Valvular heart disease (VHD) is associated with substantial morbidity, mortality, and health care costs, yet its contemporary prevalence among older adults in the United States is unknown. We performed a decentralized study of older adults (PREVUE-VALVE) to determine the population prevalence of VHD among older Americans. Individuals 65-85 years old who previously filled a prescription at CVS or Walgreens pharmacies were randomly selected; contacted via e-mail, direct mail, or text messaging; and invited to participate. Enrolled participants completed study procedures in their homes, including a comprehensive transthoracic echocardiogram. The primary endpoint was the prevalence of moderate or greater (≥ moderate) VHD, weighted to reflect the U.S. The co-primary endpoint was the prevalence of clinically significant VHD, which also included mild-to-moderate regurgitant disease. The study sample (n = 3,000) was representative of older Americans (median age 71 years, 57.1% female, 14.6% non-Hispanic Black, 9.4% Hispanic). The weighted prevalence of ≥ moderate VHD was 8.2% (95% CI: 7.0%-9.5%), which increased to 18.4% (95% CI: 16.7%-20.2%) for clinically significant VHD. Tricuspid regurgitation was the most common lesion, followed by aortic stenosis, mitral regurgitation, aortic regurgitation, and mitral stenosis. Older age, but not sex, was associated with greater prevalence. In age- and sex-adjusted analyses, non-Hispanic Black individuals had a lower prevalence of any VHD compared with non-Hispanic White individuals (adjusted RR: 0.91; 95% CI: 0.83-0.99), driven predominantly by lower rates of aortic stenosis and regurgitation. There were no significant adjusted differences in VHD prevalence between Hispanic and non-Hispanic individuals. Extrapolation of these data to the U.S. population indicates that at least 4.7 million 65-85-year-olds currently have ≥ moderate VHD, and 10.6 million currently have clinically significant VHD-values that are projected to increase to 6.5 and 14.7 million, respectively, by 2060. In this national in-home echocardiography study, VHD was common among older adults, with important age-related and valve-specific patterns. PREVUE-VALVE establishes the feasibility of large-scale decentralized cardiovascular imaging studies and provides a contemporary foundation for clinical and policy planning related to the burden of VHD. (Age- and Sex-Specific Prevalence of Acquired Valvular Heart Disease (PREVUE-VALVE; NCT05357404).
In the Italian Region Friuli-Venezia Giulia, Herpes Zoster (HZ) vaccination of actively offered free of charge to the population at age 65. Vaccination uptake is below the goal of coverage ≥50% set in the national vaccination plan. We set up a pilot project with a small number of General Practitioners (GPs) of the Health Authority of Udine, to assess whether GPs can catch-up patients invited for vaccination the previous year but not attending the appointment. Twelve GPs voluntarily adhering to the project were provided from the Vaccination Center with 10 doses of vaccine each, corresponding to the immunization of 5 individuals. They contacted patients born in 1959 not adhering to the previous invitation and proposed to immunize them. We assessed whether vaccination coverages increased among patients followed by those GPs and the feasibility of contacting the patient and handling the vaccine. Among participating GPs, from July to December 2025, coverage of patients in the cohort of interest increased from 42.9% to 63.4%. Although some physicians had difficulties in managing the vaccine and some reported that contacting patients is extremely time-consuming, the overall judgment of feasibility of both the contact and information of patients and of the actual vaccine administration was excellent. This pilot project suggests that the collaboration with GPs can strongly contribute to improve HZ vaccine uptake. Since such collaboration was considered feasible, more GPs from the same Health Authority may be involved.
ObjectiveThis qualitative exploratory study aimed to deepen the understanding of selective disclosure among adolescents and young adults (AYAs) living with chronic conditions, particularly in the context of intimate relationships. The project created a space for AYAs to reflect on and share their lived experiences of managing chronic illness and disclosing it to potential partners.MethodsThe study used a participatory design that combined elements of Youth Participatory Action Research (YPAR) with citizen science. Four YPAR partners, young people with lived experience of chronic illness, were actively involved in all stages of the research process, including topic selection, recruitment, development of questions, data collection, analysis, and dissemination. Additionally, 44 AYAs participated as respondents to a longitudinal qualitative survey consisting of 35 open-ended questions that focused on intimacy, challenges, coping mechanisms, and support systems. NVivo 14 was used to code and analyze responses thematically.ResultsOf the 44 AYAs contacted, 27 answered all survey questions. The sample had a high representation of young women with diabetes and LGBTQ + individuals with ADHD and other chronic conditions. Levels of self-acceptance, feelings of empowerment, and previous experiences of disclosure shaped participants' willingness to disclose their health conditions in intimate situations. Supportive social and relational environments, including open-minded partners and trusted peer networks, encouraged disclosure. In contrast, experiences of stigma, fear of rejection, and concerns about being misunderstood or reduced to their diagnosis acted as barriers. Additionally, the presence of visible medication use or physical symptoms contributed to a sense of vulnerability, further complicating the decision to disclose.ConclusionThe study sheds light on the nuanced relationship between chronic conditions, self-identity, and intimacy among AYAs. It highlights the importance of creating supportive environments and promoting open communication in both clinical and social settings. By integrating YPAR partners throughout the research process, the study highlights the value of participatory methods in capturing diverse youth perspectives and promoting more empathetic approaches to addressing intimacy related challenges in healthcare contexts.MESH termsChronic Disease / psychology*; Qualitative Research; Truth Disclosure*; Young Adult.
Dermatophytes cause a wide range of superficial infections of the skin, hair and nails, with high global prevalence and considerable public health relevance. Treatment regimens for dermatophytosis are limited to few antifungal drug classes, and rising resistance-particularly to terbinafine-further compromises therapeutic efficacy. Topical antiseptics such as octenidine (OCT) may represent a promising option for infection control and local therapy. This study investigated the in vitro antifungal activity of the pure antiseptic OCT (at final assay concentrations of 0.1% and 0.05%) and two OCT-based commercial ready-to-use medicinal products (octeniderm® and octenisept®) against clinical isolates of emerging (drug-resistant) dermatophytes including Trichophyton rubrum, T. mentagrophytes, T. tonsurans, T. interdigitale, T. indotineae and Microsporum canis. Quantitative suspension assays were conducted according to EN 13624:2013 under low organic load (0.3 g/L bovine serum albumin) and high organic load (3 g/L bovine serum albumin, 3 mL/L defibrinated sheep blood), with contact times ranging from 1 to 15 min. Results showed that the active OCT itself as well as the skin antiseptic octeniderm® and the wound and mucous membrane antiseptic octenisept® are effective against the tested dermatophytes in a time- and concentration-dependent manner. Notably, octeniderm® was able to inhibit fungal growth within 1 min, even under high organic load conditions. These in vitro findings suggest that OCT, a well-tolerated antiseptic already in clinical use represents a potential option for preventing transmission and managing superficial infections caused by (drug-resistant) dermatophytes.
Cancer progression involves extensive alterations in epigenetic and gene expression programs, but the accompanying changes in higher-order genome organization remain less well understood. Using high-resolution Micro-C mapping in the MCF10 cell model of breast cancer, we profiled chromatin compartments, topologically associated domains, and chromatin loops. We find large-scale compartmental shifts occur predominantly in early stages of cancer development, with more fine-scale structural changes in topologically associating domains and loops accumulating during the later transition to metastasis. Relating these chromatin features to gene expression and enhancer-associated histone marks revealed that many differentially expressed genes are physically connected to distal regulatory elements. While enhancer-promoter contact frequency and distal enhancer activity correlated with gene expression, strong changes in chromatin looping were relatively infrequent during progression, suggesting that alterations in chromatin contacts are not globally necessary, but may facilitate gene regulation at a subset of genes. These results elucidate the connection between gene regulation and genome remodeling in a cell-based cancer progression model.
In recent years, numerous carbon material and covalent organic framework (COF) composites have been reported, demonstrating remarkable potential as high-performance electrode materials for supercapacitors (SCs). COFs possess advantages such as tunable frameworks, variable pore environments, and pre-designed structures. When appropriately combined with carbon materials, these composites can not only overcome the poor conductivity of COFs but also facilitate rapid mass transport in permanently open channels and provide dense active sites for efficient adsorption of electrolyte ions. This review summarizes the representative research progress of carbon material-COF composites for SC applications, focusing on structural design strategies including the introduction of redox-active sites, interfacial bonding engineering, and controlled composite construction. The applications of these composites in various SC devices are systematically discussed, covering symmetric and asymmetric configurations, as well as flexible and micro-supercapacitor devices. Moreover, we provide a critical overview of the key challenges currently facing this field, such as insufficient structural and electrochemical stability, limited ion transport in stacked structures, difficulties in achieving large-scale and reproducible synthesis, as well as inferior interfacial contact between components. On this basis, future research directions are proposed to promote the rational design and practical development of high-performance carbon-material-COF composite electrodes for advanced supercapacitors.
The development of chiral organic semiconductors with efficient circularly polarized light (CPL) detection capability is crucial for advanced optoelectronic applications, such as secure communication and optical information processing. However, translating their promising molecular-level chirality into solid-state devices remains a challenge. The core issue lies in the difficulty of controlling the quality of the active film during film formation, including ordered molecular packing and suppressed surface defects, which governs both charge transport and chiral expression. Herein, we demonstrate high-quality thin films of a novel n-type chiral π-conjugated polymer, (S)-P(NDI2MH-T), fabricated via a kinetically controlled dip-coating method. Systematic investigation of the dip-coating parameters, particularly tailoring the surface wettability, identifies that the substrate with a contact angle of ∼36° and a temperature of 25 °C at a polymer concentration of 5 mg mL-1 yields continuous, pinhole-free films with enhanced molecular ordering. Based on these films, organic n-type phototransistors demonstrate a high electron mobility of 0.82 cm2 V-1 s-1 and a high photoresponsivity of 38 A W-1. Furthermore, the devices show pronounced chiral selectivity towards CPL, with a photocurrent dissymmetry factor (gph) of up to 0.28. Leveraging this selectivity, we successfully demonstrate the application of the device in binary logic information encoding and decoding, mimicking Morse code communication. This work provides a viable pathway from material processing to device integration for constructing sensitive and integrable chiral optoelectronic systems.
Rhythm is a fundamental organizing principle in biological systems, shaping physiological regulation, affect, and social interaction across species. In caregiving, rhythmic passive movement, such as carrying and rocking, has long been recognized as a soothing strategy in mammals, reducing crying, heart rate, and arousal while promoting sleep. Anecdotal and behavioral evidence in humans also suggest that some forms of rhythmic motion, such as sliding or tossing infants, can elicit overt enjoyment. Yet, no study has directly investigated the effects of passive rhythmic movement beyond the mammalian lineage or in species lacking maternal carrying, nor assessed its potential to evoke pleasurable states. Here, we examined the effects of rhythmic passive movement in domestic chicks (Gallus gallus), a precocial bird that walks immediately after hatching and is never carried by the mother. Chicks were exposed to rocking (horizontal, vertical) and carrying-like motion at different frequencies. Slow rhythmic movements reduced contact calls, replicating the soothing effects known in mammals, while faster movements increased brood calls, indicating a transition from distress reduction to positive arousal. These results demonstrate that rhythmic passive motion modulates affective states in birds, revealing both calming and pleasurable dimensions and suggesting deeply conserved mechanisms for rhythm-based affect regulation across vertebrates.
Respiratory syncytial virus (RSV) induces pathogenic syncytia via its fusion (F) protein, yet how it orchestrates fusion within the crowded plasma membrane remains unclear. By integrating live-cell and dSTORM imaging, we visualized the spatiotemporal dynamics of RSV F from secretion to membrane assembly. We show that RSV F efficiently traffics to the plasma membrane and triggers F-actin-enriched protrusions that facilitate fusion, depending on branched actin remodeling. Super-resolution imaging further reveals that RSV F reorganizes from nanoscale clusters into near-continuous ribbon-like nanodomains at cell-cell contacts, forming a stable fusion platform. This work directly visualizes the actin-driven nanoscale assembly of a viral fusogen, defining a key mechanism in RSV pathogenesis and revealing a nanoscale target for antiviral intervention, thereby underscoring the power of advanced nanoscopy to unravel complex host-pathogen interactions at the molecular level.
Contact allergy to methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) remains common in the EU despite regulation. To assess the extent of use of MCI/MI and MI in cosmetic products on the Danish market, identify product categories involved and evaluate compliance of rinse-off products with the 15 ppm limit. Products listing MCI/MI or MI were identified through Kemiluppen, a Danish database of marketed cosmetics. Thirty products (16 shampoos and 14 liquid soaps) were examined using liquid chromatography-tandem mass spectrometry: 25 labelled as containing MCI/MI or MI, 5 unlabelled. In total, 257 cosmetic products containing MCI/MI or MI were identified, primarily shampoos (127), conditioners (98) and liquid soaps (8). Chemical analysis showed that 2 of 25 labelled products (8%) exceeded the 15 ppm limit, and 4 products did not meet the required 3:1 MCI/MI ratio. MCI/MI is used infrequently in cosmetic products. All, except two products complied with the limit in the regulation. Given the continued occurrence of contact allergy, this indicates that the limit (15 ppm) may be too high to be sufficiently protective. Further investigation into MCI/MI use in cosmetic products is warranted, alongside more proactive risk assessment and management strategies.
Oral cavity cancer (OCC) patients are treated with surgery as the primary modality of treatment world over. This study is aimed to compare surgery with adjuvant radiation practiced at center A with Radical radiation practiced at center B in terms of disease control and quality of life (QOL) for OCC patients. Wide excision and neck dissection with or without reconstruction was followed by adjuvant radiation with or without chemotherapy in selected cases in center A. Radical chemoradiation was used in center B. Their disease status at 2 years of follow-up was assessed along with QOL. The results were compared between the two centers. A total of 43 patients from center A and 33 patients from center B were looked at and the 2-year survival rate was 66% and 48%, respectively ( P = 0.04). Among QOL scores, pain in the mouth and shoulder was significantly higher in center A, while scores of social contact and weight losses were significantly higher in center B. Lost to follow-up was higher in center B, 52% versus 12%. Surgery followed by radiation with or without chemotherapy should be considered for operable OCC and provides better tumor control with a lesser QOL of subscales related to surgery. Wherever surgical expertise is not available, radical chemoradiation is preferred for a better QOL compared to palliative treatment.
Despite the importance of biophysical cues in tuning the immune response, the connections between these cues and immunological outcomes are poorly understood in the context of immunotherapies. To study these connections, our lab designed therapeutic complexes that are self-assembled from peptide antigens modified with cationic amino acid residues and anionic, nucleic acid-based modulatory cues. We utilized the self-assembly platform as a tool to understand how tuning the biophysical properties of immune signals impacts molecular interactions during self-assembly. Here, we implemented molecular dynamics simulations as a tool to study how molecular interactions between cationic peptides and anionic modulatory cues change as a function of peptide design. Using temperature replica exchange molecular dynamics, we compare molecular contacts - including hydrogen bonding and salt bridges - across a library of peptide sequences that are mistakenly attacked during autoimmune disease. We show that peptides with higher cationic charge and peptides anchored with arginine residues form more electrostatic interactions during self-assembly than peptides with lower cationic charge and peptides anchored with lysine residues, respectively. Surface plasmon resonance studies revealed that in addition to the type of anchored amino acid residue, the distribution of charge across the peptide also impacts the binding affinity of self-assembled immune cues. In vitro primary cell studies using these same antigen designs revealed signaling that was likewise sensitive to the total charge, charge distribution, and type of anchored amino acid residues within the therapeutic complexes. Taken together, these insights help intuit how to modify biophysical cues to self-assemble a range of peptide antigens for distinct disease targets. This granular understanding of nanomaterial-immune interactions contributes to more rational immunotherapy design.
Breathlessness is a common and distressing symptom impacting quality of life and limiting activities of daily living. Social isolation and loneliness are associated with increased morbidity and mortality, being problems in themselves and risk factors for poor health. Qualitative studies indicate breathlessness impacts social health; however, quantitative evaluation is limited. We aimed to assess the relationship of breathlessness with social isolation and loneliness in adults. Using a nationally representative sample of older adults aged ≥50 years from the English Longitudinal Study of Ageing (N=6623). The sample had 44% males, mean age of 70 years (SD=10). We examined associations of baseline breathlessness (modified Medical Research Council (mMRC) breathlessness scale) with loneliness (3-item University of California and Los Angeles (UCLA) loneliness scale) and social isolation (low social contact, low community participation, living alone) at baseline and follow-up at 4 and 8 years later, using regression models adjusted for confounders. At baseline, breathlessness was associated with higher levels of loneliness (coef.=0.161, 95% CI 0.113 to 0.209) and social isolation, including low social contact (coef.=0.094, 95% CI 0.028 to 0.159), low community participation (coef.=0.169, 95% CI 0.117 to 0.221) and living alone (OR 1.089, 95% CI 1.026 to 1.157). Longitudinally, breathlessness was associated with increasing loneliness and reducing social contact and community participation at 4-year and 8-year follow-up. Breathlessness was not associated with a change in living alone. Findings were independent of identified confounders. Breathlessness is related to increasing social isolation and loneliness, potentially due to limiting the amount and quality of social interactions. These findings suggest important psychosocial impacts of breathlessness requiring holistic management strategies.
Insertion of fluorescent reporter genes into viral genomes is a powerful tool for monitoring infection. In coronaviruses, this is commonly achieved by replacing accessory ORFs, thereby deleting endogenous gene functions. An alternative strategy is to manipulate viral RNA synthesis by inserting copies of the viral transcription regulatory sequence (TRS), which drives the transcription of viral subgenomic RNAs. However, coronavirus transcription is tightly regulated, and these modifications frequently disrupt native subgenomic RNA synthesis and attenuate viral growth. Here, we describe a reporter coronavirus that overcomes these limitations. Using human coronavirus (HCoV)-OC43 as a model system, we inserted an mNeonGreen reporter between the Spike and ORF5 coding regions, engineering the TRS and surrounding sequence to minimize off-target effects to transcription. This virus is genetically stable, with WT growth kinetics and unaltered subgenomic RNA transcriptional ratios. We developed a flexible reverse genetics system, which allows rapid cloning and virus recovery, supported by optimized HCoV-OC43 culture conditions for high-titre stock generation, and validated analytical reagents. Our reporter virus enabled sensitive detection and isolation of infected cells, facilitating transcriptomic analyses that distinguish host responses in infected and bystander populations based on active viral translation. We found that transcriptional responses to infection of A549 human lung epithelial cells were predominantly inflammatory, rather than interferon-mediated, and that bystander cells upregulated pathways associated with cytokine response signalling and cell-cell contact sensing. Together, these tools expand the experimental utility of HCoV-OC43, an important seasonal respiratory pathogen and low-containment model for betacoronavirus biology.
Oxides of cerium and manganese have been extensively employed in catalytic reactions due to their redox versatility. In the present study, pristine CeO2, Mn3O4 and mixed metal oxides (with Ce : Mn in ratios 2 : 1, 1 : 1 and 1 : 2) were synthesized via a facile sol-gel auto-combustion method and evaluated as polyphenol oxidase (PPO) mimics. Comprehensive structural and morphological characterization was performed using XRD, XPS, BET, TEM, SEM-EDX and EIS. Manganese doping modulated the Ce3+/Ce4+ ratio and enhanced electron transfer ability and surface area. Manganese oxide (Mn3O4) displayed the highest PPO-mimicking activity, as corroborated by structural studies. The reaction parameters, namely, pH, substrate concentration, contact time, temperature and catalytic dose, were optimized to achieve maximum activity. Michaelis-Menten kinetic studies confirmed the highest Vmax and Km for pristine Mn3O4 (Km = 0.84 mM) and the lowest for pristine CeO2 (Km = 3.48 mM), indicating enhanced substrate affinity of Mn3O4 NPs. A colorimetric sensing assay employing 3,3',5,5'-tetramethylbenzidine was used for the determination of catechol (LOD = 3.25 μM) and resorcinol (LOD = 6.9 μM) with low detection limits. Furthermore, the study was successfully extended to the detection of polyphenols in green tea and wine samples. The results correlated with the conventional Folin-Ciocalteu assay with the added advantages of fast detection, sensitivity and reusability of NPs. Thus, the present study demonstrates the potential of Mn3O4 NPs for the colorimetric detection of polyphenols.
Following a loss of balance, proper reactive responses are needed to avoid a fall. Efforts have focused on how physiological factors affect these responses, but few have addressed psychological states. One psychological factor of particular interest is fear of falling (FoF); while prevalent in older adults, the mechanisms by which it increases fall risk are not fully understood. The purpose of this study was to use a well-established, postural-threat manipulation (standing at a height) to evaluate how such threat affects reactive stepping behavior during a perturbation protocol designed to identify the perturbation magnitude at which stepping became necessary for balance recovery. Ten healthy, young adults completed a single-step threshold (SST) test using a waist-mounted spring scale device to provide progressively-ordered anterior and posterior perturbations while standing on level ground and on a 1-m-high platform. Stepping kinematics and dynamic stability (i.e., margin of stability, MoS) were assessed. For a given direction, standing at a height (increased postural threat) did not significantly alter SST, although a trend toward lower posterior SST at height was observed (p = 0.057). However, increased postural threat substantially altered the timing and execution of the recovery step performed at SST. Participants initiated steps 200-300 ms earlier and took shorter steps at raised height (p < 0.05), yet achieved greater MoS at foot contact. Under threat, MoS was reduced to a lesser extent before stepping, with participants often stepping before MoS < 0, indicating that steps were initiated at a larger safety margin relative to instability. Findings suggest that within the current paradigm, postural threat influences when recovery steps are initiated and how they are executed at SST, even when the perturbation magnitude required to evoke stepping remains largely unchanged. Future work should evaluate whether older adults with FoF adopt such strategies and whether this impacts fall risk.
Bacterial infection and biofilm formation are major barriers to effective wound healing, often leading to persistent inflammation, delayed tissue repair, and chronic wound conditions. To address these issues, a chitosan-based hydrogel patch embedded with silver-decorated two-dimensional magnesium oxide nanosheets (Cs-AMO) was developed as a multifunctional wound dressing. Morphological analysis confirmed the formation of porous 2-D MgO nanosheets uniformly decorated with Ag nanoparticles and well dispersed within the chitosan matrix. Owing to the combined effects of Ag+ ion release, reactive oxygen species generation, and contact-mediated antibacterial interactions, the Cs-AMO hydrogel patch showed nearly complete antibacterial inhibition (∼100%) against both Gram-negative and Gram-positive bacteria. In addition, the hydrogel exhibited strong antibiofilm activity, achieving biofilm inhibition of up to 82% against E. coli and 83% against B. subtilis, as confirmed by crystal violet assay and confocal microscopy. Cytocompatibility studies using HEK-293 cells revealed up to 85% cell viability, indicating favourable biocompatibility. Furthermore, in vivo evaluation using an infected rat wound model demonstrated accelerated wound healing, achieving 96% wound closure by day 12 post-treatment, along with effective bacterial clearance, reduced inflammation, and enhanced tissue regeneration compared to the control groups. Overall, the developed Cs-AMO hydrogel patch demonstrates strong potential as an antibacterial and antibiofilm wound dressing for the treatment of infected wounds.
Continuous intracanal disinfection facilitates the complete elimination of residual pathogenic microorganisms and prevents the recurrence of root canal infections. Current prolonged disinfection strategies rely on calcium hydroxide or antibiotic pastes; however, these agents require thorough subsequent removal, which extends the treatment cycle and increases procedural complexity. Herein, we report a two-component irrigation system based on tannic acid (TA) solution and silver nitrate (AgNO3) solution that rapidly forms a long-lasting antibacterial coating (≤3 min) without the need for subsequent removal. Delivered via a dual-chamber syringe, this system generates a TA-Ag nanocoating in situ on the root canal wall through phenolic hydroxyl-Ag+ coordination and subsequent reduction, enabling long-term disinfection through sustained Ag+ release. Antibacterial assays demonstrated that the TA-Ag irrigation system achieved over 99% eradication of Enterococcus faecalis biofilms after a 3-min treatment and maintained inhibition of bacterial colonization on dentin for up to 2 weeks. In addition, TA molecules can chelate calcium ions from body fluid via phenolic hydroxyl groups, inducing calcium crystallization and promoting root canal wall remineralization. In vivo mouse wound infection models confirmed that the TA-Ag irrigant efficiently eliminates bacteria, attenuates inflammation, and accelerates tissue healing. Dental pulp stem cell experiments and oral mucosal contact tests verified its biocompatibility and safety. Collectively, this study presents a safe and effective root canal irrigation system capable of sustained intracanal disinfection and remineralization, showing great promise in root canal therapy and also other biomedical applications.
Preoperative identification of minimal extrathyroidal extension (mETE) in papillary thyroid microcarcinoma (PTMC) remains clinically challenging due to the limited sensitivity and specificity of conventional imaging. Although spectral computed tomography (CT) enables three‑dimensional (3D) quantitative tissue characterization, its integration with clinical data for mETE prediction has yet to be systematically evaluated. This study aimed to develop and validate multiple machine learning (ML) models integrating spectral CT 3D parameters with clinical features to predict mETE in PTMC patients. A total of 253 patients with pathologically proven PTMC who had undergone spectral CT were retrospectively enrolled in this study and randomly assigned to either a training cohort (n=177) or a testing cohort (n=76). Patients with prior thyroid surgery, poor image quality, missing clinical data, or other malignancies were excluded. We collected 12 clinical features along with 13 spectral CT 3D quantitative parameters. mETE status was confirmed by postoperative histopathology. Feature selection was performed using Pearson correlation analysis and the Boruta algorithm. Predictive models were developed using 4 ML algorithms: light gradient boosting machine (LightGBM), multilayer perceptron classifier (MLP-C), Adaptive Boosting (AdaBoost) and logistic regression (LR). We evaluated the predictive models using receiver operating characteristic (ROC) curve analysis. The accuracy, area under the curve (AUC), sensitivity, specificity, positive predictive value and negative predictive value were all calculated. Shapley additive explanations (SHAP) values were used to interpret variable contributions. A total of 253 patients (170 mETE-positive, 83 mETE-negative; mean age 39.77±10.71 years) were included. Four variables were selected for inclusion in the final model, namely 3D-arterial enhancement fraction (AEF), BRAF V600E status, capsular contact status, 3D-arterial phase (AP)40keV. LightGBM, MLP-C, AdaBoost, and LR model demonstrated satisfactory diagnostic efficacy, with the AUCs of 0.99, 0.95, 0.91, 0.88 and 0.78, 0.77, 0.81, 0.80 in the training and testing cohorts, respectively. The SHAP method showed that the top three variables ranked by contribution degree were: 3D-AEF, BRAF V600E status, capsular contact status. ML models that incorporate spectral CT 3D parameters and clinical features offer a promising approach for preoperative prediction of mETE in PTMC. Following external validation in multicenter cohorts, these models may serve as adjunctive tools to inform clinical decision-making and risk stratification.
Patch testing is used when delayed-type hypersensitivity to dental materials is suspected, but no European baseline series exists for patients with suspected allergy to dental materials. To describe patch test positivity to a 24-allergen dental series, assess the added yield of late readings at D6/7 and characterise methacrylate reactivity patterns. In this retrospective single-centre study, 439 adults referred between 2016 and 2025 for suspected allergy to dental materials were patch tested with an institutional 24-allergen dental series comprising 11 metals, 8 methacrylates and 5 other substances. Reactions were read on D3 and D6/7 and scored by ICDRG criteria. Overall, 50.1% of patients had at least one positive reaction, and 41.0% had a positive metal reaction. Nickel (23.0%) and palladium (16.6%) were the most frequent allergens. Amongst methacrylates, HEMA (3.6%), HPMA (3.0%) and EGDMA (2.5%) were most frequent. Amongst methacrylate-positive patients, 44.4% had two or more positive reactions, 40.7% were HEMA-negative and 14.8% were HEMA-negative but HPMA-positive. Across all allergens, 19.8% of positive reactions were detectable only at D6/7, corresponding to a 24.7% relative increase in detection compared with D3 alone. Late readings improved detection, and methacrylate reactivity was not fully captured by HEMA alone.