diphosphatidylglycerol, an unidentified aminolipid, two unidentified phospholipids, and three unidentified lipids. The genomic size of strains KMM 9989^T and KMM 9879 was determined to be 4,040,543 bp and 3,969,839 bp with a DNA GC content of 61.3 and 61.4 mol%, respectively. Both strains contained a common plasmid of 238,277 bp and a strain-specific plasmid (188,734 bp for KMM 9989^T and 118,029 bp for KMM 9879). It is suggested that the motility of KMM 9879 may be mediated by the presence of a complete fla2-type operon in the strain-specific chromid. Thus, based on the phylogenetic analyses and distinctive phenotypic characteristics, the novel marine strains KMM 9989^T and KMM 9879 are proposed to be classified as a novel species Marinovum sedimenti sp. nov. with the strain KMM 9989^T (=KCTC 8835^T) as the type strain of the species. Full article

Background. Glucocorticoid-induced osteoporosis represents a well-known type of secondary osteoporosis (SOp). While the most prevalent sub-category includes corticotherapy, another important contributor is represented by Cushing’s syndrome. In this traditional landscape, adrenal incidentalomas do not involve a standard cause of SOp, since most of them are non-functioning adrenal tumours (NFATs). Yet, 30–40% of them are not entirely “non-functioning”, due to mild autonomous cortisol secretion (MACS). Despite not being a guideline-based diagnosis, a lower ACTH might point to various NFATs/MACS complications. Objective. This study aimed to determine the relationship between the bone health status of post-menopausal women with NFATs/MACS and their baseline morning ACTH level. The bone health indicators were DXA, FRAX, and bone remodelling markers. Methods. This was a retrospective, real-life, transversal study in adult females who were hospitalized in a single tertiary centre of endocrinology. They were all anti-osteoporotic drug-naïve. The subjects underwent CT and DXA scanning and a 1 mg dexamethasone suppression test (DST). Results. The cohort (sample size of N = 84 patients, 61.49 ± 7.86 years) had a type 2 diabetes rate of 18%, arterial hypertension rate of 75%, and a dyslipidemia rate of 78%. Median ACTH was 11.89 pg/mL. The prevalence of MACS was 30.95%. The mean largest tumour diameter (LTD) was 2.25 ± 0.99 cm. ACTH correlated with second-day cortisol after the 1 mg DST (r = −0.301, p = 0.024), and LTD (r = −0.434, p < 0.001). ROC analysis for the bone resorption marker CrossLaps showed an AUC of 0.647 (p = 0.05), with the highest Youden index for the cut-off at 0.32 ng/mL (sensitivity 87.50%, specificity 39.50%). Bone impairment (osteoporosis + osteopenia) was found in 65% of patients, with an osteoporotic fracture prevalence of 4.76%. The lowest mean T-score (−1.12 ± 1.00) showed osteopenia, and the median trabecular bone score pointed a partially degraded microarchitecture [median (interquartile interval): 1.320 (1.230, 1.392)]. FRAX and FRAXplus estimations correlated with bone mineral density (BMD) at all three central DXA sites, regardless of the ACTH cut-off. Patients with a low ACTH (<10 pg/mL) displayed similar bone/adrenal features when compared to those with normal ACTH, except forbut they had a higher MACS rate (45.45% versus 21.57%, p = 0.021) and a larger LTD (2.67 ± 0.98 versus 1.98 ± 0.92 cm, p = 0.003). Fracture estimation showed that only in patients with a low ACTH, the 10-year fracture risk for major osteoporotic fractures (MOF) adjusted for lumbar BMD was lower than the risk for MOF adjusted for diabetes (p = 0.036), and the 10-year hip fracture risk was lower when adjusted for lumbar BMD (p = 0.007). ACTH correlated with lumbar BMD (r = 0.591, p = 0.002) only in the group with an ACTH < 10 pg/mL, suggesting its potential usefulness as a bone biomarker in these cases. On the other hand, MACS-negative subjects with a low ACTH versus those with a normal ACTH showed higher CrossLaps (0.60 ± 0.27 versus 0.42 ± 0.21 ng/mL, p = 0.022), indicating an elevated bone resorption even in patients with tumours that are regarded as true non-secretors. Conclusions. A subgroup of patients diagnosed with NFATs/MACS might be prone to skeletal damage, and biomarkers such as ACTH (specifically, suppressed ACTH) might serve as a surrogate pointer to help refine this higher risk in daily practice. Further research to address other ACTH cut-offs will place ACTH assays in the overall bone status evaluation in these patients, most probably not as a single biomarker, but in addition to other assays. Full article

Background: Transjugular intrahepatic portosystemic shunt (TIPSS) outcomes in patients with moderate-to-severe pre-existing kidney disease (PKD, stages G3a–G4) remain poorly characterized. This study aimed to identify potential predictors of mortality specifically in patients with an eGFR 15–59 mL/min/1.73 m². Methods: We retrospectively analyzed 68 cirrhosis patients with PKD (eGFR < 60 mL/min/1.73 m²) undergoing a TIPSS between April 2021 and April 2024. Clinical outcomes, renal function changes, and 12-month survival were assessed. Statistical analyses included paired t-tests with false discovery rate adjustment and Kaplan–Meier survival analysis to identify potential predictors of mortality. Results: The cohort (mean age 61.0 ± 8.3 years, 83.8% male, 79.4% with PKD G3a–G3b) showed modest improvement in renal function (creatinine 1.93 to 1.75 mg/dL, p = 0.031), though this biochemical change did not predict survival. Overall mortality was 36.8% (95% CI: 25.4–49.5%) at mean follow-up of 6.7 months. Traditional severity scores (MELD, Child–Turcotte–Pugh) showed no significant association with survival (p > 0.05 for all comparisons). In exploratory analyses, mortality was significantly higher in patients with the following: (1) uncontrolled diabetes before a TIPSS (55.2% vs. 25.9%; RR 2.35, 95% CI: 1.08–5.15, p = 0.032); (2) post-TIPSS infection (70.0% vs. 31.0%; HR 5.44, 95% CI: 1.54–19.23, p = 0.009); and (3) post-procedural cardiac events (85.7% vs. 31.1%; p = 0.005). These associations persisted after false-discovery rate adjustment but require prospective validation given the modest sample size and wide confidence intervals. Conclusions: In this exploratory single-center study of patients with moderate PKD undergoing a TIPSS, we observed associations between mortality and pre-TIPSS poorly controlled diabetes, infections, and cardiac events. These hypothesis-generating findings suggest potential areas for future research. Prospective multi-center studies are needed to validate these associations and determine whether interventions targeting these factors improve outcomes. Full article

Objectives: Against common belief, mandibular condyle fractures are not that rare, with morbidity rates ranging from 19 to 52%, depending on actual literature sources. Practitioners try to improve the surgical techniques applied to obtain the most satisfactory anatomical and functional effect. The purpose of this study is to identify the relationships that affect bone loss around screws and plates in mandibular condylar process fractures treated surgically using the Open Reduction and Internal Fixation (ORIF) technique. Materials and Methods: Our research covered 276 fractures of the base, low and high neck of the condylar process. No formal sample size calculation was performed; the study enrolled patients treated at the Department during the last 4 years, based on informed consent granted both prospectively and retrospectively compares to the actual treatment time. The study group was selected based on injury type and the ability to implement surgical treatment. The imaging modality selected for the study was computed tomography (CT), which was assessed in each case by the same operator. Therefore, there was no need to account for inter-rater variability in the results. Based on CT scans, we studied various parameters, including bone healing in the fracture area, bone loss in the screws and plates area, change in the length of the mandibular ramus following osteosynthesis and on the opposite side after 12 months, as well as deformities of the mandibular head. Results: Using screws and plates is the gold standard for treating mandibular condylar process fractures. The number of screws used affects the bone loss ratio around head of the screw. Another factor that impacts the results achieved is the distance from the plate edge to the lateral pole of the mandibular head. Statistical evaluation indicated that proximity to the lateral pole is a risk factor for bone resorption at the plate edge. Conclusions: Based on the collected data, it is possible to predict bone loss, determine the location and selection of plates and screws, as well as to plan the procedure, achieving the lowest possible loss rates. Full article

Background/Objectives: Caffeine citrate represents the standard pharmacological intervention for apnea of prematurity (AOP) and episodes of intermittent hypoxia (IH). Despite its widespread use, consensus regarding the necessity of routine serum monitoring, optimal dosing protocols, and precise clinical indications remains elusive. The primary objective of this investigation was to evaluate the longitudinal trajectory of serum caffeine concentrations in preterm infants and to analyze their correlation with the incidence of AOP and IH episodes. Furthermore, we sought to determine whether blood caffeine concentrations varied significantly across gestational ages throughout the postnatal period. Methods: This multicenter, prospective observational study enrolled preterm infants with a gestational age of ≤30 weeks. Participants were administered a standard loading dose of caffeine citrate within the first 24 h of life, followed by a standardized maintenance regimen. Serum caffeine levels were quantified on a weekly basis. The cohort was stratified into two distinct groups based on gestational age: Group 1 (23–27 weeks) and Group 2 (28–30 weeks). Results: The study yielded 588 serum caffeine measurements from a cohort of 104 preterm infants, characterized by a median gestational age of 28 weeks (range: 23–30 weeks) and a mean birth weight of 1034 ± 296 g. Statistical analysis revealed no significant disparities in serum caffeine concentrations across gestational age groups (p > 0.05). Notably, during the third week of life, infants with apneic episodes demonstrated significantly lower caffeine levels than those without apnea (p = 0.016). Furthermore, a significant negative correlation was identified between serum caffeine concentrations and the frequency of IH episodes during the third, fourth, and fifth weeks of life across multiple oxygen saturation thresholds. Conclusions: While serum caffeine concentrations in preterm infants did not vary significantly with gestational age, lower levels were associated with a higher incidence of AOP and IH episodes. These results suggest that while routine monitoring or dose adjustment based solely on gestational age may not be warranted, maintaining adequate serum levels is critical for symptom management. Future research should prioritize randomized controlled trials with expanded sample sizes, extended follow-up periods, and a rigorous analysis of adverse effects. Full article

Background: Our study aimed to investigate whether the general movements assessment (GMA) and Amiel-Tison Neurologic Examination performed at term-equivalent age (TEA) and 12 weeks corrected age (CA) could predict the occurrence of cerebral palsy (CP) and delayed gross motor milestones in a sample of term and preterm infants and whether the predictive values could be increased by using the two examinations during the same visit. Methods: A total of 70 infants (62 preterm and 8 at term) were examined at TEA and 12 weeks CA using GMs (General Movements) and Amiel-Tison (AT) examinations. We determined the correlation between the results of the examinations and several selected items (scarf sign, popliteal angle, and axial tone) and neuromotor outcomes (presence of cerebral palsy (CP), independent sitting, and independent walking). We attempted to build binary logistic regression models using items from both examination techniques to assess whether the combined use of the two exams could have a better predictive value than using one technique alone. Results: We analyzed the entire group and, separately, the subgroup of preterm infants. For the whole group, there was a statistically significant correlation between the GM examinations at TEA and 12 weeks CA (p < 0.008) as well as between the results of GM and AT exams performed at TEA (p < 0.001) and 12 weeks CA (p < 0.001). The strongest individual predictor for CP in the whole group was the absence of fidgety movements at 12 weeks CA (AUC (Area Under the Curve) = 0.873; CI (confidence interval) 95%: 0.748–0.998; p < 0.001) and a non-optimal result at the synthesis of findings of AT exam at 12 weeks CA (AUC = 0.755; CI 95%: 0.617–0.892; p < 0.003). In the subgroup of 62 premature neonates, absent fidgety movements at 12 weeks CA (AUC = 0.925; CI 95%: 0.819–1.031; p < 0.001) and a non-optimal result in the synthesis of findings of AT exam at 12 weeks CA (AUC = 0.772; CI 95%: 0.620–0.924; p < 0.005) were statistically significant predictors for the risk of CP. In the case of delayed sitting and delayed/absent walking, absent fidgety movements and non-optimal results in the AT exam at TEA and 12 weeks CA were the strongest individual predictors in the whole group as well as in the subgroup of preterm infants. The following exploratory logistic regression models reached statistical significance: one model combining absent fidgety + abnormal scarf sign + abnormal popliteal angle at 12 weeks CA for CP in the whole group (p < 0.032) and preterm infants (p < 0.034) and for delayed sitting in preterm infants (p < 0.041) and a second model combining absent fidgety + abnormal scarf + abnormal popliteal + abnormal axial + abnormal synthesis for CP risk (p < 0.046) and delayed sitting (p < 0.001) in preterm infants at 12 weeks CA. Conclusions: The absence of fidgety movements at 12 weeks CA represented the strongest individual predictor for the occurrence of CP and delayed gross motor milestones in our sample, both in the whole group and the subgroup of preterm infants. The combination of GM and AT findings reached statistical significance for the detection of CP risk in the whole group and CP risk and delayed sitting in the subgroup of preterm infants. Due to sample size limitations, the results should be regarded with caution, and larger studies are needed before robust conclusions can be drawn. Full article

The concordance correlation coefficient (CCC) is a popular measure of agreement between two continuous variables but is highly sensitive to outliers and data contamination. In this study, we propose a robust reformulation of the CCC by replacing classical moment estimators with Minimum Covariance Determinant (MCD) estimators. The proposed robust CCC preserves the interpretability of the classical coefficient while providing substantially improved robustness. Comprehensive Monte Carlo simulations under normal and non-normal distributions, varying sample sizes, correlation levels, and contamination schemes compare the proposed coefficient with the classical CCC and existing robust alternatives. The results show that the proposed robust CCC achieves superior stability and accuracy in contaminated settings while remaining competitive under clean data. Theoretical properties of the estimator are discussed, and its practical usefulness is demonstrated using real glucose measurement and blood pressure data sets. The proposed method is implemented in the MVTests R package, enabling straightforward application to real-world data. Full article

Background and Objectives: Meniscus injuries, particularly Grade I and II, are common knee injuries that can affect pain, joint function and quality of life, but the effectiveness of non-invasive treatments like Kinesiology taping (KT) in this population remains limited. This pilot randomized controlled trial aimed to explore the short-term effects of KT on pain, fear of movement, muscle strength, proprioceptive force sense, joint range of motion, joint position sense and quality of life in individuals with Grade I/II meniscus injuries. Materials and Methods: 26 participants diagnosed with Grade I-II meniscus injury were randomly assigned to two groups: the experimental group was applied ‘Y shaped’ kinesiology taping on quadriceps femoris muscle, based on facilitation technique with 25–50% tension. The control (placebo) group was applied a tape without tension, perpendicular to the quadriceps femoris muscle. Outcomes were evaluated before and 48–72 h after taping. Results: Between-group analysis demonstrated a significant improvement in joint position sense at 60° flexion with eyes closed in KT group compared with placebo (p = 0.002). Additionally, the KT group showed significantly greater improvements in the physical function (p = 0.006) and energy (p = 0.013) subdomains of the SF-36 quality of life scale. No significant between-group differences were observed for pain, fear of movement, muscle strength, proprioceptive force sense, or joint range of motion. Conclusions: In this pilot study, KT showed acute benefits in proprioception and quality of life in grade I-II meniscus injuries, but no advantage over placebo taping for pain, fear of movement, joint range of motion or muscle strength. Given the exploratory nature and limited sample size, these findings should be interpreted cautiously. Larger trials should confirm these results and determine the role of KT within multimodal rehabilitation programs. Full article

Alterations in the tumor extracellular environment and matrix stiffness promote tumor progression. Furthermore, correlational studies have identified enrichment of extracellular matrix (ECM) proteins (glycoproteins, collagens) in breast tumors. Despite these findings, there has yet to be an interdisciplinary analysis of both ECM composition and structural architecture in rare breast tumors, such as metaplastic breast cancer. Here, we explored changes in ECM protein expression and architecture in a triple-negative breast cancer (TNBC) metaplastic tumor through SEM, proteomics, and RNA sequencing. SEM revealed that the tumor pore size was larger compared to the control adipose tissue. Oscillating rheometry demonstrated increased ECM stiffness in the tumor compared to the control adipose breast adipose. Proteomic analysis of the metaplastic TNBC tumor showed significant enrichment for ECM proteins, notably glycoproteins compared to the control adipose. Interestingly, these samples showed no observed changes in expression for major fibrillar collagens COL1A1 and COL1A2, and a reduced expression of COL3A1. To determine the impact of less characterized ECMs in metaplastic TNBC, we overexpressed MFAP2 in primary metaplastic breast cancer cells and performed RNA sequencing. MFAP2 overexpression was associated with upregulation of epithelial-to-mesenchymal transition-related genes. Overall, our results establish an extracellular signature and onco-architecture for the metaplastic triple-negative tumor type. Full article

The Mediterranean Sea is recognized for its high biodiversity but is also a hotspot for pollution. In this study, fish samples of four native marine species were collected from wild catches to determine contaminants such as Anisakis parasites and heavy metals, including nickel, lead, copper, zinc, and chromium, within local marine fish species. The detection of Anisakis parasites was performed by a visual inspection and a digestion method. Metal analysis was carried out on skin, muscle, viscera, and bones of fish, using Microwave Plasma-Atomic Emission Spectroscopy. This study demonstrated that Boops boops was the least infested species by Anisakis parasite, while Scomber colias was the most infested, with Sardinella aurita and Trachurus trachurus showing a lower infestation rate. Pearson correlation statistics revealed that infestation correlated with fish size but not with maturity or sex. Principal component analysis (PCA) demonstrated that the carnivorous species were more prone to Anisakis infestation than the omnivorous species. The maximum levels of copper, nickel, chromium, lead, and zinc content in fish tissues were 13.2 ± 0.11, 19.5 ± 0.02, 19.9 ± 0.01, 28.8 ± 0.09, and 184.87 ± 0.63 µg/g, respectively. PCA revealed that heavy metal contamination does not discriminate between fish species and sex, as opposed to tissue type and location of catch. Some metals, such as zinc and lead, seem to accumulate more in muscle rather than the other tissues. These findings indicate that Anisakis infestation and heavy metal analysis should be monitored and extended beyond the current EU requirements. Full article

Background/Objectives: The complexity of healthcare systems and the unclear interactions within them remain key challenges to improving quality and outcomes. The Patient Activation Measure (PAM-13) is a tool that offers insight into patient interactions with healthcare services and has been used for nearly 20 years. However, its application in tertiary healthcare facilities in Saudi Arabia has not been evaluated. This study aimed to assess the feasibility and acceptability of implementing the PAM-13 in a university Family Medicine Center and to evaluate its effect on enhancing patients’ engagement, activation, self-management, and participation in routine care. Methods: A quasi-experimental study was conducted from November 2024 to June 2025 using stratified cluster sampling from the diabetes and chronic diseases unit, care of older adults’ unit, and general family medicine unit. The estimated sample size was 65 patients. Statistical analyses were performed using SPSS. Results: Baseline PAM-13 scores varied across participants, with most patients in levels 2 and 3. Following the tailored intervention, activation significantly improved in the intervention group (p = 0.004), particularly among those initially in levels 1 and 2. Activation scores in the control group declined. No significant short-term changes were observed in clinical outcomes, including blood pressure, glucose, or cholesterol levels. Conclusions: Tailored interventions based on PAM-13 enhanced patient activation in a tertiary care setting. Patients with lower baseline activation showed notable improvements in engagement and self-management. Further longitudinal, multicenter studies are needed to determine the sustainability and clinical impact of these improvements. Full article

Background: Some patients suffer from persistent symptoms following a COVID-19 infection, referred to as long COVID. The aims of the study were to estimate the prevalence of long COVID and study its determinants in Tunisia. Methods: We conducted a nationwide cross-sectional study among a representative sample of COVID-19 survivors residing in Tunisia between June and August 2022. We selected a random sample, stratified by age and region, among residents registered in the national surveillance database with a SARS-CoV-2 positive test taken from September 2020 to September 2021 (n = 479,743). The expected sample size was 384. We defined a patient with long COVID as having at least one self-reported symptom persisting for more than four weeks after the first confirmation of SARS-CoV-2 infection (RT-PCR or Ag-RDT) and not explained by an alternative diagnosis. Trained healthcare workers interviewed consenting respondents by phone using a structured questionnaire. We described continuous variables using median and interquartile range (IQR). We measured the prevalence of long COVID and its 95% confidence interval (95% CI). We estimated the association between explanatory variables (socio-demographic, lifestyle and comorbidities, SARS-CoV-2 history infection, COVID-19 vaccination status) and long COVID using a log-binomial model, reporting adjusted prevalence ratios (a-PR) and its 95% CI. Results: Of 1094 persons contacted, 416 were enrolled (response rate: 38%). Long-COVID prevalence was 64% (267/416); 95% CI [59–69%]. The sex ratio (M:F) was 0.72. Age ranged from 1 to 101 years, with a median of 41 years (IQR:31–55 years). The most common symptoms were fatigue (63%), myalgia/arthralgia (33%), and cognitive symptoms (52%). Median duration of long-COVID symptoms was 11 months (IQR: 3–14 months). In multivariate analysis, experiencing acute COVID-19 (a-PR = 1.5; 95% CI [1.0–2.1]), being a woman of childbearing age (a-PR = 1.2; 95% CI [1.0–1.4]) and residing in the central region (a-PR = 1.5; 95% CI [1.1–2.0]) were significantly associated with a higher prevalence of long COVID. Conclusions: Long COVID is prevalent in Tunisia affecting patients with multiple symptoms initially, those residing in the central region and young women. We recommend to enhance healthcare access and medical follow-up both during and after the infection, focusing on identified risk groups. We also recommend to conduct further research to optimize management of long-COVID patients. Full article

Background: Total hip arthroplasty (THA) is a well-tolerated and effective procedure that can improve a patient’s mobility and quality of life. A main concern, however, is the release of metal ions into the body due to wear and corrosion. Commonly reported ions are Co and Cr, while others, such as Ti, Mo, and Ni, are less frequently studied. The objective of this study was to characterize compartmentalization and time-dependent ion behaviors across serum, whole blood, and urine after hip prosthetic implantation. The goal of using Random Forest (RF) was to determine whether machine learning modeling could support temporal trends across data. Methods: Data was gathered from the literature of clinical studies, and we conducted a pooled analysis of the temporal kinetics from cohorts of patients who received hip prosthetics. Mean ion concentrations were normalized to µg/L across each fluid and weighted by cohort sample size. RF was used as a study-level test of predictive accuracy across ions. Results: For serum and whole blood, Co and Cr displayed one-phase association models, while Ti showed an exponential rise and decay. Ions typically rose quickly within the first 24 months postoperatively. Serum Co and whole blood had similar patterns, tapering off just under 2 µg/L, but serum Cr (~2.02 µg/L) was generally higher than that of whole blood (~0.99 µg/L). Mean urinary Co levels were greater than those of Cr, suggesting a larger, freely filterable fraction for Co. RF was implemented to determine predictive accuracy for each ion, showing a stronger fit for Co (R² = 0.86, RMSE = 0.57) compared to Cr (R² = 0.52, RMSE = 0.50). Conclusions: Sub-threshold exposure was prevalent across cohorts. Serum and whole blood Co and Cr displayed distinct kinetic profiles and, if validated, could support fluid-specific monitoring strategies. We present a methodology for interpreting ion kinetics and show potential for machine learning applications in postoperative monitoring. Full article