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Achondroplasia (ACH) is the most common skeletal dysplasia characterized by disproportionate short stature due to impaired endochondral ossification. One of the most critical and potentially fatal complications of ACH is foramen magnum and upper cervical canal stenosis. Compression at the cervicomedullary junction may lead to myelopathy, hypotonia, developmental delay, and central sleep apnea. Early detection and timely surgical intervention are essential to prevent permanent neurological injury. This retrospective study evaluated 15 pediatric patients with ACH (9 girls, 6 boys; age range 3-42 months, mean 17.2 months) who underwent foramen magnum decompression and C1 laminectomy at Marmara University Neurosurgery Department between 2016 and 2025. All patients underwent comprehensive neurological and radiological evaluation, including MRI and 3D CT of the craniovertebral junction, and were classified by the Achondroplasia Foramen Magnum Score (AFMS). Nine patients had AFMS level 4 stenosis and six had level 3. The anteroposterior diameter of the foramen magnum ranged from 4.03 to 11.03 mm, with an area between 17.40 and 105.16 mm2. Presenting symptoms included motor delay (n = 4), respiratory disturbances or central apnea (n = 4), and macrocephaly (n = 3). Postoperative imaging confirmed adequate decompression in all patients. Neurological and respiratory improvement occurred in all patients except one with persistent hypotonia. One patient died early postoperatively due to recurrent pneumonia and sepsis. Complications were minimal. Foramen magnum decompression with C1 laminectomy is a safe and effective procedure for infants and children with achondroplasia presenting with cervicomedullary compression. Early radiological and neurological evaluation, particularly with AFMS, facilitates accurate surgical decision-making and improves outcomes.

The RxPONDER trial established that adjuvant chemotherapy does not confer survival benefit in postmenopausal women with hormone receptor-positive (HR+)/HER2-negative breast cancer, 1-3 positive lymph nodes, and a low 21-gene Recurrence Score (RS ≤ 25). Whether these findings have been adopted in routine clinical practice in Asian populations remains unclear. We conducted a multicentre retrospective cohort study of postmenopausal Chinese patients with HR+/HER2-breast cancer and limited nodal involvement who underwent surgical treatment and Oncotype DX testing between 2017 and 2023. Among 385 eligible patients, 54.8% had an RS ≤ 25, yet 46.4% of this low-genomic-risk group received adjuvant chemotherapy. Chemotherapy use declined substantially following publication of RxPONDER, indicating a marked shift in treatment patterns. Importantly, no disease-free survival (DFS) benefit was observed with chemotherapy in patients with RS ≤ 25. Multivariable analyses revealed that higher nodal burden, high histologic grade, and low progesterone receptor expression independently influenced chemotherapy decision-making despite low genomic risk. These real-world data provide supportive evidence consistent with the RxPONDER findings in a Chinese population; however, given the relatively short follow-up duration, longer-term outcomes are warranted to further substantiate these observations.

Pediatric femoral neck fractures require stable fixation to avoid complications. It remains unclear whether fixation with the Proximal Humeral Internal Locking System (PHILOS) can serve as an alternative to cannulated screw fixation. The purpose of this study was to compare the biomechanical properties of PHILOS and cannulated screws for stabilizing unstable pediatric femoral neck fractures using a synthetic bone model. Twelve fourth-generation synthetic composite femurs were randomly assigned to screw fixation (Group S) or PHILOS fixation (Group P) (n = 6 each). A standardized vertically oriented Delbet type II osteotomy was created in all specimens. Group S was fixed with three 6.5-mm cannulated screws, whereas Group P received a PHILOS plate with 3.5-mm locking screws. Each specimen underwent a standardized loading protocol using a universal testing machine. Axial stiffness, cyclic displacement, ultimate failure load, and failure modes were recorded and statistically compared between groups. No statistically significant difference was found in axial stiffness between Group P (746 ± 300 N/mm) and Group S (753 ± 256 N/mm) (p = 1.000). Displacement after cyclic loading was significantly greater in Group P (1.42 ± 0.3 mm) compared with Group S (0.57 ± 0.2 mm) (p = 0.004). The ultimate failure load was higher in Group S (2378 ± 513 N) than it was in Group P (1652 ± 206 N) (p = 0.025). Upon reaching ultimate load, all specimens in both groups failed at the femoral head region due to femoral head broken. The adult PHILOS plate with 3.5-mm locking screws demonstrated inferior biomechanical stability compared with three 6.5-mm cannulated screws in this synthetic composite femur model. Controlled laboratory study.

The paper is an analytical study of a low-pass electrical model of nonlinear type in a fractional perspective, in which the classical derivative is generalized to the Katugampola fractional operator. Precise traveling-wave solutions are built based on an extended Riccati-Bernoulli sub-ODE scheme together with a Bäcklund transformation. The families of obtained solutions contain bright and dark kink type structures. These solutions have a dynamical behavior that is demonstrated with the help of detailed 3D and 2D visualizations. The 3D plots reveal how sensitive the integer-order parameter is to the waveform whereas the 2D plots show how sensitive the waveform is to the changes in the fractional order (α). To deeper examine the qualitative dynamics, a hamiltonian formulation is created and phase-portrait diagrams are plotted. These unveil the local and global organization of the nonlinear flow underlying. Besides, chaotic behavior is also studied by analyzing sensitivity to initial conditions by determining the largest Lyapunov exponent [Formula: see text]. The findings validate the occurrence of regular, quasi-periodic and chaotic regimes in the parameter space. The entire process of analytical calculations and visualization is implemented in MATLAB, which provides the numerical accuracy of calculations and high-resolution graphical confirmation of fractions solutions. The results illustrate the presence of significant enrichment of the dynamical behavior of the nonlinear electrical model by the fractional extension. It also offers a practical and efficient model to study intricate waves phenomena in the systems of the fractional-order.

Epicardial radiofrequency ablation can fail when lesions are not sufficiently deep or transmural, yet intraoperative feedback remains largely indirect. This study presents a fiber-based, side-viewing near-infrared spectroscopy (NIRS) probe with multiple source-detector separations (SDS) to enable depth-sensitive mapping of lesions on the porcine left-ventricular epicardium. Monte Carlo simulations predicted progressively deeper sampling with increasing SDS, motivating the use of multi-separation acquisition for depth-resolved contrast. Experiments were performed on 11 porcine hearts with 133 irrigated epicardial lesions spanning a wide depth range, with lesion depth ground truth reconstructed from post-stain gross section measurements. SDS-dependent spectral signatures were observed across lesions with depths greater than 4 mm, lesions with depths ≤ 4 mm, adipose tissue, and untreated epicardial muscle, and optical indices capturing these patterns were identified for lesion and adipose classification, as well as for lesion-depth sensitivity. Lesion and adipose indices achieved strong receiver operating characteristic (ROC) performance across SDS (lesion AUC 0.87-0.91; adipose AUC 0.94-0.97), and depth-sensitive indices exhibited monotonic trends with lesion depth (R² up to 0.97). Applying a random forest lesion mask enabled depth-sensitive maps that were consistent with variations in the ground truth.

Light pollution has been implicated in liver health. This study aimed to investigate the association between bedroom nighttime light pollution and the risk of hepatic encephalopathy (HE) in patients with hepatocellular carcinoma (HCC). A total of 454 HCC patients were enrolled from communities. Bedroom nighttime light intensity was measured using an illuminometer (lux) at baseline, 2 months, and 4 months. Sleep quality was assessed at these three time points using the Pittsburgh Sleep Quality Index. These data at different time points were averaged separately for subsequent analyses. All patients were followed up for 12 months from baseline (unless death occurred), and HCC-related adverse outcomes were recorded. Multivariate logistic and Cox regression were adopted for statistical analysis. The results indicated that higher mean bedroom nighttime light intensity (> 50 lx) was significantly associated with an increased risk of both overt HE and minimal HE. Furthermore, it was associated with impaired liver function, esophagogastric variceal bleeding, and elevated HCC-related mortality. Notably, interaction analysis revealed that age and TNM stage may modify the aforementioned associations to some extent. In conclusion, bedroom nighttime light pollution is linked to an elevated risk of HE and may represent a potential risk factor warranting future validation.

BACKGROUND This retrospective study aimed to radiographically compare injectable platelet-rich fibrin (I-PRF)-enriched bone graft matrix (sticky bone) with conventional particulate grafting during lateral sinus lift procedures performed simultaneously with implant placement in patients exhibiting insufficient posterior maxillary residual bone height. MATERIAL AND METHODS Twenty-four systemically healthy, non-smoking patients who underwent lateral sinus lift surgery between January 2014 and June 2023 were included. Patients were retrospectively allocated into groups according to grafting material: conventional particulate bone graft (group 1, n=12) and I-PRF-enriched bone graft matrix (sticky bone) (group 2, n=12). Radiographic bone height measurements were obtained using panoramic radiographs acquired preoperatively, immediately postoperatively, and at 6 months postoperatively. Measurements were conducted using calibrated digital software. Inter- and intragroup comparisons were analyzed via paired and independent samples t-tests, using a statistical significance threshold of P<0.05. RESULTS Immediate postoperative bone gain was significantly higher in group 1 than in group 2 (11.94 mm vs 10.15 mm; P<0.05). However, bone resorption at 6 months was significantly greater in group 1 than in group 2 (2.61 mm vs 1.07 mm; P<0.05). Bone loss percentage also was significantly higher in group 1 than in group 2 (16.50% vs 7.74%; P<0.05), indicating superior bone preservation in group 2. CONCLUSIONS Although conventional grafting resulted in greater initial bone gain, I-PRF-enriched bone graft matrix demonstrated significantly reduced bone resorption at 6 months. Sticky bone may provide a clinical advantage in bone preservation after sinus lift procedures.

Non-small cell lung cancer (NSCLC) remains one of the leading causes of cancer-related mortality worldwide. However, the diagnostic sensitivity and specificity of commonly used tumor markers, such as carcinoembryonic antigen (CEA) and cytokeratin-19 fragment (CYFRA21-1), remain limited. This study aimed to evaluate the diagnostic value of serum exosomal 3'tiRNA-PheGAA and interleukin-6 (IL-6), alone and in combination with conventional tumor markers, for the detection of NSCLC. Peripheral blood samples were collected from 110 patients with NSCLC and healthy controls. Serum exosomes were isolated, and the expression of 3'tiRNA-PheGAA was measured using quantitative real-time polymerase chain reaction (qRT-PCR). Serum levels of CEA, CYFRA21-1, and IL-6 were determined by electrochemiluminescence immunoassay (ECLIA). The diagnostic performance of individual and combined biomarkers was evaluated using receiver operating characteristic (ROC) curve analysis. Serum levels of 3'tiRNA-PheGAA, IL-6, CEA, and CYFRA21-1 were significantly higher in NSCLC patients than in healthy controls (P&#x2009;<&#x2009;0.0001). ROC analysis showed that the area under the curve (AUC) values for 3'tiRNA-PheGAA and IL-6 were 0.680 and 0.898, respectively. The combination of 3'tiRNA-PheGAA and IL-6 increased the AUC to 0.926, while the four-marker panel (3'tiRNA-PheGAA, IL-6, CEA, and CYFRA21-1) achieved the highest diagnostic performance with an AUC of 0.971. Serum exosomal 3'tiRNA-PheGAA and IL-6 may serve as promising non-invasive biomarkers for NSCLC diagnosis, and their combination with conventional tumor markers significantly improves diagnostic accuracy.

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Tanzania has adopted artificial intelligence (AI)-assisted chest X-ray screening for tuberculosis (TB), including the use of CAD4TB version 6, which is registered by the Tanzania Medicines and Medical Devices Authority (TMDA). While GeneXpert, practical reference standard used in routine practice, remains the primary bacteriological confirmatory test in routine practice, there is currently no established national threshold for CAD4TB use in either active case finding (ACF) or passive case finding (PCF) settings. This study evaluates the implementation and operational use of CAD4TB version 6 within mobile TB screening units in Tanzania and highlights challenges affecting its effective use. We conducted a retrospective analysis of screening data from 11,923 individuals collected from mobile clinics equipped with digital X-ray, CAD4TB version 6, and GeneXpert systems. Comparisons were made between manual chest X-ray interpretation, CAD4TB scores, and GeneXpert results within the subset of individuals who underwent confirmatory testing. The findings reveal substantial inconsistencies in screening workflows, including non-uniform use of CAD4TB prior to GeneXpert testing, missing radiological records, and deviations from intended protocols across sites. Descriptive analysis showed that CAD4TB scores generally aligned with GeneXpert-positive cases within the tested subset; however, due to selective application of GeneXpert and incomplete data, these observations cannot be interpreted as measures of diagnostic accuracy. This study should be interpreted as an implementation and operational assessment of AI-assisted TB screening rather than a diagnostic accuracy or threshold-setting study. The findings highlight important gaps in protocol adherence, data completeness, and workflow standardization, underscoring the need for prospective, protocol-driven studies to establish validated national thresholds for CAD4TB use in Tanzania.

To evaluate the prevalence of degenerative bony changes of the mandibular condyle and their associations with age, gender, and joint laterality. CBCT scans of 112 temporomandibular joints of 56 clinically symptomatic patients were included based on predefined inclusion and exclusion criteria. Degenerative changes, including erosion, flattening, osteophytes, subchondral sclerosis, and subcortical pseudocysts, were assessed for their presence, frequency, and demographic associations using the Chi-square test, McNemar test, Spearman's correlation analysis, and Cohen's kappa statistics. Erosion was the most prevalent finding (84.8%) and frequently coexisted with flattening. Subcortical pseudocyst showed a positive association with increasing age (p&#x2009;<&#x2009;0.05), osteophytes were more commonly observed in males (p&#x2009;<&#x2009;0.01), and subchondral sclerosis occurred more frequently on the left side (p&#x2009;<&#x2009;0.05). Symptomatic TMJs demonstrated at least one degenerative change, where Erosion was the most prevalent, and subcortical pseudocyst was the least common degenerative change in the mandibular condyle. Age, gender, and joint side showed associations with specific changes.

Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival rate of 13%. Surgical resection followed by adjuvant chemotherapy remains the only curative approach. However, complications such as postoperative pancreatic fistula (POPF) and postpancreatectomy hemorrhage (PPH) often delay or prevent further treatment. Reliable preoperative biomarkers for predicting these complications are lacking. This study investigated soluble CD40 (sCD40) as a potential predictive marker for pancreas-specific complications after pancreatoduodenectomy (PD) in patients with PDAC. Preoperative serum samples from 185 patients with PDAC undergoing pylorus-preserving pancreatoduodenectomy or a Whipple procedure were analyzed using enzyme-linked immunosorbent assay to quantify sCD40 levels. Clinical and postoperative data were systematically collected and classified. Of the 185 patients, 151 underwent pylorus-preserving PD and 34 a Whipple procedure. Clinically relevant POPF occurred in 9.7% and PPH in 7.6% of patients. Preoperative sCD40 levels were significantly lower in patients who developed POPF or PPH (P&#x202f;=&#x202f;0.025 and P&#x202f;=&#x202f;0.008). The association remained significant in multivariable analysis. Receiver operating characteristic analysis demonstrated an area under the curve of 0.660 for sCD40. Adding leukocytes and body mass index improved predictive performance (area under the curve 0.705 for POPF and 0.752 for PPH). Reduced preoperative sCD40 serum levels are associated with a higher risk of POPF and PPH after PD. Combining sCD40 with leukocytes and BMI may enhance preoperative risk assessment in patients with PDAC.

The optimal fixation method in total hip arthroplasty (THA) remains under debate. While cemented fixation has been associated with a lower risk of periprosthetic fracture, uncemented fixation predominates in Japan. This study aimed to compare early postoperative complications between cemented and uncemented fixation in elective THA using a nationwide inpatient database. We identified 198,102 patients aged&#x2009;&#x2265;&#x2009;65 years who underwent primary THA for osteoarthritis, osteonecrosis, or rheumatoid arthritis between December 2011 and March 2023 from the Japanese Diagnosis Procedure Combination (DPC) database. After 1:1 propensity score matching for age, sex, body mass index (BMI), and Charlson Comorbidity Index, 36,859 patients were included in each fixation cohort. Surgical and medical complications, and in-hospital mortality were compared using multivariate logistic regression. Cemented fixation was associated with a significantly lower risk of periprosthetic fracture (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.30-0.53; p&#x2009;<&#x2009;0.001), blood transfusion (OR, 0.76; 95% CI, 0.74-0.78; p&#x2009;<&#x2009;0.001), and deep vein thrombosis (OR, 0.79; 95% CI, 0.74-0.84; p&#x2009;<&#x2009;0.001). There were no statistically significant differences based on the predefined threshold (p&#x2009;<&#x2009;0.001) in dislocation, infection, pulmonary embolism, cardiac or cerebrovascular events, or in-hospital mortality between fixation types, although a trend toward higher in-hospital mortality in the cemented group was observed. Cemented THA was associated with reduced rates of periprosthetic fracture, transfusion, and deep vein thrombosis without increasing other perioperative or medical complications. These findings suggest that cemented fixation may be associated with favorable short-term outcomes in selected patients.

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality globally, particularly in women with antepartum hemorrhage (APH). Current risk assessment methods lack standardized predictive tools that are both simple and reliable for clinical application. We conducted a secondary analysis of a prospectively collected cohort of 100 pregnant women presenting with APH at &#x2265;28 weeks' gestation at a tertiary care centre in northern India. Multivariable logistic regression was used to identify significant predictors of PPH. A point-based clinical risk score was then developed based on the multivariable model and internally validated using bootstrap techniques with 1000 replicates. PPH occurred in 30% of patients (n=30). Multivariable analysis identified four independent predictors of PPH: maternal age (adjusted odds ratio [OR] 1.29 per year; 95% confidence interval [CI] 1.10-1.51; p=0.002), gravidity (OR 2.11 per unit; 95% CI 1.00-4.43; p=0.049), gestational age at delivery (OR 0.64 per week; 95% CI 0.44-0.94; p=0.021), and antepartum blood transfusion (OR 2.44; 95% CI 1.02-5.84; p=0.045). The prediction model demonstrated excellent discrimination with an area under the receiver operating characteristic (ROC) curve of 0.86 (95% CI 0.80-0.92) and good calibration (slope 0.95). Bootstrap internal validation yielded an optimism-corrected AUC of 0.84. The resulting four-factor risk score stratified patients into four risk categories with PPH rates ranging from 4% (low risk) to 100% (very high risk). The four-variable score provides an accurate, easily applicable tool with excellent predictive performance. The score is a promising tool that, pending external validation, may facilitate early identification of high-risk patients and improve maternal outcomes. Further research should focus on external validation of this tool in diverse populations and its integration into clinical practice.

The study presents experience in using a wound protector device named lap-protector during costal cartilage harvest in auricular reconstruction in order to improve outcomes, particularly final scar quality and length. The present study retrospectively comprised fifty-five patients who underwent costal cartilage harvesting for auricular reconstruction were admitted between June to August 2022. The author divided the patients into 2 groups according to whether the lap-protector was used or not: group 1 underwent costal cartilage with the minimal invasive conventional technique by using the lap-protector, while group 2 underwent the same procedure without. Patients were followed-up for a 6-months period. The time of surgery, the amount of blood loss during surgery, postoperative pain, donor-site scar quality and length were recorded and measured for both groups. Twenty-five patients with lap-protector were compared to thirty without. There were no significant differences between the two groups in the demographic of patient characteristics (P&#x2009;>&#x2009;0.05). The score of pain dropped steadily over the 5 days in both groups, and patients in group 1 reported a lower level of pain in the following days compared with group 2 (P&#x2009;<&#x2009;0.05), except the fifth day. In those without, the length of the scar on average was 5.43&#x2009;&#xb1;&#x2009;0.44&#xa0;cm, which was longer than the average 3.61&#x2009;&#xb1;&#x2009;0.29&#xa0;cm in group 1 (P&#x2009;<&#x2009;0.05). Analysis of VSS results showed a better formation of the scar in the group1 (P&#x2009;<&#x2009;0.05). The differences in postoperative pain, scar length and quality between the two groups were statistically significant(P&#x2009;<&#x2009;0.05). There were no differences between the two groups in terms of the operation time and the amount of bleeding during the operation (P&#x2009;>&#x2009;0.05). The application of lap-protector in costal cartilage harvest can optimize the scar formation and reduce postoperative pain without prolonging the operative time, which is a convenient and effective technique for achieving satisfactory results.

Therapeutic plasma exchange (TPE) is being increasingly utilized in the clinical management of severe rheumatic immune diseases, providing an effective means for rapidly removing pathogenic autoantibodies and inflammatory mediators. However, the non-selective nature of this technique can also lead to the unintended clearance of concomitantly administered antirheumatic drugs, potentially compromising therapeutic efficacy and disease control. Therefore, effective management of potential drug removal process during TPE and the implementation of individualized risk assessment are crucial for optimizing treatment outcomes in patients undergoing TPE. The variability in the extent of drug removal during TPE is primarily determined by their distinct pharmacokinetic characteristics, necessitating the establishment of a systematic, evidence-based strategy for adjusting drug administration regimens in patients receiving TPE treatment. This review synthesizes current evidence from 65 studies on the removal of antirheumatic drugs during TPE, identifying key determinants influencing clearance rates, including volume of distribution, protein binding, molecular size, and elimination half-life. Our analysis reveals that the risk of drug removal exists as a continuous spectrum: large monoclonal antibodies (e.g., rituximab, natalizumab), characterized by a large molecule size, low volume of distribution, with which mostly confined to the vascular space, are cleared with high efficiency. This finding supports the clinical recommendation of administering such drugs after TPE. For drugs with limited direct evidence, we propose a predictive model based on fundamental pharmacokinetic parameters to estimate their removal risk and guide clinical decision-making. Based on this evidence, we have constructed a stratified clinical management framework. It aims to maintain effective therapeutic drug exposure levels during chronic TPE therapy and to provide a rationale for the judicious application of TPE in overdose scenarios. Implementing this pharmacokinetic-informed, risk-adapted individualized strategy is important for ensuring treatment continuity, enhancing patient safety, and advancing empiricism-based therapy towards precision medicine.

High-risk stage II colorectal cancer (CRC) shows heterogeneous outcomes despite adjuvant chemotherapy. We developed and validated an interpretable multimodal deep learning model integrating clinical data, serum biomarkers, and venous-phase CT to predict 5-year CRC-specific mortality in high-risk stage II CRC. This retrospective, multicenter cohort included 778 high-risk stage II CRC patients from three centers, all treated with adjuvant chemotherapy and with complete preoperative clinical, biomarker, and venous-phase CT data. Patients were split into a development cohort (Centers A&#x2009;+&#x2009;B, n&#x2009;=&#x2009;720) and an external testing cohort (Center C, n&#x2009;=&#x2009;58). A multimodal model combining numerical (clinical&#x2009;+&#x2009;biomarker) and imaging (CT) inputs was developed and internally validated using tenfold cross-validation in the development cohort and evaluated in the external cohort. Interpretability was assessed using SHAP and Grad-CAM. In the development cohort, the multimodal model showed superior discrimination (AUC 0.89; 95% CI, 0.87-0.91) versus numerical-only (AUC 0.76) and imaging-only (AUC 0.69). In the external testing cohort (9/58 CRC-specific deaths), the multimodal model achieved an AUC of 0.88 (95% CI, 0.76-0.96). SHAP and Grad-CAM consistently highlighted age, CA125, and tumor regions on CT as key contributors. This interpretable multimodal approach, using routine clinical, biomarker, and CT data, improves 5-year mortality risk stratification in high-risk stage II CRC and may inform risk-adapted surveillance and clinical decision support; prospective validation is warranted before treatment modification.

Alzheimer's disease (AD) is a growing public health concern, with neuroinflammation implicated in its pathogenesis. Allergic rhinitis (AR), a prevalent chronic inflammatory disorder, may contribute to systemic inflammation and potentially influence AD risk. This study sought to critically assess the association between a history of AR and subsequent AD development in a large, representative Taiwanese cohort. Leveraging Taiwan's National Health Insurance Research Database (LHID2010), this nationwide case-control study identified 4,681 individuals aged&#x2009;&#x2265;&#x2009;65 years with a first-time AD diagnosis (cases) and 14,043 propensity-score-matched controls. A rigorous definition of prior AR required at least two clinical diagnoses, including one by an otolaryngology specialist. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for potential confounders. The prevalence of prior AR was significantly higher in AD patients than in controls (25.29% vs. 21.01%, p&#x2009;<&#x2009;0.001). Following meticulous adjustment for demographic variables, socioeconomic status, geographic factors, and medical comorbidities (including hyperlipidemia, diabetes, coronary heart disease, hearing loss, and hypertension), prior AR was robustly associated with elevated odds of AD (adjusted OR&#x2009;=&#x2009;1.279, 95% CI&#x2009;=&#x2009;1.182&#x2009;~&#x2009;1.384). This association remained significant for both males (adjusted OR&#x2009;=&#x2009;1.196, 95% CI&#x2009;=&#x2009;1.053&#x2009;~&#x2009;1.358) and females (adjusted OR&#x2009;=&#x2009;1.339, 95% CI&#x2009;=&#x2009;1.210&#x2009;~&#x2009;1.482). This study suggests a significant association between prior AR and an increased odds of developing AD in an elderly Taiwanese population. These findings highlight chronic peripheral inflammation as a factor potentially associated with neurodegeneration.

Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal tumors composed of cells exhibiting an epithelioid morphology. These cells typically arrange around small blood vessels (perivascular spaces) and display dual differentiation characteristics of smooth muscle cells and melanocytes. Diagnosis is challenging due to the absence of specific symptoms or tumor markers. This case features a young male patient with a large hepatic PEComa, whose imaging findings resemble those of hepatocellular carcinoma. We have detailed the entire process from diagnosis to treatment to aid in differential diagnosis and surgical planning. A 31-year-old male patient with no prior medical history underwent a routine health examination 20&#xa0;days prior to presentation. Although the patient was asymptomatic, ultrasound revealed an incidental hepatic lesion measuring 58&#x2009;&#xd7;&#x2009;50&#x2009;&#xd7;&#x2009;45&#xa0;mm (maximum diameter 58&#xa0;mm, or 5.8&#xa0;cm). The screening center suspected a hemangioma. Subsequently, he presented to our hospital. Comprehensive imaging studies, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI), revealed a 58&#xa0;mm-diameter space-occupying lesion in segments V and VIII of the right hepatic lobe. Imaging findings initially raised suspicion for hepatocellular carcinoma. To minimize surgical trauma and preserve liver function, our team discussed surgical approaches and ultimately decided on a laparoscopic partial hepatectomy. During the procedure, we obtained a specimen for pathological examination. The final histopathological analysis confirmed the diagnosis of a PEComa with undetermined malignant potential. The patient recovered smoothly postoperatively and was successfully discharged. PEComa has an insidious onset and is rare. Early diagnosis is often challenging, and imaging studies typically show no highly specific findings. Clinical diagnosis frequently relies on biopsy. In terms of treatment, radical resection (R0 resection, i.e., negative margins) represents the definitive therapeutic approach.