This study aimed to compare changes in enamel morphology, mineral composition, crystal structure, and mechanical properties under naturally formed dental plaque at different maturation stages versus dental calculus, using an intraoral in situ device and multimodal characterization. Six groups were analyzed (n = 5/group): a blank control group (fully bone-impacted mandibular third molars), a calculus group (extracted molars with naturally adherent dental calculus), and plaque groups formed in vivo for 1, 7, 14, and 28 days using an intraoral in situ device. Mirror-polished longitudinal sections were examined by EDS, Raman spectroscopy, and nanoindentation, followed by SEM for morphology. With increasing plaque coverage time, enamel prisms became progressively disrupted, with widened interprismatic spaces and more microcracks. Mean Ca/P across 5-100 μm decreased from 2.09 ± 0.08 (blank control) to 1.73 ± 0.09 (28-day plaque; P < 0.05). The ν₁(PO₄³⁻) band downshifted and broadened (960.85 ± 0.42-957.19 ± 0.56 cm-1; FWHM 16.03 ± 1.01-26.35 ± 1.06 cm-1; P < 0.05) with increased I(1070)/I(960) and I(1450)/I(960). Hardness and elastic modulus declined from 4.44 ± 0.72 and 88.67 ± 12.94 GPa to 3.45 ± 0.55 and 71.77 ± 14.34 GPa in the 28-day plaque group (P < 0.05). The calculus group showed changes in the same direction, but with a smaller magnitude within the measured indicators and depth range. Natural plaque and calculus coverage promoted dissolution of the enamel inorganic phase, increased lattice disorder, and deterioration of mechanical performance; however, mature plaque (e.g., the 28-day group) caused substantially greater damage than dental calculus. Early inhibition of plaque maturation may be more important for maintaining enamel structural stability than removal of dental calculus.
The rapid advancement of quantum-inspired classical algorithms, particularly Quantics Tensor Trains (QTT), has demonstrated that exponentially large vectors can be manipulated efficiently via Matrix Product States (MPS). Conventionally, the compression of these tensor networks relies exclusively on Singular Value Decomposition (SVD)-based truncation. While SVD is optimal for minimizing the Frobenius norm error, it remains structurally blind to exact algebraic correlations, such as reversible logic gates or Clifford symmetries, that do not require numerical approximation to factor out. In this work, we propose a hybrid compression protocol that integrates the topological rigor of ZX-Calculus with the numerical power of SVD. We construct an explicit isomorphism between Rank-3 MPS tensors and ZX-diagrams, allowing us to subject QTT representations to formal diagrammatic rewriting rules prior to numerical truncation. We establish that this Topological Preconditioning can algebraically collapse the effective bond dimension (χ) and T-count of the underlying tensor network without information loss. By benchmarking the algorithmic implementation against hardware-accelerated SVD on discretized functions and stabilizer states, we demonstrate that ZX-driven algebraic erasure fundamentally bypasses standard [Formula: see text] bottlenecks, yielding up to a computational speedup. Finally, we formalize this advantage by defining the structural complexity class [Formula: see text], proving that for systems characterized by algebraic symmetry, this work reflects our ongoing effort to deepen understanding of Categorical Quantum Mechanics, aiming to contribute to the optimization of high-dimensional linear algebra.
Mirizzi Syndrome (MS) is a rare cause of biliary obstruction. While laparoscopic cholecystectomy is the standard treatment, severe inflammation often necessitates subtotal cholecystectomy to prevent bile duct injury (BDI). However, retained stones in the gallbladder remnant or cystic duct can cause recurrent obstruction, termed post-cholecystectomy Mirizzi Syndrome (PCMS). A 34-year-old female presented with PCMS 6 years after undergoing a subtotal cholecystectomy for MS. Despite initial conservative management, definitive resolution required secondary surgical intervention. As subtotal cholecystectomy becomes more frequent to avoid BDI, the incidence of PCMS is expected to rise. Clinicians must maintain a high index of suspicion. Management should be multidisciplinary; however, surgery remains the definitive treatment when conservative approaches fail.
[This retracts the article DOI: 10.1007/s00500-022-06996-y.].
Oral health findings in pediatric chronic kidney disease (CKD) are heterogeneous, and CKD-related metabolic alterations may contribute to plaque mineralization and oral hygiene outcomes. Yet, the relationship between routinely measured serum biochemical parameters and standardized caries/oral hygiene indices in children with CKD is not well defined. This study aimed to evaluate the associations between serum biochemical parameters and oral health indices in pediatric CKD. This cross-sectional study included 34 children aged 6-14 years with diagnosed CKD. Demographic and available clinical data were recorded, and routinely measured serum biochemical parameters reflecting renal function, mineral metabolism, acid-base status, hematologic status, and nutritional/metabolic profile were obtained from routine laboratory records. Oral examination included caries assessment using Decayed, Missing, and Filled Teeth (dmft/DMFT) index for primary/permanent dentition and International Caries Detection and Assessment System (ICDAS) II indices, as well as oral hygiene evaluation using the Simplified Oral Hygiene Index (OHI-S), Debris Index (DI), and Calculus Index (CI). Developmental enamel defects were evaluated, and soft tissue lesions were examined. Pearson correlation analysis and Mann-Whitney U tests were performed. Statistical significance was set at p < 0.05. Most serum biochemical parameters were not significantly associated with caries experience or oral hygiene indices (p > 0.05). Serum magnesium showed weak-to-moderate negative correlations with CI (r = - 0.383, p = 0.026) and OHI-S (r = - 0.362, p = 0.035), indicating lower calculus accumulation and lower OHI-S scores with higher magnesium levels. In contrast, ALP demonstrated a weak-to-moderate positive correlation with CI (r = 0.386, p = 0.024). In this pediatric CKD cohort, routine serum biochemical parameters showed limited cross-sectional associations with caries experience and oral hygiene indices. However, the observed associations of serum magnesium and alkaline phosphatase with calculus accumulation suggest that mineral metabolism-related markers may be linked to plaque mineralization. These findings should be interpreted cautiously in view of the cross-sectional design, small sample size, and clinical heterogeneity of the study group.
This study aims to investigate the effects of abrasive flow finishing (AFF) on the surface quality, frictional resistance, and biological performance of orthodontic brackets. Stainless-steel brackets were randomly allocated into blank, control, and AFF groups. The blank group was left untreated. The control group underwent conventional magnetic polishing, while the AFF group was treated with AFF. Surface morphology was observed using scanning electron microscopy. Surface roughness at the micro- and nanoscale was investigated via 3D optical profilometry and atomic force microscopy, respectively. The arithmetic average roughness (Ra) and root mean square roughness (Rq) were analysed. The changes in slot dimensions were evaluated. Frictional resistance was determined using a universal testing machine. Biological performance was evaluated via bacterial adhesion and in vitro calculus formation assays. The AFF group presented a mirror-like finish. Scanning electron microscopy micrographs exhibited the smooth and uniform surface in outer and slot areas in the AFF group, while the control group showed obvious defects and pits within slots. 3D optical profilometry and atomic force microscopy demonstrated the smooth and regular surface topography in the AFF group. Quantitative analysis showed that Ra and Rq values of the slot area in the AFF group were significantly lower than those of blank and control groups. There were no significant changes in slot dimensions following AFF treatment. The kinetic friction force was significantly reduced in the AFF group. Furthermore, AFF treatment inhibited bacterial adhesion and calculus-like mineral deposition on brackets. AFF treatment effectively reduced the surface roughness of orthodontic brackets, especially within slot area, outperforming conventional magnetic polishing. This improvement further minimized frictional resistance and inhibited bacterial adhesion and calculus-like mineral deposition. This study demonstrates that AFF is a superior post-processing technique for orthodontic brackets.
Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder that may adversely affect oral health in children. However, the contribution of preventive determinants to oral health outcomes in this population remains insufficiently explored. To compare oral health status and preventive determinants between children with T1DM and non-diabetic peers and to investigate their associations with oral health outcomes. A cross-sectional study was conducted among 100 children with T1DM and 100 age- and sex-matched non-diabetic controls (3-17 years). Data on oral hygiene practices, dietary habits, and dental attendance were collected using structured questionnaires. Clinical examinations assessed dental caries (DMFT/dmft), plaque index (PI), gingival index (GI), and calculus deposition. Statistical analyses included chi-square tests, Student's t-tests, and ANOVA. The mean age of participants was 9.6 years. No significant difference in DMFT/dmft was observed between groups (p = 0.60). Children with T1DM exhibited higher plaque index values (p = 0.05), a greater prevalence of calculus deposition (p = 0.001), and more severe gingival inflammation (p = 0.022). Poor glycemic control was significantly associated with gingival inflammation (p = 0.043). Incorrect toothbrushing technique was more frequent among children with T1DM (p < 0.001), and dietary behavior was associated with DMFT/dmft in this group (p = 0.02). Children with T1DM exhibited poorer periodontal and oral hygiene status than non-diabetic peers despite similar caries experience. Oral hygiene practices and dietary behaviors were significantly associated with oral health outcomes. These findings support the integration of targeted oral health promotion strategies into routine pediatric diabetes care.
Urolithiasis prevention depends on sustained fluid intake, timely urination, and appropriate dietary and lifestyle practices. However, occupational routines may make these behaviors difficult to maintain. This study explored participants' perceptions of how occupational routines relate to stone-preventive self-care among individuals with CT-confirmed urolithiasis. An observational qualitative exploratory study was conducted at a tertiary care teaching hospital in South India. Adults with CT-confirmed urolithiasis and at least one calculus measuring 3 mm or more were recruited using maximum-variation purposive sampling across physically demanding or heat-exposed, sedentary or professional, travel-based or mobile, and shift-based or irregular work contexts. Face-to-face semi-structured interviews were conducted in Tamil between February and July 2025. Contemporaneous interview notes were expanded after each interview, translated into English, and analysed using thematic analysis. Clinical and CT-related variables were summarized descriptively to characterize the sample. Twenty-four of 32 approached participants were included. The median maximum stone diameter was 7 mm (interquartile range, 5-10 mm), 15 participants had hydronephrosis and/or obstructive features, and 9 had recurrent stone disease. Six themes were identified: occupationally shaped inadequate hydration; restricted or delayed urination in relation to work setting; disruption of meal timing and food quality; occupational absorption and neglect of self-care; schedule instability, travel, and disruption of daily routines; and stone disease understood as multifactorial, with occupation interacting with other perceived contributors. Across themes, participants described three interconnected pathways through which work routines could make preventive self-care difficult to sustain: infrastructural and access constraints, schedule instability and routine disruption, and cognitive-attentional absorption. Family history, dietary and lifestyle practices, supplements, smoking, alcohol use, and comorbidities were also described as contextual contributors. Occupational routines may influence the feasibility of maintaining stone-preventive self-care among individuals with urolithiasis. The findings support occupation-sensitive counselling and practical workplace strategies that consider water and toilet access, break opportunities, travel demands, shift work, and workload. Longitudinal and implementation studies should assess whether such approaches improve preventive behaviours and stone-related outcomes.
A 5-month-old Munchkin cat was referred for hematuria. Computed tomographic angiography revealed hepatic arteriovenous malformation (HAVM) within the left lateral liver lobe and multiple acquired portosystemic shunts (APSSs), in addition to a bladder calculus. Following medical management, the cat underwent attenuation of arterioportal communications. Because ligation of the left hepatic artery did not normalize portal pressure, the left hepatic division was resected. Surgical ligation of a subset of the APSSs was performed 1 month later. Postoperatively, clinical signs improved, hepatopetal portal flow was restored, and biochemical liver function parameters normalized. The remaining APSSs regressed spontaneously. To our knowledge, based on the English-language literature, this is the first reported case of feline or canine HAVM in which liver function parameters normalized.
The breakdown of the Stokes-Einstein relation in supercooled water, where the product [Formula: see text] increases by 35% approaching the homogeneous nucleation limit, has resisted theoretical explanation for decades. We develop a two-state fractional thermodynamics framework that quantitatively resolves this anomaly with 1.0% experimental agreement. The key insight is that translational and rotational degrees of freedom exhibit dramatically different fractional dynamics in the tetrahedral low-density liquid phase: translation approaches ballistic motion ([Formula: see text]) through coherent inter-cage jumps while rotation remains strongly subdiffusive ([Formula: see text]) due to cooperative hydrogen-bond network constraints. This yields a decoupling ratio [Formula: see text] that, combined with percolative transport and critical fluctuations near the Widom line, explains the observed breakdown. We derive modified critical exponents from fractional Landau theory and present testable predictions for neutron scattering and molecular dynamics simulations. This framework establishes fractional calculus as essential for understanding anomalous transport in hydrogen-bonded liquids.
Research on digital parenting and sharenting has expanded rapidly, yet the literature remains distributed across media studies, child development, communication, law, and health-related domains. This dispersal has limited integrative understanding of how parental online disclosure is linked to children's privacy, autonomy, digital identity, and digitally mediated visibility. This study synthesized publications indexed in Web of Science Core Collection and Scopus at the intersection of digital parenting and sharenting. Guided by a structured review question, the study was conducted as a scoping review with bibliometric mapping and reported in line with PRISMA-ScR principles. The review aimed to map conceptual, thematic, and evidentiary patterns across an interdisciplinary corpus rather than to perform quality-weighted effect synthesis. Records were screened against four explicit eligibility criteria concerning children's privacy, online visibility, digital identity, consent, and parent-child boundary regulation. The final corpus comprised 252 English-language articles and reviews published between 1992 and 2025. Narrative synthesis was combined with bibliometric mapping using bibliometrix in R and VOSviewer to identify thematic concentrations, intellectual linkages, and temporal trends. The field showed limited early output, followed by sustained growth after 2016 and marked acceleration from 2019 onward. The literature has consolidated around a conceptual core defined by sharenting, social media, children, privacy, and digital parenting. Communication Privacy Management, privacy calculus, mindful sharenting, and psychological ownership emerged as recurrent interpretive frameworks. Across the corpus, children's privacy, consent, boundary negotiation, and digital identity increasingly functioned as organizing concerns, while more recent studies showed stronger engagement with platformized visibility, influencer culture, and rights-based governance. Intellectual mapping indicated a coherent citation base anchored in foundational work on sharenting, adolescents' perceptions, and children's privacy. The review indicates that sharenting is no longer examined solely as an everyday parental sharing practice. It is increasingly treated as a psychologically and ethically consequential process through which children's online identities are constructed, negotiated, and exposed in platformed environments. The study clarifies the conceptual and intellectual structure of the field and highlights the need for more child-centered, cross-cultural, and psychologically explicit research.
This in-vitro study compared cemental and periodontal ligament changes in fluorosed and non-fluorosed teeth using Scanning Electron Microscopy. Sixty premolar teeth (30 fluorosed and 30 non-fluorosed) extracted for orthodontic indications were retrieved from the Department of Oral and Maxillofacial Surgery, Mamata Dental College, Khammam, Telangana. Teeth were sectioned transverse to the cemento-enamel junction to separate crown and root portions. scanning electron microscopy photomicrographs of root specimens were analyzed for hypermineralized surfaces, mineralized debris, resorption bays/cavitation, calculus-related debris, fiber insertion areas, and mineralization of connective tissue fibers. Results revealed a higher percentage of resorption bays, calculus and calculus-related debris, and globular mineralized debris in fluorosed teeth compared to non-fluorosed counterparts. Additionally, partial and initial mineralization of connective tissue fibers was more prevalent in fluorosed teeth. These findings suggest that dental fluorosis induces distinct structural alterations at the cemental and periodontal ligament level, even in periodontally healthy teeth. This study concludes that fluorosis causes definite cemental and periodontal ligament changes on the root surface, which may have implications for periodontal health and clinical management of fluorosed dentition.
To address the shortcomings of traditional rock creep models, including neglecting the time-varying cumulative effect of thermal damage, low accuracy in describing accelerated creep, and failing to reflect the thermo-mechanical coupling rheological mechanism of deep high-temperature rock mass, this paper proposes a fractional-order rock creep damage model considering temperature influence, based on continuum damage mechanics and fractional calculus theory. Firstly, a time-varying thermal damage evolution equation dependent on both temperature level and heating duration is developed, and a temperature-coupled stress creep damage equation is established synchronously to realize the synergistic evolution of dual time-varying damage, with damage only acting on the fractional viscosity coefficient to keep the elastic modulus unchanged. Then, combined with the improved fractional-order Kelvin element and optimized Nishihara model, the uniaxial creep damage model is derived via rigorous equation derivation and integration, and the corresponding triaxial model is further deduced for complex engineering stress conditions. Finally, model verification and comparison are conducted based on rock creep tests under 25 °C, 50 °C, 75 °C and 100 °C. The results indicate that the model can accurately characterize the full three-stage creep behavior of rock, with the predicted curves in excellent agreement with test data and all correlation coefficients exceeding 0.95. Compared with the classical Nishihara model and existing models, the proposed model has higher fitting precision and better performance in capturing accelerated creep inflection points, verifying its superiority and reliability, and providing theoretical support for long-term stability analysis of deep high-temperature rock engineering.
Electric toothbrushes are known to outperform manual devices in plaque removal, yet most comparative trials rely on conventional examiner-based indices and none have evaluated efficacy across smoking profiles using objective fluorescence-based measurement. This 24-week, 2-arm, parallel-group randomized controlled trial compared an oscillating-rotating electric toothbrush (Oral-B iO 6) with a manual toothbrush in 126 adults aged 18 to 50 years attending a dental clinic for routine scaling and polishing. Current smokers and never-smokers were enrolled to allow prespecified subgroup analysis by smoking status. Dental plaque accumulation was quantified using quantitative light-induced fluorescence (QLF) technology. The primary endpoint was ΔR30 (percentage of tooth surface with fluorescence increase ≥30%, reflecting total mature plaque); ΔR120 (fluorescence increase ≥120%, reflecting thick plaque and calculus-like deposits) was the secondary endpoint. The primary analysis used analysis of covariance adjusting for baseline plaque levels, treatment arm, smoking status, and their interaction. Use of the electric toothbrush was associated with significantly lower ΔR30 at 24 weeks compared with manual brushing (β = -1.84, 95% CI [-3.27, -0.41], p = .012), an effect that remained robust after adjustment for age, sex, and habitual oral hygiene behaviours. Baseline plaque level was the strongest predictor of follow-up values in both outcome models. No significant treatment effect was observed for ΔR120 (β = -0.77, 95% CI [-1.71, 0.18], p = .112). Subgroup analyses showed significant between-arm differences on both outcomes among never-smokers; among smokers, differences were directionally consistent but did not reach statistical significance, and the treatment-by-smoking interaction was not statistically significant. Oscillating-rotating electric toothbrushing produced significantly lower plaque accumulation than manual brushing over 24 weeks, as indexed by QLF-derived ΔR30. These findings support the potential advantage of oscillating-rotating powered toothbrushes for reducing plaque accumulation in adult patients and further support the utility of QLF as a precise and reproducible outcome measure for toothbrush efficacy trials. ClinicalTrials.gov, NCT06358482.
Generative AI adoption is often framed primarily as a question of learning technical skills. It is thought that if users learn better prompting and evaluation practices, useful outputs will follow, leading to greater reliance on the technology. This perspective overlooks a defining feature of large language models (LLMs): their output quality depends heavily on how users engage with them. Because LLM performance varies substantially with depth of disclosure, contextual richness, and iterative refinement, user interaction strategies directly shape perceived usefulness and observed performance. This paper develops a conceptual framework that proposes how risk salience may shape these interaction dynamics. Drawing on research in trust in automation, privacy calculus, algorithm aversion, and the social amplification of risk, we propose the guarded engagement loop, a multilevel feedback mechanism in which risk perceptions may shape interaction strategies that influence observed performance and, in turn, recalibrate trust in generative AI systems. At the micro level, elevated risk salience related to privacy, safety, or ethical concerns may lead users to adopt guarded interaction strategies characterized by reduced contextual disclosure and limited iteration. These constrained interactions can lower output quality and increase the likelihood of visible errors, which may further erode trust and reinforce cautious engagement. At the macro level, values-driven withdrawal from AI use has the potential to narrow the diversity of visible applications, amplifying risk-focused narratives, reinforcing perceptions of harm in public discourse. The guarded engagement loop framework conceptualizes generative AI adoption as a feedback process in which risk perceptions may shape interaction conditions that, in turn, can influence observed performance and subsequent trust calibration. We articulate testable propositions and discuss implications for organizational governance, AI system design, and institutional conditions that enable bounded openness and calibrated reliance.
This study evaluated oral health status and oral health-related quality of life in patients with chronic kidney disease (CKD) in the pre-dialysis stage compared to individuals without CKD. A total of 49 pre-dialysis CKD patients (GFR < 60 mL/min./1.73 m2) and 46 controls (GFR ≥ 90 mL/min./1.73 m2) underwent full-mouth clinical examinations, including periodontal assessment, dental caries evaluation, and prosthesis use. Data on age, gender, ethnicity, education, smoking status, body mass index (BMI), and creatinine levels were collected. Quality of life was assessed using the SF-36 and OHIP-14 questionnaires. The CKD group had a mean age of 59.29 (±10.08) years, while the control group had 56.46 (±7.87) years. No significant differences were observed between groups in age, ethnicity, education, or smoking status (p > 0.05). CKD patients exhibited higher levels of dental plaque (p = 0.02), calculus (p = 0.03), periodontitis (p = 0.01), and edentulism (p = 0.02) but showed no differences in caries prevalence (p > 0.05). General health-related quality of life (SF-36) was similar between groups (p > 0.05), whereas oral health-related quality of life (OHIP-14) was worse in the control group (p < 0.005). The higher prevalence of edentulism in CKD patients resulted in greater prosthesis use.
The more advanced the symbolic mathematics, the more impenetrable the meaning. This is particularly evident in quantum theory, where symbolic formalisms foreground states and objects. An alternative diagrammatic approach, Quantum Picturalism (QPic), privileges structure, relation, and transformation. As a category theoretic formalism, it supports reasoning through the composition of visually represented quantum processes, a distinction that not only concerns representation but also shapes how quantum phenomena are conceptualized, opening new educational possibilities and ways of knowing. The choice of formalism-algebraic or diagrammatic-is not neutral, but embodies underlying ontological commitments that shape which structural features of quantum phenomena-such as states vs. relations; objects vs. transformations-are made accessible. This paper examines the epistemological, cognitive, and educational significance of non-symbolic thought in mathematics, and in quantum mechanics in particular, using QPic as a guiding example. We raise a central question: can quantum processes be represented in ways that align more naturally with human cognition? What is new here is showing how the epistemological and cognitive aspects of non-symbolic formalism are brought into pedagogical practice. Such paradigm largely benefits from the language of thought hypothesis alongside theories of embodied cognition, dual coding, and conceptual metaphor theory to articulate a holistic framework in which multiple, interacting conceptual systems underpin understanding. Drawing on historical precedents-from Euclidean geometry to Leibniz's universal calculus of thought-we contend that human intuition works more naturally within relational and visual frameworks, particularly those that help complex ideas to be seen and manipulated as structured wholes. The broader impact of this paradigm lies in democratizing access to quantum innovation and rethinking what it means to understand the quantum world, offering an inclusive entry point into it.
Despite rapid growth in oral microbiome research, it remains unclear how well publicly available data reflect the diversity of the global human population. This study systematically evaluated the geographic and sampling-type representativeness of publicly available human oral microbiome data. A global meta-research analysis of publicly available human oral microbiome records in the NCBI BioSample database released up to December 31, 2025, was conducted. Records were retrieved, harmonized, and analyzed across 4 dimensions: geographic origin, oral sampling type, temporal trends, and population-adjusted representation using a derived representation index (RI). A total of 222,454 BioSamples from 1,600 studies were identified, spanning 92 countries and 4 major oral sampling-type groups: oral fluids, oral mucosa and surfaces, dental plaque and calculus, and special or lesion-associated sites. Geographic distribution was highly concentrated; nearly half of all geographically annotated samples originated from the United States and China, while 61% of countries worldwide contributed no samples. Low- and middle-income regions, including Central and Southern Asia (RI = -12.76) and Sub-Saharan Africa (RI = -11.21), were underrepresented relative to their population sizes. Sampling-type distribution was similarly uneven, with saliva samples comprising more than half of all samples. In contrast, disease-relevant sites, including carious lesions, periapical lesions, and the dental pulp, each represented less than 0.2% of the dataset. Together, these findings underscore that publicly available human oral microbiome data remain unevenly distributed across geographic origin and sampling types, reflecting structural and practical factors that have persisted over time. Deliberate efforts to improve global representation, sampling diversity, and metadata standardization are needed to build a more scientifically robust oral microbiome evidence base.
Purpose To apply a vendor-neutral Agatston score (vnAS) for aortic valve calcification across multiple CT systems and to aortic stenosis severity classification. Materials and Methods Anthropomorphic phantoms with varying degrees of calcification were scanned using seven different CT systems and a reference electron-beam CT system to determine the vnAS. The vnAS was calculated using a regression model, whose performance was evaluated by both the coefficient of determination and analysis of variance. The vnAS was subsequently validated on a retrospective patient sample from eight international centers. Thresholds of severe aortic valve stenosis were defined as 1274 and 2065 AU for women and men, respectively. Results The Agatston scores from all CT systems were strongly correlated with that of the reference system (R2 > 0.932). On the basis of their echocardiographic findings, 183 of 831 (22.0%) patients (mean age ± SD, 77 years ± 10; 351 of 831 [42.2%] women) had discordant echocardiographic aortic valve stenosis findings. Among women with discordant results, the vnAS was higher than the traditional aortic valve calcium score (median, 1693 AU [IQR, 908-2513 AU] vs 1181 AU [IQR, 726-1964 AU], respectively; P < .001). Similar findings were observed for men (median, 2658 AU [IQR, 1894-3822 AU] vs 2056 AU [IQR, 1408-3056 AU], respectively; P < .001). Using the vnAS, 8.5% of women and 17.8% of men with discordant echocardiographic findings were reclassified into the severe aortic stenosis group. Conclusion A previously developed calibration tool, the vnAS, was validated and reclassified patients with discordant echocardiographic findings into the severe aortic stenosis group. Keywords: CT, Echocardiography, Percutaneous, Cardiac, Valves, Calcifications/Calculi, Technology Assessment, Vendor-neutral Agatston Score, Aortic Stenosis, Aortic Valve Calcification, Phantoms Supplemental material is available for this article. © RSNA, 2026 See also commentary by Jaltotage and Leipsic in this issue.
To determine the prevalence of different urinary stone types in Rostov Region, as well as the frequency and distribution patterns of single-component and mixed stones by sex and age. The chemical composition of 673 urinary stones was analyzed using infrared spectroscopy and X-ray diffraction. Stones were received in an anonymized form from the Clinical and Diagnostic Center "Zdorovie", Rostov-on-Don, for the period 2023-2025. A total of 673 urinary stones were analyzed with consideration of patient sex and age. The male-to-female ratio was 1.3:1. Overall, 148 different mineral combinations were identified. Single-component stones were found in 129 cases (19.2% of all stones). Calcium oxalate stones (CaOx) (mono-, dihydrate, and combinations of CaOx monohydrate and dihydrate (COM, COD, COM+COD)) were observed in 55 cases (42.6% of single-component stones and 8.2% of all stones). COM stones predominated over COD and were observed twice as often in men. The remaining CaOx stones were represented by COM+COD. Uric acid (UA) stones, including anhydrous uric acid (AUA) and uric acid dihydrate (UAD), were found in 63 cases (48.8% of all single-component stones and 9.4% of all stones) and were distributed almost equally between men and women. Peak uric acid stone formation in women occurred between 51 and more or equal 71 years (93.5%), whereas in men it occurred between 41 and 70 years in 90.6%. Cystine stones were identified in 5 cases, only in men. Single-component calcium phosphate stones (CaP, brushite and carbonate apatite) accounted for only 8.5% of single-component stones and 1.6% of the overall cohort. Struvite as a single-component stone was not identified in any case. Two-component stones accounted for 60.6% of all stones. The most common combination was CaOx and carbonate apatite (CAP), consisting 51.7% of all stones and 85.3% of two-component stones, with predominance in men aged 31-60 years. CaOx+CAP was markedly more common than CAP+CaOx. Combinations of CaOx+struvite, CAP+struvite, CaOx+brushite, and UA+struvite accounted for only 1.5% of two-component stones. The combination of CaOx and UA accounted for 13.2% of two-component stones and predominated in men. The combination of uric acid and a phosphate component was observed in only 2.9% of cases, with a pronounced predominance in men. In both situations, increased prevalence was noted after the age of 30-40 years. A combination of uric acid and ammonium urate was exceptionally rare and was observed in one woman. Multicomponent stones containing three or more minerals accounted for 13.8% of all stones. The predominant combination was CaOx+CAP+UA (62%), while the remaining stones were CaOx+CAP+struvite mixtures. The assessment of regional trends in stone formation may support empirical clinical decision-making and inform the choice of surgical and conservative management. A substantial proportion of mixed stones may represent a diagnostic and metaphylaxis challenge due to multiple metabolic abnormalities and additional external factors that aggravate crystallization and stone formation. Further periodic studies of regional trends in stone composition are needed to develop specific individualized metaphylaxis approaches and to assess the effficiency of conservative treatment.