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Fracture healing is a complex biological process involving orchestrated interactions among cells, growth factors, and transcriptional pathways. Despite significant advancements in understanding bone repair, non-union and delayed healing remain prevalent, especially in patients with comorbidities such as aging, diabetes, or substance use. Murine models serve as a cornerstone in fracture healing research, offering genetic manipulability, cost-effectiveness, and biological relevance to humans. This scoping review consolidates findings from studies conducted between 2010 and 2024, focusing on mechanistic pathways derived from transcriptional analysis in secondary bone healing as identified through bulk RNA sequencing of murine models. Key mechanistic pathways were categorized and analyzed across the distinct phases of fracture healing-reactive, reparative, and remodeling-highlighting their unique roles in inflammation, ECM remodeling, cell proliferation, and tissue mineralization. The most recurrent mechanistic pathways included ECM-receptor interaction, focal adhesion, and signaling mechanisms such as MAPK and TGF-beta. Variability in methodologies and limited overlap among studies underscore the need for standardized protocols in RNA sequencing analysis. Additionally, comparisons across long bone fractures, hole defects, and craniofacial bone healing revealed shared molecular mechanisms alongside unique challenges, particularly in craniofacial models. This scoping review underscores the promise of integrating systems biology approaches with transcriptomic data to elucidate the intricate regulatory networks governing fracture repair. Addressing the identified gaps in early-phase healing and harmonizing research methodologies will advance therapeutic strategies to reduce non-union rates and improve clinical outcomes., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ara Nazarian reports was provided by Beth Israel Deaconess Medical Center. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier Inc.)

Endodontic infections include conditions such as pulp necrosis, apical periodontitis, abscesses, granulomas, and periapical cysts. Detection of pathogenic microorganisms responsible for these diseases is essential for accurate diagnosis and future therapy. Enterococcus faecalis, Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were analyzed qualitatively and quantitatively using the Checkerboard methodology for DNA-DNA hybridizations as a bacterial identification tool. Clinical investigations have shown a significant frequency of these microorganisms. The present systematic review and meta-analysis aimed to determine the prevalence of E. faecalis and red complex bacteria (RCB) (P. gingivalis, T. forsythia, and T. denticola) analyzed by the Checkerboard DNA-DNA hybridization technique in endodontic infections. This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines-electronic databases: PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar. Statistical analysis was performed using STATA V.15 software. Seventeen articles were included, of which a total of 620 samples were evaluated. Five hundred sixty-seven samples were taken from infected root canals, 34 samples from periradicular tissues, and 27 samples from periapical abscesses of infected teeth. The prevalence of E. faecalis in endodontic infections in all studies was 74 %, of P. gingivalis was 63 %, of T. forsythia 46 %, and of T. denticola 58 %. The presence of bacteria such as E. faecalis reduces the efficiency of endodontic therapy and leads to recurring infections. It is recognized that "RCB" can be identified in endodontic lesions; however, they are not usually prominent. The DNA-DNA hybridization approach is critical for identifying bacteria and detecting difficult-to-culture microorganisms, making it a helpful and cost-effective tool for directing personalized endodontic treatments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Low muscle mass is negatively associated with survival in patients undergoing surgery for colorectal cancer. Current evidence is limited regarding whether the surgical approach for liver resection of colorectal metastasis impacts postoperative changes in body composition and whether preoperative body composition can impact complication rate and survival., Method: This study included patients previously included in the randomized OSLO-COMET trail where patients was allocated to laparoscopic or open liver resection for colorectal liver metastasis. CT scans 0-3 months before and 2-6 months after liver resection were segmented with the artificial intelligence-based tool BodySegAI to measure skeletal muscle mass (SM), visceral adipose tissue (VAT), and inter- and intramuscular adipose tissue (IMAT). SM, VAT and IMAT was compared between the open and laparoscopic group and as predictors for 5-year survival and postoperative complications., Results: This study included 216 patients, median age was 67, 127 (59%) were male, 91 (42%) had primary tumor in rectum and 86 (40%) had multiple liver metastasis. There was no significant difference in postoperative change in SM, VAT or IMAT between those undergoing laparoscopy or open surgery. In multivariate analysis, high preoperative IMAT was a predictor for increased risk of postoperative complications (HR (95% CI): 1.045 (CI 95%: 1.003-1.089), p = 0.034). Moreover, postoperative increase in IMAT was a negative predictor for 5-year survival (HR (95%CI):1.009 (1.003-1.016), p = 0.003)., Conclusion: Postoperative change in body composition did not differ between patients randomly assigned to open or laparoscopic liver resection for colorectal metastasis. High preoperative IMAT was associated with an increased risk of postoperative complications., Competing Interests: Declarations. Conflict of interests: Dr. Åsmund Avdem Fretland has received speaker honoraria from Olympus medical, Medtromic and Angiodynamics symposium. Dr Fretlands’ institution has received honoraria from Siemens Healthineers. Drs. Martin Alavi Treider, Elisa Romandini, Dena Treider Alavi, Davit Aghayan, Margrethe K. Rasmussen, Giovanni Marchegiani, Peter M. Lauritzen, Egidijus Pelanis, Bjørn Edwin, Rune Blomhoff have no conflicts of interest or financial ties to disclose., (© 2025. The Author(s).)

Background: Parapharyngeal space liposarcomas (PPS-LS) are rare tumors often associated with a moderate-to-poor prognosis., Objectives: This study aims to assess tumor control and survival outcomes across the various subtypes of PPS-LS., Material and Methods: We conducted a systematic review of cases using PubMed, OVID, Scopus, Web of Science, ScienceDirect, and EBSCO from inception to October 2024. Given the data on individual patient follow-up, Kaplan-Meier survival analysis was utilized to calculate disease-free survival (DFS) and disease-specific survival (DSS)., Results: Out of 303 articles, 10 studies with 11 patients (72.7% male) met the inclusion criteria, with a mean age of 51.3 years (range: 12-77.5). Preoperative fine needle aspiration cytology was conducted in 45.4%, with 80% yielding inconclusive results. The 2-year and 5-year DFS rates for PPS-LS were 64% and 50%, respectively, while the 2-year DSS rate was 84%. Tumor recurrence occurred in 36.3% of patients, with an average of 2.5 recurrences per patient, specifically the myxoid subtype of PPS-LS., Conclusion: This systematic review highlights the varied prognostic outcomes of PPS-LS and its subtypes, emphasizing the need for vigilant surveillance to improve DFS and reduce recurrence rates., Significance: This provides surgeons with critical insights into probable prognostic outcomes when dealing with specific subtypes of PPS-LS.

Introduction: A National Immunization Technical Advisory Group (NITAG) provides independent guidance to Ministries of Health (MoH) and policymakers, enabling them to make informed decisions on national immunization policies and practices. As of 2022, 50 of the 53 countries in the World Health Organization (WHO) European Region (the Region) had established a NITAG, with 58% of all NITAGs and 66% of those in middle-income countries (MICs) in the Region meeting all six WHO process indicators of NITAG functionality. However, many newly established NITAGs in MICs in the Region experience challenges in terms of their functioning, structure, and outputs., Methods: To address these challenges and achieve the goal of evidence-informed decision making on immunizations, the WHO Regional Office for Europe and the Robert Koch Institute (RKI) implemented a project to strengthen the functioning of MIC NITAGs of the Region through comprehensive evaluations of nine NITAGs and development and implementation of improvement plans., Results: All evaluated NITAGs are formally established and complete the most important aspects of NITAG functioning. The main challenge for all NITAGs is the lack of a well-staffed Secretariat to establish annual workplans and develop NITAG recommendations following a standardized process., Discussion: The evaluation identified NITAGs' strengths and challenges. Some challenges have been addressed through improvement plan implementation. WHO and RKI will continue to evaluate NITAGs and support development and implementation of improvement plans. WHO and NITAG partners will continue to provide training on the standardized recommendation-making process and advocate increased MoH support to NITAGs, including dedicated Secretariat staff., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Külper-Schiek, Mosina, Jacques-Carroll, Falman, Harder, Kakarriqi, Preza, Badalyan, Sahakyan, Romanova, Shimanovich, Musa, Bayesheva, Azimbayeva, Nurmatov, Toigombaeva, Revenco, Gutu, Markovic-Denic, Bonaci-Nikolic, Tursunova, Tadzhiyeva, Wichmann and Datta.)

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The success of hemisection is based on meticulous case selection, considering the quality and quantity of bone surrounding the remaining roots. Additionally, a well-devised prosthetic plan is crucial to direct forces along the preserved roots, and ongoing maintenance is imperative for long-term success. This case report aims to present two different restorative designs for the pontic on the edentulous space after the hemisection of a molar tooth. The treatment approach included initial root canal treatment, followed by periodontal intervention involving hemisection. The hemisected tooth was restored through a fixed partial denture, utilizing premolar, or molar as abutments. Hemisection is an excellent option for retaining the molar tooth in the mouth. The restorative option might be chosen between original molar anatomy or transformation into premolars. This must be in accordance with the patient's wishes as well., Competing Interests: The authors declare no conflict of interest., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2025.)

Purpose: To illustratively evaluate and compare the effectiveness of aspiration of 7.5Fr and 9.2Fr single-use flexible ureteroscopes with direct in-scope-suction (DISS) with a 12/14Fr flexible and navigable suction ureteral access sheath (FANS) in an in-vitro setting., Methods: Our experimental setup included a 6.5-size sterile glove, 2 mm and 4 mm stone fragments, and a porcine ureter. Three experimental scenarios were evaluated in the upper, middle and lower calyx: 1. Suction via 12/14Fr FANS, 2. Suction via 7.5Fr DISS, 3. Suction via 9.2Fr DISS., Results: Evacuation of the 2 mm stone was reported in all trials regardless of the used instrument. Aspiration and repositioning of the 4 mm fragment was observed from the upper calyx with all instruments. In the middle calyx, stone evacuation was successful in 5 out of 5 trials with 7.5Fr DISS, and 3 out of 5 with 12/14Fr FANS or 9.2Fr DISS. Stone relocation using suction with subsequent evacuation of the 4 mm fragment from the lower calyx was achieved in none of the trials with 12/14Fr FANS and only in 1 trial with 9.2Fr DISS scope whereas it was successful in 4 trials when 7.5Fr DISS was used. Collapse of the pelvicalyceal system (PCS) was more pronounced with the 12/14Fr FANS and 9.2Fr DISS scope (3-4 s) compared to 7.5Fr DISS scope (6-7 s)., Conclusion: In this study, the 7.5Fr single-use flexible ureteroscope was found to be superior in terms of stone extraction and relocation, while it seemed to have less impact on the collapse of the PCS compared to 9.2Fr DISS and 12/14Fr FANS., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Nature B.V.)

Background and Aims: Although every human has the right to overall well-being, refugees worldwide often sustain inadequate healthcare. Türkiye, hosting a large refugee population, raises public concerns about providing equitable healthcare. This study aims to evaluate the Turkish healthcare system's effectiveness and limitations in addressing refugee health needs, identify challenges in accessing care, assess the impact of policies, and propose recommendations for improving refugee life quality., Methods: We conducted a comprehensive review of the literature using databases like PubMed, MEDLINE, ScienceDirect, and Google Scholar. Our search focused on refugees impacted by recent crises and relevant policies. Keywords included "Refugee population in Türkiye," "Barriers to accessing healthcare," and "Turkish healthcare system." We included English-language articles relevant to our research objectives and empirical data, excluding studies not focused on refugees or migrants in Türkiye, and those published before 2010., Results: The review emphasizes the ongoing disparities in healthcare access for refugees in Türkiye. Despite significant efforts, barriers such as the locations of refugee camps, legal restrictions, and language differences continue to hinder healthcare access. Moreover, the sheer number of refugees exacerbates these issues. The recommendations focus on addressing these issues, ensuring better healthcare access, and improving refugee integration., Conclusion: The large influx of refugees into Türkiye has led to an unequal distribution of resources, creating substantial challenges in providing equitable healthcare. Chronic conditions and mental health disorders among refugees further highlight these issues. This underscores the need for international policy improvements, legal reforms, innovative solutions like telemedicine, and a more comprehensive healthcare approach to support refugees. Reducing social stigma and improving refugee integration into the healthcare system is crucial for achieving better health outcomes., Competing Interests: The authors declare no conflicts of interest., (© 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Background: Aerosol generation in dental practice is a significant concern in infection control. This study aimed to investigate the strategies for controlling and preventing aerosol-generated microbes during dental procedures., Methods: A comprehensive literature search was performed using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines through electronic databases (PubMed, ScienceDirect, Cochrane Library, Google Scholar, and Scopus) for studies reporting interventions, including mouthwash and suction devices, that were effective against pathogens generated during dental procedures. Predefined criteria identified eligible studies. Pooled efficacy was estimated using RevMan 5.4's random-effects model.Quality assessments were performed using RoB-2.0 and the Robvis web application., Results: This systematic review and meta-analysis included 19 papers. Cetylpyridinium chloride, chlorhexidine, chlorine dioxide, hydrogen peroxide, botanical medicines, and suction devices are the most used dental therapies to minimise microbial contamination. Overall, these treatments showed success with a pooled effectiveness of -46.64 (95% CI: -60.89 to -32.38, I2=100%, p<0.00001)., Conclusions: This study emphasises the need for a multifaceted approach that uses antiseptic mouthwash and suction devices to reduce cross-contamination and infection transmission during aerosol-generated dental procedures, safeguarding patients and dental workforce., (Copyright © 2025 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Background and Aims: The year 2023 marked the 10-year anniversary of the launch of direct-acting antivirals (DAAs) for the treatment of the hepatitis C virus (HCV). HCV treatment trends by country, region, and globally are important to monitor progress toward the World Health Organization's 2030 elimination targets. Additionally, the historical patterns can help predict the treatment uptake for future therapies for other liver diseases., Methods: The number of people living with HCV (PLHCV) treated between 2014-2023 across 119 countries was estimated using national HCV registries, reported DAA sales data, pharmaceutical companies' reports, and estimates provided by national experts. For the countries with no available data, the average estimate of the corresponding Global Burden of Disease region was used., Results: An estimated 13,816,000 (95% uncertainty intervals (UI): 13,221,000-16,415,000) PLHCV were treated, of whom 12,748,000 (12,226,000-15,231,000) were treated with DAAs, of which 11,081,000 (10,542,000-13,338,000) were sofosbuvir-based DAA regimens. Country-level data accounted for 97% of these estimates. In high-income countries, there was a 41% drop in treatment from its peak, and reimbursement was a large predictor of treatment. In low- and middle-income countries, price played an important role in expanding treatment access through the public and private markets, and treatment continues to increase slowly after a sharp drop at the end of the Egyptian national program., Conclusions: In the last 10 years, 21% of all HCV infections were treated with DAAs. Regional and temporal variations highlight the importance of active screening strategies. Without program enhancements, the number of treated PLHCV stalled in every country/region which may not reflect a lower prevalence but may instead reflect the diminishing returns of the existing strategies., Impact and Implications: Long-term hepatitis C virus (HCV) infection can lead to cirrhosis and liver cancer. Since 2014, these infections can be effectively treated with 8-12 weeks of oral therapies. In 2015, the World Health Organization (WHO) established targets to eliminate HCV by 2030, which included treatment targets for member countries. The current study examines HCV treatment patterns across 119 countries and regions from 2014 to 2023 to assess the impact of national programs. This study can assist physicians and policymakers in understanding treatment patterns within similar regions or income groups and in utilizing historical data to refine their strategies in the future., (Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.)

We report for the first time whole-genome sequencing of four multidrug-resistant sequence type (ST) 307 Klebsiella pneumoniae recovered from patients in two hospitals in Armenia. Comparative genomic analysis revealed that the isolates were closely related, with a maximum of 39 single nucleotide polymorphism (SNP) differences in the core genome. All Armenian isolates carried the integrative and conjugative element ICE Kp 4, which bears the yersiniabactin locus, and shared a common evolutionary origin, diverging around 2005 (95% CI: 1999 to 2011). Antibiotic susceptibility testing showed resistance to several antibiotics, including ampicillin, amoxicillin-clavulanic acid, cefepime, ceftazidime, norfloxacin, levofloxacin, and chloramphenicol. Specifically, isolates designated as ARM03 and ARM06 were resistant to piperacillin-tazobactam, ARM04 and ARM05 had intermediate resistance to both piperacillin-tazobactam and imipenem, and ARM03 showed intermediate resistance to amikacin. We further identified antimicrobial resistance (AMR) genes in four Armenian isolates, including bla OXA-1 , bla TEM-1D , bla SHV-28 , dfrA14 , tet(A ), sul2 , qnrB1 , aac(6´)-Ib-cr , strA , strB and the extended-spectrum β-lactamase gene bla CTX-M-15 . Additionally, ARM03 and ARM06 also obtained dfrA5 , sul1 , sul3 , cmlA1 , mphA , aph3-Ia and the unique colistin resistance gene mcr-8.1 , which was absent in all other publicly available ST307 isolates. These two isolates also acquired aerobactin siderophore-encoding gene clusters ( iucABCD-iutA ) and the hypermucoidy locus rmpADC (ARM06 had rmpA fragment). ARM04 and ARM05, as well as ARM03 and ARM06, had nearly identical AMR and virulence genes, along with similar plasmid replicon profiles, respectively. Our findings suggest that a transmission event occurred between the two hospitals in Armenia, likely facilitated by patients or community members, during which K. pneumoniae ST307 isolates acquired plasmids carrying AMR and virulence genes.IMPORTANCEMultidrug-resistant (MDR) Klebsiella pneumoniae sequence type (ST) 307 has emerged as a high-risk clone associated with hospital- and community-acquired infections, posing a major threat to global public health. We report in-depth comparative genomics analyses of K. pneumoniae ST307 isolates recovered from patients in Armenia. The unique colistin resistance gene mcr-8.1 identified in ARM03 and ARM06 was absent in all other ST307 isolates obtained from the publicly available data sets. ARM03 and ARM06 also acquired aerobactin siderophore-encoding gene clusters ( iucABCD-iutA ) and the hypermucoidy locus rmpADC (ARM06 possessed incomplete rmpA fragment). Our findings suggest that a transmission event has occurred between two hospitals in Armenia either through patients or community members. In addition, the Armenian isolates obtained plasmids carrying virulence and AMR genes during the transmission event. Our study emphasises the importance of genomic surveillance of this emerging MDR-hypervirulent pathogen to provide early interventions., Competing Interests: The authors declare no conflict of interest.

Background: In the oral environment, the production of bacteriocins or antimicrobial peptides (AMPs) plays a crucial role in maintaining ecological balance by impeding the proliferation of closely related microorganisms. This study aims to conduct in silico genome screening of Streptococcus salivarius to identify potential antimicrobial compounds existing as hypothetical peptides, with the goal of developing novel synthetic antimicrobial peptides., Methods: Draft genomes of various oral Streptococcus salivarius strains were obtained from the NCBI database and subjected to analysis using bioinformatic tools, viz. Expert Protein-Analysis System (Expasy), UniProt Knowledgebase (UniProtKB), European Molecular Biology Open Software Suite (EMBOSS), Pepwheel, and PEP-FOLD Peptide Structure Prediction Server. The antimicrobial potential of peptides was assessed through the Antimicrobial Peptide Database (AMP) and Bactibase. Two short peptides, viz. synthetic antimicrobial peptides (SAMPs), were designed based on current knowledge of hydrophobic and cationic residues, synthesized, and their efficacy against biofilm formation was evaluated with standard microbiological methods., Results: The synthesized short peptides reduced the growth and effectively inhibited biofilm formation by specific oral microbial strains, demonstrating their potential as antimicrobial peptides. Furthermore, the alignment of bacteriocin biosynthetic clusters among streptococcus strains revealed variations in putative bacteriocin amino acid sequences across different strains of the same organism., Conclusion: Streptococcus salivarius emerges as a promising bioresource for the development of novel antimicrobial agents, particularly for combating biofilm-associated oral infections., (© 2025 The Author(s). Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

Background: The objective of this systematic review was to identify genetic variants of the IL-23, IL-17, IL-23R and IL-17R genes and isoforms and its possible association with increased development of periodontitis and peri-implantitis., Methods: A systematic review was prepared according to the guidelines, registered in the OSF database with the registration number: 10.17605/OSF. IO/X95ZC. The electronic search was performed in four databases: PubMed, Scopus, Web of Science, and Google Scholar from 1984 until March 15th, 2024. The JBI Critical Appraisal Checklist for Case-Control Studies was used to assess the quality of included studies., Results: Eighteen papers with a case-control design were those that ultimately met the eligibility criteria. A total of 3904 individuals (2315 with periodontitis and 90 with peri-implantitis), and 1589 healthy subjects) were studied. The age range of the study population was 14-70 years, with a mean age ± (SD) of 40.43 ± 6.33 years. A total of 28 genetic variants corresponding to the IL-17A (rs 2275913, rs 3819024, rs 10484879) IL-17F (rs 763780), IL-17R (rs 879576) and IL-23R (rs 11209026) genes were analyzed in this study. Six (33.3%) studies found an association between the IL-17A 197 G/A (rs 2275913) genetic variant and peri-implantitis and periodontitis. One study (5.5%) found an association between the IL-17A rs10484879 variant and peri-implantitis and periodontitis., Conclusion: Six polymorphisms were evaluated, highlighting rs 2275913 of the cytokine IL-17A in patients with periodontitis or peri-implantitis. Only 50% of studies found an association despite having a small sample. This suggests that other factors such as the degree of disease, systemic diseases and ethnic groups studied may play a role., (© 2025 The Author(s). Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

Aims: We sought to characterize the clinical course of patients following worsening heart failure (WHF) treated in an outpatient setting and to identify factors associated with a poor response to standard of care with loop diuretics., Methods and Results: Between September 2022 and March 2023, 44 eligible patients (mean age 66.3 years, 84% male) with ejection fraction <50% and with WHF symptoms in the preceding week treated in an outpatient setting were enrolled. Patients were assessed weekly over 4 weeks following the WHF episode. At week 4, responses to fluid expansion and furosemide administration were assessed in 39 patients to unmask persistent subclinical congestion. Patients were on stable doses of guideline-directed medical therapy (GDMT) with a mean daily furosemide dose of 47.4 mg. Patient-reported and physician-assessed symptoms and quality of life improved over the 4 weeks. At 1 h following 1 L Ringer solution infused over 2 h, the median (interquartile range) urine volume and urine sodium excreted over 3 h were 300 (200.0-500.0) ml and 39.6 (12.4-63.0) mEq, respectively. Receiver-operating characteristic curves suggest that cystatin C >1.2 ng/ml, N-terminal pro-B-type natriuretic peptide (NT-proBNP) >1500 pg/ml, and high-sensitivity troponin T >20 pg/ml represent good predictors of non-response to a fluid challenge (diuresis, natriuresis, and rales) following an outpatient WHF, with having all three markers associated with the worst response., Conclusion: Patients with high levels of troponin, or NT-proBNP, or cystatin C who develop WHF despite being treated with a loop diuretic, need novel therapies for WHF., (© 2024 The Author(s). European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Traumatic brain injury (TBI) is a global medical concern and has a lasting impact on brain activity with high risks of mortality. Current treatments are inadequate for repairing damaged brain cells or correcting cognitive and behavioral disabilities in TBI patients. Mounting evidence links TBI to the activation of the Integrated Stress Response (ISR) signaling in the brain. A novel small molecule, ISRIB, is an effective inhibitor of the ISR pathway, offering potential advantages for brain health. Here, we investigated how ISRIB affects brain transcriptome and behavior in zebrafish TBI model evoked by telencephalic brain injury. Overall, while TBI diminished memory and social behavior in zebrafish, administering ISRIB post-injury markedly reduced these behavioral deficits, and modulated brain gene expression, rescuing TBI-activated pathways related to inflammation and brain cell development. Collectively, this supports the role of brain ISR in TBI, and suggests potential utility of ISRIB for the treatment of TBI-related states., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. N.P.I. and D.S.G. received support by St. Petersburg State University., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The aim of this study was to evaluate long-term outcomes and patient satisfaction after nasal dorsal rhinoplasty with allogeneic cartilage graft of the nasal septum., Materials and Methods: The present study included 104 patients (41 males and 63 females) whose mean age at surgery was 28.7 years and who underwent nasal dorsal augmentation with allogenous nasal septal cartilage graft during the period 2017-2023. Depending on the use of platelet-rich fibrin (PRF), the patients were divided into two groups: Group I had PRF applied in dorsal rhinoplasty and included 53 patients (29 males and 24 females). Group II (control group) had dorsal rhinoplasty without the use of PRF and included 51 patients (26 males and 25 females). Donor patients included those who had taken excess nasal septal cartilage during functional rhinoplasty. According to the indications, crushed allogenic septal cartilage graft and PRF were also used. Esthetic results of rhinoplasty were assessed from preoperative and postoperative clinical pictures and also by visual examination. To assess the results of esthetic rhinoplasty, the Portuguese version of the Utrecht Questionnaire (UQ) was used, which contains a visual analog scale (VAS) on a 5-point Likert scale., Results: In patients included in the study, there were no serious complications: there was no deformation or extrusion, and allograft resorption was not observed. After rhinoplasty in the Group I patients, the mean score of VAS esthetic satisfaction with nose improved from 3.6 preoperatively to 8.5 3 months postoperatively and 9.2 12 months postoperatively. After rhinoplasty in the Group II patients, the mean score of VAS esthetic satisfaction with nose improved from 3.7 preoperatively to 7.8 3 months postoperatively and 8.3 12 months postoperatively., Conclusions: Rhinoplasty with allogeneic cartilage graft of the nasal septum allows to achieve stable, positive, functional, and esthetic results and is safe to use. It is an alternative to autologous cartilage used in rhinoplasty and also prevents additional surgical procedures., (© 2024 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)

Background and Aims: Oral Lichen Planus (OLP) is a common chronic inflammatory autoimmune illness that mostly affects the oral mucosa but may also affect other mucous membrane. It has higher prevalence in female patients of fourth to sixth decade of life with reticular being the commonest clinical variant. Clinical assessment, patient history, biopsy findings, and immunofluorescence were used to diagnose OLP. This study aimed to assess research publication trends in therapeutic strategies in the treatment of OLP, examining publication growth, country and institution contributions, and collaborative networks., Methods: Using the Dimensions and Lens.org databases with Boolean operators combined the keywords a total of 40,046 peer-reviewed international publications were initially assessed. The article was selected from 2014 to December 2023. Through rigorous application of inclusion and exclusion criteria using an advanced search, a subset of 134 papers emerged to meet the high relevance standards. This subset, constituting a representative sample, was selected for in-depth bibliometric analysis., Results and Conclusion: The result shows a clear upward trend in the number of publications, with a notable increase in 2018. After 2018, there is decrease in the number of publications, but it has an upward trend, reaching a peak of 215 in 2022. Chaitanya Nallan CSK leads the list of authors with four publications and a respectable total citation count of 12. Cairo University is the leading institution in this data set, with the 8 number of publications and 11 citations. The analysis revealed that at the top of the list is the "Egyptian Dental Journal" from Egypt, with six publications, four citations, and a link strength of two. In the second position is "BMC Oral Health" from the United Kingdom, with five publications, one citation, and a link strength of three. This study offers valuable insights for future research, clinical practice, and policy decisions., Competing Interests: The authors declare no conflicts of interest., (© 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Background: Proximal humerus fractures are common in adults aged 65 and older and provide challenges for osteoporotic patients due to the risk of suboptimal fixation and complications. Locking plates are often utilized to treat two-part fractures; however, ongoing concerns about their stability exist. This pilot study investigates the biomechanical impact of subchondral locking screws compared to unicortical screws in osteoporotic two-part cadaveric proximal humerus fractures., Methods: Using dual-energy X-ray absorptiometry (DXA), cadaveric shoulder specimens from eight female Caucasian donors with comparable bone mineral densities were used for the study. Either unicortical or bicortical locking screws (the latter representing subchondral screws in real surgeries) were utilized to fix locking plates. Axial load to failure and cyclic physiologic abduction moments were applied in biomechanical testing., Findings: The study found no statistically significant difference in interfragmentary displacement between the unicortical and bicortical groups (p = 0.78). The mechanical properties of both groups were found to be comparable in terms of yield (p = 0.59), ultimate (p = 0.86), and fracture strengths (p = 0.70). Furthermore, rigidity analysis did not identify any significant difference between the two groups (p = 0.22)., Interpretation: Our findings indicate that there is little to no difference in the stability of the construct for osteoporotic two-part proximal humerus fractures, in contrast to general recommendations against unicortical screws. This pilot study suggests that the choice between unicortical and subchondral locking screws may not significantly affect biomechanical characteristics in osteoporotic two-part proximal humerus fractures, despite the study's limitations., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2025 Published by Elsevier Ltd.)

Experimental studies of chronic noise exposure in modern urban life testified about oxidative stress due to the corresponding hormones effects leading to accumulation of reactive oxygen species and endothelial dysfunction. This study aims to evaluate the protective effect of α2-adrenoblockers to modulate oxidative stress and corticosterone levels due to chronic noise exposure. To achieve this, we examined the effects of beditin (2-aminothiozolyl-1,4-benzodioxane) and mesedin (2-(2-methyl-amino-thiozolyl)-1,4-benzodioxane hydrochloride), along with changes in corticosterone, Ca2 + content, and morphological alterations in various tissues under noise-induced stress. Beyond this, detection of immune-reactivity and proliferation of Galarmin-containing cells in adrenals, and isolation of the total fractions of superoxide-producing associate from the rat liver under noise exposure and the beditin and mesedin actions on them were pertinent. Experiments were provided on the albino female rats divided into four groups: (1) control, (2) noise-exposed, (3) noise-exposed and beditin-injected (2 mg/kg, i.p.), and (4) noise-exposed and mesedin-injected (10 mg/kg, i.p.) animals. The noise exposure was of 91 dBA noise on 60 days with a daily duration of 8 h. For the first time, the total fractions of superoxide-containing associates were separated from the cell membranes of the rat liver tissue under the chronic noise stress conditions and the regulative effects of the α 2 -adrenoblockers. Increased 45 Ca 2+ and decreased corticosterone levels in the mentioned tissues, as well as dystrophic changes, were observed under the chronic noise exposure. Prominently, α 2 -adrenoblockers showed antioxidant effects, modulating pathological shifts of the noise-induced stress., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: The aim of the study is to compare the clinical efficacy of the application of "Armenicum" paste as an adjunct to SRP for the non-surgical treatment of patients with periodontitis., Methods: The current RCT prospective study was conducted on 157 patients with chronic periodontitis. The patients were blind randomly assigned into two groups: Group A (SRP + Armenicum" paste) 81 patients (42 males and 39 females, 37 to 68 years) and Group B (SRP) 76 patients (39 males and 37 females, 37 to 68 years). Periodontal indices BOP, PPD, and DPI within each treatment group were measured before periodontal therapy, 3 and 6 months after the treatment. Group A underwent a periodontal treatment which included: supragingival and subgingival scaling, and additional use of local "Armenicum" paste. The Group B group only received supragingival and subgingival scaling., Results: In our study, the mean BOP, DPI, and PPD showed a statistically significant difference from baseline to 3 months and 6 months (p ≤ 0.05) in both Group A and Group B. But, mean BOP and mean PPD reduction gain was found to be greater in Group-A than Group B at 3 months and 6 months. No statistical differences in clinical indices were recorded depending on gender and age., Conclusion: These results indicate that topical "Armenicum" paste provides an effective adjunctive treatment of chronic periodontitis., Clinical Relevance: The results of the current study showed that the adjunctive use of "Armenicum" reduced signs of inflammation compared to standard SRP treatment alone. Periodontal therapy using Armenicum paste application can be considered as a promising method in the treatment of periodontitis., Competing Interests: Declarations. Ethical approval and consent to participate: The study was reviewed and approved by Yerevan State University Ethical Committee and in accordance with those of the World Medical Association and the Helsinki Declaration. Consent for publication: Patients were informed verbally and in writing about the study and gave written informed consent. Clinical trial registration: N/A Permission to reproduce material from other sources (if needed): N/A Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study aimed to present a complete overview of the trends, difficulties, and improvements in dental treatment for children diagnosed with autism spectrum disorder through rigorous bibliometric analysis. The dimensional database field was chosen to enable the inclusion and recall of the greatest number of relevant entries. All peer-reviewed international journals published between 2004 and 2023 were included in this study. The sophisticated search keywords' Autistic Disorder" OR "Autism Spectrum Disorder" AND "Dental management" were used. Studies that examined patterns and difficulties in the dental care of children with ASD were included in the inclusion and exclusion criteria for this analysis. Among the listed countries, The United States had the highest number of documents and citations. Barbara Sheller is the most cited author, followed closely by Arthur H.Friedlander, Michael E.Mahler, and John A.Yagiela. This study also revealed that most articles involved multinational collaborations, highlighting the global scope of dental research. The United States leads in terms of research output and citations, followed by India and China. Research on autism spectrum disorder has grown substantially over the past few years, and the authors recommend that future research concentrate on creating effective behavioral techniques that will assist children with autism spectrum disorder in coping with dental treatment., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable due to the design of the study as a bibliometric analysis. Consent for publication: Not applicable. Informed consent: Not applicable due to the design of the study as a bibliometric analysis. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Illness severity, comorbidity, fever, age and symptom duration influence antibiotic prescribing for respiratory tract infections (RTI). Non-medical determinants, such as patient expectations, also impact prescribing., Aim: To quantify the effect of general practitioners' (GPs') perception of a patient request for antibiotics on antibiotic prescribing for RTI and investigate effect modification by medical determinants and country., Design & Setting: Prospective audit in 18 European countries., Method: Consultation data were registered of 4982 patients presenting with acute cough and/or sore throat. A mixed-effect logistic regression model analysed the effect of GPs' perception of a patient request for antibiotics. Two-way interaction terms assessed effect modification. Relevant clinical findings were added to subgroups of lower RTI (LRTI), throat infection, and influenza-like-illness (ILI)., Results: GPs who perceived a patient request for antibiotics were four times more likely to prescribe antibiotics (OR: 4.4, 95%CI: 3.4-5.5). This effect varied by country: lower in Spain (OR: 0.06), Ukraine (OR: 0.15), and Greece (OR: 0.22) compared to the lowest prescribing country. The effect was higher for ILI (OR: 13.86, 95%CI: 5.5-35) and throat infection (OR: 5.1, 95%CI: 3.1-8.4) than for LRTI (OR: 2.9, 95%CI: 1.9-4.3). For ILI and LRTI, GPs were more likely to prescribe antibiotics with abnormal lung auscultation and/or increased/purulent sputum and for throat infection, with tonsillar exudate and/or swollen tonsils., Conclusion: GPs' perception of an antibiotic request and specific clinical findings influence antibiotic prescribing. Incorporating exploration of patient expectations, point-of-care testing and discussing watchful waiting into the decision-making process will benefit appropriate prescribing of antibiotics., (Copyright © 2024, The Authors.)

Background: Survival rate of patients with oral cancer (OC) remains to be very low despite advancements in therapy and surgical techniques. This is attributed to the fact that most OC cases are discovered at a late stage. Dentists play a vital role in early detection of OC through oral mucosal examination, and in informing the patients about avoidable risk factors of the disease, such as tobacco and excessive alcohol use. This study aimed at evaluating knowledge about OC among dental students in Moldova, Armenia and Belarus; three former soviet countries with high rates of tobacco use., Methods: This was a cross-sectional, multi-country study based on self-administered questionnaire. Dental students in their clinical years at three dental faculties in Moldova, Armenia and Belarus were invited to participate in the study. Data collection took place during the period May to September 2019. Association between different categorical variables was investigated using Chi-squared test. A knowledge score ranging from 0-14 was constructed from the obtained data. Differences in the knowledge score between different groups of students was investigated using either student`s t-test whenever comparing two groups, or One-way ANOVA with Bonferroni`s correction for three or more groups. The level of significance was set to 0.05 for all statistical tests., Results: A total of 642 dental students participated in the study. The mean knowledge score was found to be 6.62 ± 2.61, with 45% of the students scoring below the mean. Students from Belarus had the highest score (7.3 ± 2.14) in comparison to Armenia (6.66 ± 2.64) and Moldova (5.66 ± 2.81), as revealed by ANOVA test. However, we observed a significant increase (p-value < 0.001, ANOVA) in the students` knowledge score as they proceed through study years from third (6.07 ± 2.61) to fifth year (7.49 ± 2.48). In addition, we found that Students with current or previous cigarette smoking habits had significantly (p-value < 0.001, student`s t-test) lower mean knowledge score (5.96 ± 2.82) when compared to students who have never been smokers (6.98 ± 2.42)., Conclusions: The present study reveals notable gaps in OC knowledge and concerning tobacco use behaviors among dental students in Moldova, Belarus, and Armenia. By providing comprehensive education on risk factors and addressing personal habits, dental schools can better prepare future professionals to play a critical role in OC prevention and management., Competing Interests: Declarations. Ethics approval and consent to participate: The study was conducted in conformity with relevant regulations and guidelines of all the institutes involved. The study received ethical approval from the ethical committees in Moldova (Comitetului de Etica a Cercetarii, Nicolae Testemitanu, application number 29, date: 20.12.2017), Belarus (Belarusian State Medical University, Protocol number: 10, Date: 20.05.2019), and Armenia (Ethics Committee of Yerevan State Medical University, protocol number: 12–15/2019). All students that agreed to participate in the study have signed an informed consent explaining the purpose of the study and ensuring anonymity of the data when published. The study was also registered at the Norwegian Centre for Research Data (NSD) under Project No: 471282 and 57451. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Dried blood collection devices might be beneficial for diagnosing infectious diseases in areas far from the medical facilities and in lockdown situations. There are several reports on the efficacy of such applications for qualitative tests. Here we demonstrated the feasibility of a novel Ser-Col blood collection device as a standardized approach for qualitative and quantitative detection of infectious markers and several over immunochemical tests., Methods: In the current study, we included 395 adult participants, 191 men and 204 women, with a median age of 41 years, as well as 75 children with a median age of 3 years. Serological status was determined by testing serum samples for three groups of infection diseases: hepatitis A and C, SARS-CoV-2, and herpes family viruses, as well as for thyroid peroxidase (TPO), prolactin, vitamin B12, and folate. Blood collected on the Ser-Col device (Labonovum) was eluted using an automated system (SCAUT Ser-Col automation, Blok System Supply) and manually. Ser-Col results were compared with serum sampled via standard venipuncture considered as the reference., Results: High correlation coefficients (r = 0.95-0.99) were observed between serum samples collected with Ser-Col and via standard venipuncture for the following tests: anti-HCV, anti-SARS-CoV-2 IgG, anti-HSV-2 IgG, and anti-CMV IgM. Correlation coefficients between Ser-Col and standard venipuncture serum for anti-HSV-1 IgG, anti-CMV IgG, and anti-EBV tests were relatively low (r = 0.73-0.77). Correlation coefficients for anti-TPO, prolactin, vitamin B12, and folate were also characterized with high values (r = 0.97-0.99)., Conclusions: High accuracy and quantitative correlation were demonstrated between Ser-Col and samples collected by standard venipuncture. Hence, the Ser-Col blood collection device should be considered as a promising alternative for blood collection, storage, and transportation in both adult and pediatric populations., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with various hematological disorders. Understanding the pathology of erythrocytes (red blood cells) in coronavirus infection may provide insights into disease severity and progression. Objective: To review and analyze the general pathology of erythrocytes in patients infected with SARS-CoV-2, focusing on clinical and laboratory findings across different severity groups. Methods: Patients were classified into four groups based on clinical criteria: Group 1: Regular group (fever, respiratory symptoms, and radiographic evidence of pneumonia). Group 2: Severe group (shortness of breath >30 breaths/min, peripheral blood oxygen saturation <92% at rest, extensive pneumonia, respiratory failure requiring mechanical ventilation, and/or organ failure necessitating intensive care). Group 3: Low saturation group (peripheral blood oxygen saturation <85% at rest). Group 4: Erythroblastosis group (erythroblast count >0.5% among total nucleated blood cells). Clinical laboratory investigations included major routine studies and scanning microspectrophotometry to measure hemoglobin (Hb) spectra in unstained erythrocytes. Results: Erythroblasts were detected in approximately 30% of SARS-CoV-2 patients, predominantly in the severe group. Serum ferritin, C-reactive protein (CRP), and anisocytosis were strongly correlated with disease severity. Microspectrophotometric studies revealed significant changes in hemoglobin adsorption spectra, with an increase in Hb absorbance at 420 nm in severe cases compared to normal controls. Conclusions: Elevated serum ferritin, CRP levels, anisocytosis, and altered hemoglobin absorption at 420 nm wavelength are associated with adverse outcomes in SARS-CoV-2 infection. These findings highlight the potential utility of hematological parameters as markers for disease severity and prognosis in viral infections.

Background: Linezolid is included in most of the regimens for treatment of rifampicin-resistant tuberculosis. The prior publications presented the safety profile and clinical effectiveness of linezolid., Objectives: The research objectives of this study include: description of cumulative incidence rates of linezolid-induced adverse events, assessment of associations of those events with different variables, evaluation of the adverse event management and impacts of the unfavorable events on the effectiveness of treatment for rifampicin-resistant tuberculosis., Methods: We analyzed and compared the data of 2 cohorts: the retrospective cohort of the longer treatment regimens, and the prospective longitudinal cohort consisting of patients on the shorter regimens. Systematic collection of data on adverse events was conducted according to the principles of active pharmacovigilance., Results: The most common linezolid-induced adverse event was peripheral neuropathy (17.5%, 95% confidence interval [CI]: 9.2-25.8). Developing peripheral neuropathy was associated with comorbidities (HIV and endocrine disorders) and the age above 56. The patients exposed to the combination of linezolid and cycloserine were at higher risk of peripheral neuropathy compared with the patients receiving only one of those drugs. The mean time to recovery from peripheral neuropathy was 5.5 months. Myelosuppression and optic nerve disorders were observed at a relatively low frequency., Conclusion and Relevance: The rational management of linezolid-induced adverse events minimizes their impact on the effectiveness of treatment. The timely withdrawal of linezolid is the most rational way to prevent delayed recovery from peripheral neuropathy. The withdrawal of linezolid during the first 4 months of chemotherapy was associated with the failure to complete the shorter regimens in 9 months because of slow radiological dynamics. In our research, we are the first to assess the safety and effectiveness of the mSTR regimens in the context of linezolid-induced adverse events by comparing the findings with the data of conventional treatment., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The global dissemination of Klebsiella pneumoniae pathotypes with multidrug-resistant (MDR) and hypervirulent traits poses a threat to public health. The situation in Armenia is unclear, and we performed a comprehensive characterisation of 48 clinical isolates of K. pneumoniae , collected from 2018 to 2024. The majority of the isolates (64.58%) were extensively drug-resistant (XDR) and MDR. Genomic analysis of 21 isolates revealed the presence of international high-risk MDR clones (ST395, ST15, and ST307). The ST395 strains were isolated from children and resisted the first-line drugs such as beta-lactams. These isolates harboured a range of virulence determinants, from capsule polysaccharides to siderophores to regulators of the mucoid phenotype. The ST395 strains are enriched by ICEs, plasmids, and prophages, on which antimicrobial resistance (AMR) and virulence genes are located and which may lead to the convergence of MDR and hypervirulent traits. There is a widespread non-specific AMR mechanism among our K. pneumoniae strains. These are mutations in the porin genes, which reduce permeability to antimicrobials, and mutations in the regulators of efflux pumps, which lead to overexpression of drug efflux pumps such as AcrAB. These mechanisms may contribute to the elevated MICs and confer AMR to strains with no specific AMR genes.

Objective: This study aimed to identify and evaluate scholarly research on the efficacy, durability, and long-term stability of various adhesive systems used for bonding direct resin composite restorations and to identify factors influencing bonding performance, such as adhesive composition, application protocol, substrate type, and etching technique., Materials and Methods: An all-inclusive electronic database search for peer-reviewed scholarly journal articles was conducted using PubMed, ScienceDirect, Google Scholar, Dimensions, and the Cochrane Library for research articles investigating the effectiveness of different adhesive systems in direct resin composite restorations, excluding reviews, meta-analyses, opinion pieces, and case reports. The risk of bias was assessed using the Cochrane tool (Robvis 2.0). Data were extracted and thematically analyzed, and quantitative data were statistically analyzed using Review Manager software. Dichotomous data were evaluated using the Mantel-Haenszel method, applying a random effects model and 95% confidence interval., Results: The database search yielded 1632 potential articles, of which 14 were included in this study. Several adhesive systems exhibit excellent tensile bond strength. In addition, the type of resin composite, adhesive system, and artificial aging significantly influenced the bonding performance of resin composite restorations. However, the failure rates were low in the different adhesive systems, showing comparable results between the two-step etch-and-rinse and one-step self-etch adhesive systems (p = 0.71). The results showed an overall trend of high bonding effectiveness with a low incidence of adverse events, such as postoperative sensitivity, adhesive failure, and fractures., Conclusion: The study results emphasize the importance of selecting appropriate adhesive systems based on clinical case requirements, restoration characteristics, and patient factors to enhance bonding efficacy, durability, and long-term stability., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to British Dental Association.)

The current study aimed to systematically review the literature on the accuracy of artificial intelligence (AI) models for osteoporosis (OP) diagnosis using dental images. A thorough literature search was executed in October 2022 and updated in November 2023 across multiple databases, including PubMed, Scopus, Web of Science, and Google Scholar. The research targeted studies using AI models for OP diagnosis from dental radiographs. The main outcomes were the sensitivity and specificity of AI models regarding OP diagnosis. The "meta" package from the R Foundation was selected for statistical analysis. A random-effects model, along with 95% confidence intervals, was utilized to estimate pooled values. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was employed for risk of bias and applicability assessment. Among 640 records, 22 studies were included in the qualitative analysis and 12 in the meta-analysis. The overall sensitivity for AI-assisted OP diagnosis was 0.85 (95% CI, 0.70-0.93), while the pooled specificity equaled 0.95 (95% CI, 0.91-0.97). Conventional algorithms led to a pooled sensitivity of 0.82 (95% CI, 0.57-0.94) and a pooled specificity of 0.96 (95% CI, 0.93-0.97). Deep convolutional neural networks exhibited a pooled sensitivity of 0.87 (95% CI, 0.68-0.95) and a pooled specificity of 0.92 (95% CI, 0.83-0.96). This systematic review corroborates the accuracy of AI in OP diagnosis using dental images. Future research should expand sample sizes in test and training datasets and standardize imaging techniques to establish the reliability of AI-assisted methods in OP diagnosis through dental images., Competing Interests: Declarations. Conflicts of interest: None., (© 2024. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)

Introduction: Although sodium-glucose cotransporter-2 inhibitors (SGLT2i) were shown to lower hyperuricemic events in patients with type 2 diabetes mellitus (T2DM), the extent of this effect in the general population is yet to be elucidated. We performed an updated systematic review and meta-analysis on a large sample of patients with and without T2DM to evaluate the influence of SGLT2i therapy on clinically relevant hyperuricemic events, defined as the composite of acute gout flare episodes, acute anti-gout management or urate-lowering therapy initiation. Furthermore, we conducted a multivariate meta-regression to assess the relationship between different covariates and the pooled effect size., Materials and Methods: We systematically searched all reported outcomes of interest in patients on SGLT2i (PROSPERO: CRD42023442077) across PubMed, Scopus and Cochrane databases looking for randomized controlled trials, observational studies and post-hoc analyses since inception until August 2023., Results: Data from seven randomized controlled trials and seven observational studies were included for a total of 464,009 patients, 13,370 of whom did not have T2DM. A total of 50% of the patients included were on SGLT2i. The pooled analysis demonstrated that SGLT2i reduce clinically relevant hyperuricemic events by 33% (HR, 0.67; 95% CI, 0.59-0.77; I 2 =83%) regardless of the concomitant diagnosis of T2DM. The multivariate meta-regression on chronic kidney disease (CKD) showed a positive correlation on the pooled effect size., Conclusions: SGLT2i reduce the risk of developing hyperuricemic events regardless of the concomitant diagnosis of T2DM. The multivariate meta-regression on CKD showed a significant impact on the main outcome. Further studies are essential to investigate more conclusively the extent of these beneficial effects., (Copyright © 2024 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: This systematic review and meta-analysis aims to assess the knowledge and awareness of oral cancer risk factors among medical and dental students., Methods: This study followed the PRISMA guidelines and was registered in INPLASY (ID: 2024110035). Four databases were consulted (PubMed, Science Direct, Scopus, and Web of Science) from February 20th, 2005, to May 10th, 2024. The study selection and data extraction process was performed independently by 2 investigators. The risk of bias was assessed using the JBI tool, which can be found at: https://jbi.global/critical-appraisal-tools. A third investigator was consulted in case of disagreement. Meta-analysis results were systematically illustrated in a forest plot and expressed as odds ratio with 95% confidence interval. The I 2 statistic assessed heterogeneity between studies. Funnel plot and Egger regression analysis were used for bias analysis. A P value <.05 was considered significant. All statistical analyses were performed using the STATA V.15 software., Results: After the selection process, 41 studies met the eligibility criteria, comprising a total of 14,425 participants, 22% medical students and 78% dental students, primarily female (53%). The meta-analysis showed that 98% of students demonstrated relatively good knowledge about oral cancer risk factors. The most recognized risk factor was smoking (99%), followed by advanced age (68%), UV-rays exposure (64%), and alcoholism (57%). Knowledge of several other factors was comparatively lower, with less than 50% of students recognizing them. The studies indicated significant heterogeneity (I 2 = 99.8%) and publication bias ( P < .001)., Conclusions: These findings suggest that while medical and dental students have a strong understanding of key risk factors for oral cancer, there are gaps in knowledge regarding other important factors. Addressing these gaps through enhanced education and training is essential to improving early detection and prevention efforts., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In the period of increasing prevalence of metabolic disorders such as obesity and diabetes, healthcare professionals are facing significant challenges. Therefore, an accurate global assessment of insulin resistance is of utmost importance. Current medical research is focused on identifying an easily accessible and reproducible gold-standard surrogate marker for insulin resistance. Ideally, such a marker would enable healthcare providers to predict the risk of type 2 diabetes and cardiovascular diseases. The triglyceride-glucose index (TyG) is a promising marker for preventive cardiology and cardiometabolic medicine. This narrative review article aims to provide a comprehensive evaluation of the credibility of TyG as a surrogate marker of insulin resistance among patients at different stages across the cardiometabolic continuum. This assessment fully complies with evidence-based medicine and offers valuable insight into the clinical utility of TyG., Competing Interests: Declaration of competing interest Epson., (Copyright © 2024. Published by Elsevier B.V.)

Background: Oral cancer remains 1 of the biggest health care challenges; it has a poor response to treatment, and treatment often results in severe side effects. Nano-targeted drug carrier-assisted drug delivery systems can improve the benefits of targeted drug delivery and treatment efficacy. A systematic review and meta-analysis was conducted to investigate the effect of targeted nano carrier drug delivery systems on the management of oral cancer., Methods: A comprehensive literature search was performed using PubMed, ScienceDirect, the Cochrane Library, Google Scholar, and Scopus using PRISMA guidelines, to identify relevant in vitro and in vivo (human) studies. Studies evaluating the impact of nanocarrier-based delivery systems on oral cancer cells or human models were selected. Pooled effect sizes were calculated using random-effects models via RevMan 5.4, and heterogeneity among studies was assessed., Results: After full-text assessment, 15 research articles were included [14 in vitro studies and 1 randomized controlled trial (RCT)]. In the meta-analysis, the pooled data (IC 50 ) for the impact of the nanocarrier delivery system vs control on oral cancer was -7.67 (95% CI: -41.77, 26.43), with a high heterogeneity ( I 2 = 92%, P < 0.00001). Moreover, in vitro studies had a medium risk of bias, while the RCT had some concerns in the randomization domain., Conclusion: Nanocarrier-based drug delivery has been found to be a superior approach compared to drug delivery in free form, increasing the efficacy and safety of oral cancer treatment., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

More than a billion people live in fragile, conflict-affected, and vulnerable settings requiring humanitarian support, where cancer is a substantial health issue. Despite its substantial effect on populations, cancer care remains underprioritised in emergency preparedness and response frameworks and humanitarian operational planning. This Policy Review summarises the perspectives and actionable recommendations from the First Global High-Level Technical Meeting on Non-communicable Diseases in Humanitarian Settings, with a focus on cancer. The paper highlights the challenges of providing cancer care in fragile, conflict-affected, and vulnerable settings and proposes a comprehensive roadmap to address both immediate and long-term needs of patients with cancer living in these settings. Key solutions include: integrating the cancer care continuum into national preparedness and response plans to enhance health-care system resilience; integrating cancer into humanitarian responses efforts; addressing the specific needs of paediatric patients with cancer; improving cancer intelligence and surveillance systems; and developing strategies to navigate the logistical and financial challenges of providing cancer care during crises. Additionally, the paper outlines practical actions and next steps for international cooperation needed to drive a shift in global health priorities and elevate cancer in the global health security agenda. We hope the presented notions will help prevent millions of avoidable deaths among people with cancer., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Purpose: Pancreatic cancer is one of the deadliest cancers in the world. In Armenia, it is 12th by incidence. The aim of this study is to evaluate treatment and outcomes of pancreatic cancer in Armenia during the past 12 years., Methods: This is a retrospective study with data from three oncology centers in Armenia: "Muratsan" Hospital of Yerevan State Medical University, Mikaelyan institute of surgery, and Yeolyan Hematology and Oncology Center. The information was obtained from the medical records of the patients with pancreatic cancer treated at these centers during January 1, 2010-January 1, 2022. Log-rank test and Kaplan-Meier curves were used for survival analysis. Cox regression analysis was performed for identification of main prognostic factors., Results: Of 70 patients involved in the final analysis, 45.7% was female. The median age at diagnosis was 63 years. The median follow-up time was 11 months (range, 2-146). A total of 11.4% of patients had stage I-II, 27.1% had stage III, and 60% had stage IV disease. The main independent prognostic factor for overall survival (OS) was the TNM stage, whereas grade of the tumor was not significant. The median OS was 11 months (range, 2-169 months): In stages I-III, patients who had surgery (44.4%) lived significantly longer than those who did not (20 v 11 months; P = .008). Main chemotherapy regimens were 5-fluorouracil, oxaliplatin, folinic acid and irinotecan (41.4%) and gemcitabine plus capecitabine (38.6%). No significant survival difference was found between these groups (13 v 11 months; P = .162)., Conclusion: Survival of patients with pancreatic cancer in Armenia is dismal, not exceeding 1 year. Hopefully, further research in the field and new treatment modalities will improve the situation.

Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA., Materials and Methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process., Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12-19 IU/mL by 22.5% of participants and 20-40 IU/mL by 27.8%, while 31.8% reported no upper limit., Conclusions: This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines., Competing Interests: The authors have nothing to disclose., (Copyright © 2025 Korean Society for Sexual Medicine and Andrology.)

Introduction: Structural and functional cardiac defects leading to inadequate tissue oxygenation is known as Heart failure (HF) which is characterized by extensive morbidity and mortality. Pathophysiology of HF involves systolic and diastolic dysfunction, neurohormonal dysregulation, and imbalance in inflammatory mediators which complicates treatment further. Cardiac resynchronization therapy (CRT) is an approach used for restoring ventricular synchrony and enhancing mechanical efficiency. This study discusses various key points of CRT and its uses in HF and discusses challenges and future implications., Methods: An extensive review of the literature was conducted with evidence from several databases like Medline, PubMed Central, and Embase. Preference was given to articles published after 2010, but relevant articles even pre-2010 were included. Mendeley was used as a reference manager for formatting., Results: Functional improvements and an enhanced quality of life across a diverse range of patients have been demonstrated using CRT. This has significantly impacted the mortality rates of patients with HF. This manuscript conducted a comparative analysis various hallmark clinical trials conducted in lieu of CRT, across many years (2002, 2003, 2004, 2005, 2017, 2018, 2020). All trials have noted the supremacy of CRT compared to pharmaceutical treatment or other therapeutic methods. Majority of the trial participants had an LVEF of ≤ 35%, a QRS duration of ≤ 150 ms, and were categorized as NYHA class II-IV before initiation of CRT and, posttreatment, LVEF was improved significantly. The main advantages noted were functional improvements, such as enhanced quality of life and reduced mortality., Conclusion: There have been multiple efforts undertaken to address the challenges in CRT, which include a reduction in the rates of nonresponding patients and using alternative adjunctive therapies like defibrillators. These have been shown to improve outcomes among HF patients. Although CRT is noted to be very efficient, some challenges like technological limitations, uncertainty regarding optimal pacing, and nonresponding patients, exist. Ongoing research aims to further develop and revolutionize HF care and improve patient outcomes across the world by refining patient selections and CRT efficacy., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)