The incidence of atypical femoral fractures in breast cancer patients is theoretically expected to be significantly higher than in those with primary osteoporosis. This is due to the prolonged and higher dosages of bisphosphonates used for post-operative bone protection and secondary osteoporosis. However, there is a notable lack of literature addressing this issue. Diagnosing and managing atypical femoral fractures in breast cancer patients presents unique challenges that differ substantially from those encountered in osteoporosis patients. We present a 58-year-old postmenopausal woman with a history of breast cancer who reported bilateral mid-thigh pain. From June 2015 to January 2017, she received zoledronic acid (4 mg) intravenously every 3 months, totaling seven doses. From 2017 to 2021, her regimen changed to a 4 mg infusion every 6 months, resulting in ten doses during this period. Overall, she underwent 17 zoledronic acid infusions over approximately 5.5 years. After minor trauma, she suffered sequential bilateral femoral shaft fractures. Bone metastases were initially suspected but ruled out through histopathological examination of both fracture sites, which showed no malignancy. Following her last infusion in June 2024, a multidisciplinary team (MDT) discussion was held. Considering her prolonged bisphosphonate exposure, the fracture sites, and imaging consistent with the 2013 American Society for Bone and Mineral Research (ASBMR) criteria, she was diagnosed with bisphosphonate-related atypical bilateral femoral fractures. Zoledronic acid was discontinued, and teriparatide treatment began, leading to significant pain relief, improved mobility, and radiological evidence of fracture healing after 9 months. However, due to mildly elevated tumor markers (CA19-9 and neuron-specific enolase [NSE]), teriparatide was switched to denosumab, which led to a prompt recurrence of bilateral thigh pain. This case underscores the critical importance of early and differential diagnosis of atypical femoral fractures in this patient population. The findings suggest that teriparatide can be effective in promoting atypical femoral fracture healing; however, its use in patients with a history of cancer remains controversial and requires individualized risk-benefit assessment under multidisciplinary guidance. Furthermore, switching to denosumab during active fracture healing may lead to symptomatic recurrence. This approach might also be relevant for patients with primary osteoporosis. Multidisciplinary management and long-term monitoring are crucial for managing such complex cases.
Percutaneous pericardiocentesis is the standard diagnostic and therapeutic procedure for severe pericardial effusion (PE). While its procedural safety has improved over time, data on long-term outcomes in cancer patients remain limited. We aim to evaluate clinical outcomes after pericardiocentesis, with a specific focus on neoplastic-related PE. We collected data of patients who underwent percutaneous pericardiocentesis at the University Hospital of Modena, between December 2006 and September 2025. Patients were stratified into three groups: neoplastic, idiopathic, and other specific etiologies. The primary endpoint was all-cause mortality, while the secondary endpoint was a composite of in-hospital adverse events. A total of 179 patients were included (median age 72, 39.7% women). Major procedural-related complications occurred in 4.5% of patients, while in-hospital mortality was 15.6%. During a mean follow-up of 15.8 months, 44.1% of patients died. Mortality was significantly higher in patients with neoplastic PE (61.1%) compared with those with other etiologies (44.9%) and idiopathic PE (23.4%, p = 0.001). Neoplastic etiology was independently associated with an increased risk of death compared with idiopathic PE (aHR 5.22, 95% CI 2.41-11.35). Our study showed that percutaneous pericardiocentesis is an effective and safe procedure, with a major complication rate consistent with contemporary series across variable etiologies. Despite similar procedural safety, patients with neoplastic PE experienced markedly worse long-term outcomes linked to the underlying malignancy rather than the procedure itself. In oncological patients, pericardiocentesis should be contextualized within the overall oncological trajectory, balancing procedural benefit with patient prognosis and individual treatment goals.
A-to-I RNA editing, one of the most frequent RNA modifications, is essential for most aspects of RNA metabolism. However, the accuracy of quantifying A-to-I editing levels has been largely neglected, particularly when contrasting next-generation sequencing (NGS) with long-read sequencing (LRS) RNA-seq. To address it, we performed paired NGS and LRS cDNA RNA-seq of both HEK293T and U2OS cells, revealing that the A-to-I editing levels were estimated to be lower by NGS compared with LRS, a conclusion that was confirmed through full-length amplicon sequencing. Furthermore, the lower estimation of A-to-I editing levels is widespread, while we also identified this consequence using released public both same-study and cross-study NGS and LRS RNA-seq data in various human cancer cell lines. In addition, our analyses indicate that the primary factor contributing to this lower estimation is the sequencing read length difference, and a significantly positive correlation between the quantification and read length is identified by analyzing the public NGS RNA-seq data of various cell lines. We additionally found that shorter sequencing reads are more prone to aligning incorrectly to the reference genome, such as uniquely-to-multiply mapped and uniquely mapped-to-unmapped, inducing the lower estimation of A-to-I editing levels. In summary, our analyses indicate that LRS RNA-seq is preferable for accurately quantifying A-to-I editing levels.
The prevalence, characteristics, management, and long-term outcome of patients with non-ST-segment elevation myocardial infarction (NSTEMI) due to a completely occluded culprit coronary artery (NSTEMI-OMI) remain insufficiently characterised. In this international multicentre study, consecutive patients with centrally adjudicated type I NSTEMI were classified as NSTEMI-OMI if they had a TIMI flow grade of 0 or 1 or grade 2 with severe coronary narrowing (> 70%) and a high-sensitivity cardiac troponin T (hs-cTnT) ≥ 500 ng/L. Prospectively recorded chest pain characteristics, 12-lead ECG, serial hs-cTnT concentrations, time to coronary angiography/revascularisation, and 5-year mortality were compared in patients with NSTEMI-OMI versus other type I NSTEMI (NSTEMI-NOMI). Among 801 patients with type I NSTEMI (median age 68 years, 22.2% female), 251 patients (31.3%) had NSTEMI-OMI. Patients with NSTEMI-OMI presented more often with persistent chest pain (56.1% vs. 37.9%, p < 0.001), more often had ST-segment depression (34.3% vs. 23.0%, p < 0.001), and exhibited higher and faster rising hs-cTnT concentrations. Time from admission to coronary angiography (median 7.2 h [IQR 4.7, 21.8] vs. 19.6 h [IQR 6.2, 27.9], p < 0.001) and coronary revascularisation (median 8.2 h [IQR 4.9, 24.0] vs. 22.0 h [IQR 6.3, 46.1], p < 0.001) were both significantly shorter in patients with NSTEMI-OMI versus NSTEMI-NOMI. Five-year mortality was comparable in patients with NSTEMI-OMI versus NSTEMI-NOMI (adjHR 1.13 [95% CI 0.78-1.63], p = 0.51). One in three patients with type I NSTEMI had NSTEMI-OMI. These patients more often present with very high-risk clinical, ECG, and biomarker features and receive earlier invasive management. Likely related to the latter, 5-year mortality was similar between NSTEMI-OMI and NSTEMI-NOMI.
Long non-coding RNA (lncRNA) antisense RNA 1 (LOXL1-AS1), reportedly, exerts carcinogenic effects in cancers including non-small cell lung cancer (NSCLC) via competitive endogenous RNA (ceRNA) mechanism. Additionally, previous studies have implied that microRNA-122-5p (miR-122-5p) and E2F transcription factor 3 (E2F3) have cancer-promoting properties and tumor-suppressive properties, respectively. Here we aim to further explore the function and mechanism of LOXL1-AS1 in NSCLC. In this experimental study, we found that LOXL1-AS1 was high expression in NSCLC tissues and cell lines. High LOXL1-AS1 expression was significantly relevant to the advanced tumor node metastasis (TNM) stage and positive lymph node metastasis of NSCLC patients. LOXL1-AS1 overexpression promoted proliferation, migration and invasion of NSCLC cells, while LOXL1-AS1 knockdown had the opposite effect. LOXL1-AS1 could sponge miR-122-5p. E2F3 was a downstream target of miR-122-5p. LOXL1-AS1 increased E2F3 expression through repressing miR-122-5p. In addition, miR-122-5p up-regulation or E2F3 knockdown could offset the promoting effect of LOXL1-AS1 overexpression on proliferation, migration and invasion of NSCLC cells. Overall, this study demonstrates that LOXL1-AS1 promotes NSCLC cell proliferation and migration in vitro, and correlates with poor clinical outcomes, partially via modulating miR-122-5p/E2F3 axis.
Single-cell long-read transcriptomics (scLR-seq) extends single-cell analysis beyond gene abundance by resolving full-length transcript structures in individual cells. It can directly interrogate isoform usage, alternative splicing, and transcription start and end site selection, thereby revealing regulatory variation that is often obscured by short-read measurements. In this review, we examine the experimental and computational foundations of scLR-seq, including platform selection, library design, cell barcode and unique molecular identifier (UMI) recovery, transcript discovery, and isoform quantification. We discuss how these choices influence the reliability of downstream biological interpretation, and summarize emerging insights into isoform usage, alternative splicing, transcription start and end site selection, allele-specific expression, fusion transcripts, transposable element-derived transcripts, and RNA modifications. Finally, we highlight applications of scLR-seq in diverse biological systems, such as the immune system, neural development, and tumor microenvironments, and consider future opportunities and challenges in integrating multi-omics data to decode cellular programs and disease evolution.
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Aqueous zinc-ion battery anodes face corrosion and the hydrogen evolution reaction, causing the Zn anode to grow dendrites and die after piercing the diaphragm during the plating-stripping process. In this work, Carboxylated Cellulose Nanofibers (CNF) were introduced into the ZnSO4 electrolyte. Owing to their inherent physicochemical properties and a high HOMO energy level, CNF molecules exhibit strong electron-donating capability and preferentially adsorb on the Zn surface. The adsorbed CNF molecules dynamically occupy interfacial active sites, limiting direct contact between H2O molecules and the Zn anode and thereby forming a H2O-poor electric double layer (EDL) buffer layer. This adsorption-based interfacial regulation layer effectively suppresses hydrogen evolution, corrosion, and dendrite growth. Specifically, Zn anodes adsorbed by CNF molecules have high cycling stability (more than 3000 h at 5 mA cm-2 and 1 mAh cm-2). The Coulombic efficiency of the Zn||Cu half-cell was maintained at 99.41% after 1000 cycles, and the capacity retention of the Zn||ZnI2 full-cell was 96.8% after 2000 cycles at 4 C. Moreover, the 0.9 Ah Zn||ZnI2@Ti pouch cell (with 10 × 10 cm AC films) using 1 M ZnSO4@10% CNF electrolyte retained 56.9% specific capacity after 500 cycles, showing favorable performance.
Shiga toxin-producing Escherichia coli (STEC) represent a genetically diverse group of pathogens whose virulence is largely driven by mobile genetic elements (MGEs), including plasmids and bacteriophages. While horizontal gene transfer is central to STEC evolution, the extent to which virulence-associated MGEs circulate within natural reservoirs remains poorly understood. In this study, we investigated the diversity, distribution and lineage associations of MGEs in a collection of 73 E. coli strains isolated from cattle in France, a major reservoir for pathogenic STEC. Using both short-read and long-read whole-genome sequencing, we characterized plasmid content, prophage repertoires and stx-encoding phages and examined their relationships with strain phylogeny. We observed a high diversity of plasmids, with individual strains carrying up to four large plasmids, alongside an even greater diversity of prophages. Despite this diversity, some associations were identified between specific virulence plasmid groups, Stx phage types and defined pathogroups or lineages. These patterns were supported by the congruence between core-genome and accessory-genome phylogenies, suggesting long-term evolutionary coupling rather than frequent exchange of entire MGEs. In contrast, some non-virulence plasmids were broadly distributed, consistent with more general selective advantages. Notably, we identified enterohaemorrhagic E. coli strains (stx- and eae-positive strains) in atypical phylogenetic backgrounds, highlighting the capacity for virulence determinants to emerge in diverse lineages, while underscoring the constraints that limit their stable establishment, as their long-term persistence appears limited to specific genetic backgrounds. Together, our findings indicate that the circulation of virulence-associated MGEs in the bovine reservoir is constrained by ecological and evolutionary factors.
Systemic lupus erythematosus (SLE) is a complex autoimmune disease in which neutrophils, especially the pro-inflammatory low-density neutrophil (LDN) subset, play a central pathogenic role. Yet, the molecular mechanisms that link neutrophil ferroptosis, degranulation, and interferon amplification remain incompletely understood. Through integrative bioinformatics and validation in clinical samples, we identified acyl-CoA synthetase long-chain family member 1 (ACSL1) as a pivotal regulator in SLE. ACSL1 expression was consistently elevated in patient-derived neutrophils, with the highest levels observed in LDNs. Elevated ACSL1 strongly correlated with signatures of ferroptosis, mitochondrial dysfunction, neutrophil degranulation, and type I interferon responses. Single-cell RNA sequencing further revealed ACSL1 enrichment along the trajectory of neutrophil differentiation toward a transcriptional state consistent with pathogenic LDNs, suggesting a potential role in shaping their inflammatory phenotype that warrants further experimental validation. Importantly, molecular docking identified several small-molecule compounds, including the FDA-approved drug fenofibrate, with strong predicted binding to ACSL1. Together, these findings establish ACSL1 as a novel dual regulator orchestrating ferroptosis and degranulation in LDNs, thereby bridging mitochondrial dysfunction with aberrant immune activation in SLE. Targeting ACSL1 may represent a feasible approach to restrain neutrophil-driven inflammation with reduced risk of broad immunosuppression, highlighting its potential as a precision therapeutic target in systemic lupus erythematosus and related autoimmune conditions.
This study investigated the effects of Coenzyme Q10 (CoQ10) oral administration on biochemical, immunological, microbiological, and productive parameters in sheep. Forty Barki ewes (3.5 ± 0.6 years; 47.5 ± 0.5 kg; 91-96 days of gestation) were randomly assigned to a control group (standard diet) and a treatment group (standard diet + 2 mg CoQ10 /kg BW). The experiment was conducted from late gestation through four weeks postpartum. CoQ10 administration increased serum total protein (5.49 vs. 5.01 g/dL) and globulin (3.00 vs. 2.49 g/dL) at parturition (p < 0.01), along with higher immunoglobulin A (IgA) (92.60 vs. 74.20 ng/mL) and glutathione peroxidase (GPx) activity (28.55 vs. 19.15 U/mL). In lambs of CoQ10-treated ewes, total protein (5.41 vs. 4.52 g/dL), IgA (137.10 vs. 88.01 ng/mL), and total antioxidant capacity (TAC) (43.96 vs. 32.11 mM/L) were higher (p < 0.05). Colostrum and milk from treated ewes showed higher solids-not-fat (15.41 vs. 12.32%, p < 0.01) and fat content (up to 7.7 vs. 5.7%, p < 0.01), with consistently higher immunoglobulins and reduced microbial incidence. Milk yield was higher in treated ewes, with a significant increase at week 4. Lambs of CoQ10-treated ewes had consistently higher body weight at all measured time points (p < 0.05). In conclusion, periparturient CoQ10 administration enhanced antioxidant status, immune-related parameters, milk quality, and growth performance. These findings support CoQ10 as a potential management strategy to alleviate periparturient stress and improve productivity in sheep production systems. Further studies are needed to optimize dosage and evaluate long-term effects under commercial conditions.
Rapidly evolving begomoviruses are a serious threat to cash crops worldwide. Perennial plants often harbor these viruses for a long time, making them accessible to crop plants. Perennial ornamental plants Duranta erecta variegata (Variegated Sky Flower) were found with typical begomoviral symptoms, including leaf curling, leaf deformation, and leaf shortening in the plant nurseries of Faisalabad, Pakistan, in 2021. Begomovirus and its associated satellite molecules of ~ 2.8 and ~ 1.4 kb, respectively, were amplified using rolling circle amplification (RCA). Sanger sequencing of cloned molecules revealed the presence of rose leaf curl virus (RoLCuV, Begomovirus rosae) accompanied by a novel recombinant DNA-B, tentatively named "rose leaf curl virus DNA-B," along with hollyhock yellow vein alphasatellite (HYVA, Gosmusatellite alceae). Another plant sample showed the presence of agriculturally important papaya leaf crumple virus (PaLCrV, Begomovirus papayae). To our knowledge, this is the first report of RoLCuV, a novel DNA-B, PaLCrV, and HYVA infecting D. erecta variegata in Pakistan.
Heterozygote carriers of Gaucher's disease mutations and other polymorphisms in the glucocerebrosidase (GBA) gene show an increased incidence of Parkinson's disease. We hypothesized that common GBA polymorphisms would be associated with subtle parkinsonian features, mild cognitive impairment, and "silent" Lewy body (LB) pathology in aging individuals without a clinical diagnosis of parkinsonism. The most prevalent GBA variants, T369M and E326K, appear in the general population at rates of approximately 0.6% and 1%, respectively. We evaluated 845 participants from the Oregon Alzheimer's Disease Research Center (OADRC) with SNP data generated by the National Centralized Repository of Alzheimer's Disease (NCRAD). Twenty-one subjects were E326K carriers and eighteen were T369M carriers. Clinical measures and postmortem neuropathology were compared between each SNP group and non-carriers. Although there were no statistically significant clinical differences related to synucleinopathy across groups, neuropathological analyses revealed a significantly higher prevalence of LB pathology in E326K carriers compared to T369M carriers. When stratifying each genetic group by LB status (LB+ or LB-), LB+ E326K carriers demonstrated a significant reduction in Mini-Mental State Examination (MMSE) scores compared with LB- non-carriers and a modest decrease compared with T369M carriers. These preliminary findings from a small, uni-center cohort suggest that the E326K GBA polymorphism may predict LB pathology and subtle cognitive decline in aging individuals who lack overt parkinsonian symptoms. Further validation in a larger cohort is warranted. Identifying at-risk individuals through targeted genetic screening may ultimately support earlier intervention and preventative care strategies. Understanding How Two Common GBA Gene Variants Affect Brain Aging in People Without Parkinson's Disease: What We Learned by Comparing Thinking Abilities and Brain Changes in Older AdultsThis study explored whether two common changes in the GBA gene, called E326K and T369M, influence how the brain ages in people who never developed Parkinson's disease during life. We wanted to learn whether these genetic differences affect thinking or memory and whether they are linked to changes in the brain that are usually seen only after symptoms appear. This question matters because many people now learn about their genetic risks through medical or consumer testing, yet doctors often do not have clear information about what these results mean for older adults who have no symptoms. To study this, we followed a large group of older adults who completed yearly thinking and movement tests and then donated their brains for research. This approach allowed us to compare their everyday functioning with the actual brain changes seen under the microscope. We found that people with the E326K variant showed more of the protein buildup typically linked to Parkinson's disease, even though they never showed the disease in life. They also tended to have lower memory scores. This suggests that E326K may contribute to “silent” brain changes long before symptoms appear. In contrast, people with the T369M variant did not show these harmful changes. They had no signs of Parkinson's-related protein buildup and tended to have fewer Alzheimer's-related changes as well, along with slightly better memory performance. These findings show that not all GBA variants act the same way. One variant may increase risk for early, hidden brain changes, while another may be neutral or even somewhat protective. Understanding these differences can help doctors better explain genetic test results, guide decisions about monitoring and follow-up, and support future research aimed at early prevention of brain diseases.
The clinical value of using a spine robot to guide unilateral PVP for lumbar Kümmell's disease has not been fully established. The traditional bilateral pedicle PVP tends to cause suboptimal cement distribution, longer operation time, and increased exposure to radiation. To compare the safety and effectiveness of spine robot-assisted modified unilateral PVP with conventional bilateral pedicle puncture PVP. We performed a single-blind randomized trial including 110 patients with lumbar Kümmell's disease. Patients were assigned in equal numbers to robot-assisted modified unilateral PVP or manual bilateral pedicle PVP. The main endpoint was 12-month Cobb angle change. Additional endpoints included AVH, PVH, WA, VAS, ODI, operative indicators, and complications. At all time points after the operation, the robot-assisted group showed significantly higher reductions in Cobb angle, WA, VAS, and ODI and significantly better preservation of AVH and PVH (all P < 0.05). Operative time (47.15 ± 8.26 vs. 69.25 ± 10.94 min), blood loss (10.29 ± 2.87 vs. 25.31 ± 4.43 mL), and fluoroscopy times (9.80 ± 1.59 vs. 26.24 ± 4.74) are significantly reduced in the robot-assisted group. The rate of bone cement leakage and vertebral recollapse also decreased. Robot-assisted modified unilateral PVP has better long-term correction of kyphotic deformation, reduced complications, and higher procedural efficacy compared to utilizing conventional bilateral PVP under the limitation of single-center single-blind trial. It is a more precise and minimally invasive approach for treating lumbar Kümmell's disease.
To synthesize recent evidence on how environmental exposures influence stroke risk, with emphasis on air pollution, thermal stress, circadian and occupational disruption, built and social environments, and selected toxicants. Long-term and episodic air pollution, especially fine particulate matter with aerodynamic diameter ≤ 2.5 μm (PM₂.₅) and wildfire smoke, remain most consistently associated with stroke risk. Extreme heat combined with heat-humidity metrics is emerging as an important acute stroke trigger. Noise, artificial light at night, shift work, and long working hours show smaller but plausible associations, while greener and more walkable environments may be modestly protective. Social and structural disadvantage clusters, multiple exposures and inequities play an integrated role in risk and prevention. Environmental determinants are increasingly relevant to stroke risk. The strongest current links are realted to pollution, heat, sleep, and work disruption, as well as environmental inequity. Future research should move beyond single-exposure models toward combined-exposure as well as intervention-focused approaches.
The EyeMate-SC (G-Metrics GmbH, Hanover, Germany) is a permanently implantable microsensor positioned in the suprachoroidal space for telemetric, high-frequency self-measurement of intraocular pressure (IOP), with measurements transmitted to the treating ophthalmologist via an external reading device. The aim of this review is to summarize the evidence regarding the safety of the implant, agreement of measurements with Goldmann applanation tonometry (GAT), patient adherence and acceptance, and the potential for capturing IOP fluctuations. This review includes 24 patients with open-angle glaucoma who received an EyeMate-SC sensor as part of a nonpenetrating glaucoma surgery and were followed for 3 years within the ARGOS-SC01 study and its follow-up study, ARGOS-SC01_FU. Implantation was successfully performed in all cases without complications. Over the observation period 15 moderate adverse events occurred beyond the early postoperative phase, of which one case was possibly related to the sensor. The device demonstrated long-term positional stability without dislocation and remained astigmatically neutral despite its superficial location. Agreement with GAT remained consistently good. Patients reported high acceptance and adherence and stated they would recommend the system to other glaucoma patients. In addition, the sensor enabled the assessment of both short-term and long-term IOP fluctuations. The EyeMate-SC enables, for the first time, high-frequency telemetric self-monitoring of IOP independent of lens status and supports therapeutic decisions based on comprehensive pressure profiles rather than single measurements. Newer system generations further extend this concept by enabling automated, continuous data acquisition with higher temporal resolution. In combination with artificial intelligence, this could enable early detection of progression-associated patterns; however, the impact on disease progression, quality of life and social participation requires further investigation. HINTERGRUND: Der EyeMate-SC (G-Metrics GmbH, Hannover, Deutschland) ist ein dauerhaft im suprachoroidalen Raum implantierbarer Mikrosensor zur telemetrischen, hochfrequenten Selbstmessung des intraokularen Drucks (IOD), dessen Messwerte über ein externes Lesegerät an den behandelnden Augenarzt übermittelt werden. Ziel dieser Arbeit ist die Zusammenfassung der Evidenz zur Sicherheit des Implantats, zur Übereinstimmung der Messwerte mit der Goldmann-Applanationstonometrie (GAT), zur Patientenadhärenz und -akzeptanz sowie zum Potenzial der Erfassung von IOD-Fluktuationen. In diese Übersichtsarbeit wurden 24 Patienten mit Offenwinkelglaukom eingeschlossen, die im Rahmen einer nicht penetrierenden Glaukomoperation mit einem EyeMate-SC-Sensor versorgt und über 3 Jahre im Rahmen der ARGOS-SC01-Studie und der Follow-up-Studie ARGOS-SC01_FU nachverfolgt wurden. Die Implantation verlief in allen Fällen komplikationslos. Über den Beobachtungszeitraum traten jenseits des frühen postoperativen Intervalls 15 moderate unerwünschte Ereignisse auf, von denen ein Fall möglicherweise sensorassoziiert war. Der Sensor zeigte eine hohe langfristige Lagestabilität ohne Dislokationen und blieb trotz seiner oberflächlichen Position astigmatismusneutral. Die Übereinstimmung mit der GAT war dauerhaft gut. Zudem berichteten Patienten eine hohe Akzeptanz und Adhärenz und würden das System weiterempfehlen. Darüber hinaus ermöglichte der Sensor die Erfassung sowohl kurzfristiger als auch langfristiger IOD-Fluktuationen. Der EyeMate-SC ermöglicht erstmals eine hochfrequente telemetrische Selbstmessung des IOD unabhängig vom Linsenstatus und erlaubt eine Therapieentscheidung auf Basis umfassender Druckprofile statt Einzelmessungen. Neuere Systemgenerationen erweitern dieses Konzept um eine automatisierte, kontinuierliche Datenerfassung mit höherer zeitlicher Auflösung. In Kombination mit künstlicher Intelligenz könnten so progredienzassoziierte Muster frühzeitig erkannt werden. Der Nutzen hinsichtlich Krankheitsprogression, Lebensqualität und gesellschaftlicher Teilhabe bedarf weiterer Studien.
Solitary fibrous tumour of the pleura (SFTP) is a rare mesenchymal neoplasm with an excellent prognosis after surgery. However, a small subset exhibits aggressive behaviour, developing metastases and recurrences even more than 10 years after treatment. Several classifications based on clinical and histological features attempt to predict the risk of recurrence and metastasis. The aim of this study is to describe our experience in the management of these tumours, review the existing literature, and assess whether the different prognostic classifications are applicable to our series. We conducted a retrospective observational study of 48 patients who underwent surgery for SFTP between January 2006 and July 2025. The following variables were recorded: clinical presentation, imaging characteristics, surgical approach, histopathology, immunohistochemistry, long-term outcomes, and recurrence-free and overall survival were analysed. The prognostic classifications used were those of England, de Perrot, Demicco, Tapias, and Diebold. VATS was the predominant surgical approach. 36 cases (75%) were histologically benign, while 12 cases (25%) met criteria for malignancy. Only one patient (2.1%) developed tumour recurrence, occurring 8 years after surgery. None of the prognostic classifications were useful in predicting recurrence. The single recurrent case was classified as histologically benign and low-risk by all classifications except Demicco, which designated it as intermediate risk. In our series, the existing prognostic classifications did not reliably predict recurrence, supporting the recommendation for long-term follow-up regardless of histological features. While standardized clinical-pathological criteria remain the current cornerstone of management, the future integration of routine molecular markers across pathology laboratories may help refine these risk stratification protocols.
Osteoarthritis, a degenerative joint disease affecting hundreds of millions of people worldwide, leads to chronic pain and reduced mobility, for which total joint arthroplasty remains the definitive and most effective treatment. Ultrahigh molecular weight polyethylene (UHMWPE) has been the most widely used bearing material in artificial joints owing to its excellent tribological properties and biocompatibility. However, the long-term clinical outcome of this treatment is limited by the wear-induced failure of UHMWPE implants. Inspired by the natural joint's lubrication mechanism, a bulk grafting modification strategy was adopted to fabricate a bio-lubricating UHMWPE composite with an extended service life. Hydrophilic anionic polymer brushes poly(3-sulfopropyl methacrylate potassium salt) (PSPMK) were grafted onto UHMWPE powder via photo-induced polymerization, while halloysite nanotubes (HNTs) were similarly modified to enhance dispersion and interfacial synergy. The composite with 1 wt % modified HNTs exhibited a remarkably low coefficient of friction (0.012) and wear rate (8.98 × 10-7 mm3·N-1·m-1), representing reductions of 52.9% and 66.2%, respectively, compared to pristine UHMWPE. Mechanical properties, including compressive strength, modulus, and hardness, were also improved due to the reinforcing effect of well-dispersed HNTs. The integrated PSPMK brushes embedded throughout the bulk material ensure persistent hydration lubrication even after surface wear. This work provides a promising material design for next-generation long-lasting artificial joints with combined high strength and superior lubrication.
The integration of high-density surface electromyography with ultrasound-transparent electrodes (HDEMG-US) and B-mode ultrasonography enables concurrent assessment of motor unit (MU) firing properties and fascicle length (FL) from the same muscle region. Although the isometric relations between MU discharge, FL, and torque have been characterised, their interactions during anisometric contractions remain poorly understood. This study examined MU discharge behaviour and its relation with FL changes during shortening and lengthening contractions of the tibialis anterior muscle. Ten healthy males performed isokinetic dorsiflexion contractions at a constant angular velocity of 2°/s while maintaining a constant submaximal torque of 25% maximum voluntary contraction torque, measured at a long muscle-tendon length (~30° of plantarflexion), with HDEMG-US signals and ultrasound images recorded simultaneously. MUs were identified using blind-source separation decomposition and FL was tracked with an optical flow algorithm. Cross-correlation analysis revealed high associations between cumulative spike train (CST), FL, and torque in both contraction phases. Neuromechanical delays were significantly longer during lengthening than shortening (phase effect: F(1, 7) = 8.51, P = 0.023; mean difference: -25.04 ms, 95% CI: -45.35 to -4.74). Discharge rate changed at a similar rate with variations in FL during both shortening and lengthening contractions (similar discharge rate-FL slopes, P = 0.44); however, absolute discharge rates were systematically lower during lengthening (difference in intercepts: P < 0.0001). These findings demonstrate the feasibility of HDEMG-US for characterising neuromechanical coupling during dynamic contractions and provide new evidence of neural drive regulation during shortening and lengthening muscle actions.
Community-based interventions (CBIs) are widely used to address behavioral risk factors for non-communicable diseases, yet evidence of their effectiveness in low- and middle-income countries (LMICs) remains limited. This study systematically reviewed evidence on the effectiveness of CBIs promoting physical activity (PA) and/or reducing sedentary behavior (SB) among community-dwelling adults in LMICs. We searched PubMed, Embase, Scopus, and the Cochrane Library (2000-2024) for CBIs in LMICs. Primary outcomes were changes in PA and/or SB. Descriptive and graphical depictions were used to draw inferences. We selected 24 studies (11 RCTs) from 15,396 for review. Most studies (n = 16) reported significant improvements in PA outcomes. Changes were observed in Metabolic Equivalents (+ 100 - +2,700), moderate-to-vigorous PA (+ 7 to + 60 min/week), and steps/day (+ 3,000). Broadly, interventions were delivered using digital/technology format (n = 10), peer-led/community health worker-facilitated (n = 8), and Environmental restructuring (n = 6), with the digital interventions depicting the most consistent significant improvements. Two studies directly measured SB as a primary outcome. Short- (≤ 6 months; n = 11) and medium-duration (6-12 months; n = 4) interventions more frequently reported significant PA improvements than long-duration interventions (> 12 months; n = 9). PA/SB-focused CBI demonstrated proportions of significant effects similar to those of broader lifestyle interventions (88.9% and 53.3%, respectively). CBIs can be effective in improving PA in LMICs, although evidence is heterogeneous and SB is less addressed. Digital interventions show more consistent positive signals, but high heterogeneity in studies precludes firm conclusions. The impact of duration on effectiveness looks counterintuitive but underscores the need for more rigorous evaluation of longer-duration interventions and SB outcomes. PROSPERO registration number: CRD42024579461.