Material properties such as rigidity, topography, and wettability significantly influence stem cell differentiation and are therefore optimized in implants. In this context, surface potential has been repeatedly, albeit inadvertently, shown to enhance osteogenesis. Here, we demonstrate that this surface property modulates cellular mechanosensing by altering the cell's perception of substrate rigidity. Specifically, we show that human bone marrow-derived mesenchymal stem cells (hBM-MSCs) on surfaces with a net zero charge, coated with collagen type I, exhibit characteristics typical of cells adhering to compliant substrates. Conversely, mesenchymal stem cells on polarized surfaces activate mechanoresponsive pathways that promote osteogenesis, as evidenced by large spreading areas, enhanced contractility, and Yes-associated protein (YAP) translocation into the nucleus. Furthermore, our data suggests that negative net surface potentials lead to the local accumulation of calcium ions, which further facilitates osteogenic differentiation. Collectively, these results show that surface potential is a powerful determinant of stem cell lineage commitment, offering a novel strategy to control cell fate in next-generation regenerative biomaterials.
This study aimed to investigate the effects of demographic factors, diet, sleep patterns, and physical exercise on the incidence of colorectal cancer (CRC) in Hunan, China. This study consecutively recruited patients newly diagnosed with CRC between July 30, 2020, and October 27, 2021. Each case was individually matched in a 1:1 ratio with one of the patient's family members' data control based on gender and age (±2 years). Additionally, efforts were made to ensure that matches were closely aligned with respect to educational level, place of residence, and occupation. The results showed that participants with primary school education or below were more likely to develop CRC compared with those with college education or above (OR = 5.693, 95% confidence interval [CI] = 0.789-41.076, P = .085). A balanced diet appears to be a risk factor for CRC compared with a plant-preference diet (PPD) (OR = 1.726, 95%CI = 0.980-3.040, P = .059). The risk of CRC was 1.542 times higher in participants who drank carbonated beverages than in those who did not (OR = 1.542, 95%CI = 0.989-2.405, P = .056). Participants with a walking habit exhibited a protective factor relative to those without a walking habit (OR = 0.533, 95%CI = 0.392-0.725, P < .001). After adjusting for gender and age, our case-control study found that the following factors were associated with an increased risk of CRC: consumption of carbonated soft drinks, lack of exercise, having a balanced diet compared with a PPD, and educational attainment at primary school level or below compared with college or higher. It should be noted that people with higher education level, regular exercise routines, and walking habits can reduce their risk of CRC. However, this paired study failed to prove the influence of alcohol consumption (AC) and smoking on the incidence of CRC. Since the incidence of CRC is the result of complex effects of multiple factors, further research is needed to discover its mechanism.
Malaria rapid diagnostic tests (RDTs) have revolutionized malaria diagnosis in endemic settings. RDTs are simple to use and accurate for clinical cases, although sensitivity is reduced at parasite densities below 200 parasites/μl. However, increasing prevalence of hrp2/3 gene deletions in certain areas threaten utility of histidine-rich protein 2 (HRP2)-based RDTs, and lingering HRP2 antigenemia can generate false-positive results after parasite clearance. This review summarizes current performance of malaria RDTs, threats to their validity, and recent innovations to improve their performance and continued role in malaria diagnosis. Most World Health Organization (WHO) prequalified RDTs perform well for clinical diagnosis, with only occasional exceptions, including a recently reported issue affecting several countries. RDT sensitivity is generally related to malaria transmission intensity, with higher proportions of false-negative results in lower-transmission areas. Newly prequalified lactate dehydrogenase (pLDH)-based RDTs perform well for both Plasmodium falciparum in areas with >5% hrp2/3 gene deletions and for Plasmodium vivax diagnosis. Several point-of-care alternatives to RDTs, including micro-fluidic devices, hemozoin-detecting devices, and automated hematology analyzers, have shown promising results in small studies, but require larger-scale trials before widespread use. RDTs remain a critical tool in clinical diagnosis of malaria, and newer pLDH-based tests perform well in areas where hrp2/3 gene deletions threaten validity of HRP2-based RDTs.
Clostridium difficile infection (CDI) occurs in up to 30% of hematopoietic stem cell transplant (HSCT) recipients and remains a significant cause of infectious diarrhea. This meta-analysis evaluated the association of oral vancomycin prophylaxis (OVP) with CDI prevention after HSCT. We conducted a literature search of PubMed, Cochrane, and Google Scholar for articles from inception to July 2025 that compared the safety and efficacy of OVP for CDI in post-HSCT patients. Statistical analysis of the extracted data was conducted using Review Manager 5.4. The odds ratio for dichotomous variables and the mean difference for continuous variables were analyzed along with the corresponding 95% confidence intervals. A random-effects model was applied when heterogeneity was high (I2 ≥ 50%), and a fixed-effect model was applied when heterogeneity was low (I2 ≤ 50%). This meta-analysis included 5 studies comprising 957 patients, with 490 (51.2%) receiving OVP and 467 (48.8%) not receiving OVP (no OVP). OVP was significantly associated with a reduced incidence of CDI during hospitalization (P < .00001). Although a lower overall incidence of CDI (hospitalization plus 180-day follow-up) was observed in the OVP group, the result was not statistically significant (P = .06). A leave-one-out analysis was performed to establish a significant association (P = .04). In the OVP group, higher rates of grade 2 to 4 acute graft-versus-host disease (P = .13) and lower rates of bloodstream infections (P = .74), 1-year event-free survival (P = .44), and longer hospital stays (P = .36) were observed, although none reached statistical significance. We conclude that oral vancomycin might be associated with a lower incidence of CDI during hospitalization in post-HSCT recipients and can be considered for CDI prophylaxis. No statistically significant adverse outcomes were observed in the OVP group compared with placebo. However, given the observational nature of these studies, these findings should be considered preliminary. Large-scale randomized controlled trials are needed to confirm the true efficacy and safety profile of OVP in post-HSCT recipients.
Monoaminergic signaling controls many aspects of human physiology, including autonomic responses, movement, and emotion. The vesicular monoamine transporters (VMAT1 and VMAT2) sequester monoamines into synaptic vesicles within the central and peripheral nervous system. Dysregulation of VMAT function contributes to neuropsychiatric and neurodegenerative disorders, including Parkinson's disease, depression, and psychostimulant substance abuse. Clinically, VMATs are targeted by the inhibitors tetrabenazine and reserpine, used to treat hyperkinetic movement disorders and hypertension, respectively, while amphetamines exploit VMAT2-mediated dopamine efflux to treat ADHD. Emerging VMAT2-selective compounds such as lobeline derivatives and GZ-11610 attenuate psychostimulant reinforcement. Tricyclic antidepressants upregulate VMAT2 function and rescue disease-causing variants, highlighting VMAT2 as a promising therapeutic target. Despite their importance, the molecular mechanisms driving proton-coupled transport, inhibition, and psychostimulant action remain poorly understood. This review summarizes current biochemical, structural, and functional insights into VMATs, highlighting proton coupling, transport kinetics, inhibition mechanisms, unresolved questions, and future research directions.
Strong and resilient health systems are those equipped to withstand shocks and continue providing quality services as response measures are implemented. We conducted a qualitative evidence synthesis of stakeholders' understanding of health system resilience in Africa, focusing on definitions and attributes. We searched for peer-reviewed articles and grey literature, filtered for Africa, from 1980 to November 2025, using the SPIDER framework. The search was conducted in four databases: PubMed, the Bielefeld Academic Search Engine, the Cumulative Index to Nursing and Allied Health Literature, and Scopus; we also reviewed the websites of the World Health Organization (WHO), Africa Centers for Disease Control and Prevention (Africa CDC), and Ministries of Health of African countries. Articles were selected based on predefined inclusion and exclusion criteria. Qualitative articles were appraised using the Critical Appraisal Skills Programme, and mixed-methods articles using the Mixed Methods Appraisal Tool. We mapped the distribution of included articles by the country studied, the infectious disease responsible for the shock, and the health system building block described. For each article, we identified the definition of health system resilience and its attributes. The search yielded 5,448 relevant articles, eighty-three of which were included in the synthesis. Articles were from 48 of the 54 African countries. Up to 74.5% of the articles focused on COVID-19; others were on Ebola Virus Disease, cholera, and meningitis. Service delivery, leadership and governance and health workforce were the most frequently cited health system building blocks. Adaptive capacity of health systems resilience was most frequently cited, followed by absorptive capacity, preparedness, and recovery. Identified attributes of a resilient health system were community engagement and involvement; leadership and governance; collaborations and partnerships; human resources for health; health education and promotion; health information systems; health service delivery; decentralization and local governance; health infrastructure and logistics; preparedness; learning and adaptation; and innovation and financing.
This pre-registered study investigated approach and avoidance processes in chronic pain using tasks that index active avoidance tendencies and behavioural suppression. Chronic pain patients and healthy controls completed an approach-avoidance task involving pain-related, medication-related, and neutral images, alongside a cued go/no-go Pavlovian Bias task using monetary rewards and punishments. Relative to controls, individuals with chronic pain showed an exaggerated approach bias towards medication-related images, despite not explicitly rating these images as more pleasant. Unexpectedly, we did not find evidence of greater active avoidance responses to pain-related images in the chronic pain group. Instead the pattern of results was in the opposite direction to that hypothesised, despite these images being rated as more painful and unpleasant. In the Pavlovian Bias task, chronic pain patients showed exaggerated behavioural suppression in the presence of cues signalling potential monetary loss, which interfered with instrumental responding. This pattern was not explained by general learning deficits or altered reward sensitivity. Together, the findings provide preliminary evidence that chronic pain may be characterised by altered responding to motivationally-salient cues, although replication in larger samples is required. Our results are consistent with the possibility that active avoidance of pain-related cues may emerge over longer timescales and involve more cognitive, volitional processes. These results highlight behavioural suppression as a sensitive and behaviourally-relevant analogue of avoidance behaviour in chronic pain.
Combining immune checkpoint inhibitors (ICIs) with chemotherapy has become a major clinical research focus. Patients with extensive-stage small-cell lung cancer (ES-SCLC) have been treated with different first-line ICI combinations in randomized controlled trials (RCTs), but the optimal combination strategy has not yet been determined. Our aim was to evaluate this strategy through a systematic review and meta-analysis. Articles published from inception to October 20, 2024 were systematically searched in PubMed, Cochrane CENTRAL, Embase, and MEDLINE. Candidates were RCTs using ICI treatments as first-line treatment for ES-SCLC. According to PRISMA guidelines, 3 independent investigators extracted data. Hazard/odds ratios (HRs/ORs) with their 95% confidence intervals (CIs) and adverse event (AEs) were extracted. ICI combinations were compared for overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and AEs. A random-effects model and Bayesian network meta-analysis were used. PROSPERO: CRD42023388838. The meta-analysis included 8 RCTs with 3910 patients. Overall, ICI-chemotherapy provided superior OS (HR, 0.78; 95% CI, 0.72 to 0.86), PFS (HR, 0.73; 95% CI, 0.64 to 0.82), ORR (OR, 1.20; 95% CI, 1.01 to 1.42) and DCR (OR, 2.64; 95% CI, 1.32 to 5.24) compared with chemotherapy alone. A higher risk of any grade irAEs (OR, 3.88; 95% CI, 2.09 to 7.18) and grade ≥ 3 irAEs (OR, 5.54; 95% CI, 2.38 to 12.88) was associated with ICI addition. ICI-chemotherapy combinations did not differ significantly in OS, PFS, ORR, DCR, or safety. In the Bayesian ranking analysis, the PD-1 inhibitor-based regimens Serplu-EP and Nivo-EP achieved the highest efficacy rankings; Serplu-EP ranked first for both OS and PFS, followed by Nivo-EP. Efficacy and safety were effectively balanced in Serplu-EP and Adebre-EP. Similar results were shown in subgroup analyses. First-line ICI-chemotherapy combinations improved survival outcomes but increased the risk of irAEs, with no significant differences in efficacy or safety among ICI-chemotherapy combinations. Among the evaluated regimens, the PD-1 inhibitor-based Serplu-EP and Nivo-EP achieved the highest efficacy rankings, whereas Serplu-EP and Adebre-EP appeared to provide the most favorable efficacy-safety balance. Further head-to-head trials are warranted to confirm the optimal first-line ICI strategy for ES-SCLC.
The health benefits of tea drinking have been extensively studied, and in the past 20 years, there has been increasing interest in the role of tea drinking in promoting cognitive health among older adults. This review aims to analyze existing evidence on the benefits of tea drinking to promote cognitive health from both observational and interventional studies. Using a narrative approach and in-depth discussion, the major studies on tea and cognitive health were identified and summarized. Gaps in knowledge and future directions are discussed. Solid evidence from prospective cohort studies demonstrates that tea drinking slows cognitive decline, lowers the risk of cognitive impairment, and improves cognitive function. Current evidence from randomized controlled trials is inadequate for a definitive conclusion. Tea is associated with better cognition in aging. Further clinical trials should be conducted to validate the claim that tea drinking can promote cognitive health in aging.
The purpose of this study was to evaluate the effect of stimulus frequency and tinnitus severity on measurements indicative of inhibition called onset-offset and sensory gating auditory evoked potentials (AEPs). The specific aims were to (a) determine the effect of stimulus frequency on AEPs in people with and without tinnitus; (b) determine if people with high-frequency tinnitus demonstrate abnormal AEPs in response to high-frequency stimuli; and (c) compare AEPs in people with tinnitus of varying severity. A total of 26 people with tinnitus and 26 age-, sex-, and hearing-matched no-tinnitus controls participated. AEPs were recorded in response to stimuli of varying frequency (broadband noise [BBN], 0.25, 2, 8 kHz). AEPs were quantified by measuring difference wave amplitudes and latencies. For Aims 1 and 2, mixed-model ANOVAs were calculated to determine the main effect of and interaction between stimulus frequency and tinnitus presence. For Aim 3, participants were divided into subgroups based on median tinnitus severity and t tests were used to compare AEPs between subgroups. (1) BBN evoked the largest amplitude onset-offset and sensory gating difference waves. As stimulus frequency increased, amplitude decreased. (2) Individuals who perceived high-frequency tinnitus did not demonstrate the most abnormal onset-offset and sensory gating AEPs in response to high-frequency stimuli. (3) Individuals with moderate and severe tinnitus demonstrated abnormal sensory gating AEPs compared to age-, hearing-, and sex-matched no-tinnitus controls and compared to individuals with milder tinnitus who were of similar age and hearing status. Stimulus frequency does influence onset-offset and sensory gating AEPs. People with moderate and severe tinnitus demonstrated reduced inhibition compared to people with milder tinnitus, indicated by abnormal sensory gating AEPs. This suggests that a person's psychological reaction to their tinnitus may be linked to unconscious physiological mechanisms underlying tinnitus, including reduced inhibition. https://doi.org/10.23641/asha.33155000.
Sleep problems are increasingly prevalent among children and adolescents, contributing to impaired daytime functioning, reduced academic performance, and long-term health risks. Aerobic exercise has been proposed as a promising behavioral strategy to promote sleep health in youth; yet, evidence from randomized controlled trials (RCTs) remains variable. This systematic review and meta-analysis synthesized randomized controlled trials to estimate the effects of aerobic exercise on sleep-related outcomes in children and adolescents and to explore potential sources of heterogeneity. Several major English and Chinese databases, including PubMed, Web of Science, EBSCO, Cochrane Library, Scopus, and CNKI, were systematically searched up to August 2025. Fourteen studies were included. Effect sizes were expressed as standardized mean differences (SMDs) and oriented so that positive values indicated improvement in sleep-related outcomes. A random-effects meta-analysis using restricted maximum likelihood estimation and the Hartung-Knapp adjustment was performed, with 95% prediction intervals calculated. Prespecified exploratory subgroup analyses examined intervention duration, measurement modality, and age group, with formal tests for subgroup differences where feasible. Aerobic exercise was associated with improved sleep-related outcomes (SMD = 0.91, 95% CI: 0.40-1.43), with considerable heterogeneity (I2 = 91.5%) and a 95% prediction interval of -0.98 to 2.80. Exploratory subgroup estimates varied by intervention duration, measurement modality, and age; however, tests for subgroup differences were not statistically significant (P = .291, P = .868, and P = .873, respectively). These findings should be interpreted cautiously because several subgroups contained few studies. Aerobic exercise may improve sleep-related outcomes in children and adolescents. However, the magnitude and consistency of the benefit remain uncertain because of considerable heterogeneity, a prediction interval crossing the null, heterogeneous outcome definitions, and the limited number of studies in several subgroups. Further well-designed RCTs using standardized sleep outcomes and objective measures, where feasible, are needed.
Prostate cancer (PCa) is the most commonly diagnosed noncutaneous malignancy in men and a leading cause of cancer-related death worldwide. Its clinical heterogeneity, ranging from indolent to aggressive disease, presents major diagnostic and therapeutic challenges. However, prostate-specific antigen (PSA), the current standard biomarker, lacks sufficient sensitivity and specificity, resulting in both overdiagnosis and missed cases. Therefore, more accurate noninvasive biomarkers are urgently needed. In this study, we isolated plasma-derived extracellular vesicles (EVs) using a wheat germ agglutinin (WGA)-conjugated magnetic bead method and identified differentially expressed transcripts between PCa patient and healthy control (HC) EVs. Candidate biomarkers were selected through weighted gene co-expression network analysis (WGCNA) and Random Forest modeling, followed by validation using RT-qPCR in independent cohorts including PCa, benign prostatic hyperplasia (BPH), and HC samples. We identified three EV-derived RNAs (NM_024955, NR_047469, and NR_002564), which were significantly dysregulated in PCa compared with both HC and BPH. Combined analysis demonstrated high diagnostic performance, outperforming PSA and notably NM_024955 expression showed a strong correlation, indicating potential relevance to disease severity. These findings suggest that lectin-based EV isolation coupled with RNA profiling provides a robust and scalable platform for PCa diagnosis, offering promising noninvasive biomarkers to complement or improve current PSA-based screening.
The association between the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and lacunar infarction (LI) remains inconclusive. The literature retrieval encompassed PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang (inception - March 2026). Case-control studies that reported genotype frequencies of MTHFR C677T (CC, CT, and TT) in LI patients and controls were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) for 5 genetic models were calculated using random/fixed-effects models in Stata 13.0. Prespecified exploratory subgroup analyses were conducted by ethnicity and symptom status. Four methodological sensitivity analyses assessed the robustness of findings by restricting analyses to studies with magnetic resonance imaging (MRI) only versus CT/MRI, Trial of Org 10172 in Acute Stroke Treatment classification versus radiological criteria, Hardy-Weinberg equilibrium-compliant controls, and Newcastle-Ottawa Scale score ≥ 7. Meta‑regression, heterogeneity (I2), and publication bias (Begg/Egger tests with trim‑and‑fill) were also performed. Twelve studies comprising 5097 participants (1598 cases/3499 controls) were included. Significant associations were observed in 4 genetic models: recessive (TT vs CT + CC): OR = 1.36, 95% CI = 1.05 to 1.77; dominant (TT + CT vs CC): OR = 1.22, 95% CI = 1.05 to 1.41; allelic model (T vs C): OR = 1.19, 95% CI = 1.07 to 1.33; and homozygous contrast (TT vs CC): OR = 1.45, 95% CI = 1.11 to 1.89. Exploratory subgroup analyses, limited by small numbers of studies in several strata, suggested stronger associations in Asian populations and symptomatic lacunar stroke; these findings are underpowered and should be interpreted with caution. Sensitivity analyses restricting to MRI‑only studies, Trial of Org 10172 in Acute Stroke Treatment‑defined cases, Hardy-Weinberg equilibrium‑compliant controls, or higher‑quality studies (Newcastle-Ottawa Scale ≥ 7) produced results broadly consistent with the primary findings. However, significant publication bias was detected, and all pooled ORs decreased and lost statistical significance after trim‑and‑fill adjustment. The initially observed association between MTHFR C677T and LI was no longer significant after trim‑and‑fill adjustment for publication bias. All analyses used unadjusted crude genotype data, so residual confounding by vascular and nutritional factors cannot be excluded, and the pooled estimate combined distinct lacunar phenotypes. A formal assessment using the Grading of Recommendations Assessment, Development and Evaluation framework showed very low certainty of evidence. Routine MTHFR genotyping for LI risk assessment is therefore not currently supported, and further rigorous studies are warranted.
Despite limited efficacy, patients are prescribed opioids for chronic non-cancer pain (CNCP). Guidelines recommend supporting the safe tapering of opioid prescriptions for these patients. This usually occurs in primary care, so there is a need to ascertain the efficacy of interventions implemented in this setting. This review aims to evaluate the effectiveness of interventions to reduce opioids in CNCP patients in primary care and identify effective behavior change techniques (BCTs). A comprehensive search was conducted in Medline, Cumulative Index to Nursing and Allied Health Literature and Web of Science databases in May 2023 using the MESH terms: "Chronic pain," "opioid," "primary care," and "psychosocial interventions." Manual searches were conducted in 7 systematic reviews. Psychosocial intervention trials with a control group were eligible for the review. Studies were excluded if opioid dosages were not reported. Thirteen studies were included - 7 randomized controlled trials and 6 cohort studies with a total of 3130 patients. Upon quality assessment, one study was deemed strong, two were moderate, and ten were of weak quality. Eight interventions demonstrated success in opioid tapering in primary care settings. A broad spectrum of intervention techniques were identified, with Behaviour Substitution consistently applied in the effective interventions. We determined the effective BCTs used across these trials to guide design and implementation of future interventions. This is the first review to identify BCTs that may contribute to supporting patients in tapering opioids in CNCP in primary care settings. Limitations include high heterogeneity in study designs and in the reporting of techniques used.
The incidence of vestibular schwannoma (VS) diagnosis among octogenarians has increased due to longer life expectancy and greater MRI accessibility and utilization. Stereotactic radiosurgery (SRS) offers a safe management strategy for these patients. The authors retrospectively analyzed the data of octogenarians with VS managed with SRS across 27 institutions, assessing clinical and audiological outcomes, including survival rates, tumor control responses, complications, and posttreatment functional outcomes. Among 309 octogenarians with VS managed with single-fraction SRS, overall survival was 97.8% at 1 year, 88.5% at 3 years, and 78.1% at 5 years; the corresponding progression-free survival rates were 95.8%, 81.1%, and 71.1%, respectively. In competing risk analysis, tumor progression occurred in 5.2% of patients by 5 years, whereas death without progression reached 19.8%. Tumor control was achieved in 94.8% at 3 and 5 years. At last imaging follow-up (median 33.5 months, IQR 14-60 months), 29.1% showed volume regression. Communicating hydrocephalus developed in 4.2% and was successfully managed with CSF diversion. Age, sex, tumor volume, Koos grade, and margin dose were not significant predictors of patient survival or tumor progression. Single-fraction SRS is a safe and effective management modality for octogenarians with VS, providing durable tumor control with minimal morbidity.
Rodents are well-recognized agricultural pests, causing significant damage to crops and infrastructure, as well as posing health risks to both animals and humans by transmitting various infectious agents. On livestock farms, they can contribute to disease transmission dynamics, for example by acting as mechanical vectors that carry pathogens from one stable to another, forming a hidden transmission network. This study explored the potential role of commensal rodents as mechanical vectors for the roundworm Ascaris suum on pig farms in Belgium. While A. suum is a highly prevalent intestinal parasite in pigs worldwide, its potential spread by rodents on pig farms has not been thoroughly investigated. It addresses this gap by examining whether Mus musculus and Rattus norvegicus, two common rodent species found on farms, can carry and spread A. suum eggs between different areas of the farm. Rodents were trapped on two pig farms and their faecal samples were analysed microscopically for the presence of A. suum eggs. The results showed a low prevalence of eggs in the faecal samples, with 4.17% in M. musculus and 17.14% in R. norvegicus. Serological screening of pigs further confirmed prior exposure to A. suum in both farms. Despite the low prevalence, these findings suggest that rodents could act as mechanical vectors of A. suum eggs between stables, potentially leading to persistent environmental contamination. This highlights the potential need to include rodent control as part of broader biosafety strategies to limit A. suum transmission on pig farms, particularly by reducing the risk of reintroducing eggs into stables that have already been cleaned and disinfected.
The aim of this study was to evaluate the prognostic value of intraoperative EEG during corpus callosotomy (CC) in pediatric patients with drug-resistant epilepsy (DRE), with a particular focus on bisynchronization blockade and its correlation with long-term seizure outcomes. A retrospective review was performed of pediatric patients with DRE and injurious drop attacks who underwent CC between 2005 and 2024. Patients were stratified into three groups based on intraoperative scalp EEG findings: 1) > 50% bisynchronization blockade, 2) < 50% blockade, and 3) absent bisynchronization. Baseline clinical characteristics, surgical approach, and extent of CC were recorded. Seizure outcomes were assessed using Engel and International League Against Epilepsy (ILAE) classifications with a minimum follow-up of 1 year. Whether atonic seizures resolved postoperatively was also evaluated. Group comparisons were performed using Fisher's exact test and Kruskal-Wallis rank-sum testing. Forty-six patients met the inclusion criteria. The majority underwent complete CC (65%), most via an open approach (67%). At 1 year, freedom from atonic seizures (ILAE class 1Engel class I) was highest in the > 50% blockade group (70.0%) compared with the < 50% blockade (40.0%) and absent bisynchronization (25%) groups (p = 0.042). At last follow-up (mean 5.3 years), the > 50% blockade group similarly achieved significantly higher rates of atonic seizure freedom (ILAE class 1/Engel class I, 76%) compared with 0% in the < 50% blockade and 25% in the absent bisynchronization groups (p < 0.001). Outcomes for total seizure freedom varied and did not reach statistical significance between groups. Achieving > 50% intraoperative bisynchronization blockade during CC was strongly associated with improved long-term atonic seizure freedom. These findings support the role of intraoperative EEG as a prognostic marker of effective seizure control.
The integration of temporary anchorage devices (TADs) to aid clear aligner therapy (CAT) represents an evolving strategy that has gained expanding application over the past decade. This retrospective cohort study aimed to investigate the treatment outcomes of CAT cases involving maxillary incisor retraction following premolar extraction, managed with assistance of various TAD patterns. Adult premolar extraction CAT cases were included in this retrospective cohort study. The maxillary central incisors (U1) were grouped based on the TAD pattern for their retraction: Non-TAD (n = 54), posterior TADs only (P-TADs; n = 50), or combined anterior and posterior TADs (AP-TADs; n = 46). Pretreatment and post-treatment CBCTs quantified U1 lingualization, intrusion, retroclination and potential side effects such as apical root resorption (ARR), pulp chamber reduction and palatal dehiscence incidence. P-TADs and AP-TADs patterns achieved greater U1 lingualization than the Non-TAD group. Vertical control differed markedly: AP-TADs achieved U1 intrusion (1.07 ± 1.64 mm), whereas P-TADs and Non-TAD showed U1 extrusion (-0.46 ± 1.12 mm and -1.51 ± 1.29 mm, respectively). U1 retroclination was over 10° in all three groups. AP-TADs exhibited greater ARR (1.31 ± 0.91 mm) and a higher proportion of Grade III ARR than the other groups. In regression analysis, the intrusion achieved was the strongest independent predictor of ARR. Pulp chamber reduction and palatal dehiscence incidence was similar among groups. Residual confounding may persist due to the inherent limitations of retrospective study designs. In CAT cases involving maxillary incisor retraction following premolar extraction, P-TADs and AP-TADs patterns were associated with notable clinical treatment outcomes. These preliminary findings may provide prognostic indication for the management of such cases in the future.
Chemical investigation of the endophytic fungus Aspergillus sp. FH-1 from Valeriana officinalis L., guided by GNPS molecular networking, afforded six compounds. These included two rare open-chain butenolides, designated as terrusnolides D (1) and F (2), together with four known analogues: terrusnolide A (3), versiol (4), decumbenone A (5), and decumbenone B (6). Their structures were unequivocally determined through extensive spectroscopic methods (HRESIMS, 1D/2D NMR, and ECD). Antifungal evaluation against the phytopathogen Colletotrichum gloeosporioides demonstrated that compounds 1 and 3 exhibited significant inhibitory activity, with EC50 values of 32.77 ± 1.12 μg/mL and 42.81 ± 1.01 μg/mL, respectively, both outperforming the positive control carbendazim.
Facial nerve schwannomas (FNSs) are rare benign tumors that can involve any segment of the facial nerve. Comprehensive understanding of these tumors remains limited, largely due to the paucity of reports on large surgical series in the literature, and their clinical management is particularly challenging. To balance tumor control with favorable facial nerve function, the authors have adopted nerve-preserving surgery (nonradical tumor removal and bony decompression) for moderate facial nerve palsy and conventional nerve reconstruction surgery (total tumor removal and facial nerve reconstruction) for severe or complete palsy cases. In this study, the authors evaluate the utility of a function-centered surgical strategy and a five-category, location-based classification system, based on a relatively large contemporary series. A total of 67 consecutive FNS surgeries performed in 61 patients between 2004 and 2022 were retrospectively reviewed. The surgical strategy was selected according to the patient's preoperative facial nerve function and intraoperative electromyography (EMG) responses. Nerve-preserving surgery was performed in 47 cases (70.1%) and was associated with improved or stable facial nerve function in 87.2%. The mean House-Brackmann grade improved from 3.5 to 3.0 in the nerve preservation group and from 4.6 to 4.0 in the nerve reconstruction group. Overall, facial nerve function improved in 50.7% and worsened in 13.4% of cases. In the nerve preservation group, tumors confined within the temporal bone (intrameatal, tympanic, and mastoid types), younger age, and favorable EMG responses were associated with better postoperative facial nerve function. During long-term follow-up (mean 87.2 months), 27.7% of this group required additional treatment. A function-centered strategy, supported by intraoperative EMG monitoring and a tumor-centered classification, enables selective nerve preservation and was associated with favorable outcomes in FNS surgery. This strategy may serve as a practical framework for individualized surgical treatment of FNSs.