To compare the image quality and diagnostic value of field-of-view optimized and constrained undistorted single-shot multiplexed sensitivity-encoding diffusion-weighted imaging (FOCUS-MUSE DWI) with single-shot echo-planar imaging (SS-EPI) DWI in gastric cancer. Patients with biopsy-proven gastric cancer who underwent FOCUS-MUSE and SS-EPI DWI were enrolled in this prospective study between February and October 2024. Qualitative image quality was evaluated by two radiologists using a standardized five-point scale. Quantitative comparisons of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and apparent diffusion coefficient (ADC) were conducted for all measurable lesions. Preoperative T-staging accuracy was compared between the two techniques, with pathological or surgical findings as the reference. Agreement between estimations was evaluated using weighted kappa values and Bland-Altman plots. Pairwise differences between sequences were assessed using the Wilcoxon signed-rank and McNemar tests. Among 177 patients (age 65.4 ± 9.8 years, mean ± standard deviation; 133 males), FOCUS-MUSE DWI outperformed SS-EPI DWI in lesion conspicuity and overall image quality (median scores, 5 versus 4; both p < 0.001). For 148 patients with measurable lesions, FOCUS-MUSE yielded higher SNR (33.6 and 34.6 versus 26.9 and 26.9) and CNR (7.1 and 7.7 versus 5.3 and 5.9; all p < 0.001). Among 128 patients with pathologically T1-4a (pT1-T4a), surgically T4b (sT4b), or pathologically T4b (pT4b), T-staging accuracy was higher with FOCUS-MUSE (64.8% and 63.3%) than SS-EPI (44.5% and 47.7%; both p < 0.001). Intra- and inter-reader agreement was good to excellent. FOCUS-MUSE DWI demonstrated higher image quality and T-staging accuracy than SS-EPI DWI in gastric cancer. FOCUS-MUSE DWI provides improved image quality compared with conventional SS-EPI DWI and enables more accurate preoperative T staging in gastric cancer. These findings support the potential role of advanced DWI techniques in improving local tumor assessment. FOCUS-MUSE DWI demonstrated higher image quality compared to SS-EPI DWI in gastric cancer. FOCUS-MUSE DWI significantly improved preoperative T-staging accuracy over SS-EPI DWI. This advanced DWI technique shows potential to enhance preoperative risk stratification and surgical planning.
Myocardial Ischemia-reperfusion injury produces excessive reactive oxygen species, leading to myocardial cell death and debilitated cardiac function. The regenerative properties of cardiac stem/progenitor cells, particularly the Sca-1+ population, remain narrow under ischemia-reperfusion injury conditions. Multilineage stress-enduring cells known as Muse cells, a distinguished subpopulation of SSEA-3+ mesenchymal stromal cells (MSCs), have shown promise in tissue repair due to their stress-enduring, non-tumorigenic, and pluripotent-like properties. This study questioned the regenerative potential of Muse cells in rescuing Sca-1+ cardiac stem cells exposed in vitro to oxygen-glucose deprivation/reoxygenation injury. Muse cells were first isolated from human adipose mesenchymal stromal cells using Magnetic-activated cell sorting for SSEA-3+ cells. Co-culture experiments were conducted to assess the impacts of Muse cells on Sca-1+ cardiac stem cells proliferation, apoptosis, oxidative stress. Spontaneous Cardiac differentiation of Muse cells was assessed using expression of cardiac markers (GATA-4, Myosin light chain 2, Connexin-43, Troponin C1, and Myosin heavy chain 6. Muse cell co-culture with cells exposed to oxygen-glucose deprivation/reoxygenation injury significantly improved the survival and proliferation of Sca-1+ cardiac stem cells, while reducing apoptosis and oxidative stress compared to untreated cells. Additionally, Muse cells enhanced spontaneous cardiac differentiation, as indicated by the upregulation of assessed cardiac markers. Muse cells exert protective and supportive effects on cardiac stem cells under ischemic-like conditions and may represent a promising adjunct therapy to enhance endogenous cardiac repair. However, further studies are required to confirm functional cardiomyocyte differentiation and clinical applicability. Not available.
To compare the image quality of diffusion-weighted imaging (DWI) between deep learning reconstruction (DLR)-applied Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction (PROPELLER) and MUltiplexed Sensitivity Encoding (MUSE) sequences in MRI of uterine malignancies. This retrospective study included 66 MRI examinations of 48 patients. The cohort consisted of cases with uterine malignancies (cervical cancer (n = 50), endometrial cancer (n = 15) and endometrial stromal sarcoma (n = 1)) at different clinical settings (initial staging, post-treatment, or recurrence). DWI was performed using both DLR-applied PROPELLER and MUSE sequences using b-values of 0 and 800 s/mm2. Two independent reviewers evaluated overall image quality, artifacts, sharpness, and lesion conspicuity using a 5-point Likert scale. Apparent diffusion coefficient (ADC), apparent signal-to-noise ratio (aSNR), and apparent contrast-to-noise ratio (aCNR) were quantitatively measured in both sequences. In the qualitative assessment, DLR-applied PROPELLER-DWI showed significantly fewer artifacts and better lesion conspicuity than MUSE-DWI. No significant difference was found in overall image quality or sharpness. Inter-reader agreement was slight to moderate, except for strong agreement on DLR-applied PROPELLER-DWI lesion conspicuity (κ = 0.696, good). Quantitatively, the mean ADC values were significantly higher with DLR-applied PROPELLER-DWI compared to MUSE-DWI for both readers (p < 0.001). Furthermore, both aSNR and aCNR were significantly higher with DLR-applied PROPELLER-DWI compared to MUSE-DWI. DLR-applied PROPELLER-DWI demonstrated fewer artifacts and better lesion conspicuity than MUSE-DWI, with higher measured aSNR and aCNR. However, DLR-applied PROPELLER-DWI yielded significantly higher mean ADC values.
Cell replacement therapy is a promising investigational approach for Parkinson's disease (PD), a neurodegenerative disorder characterized by progressive loss of dopaminergic neurons in the substantia nigra. Although current PD therapies provide symptomatic relief, none halt or reverse disease progression. Early transplantation studies using fetal dopaminergic neurons provided proof of concept for PD cell replacement, with recent efforts focusing on pluripotent stem cell-derived dopaminergic progenitors that are now entering clinical testing. These strategies face challenges, however, including immune compatibility, tumorigenic risk, and the need for controlled differentiation and functional integration. Multi-lineage differentiating stress-enduring (Muse) cells are endogenous, non-tumorigenic pluripotent-like stem cells that home to sites of tissue injury and differentiate in response to the host microenvironment. A targeted literature search of PubMed and Scopus, however, did not identify prior reviews specifically addressing Muse cells in the context of PD, highlighting a gap in the literature. Here, we examine current limitations of established cell-replacement approaches and consider whether Muse cells may represent a mechanistically distinct cell source. Early clinical studies of Muse cell therapy in stroke and amyotrophic lateral sclerosis suggest an encouraging safety profile and preliminary signals of potential therapeutic benefit, although these findings are based on small, early-stage trials and require confirmation. The evidence supporting Muse cell therapy in PD is currently limited to a single preclinical animal study, supported by mechanistic in vitro findings and indirect evidence from other neurologic disease models; therefore, its relevance to PD remains to be established, and current evidence is insufficient to support conclusions regarding clinical efficacy. Together, these observations provide a rationale for further targeted preclinical investigation and support the systematic evaluation of Muse cells as a mechanistically distinct candidate for regenerative therapy in PD.
As part of the development of practice guidelines, developers need to systematically engage relevant interest-holder groups. The Reporting Items for practice Guidelines in HealThcare (RIGHT) checklist for reporting practice guidelines lacks detailed guidance on how to report the engagement process. To develop a standardized checklist for reporting interest-holder engagement in practice guidelines, named the RIGHT-MuSE checklist. The development process followed the methods recommended by the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, as well as lessons learned from the development of the RIGHT statement and its extensions. Key steps included developing the protocol, registering the project, establishing a working group, conducting background work, generating an initial list of items, conducting a consensus survey, holding panel discussions, and creating the final RIGHT-MuSE checklist and an accompanying explanation and elaboration document. International collaboration. 25 panelists from various guideline development interest-holder groups. Consensus agreement on checklist items. The final RIGHT-MuSE checklist consists of 11 items covering the guidance used, methods of engagement, characteristics of interest-holders, evaluation of engagement, and management of conflicts of interest. The checklist is supplemented with a glossary of key terms and detailed explanations for each item to facilitate its use. The RIGHT-MuSE checklist has not been evaluated in a broader context or widely applied in real-world guideline development processes. Guideline developers can use the RIGHT-MuSE checklist to comprehensively report on interest-holder engagement. The Vincent and Lily Woo Foundation.
Cutaneous T-cell lymphoma is a chronic disease with a highly heterogeneous and unpre-dictable clinical course, and the impact on psychological resilience is still unknown. The primary aim was to investigate psychological resilience in cutaneous T-cell lymphoma patients over time and to relate it to dermatology-related quality of life (QoL) metrics. Psychological investigations were evaluated in 45 patients with mycosis fungoides included in the BIO-MUSE study. Psychological resilience was assessed using the Connor-Davidson Resilience Scale (CD-RISC), and dermatology-associated QoL was assessed with the Dermatology Life Quality Index (DLQI) and numeric rating scales for itch and sleep disorders. The resilience of the mycosis fungoides patients was further compared to a Swedish general population cohort comprising more than 2,500 individuals. This study demonstrates that mycosis fungoides patients in the BIO-MUSE cohort, where 39 of 45 cases had early-stage disease, exhibit a high and stable resilience over 1 year of the disease. The CD-RISC score is higher than in a Swedish general population cohort and in a subgroup of that cohort with psoriasis or eczema. Furthermore, the DLQI was consistently low, indicating a higher QoL in the BIO-MUSE cohort than in published data for similar patient populations.
To develop a reconstruction framework for DW-PROPELLER-EPI that improves image quality and SNR efficiency under per-blade acceleration while minimizing EPI-related artifacts, enabling high-resolution diffusion-tensor imaging (DTI) with fewer blades. We propose CORPUSE, a joint reconstruction framework adapted from POCSMUSE and tailored for multiblade DW-PROPELLER-EPI. The method integrates distortion-correction operators into a joint-blade reconstruction model and exploits the inherent redundancy of multiblade sampling. Leveraging self-extracted composite 2D phase errors and blade-specific field maps as physics-based constraints, CORPUSE improves reconstruction performance. By using wider blades with higher per-blade acceleration, the framework increases scan efficiency while preserving image quality and geometric fidelity. The framework was evaluated in healthy volunteers on a 1.5T MRI scanner across varying numbers of blades and with two PROPELLER-EPI trajectories: long-axis (LAP) and short-axis (SAP), under different per-blade accelerations and scan conditions. In vivo experiments showed that CORPUSE improved image sharpness, geometric fidelity, and overall reconstruction quality compared with conventional PROPELLER-EPI reconstruction. These improvements enabled higher per-blade acceleration and wider blades without compromising image quality, thereby supporting more flexible and efficient reconstruction for LAP and SAP trajectory. Additionally, CORPUSE demonstrated greater motion resilience than multishot EPI based on multiplexed sensitivity encoding (MUSE), preserving structural detail even under subtle motion conditions. The CORPUSE framework enables high-resolution, high-quality DTI with fewer blades, improving the practicality of DW-PROPELLER-EPI. By maintaining SNR and geometric accuracy under high per-blade acceleration, it offers a robust and efficient alternative to other multishot diffusion imaging approaches.
Human multilineage-differentiating stress-enduring (MUSE) cells represent a promising cell population for tissue engineering and translational medicine owing to their intrinsic pluripotency and stress resistance. MUSE cells express pluripotency markers such as SSEA-3, Nanog, Sox2, and Oct3/4, while maintaining their immunomodulatory capabilities. This systematic review (PROSPERO CRD42024532621) analyzed studies on human MUSE cell isolation, characterization, and translational potential through searches of the PubMed, Scopus, and Web of Science databases in April 2024. The TIDieR and SYRCLE checklists were used to assess the risk of bias. Our findings identified 34 studies that followed the PRISMA guidelines for assessing different tissue sources, isolation techniques, and characterization methods. MUSE cells are primarily obtained from bone marrow mesenchymal stem cells, and fluorescence-activated cell sorting is the predominant isolation method. Characterization was mainly performed using SSEA-3 immunodetection (positivity ranged from <1% to 6.30%) and was linked to the expression of pluripotency and mesenchymal markers. These findings highlight the relevance of MUSE cells in regenerative medicine as a distinct pluripotent subpopulation within adult mesenchymal tissues. In addition, SSEA-3-based isolation approaches complemented by functional assays has emerged as a key methodological approach for the reliable identification and characterization of MUSE cells. However, isolation efficiency varies depending on the cell source and method. Standardized protocols are, therefore, needed to improve reproducibility and facilitate the translational development of MUSE cell-based regenerative therapies.
With the increasing prevalence of mental health issues, music therapy has gained attention as a non-pharmacological intervention, and deep learning techniques have shown promise in music emotion recognition and preference prediction. This study constructed a deep neural network model (CNN+RNN/EEGNet) to efficiently identify music type preferences and examine the influence of user familiarity on prediction accuracy. EEG signals were collected using a four-channel Muse S wearable device, and user familiarity scores were used as input features. The study followed a four-stage workflow: preparation, experimental design, model construction, and result analysis. In the experimental design, music was categorized into rock, ballad, and folk, and EEG data and familiarity ratings were collected for each category. Data was trained and tested using CNN+RNN or EEGNet models, and model performance was evaluated via subject-level 10-fold cross-validation. Results indicated that predicting all music types with EEG data alone achieved an accuracy of 82.28 ± 3.42%. For individual music types, accuracies were 91.13 ± 3.60% (rock), 91.83 ± 2.07% (ballad), and 87.87 ± 4.76% (folk). When incorporating user familiarity as a feature and using a multi-level rating output, overall prediction accuracy increased to 94.94 ± 1.61%, while individual music type accuracies reached 99.15 ± 1.56% (rock), 98.51 ± 2.30% (ballad), and 98.21 ± 2.60% (folk). These results demonstrate that combining familiarity features with a multi-level scoring system significantly improves the prediction of music preferences. By using an affordable, wearable Muse S EEG device and leveraging user familiarity, this study successfully developed a highly effective deep neural network model (CNN+RNN/EEGNet) for recognizing music type preferences. The findings indicate that both overall and individual music-type predictions benefit from the inclusion of familiarity information, highlighting the potential of this approach for personalized music recommendations and music therapy applications.
RTA-408 is a synthetic activator of the nuclear factor erythroid 2-related factor 2 pathway with antioxidant and anti-inflammatory act2ivity, but its antitumor effects in breast cancer (BC) have not fully been defined. The present study evaluated the antiproliferative efficacy and underlying mechanisms of RTA-408 in BC cells. Estrogen receptor-positive MCF-7 and triple-negative MDA-MB-231 BC cells were exposed to 0-1,000 nM RTA-408 for 72 h in standard serum-containing culture medium. Cell viability was quantified using a tetrazolium-based colorimetric assay and apoptosis was evaluated by the Muse® Annexin V & Dead Cell assay based on Annexin V and 7-amino-actinomycin D staining; the expression levels of JNK, p38, ERK, beclin-1, microtubule-associated protein 1 light chain 3B (LC3B), p62/sequestosome 1 (SQSTM1) and poly (ADP-ribose) polymerase (PARP) were assessed by western blotting. Pathway dependence was examined using the JNK inhibitor SP600125. Results showed that RTA-408 reduced cell viability in a concentration-dependent manner, with an IC50 of ~400 nM, decreasing survival to 28% in MCF-7 cells and 22% in MDA-MB-231 cells at 1,000 nM. RTA-408 increased annexin V+ apoptotic fractions, enhanced PARP cleavage and increased beclin-1, LC3B and p62/SQSTM1 levels. RTA-408 markedly enhanced JNK phosphorylation, with more modest activation of p38 and ERK. Pharmacological inhibition with SP600125 attenuated JNK phosphorylation, reduced apoptotic responses and diminished autophagy-associated marker accumulation, supporting the notion that JNK signaling contributes, at least in part, to these effects. These findings indicate that RTA-408 exerts nanomolar antiproliferative activity in both hormone receptor-positive and triple-negative BC cells through a JNK-dependent mechanism that simultaneously engages apoptosis and autophagy, supporting further in vivo and translational investigation.
The Human Experience in Regulated Offices (HERO) dataset is a synchronized, multimodal resource dataset designed to characterize human physiological and perceptual dynamics during realistic office activities in a controlled indoor setting. The dataset comprises data gathered on 24 voluntary healthy adults, each completing two laboratory sessions under distinct thermal regimens: Lower Temperature (LT; 22-24 °C) and Higher Temperature (HT; 30-32 °C), regulated within ±0.5 °C, conducted during the summer season in Köppen-Geiger Csa climate classification (temperate with dry and hot summer). In each session, participants followed a standardized nine-phase office-work protocol comprising an acclimation baseline, activity blocks, and interleaved washout periods, enabling analyses that explicitly account for activity type, sequencing, and recovery. The release integrates four-channel electroencephalography (EEG) acquired with a Muse-2 headband, electrodermal activity (EDA), and peripheral skin temperature (ST) recorded using an EmotiBit wrist-worn wearable sensor, indoor multi-domain environmental measurements acquired via the NEXT.ROOM facility, and phase-aligned surveys capturing multi-domain perceptions of the indoor environment and task experience. Visual context, such as, derived video quality check (QC)/coverage features, was recorded using laptop webcams. All data are distributed as level-0 device exports, restricted to the experimental window and enriched with consistent session identifiers and phase labels, while intentionally avoiding downstream preprocessing choices. The dataset is archived on Zenodo (DOI: 10.5281/zenodo.17957768) with documentation and code in the associated project's GitHub repository.
Etoposide is a widely used chemotherapeutic agent whose clinical application is limited by systemic toxicity and suboptimal intracellular delivery. Lipid-polymer hybrid nanoparticles have emerged as promising drug delivery systems that combine structural stability with enhanced cellular interaction. This study aimed to evalute the apoptotic and metastasis-related effects of etoposide-loaded lipid-polymer hybrid nanoparticles (ET-NPs) against human breast cancer cells. ET-NPs were synthesized and characterized, and their biological effects were compared with free etoposide in MCF-7 and MDA-MB-231 breast cancer cell lines. Cell viability was assessed using the MTT assay. Cell cycle distribution, Annexin V binding activity, mitochondrial membrane potential, and caspase activation were analyzed by flow cytometry based Muse Cell Analyzer. MMP-2 and MMP-9 mRNA levels were determined by quantitative real-time PCR. ET-NPs significantly enhanced the cytotoxic and pro-apoptotic effects of etoposide in both breast cancer cell lines. Annexin V analysis demonstrated increased apoptotic cell populations following ET-NP treatment compared with free etoposide. ET-NP also induced significant mitochondrial membrane depolarization, caspase activation, and G2/M phase arrest. Furthermore, ET-NP significantly exerted potential anti-metastatic activity indicating a preferential antitumor effect in MCF-7 cells compared with MDA-MB-231 cells. The findings of this study demonstrate that lipid-polymer hybrid nanoparticle-mediated delivery enhances the anticancer efficacy of etoposide in breast cancer cells by potentiating apoptotic signaling and suppressing metastasis-related gene expression. ET-NP may therefore represent a promising nanotherapeutic strategy for improving breast cancer treatment outcomes.
Anifrolumab, a type I interferon receptor antagonist, has shown effectiveness in treating moderate-to-severe systemic lupus erythematosus (SLE). To fully understand its long-term efficacy, glucocorticoid (GC)-sparing potential, and cumulative safety profile in everyday clinical practice, it is essential to combine up to 4 years of long-term extension (LTE) trial data with emerging real-world evidence (RWE). A systematic literature search was performed across major electronic databases to identify phase 2/3 randomized controlled trials (RCTs), long-term extension (LTE) studies, and RWE cohorts assessing anifrolumab in SLE. Comparative odds ratios (ORs) for RCTs were calculated using the Mantel-Haenszel method, while pooled proportions for single-arm RWE cohorts were estimated using a random-effects model. Primary outcomes included BICLA response, Lupus Low Disease Activity State (LLDAS), GC reduction (to ≤ 7.5 mg/day), and Herpes Zoster (HZ) incidence. Ten studies were included, comprising phase 2/3 RCTs, their LTEs (TULIP-LTE, MUSE-LTE), and four European RWE cohorts. In the RCTs (N = 1,093), anifrolumab significantly improved BICLA responses compared to placebo (pooled OR 1.85, 95% CI 1.42-2.41, p < 0.001) and enhanced the likelihood of achieving a target GC dose of ≤ 7.5 mg/day (OR 2.24, 95% CI 1.52-3.29, p < 0.001). In the pooled RWE cohorts (N = 294), the estimated attainment rate for LLDAS at 6-12 months was notably high at 75.8% (95% CI 68.4-82.5%). Additionally, 72.5% of real-world patients achieved a >50% reduction in GC dosage. Regarding safety, there was no significant increase in overall serious adverse events (SAEs) (OR 0.82, p = 0.25). Although anifrolumab was linked to a higher risk of HZ (OR 3.45, 95% CI 1.95-6.10, p < 0.001), both LTE and RWE data indicated that these cases were mainly mild to moderate and manageable. Anifrolumab offers rapid, strong, and sustained disease control while providing significant GC-sparing effects in both tightly controlled clinical trials and diverse real-world populations. The long-term safety profile remains stable; however, preventative measures, such as HZ vaccination, should be implemented as part of standard care.
Ultraviolet (UV) light is emerging as an important tool for biosensing, biomedical signal readout, and dose monitoring because of its strong and selective interactions with nucleic acids, proteins, and other biological components. This review summarizes recent progress in UV sensing-guided biomedical systems, with emphasis on three interconnected directions: label-free and surface-weighted imaging, wearable and embedded UV dosimetry, and sensor-assisted therapeutic guidance. Representative examples include ultraviolet photoacoustic microscopy (UV-PAM) for label-free nuclear imaging, microscopy with ultraviolet surface excitation (MUSE) for rapid slide-free histology-like readout, epidermal and flexible UV dosimeters for skin-level exposure quantification, and UV therapeutic platforms that are increasingly supported by sensing, dosimetry, and feedback for safer dose delivery. Across these applications, we emphasize the shared biosensing principles of signal generation, optical or acoustic transduction, quantitative readout, calibration, and feedback-informed decision support. We also discuss the role of artificial intelligence in virtual staining, image enhancement, domain correction, dose prediction, and decision support. The review concludes with key translational challenges in standardization, uncertainty quantification, multimodal integration, and feedback-driven system design. Overall, this sensing-centered perspective helps define the role of UV technologies more clearly within biosensors-oriented biomedical engineering.
Two species of the deep-sea squat lobster family Munidopsidae are reported as new additions to the Japanese marine fauna on the basis of specimens collected from the Sea of Kumano (off Kii Peninsula), central Japan. Galacanthakumano sp. nov. is morphologically similar to G. subspinosa Macpherson, 2007, but distinguishable by the weaker armature on the dorsal surface of the carapace and pleon and proportionally wider thoracic sternite 3. An identification key to all species of the genus Galacantha A. Milne-Edwards, 1880 is provided. Munidopsis concava Macpherson, 2007 is re-redescribed to supplement diagnostic characters with re-examination of the type material. The identity of the Japanese specimens was verified with genetic data derived from the two mitochondrial markers (COI and 16S rRNA genes). The present Japanese material revealed association of M. concava with sunken wood, a trait observed in some congeneric species, including those with similar morphology.
Overground walking involves various challenges (i.e., surface changes, elevation) in maintaining balance and preventing falls. One of the most important properties of locomotor behavior in this context is resilience: the capacity to resist and recover after a disturbance. Despite its importance, locomotor resilience through recovery dynamics remains poorly documented in older adults. This study aims to investigate differences in recovery time between young and older adults during step synchronization with a periodic metronome displaying auditory tempo perturbations. Twenty healthy young and older adults were instructed to synchronize their steps with a periodic metronome presenting two unexpected tempo alterations (± 25%). Post-perturbation recovery time was quantified from the vertical displacement of a virtual S2 position, used as an estimate of center of mass motion (zCoM). In addition, the time required to regain step synchronization, computed from the temporal delay between foot contact events and auditory cue, was measured to compare relative timing between recovery processes. Step resynchronization occurred earlier relative to zCoM stabilization following both slow (+5.79 s, 95% CI [2.04, 10.15], Cohen's d = 1.17 and fast (+4.66 s, 95% CI [0.65, 9.76], Cohen's d = 0.7) perturbations in young adults. No significant temporal difference between recovery processes were observed in older adults. These findings provide insights into recovery dynamics following perturbation, emphasizing differences in temporal classification of recovery processes between individuals. In addition, this protocol could serve as a complementary assessment tool for postural adaptation strategies in older adults.
The high 10-year extraction rate of failed second- and third-generation total ankle replacements (TARs) has led to an increasing prevalence of revision procedures with substantial bone defect. In this context, revision technique utilizing tibiotalocalcaneal arthrodesis (TTCA) with massive bone allograft and autograft is a salvage procedure, providing variable outcomes that need to be compared to those after primary TTCA. This study compared fusion rates, reoperations, and clinical outcomes of two cohorts of TTCA. A retrospective single-center cohort of patients was initially identified, finally including 10 patients who underwent revision TTCA (R-TTCA) with augmented allograft after failed TAR, and compared to a control group of 10 patients who underwent primary TTCA (P-TTCA), matched at a 1:1 ratio for age, sex, side and body mass index. Tibiotalar and subtalar fusion rates, reoperations, and AOFAS scores were collected retrospectively. The mean follow-up was 3 years (range 1-7 years). Tibiotalar and subtalar fusion rates after R-TTCA were 100% and 70%, respectively, similar to those after primary TTCA (100% and 70%, p > 0.999, respectively). Reoperations after R-TTCA occurred in 2 cases, showing a similar reoperation risk (20% versus 30%, p > 0.999). Mean postoperative AOFAS scores were similar in both groups (63 versus 48, p = 0.083, respectively), with residual pain being lower in the R-TTCA group (p = 0.013). Tibiotalocalcaneal arthrodesis utilizing a retrograde nail with femoral head structural allograft and autograft could be a valuable salvage procedure after failed TAR. While subtalar nonunion was the main complication, radiographic and functional outcomes appear to be comparable to those of primary tibiotalocalcaneal arthrodesis. These results should be considered in relation to the small number of cases in our series; larger-scale studies need to be carried out to confirm them. III; retrospective matched cohort study.
Hyperuricemia is a recognized biochemical finding in preeclampsia (PE), but the reported frequency varies across low- and middle-income countries (LMICs). A pooled estimate from LMIC settings may help clarify the extent of this finding in hospital-based populations. To estimate the pooled prevalence of hyperuricemia among women with preeclampsia in hospital-based studies from LMICs. A systematic review and meta-analysis was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251107624). PubMed, Scopus, Web of Science, and Lens.org were searched for observational studies published from 2010 to 2025 reporting hyperuricemia among women with preeclampsia in LMIC hospital settings. Prevalence estimates were pooled using a random-effects model with logit transformation. Heterogeneity was assessed using Cochran's Q, Tau², and I². Sensitivity analyses included subgrouping by hyperuricemia threshold and leave-one-out analysis. Eleven studies involving 1,099 women with preeclampsia from seven LMICs were included. The pooled prevalence of hyperuricemia was 53.47% (95% CI: 45.17% to 61.58%), with low-to-moderate heterogeneity (I² = 27.47%, p = 0.204). Included studies used different diagnostic thresholds for hyperuricemia, ranging from 5.0 to 7.0 mg/dL. All studies were hospital-based, and reporting of gestational age at the time of uric acid measurement was inconsistent. Hyperuricemia was common among women with preeclampsia in hospital-based LMIC studies. These findings describe prevalence only and should not be interpreted as evidence of diagnostic accuracy, prognostic performance, or clinical utility. Future studies should standardize diagnostic thresholds and report gestational timing of uric acid measurement more consistently.
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The timing of a woman's first marriage is a critical demographic event with profound implications for health, fertility, and socio-economic development. In Somalia, where early marriage is prevalent, a nuanced understanding of its associated factors is essential for developing effective policies. This study aims to identify the factors associated with the time to first marriage among Somali women using parametric Weibull survival analysis. This study utilized data from the 2020 Somali Demographic and Health Survey (DHS) for 16,428 women aged 15-49. Survival analysis was employed to model time from birth to first marriage. After evidence of non-proportionality in the Cox proportional hazards model, parametric survival models were compared, and the Weibull proportional hazards model was retained as the best-fitting hazard-based model according to the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). The median age at first marriage was 20 years (Interquartile Range [IQR]: 15-24). The multivariable Weibull analysis revealed that secondary (adjusted Hazard Ratio [aHR] = 0.75; 95% confidence interval [CI]: 0.67-0.84) and higher education (aHR = 0.54; 95% CI: 0.46-0.64) and belonging to the rich wealth category (aHR = 0.88; 95% CI: 0.82-0.93) were significantly associated with a lower hazard of early marriage. Conversely, illiteracy (aHR = 1.21; 95% CI: 1.13-1.29), lack of radio exposure (aHR = 1.16; 95% CI: 1.07-1.25), and living in a nomadic community (aHR = 1.10; 95% CI: 1.03-1.18) were associated with a higher hazard. Regional heterogeneity was observed, with women in the Bay region facing a more than three-fold higher hazard of early marriage compared to those in Awdal (aHR = 3.23; 95% CI: 2.76-3.78). Education and household wealth are critical protective factors against early marriage in Somalia. However, the strong association with illiteracy, nomadic lifestyles, lack of media exposure, and extreme regional disparities highlights the need for tailored, context-specific interventions beyond uniform national policies. Programs should prioritize increasing girls' access to education while addressing the unique circumstances of nomadic populations and high-prevalence regions.