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Introduction In recent years, artificial intelligence (AI)-generated prostate whole-gland segmentation has shown promise for clinical use. This study compares AI- and human-derived prostate segmentation on magnetic resonance imaging (MRI) and evaluates its practical application. Methods A retrospective study from December 2020 to December 2022 evaluated 31 randomly selected patients who had previously undergone MRI-ultrasound (US)-guided fusion biopsies. AI-generated auto-contours&#xa0;of the whole-gland prostate, seminal vesicle, and urethra were produced using the&#xa0;Prot&#xe9;g&#xe9;AI feature of the MIM Software from MRIs obtained on GE Signa HDxt 3.0T and Siemens Altea Magnetom 1.5T scanners. The same MRIs were independently contoured manually by a board-certified urologist (U) and a board-certified radiologist (R) using MIM Software contouring tools. Volumetric conformity among the three contour sets was assessed using the Dice similarity coefficient, Hausdorff distance (HD), and mean distance to agreement (MDA). Contouring time was recorded for each method, with AI timed from command execution to file generation and physicians timed from file opening to save. Pairwise Wilcoxon signed-rank tests (JMP Pro 15) compared contouring times and similarities across AI to urologist (AI-U), AI to radiologist (AI-R), and urologist to radiologist (U-R) contours. Results The average volumetric Dice similarity, HD, and MDA for the AI-U&#xa0;contours were 0.875&#xb1;0.039, 9.186&#xb1;4.004 mm, and 1.410&#xb1;0.511 mm for the whole-gland prostate, 0.283&#xb1;0.185, 18.117&#xb1;13.265 mm, and 4.907&#xb1;4.992 mm for the urethra, and 0.377&#xb1;0.244, 14.708&#xb1;9.489 mm, and 4.260&#xb1;4.092 mm for the seminal vesicle. For the AI-R contours, the values were 0.757&#xb1;0.072, 17.562&#xb1;7.240 mm, and 3.050&#xb1;1.339 mm for the prostate, 0.162&#xb1;0.105, 19.956&#xb1;11.962 mm, and 4.798&#xb1;3.879 mm for the urethra, and 0.451&#xb1;0.219, 16.069&#xb1;9.245 mm, and 4.075&#xb1;3.734 mm for the seminal vesicle. For the U-R contours, the values were 0.769&#xb1;0.070, 15.109&#xb1;6.177 mm, and 2.733&#xb1;1.265 mm for the prostate, 0.144&#xb1;0.091, 13.560&#xb1;7.087 mm, and 3.406&#xb1;1.985 mm for the urethra, and 0.471&#xb1;0.216, 12.981&#xb1;6.756 mm, and 3.264&#xb1;2.308 mm for the seminal vesicle. Using the Wilcoxon signed-rank test with statistical significance defined as p<0.01, the AI-U Dice similarity for the prostate differed significantly from both the AI-R and U-R comparisons. Similarly, AI-U demonstrated significantly different HD values than both AI-R and U-R, whereas the AI-R and U-R HD comparison was statistically insignificant. All pairwise MDA comparisons for the prostate were statistically significant. For the urethra, the AI-U Dice similarity differed from the other two comparisons, while for HD, the AI-R and U-R comparisons differed significantly from each other. No significant differences were observed among the three comparisons for the seminal vesicle across any metric. The average times to produce contours for the AI, urologist, and radiologist were 96.5 seconds, 285.8 seconds, and 217.9 seconds, respectively (p<0.01 for each time comparison). Conclusion This study suggests that AI may be a useful tool for prostate segmentation workflows in streamlining MRI-US prostate cancer diagnostics by producing similar contouring results in less time. Additional investigation should be conducted regarding the differences between the pathological outcomes of AI and non-AI contours, and the accuracy, cost analysis, and efficiency of AI technology should be elucidated.

Accelerator mass spectrometry (AMS) is one of the most precise analytical tools for tracing fossil fuel-derived CO2 in the atmosphere. In this study, deciduous tree leaves were collected from Gyeongju and neighboring cities in South Korea to analyze the radiocarbon (&#x394;14C) characteristics of atmospheric CO2. The measured &#x394;14C values were used to estimate fossil fuel-derived CO2 concentrations (CO2_ff, ppm) for comparison among the different regions. The sampling locations were expanded incrementally from 2018 to 2024, with 12 sampling sites in 2024. A comparison of &#x394;14C and CO2_ff revealed clear spatial differences associated with regional characteristics, such as traffic density, population activity, and industrial emissions. Long-term observations from 2018 to 2024 indicated persistent &#x394;14C depletion in densely populated and industrialized areas, highlighting the sensitivity of radiocarbon to changes in human activity levels. Industrial areas exhibited substantially lower &#x394;14C values and correspondingly higher (&#x2264;23.6&#x202f;ppm) CO2_ff concentrations than rural areas. These results demonstrate that regional fossil fuel-derived CO2 distributions are influenced by regional differences in human activity.

To evaluate the microhardness of conventional and bulk-fill composite resins based on the depth of light-curing (2 mm and 4 mm) and the curing unit used (VALO Grand and BluePhase N G4 lamp). Discs were fabricated using two bulk-fill resins: Beautifil Bulk (BB) and Filtek Bulk Fill (ZB); and two conventional resins: Beautiful II (BC) and Filtek Z350 XT (ZC). For the preparation, the light-curing depth was set at 2 and 4 mm, and the curing units used were VALO Grand and BluePhase N G4. Microhardness was measured using the Vickers test on light-cured samples under standardized conditions. Statistical analysis was performed using ANOVA and the Tukey test (p < 0.05). Significant differences were found between the groups, with the BB 4mm Valo group exhibiting the lowest microhardness values and significant differences compared to the others. Meanwhile, the 4 mm Bluephase ZC resin exhibited the highest microhardness values compared to the bulk-fill resin. At a thickness of 2 mm, the conventional resins showed similar values regardless of the polymerization source, except for BB, which performed better with the Valo unit. In addition, Valo demonstrated good performance with ZC at both thicknesses and results comparable to Beautifil II at 2 mm. Bluephase showed consistent values across all groups and depths, with superior performance when applied over ZC. The results showed that the final microhardness of the restorative material is influenced by a combination of resin type, depth, and light-curing unit; the conventional composite resin that exhibited the highest microhardness values was ZC, light-cured using a Bluephase light source at a thickness of 4 mm, compared to the bulk-fill resin.

Peri-implant soft tissue stability depends on the implant-abutment interface and collagen fiber organization. Unlike natural teeth, peri-implant fibers exhibit a less favorable orientation, potentially weakening the biological seal. Implant connection design may influence this collagen arrangement and tissue integrity. Eighteen immediately loaded implants (n = 9 per group) were placed in nine mongrel dogs. Group I received external hexagon implants, while Group II received Morse taper implants. After a 4-month healing period, animals were euthanized and specimens were processed for histological evaluation. Collagen fiber orientation was analyzed using polarized light microscopy and quantified with ImageJ software. Statistical analysis was performed using the Mann-Whitney U test ( = 0.05). Group I exhibited predominantly parallel and parallel-oblique collagen fibers, with mean orientations of 19.88&#xb0; (buccal) and 21.92&#xb0; (lingual). In contrast, Group II showed mainly oblique and oblique-perpendicular fibers, with mean orientations of 70.20&#xb0; (buccal) and 54.73&#xb0; (lingual). No significant differences were observed between buccal and lingual aspects within each group (p > 0.05). However, a significant difference was observed between implant connection types, with Group II presenting a significantly higher proportion of oblique and oblique-perpendicular fibers compared with Group I (p = 0.004; r = 0.71). Morse taper implants were associated with a more perpendicular collagen fiber orientation, which may enhance the biological seal of peri-implant soft tissues.

This study aims to evaluate the clinical and objective biomechanical outcomes at a minimum 10-year follow-up following open double-Tajima repair combined with a structured functional loading protocol. Between January 2011 and December 2014, a total of 47 consecutive non-competitive adults (Tegner Activity Scale &#x2264; 4) with acute unilateral Achilles tendon rupture treated with open double-Tajima repair and an eight-week functional loading protocol were included in this retrospective cohort study. The primary outcome was the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. Secondary outcomes included isokinetic dynamometry (peak torque at 30&#xb0;/s and total work at 120&#xb0;/s for plantar flexion and dorsiflexion), joint position sense, and ankle/calf circumference. Between-limb comparisons were performed. Of the patients, 35 were male and 12 were female with a mean age at the time of surgery of 36.7 &#xb1; 6.6 (range, 22 to 55) years. The mean follow-up was 132.4 &#xb1; 13.5 (range, 120 to 168) months. The rupture involved the dominant limb in 29 patients (61.7%) and the non-dominant limb in 18 patients (38.3%). The primary outcome (AOFAS score) showed no statistically significant between-limb difference: the median score was 91.0 (IQR, 91.0 to 93.0) on the operated limb versus 93.0 (IQR, 91.0 to 93.0) on the contralateral limb (median difference: 0.00 points; 95% confidence interval [CI]: -1.00 to 1.00; p = 0.92). No statistically significant between-limb differences were detected across the secondary outcomes, including peak torque at 30&#xb0;/s, total work at 120&#xb0;/s, joint position sense, and ankle/calf circumference (p &#x2265; 0.09 for all). The complication rate was 4.3% (2/47): one partial rerupture managed conservatively and one superficial wound infection treated with oral antibiotics. No complete reruptures were observed. Open double-Tajima repair combined with a structured functional loading protocol seems to be associated with clinically acceptable long-term outcomes in this cohort of non-competitive adults. However, given the retrospective, single-cohort design without an independent comparison group or formal equivalence framework, these findings should be interpreted as descriptive long-term observations.

This study aims to compare the clinical and radiological outcomes of the direct anterior approach (DAA) and the traditional posterior-lateral approach (PLA) for total hip arthroplasty (THA) in patients with ankylosing spondylitis (AS). Between July 2001 and May 2024, a total of 137 patients (117 males, 20 females; mean age: 40.21 &#xb1; 13.28 years; range, 17 to 73 years) with AS who underwent THA using the DAA or PLA were retrospectively analyzed. Using propensity score-matching, we retrospectively analyzed data on 164 hips with AS for which THA was performed, with 41 and 123 hips in the DAA and PLA groups, respectively. Preoperative baseline characteristics, surgical data, clinical and radiological outcomes at follow-up were collected and compared between the two groups. The mean follow-up was 68.05 &#xb1; 38.09 months. There were no significant intergroup differences in terms of surgical data, postoperative complications, clinical scores, or patient satisfaction (p > 0.05). Compared to the PLA group, the DAA group had a significantly higher rate of achieving hip flexion over 90&#xb0; (82.93% vs. 60.98%, p = 0.010), with fewer patients in the group reporting difficulty with putting on socks (p = 0.003). The DAA group exhibited a smaller acetabular anteversion (17.10 &#xb1; 6.60&#xb0; vs. 20.68 &#xb1; 8.73&#xb0;, p = 0.031), with a higher proportion of acetabular components positioned within the Lewinnek safe zone (82.93% vs. 60.16%, p = 0.008). Although both surgical approaches are effective for managing hip involvement in ankylosing spondylitis undergoing THA, the DAA may offer functional benefits and improved prosthetic alignment. These advantages support its consideration as a favorable surgical option in appropriately selected patients.

Additional polymerization in the semidirect technique improves the physicochemical properties of resin composites. However, the effects of long-term water storage on the color stability and surface roughness of resin composites containing S-PRG (Surface Pre-Reacted Glass) fillers remain unclear. This study evaluated the effect of autoclave polymerization on the color stability and surface roughness of a conventional nanohybrid resin composite and one containing S-PRG fillers after one year of water storage. Disc-shaped specimens of Forma (Ultradent) and Beautifil II LS (Shofu; containing S-PRG fillers) were prepared (N = 48). Half of the specimens (n = 12) underwent additional autoclave polymerization. Color parameters (L*, a*, b*, Eab, E00) and surface roughness (Ra) were measured at baseline (24 h) and after 12 months of storage in distilled water. Scanning electron microscopy (SEM) was performed. Data were analyzed using generalized linear mixed models (=0.05). Color variation (Eab and E00) was significantly greater for the resin composite containing S-PRG than for the conventional nanohybrid resin composite (p<0.05), whereas the polymerization method did not affect color variation (p>0.05). Ra values did not differ according to resin composite type or polymerization method (>0.05); however, all groups exhibited a significant increase after storage (<0.05). SEM revealed no differences attributable to the polymerization method. Additional autoclave polymerization did not influence the color stability or surface roughness of resin composites used in the semidirect technique. However, the resin composite containing S-PRG fillers exhibited lower long-term color stability, highlighting the influence of filler composition on esthetic durability.

This study aims to evaluate the midterm clinical outcomes of patients with complex clubfoot treated using the Ponseti method and to assess the sustainability of deformity correction over time. Between January 2016 and January 2021, a total of 38 feet in 26 patients with complex clubfoot treated using the modified Ponseti method were retrospectively analyzed. The patients were divided into two groups: those treated entirely in our institution (study center group) and those referred from external centers after unsuccessful initial treatment (external center group). Clinical severity was assessed using the Pirani score, and ankle dorsiflexion (DF) was measured during follow-up. Functional outcomes were evaluated using the Pirani-Based Score (PBS) and the Oxford Ankle Foot Questionnaire (OxAFQ). Relapse rates, additional procedures, and treatment success were analyzed. Independent predictors of outcomes were identified. Of a total of 26 patients included in the study, 2 were male and 24 were female with a mean age of 6.78 &#xb1; 1.29 (range, 5 to 8) years. Of these patients, 14 (53.8%) had unilateral involvement, while 12 (46.2%) had bilateral deformity. The external clinic group presented at a significantly later age than the study center group (p < 0.001), while baseline deformity severity was comparable. Pirani scores and DF measurements improved significantly in both groups, with no intergroup differences during follow-up (p > 0.05). Functional outcomes showed a significant difference in PBS scores, which were higher in the external clinic group (p = 0.045), indicating worse functional performance, while the OxAFQ scores were similar between groups (p = 0.911). Relapse rates were higher in the own clinic group but did not reach statistical significance (p = 0.254). Multivariate analysis revealed that age was the only independent predictor of treatment success (odds ratio [OR] = 2.067, p = 0.019), while referral status was not an independent determinant. The modified Ponseti method provides effective midterm correction in complex clubfoot regardless of referral status. Although referred patients present later and may demonstrate worse functional outcomes, referral source does not independently influence treatment success. Early recognition and appropriate application of modified Ponseti principles remain critical for optimal outcomes.

[-2]proPSA(p2PSA)-related indices have demonstrated diagnostic value for detecting prostate cancer (PC) in males with modest increases in prostate-specific antigen levels (PSA) of <&#x2009;10&#x2009;ng/mL. However, the "leak point" of p2PSA level in the blood circulation before developing screen-detectable PC remains uncertain. Therefore, this study evaluated the ability of p2PSA-related indices in the years before considering conventional biopsy indications. This case-control study analyzed database and serum bank information from a population-based screening cohort in Gunma Prefecture. The case group included 58 males diagnosed with PC due to increased PSA (4-10&#x2009;ng/mL) followed serially for 5 years. The control group comprised 58 males without PC based on biopsy who were matched to the case group by adjusted PSA levels (&#xb1;&#x2009;2&#x2009;ng/mL) and age (&#xb1;&#x2009;5 years) at the time of biopsy. p2PSA, free PSA, and PSA were measured from frozen serum samples from 0 to 5 years before biopsy. p2PSA-to-free PSA ratio (%p2PSA) and prostate health index (phi) were significantly higher in the case group than in the control group from five, three, and 3 years before biopsy, respectively. The areas under the receiver operating characteristic curve for predicting PC were 0.437 for PSA, 0.637 for phi, 0.663 for %p2PSA, and 0.618 for free PSA-to PSA ratio (%fPSA) at 3 years before biopsy. p2PSA-related indices showed group-level differences between future PC cases and matched controls before PSA exceeded conventional cut-offs. These findings should be regarded as hypothesis-generating and require validation in prospective studies before clinical application to risk-stratified screening.

ALKBH5, as an m6A demethylase, plays a crucial regulatory role in various kidney diseases such as acute kidney injury, chronic kidney disease, renal fibrosis and renal cell carcinoma. However, its function often exhibits contradictory effects: In renal fibrosis, ALKBH5 has been reported to both promote and suppress fibrogenesis, whereas in renal cell carcinoma most studies support an oncogenic role, but some clinical observations link ALKBH5 downregulation to poor prognosis. These contradictions may stem from differences in cell types, disease stages, and microenvironments. This manuscript systematically reviews the complex function of ALKBH5 in kidney diseases and its underlying mechanisms, explores its potential as a therapeutic target, evaluates its therapeutic potential, and highlights the need for cell- and pathology-specific strategies to enable precise intervention. Future research should focus on its cell and pathological background specificity to achieve precise intervention.

Revitalization measures currently represent an important tool in ecological practice for the recovery of disturbed habitats, and their effectiveness is increasingly assessed using bioindicator groups, including ground beetles (Carabidae). Between 2020 and 2023, we conducted research in the European habitat of the Danube Floodplains, where we evaluated the impact of revitalization measures on ground beetle assemblages. The study was carried out at 15 study sites representing eight habitat types. At each site, five pitfall traps were installed in a linear arrangement. In total, 5,292 individuals belonging to 47 species were analyzed, with a mean ellipsoid biovolume of 192 mm3 per individual. PCA analysis revealed a division of species into two main clusters according to their preference for forest and open habitats, with reference sites without management characterized by a higher proportion of apterous and brachypterous species. In contrast, habitats subjected to restoration measures showed dominance of macropterous species typical of disturbed and dynamic ecosystems. Significant differences in ellipsoid biovolume and all morphometric traits were confirmed among habitats and study years. Habitats with restoration measures exhibited a gradual increase in ellipsoid biovolume and morphometric traits of individuals, indicating improved food availability and more favorable living conditions. Prediction of ellipsoid biovolume development using LSTM models (neural networks) indicated stabilization of Carabidae assemblages in forest habitats after the completion of restoration measures, whereas pronounced fluctuations persisted in open habitats, suggesting the need for a longer time period or more intensive interventions to achieve community stability. The results provide a practical basis for planning and evaluating the effectiveness of restoration and management measures in European habitats of conservation importance, as well as for biodiversity conservation and adaptive landscape management, particularly in optimizing interventions in forest and open ecosystems to achieve long-term stability of Carabidae assemblages.

The aim of this study was to investigate the potential relationship between rod overhang (RO) and quality of life (QoL) scores, as well as implant-related irritation, in patients with adolescent idiopathic scoliosis (AIS) and Scheuermann's kyphosis (SK). Between October 2016 and December 2018, a total of 33 pediatric patients with AIS and SK who underwent posterior instrumentation were retrospectively analyzed. On radiographs, the longest RO at both the superior and inferior ends (right or left) was recorded, and patients were grouped according to whether RO exceeded 1 cm. Quality of life outcomes were assessed using the Scoliosis Research Society-22r (SRS-22r), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) questionnaires, and patients were also asked about implant-end irritation. Of the patients, 10 were male and 23 were female. The mean age at the time of operation was 15.18 &#xb1; 1.98 years, while the mean age at the latest follow-up was 23.85 &#xb1; 1.86 years. The median follow-up was 104.08 months. The mean maximum RO was 11.3 &#xb1; 7.8 mm superiorly and 11.1 &#xb1; 6.2 mm inferiorly. Superior RO correlated significantly with SF-36 role-physical (r = -0.36, p = 0.04) and vitality (r = -0.43, p = 0.01) subdomains; no other significant QoL correlations were found. Implant-related irritation was reported in eight (n = 3 superior, n = 5 inferior) patients. There was no significant difference in RO between patients who did and did not report implant-related irritation (superior p = 0.18 vs. inferior p = 0.48). There were no significant differences in QoL scores (for superior, inferior, and either end; p > 0.05) or in the rate of implant-related irritation between patients with RO greater or less than 1 cm (superior p = 0.70; inferior and either end p = 1.00). Our study results suggest that rod overhangs up to 3 cm may not be a clinically relevant determinant of patient-reported outcomes or implant-related irritation in AIS and SK surgery. From a clinical perspective, this may help reduce concern regarding minor distal or proximal overhang during posterior instrumentation, particularly when optimal correction and fixation require slight extension of the construct. The absence of a measurable association with QoL or irritation also supports a more flexible intraoperative decision-making approach, prioritizing deformity correction and implant stability over strict limitation of rod length within this range.

This study aims to evaluate the biomechanical contribution of medial support plating compared to isolated screws and to determine the impact of plate design (one-third tubular vs. mini-plate) and distal screw configuration (unicortical vs. bicortical) on construct stability. Five finite element models were analyzed in this study: three cannulated screws (CS) alone (control), and CS augmented with either a one-third tubular plate or a 2.4-mm mini-plate. For the plated models, the distal fragment was fixed using either unicortical or bicortical screws to isolate the effect of cortical purchase. A 1,400 N axial load was applied to simulate the single-leg stance phase of gait. Fracture micromotion, femoral head displacement, and von Mises stress distribution were recorded. Medial support plating substantially improved construct stability compared to screws alone, reducing femoral head displacement and fracture gap movement. Notably, no significant biomechanical differences were observed between unicortical and bicortical fixation configurations for either plate type. Both the one-third tubular plate and the 2.4-mm mini-plate provided equivalent rigidity. Although mini-plates exhibited higher internal stress concentrations, values remained below the yield strength of the material. Bicortical fixation provided no additional mechanical advantage over unicortical fixation in improving construct stability or reducing implant stress. Therefore, the primary determinant of stability is the medial buttress effect itself; once this is established, neither the plate profile nor the screw length significantly alters the biomechanical outcome, suggesting that unicortical fixation with low-profile plates provides sufficient mechanical stability.

This study aims to evaluate the effects of BPC-157, synthetic thymosin beta-4 (TB-500), and their combination on Achilles tendon healing using biomechanical, histopathological, histochemical, and immunohistochemical analyses in a rat model. Thirty-two male Sprague-Dawley rats, each aged 12 weeks and weighing approximately 330 g, underwent standardized Achilles tendon transection and repair and were randomly assigned to four groups, with eight rats in each group: control, BPC-157 (10 &#xb5;g/kg/day), TB-500 (60 &#xb5;g/kg/day), and combined BPC-157 + TB-500 (BPC + TB). Treatments were administered intraperitoneally for four weeks postoperatively. At four weeks, tendons were harvested for biomechanical testing or histological evaluation. Maximum load to failure was assessed biomechanically. Histological and histochemical analyses included hematoxylin-eosin, Masson trichrome, Alcian blue, and Sirius red staining and were evaluated using Bonar and Movin scoring systems. Expression of collagen types I and III was assessed immunohistochemically and semiquantified using H-score analysis. Biomechanical testing revealed higher maximum load to failure values in the BPC-157 and TB-500 groups compared to controls, reaching statistical significance in the TB-500 group (p < 0.05). Histopathological evaluation demonstrated significantly lower total Bonar scores in the TB-500 group (p = 0.016) and significantly lower total Movin scores in the TB-500 and BPC + TB groups (p = 0.017 and p = 0.040, respectively) relative to controls, indicating improved tendon architecture, collagen alignment, and reduced degenerative changes. The BPC-157 group showed numerically lower scores without reaching statistical significance for total scores. Sirius red birefringence analysis showed increased type I collagen organization and altered type III collagen distribution in treatment groups, particularly in the TB-500 group, suggesting progression toward matrix maturation. Immunohistochemical analysis revealed no significant differences in collagen type I expression among groups, whereas collagen type III expression differed significantly, consistent with histochemical findings. Combined BPC-157 and TB-500 treatment did not confer additional benefits compared to either agent alone. In this exploratory rat model study, both BPC-157 and TB-500 were associated with improved histopathological parameters and extracellular matrix organization during early Achilles tendon repair, with TB-500 additionally demonstrating a significant biomechanical advantage at four weeks. The absence of additive effects with combination therapy may reflect convergence on shared downstream pathways; however, this hypothesis requires further experimental confirmation. These preliminary findings indicate that both peptides warrant further investigation as candidate adjuncts to tendon repair, pending dose-optimization and longer-term studies.

Workplace violence against nurses and midwives intensified during the COVID-19 pandemic, exposing and amplifying longstanding structural marginalization in health systems across Latin America. This study analyzes how different forms of violence were experienced and described by nursing professionals during this period. A secondary qualitative analysis was conducted using text-based responses from an international online survey developed by the Global Consortium, which included 3860 nurses and midwives from 18 Latin American and Caribbean countries. Data were examined through Descending Hierarchical Classification using IRaMuTeQ, followed by reflective thematic analysis for interpretive integration. The analysis identified five lexical classes, reorganized into three interconnected themes: direct violence related to care delivery and system collapse; stigma, fear, and disruption of social belonging; and ethical-political suffering associated with structural blame, moral suffering, and moral injury. Despite contextual differences across countries, narratives revealed recurring patterns of emotional overload, professional delegitimization, and exposure to multiple forms of violence. These findings position violence against nursing professionals during the pandemic as a structural and multifaceted phenomenon rooted in historical inequities and institutional fragility, underscoring the need for sustained policies that strengthen workforce protection, ethical accountability, and institutional support in both routine healthcare settings and future public health emergencies.

This study aims to define the greater sciatic notch (GSN)-based transcolumnar "magic screw" corridor in the acetabulum and to assess its morphometric characteristics and anatomical feasibility according to quadrilateral plate (QP) morphology. Between November 2025 and January 2026, three-dimensional morphometric analysis was performed on pelvic CT reconstructions of 90 adults (180 acetabulae) with intact pelvic bones and no evidence of hip or pelvic pathology. Using Mimics, pelvic models were reconstructed and a virtual 6.5-mm cannulated screw was advanced from the midpoint of the GSN toward the anterior column along a transcolumnar intraosseous trajectory. Bilateral trajectory length, angulation, and QP thickness were recorded. Differences by sex and side, age associations, and anatomical feasibility ("easy" versus "hard") were analyzed based on anatomical corridor constraints. Of the patients included in the study, 42 were male and 48 were female with a mean age of 49.88 &#xb1; 17.18 (range, 19 to 86) years. The defined GSN-based transcolumnar screw corridor was anatomically feasible in 94.44% of cases. Mean posterior acetabular screw length was 74.16 &#xb1; 7.49 mm right and 73.21 &#xb1; 6.90 mm left. Mean GSN entry segment length was 22.95 &#xb1; 4.14 mm right and 23.48 &#xb1; 4.34 mm left. Mean acetabular screw angles were 125.86&#xb0; &#xb1; 6.05&#xb0; right and 124.26&#xb0; &#xb1; 5.24&#xb0; left, with a small but significant right-left difference (p = 0.004). The QP morphology demonstrated substantial variability: mean maximum thickness was 14.87 &#xb1; 2.75 mm right and 14.77 &#xb1; 2.82 mm left, while minimum thickness was 3.46 &#xb1; 1.37 mm right and 3.48 &#xb1; 1.32 mm left. Men had significantly greater superior and posterior acetabular screw lengths and markedly thicker QP parameters compared with women (all p &#x2264; 0.027), with large effect sizes for QP thickness (d > 1.0). A GSN-based transcolumnar magic screw corridor appears anatomically feasible in most adult pelves and provides a quantifiable intraosseous trajectory reaching both acetabular columns. Quadrilateral plate thickness emerges as the main anatomical limiting factor, particularly in female pelves and in cases categorized as corridor-constrained.

a significant proportion of medical errors can be attributed to miscommunication between healthcare professionals. Effective interprofessional handover is heavily dependent on interprofessional collaboration, which can itself be affected by factors such as hierarchies, interprofessional differences, and unawareness of the other professionals' skillsets and expertise. The purpose of this study was to establish the potential effect(s) that interprofessional knowledge or lack thereof had on interprofessional communication and collaboration within prehospital to emergency centre (EC) patient handover. a qualitative descriptive design was used, with face-to-face, semi-structured interviews to gather data from 15 purposefully selected prehospital emergency care providers. Interviews were transcribed and imported into ATLAS.ti where they were coded using the principles of qualitative description. Data collection was concluded when saturation had been reached. four dominant themes were identified relating to interprofessional knowledge as a factor in prehospital to emergency centre (EC) handover. These themes were: 1) lack of interprofessional knowledge, 2) lack of understanding of working environments, 3) prehospital understanding of pressures within the EC, and 4) the need for interprofessional education and collaboration. this is one of the few studies in a middle-income country relating the prehospital to the emergency centre patient handover. Improving interprofessional knowledge regarding qualification, capabilities, and working environment, interprofessional respect and communication can potentially improve interprofessional patient handover and patient safety. The findings of this study could be used to inform healthcare providers, policymakers, healthcare staff, and researchers to formulate intervention strategies to improve prehospital to emergency centre patient handover.

This study aims to compare the biomechanical performance of three different surgical fixation techniques in the treatment of proximal humerus fractures with medial metaphyseal defects. A total of 24 synthetic humerus bone models were used and equally divided into three groups (n = 8 per group). A standardized unstable proximal humerus fracture model with a medial metaphyseal cortical defect extending to the surgical neck was created using a three-dimensional (3D)-printed osteotomy guide. Group 1 received fixation with a lateral anatomical locking plate. Group 2 was treated with a combination of a lateral anatomical plate and a medial buttress plate (dual plating). Group 3 underwent fixation with an intramedullary nail (IMN); in this group, four specimens had distal locking with an endopin (Group 3a), and the other four with static screws (Group 3b). All specimens were subjected to axial loading until failure. Forces at the onset of failure and complete failure were recorded, and fracture patterns were documented. In Groups 1 and 2, transverse fractures consistently occurred at the level of the most distal screw of the lateral plate. In Group 3, failure was observed either proximally or distally at the nail tip, including butterfly fragment formation and metaphyseal collapse. Group 2 exhibited the highest resistance to axial loading, followed by Group 1 and Group 3, with statistically significant differences between all groups (p = 0.043, p = 0.0003, p < 0.00001). No significant difference was found between subgroups 3a and 3b (p > 0.05). Our study results indicate that double plating provides the greatest axial stability in proximal humerus fractures with medial metaphyseal defects, supporting its use in fracture patterns with medial column deficiency. However, as fixation choice should be guided by patient-specific factors and surgical feasibility, these findings should be interpreted in the context of experimental conditions and loading limitations.

In this study, we aimed to compare the clinical and radiological outcomes of patients undergoing arthrodesis and trapeziectomy with ligament reconstruction and tendon interposition (T + LRTI) for thumb carpometacarpal (CMC) osteoarthritis and to investigate whether patient-specific decision-making could offer advantages over LRTI or arthrodesis as a surgical approach. Between August 2014 and January 2025, a total of 40 patients who underwent surgical treatment for thumb CMC osteoarthritis were retrospectively analyzed. The patients were divided into two groups as the T + LRTI group (n = 22) and arthrodesis group (n = 18). Clinical outcomes were assessed using the Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), grip strength (kg), and pinch strength (kg) measurements. Of the patients, 7 were male and 33 were female with a mean age of 62.9 &#xb1; 6.5 years in T + LRTI group, 60.1 &#xb1; 7.4 years in arthrodesis group (range, 40 to 75 years). Both groups demonstrated significant improvement in VAS and QuickDASH scores postoperatively (p < 0.001). The mean postoperative VAS scores were 2.7 &#xb1; 2.0 in the T + LRTI group and 1.9 &#xb1; 0.9 in the arthrodesis group (p = 0.267), while QuickDASH scores were 26.4 &#xb1; 17.3 and 19.1 &#xb1; 3.2, respectively (p = 0.085). No significant differences were observed in grip strength (p = 0.358), palmar pinch (p = 0.104) and key pinch strength (p = 0.097) between the groups. The overall complication rate was 12.5% in both groups, indicating no statistically significant difference (p = 0.642). Our study results suggest that both T + LRTI and arthrodesis provide effective and comparable pain relief and functional outcomes in the surgical management of thumb CMC osteoarthritis and can be considered reliable surgical options.