Search Results (1,415)

Background/Objectives: Adequate micronutrient intake during pregnancy is critical for fetal development, yet whether pregnant women and healthcare professionals share consistent knowledge, beliefs, and supplementation practices remains poorly characterized. Methods: Two parallel cross-sectional surveys using identical core items were conducted at a German tertiary care center between April and November 2024. Pregnant women (n = 132) and healthcare professionals who initiated the survey (n = 105) completed anonymous QR-code-based questionnaires assessing micronutrient-related knowledge, perceived dietary adequacy, and supplementation practices or recommendation patterns. Comparative analyses were restricted to fully completed healthcare professional questionnaires (n = 80). Group differences were analyzed using chi-square or Fisher’s exact tests. Results: Healthcare professionals demonstrated higher knowledge levels across most micronutrients. Knowledge gaps were most pronounced for vitamin B12, with 53.0% of pregnant women unable to identify any fetal effect compared with 20.0% of providers (p < 0.001). Beliefs about dietary sufficiency were broadly aligned for folic acid (p = 0.452) and vitamin D (p > 0.999), but diverged markedly for vitamin B12, where 79.2% of providers considered dietary intake alone adequate compared with 47.3% of pregnant women (p < 0.001). Substantial differences were observed between patient-reported supplementation practices and provider-reported recommendation patterns: Vitamin B12 (70.0% vs. 3.8%), vitamin D (76.2% vs. 41.3%), omega-3 fatty acids (76.2% vs. 47.5%), and folic acid (98.5% vs. 81.3%; all p < 0.001). The internet was the most frequently cited information source among pregnant women (89.4%), while healthcare professionals reported using both scientific literature (75.0%) and internet-based resources (76.3%), the latter primarily for accessing professional and scientific information. Conclusions: Substantial patient–provider differences in micronutrient knowledge, beliefs, and supplementation practices persist even within a highly educated population at a tertiary care center. These findings suggest potential differences between patient-reported supplementation behavior and provider-reported recommendation practices, particularly for vitamin B12 and vitamin D. These findings suggest that more structured communication regarding micronutrient supplementation during pregnancy is needed. Full article

Background: Crohn’s disease-associated intestinal strictures represent a major source of morbidity and frequently require endoscopic or surgical intervention. However, patients with stricturing Crohn’s disease demonstrate substantial clinical heterogeneity regarding disease localization, penetrating complications, systemic manifestations, metabolic alterations, and treatment exposure. This study aimed to explore phenotypic heterogeneity within patients with Crohn’s disease-associated intestinal strictures. Methods: In this retrospective exploratory cohort study, 96 patients with Crohn’s disease-associated intestinal strictures treated at a tertiary referral center between 2014 and 2024 were included. Clinical, structural, metabolic, and treatment-related variables were analyzed. Univariate analyses were performed using chi-square, Fisher’s exact test, Student’s t-test, or Mann–Whitney U test as appropriate. Exploratory multivariable logistic regression models were constructed to explore relationships between different clinical phenotypes and disease-related characteristics, including extraintestinal manifestations (EIMs), smoking status, penetrating disease manifestations, hepatic steatosis, stenosis localization, and abscess formation. Given the limited sample size and event numbers in several subgroup analyses, all multivariable analyses were considered exploratory and hypothesis-generating. Results: The cohort demonstrated a heterogeneous clinical presentation with a high prevalence of perianal disease, penetrating complications, prior intestinal surgery, and biologic therapy exposure. Female sex (OR 4.63, p = 0.044), autoimmune disease (OR 23.5, p = 0.049), rectal stenosis (inverse association; OR 0.08, p = 0.041), and exposure to multiple biologic therapies (OR 20.11, p = 0.036) remained associated with EIMs after multivariable adjustment. Smoking status was associated with anastomotic stenosis (OR 3.16, p = 0.023) and inversely associated with female sex (OR 0.35, p = 0.036). Phenotype-oriented analyses further suggested clustering of penetrating disease manifestations, including associations between intestinal fistulas, perianal fistulas, and abscess formation. Hepatic steatosis demonstrated exploratory associations with intestinal fistulas, intestinal resection, and appendectomy. Several analyses demonstrated wide confidence intervals and should therefore be interpreted cautiously. Conclusions: This exploratory retrospective cohort study highlights the substantial clinical heterogeneity observed among patients with Crohn’s disease-associated intestinal strictures. Different structural, systemic, penetrating, behavioral, and metabolic disease manifestations may indicate potentially overlapping phenotypic patterns within stricturing Crohn’s disease. Given the retrospective design, limited sample size, and exploratory statistical approach, these findings should be interpreted cautiously and require validation in larger prospective studies. Full article

Background: Firefighting is a hazardous occupation, yet data online-of-duty deaths in European firefighter populations remain limited. This study aimed to characterise the mechanisms and circumstances of firefighter fatalities in Poland and to estimate exposure-based fatality rates, with particular attention to differences between career and volunteer personnel. Methods: In this retrospective observational study, line-of-duty firefighter fatalities in Poland from 1995 to 2025 were identified from a nationwide repository and cross-validated against official sources. The mechanism of death was classified from case narratives following the Utstein framework. Group comparisons used chi-square, Fisher’s exact, and Welch’s tests; multivariable probit regression assessed predictors of mechanism; and per-capita and per-deployment fatality rates were computed using national denominator data. Results: Of 112 fatalities, 73 (65.2%) involved volunteer firefighters. Sudden Cardiac Arrest of Presumed Non-Traumatic origin (SCA-PNT) was the leading mechanism (44.6%), followed by traumatic injury (37.5%). Volunteers were older than career firefighters (46.4 ± 14.0 vs. 34.6 ± 8.7 years; p < 0.001) and more likely to die of SCA-PNT (odds ratio 6.35; 95% confidence interval 2.46–16.40) and during the response phase (odds ratio 5.07; 1.89–13.55). Age was the strongest independent predictor of mechanism. The per-capita fatality rate was higher among career firefighters (incidence rate ratio 5.16), whereas the per-deployment rate was higher among volunteers (incidence rate ratio 2.25). Conclusions: Firefighter mortality in Poland differs by employment status and is strongly age-dependent. Age-stratified cardiovascular surveillance and prevention may be more effective than formation-based approaches. Full article

Background: Scar carcinoma represents a distinct subtype of lung malignancy developing in areas of chronic pulmonary fibrosis, inflammation, and structural remodeling, frequently associated with previous pulmonary tuberculosis (TB). The present study aimed to evaluate the radiological, clinical, inflammatory, and histopathological characteristics associated with the scar carcinoma phenotype in patients with lung cancer (LC) and previous TB-related pulmonary abnormalities. Methods: A retrospective observational cohort study conducted between February 2020 and December 2025 included 844 patients diagnosed with lung cancer. The scar carcinoma phenotype was operationally defined by the coexistence of: (1) confirmed lung cancer, (2) post-tuberculous structural pulmonary abnormalities on thoracic imaging, and (3) clinical history compatible with prior pulmonary TB. Associations between the scar carcinoma phenotype and clinicopathological variables were evaluated using Pearson’s Chi-square and Fisher’s exact tests. Binary logistic regression analysis was performed to identify independent predictive factors associated with scar carcinoma. Receiver operating characteristic (ROC) curve and precision–recall curve analyses were additionally performed. Results: Post-TB sequelae were identified in 58.2% of patients, while active TB was present in 7.8% of cases. Adenocarcinoma represented the predominant histopathological subtype (63.3%). Fibrotic/interstitial/bronchial abnormalities (67.7%), cavitary/destructive lesions (69.0%), atelectatic/retractile changes (65.4%), and infectious/inflammatory pulmonary abnormalities (60.4%) were highly prevalent. Significant associations were identified between scar carcinoma and TB sequelae (χ² = 811.850, p < 0.001), adenocarcinoma histology (χ² = 655.545, p < 0.001), infectious/inflammatory changes (χ² = 635.168, p < 0.001), cavitary/destructive lesions (χ² = 508.347, p < 0.001), fibrotic/interstitial abnormalities (χ² = 539.895, p < 0.001), and atelectatic/retractile changes (χ² = 597.346, p < 0.001). Logistic regression identified haemoptysis (OR = 0.651 (95% CI: 0.486–0.871), p = 0.005) and pulmonary opacities and/or condensation (OR = 1.343 (95% CI: 1.014–1.779), p = 0.040) as independent predictive factors. ROC analysis demonstrated moderate predictive performance (AUC = 0.703). Conclusions: TB-associated pulmonary remodeling was strongly associated with the scar carcinoma phenotype, consistent with an associative role of chronic inflammation, fibrosis, and post-TB structural damage in lung carcinogenesis; however, causal inferences cannot be drawn from this retrospective observational design. Full article

Background: Pathogenic BRCA1 and BRCA2 mutations confer a homologous recombination deficiency that underlies PARP inhibitor sensitivity. While BRCA1 mutation carriers more frequently develop triple-negative breast cancer (TNBC) and BRCA2 carriers hormone receptor-positive (HR+) disease, whether the specific protein domain harboring a pathogenic somatic mutation differs systematically between breast cancer subtypes remains uncertain. Apparent domain enrichment in earlier unfiltered analyses may be confounded by missense variants of uncertain significance (VUSs), which lack clinical actionability. Methods: We assembled three independent breast cancer cohorts via cBioPortal: TCGA-BRCA (brca_tcga_pub2015), METABRIC (brca_metabric), and MSK-CHORD (msk_chord_2024). All somatic BRCA1/2 mutations were mapped to UniProt-annotated functional domains and to Rebbeck-defined breast/ovarian cancer cluster regions (BCCR/OCCR). Per ENIGMA/ACMG guidance, pathogenic mutations (nonsense, frameshift, and canonical splice site) were analyzed inferentially, while missense and in-frame variants—predominantly VUSs—were only reported descriptively. Fisher’s exact tests with Benjamini–Hochberg FDR correction were applied across domain × subtype contingencies. Cohort heterogeneity was assessed via Cochran’s Q and I² statistics; pooled effect estimates were computed using inverse-variance fixed-effects meta-analysis. Results: A total of 394 somatic BRCA1/2 mutations were identified across the three cohorts (BRCA1 n = 166; BRCA2 n = 228), of which 147 (37.3%) met pathogenic criteria. Among 131 pathogenic mutations in HR+/HER2− or TNBC subtypes, 84 (64.1%) occurred in HR+/HER2− disease and 47 (35.9%) in TNBC. Domain-level distributions did not differ significantly between subtypes for any BRCA1 domain (BRCT: TNBC 20.0% vs. HR+ 18.8%, OR = 1.08, 95% CI 0.31–3.78, and FDR-adjusted p = 1.00) or BRCA2 domain (DBD: TNBC 17.6% vs. HR+ 30.8%, OR = 0.48, and FDR-adjusted p = 1.00). Cluster-region analyses (nine Rebbeck BCCR/OCCRs) similarly showed no significant enrichment. Post hoc power analysis indicated that the study could only reliably detect large effects (OR ≥ ~3.0 for the principal BRCT contrast), and formal equivalence testing (TOST) demonstrated equivalence within a prespecified ±20% margin for BRCA1 BRCT (TOST p = 0.031). Heterogeneity across cohorts was minimal (Cochran’s Q = 0.62, I² = 0.0%). Descriptive analyses of VUSs suggested the apparent enrichment of BRCA1 BRCT-localized missense variants in TNBC (31.8% vs. 17.9% in HR+), but this signal did not extend to pathogenic mutations. Conclusions: Within the statistical power available, our three-cohort analysis shows no evidence of large subtype-specific enrichment of pathogenic BRCA1/2 somatic mutations across protein domains or cluster regions; small to moderate effects cannot be excluded. Notably, the majority (64%) of pathogenic mutations occurred in HR+/HER2− disease, underscoring that BRCA1/2 testing should not be deprioritized in non-TNBC subtypes. The apparent BRCT enrichment observed in earlier unfiltered analyses appears to be driven by VUSs rather than pathogenic variants, highlighting the methodological necessity of pathogenicity filtering for clinically actionable inference. These findings provide cohort-scale supportive evidence for emerging clinical guidelines that recommend broader BRCA1/2 testing across breast cancer subtypes. Full article

Background/Objectives: Children of families facing unmet social needs experience higher rates of adverse outcomes compared to those not experiencing unmet social needs. This study aimed to identify factors associated with families’ unmet social needs as reported by parents or guardians at their children’s primary care visits. Methods: This cross-sectional study recruited English-speaking primary caregivers of children less than 18 years of age from the Southwestern Ohio Ambulatory Research Network (SOAR-Net) who were surveyed between January 2023 and August 2024. Surveys included the Maternal Social Support Index, Social Capital Scale, RAND Depression Screener, Children with Special Health Care Needs Screener, Medical Expenses of Children Survey, a 10-item social needs screener, and demographics. Data were analyzed with chi-square or Fisher’s exact tests, adjusted logistic regression, and ANOVA. Results: Among 1167 respondents (78% response rate), 1114 provided complete data. Primary caregivers were predominantly mothers (79.9%) or fathers (13.6%), White (72.0%) or Black (16.0%), and had an associate’s degree or less (65.1%). The mean (SD) index child’s age was 6.4 (5.3) years, and 52.4% were female. Underinsurance, positive depression screens, and poor child health were positively associated with unmet social needs. Higher scores for social support and social capital were associated with fewer social needs. Multinomial logistic regression revealed significant relationships with reporting two or more unmet social needs with the following variables: childhood underinsurance, household annual income < $50,000, positive depression screens, raising a child with a chronic health condition, and Black race/ethnicity. Conclusions: Several significant social factors were independently associated with a greater number of unmet social needs. These findings highlight the complex interplay among social factors in children’s healthcare. Future research should explore the putative longitudinal stability of these relationships. Full article

Orofacial clefts are among the most common congenital craniofacial anomalies in the world. Immunity factors modulate response, inflammation, and healing in clefted tissue. This study aims to evaluate the levels of the pro-inflammatory biomarkers Granulysin, Resistin, FCGR1A, NF-kßp65, and CD68 to describe and understand the morphopathological basis of inflammation. The comparison was done between patient and control samples across milk and mixed dentition age groups. In total, 14 patient samples were analyzed with a total of 10 control samples to form two distinct control groups with milk dentition age and mixed dentition age. Samples were analyzed using light microscopy, and a semi-quantitative method of evaluation and comparison was used to determine the number of immunohistochemically positive structures of patient and control samples. Statistics included Spearman’s correlation and Fisher’s exact test to compare groups and detect significant differences. NF-kßp65 in the milk dentition age group (p = 0.043 for NF-kßp65 in connective tissue, p = 0.017 for NF-kßp65 in salivary glands), and FCGR1A and CD68 in the mixed dentition age group showed statistically significant differences in the expression of palatal tissues compared to the controls (p = 0.016 for FCGR1A in connective tissue, p = 0.048 for CD68 in epithelium). Spearman’s rank correlation revealed eight very strong correlations among several factors and one strong correlation between factors. The presence of many very strong and strong Spearman’s correlations among inflammatory factors in cleft-affected individuals suggests heightened signaling in these pathways. Furthermore, the difference in the inflammatory factor expression at different dentition ages suggests variation in the inflammation character with age. Full article

Background/Objectives: This study aims to estimate the prevalence of MASLD in a general outpatient population, describe associated metabolic risk factors, and evaluate liver fibrosis. Methods: We conducted a prospective, cross-sectional study at a tertiary hospital that included adults referred there for abdominal ultrasound for non-hepatic indications. Exclusion criteria were significant alcohol intake or known liver disease. Hepatic steatosis was assessed by ultrasound in all patients, and vibration-controlled transient elastography (VCTE) was performed in a subgroup. Clinical and laboratory data were collected. Comparisons used the chi-square test, Fisher’s exact test, and the Wilcoxon test, and logistic regression identified associated factors. Results: Hepatic steatosis was identified by ultrasound in 57.6% of the 182 patients, with most (93%) fulfilling the MASLD criteria. MASLD was diagnosed in 58.2% of patients based on ultrasound or VCTE findings of steatosis. Hepatic steatosis by ultrasound was associated with higher BMI (OR 1.30; 95% CI 1.18–1.43), hypertension (OR 1.92; 95% CI 1.04–3.53), glucose disorders (OR 3.33; 95% CI 1.60–6.92), and triglycerides (OR 1.01; 95% CI 1.00–1.03), while physical activity was protective (OR 0.86; 95% CI 0.26–0.99). Among 74 patients evaluated by VCTE, 8% had fibrosis (≥F1), which was more frequent in those with higher BMI and a number of cardiometabolic risk factors. Conclusions: This study reveals a high prevalence of MASLD and fibrosis among outpatients, supporting the use of abdominal ultrasound for opportunistic screening of MASLD and emphasizing the need for early risk stratification and referral. Full article

Background and Objectives: Professional ballet dancers endure high occlusal loads, increasing cervical defect prevalence. Conventional composites fail frequently under such conditions. This randomized clinical trial (RCT) compared 24-month performance of a polymer-infiltrated ceramic network (PICN, VITA Enamic) versus a self-curing bioactive composite (Stela) for cervical restorations. Materials and Methods: Twenty professional ballet dancers (40 cervical defects: 21 carious, 19 abfraction) were enrolled in a paired split-mouth RCT. Each received one PICN inlay and one self-curing composite restoration on two non-adjacent defects. Restorations were assessed at 6, 12, and 24 months using United States Public Health Service (USPHS) criteria (primary: marginal integrity) and a dye penetration test. Secondary outcomes included secondary caries, hypersensitivity, and Oral Health Impact Profile-14 (OHIP-14). Statistical tests: McNemar, Fisher’s exact, Kaplan–Meier, log-rank (α = 0.05). Results: At 24 months, marginal integrity (USPHS Alpha) was maintained in 91% of PICN restorations for carious defects and 89% for abfraction defects, compared to 70% and 50% for self-curing composite, respectively. No PICN restoration failed (0%). Self-curing composite failures were 20% (carious) and 30% (abfraction) (exploratory uncorrected p = 0.031; non-significant after correction). Dye penetration was lower for PICN in abfraction defects (11% vs. 60%, adjusted p = 0.048) but not in carious defects (9% vs. 30%, adjusted p = 0.317). Kaplan–Meier survival favoured PICN (log-rank p = 0.001); 24-month survival probability: PICN 100% (95% CI: 83–100%), self-curing composite 75% (95% CI: 55–95%). No secondary caries or serious adverse events occurred. Conclusions: PICN hybrid ceramic provided superior marginal integrity and zero failures over 24 months in cervical restorations of professional ballet dancers, outperforming the self curing composite. Within this high-risk population, PICN inlays are recommended for abfraction defects. However, because the study was conducted exclusively in professional ballet dancers, direct extrapolation to the general population should be made with caution. The self-curing composite may be considered for carious defects when light curing is problematic, but patients should be informed of higher failure risk. Longer studies are needed. Full article

Per-tree geolocation in closed tropical canopies has typical uncertainties of 5–15 m with GNSS receivers, preventing automated linking of field inventories to point-cloud stem data. We propose an anchor-based matching framework that does not require per-tree GNSS. A handheld SLAM LiDAR scanner maps stems and girths within ≈40 min; field crews record species, girth, and serial numbers without physical markers or tools. Dataset linkage uses a small subset of reflective-tape anchor trees (35 and 43 per hectare, roughly one per 400–500 m²) with approximate GNSS locations. Species identity is transferred using median-based GNSS bias correction and quadrant-partitioned Hungarian matching with global deduplication; accuracy is validated by leave-one-anchor-out (LOAO) tests and exact binomial statistics. Tested in two 1-ha plots of open Dry Dipterocarp Forest (DDF; 280 trees/ha) and dense Dry Evergreen Forest (DEF; ~1054 trees/ha) at the Sakaerat Biosphere Reserve, Thailand, SLAM girth matched tape data with R² = 0.997, RMSE = 1.82 cm in DDF; in DEF, after correcting a 6.38 m GNSS bias, R² = 0.986 and RMSE = 7.01 cm, with ≥99% detection for stems ≥30 cm girth (99.2% DDF; 100% DEF). LOAO accuracy was 35/35 in DDF and 40/43 in DEF. Retroreflective-tape anchors were additionally detected automatically from the SLAM intensity channel in 71.4% of DDF anchors (95% CI 53.7–85.4) and 76.7% of DEF anchors (95% CI 61.4–88.2) at intensity ≥ 150 DN, with up to 59-fold enrichment over matched non-anchor controls at I ≥ 250 in DEF (Fisher’s exact p < 1 × 10⁻¹⁵), enabling a fully automated anchor-detection pipeline. Full article

Background and Objectives: Child dental neglect is a clinically significant form of maltreatment that frequently reflects broader challenges related to caregiving within the family environment. Although oral manifestations have been described in prior research, the socio-behavioral profile of responsible caregivers remains insufficiently characterized, particularly in Central and Eastern European contexts. This study aimed to identify caregiver-level socio-behavioral characteristics associated with child dental neglect and to examine their relationships with clinical outcomes. Materials and Methods: A retrospective cross-sectional analytical study was conducted on 333 children (aged 4–17 years) diagnosed with dental neglect, presenting at a municipal hospital and a private dental practice in Oradea, Romania (2020–2024). Caregiver-level variables included age, educational attainment, socioeconomic status, health condition, substance use, and family structure. Associations were analyzed using Fisher’s Exact Test, Pearson Chi-Square, and Mann–Whitney U test, with Bonferroni correction applied where appropriate. Results: Most caregivers were young adults (93.1%), with low educational attainment (40.2% had no formal schooling) and high rates of alcohol use (47.1%). Low family income was present in 89.2% of cases and was significantly associated with non-adherence to the dental treatment plan (p  =  0.039). Caregivers without formal education were associated with neglect in rural areas (43.4% vs. 26.2%; p  <  0.001). Children of drug-using caregivers were significantly older at presentation (median: 12 vs. 8 years; p  =  0.014), and caregiver drug use was more prevalent in urban settings (18.0% vs. 1.8%; p  <  0.001). Over half of the children (52.9%) came from disrupted family environments. Conclusions: Dental neglect was consistently associated with young, poorly educated, and financially disadvantaged caregivers exhibiting high rates of substance use and unstable family structures. These factors may interact in complex ways, highlighting the multifactorial nature of dental neglect. Dental professionals are well positioned for early identification and have a professional and ethical responsibility to integrate child safeguarding into routine clinical practice. Full article

Background: While caregiver and health system factors are known to influence paediatric ART outcomes, their roles within routine rural South African settings remain insufficiently characterised. Aim: The aim of this study is to assess the association between caregiver-mediated ART adherence, perceived healthcare access and service quality with viral suppression among children receiving ART in a rural South African province. Methods: A cross-sectional study was conducted among 86 children aged <15 years receiving ART in routine paediatric HIV care. Viral load suppression was defined as <1000 copies/mL. Predictor variables included caregiver-reported adherence (30-day recall; adherent vs. non-adherent), perceived healthcare access and perceived service quality. Associations were assessed using Chi-square or Fisher’s exact tests, where appropriate. Effect sizes were estimated using risk differences. Results: Overall, 77.9% of the child participants were virally suppressed. Caregiver-reported adherence was significantly associated with VLS (p = 0.034). The probability of viral suppression was 100% among adherent children compared to 73.2% among non-adherent children (risk difference: 26.8 percentage points). Caregiver-reported adherence demonstrated high specificity (100%) and positive predictive value (100%) but low sensitivity (22.4%) and negative predictive value (26.8%), indicating that while reported adherence reliably identified children who were suppressed, non-adherence did not consistently predict virological failure. Perceived healthcare access (p = 0.372) and service quality (p = 0.267) were not significantly associated with viral suppression. Conclusions: Caregiver-mediated adherence was strongly associated with viral suppression, whereas perceived health system factors were not independently associated with treatment outcomes in this cohort. These findings should be interpreted cautiously given the cross-sectional design and reliance on short-term adherence measures. Strengthening household-level adherence support is critical for improving paediatric HIV outcomes in rural settings. Full article

Background/Objectives: Pediatric tracheotomy has evolved from an emergency procedure for acute infections to a planned intervention for chronic conditions requiring prolonged airway support. This study aims to describe the clinical characteristics, indications, and outcomes of pediatric tracheotomy over a 21-year period at a tertiary care center. Methods: A retrospective observational case series was conducted, including 246 pediatric patients (0–18 years) who underwent tracheotomy between 2004 and 2024. Data were collected from medical records and included demographics, indications, procedural details, complications, decannulation, and mortality. Patients were categorized into airway obstruction (AO) and respiratory support (RS) groups. Statistical analyses were performed using the Mann–Whitney U test, Chi-square and Fisher’s exact test. Results: A significant increase in tracheotomy procedures was observed over time. Respiratory support was the predominant indication (75.2%), mainly due to neurological disorders, while airway obstruction accounted for 24.8%. Patients in the AO group were significantly younger and more likely to undergo urgent procedures (p < 0.001). Complication rates were comparable between groups (AO 16.4% vs. RS 21.1%; p = 0.295). Decannulation was significantly more successful in the AO group (16.4% vs. 5.4%; p = 0.012). Mortality did not differ significantly between groups and was associated with underlying comorbidities. Conclusions: Pediatric tracheotomy is increasingly performed for chronic respiratory support. While procedural safety is high, outcomes vary by indication, with better decannulation rates in airway obstruction cases. Multidisciplinary, individualized management is essential for optimizing patient outcomes. Full article

Patient-specific implants (PSIs) in orthognathic surgery offer optimal intraoperative accuracy. However, evidence regarding their postoperative skeletal stability, specifically comparing distinct fixation designs and segmentation patterns, remains limited. We present a retrospective cohort study that evaluated 64 adult patients undergoing customized maxillary orthognathic surgery between January 2020 and June 2025. The primary predictor variables were fixation design (conventional customized plates vs. minimally invasive plates) and maxillary segmentation (monoblock vs. multisegmental). The outcome variable was 3D skeletal stability, measured as linear displacement between preoperative planning and 6-month postoperative imaging. Non-parametric tests compared displacements and clinical instability rates (defined as ≥2.0 mm). Mann–Whitney tests compared landmark displacements, Fisher’s exact tests compared proportions with ≥2.0 mm displacement, and ORs with 95% CIs were computed (α = 0.05). Analysis of 64 patients revealed that median displacement across landmarks ranged from 0.7 to 4.28 mm and 28.1% exhibited displacement ≥ 2.0 mm, primarily in molar and canine regions. While overall instability rates did not differ significantly between single-segment and multisegmental osteotomies (p = 0.28), multisegmental cases showed significantly higher displacement at the left canine (p = 0.027). Plate design was not associated with skeletal instability (p = 0.88), suggesting that minimally invasive plates provide comparable stability to conventional designs. Customized maxillary plates provide reliable postoperative stability with median displacements within clinically acceptable limits (<2 mm). Minimally invasive PSI designs offer stability comparable to conventional extended designs. However, localized instability in multisegmental cases suggests a need for careful biomechanical management regardless of the fixation method used. Full article

Within the South-Western food industry of Nigeria, the overall impact, associated challenges, and implementation of Big Data Analytics (BDA) have remained underexplored. Thus, this study aimed to investigate the extent of BDA adoption, identify key barriers and enablers, assess the operational impacts of BDA adoption, and propose a structured framework to guide effective integration. The study adopted a deductive, mono-quantitative method. Data were collected from 151 participants through a stratified sampling technique using an online survey questionnaire and analysed using descriptive and inferential statistical methods, including Chi-Square, Likelihood Ratio, and Fisher-Freeman-Halton Exact tests, using SPSS version 26 and Excel as analytical tools. While awareness and appreciation of BDA’s strategic benefits are growing, significant challenges such as high implementation costs, a shortage of skilled personnel, regulatory uncertainties, and technological limitations persist. Nevertheless, organisations that have embraced BDA report notable improvements in operational efficiency, strategic decision-making, customer satisfaction, and competitive advantage. This study proposes a practical BDA adoption framework designed to address the identified barriers and enhance successful implementation and offers several recommendations. The research helps bridge the knowledge gap on BDA adoption in emerging economies and offers actionable insights for business leaders, policymakers, and practitioners seeking to drive innovation and sustainability in Nigeria’s food industry. Full article