Methanol poisoning remains a major public health problem, particularly during outbreaks related to illicit alcohol consumption, and is associated with high mortality. Early identification of patients at high risk of death is critical to guide timely triage and aggressive management in the emergency department (ED). To identify clinical and laboratory predictors of in-hospital mortality among patients with methanol poisoning during an outbreak and to evaluate the prognostic performance of key parameters using receiver operating characteristic (ROC) curve analysis and logistic regression. This retrospective observational cohort study was conducted in the ED of a tertiary-care hospital in Istanbul, Türkiye, during a methanol poisoning outbreak between December 1, 2024, and January 31, 2025. Adult patients (≥ 18 years) diagnosed with methanol poisoning were included. Demographic data, clinical findings, laboratory results, arterial blood gas parameters, and treatments were collected. The primary outcome was in-hospital mortality. ROC curve analyses and univariate and multivariable logistic regression models were performed. A total of 55 patients were included (92.7% male; median age 46.0 years [IQR 38.5-55.0]). In-hospital mortality occurred in 25 patients (45.5%). Non-survivors had significantly lower arterial pH, bicarbonate, and base excess values and higher lactate levels and anion gap compared with survivors (all p < 0.001). Arterial pH demonstrated excellent prognostic performance (AUC 0.969), with an optimal cut-off value of ≤ 6.89 (92.0% sensitivity, 96.7% specificity). In multivariable analysis, arterial pH remained an independent predictor of mortality, with each 0.1-unit decrease associated with a 2.78-fold increase in the odds of death. In a model excluding arterial blood gas parameters, higher lactate levels and lower Glasgow Coma Scale scores were independently associated with mortality. During methanol poisoning outbreaks, arterial pH is the strongest predictor of in-hospital mortality. Serum lactate and neurological status provide additional prognostic value when arterial blood gas analysis is unavailable. These findings support the use of arterial pH as a decision-support tool for early escalation of care, including emergent hemodialysis and intensive care admission, and suggest that serum lactate and GCS may serve as actionable triage parameters in resource-limited or high-burden surge settings.
Metastatic hormone receptor-positive (HR+) breast cancer is largely incurable once resistance to conventional treatments occurs. Emerging evidence suggests that progression free and overall survival can improve by targeting the distinct metabolic phenotype of cancer cells (Warburg effect). We report a durable response in a patient with advanced metastatic breast cancer treated with a multimodal "press-pulse" metabolic strategy. A 49-year-old female from Torino, Italy presented with Stage IV (cT4N1M1) invasive ductal carcinoma (HR+/HER2-, grade 3) with extensive osseous and lymph node metastases, poor performance status (ECOG 3) and severe, debilitating pain. She underwent a combinatorial protocol at ChemoThermia Oncology Center (Istanbul, Turkey) comprising of Metabolically Supported Chemotherapy (MSCT) consisting of docetaxel, doxorubicin, and cyclophosphamide administered following a 14-hour fast and low dose insulin-induced mild hypoglycemia, alongside a strict ketogenic diet (GKI < 2.0). Adjunctive therapies included local and whole-body hyperthermia, hyperbaric oxygen therapy (HBOT), and a combination of repurposed drugs (metformin, aspirin, doxycycline, mebendazole, ivermectin, and famotidine) designed to target metabolic, inflammatory, and survival pathways. This multimodal treatment protocol was well tolerated, and grade 3/4 adverse events were not observed. The patient noticed symptomatic improvement and functional recovery shortly following the onset of therapy. Follow-up PET-CT scan conducted at 3 months revealed reduced tumor burden. At 6 months, the patient was reported to have a near complete response with the resolution of active bone metastases. On a maintenance schedule, the patient remains in sustained remission as of January 2026, over three years following diagnosis, with a full return to normal daily activities (ECOG 0). This case highlights the potential of a comprehensive metabolic approach to cancer treatment that combines therapeutic ketosis, metabolically supported chemotherapy, physical modalities (hyperthermia/HBOT), and repurposed drugs. A durable response in a patient with otherwise poor prognosis was achieved after systematically targeting cancer cell bioenergetics and the tumor microenvironment. These findings support further clinical investigation into multimodal metabolic therapies for advanced HR+ breast cancer.
Osteoarthritis (OA) is increasingly recognized as a metabolically influenced inflammatory disease, particularly in the context of obesity. Wnt1-inducible signaling pathway protein 1 (WISP1), a downstream mediator of Wnt/β-catenin signaling, has been implicated in adipose tissue inflammation and cartilage remodeling; however, clinical data regarding circulating serum WISP1 levels in obesity-associated OA remain limited. This study aimed to investigate the relationship between serum WISP1 concentrations and OA status in obese adults. This cross-sectional study included 180 participants classified into three groups: healthy non-obese controls (n = 60), obese individuals without OA (n = 60), and obese individuals with OA (n = 60). Clinical, anthropometric, metabolic, and inflammatory parameters were recorded. Serum WISP1 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Group comparisons, correlation analyses, logistic regression models, and receiver operating characteristic (ROC) analyses were performed. Serum WISP1 concentrations differed significantly among groups, showing a stepwise increase from healthy controls to obese OA (-) and obese OA (+) participants (p < 0.001). WISP1 remained independently associated with osteoarthritis among obese individuals after adjustment for age, sex, body mass index, HOMA-IR, diuretic use and C-reactive protein (OR 1.003; 95% CI 1.001-1.005). Although obese participants demonstrated adverse metabolic and inflammatory profiles compared with controls, most metabolic parameters did not distinguish OA subgroups within obesity. ROC analysis demonstrated good discriminatory performance of WISP1 for distinguishing obese OA (+) from obese OA (-) groups (AUC 0.807, 95% CI 0.727-0.879, p < 0.001). Serum WISP1 concentrations are elevated in obese individuals with osteoarthritis and are independently associated with OA status beyond conventional measures of adiposity and systemic inflammation. These findings suggest that WISP1 may serve as a potential biomarker associated with metabolic-inflammatory processes. Given the cross-sectional nature of the study, the observed findings should be interpreted as associations, and causal relationships cannot be inferred. Further longitudinal and externally validated studies are needed to clarify its clinical utility and biological significance.
Knee osteoarthritis is a major cause of chronic pain and functional limitation, particularly in advanced stages. Intra-articular steroid injections and genicular nerve interventions are commonly used for pain control; however, these methods mainly target the anterior knee and may not sufficiently relieve pain originating from the posterior capsule. The infiltration between the popliteal artery and the capsule of the knee (IPACK) block is a regional anesthesia technique that provides posterior knee analgesia without causing motor weakness. Evidence regarding its effectiveness in chronic, non-surgical knee osteoarthritis is limited. This study aimed to evaluate whether adding an ultrasound-guided IPACK block to intra-articular steroid injection improves pain and functional outcomes in patients with advanced knee osteoarthritis. This retrospective observational cohort study included 98 patients with Kellgren-Lawrence stage 3-4 knee osteoarthritis who had persistent pain despite conservative treatment. Patients received either intra-articular steroid injection alone (IASI group, n = 50) or intra-articular steroid injection combined with an IPACK block (IASI+IPACK group, n = 48). Pain severity was assessed using the Numeric Rating Scale (NRS), and functional status was evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Evaluations were performed at baseline, 1 month, and 6 months after the procedure. Non-parametric tests were used for statistical analysis, and p < 0.05 was considered significant. Both groups showed significant improvement in NRS and WOMAC scores at 1 and 6 months compared with baseline (p < 0.05). The IASI+IPACK group demonstrated greater pain reduction at 1 month and significantly better WOMAC Function and Total scores at both follow-up visits compared with the IASI group (p < 0.05). Although scores increased slightly between 1 and 6 months in both groups, outcomes remained improved compared with baseline. No major complications were observed during the follow-up period. However, minor adverse events were not systematically recorded due to the retrospective nature of the study. Adding an IPACK block to intra-articular steroid injection may provide additional benefit in early pain relief and functional improvement in patients with advanced knee osteoarthritis. This combined approach appears to be a safe and useful option for patients who are not surgical candidates or are awaiting arthroplasty. ClinicalTrials.gov, NCT07269444. Retrospectively registered on 20 November 2025.
Vestibular stimulation influences both bodily ownership and postural control. Although previous studies in the literature have examined the effects of galvanic vestibular stimulation (GVS) on body ownership and balance separately, their combined and time-dependent effects remain insufficiently explored. This study investigated how GVS modulates multisensory integration over time by assessing bodily ownership and postural control within the same participants. A within-participant design was used with four conditions: Baseline (pre-GVS), Sham (60-min post-GVS placebo), 30-min post-GVS, and 60-min post-GVS. Forty-eight healthy adults completed all conditions. Balance performance was assessed via the Single-Leg Stance (SLS) and Fukuda Stepping Test (FST), while bodily ownership was measured using the Rubber Hand Illusion (RHI) questionnaire. Balance performance on the SLS showed a significant reduction at 30 minutes post-GVS, with values returning toward baseline by 60 minutes. In contrast, angular deviation on the FST decreased significantly at both 30 and 60 minutes post-GVS. RHI ownership scores increased at both post-stimulation time points, with the most pronounced increase observed at 60 minutes. The sham condition also elicited increases in RHI scores, indicating possible expectancy-related effects. Overall, these findings indicate time-dependent and task-specific effects of GVS on bodily ownership and postural control. The results are consistent with adaptive sensory reweighting processes that differentially affect static and dynamic balance measures. Further research in clinical populations and using longer stimulation protocols is required to determine the extent to which these short-term effects translate into sustained functional benefits.
Primary tracheal tumors are rare pathologies that pose significant diagnostic and therapeutic challenges due to their low incidence, nonspecific symptoms, and technical complexity of surgical management. This study aimed to evaluate the clinical characteristics, surgical outcomes, and oncological results of patients treated for primary tracheal tumors at a single experienced center. A retrospective analysis was conducted of patients who underwent surgical treatment for primary tracheal tumors between October 2010 and October 2025. Patients treated for tracheal stenosis or managed with nonsurgical modalities alone were excluded. Demographic data, tumor characteristics, surgical approaches, perioperative outcomes, pathological findings, adjuvant treatments, and survival data were analyzed. Nineteen patients (63.2% female, 36.8% male) with a mean age of 58.4 years were included. Surgical approach was individualized according to tumor localization and consisted of collar incision, collar incision combined with partial sternotomy, thoracotomy, or video-assisted thoracoscopic surgery. No difference was seen in the means of complication, survival, operation time, or length of hospital stay between continuous or interrupted sutures with PDS or polypropylene materials. Postoperative complications occurred in three patients (15.8%), including wound infection in two patients and anastomotic dehiscence complicated by pneumonia in one patient, which resulted in postoperative mortality. Malignant pathology was identified in 84.2% of patients, and selected cases with tumor-positive surgical margins received adjuvant radiotherapy. No tumor recurrence was observed, and 89.5% of patients were alive at the end of follow-up. Mean overall survival was 157.7 months. In the management of primary tracheal tumors, early diagnosis, appropriate patient selection, surgical treatment performed in experienced centers, and the use of a multimodal treatment approach when indicated constitute the key determinants of successful oncological and functional outcomes.
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Phagocytosis is a fundamental biological process in the immune system whereby phagocytic cells eliminate pathogens and apoptotic cells. This mechanism plays a central role in ensuring the effectiveness of innate immunity and in activating the antigen recognition and response processes of acquired immunity. This review discusses the importance of phagocytosis in the immune system, its molecular mechanisms, associated disorders, relationship with immunodeficiencies, and its role in vaccine design. In this context, a deeper understanding of phagocytosis may contribute both to improved approaches for the treatment of immunodeficiencies and to the development of next-generation vaccines and immunotherapies.
Large language models (LLMs) are increasingly being explored in surgical training and clinical knowledge assessment. Although these models have demonstrated promising performance in standardized examinations, their performance in highly specialized fields such as cardiovascular surgery remains insufficiently investigated. This study aimed to evaluate the performance of current large language models in answering and generating board-level cardiovascular surgery questions reflecting guideline-based clinical reasoning. In this cross-sectional evaluation study, three large language models (ChatGPT-5.1, Gemini 3, and DeepSeek v3.2) were evaluated in two stages. In the first stage, the models answered 150 multiple-choice questions developed and validated by five cardiovascular surgery specialists using a Delphi process, designed to reflect the content scope and difficulty level of the American Board of Thoracic Surgery certification examination. Accuracy rates and pairwise comparisons were analyzed using the McNemar test. In the second stage, model-generated questions were evaluated by expert cardiovascular surgeons in terms of medical accuracy, clinical relevance, exam-level appropriateness, error type, and difficulty level. Statistical analyses included Spearman correlation, Wilcoxon signed-rank test, and chi-square analysis. The models demonstrated comparable accuracy rates (ChatGPT 80.7%; Gemini 78.7%; DeepSeek 82.0%), with no statistically significant differences between them. Question difficulty level was not associated with model accuracy. Error distribution differed significantly between models (χ² = 8.1; p = 0.02), with Gemini demonstrating the highest rate of valid question generation and DeepSeek showing a higher rate of major errors. A significant positive correlation was observed between model- and expert-assigned difficulty levels. Current large language models demonstrate strong performance in board-level cardiovascular surgery knowledge assessment. However, the presence of major errors and variability in difficulty calibration, together with known limitations in clinical reasoning, indicate that these systems should be used cautiously as supportive tools in surgical training and knowledge assessment rather than as substitutes for clinical decision-making.
Double-chambered right ventricle (DCRV) is defined as the progressive division of the right ventricle into two chambers: a high-pressure inlet chamber and a low-pressure outlet chamber. To date, only three cases diagnosed prenatally have been reported in the literature, all of which were associated with unfavorable pregnancy outcomes. In this study, we discuss DCRV in general, along with two cases of type 1 DCRV that did not cause hemodynamically significant obstruction and resulted in successful pregnancy outcomes. From a hemodynamic perspective, the following echocardiographic criteria may affect the prenatal fetal process: (1) detection of tricuspid regurgitation on echocardiography; and (2) pulmonary blood flow velocity and the difference in pressure between the proximal and distal right ventricle.
Magnetic resonance imaging (MRI) is widely used to evaluate meniscal healing after surgical repair; however, the extent to which postoperative MRI findings reflect clinically meaningful recovery remains uncertain. This study aimed to examine the relationship between MRI-based healing appearance and patient-reported functional outcomes after meniscal repair. This retrospective observational study included adult patients who underwent arthroscopic meniscal repair between January 2018 and December 2024 at a tertiary care centre. Patients with at least 12 months of follow-up, available postoperative MRI, and complete clinical outcome data were included. Postoperative MRI was obtained at a mean of 18.6 ± 7.4 months after surgery (range: 12-36 months). Meniscal healing on MRI was classified as complete healing, partial healing, or failed healing/retear. Clinical outcomes were assessed using the International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores. Clinical success was defined as IKDC ≥ 80 and Lysholm ≥ 85. The association between MRI healing status and clinical outcomes was evaluated using group comparisons and correlation analyses. A total of 240 patients (mean age 27.4 ± 6.8 years; 71.7% male) were analyzed. MRI demonstrated complete healing in 40.8% of patients, partial healing in 31.7%, and failed healing or retear in 27.5%. Mean IKDC, Lysholm, and Tegner scores differed significantly across MRI groups (all p ≤ 0.002), with lower scores observed in patients with MRI-defined failure. However, 63.6% of patients classified as having failed healing on MRI met the criteria for clinical success. MRI healing status showed moderate correlations with IKDC (r = 0.42), Lysholm (r = 0.39), and Tegner (r = 0.31) scores (all p < 0.001). The MRI-IKDC correlation was higher in patients who underwent concomitant anterior cruciate ligament reconstruction than in those who underwent isolated meniscal repair. Postoperative MRI appearance after meniscal repair is associated with patient-reported and functional outcomes, but the strength of this relationship is limited. MRI-defined structural abnormalities may persist despite satisfactory clinical recovery, indicating that MRI has restricted specificity for identifying clinically meaningful failure. These findings suggest that MRI should be interpreted in conjunction with clinical assessment rather than used as a standalone indicator of postoperative success.
FSCC is a relatively common tumor of the skin and mucocutaneous regions in cats, yet the molecular features that accompany its varying degrees of differentiation are not fully clarified. In this study, we examined 27 FSCC cases and compared well, moderately, and poorly differentiated tumors using routine histopathology together with immunohistochemical, immunofluoresence, and RT-PCR based analyses. Differentiation grade was determined by keratin pearl formation, tumor island morphology, squamous differentiation, mitotic activity, and the extent of peritumoral inflammation. Poorly differentiated tumors showed a consistent pattern in which oxidative DNA damage (8-OHdG) was noticeably higher, while the Nrf2/HO-1 pathway was clearly suppressed and Keap1 expression increased. These changes were accompanied by stronger IL-6 and ICAM-1 staining and marked activation of inflammatory markers related to the TLR4/NF-κB/COX-2 axis. In contrast, well-differentiated tumors tended to retain higher Nrf2 and HO-1 expression with lower activation of pro-inflammatory pathways, suggesting a more balanced redox response. The inflammatory burden and mitotic activity were also most pronounced in poorly differentiated lesions. Overall, the findings indicate that deterioration of differentiation in FSCC parallels a shift toward heightened oxidative stress and amplified inflammatory signaling. The combined dysregulation of the Nrf2/HO-1/Keap1 and TLR4/NF-κB/COX-2 appears to contribute to a more aggressive tumor microenvironment, offering potential insight into the biological behavior of these lesions.
This retrospective, cross-sectional study included 317 adult men, comprising 123 patients diagnosed with PD and 192 control subjects without clinical evidence of PD. Demographic data, body mass index (BMI), comorbidities, and fasting laboratory parameters (glucose, total cholesterol, LDL, HDL, and triglycerides) were collected. TG/HDL ratio and TyG index were calculated using established formulas. Between-group comparisons were performed using Mann-Whitney U and chi-square or Fisher's exact tests, with false discovery rate correction for multiple comparisons. Multivariable binary logistic regression analysis was conducted to identify independent predictors of PD presence. Within the PD cohort, associations between penile curvature degree and metabolic parameters were evaluated using Spearman's correlation analysis. Patients with PD had a significantly lower median BMI compared to controls (25.0 vs. 27.3 kg/m², p < 0.001). LDL-cholesterol and total cholesterol levels were lower in the PD group on univariable analysis; however, these differences did not remain significant after correction for multiple testing. No significant differences were observed between groups for fasting glucose, triglycerides, HDL, TG/HDL ratio, or TyG index. In multivariable analysis, BMI emerged as the only independent predictor of PD presence (OR 0.83 per kg/m² increase, 95% CI 0.76-0.90; p < 0.001). No metabolic parameter, including insulin resistance surrogates, was independently associated with PD. Among PD patients, penile curvature degree showed no significant correlation with BMI, lipid profile components, TG/HDL ratio, or TyG index. In this cohort, BMI - but not lipid profile components or insulin resistance surrogate markers - was independently associated with the presence of Peyronie's disease, while metabolic factors were not related to curvature severity. These findings suggest that systemic metabolic dysregulation may play a limited role in PD development and phenotypic expression, highlighting the importance of local tissue-specific mechanisms in disease pathogenesis.
A higher frequency of valvular heart disease is seen among Systemic Sclerosis (SSc) patients. Advanced aortic valve stenosis leads to significant morbidity in these patients with multiple other comorbidities. In this study, we aim to define the short- and long-term outcomes of transcatheter aortic valve replacement (TAVR) procedures in SSc patients. We undertook a retrospective chart review of all patients with SSc who underwent a TAVR procedure at our institution over a defined 11-year period. Demographics as well as short- and long-term outcomes were identified. Fourteen SSc patients underwent a TAVR procedure between 2012 and 2023. They were predominantly older Caucasian female patients with limited cutaneous SSc (lcSSc) with advanced aortic stenosis. Only one patient had a readmission within 30 days due to post-op heart failure and subsequently had to have the TAVR reversed to a SAVR. TAVR is a well-tolerated procedure in SSc patients with advanced aortic stenosis and multiple comorbidities.
To evaluate and directly compare the prognostic performance of three trauma scoring systems-Ocular Trauma Score (OTS), Pediatric Ocular Trauma Score (POTS), and Modified Pediatric Ocular Trauma Score (MPOTS)-in predicting visual outcomes in pediatric patients with open-globe injuries (OGI). This retrospective cohort included 110 pediatric patients (≤ 18 years) who underwent surgical repair for OGI between January 2018 and December 2024. Demographic, clinical, and surgical data were extracted from standardized medical records. Prognostic factors for final visual acuity (VA) were analyzed, and OTS, POTS, and MPOTS were calculated for each patient. Visual outcomes were classified as favorable (VA > 20/200) or poor (VA ≤ 20/200). Predictive performance was assessed using Spearman's rank correlation and receiver operating characteristic (ROC) curve analysis. The mean age was 7.85 ± 4.73 years, and the mean follow-up was 20.36 ± 16.70 months. Presenting VA, injury zone, and associated ocular pathologies (hyphema, traumatic cataract, vitreous hemorrhage, retinal detachment, choroidal involvement, vitreous prolapse, and iris prolapse) were significant predictors of poor outcomes (all p < 0.05), whereas age, sex, and time to surgery were not. Mean VA improved significantly from baseline (1.40 ± 0.92 logMAR) to final follow-up (0.68 ± 1.04 logMAR; p < 0.001). All three trauma scores correlated strongly with final VA, with OTS (r = - 0.822) and POTS (r = - 0.807) outperforming MPOTS (r = - 0.690). ROC analysis confirmed excellent discriminative ability for all three models, with the highest areas under the curve (AUC) observed for POTS (0.983), followed by OTS (0.974) and MPOTS (0.948). OTS, POTS, and MPOTS are valuable tools for predicting visual outcomes in pediatric OGI. While POTS demonstrated the best discriminative performance in our cohort, OTS remained highly reliable, and MPOTS provided a simpler framework but with slightly reduced accuracy. OTS should continue to serve as a reference standard, with pediatric-specific scores offering complementary value in challenging clinical scenarios.
Upper gastrointestinal (GI) pathologies, such as peptic ulcers and gastroesophageal reflux disease (GERD), are common causes of gastrointestinal discomfort. This study investigates the trends in the prevalence and demographic patterns of several upper GI conditions over an 18-year period (2007-2024) at a tertiary care center. A retrospective analysis was conducted using data from endoscopic procedures performed between 2007 and 2024. The data included diagnoses of gastritis, peptic ulcers, GERD, bulbitis, hiatal hernia, LES insufficiency, esophagitis, duodenitis, and malignancies. We evaluated the trends in the number of cases and the average age of patients diagnosed with these conditions. Additionally, the male-to-female ratio was analyzed for each pathology. Statistical analysis included time-series analysis to detect trends over the study period. A total of 6,188 endoscopic procedures were analyzed. Gastritis was the most prevalent condition, accounting for 60.8% of cases, followed by peptic ulcers (22.8%) and GERD (14.5%). Time-series analysis revealed a steady decline in the incidence of gastritis and peptic ulcers over the years (p < 0.05), while GERD exhibited a bimodal distribution with an increase after 2018. The average age of patients varied across conditions, with GERD showing a significant increase in the average age over time. Gender distribution was relatively balanced for most conditions, although GERD showed a higher prevalence in females. This study highlights significant trends in the prevalence of upper GI pathologies, with a decrease in gastritis and peptic ulcers and a rising trend in GERD. The findings suggest that the demographic landscape of upper GI pathologies is shifting, with GERD becoming more prominent in the later years of the study.
Maladaptive daydreaming (MD) is increasingly recognized as a complex psychological phenomenon that extends beyond ordinary fantasy. While it has been predominantly conceptualized within a dissociative framework, the present study aimed to extend this perspective by proposing a complementary integrative model focusing on less extensively examined but interacting domains, including neurodevelopmental traits, behavioral addictions, and socio-psychological factors, in a sample of university students in Türkiye. A total of 848 participants (mean age = 21.50 ± 2.59 years; 73.2% female) completed validated self-report measures assessing MD (MDS-16), ADHD symptoms, autism spectrum traits, behavioral addictions (social media and gaming), and psychosocial variables including anxiety, depression, self-esteem, narcissism, and loneliness. Using a cut-off score of ≥50 on the MDS-16, the prevalence of MD among university students was 18.3%. MD severity was positively associated with ADHD symptoms (r = 0.335), autism spectrum traits (r = 0.218), social media use (r = 0.309), anxiety (r = 0.339), and narcissistic traits (r = 0.256), and positively associated with higher RSES scores (r = 0.315; indicating lower self-esteem) and negatively associated with age (r = -0.231) (all p < .001). In hierarchical linear regression analyses, low self-esteem, ADHD symptoms, and autism traits emerged as the strongest predictors of MD severity, while anxiety, social media addiction, and narcissistic traits also contributed significantly. Age and year of study showed consistent inverse associations with MD severity (adjusted R2 = 0.283). These findings indicate that MD reflects a multidimensional process in which neurodevelopmental vulnerabilities, emotional dysregulation, and behaviorally reinforced patterns converge, supporting an integrative account that complements dissociative conceptualizations.
What is this summary about? This is a summary of the results from a clinical study of treatment for people with severe hemophilia A or moderately severe to severe hemophilia B without inhibitors. Because severe hemophilia A and B predominantly affect men and boys, this study only included men and boys aged 12 to 74 years. The study was published in Blood. People with hemophilia either have low amounts of clotting factors or are missing certain clotting factors in their blood. There are medicines that people with hemophilia can take to replace the missing clotting factor. These medicines must be injected into a vein and are usually given more than once a week. Marstacimab is an antibody that works by attaching to a protein in the blood called tissue factor pathway inhibitor (or TFPI). TFPI works separately from clotting factors. Marstacimab helps the balance between blood flowing freely and clotting. Marstacimab is given by a simple injection under the skin (not in a vein or muscle) and can be taken less often than clotting factors. Marstacimab may offer a new way to help people with hemophilia. What were the results of the study? The study showed that men with hemophilia had fewer treated bleed events during 1 year with marstacimab treatment compared to previous factor replacement therapy. The researchers reported that marstacimab was safe and most side effects were mild to moderate. What do the results mean? These studies showed that marstacimab could help prevent bleeding in men with hemophilia A or B, without inhibitors.
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This study aimed to evaluate oral and dental health status, hygiene practices, and access to dental care among adults living in Gaza, Khan Younis, and the central governorates of Palestine. A descriptive cross-sectional survey was conducted in 2025 among 39 adults aged ≥18 years residing in the study regions. Data were collected using a structured questionnaire (14 closed-ended and 4 open-ended questions) addressing oral hygiene habits, healthcare access, living conditions, and perceptions of dental services. The survey was administered via Google Forms. Descriptive statistics were used, and categorical variables were presented as frequencies and percentages. The study included 39 participants (48.7% women, 51.3% men). None reported adequate access to nutritious food. A high proportion (89.7%) experienced toothache within the last two years. The most common response was self-management with analgesics (71.6%), while other strategies included visiting a health facility (28.6%), tooth extraction (28.6%), and use of traditional remedies (28.6%). A small proportion (5.7%) reported taking no action. Only 46.2% had visited a dentist in the last two years. Open-ended responses highlighted key challenges, including lack of hygiene supplies (25.6%), limited access to dental services (20.5%), financial constraints (5.1%), poor nutrition (5.1%), and ongoing oral health problems (5.1%). Findings indicate a substantial burden of untreated oral conditions and limited access to dental care in a conflict-affected population. Oral health needs should be integrated into humanitarian health responses to ensure access to preventive and essential dental services.