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Noncommunicable diseases (NCDs) account for the majority of morbidity, mortality, and health expenditures, yet progress toward international reduction targets remains limited. Although evidence-based strategies for prevention and long-term management are well-established, health systems predominantly remain biomedical and fragmented across clinical, public health, and community sectors. This structural misalignment constrains the ability to scale prevention and deliver coordinated chronic disease management. This paper proposes "Operation Whole Health" as a framework for a paradigm shift in the health care system. Drawing on lessons from the coordinated mobilization observed in the United States during the COVID-19 response, the framework emphasizes the importance of mission clarity, cross-sector workforce integration, and sustained financing to achieve significant and scalable change. Whole health models-person-centered, interprofessional, and prevention-oriented-offer a mechanism for aligning clinical care with behavioral, social, and community determinants of health. Expanding prevention capacity includes systematic integration of traditional, complementary, and integrative medicine professionals, whose competencies align with chronic disease prevention but remain underutilized within publicly financed systems. Because effective whole health interventions for NCDs are known, a key constraint in widespread implementation may be policy prioritization rather than scientific uncertainty. A structural redesign of health care anchored in the whole health paradigm may be needed to alter NCD trajectories and stabilize long-term health expenditures.

Low-density lipoprotein cholesterol (LDL-C) is an established therapeutic target for atherosclerotic cardiovascular diseases (ASCVD), particularly in high-risk individuals. In 2022, the Japan Atherosclerosis Society Guidelines (JAS-GL) for Prevention of Atherosclerotic Cardiovascular Diseases introduced more stringent LDL-C targets to reduce ASCVD. We evaluated the non-achievement rates of the LDL-C goals across risk groups using a nationwide real-world dataset, which included a broad range of ASCVD patients. This retrospective, cross-sectional study included 200,607 adults (aged ≥18 years) with dyslipidemia. Patients were stratified according to the JAS-GL 2022 into a high-risk primary prevention population (Groups I, II, and familial hypercholesterolemia [FH]: no history of coronary artery disease [CAD] or stroke, classified by comorbidities such as diabetes), and a secondary prevention population (Groups III and IV: history of CAD or stroke, with Group IV having additional conditions such as diabetes). The primary endpoint was the proportion of patients who did not achieve their target LDL-C goals. Non-achievement rates were 28.2% (Group I), 46.7% (Group II), 64.3% (Group FH), 30.0% (Group III), and 65.6% (Group IV). Importantly, these rates remained high and showed little change before and after the revision of the guidelines across all studied risk groups. Non-achievement of LDL-C targets remained high despite updated recommendations. These findings highlight a need for more effective implementation strategies and sustained efforts to improve lipid management.

Early childhood caries (ECC) remains one of the most prevalent chronic diseases affecting children worldwide and represents a major public health challenge in many African settings. Understanding its determinants is essential for developing oral health promotion strategies and preventive policies aimed at improving child oral health and reducing inequalities. This umbrella review followed PRISMA guidelines and was registered in PROSPERO (CRD420261379153). Systematic reviews and meta-analyses published between January 2000 and May 2026 were identified through searches of MEDLINE, Scopus, Web of Science, and Embase. Methodological quality was assessed using AMSTAR 2, risk of bias using ROBIS, overlap using a citation matrix and corrected covered area (CCA), and certainty of evidence using a narrative GRADE approach. Findings were synthesized narratively. Seven systematic reviews and meta-analyses were included. Methodological quality ranged from high to critically low, while ROBIS identified predominantly low overall risk of bias, although two reviews were judged to be at high risk of bias. The corrected covered area (CCA) was 4.7%, indicating a low degree of overlap among reviews. ECC prevalence ranged from 17% to 57%, with higher estimates reported in North and Southern Africa. The most consistently reported determinants were dietary, oral hygiene-related, sociodemographic, and breastfeeding and bottle-feeding-related factors, whereas maternal/caregiver-related, biological, health-related, and contextual determinants were supported by a smaller body of evidence. Certainty of evidence was moderate for ECC prevalence and the most consistently reported determinants, but low for maternal/caregiver-related, health-related, biological, and contextual determinants. These findings support evidence-informed oral health promotion and prevention strategies across African settings. ECC remains a substantial oral health burden in Africa and is influenced by interacting behavioral, sociodemographic, caregiver-related, biological, health-related, and healthcare access determinants. Comprehensive oral health promotion strategies should strengthen caregiver education, support healthy dietary and oral hygiene behaviors, improve access to preventive services, and integrate oral health into maternal and child health programs. Such approaches may help reduce ECC burden and oral health inequalities among vulnerable populations. PROSPERO, identifier CRD420261379153, http://www.crd.york.ac.uk/PROSPERO/view/CRD420261379153.

Coal, as a porous medium, exhibits a strong adsorption capacity for gas. The laws governing gas adsorption and transport are critical research topics for gas disaster prevention and control, as well as for coalbed methane (CBM) extraction. This study takes coal samples from the Guobei Mine as the research subject. Isothermal adsorption experiments under constant pressure conditions were conducted on coal particles of different sizes to investigate the influence of particle size and initial pressure on gas adsorption capacity and adsorption rate. Based on the density gradient diffusion theory, mathematical models for gas adsorption in both cylindrical and spherical coal particles were established. These models were nondimensionalized, solved using the finite difference method for simulation analysis, and subsequently validated against experimental results. The research indicates that under the same initial pressure, smaller coal particle sizes result in a larger cumulative adsorption capacity and a faster adsorption rate. For particles of the same size, a higher initial pressure leads to a greater saturated adsorption capacity and a shorter time to reach adsorption equilibrium. The cumulative gas adsorption capacity conforms to an empirical model where ″the reciprocal of adsorption capacity shows a linear relationship with 1/t0.65″. The simulation results for cylindrical and spherical particles show a high degree of agreement. Under different initial pressures, the nondimensional pressure for both shapes follows a consistent pattern: "rapid surface response → internal gradient transmission → overall trend toward equilibrium". The equilibrium nondimensional time is approximately 0.08982 at 4.0 MPa, and ranges between 0.3 and 0.45 at 0.5 MPa, with the radial pressure gradient decay rate being consistent. The initial slope, equilibrium time, and saturated adsorption capacity of the nondimensional cumulative adsorption curves are essentially identical. For 50-60 mesh coal samples at 2 MPa, the deviation in the adsorption cycle is less than 0.05 cm3/g, confirming that particle shape has no significant effect on gas adsorption and transport. The established model accurately captures the dynamic characteristics of gas transport. The fit between simulated and experimental values is excellent, with R 2 > 0.99 and an average relative error of only 3.2%. This work breaks through the limitation of the "single spherical particle" assumption, enhances the applicability of the density gradient diffusion theory, and provides reliable theoretical support for the optimization of CBM extraction and gas disaster prevention and control.

Osteoporosis (OP) persists as the principal contributor to the global disease burden. OP is defined by reduced bone mass and impaired bone microarchitecture, thereby weakening bone strength and elevating fracture risk. Imbalanced bone remodeling is the major pathological mechanism of OP, in which osteoclast-mediated bone resorption exceeds osteoblast-mediated bone formation. Iron serves as a vital micronutrient for numerous biochemical activities and is essential for many cellular processes. Ferroptosis is an iron-dependent form of modulated cell death with unique traits, including disrupted iron balance, compromised antioxidant defenses, and aberrant lipid peroxidation. Ferroptosis participates in various physiological and pathological processes, and its role in bone-related diseases, particularly OP, is increasingly being explored. Hence, a systematic examination of the mechanisms modulating ferroptosis in OP is imperative to pinpoint potential therapeutic targets and innovate novel therapeutic and/or preventive strategies. The agents currently used to treat OP have numerous side effects, prompting increased research on natural compounds for OP treatment. This review systematically summarizes the key features and modulation mechanisms of ferroptosis based on the latest research advances, and explores its pathogenic implications and therapeutic opportunities in OP. Additionally, we also discussed investigations of natural products in vitro and in vivo to prevent OP by interfering with ferroptosis.

Coronary heart disease (CHD) is a major cause of morbidity and mortality worldwide. Regular physical activity (PA) is a vital component of secondary prevention, yet adherence among patients remains low. The study aimed to gain a deeper understanding of barriers to PA among Jordanian patients with CHD. A qualitative descriptive design was used. Semi-structured interviews were conducted with 22 patients recruited from outpatient medical clinics, and data were analyzed thematically. The main theme of the findings was "Barriers to PA of CHD." Five sub-themes were identified: Psychological and Health-Related Barriers, Motivational Barriers, Lack of knowledge regarding PA, Perceived external obstacles,and Healthcare System-Related Barriers. Patients with CHD encountered psychological, educational, social, and system-level barriers to PA. Addressing these barriers required culturally tailored active and consistent healthcare counseling, appropriate education, and improved rehabilitation accessibility to increase adherence to PA and promote better secondary prevention outcomes.

Ultrafine particles (≤100 nm) and other environmental nanoparticles have emerged as biologically active pollutants that can cross biological barriers, including the blood-brain barrier and the placenta. Growing evidence implicates ultrafine particles in a wide range of neuropsychiatric conditions, yet their effects remain poorly integrated into clinical and public health frameworks. In this review, we distinguish between size-defined ultrafine particles (UFPs, ≤100 nm), composition-defined environmental nanoparticles originating from combustion and secondary formation processes, and engineered nanomaterials (ENPs), which differ in physicochemical properties, exposure scenarios, and regulatory status. This narrative systematic review synthesizes findings from human and experimental studies on the neuropsychiatric and neurodevelopmental effects of environmental nanopollutants. A structured search was conducted in PubMed, Web of Science, Scopus, and Google Scholar up to November 2025, following explicit inclusion and exclusion criteria. Eligible studies included peer-reviewed human and animal research assessing mental health or neurological outcomes of nanopollutant exposure. Epidemiological studiesprimarily involving traffic-related air pollution and mixed combustion-derived ultrafine particle exposuressuggest associations with increased risk of cognitive impairment, autism spectrum disorder, depression, schizophrenia, and neurodegenerative diseases, including Alzheimer's, Parkinson's, and amyotrophic lateral sclerosis. Prenatal and early life exposures were linked to cortical thinning, altered neurodevelopmental trajectories, and early proteinopathies. Underlying mechanisms include neuroinflammation, oxidative stress, and protein aggregation. Despite methodological heterogeneity, the evidence supports the urgent need for regulation and prevention. Environmental nanopollutants constitute an under-recognized, modifiable risk factor for neuropsychiatric and neurodegenerative conditions. A paradigm shift is needed to incorporate environmental exposure history into mental health research, risk assessment, and prevention strategies. Regulatory action targeting nanopollutant emission and exposure, particularly in vulnerable populations, is critical to mitigating long-term neurological consequences.

Iliotibial band syndrome (ITBS) is a prevalent overuse injury among runners, characterized by lateral knee pain and associated functional limitations. Rehabilitation strategies commonly include manual therapy and strength training, yet their comparative effectiveness remains under investigation. This study aims to evaluate the efficacy of these interventions in reducing pain and promoting functional recovery in runners with ITBS. The findings are intended to inform evidence-based treatment strategies and contribute to the prevention of symptom recurrence. Thirty-four runners diagnosed with ITBS were randomly assigned to two equal groups (n = 17). Group A received manual therapy, including deep friction massage, stretching, and soft tissue mobilization. Group B followed a structured strength training program that targeted the hip and knee. The Numerical Pain Rating Scale (NPRS) and Lower Extremity Functional Scale (LEFS) were used to evaluate pain and function, respectively, both before and after a 6-week intervention. Statistical analysis was conducted using the Wilcoxon signed-rank test and the Mann-Whitney U test. The study indicates that both groups exhibited significant improvements in pain and functional scores following the 6-week intervention. Participants in group A (manual therapy) demonstrated a statistically significant reduction in pain, measured by the NPRS (p = 0.002), and a significant improvement in function, as assessed by the LEFS (p = 0.002). In group B (strength training), there was a statistically significant improvement in both pain, as measured by the NPRS (p < 0.001), and function, as measured by the LEFS (p < 0.001). When comparing post-intervention results between groups, strength training demonstrated greater improvement than manual therapy in both NPRS and LEFS. Future research should consider including a third group that receives a combination of manual therapy and exercise to explore potential synergistic effects. This pilot study concludes that both manual therapy and strength training are effective in reducing pain and improving function in runners with ITBS. However, strength training demonstrated significantly greater benefits over a 6-week intervention period. These findings support the prioritization of hip- and knee-focused strengthening programs in short-term rehabilitation. Further studies with larger samples and longer follow-up periods are needed, including exploration of combined treatment approaches for potential synergistic health effects.

To investigate the mechanism by which gas hydrates nucleate within a coal matrix, a graphene slit model with properties similar to those of coal was constructed to represent the coal matrix in molecular dynamics simulations. Molecular dynamics simulations of gas hydrate formation were then conducted under different temperature and pressure conditions in both coal matrix systems and pure water systems. The results revealed that the pure water system generated significantly more clathrate cage structures than the coal system did. In the coal matrix, the evolution of density distribution reveals a competitive migration mechanism where methane transitions from "wall adsorption" to "hydrate cage trapping," ultimately concentrating in the center of fissures distant from hydrophobic surfaces. Kinetic analysis indicates that the self-diffusion coefficients of water and methane molecules in the coal system are significantly higher than those in the pure water system, confirming that the dense hydrate layer in pure water hinders mass transfer. Thermodynamically, coal systems consistently form hydrates at 250-260 K; however, above 270 K, cage formation is inhibited, evidenced by the disappearance of the second peak in the oxygen radial distribution function (RDF) and the drop in the F4 order parameter to liquid water levels. Within the 40-60 MPa range, pressure exerts minimal influence on hydrate structural order, far outweighed by temperature effects. This work provides molecular-level insights into the hydrate method for preventing coal and gas outbursts.

Groundwater in coal mining areas is extensively extracted to prevent coal roof water inrush, generating substantial volumes of mine water that must be properly managed and treated. Accurate hydrochemical assessment is therefore crucial for developing effective strategies for water resource protection and utilization. This study proposes an integrated groundwater quality assessment framework that synergistically combines the game theory combinatorial weighting method (GTCWM) with fuzzy comprehensive evaluation (FCE) and Order Preference by Similarity to an Ideal Solution (TOPSIS). Within this framework, GTCWM reconciles subjective weights derived from the analytic hierarchy process (AHP) with objective weights from the entropy weight method (EWM) through game theory optimization, providing a balanced weighting strategy for subsequent evaluation. FCE is then applied to classify water quality into discrete categories, while TOPSIS enables refined ranking of samples within the same quality class, thereby complementing the classification with finer differentiation. The framework was applied to assess the Carboniferous Shanxi Formation sandstone aquifer in the Huafeng coal mine. Results reveal severe groundwater quality degradation, with all samples exceeding Class V standards for TDS and 77.3% exceeding Class V for total hardness (TH). Na+, Cl- are identified as the predominant contaminants. Hydrochemical analysis indicates that water-rock interactions govern the hydrochemical evolution within this confined synclinal structure. The shallow southern aquifer receives lateral recharge and is influenced by silicate weathering, and halite/gypsum dissolution, whereas the deep northern aquifer exhibits stagnant conditions characterized by halite/gypsum dissolution, reverse cation exchange, and silicate weathering. GTCWM weight analysis identifies Cl-, TH, and Na+ as the key water quality parameters and thus the primary targets for treatment and resource recovery. GTCWM-FCE classification demonstrates that 81.8% of samples fall into Class V, indicating widespread contamination that renders the groundwater unsuitable for direct use without treatment. GTCWM-TOPSIS ranking further reveals substantial spatial heterogeneity. WQRI values range from 0.011 to 0.489 (a 45-fold difference), and exhibit a 12-fold variability within Class V samples. These findings underscore the need for differentiated management strategies. Accordingly, a tiered management strategy is proposed: minimal treatment and direct reuse for the southern high-quality zone (Class III-IV); conventional treatment and industrial reuse for the treatment-oriented zone (Class V, WQRI <0.356); and salt resource recovery (NaCl and Na2SO4) via membrane concentration and crystallization for the resource-oriented zone (Class V, WQRI >0.356). This dual-method framework provides a robust tool for groundwater quality evaluation in mining-affected areas, offering critical insights for targeted water treatment and resource utilization strategies that contribute to sustainable mining practices.

Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are two independent leading causes of morbidity and death, with co-existence contributing substantially to morbidity and deaths among aging populations. Despite growing evidence on the impact of COPD-CVD co-existence, little is known about COPD-CHD co-morbidity, as other previous studies mostly examine CVD as a single aggregated health outcome, obscuring disease-specific trajectories. To assess 5-year national trends and sociodemographic disparities in the prevalence of coexisting CHD-COPD co-morbidity. Using the 2020-2024 National Health Interview Survey Integrated Public Use Microdata Series adults' dataset, we estimated the national prevalence of CHD-COPD co-morbidity. Weighted descriptive statistics, multivariate regression models, and sensitivity analysis were used to examine the associations. CHD-COPD co-morbidity prevalence showed no statistically significant increase from 2020 to 2024; although the estimated linear trend was positive, it did not reach statistical significance (OR per 1-year increase&#x2009;=&#x2009;1.04; 95% CI: 0.997-1.08; p&#x2009;=&#x2009;0.072). Age, sex, body mass index, race/ethnicity, geographical region, smoking status, insurance status, income, and educational attainment were strong independent predictors of CHD-COPD co-morbidity. Older age (aOR: 1.004; 95% CI: 1.003-1.004, p&#x2009;<&#x2009;0.0001) was independently associated with higher odds; current and former smokers had approximately 5-6 times higher odds of CHD-COPD co-morbidity. CHD-COPD co-morbidity is a rare but clinically significant condition, with a stable adjusted prevalence of approximately 0.35%-0.43% annually among United States adults from 2020 to 2024. Smoking, older age, male sex, lower income, and Southern residence were the strongest independent predictors of CHD-COPD co-morbidity. These findings underscore the need for integrated, sociodemographically targeted prevention and chronic-disease management strategies addressing shared cardiopulmonary risk factors, particularly tobacco use, across vulnerable populations.

The prevalence of carbapenem-resistant Acinetobacter baumannii (CRAb) has been increasing globally. This study aimed to investigate the risk factors, resistance gene profiles, and molecular epidemiology of CRAb bloodstream infections (BSIs) among patients in Xi'an, China, to provide evidence for clinical prevention and targeted treatment. We conducted a retrospective study of 139 patients with A. baumannii BSIs. Patients were categorized into a CRAb group (n = 84) and a carbapenem-susceptible A. baumannii (CSAb) group (n = 55). Independent risk factors were identified via multivariate logistic regression analysis. Carbapenemase resistance genes were detected using polymerase chain reaction (PCR), and CRAb isolates were molecularly typed by multilocus sequence typing (MLST). Multivariate logistic regression analysis identified the following as independent risk factors for CRAb BSIs: inappropriate empirical antimicrobial therapy (OR = 8.620; 95% CI: 2.078-35.751), deep venous catheterization (OR = 12.625; 95% CI: 2.263-70.429), prolonged hospitalization before the onset of BSIs (OR = 1.467; 95% CI: 1.123-1.915), and ICU admission (OR = 4.981; 95% CI: 1.898-13.065). Antimicrobial susceptibility testing showed that CRAb isolates were multidrug-resistant, exhibiting resistance rates exceeding 70% to most common clinical antibiotics, with the exception of tigecycline (5.95% resistance) and colistin (27.38% resistance). All 84 CRAb isolates carried both blaOXA-51-like and blaOXA-23-like genes, while other carbapenemase genes were not detected. MLST identified 7 sequence types (STs), with ST540 (45.24%, 38/84) being the dominant clone. eBURST analysis indicated that the major STs (ST195, ST208, etc.) belonged to the same clonal complex. Inappropriate empirical antimicrobial therapy, deep venous catheterization, prolonged hospitalization before the onset of BSIs and ICU admission are independent risk factors for CRAb BSIs. The prevalent strains produce OXA-23-like carbapenemase, and molecular typing indicates that the ST540 clone and its related clonal complex are predominant, suggesting potential nosocomial clonal spread.

Gypsum scale (CaSO4&#xb7;2H2O) is a persistent and costly problem in industries such as oil and gas, power generation, and water treatment. Conventional removal strategies rely heavily on aminopolycarboxylate chelants such as EDTA, which, despite their effectiveness, present significant environmental drawbacks due to their persistence, potential for heavy metal mobilization, and high treatment costs. This study introduces a fully chelant-free gypsum remediation method based on potassium carbonate (K2CO3) combined with biodegradable carboxymethyl cellulose (CMC). Using in situ FT-IR spectroscopy, SEM/XRD characterization, and geochemical speciation coupled with microkinetic modeling, we elucidate the kinetics, mechanisms, and polymorph-selective pathways governing gypsum conversion. Carbonate bases, particularly K2CO3, achieved up to 96% conversion under ambient conditions, predominantly forming vaterite, which exhibited a markedly slower transformation to calcite compared to bicarbonate systems. The addition of CMC at optimized dosage prevented secondary blockages by maintaining converted particles in suspension, with only minimal impact on conversion efficiency. By integrating a chelant-free K2CO3 conversion process with mechanistic control over CaCO3 polymorphism and a biodegradable polymer-assisted dispersion step, this study delivers the first unified gypsum scale remediation strategy that achieves substantial cost savings, offering a promising chelant-free alternative for sustainable industrial flow assurance.

Cytokines represent a diverse group of soluble proteins that play crucial roles in mediating cellular communication in order to regulate cell fate, particularly in the context of the immune system. Because of their critical roles in controlling cell differentiation, proliferation, migration, activation, and survival, cytokines are heavily implicated in the development and progression, as well as in the prevention and clearance, of cancer. Using both native cytokines and engineered versions thereof, ongoing research in the cancer field endeavors to harness the antitumor activities of cytokines to develop targeted immunotherapies. This review surveys the biology of cytokines and their use in cancer treatment, covering several categories of cytokines, including interleukins, interferons, chemokines, growth factors, and hormones. Preclinical and clinical efforts with natural and engineered cytokines along with efforts to combine these molecules with other anticancer modalities are discussed, highlighting both the triumphs and challenges for these essential proteins in oncology applications.

Pregnant women with inflammatory bowel disease (IBD) and an ileal pouch-anal anastomosis (IPAA) often receive conflicting medical advice regarding mode of delivery, and healthcare providers may have diverging opinions. Cesarean delivery is commonly performed out of concern of injuring the anal sphincter during vaginal delivery, causing poorer long-term pouch function. This study aims to describe rates of vaginal and cesarean delivery, complication rates and assess the impact of pregnancy and delivery on pouch function for patients with IBD and an IPAA. This retrospective single center chart review study included patients with IBD, an IPAA, and a completed pregnancy between January 1, 2002 and February 1, 2021. Patient demographics, IBD diagnosis, IPAA procedure details, mode of delivery and complications, and pouch function surrounding pregnancy were compared using descriptive statistics. Sixty-two patients completed 85 pregnancies. Eighty-one percent of pregnancies had a cesarean delivery (69/85); of these, 51 (73.9%) were planned elective cesareans while 18 (26.1%) were urgent. Among the planned elective cesareans, 51.6% were indicated to prevent injury to the anal sphincter and preserve pelvic pouch function. Immediate risks of cesarean and vaginal delivery were similar to the general population. Rates of delivery intervention with episiotomy were high (50% of vaginal deliveries). All vaginal deliveries took place in the later 10&#x2009;years of the study period. Pouch function postpartum was infrequently documented. Pregnant patients with IBD and an IPAA frequently had a cesarean delivery, often to avoid anal sphincter injury from vaginal delivery and preserve pelvic pouch function. Delivery practices shifted in the past 10&#x2009;years to include vaginal delivery, likely reflecting an increased perceived safety of this delivery mode.

Maxillary canine impaction is a common developmental eruption disturbance that may lead to root resorption of adjacent incisors, crowding, and prolonged treatment if not identified early. Early recognition during mixed dentition allows interceptive measures that may guide eruption and reduce the need for surgical exposure. A 9-year-old Saudi girl presented with an anterior crossbite, functional mandibular shift, poor oral hygiene, and multiple carious deciduous molars. Clinical examination showed absence of palpable maxillary canine bulges, and panoramic radiography with CBCT confirmed bilateral palatal impaction of the maxillary permanent canines with S-sector 3, &#x3b1;-angle 60&#xb0;, d-distance about 22&#x2009;mm, and close proximity to the lateral incisor roots without resorption. Preventive and restorative care were completed first, followed by the extraction of deciduous canines and first deciduous molars (53, 54, 63, and 64) and the placement of a maxillary 2 &#xd7; 4 fixed appliance to correct the anterior crossbite and maintain space. Over 14 months, both permanent canines erupted spontaneously into favorable positions without lateral incisor root resorption, and the mandibular shift resolved. In this mixed-dentition patient with bilateral palatal canine impaction and moderate radiographic risk indicators, a double extraction protocol combined with a simple 2 &#xd7; 4 appliance enabled successful nonsurgical eruption guidance and simultaneous correction of anterior crossbite.

Anastomotic leakage (AL) remains one of the most serious complications after colorectal cancer surgery and is closely linked to postoperative morbidity and poorer oncologic outcomes. Intraoperative indocyanine green fluorescence angiography (ICG-FA) has been introduced to allow real-time assessment of bowel perfusion; however, its role in reducing AL is still debated. Therefore, the primary aim of this study was to evaluate whether intraoperative ICG-FA, compared with standard visual assessment, reduces the rate of anastomotic leakage in patients undergoing laparoscopic sigmoid or rectal cancer resection. The secondary aims were to assess its impact on the incidence of anastomotic strictures, overall postoperative complications, reoperation rates, length of hospital stay, readmission, and 30-day mortality. We conducted a prospective single-center study with a retrospective historical control group, including consecutive patients undergoing laparoscopic sigmoid or rectal cancer resection. Patients who underwent intraoperative ICG-FA between October 2023 and January 2025 were compared with those undergoing similar procedures without fluorescence assessment. The primary endpoint was AL within 30 days. Secondary outcomes included anastomotic stricture within six months, postoperative complications, reoperation, length of hospital stay, readmission, and mortality. A total of 113 patients were analyzed, including 34 in the ICG-FA group and 79 in the control group. The AL rate did not differ significantly between groups (14.7% vs. 12.7%, p&#x2009;=&#x2009;0.768). No anastomotic strictures were observed in the ICG-FA group, while strictures occurred in 11.4% of patients in the control group (p&#x2009;=&#x2009;0.050). Other postoperative outcomes, such as reoperation, length of stay, readmission, and 30-day mortality, were similar between groups. Intraoperative ICG-FA did not significantly reduce the rate of AL but was associated with a lower incidence of anastomotic strictures. These results imply that fluorescence-guided perfusion assessment may help improve anastomotic healing beyond just preventing clinically evident leakage. Larger prospective multicenter studies are needed to verify these findings. https://clinicaltrials.gov/study/NCT07423130, ClinicalTrials.gov NCT07423130.