Search Results (24,848)

Introduction: Neck-preserving total hip arthroplasty (THA) has gained interest for conserving bone stock, restoring biomechanics, and facilitating revision surgery. The Nanos^® femoral stem, designed for metaphyseal fixation while preserving the femoral neck, represents a reliable alternative to conventional THA. This study reports 15-year clinical and radiographic outcomes of the Nanos implant. Materials and Methods: We retrospectively reviewed 53 patients (35 males, 18 females) who underwent THA with the Nanos stem between 2008 and 2010. Patients were stratified into two groups according to age: <50 years (n = 24) and ≥50 years (n = 29). The primary diagnosis was osteoarthritis (95%), with a few cases of avascular necrosis or dysplasia. Clinical evaluation included the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Radiographic assessment focused on implant stability, osteolysis, and heterotopic ossifications. Kaplan–Meier survival analysis was performed with revision for any reason as the endpoint. Results: At 15 years of follow-up, both groups showed significant improvement (p < 0.001). In patients <50 years, HHS increased from 53.3 to 94.8 and WOMAC decreased from 79.9 to 3.5. In patients ≥50 years, HHS improved from 47.5 to 95.2 and WOMAC from 81.5 to 3.2. Radiographs confirmed stable fixation without osteolysis. Complications included two dislocations and one cortical perforation requiring revision. Kaplan–Meier survivorship at 15 years was 100% (<50) and 96.6% (≥50). Conclusions: The Nanos stem provided excellent long-term outcomes with low complication and revision rates. It should be considered one of several reliable short-stem options for younger, active patients, offering durable function while preserving bone stock. Full article

In this article, we present density functional theory (DFT) calculations for $Z{n}_{(1-x)}{M}_{x}O$, where M represents one of the following substitutional metallic impurities: Ga, Cd, Cu, Pd, Ag, In, or Sn. Our study is based on the wurtzite structure of pristine ZnO. We employ the Quantum Espresso package, using a fully unconstrained implementation of the generalized gradient approximation (GGA) with an additional U correction for exchange and correlation effects. We analyze the density of states, energy gaps, and absorption spectra for these doped systems, considering the limitations of a finite-size cell approximation. Rather than focusing on precise numerical values, we highlight the following two key aspects: the location of impurity-induced electronic states and the overall trends in optical properties across the eight systems, including pristine ZnO. Our results indicate that certain dopants introduce electronic levels within the band gap, which enhance optical absorption in the visible, near-infrared, and near-ultraviolet regions. For instance, Sn-doped ZnO shows a pronounced absorption peak at ∼2.5 eV, which is in the middle of the visible spectrum. In the case of Ag and Pd impurities, they lead to increased electromagnetic radiation absorption at the near ultra-violet spectrum. This represents a promising performance for efficient solar radiation absorption, both at the Earth’s surface and in outer space. Furthermore, Ga- and In-doped ZnO present bandgaps of ∼0.9 eV, promising an interesting performance in the near infrared region. These findings suggest potential applications in solar energy harvesting and selective sensors. Full article

Objectives: Obesity and atrial fibrillation (AF) are strongly linked and are both associated with significant left atrial (LA) pathology. This study aimed to assess differences in LA size and function between obese and non-obese AF patients and to evaluate AF recurrence in both groups. Materials and Methods: We retrospectively analyzed patients undergoing first-time ablation for AF. Obesity was defined as body mass index ≥30 kg/m², and patients were divided accordingly into obese and non-obese groups. Results: Among 672 patients (median age of 66 years; 39.1% women), 308 (45.8%) were obese. Obese patients had significantly larger LA dimensions (LA area, LA volume, and LAVI indexed to height² (but not that indexed to body surface area (BSA)); p < 0.001), as well as higher LA-pressure-related parameters (LA stiffness index (p = 0.004), E-wave velocity (p = 0.002), and E/e′ ratio (p < 0.001)) and invasively measured mean LA pressure (p < 0.0001). However, there were no significant differences in parameters directly reflecting LA function, such as LA emptying fraction, LA reservoir strain, or LA appendage velocity. These findings remained consistent in the sinus rhythm subgroup (n = 374). The 1-year AF recurrence rate did not differ between obese and non-obese groups (data available for 73.8% (496) patients; p = 0.40), regardless of baseline rhythm. Conclusions: In AF patients undergoing their first ablation, obesity was associated with a larger LA size and higher LA pressure. In obese individuals, indexing LA dimensions to height² seems to better reflect LA enlargement than indexing to BSA. LA function and AF recurrence rates after a 1-year follow-up period were similar between obese and non-obese patients. Full article

Background: Traumatic Brain Injury (TBI) in children is a major cause of morbidity and mortality worldwide. Ocular manifestations are common but often overlooked, despite their potential to cause long-term visual impairment. This study aimed to evaluate the prevalence and characteristics of ocular findings in pediatric TBI patients admitted to the intensive care unit (ICU). Method: We prospectively reviewed records of pediatric patients (≤16 years) with TBI admitted to the Neurosurgery ICU at King Abdullah University Hospital (January 2022–December 2024). TBI was defined using U.S. CDC criteria and confirmed by clinical and radiological findings. Ocular manifestations were identified from ophthalmology consultations, neurosurgical notes, and bedside examinations. Demographics, injury details, and clinical outcomes were recorded. Statistical analyses included Chi-square, Fisher’s exact, and Mann–Whitney U tests, with significance set at p ≤ 0.05. Results: Thirty-eight patients (median age: 8 years; 55.3% male) were included. Ocular findings were present in 20 patients (52.6%). These patients were significantly older (median age 10 vs. 6 years, p = 0.007) and had lower admission GCS scores (11 vs. 14, p = 0.016). Male predominance was higher in the ocular group (75.0% vs. 33.3%, p = 0.030). Ocular findings were significantly associated with surgical intervention (60.0% vs. 22.2%, p = 0.025), orbital fractures (40.0% vs. 5.6%, p = 0.021), basal skull fracture signs (p = 0.036), and extraocular muscle limitation (p = 0.048). On multivariable analysis, orbital fracture remained the only independent predictor of ocular findings (aOR 2.22, 95% CI 1.17–3.57, p = 0.02). Conclusion: Over half of pediatric ICU TBI patients demonstrated ocular manifestations, closely linked to greater injury severity and craniofacial trauma. Routine, comprehensive ophthalmological evaluation should be integrated into the multidisciplinary management of severe pediatric TBI to optimize visual and functional outcomes. Full article

Background/Objectives: Human colostrum plays a crucial role in early microbial colonization, immune development, and gut health of newborns. Its microbiota is highly dynamic and influenced by numerous factors, yet the determinants remain poorly understood. This systematic review aims to investigate the composition of colostrum microbiota and the intrinsic and extrinsic factors that influence its diversity and abundance. Methods: PubMed and Scopus were systematically searched using a prespecified search phrase. Data on microbial composition, diversity, and influencing factors were extracted and analyzed. The systematic review is registered in PROSPERO (CRD42025644017). Results: A total of 44 eligible studies involving 1982 colostrum samples were identified. Colostrum microbiota consists predominantly of Firmicutes and Proteobacteria, with core genera including Staphylococcus, Streptococcus, Lactobacillus, and Bifidobacterium. Some studies reported higher diversity in colostrum compared to mature milk, while others noted elevated bacterial abundance in the former. Factors influencing colostrum microbiota include maternal BMI, delivery mode, gestational age, diet, gestational diabetes mellitus (GDM), maternal stress, maternal age, secretor status, perinatal antibiotic exposure, neonatal gender, geographic location, feeding type, milk collection method, and mastitis. Conclusions: Colostrum hosts a diverse and dynamic microbiota shaped by multiple maternal, neonatal, and environmental factors. Understanding these influences is crucial for optimizing infant health outcomes, emphasizing the need for further research on the functional roles of colostrum’s microbiota. Full article

Objective: To evaluate patient-assessed quality of life (QoL) following operative treatment of acetabular fractures and pelvic ring injuries and identify differences in their assessment of QoL depending on sex and age group. Methods: The study included 75 patients, 41 who had suffered acetabular fractures and 34 pelvic ring fractures, who had been treated operatively over a 6-year period (2017–2022). Post-operative HRQOL scores were evaluated using the World Health Organization Quality of Life BREF scale (WHQOL-BREF) and RAND Short Form 36 (SF-36). Separate analyses were completed for men and women, and we compared the data between five age groups. Results: The male patients scored slightly higher in all domains than the women in the acetabular fracture group. In the ring fracture group women reported higher scores in the psychological (72.67 vs. 69.44) and social domains (81.67 vs. 77.08). The men (80%) reported more significant overall satisfaction with their health in the acetabular group compared with the women (p = 0.0306). In the SF36 analysis, for both acetabular and ring fracture groups the lowest average QoL was recorded in the physical health composite summary (PHC) with a score of 41.34 ± 9.49 and 41.21 ± 9.19, respectively. Men scored higher for all eight scales in the ring fracture and all except general health in the acetabular fracture group (p = 0.0166). For the mental health composite (MHC), men had a better mean score in both fracture groups with significant differences for between both genders for the acetabular group (p = 0.0352). For age group analysis of the SF36, in the acetabular group, the youngest age group (<40 years) reported a significant decline in their performance due to role limitations due to physical health (RP) and emotional problems (RE) compared with the oldest group (>70 years) (p = 0.0306 and p = 0.0069, respectively), similarly to the PHC (p = 0.0279). Additionally, for the overall mental health summary of the acetabular group for the five age groups, there were significant differences between the youngest age group and the oldest age group (p = 0.0372). In contrast, for the ring fracture group, the oldest age group (>70 years) scored the worst in all four scales of the physical health composite and the <40 years patients had the highest score for the physical functioning (PF) scale, with statistical significance when compared with the oldest group (85 (17.53), p = 0.01501). Additionally, the lowest mean score for the PHC was recorded in >70 years and the highest in the 61–70 years age group, with a statistical significance (p = 0.0367). Conclusions: Patients that sustain a pelvic fracture and are treated operatively are at a higher risk of deterioration in quality of life. Using both functional assessments, male patients emphasized improved quality in more spheres that was evaluated than women. Full article

The rapid development of contemporary artificial intelligence and Internet of Things (IoT) technologies has given rise to the emerging paradigm of the AIoT (Artificial Intelligence of Things), which is profoundly impacting human life and driving the digital transformation of industries and society. The AIoT not only enhances product functionality and convenience but also accelerates the achievement of the United Nations Sustainable Development Goals (SDGs). However, the widespread adoption of these technologies still poses challenges related to social inclusivity, particularly regarding insufficient accessibility for elderly users, which may exacerbate the digital divide and social inequality, contradicting SDG 10 (reducing inequality). This study integrates AIoT product development processes based on sustainability and universal design principles using methods such as Quality Function Deployment, the Analytic Hierarchy Process, the Scenario Method, the Entropy Weight Method, and Fuzzy Comprehensive Evaluation. The features of this process include ease of operation and high flexibility, making it suitable for cross-departmental product development while prioritizing the needs of diverse age groups throughout the development process. The research findings indicate that the AIoT product concepts proposed can meet the needs of diverse users, contributing to the realization of age-friendly products. This study provides a reference point for future AIoT product development, promoting the inclusive and sustainable development of smart technology. Full article

Quality-of-life (QoL) needs among gynecologic cancer survivors are multifaceted and culturally mediated, yet limited research has examined how survivors in the Middle East prioritize key domains such as sexual function, emotional well-being, and relational quality. This study aimed to identify subgroups of survivors based on the perceived importance of these domains and to explore demographic and clinical predictors of subgroups within the Saudi Arabian context. We conducted a cross-sectional, survey-based study among 129 women with a history of breast or cervical cancer attending a tertiary oncology center in Jeddah, Saudi Arabia. Participants rated the importance of sexual, emotional, and relational QoL domains using a 4-point Likert scale. Latent class analysis (LCA) was used to segment survivors based on their perceived domain importance. Differences in demographic and clinical characteristics across classes were assessed using chi-square tests. A decision tree classifier was employed. Three latent classes emerged: Class 0 (48.8%) prioritized all domains highly; Class 1 (17.8%) reported low importance across domains; and Class 2 (33.3%) emphasized emotional and relational domains while downplaying sexual function. Class group was significantly associated with age (p = 0.001), education (p = 0.04), nationality (p = 0.03), and number of children (p < 0.001). Decision tree analysis identified number of children, age, and marital status as the strongest predictors of high-importance class group. Gynecologic cancer survivors in Saudi Arabia hold diverse priorities regarding QoL domains, primarily shaped by sociocultural context than clinical variables. Tailored survivorship interventions that reflect survivors’ lived values, particularly in relation to age, family structure, and cultural norms, are critical for person-centered oncology care in the region. Full article

Cellular senescence, a state of stable cell cycle arrest accompanied by a complex senescence-associated secretory phenotype (SASP), is a fundamental biological process implicated as a key driver of lung aging and lung age-related diseases (LARDs). This review provides a comprehensive overview of the rapidly evolving field of senotyping based on cellular heterogeneity in lung development and aging in health and disease. It also delves into the molecular mechanisms driving senescence and SASP production, highlighting pathways such as p53/p21, p16^INK4a/RB, mTOR, and p38 MAPK as therapeutic targets. The involvement of various novel SASP proteins, such as GDP15, cytokines/chemokines, growth factors, and DNA damage response proteins. We further highlight the effectiveness of senotherapeutics in mitigating the detrimental effects of senescent cell (SnC) accumulation within the lungs. It also outlines two main therapeutic approaches: senolytics, which selectively trigger apoptosis in SnCs, and senomorphics (also known as senostatics), which mitigate the detrimental effects of the SASP without necessarily removing the senescent cells. Various classes of senolytic and senomorphic drugs are currently in clinical trials including natural products (e.g., quercetin, fisetin, resveratrol) and repurposed drugs (e.g., dasatinib, navitoclax, metformin, rapamycin) that has demonstrated therapeutic promise in improving tissue function, alleviating LARDs, and extending health span. We discuss the future of these strategies in lung research and further elaborate upon the usability of novel approaches including HSP90 inhibitors, senolytic CAR-T cells, Antibody drug conjugate and galactose-modified prodrugs in influencing the field of personalized medicine in future. Overall, this comprehensive review highlights the progress made so far and the challenges faced in the field of cellular senescence including SnC heterogeneity, states of senescence, senotyping, immunosenescence, drug delivery, target specificity, long-term safety, and the need for robust cell-based biomarkers. Future perspectives, such as advanced delivery systems, and combination therapies, are considered critical for translating the potential of senotherapeutics into effective clinical applications for age-related pulmonary diseases/conditions. Full article

Background/Objectives: Aging and metabolic disorders are associated with a decline in muscle function, referred to as age-related sarcopenia. The underlying mechanisms of sarcopenia include cellular senescence, imbalanced protein homeostasis, accumulation of oxidative and inflammatory stressors, and mitochondrial dysfunction. Probiotic supplementation improves the gut microbiome and enhances muscle function via the gut–muscle axis. However, details of molecular mechanisms and the development of an appropriate treatment are under active investigation. Methods: We have examined the effects of Lactiplantibacillus plantarum LM1001, a probiotic that reportedly improves the digestibility of branched-chain amino acids in myocyte cultures, but exactly how it contributes to muscle structure and function remains unclear. Results: We show that aged mice (male C57BL6/J) fed a high-fat diet (HFD) exhibit weak muscle strength, as reflected by a reduction in grip strength. LM1001 supplementation increases muscle strength and restores myofibril size, which has been altered by HFD in aged mice. Expression of myogenic proteins is increased, while protein markers for muscle atrophy are downregulated by LM1001 treatment via the IGF-1/Akt/FoxO3a pathway. LM1001 improves gut microbiota that are altered in aged HFD-fed mice, by increasing their abundance in beneficial bacteria, and efficiently maintains the epithelial lining integrity of the large intestine. Conclusions: We conclude that LM1001 supplementation serves a beneficial role in patients suffering from sarcopenia and metabolic disorders, improving their muscle function, gut microbiota, and intestinal integrity. Full article

Background and Purpose: There remains a need for effective and accessible education methods to support recovery after total hip replacement. To evaluate the effects of video-based education on daily living activities and wound healing of patients undergoing total hip replacement surgery. Methods: A randomised controlled trial was used. Eligible participants were those aged 18 years and over who had undergone total hip replacement surgery in a training and research hospital. The intervention group received video-based training, while the control group received only routine care. Results: Patients in the video-based training group showed significantly greater improvement in daily living activities, hip function, and wound healing on postoperative days 5 and 30 compared to the control group (p < 0.01). Conclusions: Video-based education significantly improved daily living activities, hip function, and wound healing in patients undergoing total hip replacement. Clinicaltrials ID: NCT06523829 Full article

Non-diabetic chronic kidney disease (ND-CKD) refers to the progressive and irreversible decline in kidney function occurring in the absence of diabetes mellitus—a distinction that sets it apart from the more prevalent diabetic CKD. While diabetic nephropathy remains the leading cause of CKD globally, ND-CKD encompasses a heterogeneous group of etiologies, including hypertensive nephrosclerosis, glomerulonephritis, and interstitial nephritis. Its incidence and prevalence are steadily increasing, particularly in aging populations, and are often underrecognized. Importantly, ND-CKD is not a benign entity; it independently contributes to systemic inflammation, oxidative stress, and metabolic dysregulation, which in turn amplify cardiovascular risk. Among the most severe complications is heart failure (HF), a complex syndrome arising from structural and functional impairments in cardiac performance. Despite ongoing advancements in HF management, mortality remains unacceptably high, ranging from 2–3% at 30 days to up to 50–75% over five years. Standard pharmacologic therapies frequently fall short in halting disease progression and may provoke undesirable side effects. This therapeutic gap has spurred growing interest in natural compounds with multi-targeted effects. Bioactive molecules such as arjunolic acid, kaempferol, luteolin, and resveratrol have shown anti-inflammatory and antioxidant properties that may offer dual benefits for both renal and cardiac function. By modulating shared molecular pathways—including those involved in inflammation, oxidative damage, and cellular dysfunction—these agents hold promise as adjunctive treatments in ND-CKD complicated by heart failure. Full article

Galls of the Cynipidae, such as the Knopper gall, are abnormal plant outgrowths induced by insect activity. These structures not only protect the developing larvae but also alter the biochemical properties of host plant tissues. In this study, we report the green synthesis of silver nanoparticles (AgNPs) using ethanolic extracts of Quercus robur Knopper galls. AgNPs were synthesized via reduction of AgNO₃ and characterized using ATR-FTIR analysis, UV-Vis spectrophotometry, powder X-ray diffraction (PXRD), and transmission electron microscopy (TEM). The UV-Vis analysis showed a strong surface plasmon resonance (SPR) peak at 418 nm. A face-centered cubic (fcc) crystalline structure with an average crystallite size of about 12 nm was verified by PXRD patterns. TEM imaging revealed well-dispersed spherical nanoparticles, consistent with the size obtained via PXRD. ATR-FTIR analysis indicated the involvement of polyphenolic and protein-related functional groups in reduction and stabilization. The synthesized AgNPs exhibited strong growth inhibition capacity against B. subtilis and S. aureus, and moderate capacity against E. coli and P. aeruginosa. These findings highlight the potential of Knopper gall extract as a sustainable source for the eco-friendly synthesis of biologically active nanoparticles. Full article

Accurate prediction of earthquake—induced building damage is essential for timely disaster response and effective risk mitigation. This study explores a machine learning (ML)-based classification approach using data from the 2015 Gorkha, Nepal earthquake, with a specific focus on reinforced concrete (RC) structures. The original dataset from the 2015 Nepal earthquake contained 762,094 building entries across 127 variables describing structural, functional, and contextual characteristics. Three ensemble ML modelsGradient Boosting Machine (GBM), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM) were trained and tested on both the full dataset and a filtered RC-only subset. Two target variables were considered: a three-class variable (damage_class) and the original five-level damage grade (damage_grade). To address class imbalance, oversampling and undersampling techniques were applied, and model performance was evaluated using accuracy and F1 scores. The results showed that LightGBM consistently outperformed the other models, especially when oversampling was applied. For the RC dataset, LightGBM achieved up to 98% accuracy for damage_class and 93% accuracy for damage_grade, along with high F1 scores ranging between 0.84 and 1.00 across all classes. Feature importance analysis revealed that structural characteristics such as building area, age, and height were the most influential predictors of damage. These findings highlight the value of building-type-specific modeling combined with class balancing techniques to improve the reliability and generalizability of ML-based earthquake damage prediction. Full article

Background: The aim of this study was to describe the clinical and laboratory characteristics of hospitalized pediatric influenza cases during the 2024–2025 season in Northwestern Greece, with a focus on influenza-associated benign acute childhood myositis (BACM). Methods: We conducted a retrospective observational study of children aged 0–16 years hospitalized with laboratory-confirmed influenza between October 2024 and May 2025 at two pediatric departments. BACM was diagnosed based on calf pain, difficulty walking, elevated creatine kinase (CK), and symptom resolution without other causes. Results: A total of 113 children (mean age 7.0 ± 4.2 years; 50.4% male) were included; 61.1% had influenza A and 38.9% influenza B. None had received influenza vaccination. BACM was identified in 37 children (32.7%), who were significantly older than patients without myositis (9.3 ± 2.7 vs. 6.0 ± 4.5 years, p < 0.001). Influenza B was strongly associated with BACM (70.3% vs. 29.7%, χ²(1) = 22.7, p < 0.001, Cramer’s V = 0.448). Median CK in BACM cases was 2637 IU/L (range: 189–129,390 IU/L); all had preserved renal function. One patient with congenital myopathy developed rhabdomyolysis (peak CK 130,000 IU/L) but had a full recovery. All patients received oseltamivir and supportive care; no intensive care admissions or deaths occurred. Conclusions: In our hospitalized cohort, BACM was observed relatively frequently (32.7%), particularly in children with influenza B; however, this proportion reflects hospitalized cases and does not indicate the true incidence in the general pediatric population. Despite high CK levels, outcomes were favorable with supportive care. These findings underscore the importance of clinician awareness to avoid unnecessary investigations and hospitalizations. Full article