With rising tick-borne disease (TBD) cases and the geographical expansion of tick populations, the need for effective surveillance and public education regarding local risk is crucial. This study assessed the effectiveness of tick-check stations as a tool for tick surveillance, and their impact on community knowledge, attitude, and practices (KAP) related to ticks and TBD. To assess the effectiveness of tick-check stations for surveillance, we evaluated station engagement and compared tick density estimates, species composition, and life-stage distributions with those obtained through concurrent active surveillance. In addition, we compared submission numbers and tick species and life stages to those collected through a mail-in submission system conducted by the Colorado Department of Public Health and Environment (CDPHE). To quantify feasibility, we estimated effort per tick and compared effort across simulated sampling scenarios. Finally, in-person surveys were conducted at trailheads to assess baseline tick KAP and to evaluate differences between sites with and without tick-check stations. Engagement with tick-check stations was sustained throughout the study. Temporal tick densities estimated from tick-check station submissions were correlated with density estimates from active surveillance (R = 0.534), and species composition and life-stage distributions did not significantly differ between methods. Tick-check stations required less effort per tick than active surveillance when sampling sites were nearby or tick densities were low, whereas sites that were farther away or had higher tick densities required less effort per tick under a hybrid surveillance approach. When asked to list tick-borne pathogens in Colorado, 47% of survey participants who had read tick-check station signage identified Rocky Mountain spotted fever compared with 20% of participants in the control group (p = 0.007; odds ratio). Notably, a low proportion of survey participants (24%) reported performing tick-checks to prevent tick bites. Tick-check stations can provide tick density estimates comparable to active surveillance while requiring less effort in many scenarios, particularly in low-density settings. Our findings also highlight opportunities for targeted outreach to address gaps in TBD knowledge. As both a surveillance and educational tool, tick-check stations offer a sustainable approach for expanding tick monitoring in resource-limited settings.
Background checks aim to prevent illegal firearm transfers. Existing research has shown little evidence for the effect of point-of-sale comprehensive background check (CBC) policies on firearm-related violence at the state level, but state-level estimates may mask local variation. To estimate the association between state-level point-of-sale CBC policies and county-level firearm homicide rates in the US. This cross-sectional study used a difference-in-differences analysis with synthetic controls. Six US states that implemented a point-of-sale CBC policy between 2013 and 2019 and did not have a permit-to-purchase policy from 2000 to 2021 (Colorado, Delaware, New Mexico, Oregon, Vermont, and Washington) and 8 eligible control states that did not have a CBC or permit-to-purchase policy from 2000 to 2021 and were similar to treated states in terms of state partisanship (Alabama, Arkansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, and West Virginia) were included. The unit of analysis was county-years from January 1, 2000, to December 31, 2021. Analyses were conducted from April 1, 2023, to December 15, 2025. Implementation of point-of-sale CBC policies (that applied minimally to handguns) between July 1, 2013, and July 1, 2019. Annual county-level firearm homicide rates per 100 000 population were directly standardized to the age (<5 years, 10-year age bands from 5-84 years, and ≥85 years) and sex (female or male) distribution of the US population in 2000. The synthetic control method was used to estimate counterfactual posttreatment means. The study population included 750 counties: 59 from Colorado, 3 from Delaware, 33 from New Mexico, 36 from Oregon, 14 from Vermont, 39 from Washington, and 566 from states that did not have a CBC policy (ie, eligible controls). In unadjusted models, state-level CBC implementation was associated with a mean of -2.13 (95% CI, -3.19 to -1.04) firearm homicide deaths per 100 000 population across counties; after adjusting for covariates, a mean of 0.13 (95% CI, -0.88 to 1.13) deaths per 100 000 population were found. While there was some heterogeneity in county-specific estimates in adjusted models (with point estimates ranging from -13.2 to 20.5 deaths per 100 000 population), nearly all 95% CIs crossed the null. This cross-sectional study of the association between state-level CBC policies and county-level firearm homicide rates assessed county-level heterogeneity that may have been masked in prior state-level studies. As in prior state-level studies, no associations were found for adjusted results. Findings suggest opportunities for further research on the design, implementation, and enforcement of CBC policies.
Bicycle-sharing systems (BSS) have become an important component of sustainable urban mobility, but their demand remains difficult to model. Usage varies across hours, stations, weather conditions, and types of day, while the available data often provide only a partial view of the underlying demand process. This study proposes an interpretable probabilistic framework to characterize and generate synthetic demand for BiciMad, Madrid's dock-based BSS, using trip-level data from 2018 and 2019. The contribution is not the introduction of new probability distributions, but the calibrated integration of standard probabilistic components into a demand-side generative framework. Trip distances are modeled with Gamma distributions, and hourly trip counts are represented with Negative Binomial distributions conditioned on hour, day type, and precipitation. These components are combined with empirical station-popularity profiles to generate synthetic origin-destination demand under explicit contextual assumptions. Validation against observed data shows that the framework provides calibrated uncertainty estimates, with empirical coverage of the 95% prediction intervals close to the nominal level across contextual scenarios. An external consistency check using 2019 data further shows the practical value of the approach, as it helped identify systematic timestamp misattributions that were later confirmed by the data provider. The proposed framework is not intended as a full capacity-aware operational simulator. Instead, it provides a simple, interpretable, and uncertainty-aware baseline for demand characterization, synthetic demand generation, exploratory disruption analysis, and data-quality consistency checking in dock-based bicycle-sharing systems.
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South Korea became a super-aged society in 2024, and this demographic shift is unfolding alongside the depopulation of rural municipalities across the country. How spatial inequality and community social capital jointly relate to elderly health-and whether those relationships look different for younger versus older elderly-remains an open question. We investigated associations between two dimensions of community social capital (sense of belonging and neighbor communication), subjective perception of capital-provincial inequality, and self-rated health among Korean elderly, with separate analyses for the Young-Old (aged 60-69) and Old-Old (aged 70+). We used the 2024 Social Integration Survey from the Korea Institute of Public Administration (full sample N = 2588; elderly subsample N = 1020). Random intercept hierarchical linear models accounted for the nesting of individuals within 17 metropolitan cities and provinces. Stepwise models examined social capital antecedents, a healthcare satisfaction indirect association pathway, and the direct association of spatial inequality perception with health. The elderly subsample was stratified into Young-Old (N = 289) and Old-Old (N = 731). A mixed-effects ordered logistic regression with Liang-Zeger cluster-robust standard errors was estimated as a robustness check. Sense of belonging was positively associated with subjective health among the elderly (B = 0.065, p < 0.05) as a net of rurality and socioeconomic controls. Perceived spatial inequality showed a negative association (B = -0.070, p < 0.05). The indirect association pathway through healthcare satisfaction was not supported (Sobel Z = -1.458, p = 0.144). Age-stratified models revealed a striking split: belonging was the dominant predictor for the Young-Old (B = 0.149, p < 0.01), while neighbor communication (B = 0.078, p < 0.05) and spatial inequality perception (B = -0.092, p < 0.01) were significant only among the Old-Old. The ordered logistic robustness check confirmed the negative association of perceived spatial inequality across all specifications. What predicts health in the younger elderly is not what predicts health in the older elderly. Korea's Integrated Community Care Act, set for nationwide rollout in 2026, should account for this divergence-prioritizing psychological community attachment for the Young-Old and face-to-face social contact combined with regional equity for the Old-Old.
To evaluate prostate-specific antigen (PSA) screening patterns among gay and bisexual men and identify factors associated with screening uptake in this population. We conducted a cross-sectional analysis using 2023 Behavioral Risk Factor Surveillance System (BRFSS) data from eight states and one territory that administered key survey modules. Cisgender men aged ≥ 40 years identifying as gay, bisexual, or straight with no prostate cancer history were included. Gay and bisexual men were matched with straight men using propensity scores based on demographics. Predictors of PSA screening within two years were assessed with multivariable regression. Of 19,925 respondents, 593 identified as gay or bisexual; 49.8% reported recent PSA screening compared with 46.2% of straight men. Sexual orientation was not associated with screening differences (p=0.084). Clinician-led discussion was the strongest predictor (adjusted odds ratio [aOR] 5.45; p<0.001), while uninsured status (aOR 0.39; p=0.007) and no check-ups within two years (aOR 0.11; p<0.001) were linked to lower rates of screening. Among gay and bisexual men, age 55-69, discussion of testing, college education, and recent check-ups were associated with increased screening rates. Prostate cancer screening rates did not differ significantly by sexual orientation, suggesting that clinician communication, insurance coverage, and primary care continuity are stronger predictors of PSA testing. Enhancing provider communication through LGBTQ+-affirming training and strengthening primary care continuity may improve early detection of prostate cancer across diverse populations.
Background: Trunk and pelvic strength balance and functional movement quality are relevant factors for musculoskeletal health and injury-prevention monitoring in youth soccer players. Aim: This study aimed to evaluate longitudinal changes in isometric trunk and pelvic strength balance, functional movement quality, and selected muscle imbalance indicators during a physiotherapy-based strengthening programme in adolescent male soccer players. Methods: A longitudinal single-group repeated-measures study was conducted in male soccer players aged 12-18 years. Isometric strength balance was assessed using the Dr. Wolff Back-Check system, and functional movement quality was evaluated using the Functional Movement Screen (FMS). Complete-case analyses were performed according to available repeated measurements. Results: FMS total scores improved across repeated assessments, whereas the global Back-Check score showed no significant longitudinal change. Component-level and imbalance analyses indicated reductions in adductor-abductor imbalance, and better FMS performance was moderately associated with lower adductor-abductor imbalance. Conclusions: Functional movement quality and selected muscle imbalance indicators demonstrated favorable longitudinal changes during the physiotherapy-based strengthening programme. These findings suggest that physiotherapy-oriented strengthening and movement-control exercises may contribute to improvements in functional movement quality and selected muscle balance indicators in adolescent male soccer players. However, the small repeated-measures subsamples and observational study design limit causal interpretation and generalizability.
Aim To synthesise epidemiological and clinical evidence on in-flight barodontalgia in professional aircrew.Methods We searched Scopus, PubMed, Web of Science, and Google Scholar for cross-sectional studies of in-flight barodontalgia. Seven studies (2013-2024) met the inclusion criteria. Data were extracted in duplicate, and risk of bias was assessed with the JBI cross-sectional checklist. Given heterogeneity in case definitions, a narrative synthesis (no meta-analysis) was performed.Results Barodontalgia events occurred predominantly during descent (and also on some ascents). Prevalence varied widely across studies (~6% to 55%). Acute dental pain was the leading symptom, sometimes accompanied by headache or transient concentration loss. Overall study quality was moderate.Conclusions In-flight barodontalgia is a relevant occupational health issue for aircrew. Harmonised case definitions and prospective validation of reports are needed. Preventive measures such as routine pre-flight dental check-ups and appropriate return-to-flight restrictions after recent dental treatment (as determined by aeromedical/occupational policy) may help reduce in-flight occurrences.
Implementing cryptographic primitives on resource-constrained IoT devices involves tight latency, code-size, and energy budgets. This work proposes a general LLVM backend instruction-selection strategy that recognizes single-bit update idioms-typically expressed as LOAD--(AND/OR)--STORE sequences in SHA-256 and similar bit-oriented code-and lowers them to the most efficient target-specific bit-manipulation primitive when legality and cost conditions are met. As a concrete instantiation, we implement the strategy for the Renesas RL78/G23 ISA by rewriting eligible patterns into SET1/CLR1 instructions when the constant mask targets exactly one bit. We evaluate the resulting backend on an RL78/G23 platform using cycle counts and code size (bytes) across SHA-256-driven workloads motivated by firmware integrity checking, Merkle-tree hashing, HMAC-based authentication, password-based key derivation (PBKDF2), and chunk-level update validation. The observed cycle reductions are also converted to absolute time across the device's supported on-chip oscillator frequencies to quantify latency impact under different clocking modes. The experimental validation in this work is limited to the RL78/G23 backend implementation. The underlying instruction-selection idea may be adaptable to other RL78-family devices or to other embedded architectures that provide equivalent single-bit set/clear or bitfield operations; however, such adaptations require target-specific legality checks, cost modeling, and separate experimental validation.
The present research study explored antidiabetic, antioxidant, and organ-protective properties of Cucumis sativus (cucumber) peel powder (CPP) and ethanol extract of cucumber peel extract (CPE) in alloxan-induced diabetic rats (DR). Chemical profiling of C. sativus peel was done by using GC-MS. The male albino rats (n = 36) were split into six groups, which includes normal control (NC), diabetic control (DC), CPP 5 mg/kg oral gavage (CPP-5), CPP 10 mg/kg (CPP10), Cucumis ethanolic extract 5 mL/day (CPE5), and Cucumis ethanolic extract 10 mL/day (CE-10). Treatment was applied over a period of 28 days by oral gavage after the induction of alloxan (150 mg/kg). A histopathological study was performed on the pancreas, kidney, and liver. In silico study was performed to check the binding affinity of the phytoconstituents with α-amylase. GC-MS identified bioactive fatty acids, including 9-octadecenoic acid, linoleic acid, and hexadecanoic acid derivatives. Treatment significantly reduced fasting blood glucose and improved insulin levels, lipid profiles, and normalized liver and renal function markers. Histopathological findings showed restoration of pancreatic, hepatic, and renal architecture. Molecular docking revealed strong binding affinity of 9,12,15-octadecatrienoic acid (-6.00 kcal/mol) toward α-amylase. Cucumber peel shows promising antihyperglycemic, antihyperlipidemic, and multiorgan protective effects.
Zero-shot anomaly detection is attractive for industrial inspection, where target-domain training data are often unavailable for newly introduced products. Recent CLIP-based methods have demonstrated promising generalization, and online memory mechanisms can further improve adaptability by incorporating incoming test samples. However, unreliable or ambiguous evidence may be incorporated during online memory updates, which can degrade subsequent predictions, especially for weak or visually unstable categories. In this work, we propose TSMR, a lightweight extension of RareCLIP for online zero-shot anomaly detection. Rather than modifying the backbone or redesigning the anomaly scoring pipeline, TSMR improves the reliability of test-time memory evolution through a class-sensitive selective update strategy. Specifically, it combines a confidence quantile gate, a text-prior-based reliability check, and weak-class selective activation to derive a frame-level memory-update decision during online inference. Experiments on VisA and MVTec AD show that TSMR achieves clear improvements on VisA while maintaining competitive performance on MVTec AD. Under the online protocol, TSMR improves the reproduced RareCLIP baseline on VisA from 94.4% to 95.1% in image-level AUROC, from 98.8% to 98.9% in pixel-level AUROC, and from 93.5% to 94.0% in PRO. On MVTec AD, TSMR achieves 98.0% image-level AUROC, 97.6% pixel-level AUROC, and 93.6% PRO, remaining competitive with the strong RareCLIP baseline. Object-wise and seed-wise analyses further indicate that selective memory refinement is particularly beneficial for selected weak categories and remains stable across different online evaluation orders. These results suggest that reliable online memory evolution is an effective direction for CLIP-based zero-shot anomaly detection.
Newly licensed nurses continue to enter practice with varying levels of readiness, prompting ongoing concern among clinical leaders and renewed emphasis on academic-practice alignment following the American Association of Colleges of Nursing (AACN) The Essentials: Core Competencies for Professional Nursing Education (2021). However, limited consensus exists regarding how practice readiness is defined and evaluated across clinical settings. The primary aim of this study was to identify perceived knowledge-practice gaps among new graduate nurses as described by clinical leaders and educators in practice settings. A secondary aim was to identify strategies within academic-practice partnerships that may support competency development and transition to practice. A qualitative descriptive design was used. Focus groups were conducted with 27 nurse leaders and clinical educators across 14 clinical sites affiliated with a Midwest academic nursing program. Data were collected using semi-structured interviews and analyzed thematically. Rigor was supported through member checking, audit trail documentation, and intercoder agreement. Four interrelated themes emerged: Professional Communication Across the Clinical Environment, Underdeveloped Clinical Judgment Skills, Essential Clinical Readiness, and Professional Identity and Engagement. While participants identified areas for development across these domains, findings also suggest that many perceived gaps reflect discrepancies among expected characteristics of novice practitioners and the complexity of contemporary practice environments. Practice readiness is a multidimensional, developmental process shaped by both educational preparation and clinical context. Findings advance current understanding by suggesting that perceived deficiencies in new graduates may reflect misalignment between expectations for novice nurses and the realities of practice settings rather than educational deficits alone. Academic-practice partnerships are therefore essential not only for curricular alignment with the AACN Essentials (2021), but also for establishing shared expectations, strengthening competency development, and supporting transition to practice.
Crackers are a popular and convenient snack; however, the baking process can produce neo-formed contaminants (NFCs), such as acrylamide (AA) and 5-hydroxymethylfurfural (HMF), through non-enzymatic browning reactions. Conventional analytical methods for quantifying these NFCs are complex, labor-intensive, and require specialized personnel. The main objective of this study was to develop computer vision (CV) models based on surface digital image analysis for the rapid prediction of AA and HMF in crackers. Therefore, five baking temperatures (160, 170, 180, 190, and 200 °C) and times (15, 20, 25, 30, and 35 min) were tested and analyzed using CV alongside conventional analytical methods. CV estimates and analytical measurements for AA (4.35-829 µg kg-1) and HMF (0.004-105.4 mg kg-1) contents were compared using cross-validation with a "leave-one-treatment-out" approach. The average error for missing measurements was 3.10% for AA and 3.28% for HMF, validating CV as an efficient tool for the rapid estimation of these NFCs in crackers. Among the cracker samples with AA content below the EU benchmark of 400 μg/kg, evaluated using the Check-All-That-Apply (CATA) test, consumers preferred the samples baked at 180 °C for 25 min, which also exhibited the lowest levels of both AA and HMF.
The abdominal pressure-volume (P-V) relationship during laparoscopic insufflation is curvilinear and subject to substantial inter-individual variability, yet clinical practice relies on universal pressure targets derived from population-level guidelines. The Smart Inline Compliance Module (SICM) is a novel inline retrofit device that acquires intra-abdominal pressure and insufflation gas flow through physically separated sensing circuits, reconstructs insufflated volume by numerical integration of the flow signal, and derives the abdominal P-V curve and its biomechanical parameters in real time. This study reports the first two-arm pilot technical evaluation of the SICM system. Arm A comprised an exploratory biomechanical phantom with three defined stiffness levels (Soft, Medium, Rigid) tested under Continuous and Stepwise insufflation protocols (30 curves). Arm B comprised three female feline cadavers assessed under the same dual-protocol design (18 curves). This study should be interpreted as an early-stage technical evaluation rather than as a definitive validation benchmark. Signal quality was consistently high across both arms (Curve Quality Index: 1.0000 in the phantom arm; 0.9974 ± 0.0009 in the cadaveric arm). Volume integration accuracy was confirmed against an independent offline reference (mean absolute percentage difference: 0.07%). The system extracted reproducible biomechanical parameters under the Continuous protocol: in the cadaveric arm, maximum compliance (Cmax) ranged from 116.8 to 191.4 mL/mmHg across subjects, with intra-session coefficients of variation below 16%; Knee Pressure (Pknee), defined as a working operational index of the compliance transition, was 3.33-4.17 mmHg with CV below 8%. The Rigid phantom and cadaveric datasets showed partial numerical overlap in selected shape-derived parameters, which was interpreted only as an internal consistency check and not as evidence of biomechanical equivalence. The Stepwise protocol exposed the current methodological limits of the parameter-extraction workflow and identified specific targets for the next development iteration. These results are interpreted exclusively within the scope of technical feasibility and preliminary biomechanical characterisation; clinical applicability and optimal pressure guidance require adequately powered in vivo studies.
Improving the quality and equity of oncology care is a strategic priority in Europe. The Organisation of European Cancer Institutes (OECI) Accreditation and Designation Programme provides a unified framework integrating care, research, education, and governance. Its standards emphasise multidisciplinary coordination, digital infrastructures, and patient-centred outcomes. Head and neck cancer remains a major global challenge, with rising incidence and heterogeneous results, highlighting the need for standardised pathways and interoperable data systems. This study describes how a Head and Neck Cancer Unit was redesigned and digitalised to comply with OECI requirements, focusing on elements of the care domain. A structured organisational redesign was undertaken using workflow mapping, a RACI matrix, and Plan-Do-Act-Check cycles. Governance involved clinical leaders, specialised nurses, quality officers, and IT and engineering staff. Guidelines were updated, fast‑track pathways refined, and synoptic forms integrated into the electronic health record using terminologies compatible with OMOP. PROMs and PREMs were deployed through the institutional portal. A modified Delphi survey assessed team consensus. Between January and October 2025, 353 patients were evaluated, 198 through fast‑track referral. Diagnostic and treatment intervals met targets. PROM completion reached 61%. PREMs highlighted strengths in professionalism and multidisciplinary coordination and identified communication and administrative burden as areas for improvement. The Delphi survey showed strong agreement (α = 0.71), particularly for Multidisciplinary participation and nursing collaboration. The redesign, aligned with OECI standards, strengthened governance, digitalisation, and patient‑centred care. The model demonstrates how accreditation can drive sustainable, data‑driven improvement and support integrated cancer networks.
In this study, CS-ZnO macrotubes were prepared through co-axial extrusion techniques and were used as a template for the stabilization of silver nanoparticles (Ag NPs). FESEM, EDS, XRD, FTIR, TGA, and zeta potential analytical tools were used for structural analysis of the catalyst. The catalytic activity was explored against MB, MO, and CR dyes in distilled water (DW), tap water (TW), and seawater (SW) in the presence of NaBH4. All three model dyes were studied alone and in mixtures in the presence of NaBH4. The highest activity was displayed by Ag/CS-ZnO in DW with an apparent rate constant (kapp) of 6.5 × 10-1 min-1, 3.6 × 10-1 min-1, and 2.0 × 10-1 min-1 against MO, CR, and MB dyes, respectively. It was observed that the presence of cations or anions in a water sample can affect the rate of anionic dye degradation. Various experimental parameters, i.e., catalyst dose, initial dye concentration, and NaBH4 effect, were studied. The catalyst recyclability was checked for four consecutive cycles. These results demonstrate that Ag/CS-ZnO macrotubes act as a dip-catalyst and provide a robust, reusable, and environmentally benign catalytic platform for efficient treatment of dye-contaminated wastewater under real-world applications.
Accurate prediction of marine and atmospheric environmental variables is important for climate adaptation, ecosystem management, and operational decision-making, yet practitioners still lack clear guidance on which machine-learning models are reliable across heterogeneous environmental tasks. We therefore developed a unified, leakage-aware benchmark across nine datasets, of which seven passed quality checks for modeling, spanning chlorophyll-a, wind speed, hydrographic observations, biotoxins, and bathymetry, and compared representative linear, tree-based, and sequence models under a common evaluation framework. Results show strong heterogeneity across tasks and model classes: tree ensembles are robust baselines for tabular problems, LSTM-based recurrent sequence modeling is most useful when temporal structure is central, and predictive skill depends more on target structure and covariate quality than on model complexity alone. Within the observational settings represented in this benchmark-predominantly Chinese coastal/estuarine and regional marine datasets, plus one atmospheric reanalysis wind task and one global cast archive-quality-controlled chlorophyll-a is comparatively predictable, whereas event-driven biotoxins and bathymetry inversion remain difficult under the current predictors. These findings provide practical guidance for researchers and environmental monitoring practitioners working in similar data regimes, but they should not be assumed to transfer automatically to untested regions such as the North Atlantic, the Mediterranean, or tropical open-ocean systems without further validation.
Fused deposition modeling (FDM) of polylactic acid (PLA) produces parts whose weak interlayer bonding and low as-printed crystallinity limit their tensile performance. This work used a Taguchi L9 orthogonal array with five replicates per cell (n = 5; N = 45 annealed specimens plus five non-annealed controls) to study how annealing temperature (70, 80, and 90 °C) and holding time (40, 60, and 80 min) change the tensile response of a commercial PLA grade (eSUN PLA+) printed on a desktop FDM machine. Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) were used in parallel to measure total crystallinity, and XRD was deconvoluted to estimate the α'/α polymorph fractions; the DSC α'→α exothermic shoulder was used as an independent cross-check. Every annealed condition exceeded the non-annealed baseline ultimate tensile stress (UTS) of 39.75 ± 1.28 MPa. The optimum, 47.00 ± 0.97 MPa at 70 °C/60 min, gave an 18.2% gain. Total crystallinity rose from 8.6% (DSC baseline) to 41.8% (DSC, 90 °C/80 min), with DSC and XRD ranking the conditions consistently. ANOVA confirmed both temperature (30.0% contribution) and time (24.2%) as significant at α = 0.05. The new contribution is a combined strength-crystallinity-polymorph map for desktop FDM-printed PLA: the best-performing specimens are dominated by the disordered α' form, while the stiffer but weaker high-temperature specimens shift toward α. A partial least squares regression on all 50 specimens supports the polymorph-composition role beyond what total crystallinity alone explains. The practical conclusion is that moderate annealing just above the glass transition gives the best balance of crystal content, polymorph character, and geometric stability for FDM-printed PLA.
Background/Objectives: Despite its beneficial effect on the healing of bone fractures and in the treatment of osteoporosis, there is still a lack of evidence on the impact of clinical outcomes after a total joint arthroplasty (TJA). This review aims to establish the role of vitamin D in clinical outcomes after a total knee arthroplasty (TKA). Methods: In this review, PubMed, Scopus and Web of Science databases were cross-checked by two reviewers independently. The inclusion criteria were original human studies published in English from 2014 to 2024. For identification-relevant studies, the search terms used were as follows: "Vitamin D" and "total knee arthroplasty" or "total knee replacement" or "total joint arthroplasty" or "total joint replacement". Case reports, letters and expert consensuses were excluded from the analysis. Finally, 19 studies were included in this review. Results: A literature review shows that vitamin D may have an impact on patients treated for osteoarthritis (OA) of the knee with a significant prevalence of hypovitaminosis in orthopedic patients. The influence was observed for periprosthetic joint infections: PJI patients have significantly lower vitamin D levels than primary ones. Also, a greater incidence of revision knee surgery due to PJIs in the deficient group compared to the non-deficient group at a one-year follow-up was found, of up to a 2-fold increase. This affects the clinical outcome with a lower Knee Society Score (KSS) functional score in the vitamin D-deficient group. Conclusions: The current data suggest that the vitamin D metabolism pathway and its implications in orthopedic patients, especially those treated with TKA surgery, may be a significant factor that improves clinical and functional outcomes. A possible relation between a low preoperative concentration of vitamin D and its impact on the outcomes, such as the length of the hospital stay, implant survival, and risk of complications, is needed to support these findings in multicenter, prospective studies and randomized controlled trials.