The Journal of dermatological treatmentYuxi Zhou, Yingqiu Bao, Yu Fu
BACKGROUND: The picosecond Nd:YAG laser is a standard treatment for freckles. However, factors such as cost and technology barriers may limit accessibility, necessitating evaluation of alternative systems. OBJECTIVES: To evaluate the noninferiority and safety of a novel 532-nm picosecond Nd:YAG laser versus an established system for treating freckles. METHODS: In this randomized, evaluator-blinded, split-face trial, 84 participants received a single treatment session. Contralateral facial sides were randomly assigned to the investigational or control device in a 1:1 ratio. The primary endpoint was the response rate at week 8. Secondary endpoints included the cure rate, investigator-assessed improvement, patient satisfaction and procedural tolerability. Safety was assessed by adverse events monitoring. RESULTS: The investigational device demonstrated noninferiority to the control (response rates: 97.6% vs. 97.6%; difference, 0.0%; 95% confidence interval: -3.30% to 3.30%) with comparable cure rates (13.1% vs. 9.5%, p = .527). Participant satisfaction was significantly higher with the investigational device (72.6% vs. 58.3%, p = .001). Treatment duration suggested an association with superior efficacy (OR = 2.07, 95% CI: 1.14-3.76, p = .016). No serious adverse effects occurred. CONCLUSION: The novel 532-nm picosecond Nd:YAG laser is noninferior to the established system, with comparable short-term efficacy and safety. Further studies are needed to assess long-term safety.
The Journal of dermatological treatmentDanping Pan, Yuanfeng Wu, Haibin Wu, Ruohua Li
BACKGROUND: Non-segmental vitiligo is an autoimmune disorder causing melanocyte loss and depigmentation. The 308-nm excimer laser is effective but achieving sustained repigmentation is challenging. Crisaborole, a PDE-4 inhibitor, may synergize with laser therapy. This study evaluates crisaborole 2% ointment plus laser vs. laser monotherapy with vehicle using an intra-patient left-right controlled design. METHODS: This is a single-center, randomized, double-blind, intra-patient controlled trial. Eligible adults (18-65 years) with stable NSV and at least two comparable symmetrical lesions will be enrolled. Lesions will be randomly assigned to receive either crisaborole + 308-nm excimer laser or vehicle + 308-nm excimer laser. Laser treatment will be administered twice weekly, and ointments applied twice daily over 24 weeks. The primary endpoint is the proportion of lesions achieving ≥75% improvement in the Vitiligo Area Scoring Index (VASI/F-VASI) at the end of treatment. Secondary endpoints include mean percentage change in VASI/F-VASI, time to first repigmentation, recurrence at three months post-treatment, and patient-reported satisfaction. Adverse events will be monitored throughout the study. CONCLUSION: This trial aims to provide high-quality evidence regarding the potential synergistic effect of crisaborole combined with excimer laser therapy, potentially establishing a more effective and safe treatment option for NSV. CLINICAL TRIAL NUMBER: ChiCTR2600124948.
Annals of medicineJinglong Li, Qisen Zhu, Mohamad Nabil Mohd Noor, Chan Choong Foong
BACKGROUND: Cerebral Palsy (CP) is the main cause of motor disabilities in childhood, necessitating innovative approaches to rehabilitation and assistive technology (AT). Simultaneously, artificial intelligence (AI) is increasingly being integrated into devices to create more adaptive, personalized, and effective AT. This systematic review aimed to evaluate the effectiveness and usability of AI-powered assistive technologies designed to support daily activities and rehabilitation in children with CP. MATERIALS AND METHODS: Five databases, including Scopus, Web of Science, PubMed, Embase, and IEEE Xplore, were systematically searched, and 23 articles were included in the final analysis. Articles were identified, selected, and categorized into emerging thematic areas based on the primary function and application of the technology. RESULTS: Five key thematic topics were identified: 1) AI-driven motor rehabilitation and gait training for functional mobility; 2) intelligent assessment and monitoring systems for clinical decision support; 3) AI-supported communication, social interaction, and intention recognition tools; 4) gamified and virtual reality-based interventions to enhance engagement and usability; and 5) smart assistive systems supporting daily living and independent mobility. The findings demonstrate a strong trend toward the application of AI technologies in personalized, engaging, and data-driven interventions for children with CP. However, the field is predominantly in the proof-of-concept stage, with limitations including small sample sizes, lack of long-term clinical validation, challenges in user-centered design, and usability for children with CP. CONCLUSION: AI-powered assistive technologies hold significant potential for transforming the care of children with CP by enabling highly personalized and engaging interventions. To actualize this potential, future work must realize that practical application remains challenging owing to limited clinical validation, technological integration, and usability barriers for children with CP. Future research must prioritize user-centered design and multidisciplinary collaboration to ensure that AI and robotic advancements improve the usability and quality of life for children with CP.
Computer assisted surgery (Abingdon, England)Qingzhuo Chi, Guofeng Wang, Wenjun Wang, Xijing Zhuang, Yuanzhe Jin, Bo Liu, Ying He
Fabricating high-fidelity, patient-specific aortic phantoms that possess both complex pathological features and physiological compliance remains a significant challenge for single-method manufacturing techniques. This study presents a complete virtual-to-physical prototyping workflow, enabled by a novel Hybrid Additive Manufacturing Platform (HAMP), for translating clinical imaging data into high-fidelity, patient-specific aortic phantoms. Building upon a validated brush-spin-coating technique capable of precise wall thickness control (±0.1 mm), the HAMP synergistically integrates 3D printing and casting. This integration overcomes the limitations of single-method techniques, uniquely enabling the creation of phantoms with (i) controllable interlayer delamination for mimicking dissection, (ii) enclosed multi-chamber structures for endoleak simulation, (iii) seamless integration of dissimilar materials, and (iv) the replication of complex intra-wall pathologies such as intramural hematoma. The platform's capability was rigorously demonstrated through the successful fabrication and application of four distinct classes of aortic phantoms. These high-fidelity models were directly employed in: fundamental biomechanical studies to visualize dissection propagation; advanced surgical training for complex procedures like ex vivo fenestration; emergency preoperative planning, where a patient-specific model was delivered in under 30 h; and industrial medical device testing using parametric, ISO-compliant models. In each scenario, the phantoms provided functional, anatomically accurate representations suitable for the intended evaluation-whether physical testing, surgical rehearsal, or hydrodynamic assessment. In summary, the HAMP demonstrates a rapid virtual-to-physical prototyping workflow. By enabling the on-demand creation of complex, multi-material, patient-specific phantoms, it provides a versatile tool that bridges digital data and physical reality, addressing needs across research, clinical training, and device development.
Global health actionJordanos Tewelde McDonald, Benjamin Fayzi, Majdi Laktinah, Anna Mia Ekström, Mariano Salazar
BACKGROUND: The experience of forced migration, along with post-migration stressors, can elevate the risk of poor sexual health outcomes among young people. Despite this, little evidence is available on the sexual health needs, behaviors, and healthcare utilization of young male forced migrants in Sweden and elsewhere. OBJECTIVE: This study aims to explore the attitudes, perceived knowledge, experiences, and needs of young Eritrean, Afghan, and Syrian men regarding condom use, Sexually Transmitted Infections (STIs), transactional sex, and sexual healthcare utilization. METHODS: In this qualitative study, semi-structured interviews were undertaken with 32 young male forced migrants (former unaccompanied minors, refugees, and asylum seekers) ages 16 to 28. The data were analyzed using qualitative content analysis. RESULTS: Three broad themes and eight categories emerged from the analysis: 'Gaps in STI knowledge and ambiguity towards condom use as an STI prevention strategy'; 'knowing it is illegal to pay for sex in Sweden, yet feeling ambivalent towards transactional sex'; 'school, female partners, and trust in healthcare providers eased challenges in sexual health communication and access'. CONCLUSIONS: This study highlights important sexual health needs among the study population, emphasizing the value of school-based sexuality education in improving knowledge, including condom use. Female partners also played a key role in facilitating communication, STI testing, and service utilization. To address these needs, school-based interventions should be strengthened to include safer sexual practices, communication skills, and increased awareness of sexual health services. Programs should also provide practical guidance on accessing sexual healthcare and youth-friendly clinics.
The Journal of dermatological treatmentArchie Spindler, Derek Maas, Yana Boroumand, Isabella Zappi, Jerry Shapiro, Kristen I Lo Sicco
PURPOSE: Excimer laser therapy, a 308-nm narrowband UV-B modality, has shown promise in inflammatory dermatoses, but remains understudied in scarring alopecia (SA). MATERIALS AND METHODS: We conducted an IRB-approved retrospective study of adults with SA treated with excimer therapy to characterize clinical outcomes, response timelines, and treatment patterns. RESULTS: Most patients had lichen planopilaris or frontal fibrosing alopecia and received excimer as adjunctive therapy following prior multimodal treatment. Initial treatment was administered twice weekly, with a mean starting dose of 235.7mJ/cm2. After a mean of 3.4 months, 60% of patients reported subjective improvement in hair or hairline appearance. Symptomatic improvements were observed in scalp pain (100%), burning (75%), and pruritus (50%), generally within two to six months. Signs of inflammation, including perifollicular hyperkeratosis and erythema, improved in 83% of affected patients. Trichoscopic measures of hair density and shaft caliber remained stable, suggesting disease stabilization without accelerated follicular loss. Adverse effects were common but mild, including erythema, burning, and pain, and did not lead to koebnerization. CONCLUSIONS: Overall, excimer therapy was well-tolerated and associated with meaningful clinical and symptomatic improvement. These findings support excimer therapy as a potentially effective adjunctive treatment for inflammatory control and stabilization in SA, with response typically occurring within the first several months of therapy.
Global health actionChelsey Porter Erlank, Amani Kikula, Jackline Ngowi, Tito Muhumba, Simon Mvunabandi, Zuhura Mbuguni, Getrude Naphtali, Esther Mtumbuka, George Ruhago, Bruno Su…
BACKGROUND: Hormonal intrauterine device (IUD) is an effective contraceptive method with high user satisfaction rates. To guide the introduction of hormonal IUD into the public sector in Tanzania, an operational research study was conducted to assess client acceptability of hormonal IUDs. OBJECTIVE: To explore clients' perspectives on contraceptives and experiences with hormonal IUDs. METHODS: This observational mixed-methods study (2023-2024) used focus group discussions with current or future contraceptive users (N = 58, baseline), plus facility register reviews, a structured quantitative survey (N = 100, endline) and semi-structured in-depth qualitative interviews (N = 18 at midline 2, N = 15 at endline) with hormonal IUD clients. Register and survey data were analysed for descriptive statistics. Qualitative data was analysed thematically and triangulated with quantitative data. RESULTS: In total, 1,198 clients chose hormonal IUD during the eight-month study. At baseline, women had limited knowledge and several concerns about IUDs and emphasised the importance of good contraceptive counselling. Client satisfaction with hormonal IUD at six months post-insertion was high (93% were strongly or somewhat satisfied). Most (92%, 83% and 100%) clients were strongly satisfied with the counselling, follow-up care and removal services received, respectively. Hormonal IUD clients found the characteristic of localised release of hormones possibly offering a better side-effect profile than other hormonal methods appealing. CONCLUSION: Hormonal IUD clients showed high satisfaction with the method and care received throughout the study. The authors recommend introduction of hormonal IUD into the public sector in Tanzania, with investments in community awareness, male engagement, and strengthening the quality of contraceptive counselling and side effects management.
Renal failureElvan Onur Kırımker, Deniz Kütük, Kıvanç Kılınç, Mehmet Ali Koç, Acar Tüzüner, Akın Fırat Kocaay
BACKGROUND: Urological complications remain a significant source of morbidity following kidney transplantation, often leading to re-intervention and graft dysfunction. Although advances in surgical technique and perioperative care have reduced incidence rates, controversy persists regarding risk predictors and the prophylactic role of double-J ureteral stenting. METHODS: We retrospectively analyzed 425 adult kidney transplant recipients at a single tertiary center between January 2008 and December 2023. Patient demographics, donor characteristics, surgical variables, and postoperative outcomes were reviewed. Complications were defined as urinary leak, ureteral stricture, or anastomotic obstruction requiring intervention within 12 months. Data were compared across three eras (2008-2012, 2013-2017, 2018-2023). Multivariable logistic regression identified independent risk factors. RESULTS: Overall, 11.1% (n = 47) of patients developed urological complications. Ureteral stricture was the most frequent (57%), followed by urinary leak (28%) and anastomotic obstruction (15%). Older recipient age (OR 1.04, 95% CI 1.01-1.07, p = 0.012), re-transplantation (OR 2.95, 95% CI 1.12-7.77, p = 0.028), and deceased donor grafts (OR 2.17, 95% CI 1.12-4.19, p = 0.021) were independent predictors. Prophylactic double-J ureteral stenting demonstrated a non-significant protective trend (OR 0.71, 95% CI 0.44-1.15, p = 0.091). Routine stenting in Era 3 coincided with a non-significant reduction in leak and stricture rates. CONCLUSION: Older age, re-transplantation, and deceased donor grafts independently predicted complications, while prophylactic stenting showed a non-significant protective effect. Further multicenter studies are needed to validate these findings and optimize stent protocols.
Biosensors & bioelectronicsKaige Chen, Fan Zhuo, Changling Lv, Zeyu Chen, Xiang Chen, Han Shan
Real-time monitoring in organ-on-a-chip (OoC) systems is critical for capturing dynamic drug responses, yet standard gold (Au) electrodes utilized in electrical cell-substrate impedance sensing (ECIS) suffer from opacity, high cost, and poor reusability. Here, we report a transparent, robust, and reusable sensing interface based on iridium oxide-modified fluorine-doped tin oxide (IrOx@FTO). By electrodepositing nanostructured IrOx onto FTO, we exploited its pseudocapacitive properties to significantly improve interfacial properties, enhancing sensitivity while preserving optical clarity. We integrated these electrodes into a 128-channel high-throughput platform to monitor HaCaT keratinocytes. The system successfully resolved acute surfactant-induced barrier disruption and differentiated dose-dependent cytotoxic responses to doxorubicin (DOX) with higher precision than bare FTO. Crucially, cycling tests involving repeated culture and cleaning revealed that IrOx@FTO maintains exceptional baseline stability, significantly outperforming gold electrodes which exhibited severe degradation and delamination. This work establishes a scalable, optically compatible, and cost-effective strategy for long-term, multi-modal monitoring in advanced microphysiological systems.
International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia GroupYiyou Ma, Nianou Wang, Ke Li, Huan Liang, Jingfeng Bai, Xiang Ji
BACKGROUND: Non-ablative radiofrequency (RF) skin rejuvenation relies on controlled volumetric heating of skin and subcutaneous tissues. Clinical validation is costly and ethically constrained, while simulations require experimental validation. Existing single-layer phantoms cannot capture electrothermal heterogeneities across tissue layers. PURPOSE: To develop a thermocouple-embedded, skin-fat-muscle-mimicking multilayered phantom (MLP) that simulates electrothermal behavior relevant to RF skin rejuvenation and enables depth-resolved temperature measurement for benchtop evaluation and model validation. METHODS: A three-layer MLP (skin, fat, and muscle) was fabricated. Electrical conductivity and thermal properties (thermal conductivity, density, specific heat) were measured and compared with literature-reported human tissue ranges. Three thermocouples were embedded at depths of -1, -3, and -4 mm to record transient temperature under multiple RF voltage settings. A 3D coupled electrothermal simulation was built to replicate the experimental setup, and the simulated results were quantitatively compared with the measured results using temperature difference and temperature rise as primary metrics. A single-layer skin phantom (SLSP) was evaluated in parallel for comparison. RESULTS: MLP properties fell within reported ranges. Simulated temperature profiles showed strong agreement with experiments for both SLSP and MLP (most temperature differences <4%, and most deviation of temperature rise <0.5 °C). Compared with SLSP, MLP simulated temperature rise more closely matches layer-dependent temperature evolution across depth. CONCLUSIONS: The MLP with embedded thermocouples provides a reproducible platform for depth-resolved temperature characterization of RF-induced heating and for experimental validation of simulations, supporting efficient screening and benchmarking of RF device settings and electrode designs.
The Libyan journal of medicineAli Robaian AlQahtani
Fractured instrument retrieval remains one of the most challenging aspects of endodontics, with reported incidence rates ranging from 0.3% to 12%. This complication is particularly common with nickel‒titanium (NiTi) rotary files used in curved canals. Instrument separation hinders effective canal disinfection, compromises the quality of obturation, and may necessitate additional interventions such as bypassing, retrieval, or surgical management. Conventional retrieval techniques often lead to dentin loss, compromising root structure. The use of dental operating microscopes and their integration with ultrasonic troughs, microtubes, and specialized retrieval kits, including loop devices, has significantly enhanced the predictability of retrieval procedures while minimizing the loss of tooth structure. However, the effectiveness of these methods remains highly dependent on operator skill. Numerous innovations are continually emerging to facilitate retrieval, with recent attention on magnetic fields. Studies on such emerging devices utilizing magnetic and electromagnetic attraction have introduced a promising new direction for further exploration. This review aims to provide a comprehensive, evidence-based perspective to guide clinical decision-making and keep practitioners updated about the latest advancements in minimally invasive retrieval techniques in endodontic practice.
AutoimmunityJing He, Peiting Li, Lan Wang, Jiashun Zeng
OBJECTIVE: To investigate the effects of Platycodin D (PD) on the proliferation, migration, and angiogenesis of EA.hy926 endothelial cells stimulated by supernatant from a rheumatoid arthritis (RA) synovial cell model (MH7A), this study aims to preliminarily explore its potential mechanisms. METHODS: The TNF-α-stimulated MH7A cells were utilized as a model for rheumatoid arthritis (RA) cells. The supernatant from these cells was collected and designated as conditioned medium (CM), which was then used to stimulate EA.hy926 cells, thereby establishing an RA endothelial cell model; EA.hy926 cells were transduced with lentivirus to overexpress or knock down CD146; The experimental groups included: a normal control group, a model group (optimal CM stimulation group), and PD treatment groups (PD at concentrations of 1.25, 2.5, and 5 mg/L); sh-CD146 + CM, sh-NC + CM, sh-NC, lenti-CD146 + CM, lenti-CD146-NC. The rescue experiment included the following groups: CM, CM + PD group, CM + lenti-CD146 group, and CM + lenti-CD146 + PD treatment group. Cell proliferation was assessed using the CCK-8 assay; cell migration was evaluated through the wound-healing assay; angiogenic capability was determined via tube formation assays; and CD146 expression levels were measured by Western blotting. RESULTS: Compared to the normal group, CM stimulation significantly enhanced endothelial cell proliferation (P < 0.01). However, after 24 hours of PD treatment, a notable decrease in cell proliferation was observed (P < 0.05). Additionally, CM stimulation improved cell migration ability relative to the normal group; this enhancement was significantly diminished following PD treatment (P < 0.01). Furthermore, tube formation capability was markedly increased with CM stimulation compared to the normal group, but showed significant inhibition after 24 hours of PD treatment (P < 0.0001). Moreover, CD146 expression levels were significantly elevated in the model group when compared to the normal group and subsequently decreased following PD treatment (P < 0.01), and in a dose-dependent manner. In the rescue experiment, compared with the PD treatment group (CM + PD 5 mg/L), the proliferation, migration, and tube formation abilities of cells in the CD146 overexpression + PD treatment group (CM + lenti-CD146 + PD 5 mg/L) were significantly increased (P < 0.0001, P < 0.05, P < 0.001). Interestingly, when compared with the overexpression group (CM + lenti-CD146), these abilities in the overexpression+ PD treatment group (CM + lenti-CD146 + PD 5 mg/L) remained significantly suppressed (P < 0.0001, P < 0.0001, P < 0.05). CONCLUSION: In this study, we further found that CD146 exhibits significant pro-angiogenic, pro-migratory, and pro-proliferative effects in EA.hy926 cells. Meanwhile, PD was shown to significantly inhibit the angiogenesis, proliferation, and migration of EA.hy926 cells in a dose-dependent manner, and downregulate CD146 expression in a dose-dependent manner. CD146 overexpression partially attenuated PD's anti-angiogenic effect, but PD still exhibited strong anti-angiogenic activity in CD146-overexpressing cells, suggesting that PD acts partly through CD146 regulation and possibly other pathways, reflecting its multifaceted nature. This study is the first to link PD's anti-angiogenic effect to CD146, revealing a promising therapeutic direction for RA.
Journal of medical economicsShiv Sarna, Sachinka Ranasinghe, Ranil Johann Boaz, Mark Rochester
AIMS: To evaluate the financial impact of surgical modalities for benign prostatic hyperplasia (BPH) from the perspective of an NHS Trust. METHODS: A retrospective analysis of patients undergoing Aquablation, Holmium Laser Enucleation of the Prostate (HoLEP) and Transurethral Resection of the Prostate (TURP) was conducted at a single NHS teaching hospital between January 2023 and June 2025. Financial data was extracted from the patient-level information and costing system, including clinical income based on Healthcare Resource Group tariffs, direct and indirect costs, and overheads. Primary outcomes were median episode clinical income, total costs, and net surplus/deficit. RESULTS: 436 procedures were analysed (140 Aquablation, 160 HoLEP, 136 TURP). Mean operative time was shortest for Aquablation (61.8 ± 27.0 min), while HoLEP had the shortest length of stay (0.34 ± 1.18 days). Aquablation was the only procedure to yield a median net surplus (+£1,859, IQR +785 to +2,736), whereas both HoLEP (-£157, IQR -679 to +189) and TURP (-£852, IQR -1,716 to +84) resulted in median deficits (p < 0.001). Aquablation's financial advantage was driven by its robotic-assisted classification, attracting a higher median clinical income (£7,659) than HoLEP (£3,038) and TURP (£2,997) (p < 0.001). Surplus-generating episodes were more frequent for Aquablation (83.6%) than HoLEP (28.1%) or TURP (22.1%) (p < 0.001). Major individual losses were driven by complications and prolonged admissions across all cohorts. LIMITATIONS: This single-centre retrospective study focused on short-term hospital-level costs. It did not account for initial capital expenditure, long-term clinical outcomes, or Quality-Adjusted Life-Years. CONCLUSIONS: Under the current NHS Payment Scheme, Aquablation is the only financially sustainable surgical modality for the provider among those analysed. Its higher robotic-assisted tariff compensates for greater consumable costs. National tariff reviews may be warranted to ensure reimbursement reflects the true resource intensity of all surgical interventions. Establishing broader NHS cost-effectiveness will require long-term evaluation of clinical outcomes and retreatment rates.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal ObstetriciansTian Liu, Daoman Xiang, Wensi Chen
PURPOSE: This study aims to evaluate and compare the effectiveness of the Binocular Indirect Ophthalmoscope (BIO) and the Wide-Field Fundus Imaging System (RetCam) in the diagnosis of Retinopathy of Prematurity (ROP). METHODS: We retrospectively reviewed routinely collected records from a standardized paired-screening workflow for preterm infants examined for ROP in outpatient and inpatient settings during 2020-2021. BIO was performed first by a senior pediatric ophthalmologist, followed within 10 min by RetCam3 imaging by another ophthalmologist. The paired BIO sketches and RetCam images were reviewed by three experienced ophthalmologists, and disagreements were resolved by consensus to establish an adjudicated reference standard for this study. The primary outcome was diagnostic accuracy for ROP zone, stage, plus/pre-plus disease, and lesion extent. RESULTS: A total of 796 eyes from 398 preterm infants (birth weight 1323.8 +/- 456.2 g; gestational age 29.8 +/- 2.9 weeks) were examined using both BIO and RetCam. Compared with the adjudicated reference standard, BIO and RetCam achieved AUCs of 0.997 and 0.995 for detecting any ROP, 0.983 and 0.982 for zone classification, and 0.999 and 0.959 for stage classification, respectively. RetCam misdiagnoses were most common in zone III and stage 1 disease. BIO showed lower agreement than RetCam for lesion extent (p < 0.001). CONCLUSION: BIO and RetCam showed complementary strengths in ROP screening. BIO provided clearer peripheral three-dimensional assessment of subtle stage and plus/pre-plus findings, whereas RetCam provided objective wide-field documentation of lesion distribution. A combined strategy may improve diagnostic confidence and clinical management for ROP.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal ObstetriciansYunxiu Li, Fei Wu, Ming Yang, Xiaoling Feng, Liangliang Li, Yan Peng, Hongfa Xie
INTRODUCTION: Cesarean delivery during the second stage of labor is increasing, while the use of forceps is declining. Evidence on forceps in trial of labor after cesarean (TOLAC) is limited. We compared maternal and neonatal outcomes between attempted forceps delivery and second-stage repeat cesarean (ssRCD) among TOLAC women, and compared forceps outcomes between TOLAC women and those with no prior cesarean (NPC). METHODS: This retrospective cohort study (2015-2022) included singleton, term, vertex pregnancies requiring immediate second-stage delivery due to fetal distress, prolonged second stage, or maternal compromise. Three groups were defined: fd-TOLAC (forceps delivery in TOLAC), ssRCD (second-stage repeat cesarean without attempted forceps), and fd-NPC (forceps delivery in women with NPC). Outcomes were compared between fd-TOLAC and ssRCD, and between fd-TOLAC and fd-NPC. RESULTS: A total of 176, 30, and 769 women were included in the fd-TOLAC, ssRCD, and fd-NPC groups, respectively. Compared to ssRCD, fd-TOLAC had lower postpartum hemorrhage (1.1% vs 20.0%; aOR 0.05, 95% CI 0.01-0.33), blood transfusion (4.0% vs 23.3%; aOR 0.15, 95% CI 0.04-0.57), and postpartum infection (1.7% vs 10.0%; aOR 0.06, 95% CI 0.01-0.58). One hysterectomy occurred in ssRCD (3.3%), compared with none in fd-TOLAC (p = 0.234). No significant differences were observed in neonatal outcomes between the groups. Maternal and neonatal outcomes did not differ between fd-TOLAC and fd-NPC (p > 0.05). CONCLUSION: In TOLAC women requiring second-stage delivery, clinically feasible low forceps was associated with lower maternal morbidity than ssRCD without increased neonatal risk. Forceps outcomes in TOLAC were comparable to NPC. Findings suggest the safety of attempted forceps in selected TOLAC patients.
Journal of pharmaceutical and biomedical analysisMeng-Hua Pan, Shu-Fan Liu, Jia-Lin Yu, Yong-Jian Ai, Fei Li
Curculigo rhizome (CR) a phenolic acid-rich plant, is widely utilized as a raw material for health products, traditional Chinese medicine (TCM) preparations, and as a flavoring agent in the food industry. In the present study, a comprehensive multi-technique approach combining UPLC-Q-TOF-MS/MS, GC-MS, intelligent sensory technology (electronic nose and electronic tongue), and metabolic analysis was employed to investigate the effects of yellow rice wine processing on the chemical composition, bioactive metabolic properties, and sensory characteristics of CR. Wine-processed Curculigo rhizome (WCR) exhibited significantly decreased L* and b* values alongside reduced sweetness, whereas the a* value and total color difference (Eab*) markedly increased compared to raw Curculigo rhizome (RCR). Notably, enhanced sensory responses to nitrogen-containing compounds, particularly amines, were observed following wine processing. Metabolic assessments across bacterial, cellular, and mouse models demonstrated improved bioactivity in WCR. Non-targeted metabolomics analysis identified 84 compounds in total, with 15 differential metabolites (VIP > 1, fold change ≥ 1, P < 0.05) discriminating RCR and WCR. Post-processing reductions were observed for orcinol, palmitic acid, and oleic acid, while orcinol glucoside (SAK), orcinol gentiobioside (ANA), and curculigoside B showed elevated levels. Pearson correlation analysis revealed that downregulated compounds were negatively correlated with a* values, bioactivity-related metabolic parameters, and electronic nose sensors (EN1-EN18) as well as electronic tongue sensors (ET1, ET4, ET7, ET10, ET13); conversely, upregulated compounds displayed positive correlations with these indices. These findings elucidate the critical role of yellow rice wine processing in modulating the sensory attributes, bioactivity profile, and chemical composition of CR, thereby providing scientific foundations for establishing standardized processing protocols and offering practical guidance for industrial-scale production.
Annals of medicineAlok Jindal, Kritika Bansal, Aditi Wadhwa, Shitij Goel
INTRODUCTION: Partial unilateral lentiginosis (PUL) is rare pigmentary disorder characterized by clusters of unilateral lentiginous macules that can cause significant cosmetic and psychosocial distress. Despite its benign nature, there is no established standard treatment, and existing options often yield inconsistent results. This pilot case series evaluated the efficacy and safety of the Q-switched Nd:YAG laser (532 nm) in patients with PUL. About the Case Series. ABOUT THE CASE SERIES: Six patients (four females, two males; age range 10-32 years) underwent treatment with Q-switched Nd:YAG laser using the 532 nm wavelength. Given the rarity of the condition, this exploratory study was designed to descriptively evaluate clinical and dermoscopic outcomes rather than perform inferential statistical analysis. Treatment was initiated at low fluences and gradually titrated to a maximum of 2.5 J/cm² and 200 mJ, with sessions performed at 2-3 week intervals (mean of 23 sessions). Outcomes were assessed clinically, dermoscopically, and through patient-reported satisfaction, and were independently reviewed by three dermatologists. One patient achieved complete clearance, while the remaining five showed more than 70% improvement, with a mean dermoscopic pigment score reduction of approximately 68.6%. Patient satisfaction was high (mean VAS 8.8/10), with particular improvement noted in self-confidence and social interactions. Adverse effects were mild and included transient erythema and pigmentary changes, none of which required discontinuation. CONCLUSION: Q-switched Nd:YAG laser represents a safe, effective, and reproducible therapeutic option for PUL, offering substantial pigment clearance and meaningful improvement in patient quality of life.
BACKGROUND: High-flow nasal cannula (HFNC) is standard therapy for acute hypoxaemic respiratory failure and is increasingly used in hypercapnic COPD. Comparative data between the asymmetrical and conventional HFNC interfaces regarding respiratory muscle work of breathing is limited. This study aimed to compare the effects of both HFNC interfaces on diaphragm and parasternal intercostal thickening fraction (TFdi and TFpi), and other physiological variables. METHODS: This randomised crossover study enrolled two cohorts: 20 subjects with acute hypoxaemic respiratory failure and 18 subjects with COPD exacerbation. At baseline, subjects received low-flow oxygen cannula for 15 min then underwent randomised 15 min-sequences of asymmetrical and symmetrical HFNC at flow rates of 40 and 60 L/min, with 5-min washouts. Primary outcome was change in TFdi. Secondary outcomes were TFpi, power of breathing (TFdi × respiratory rate), and other physiological variables. RESULTS: TFdi, TFpi, power of breathing, and PtcCO2 were significantly lower than baseline with both HFNC interfaces at 40 and 60 L/min in both groups (p < 0.05). In acute hypoxaemic respiratory failure, compared to symmetrical HFNC, asymmetrical HFNC was associated with greater reduction in respiratory rate (p < 0.001) and power of breathing (p < 0.001) at both flow rates. In COPD exacerbation, compared to symmetrical HFNC, asymmetrical HFNC reduced respiratory rate at both flow rates (p < 0.001). CONCLUSIONS: Both HFNC interfaces reduced respiratory muscle workload compared to baseline in both cohorts. In acute hypoxaemic respiratory failure, asymmetrical HFNC reduced respiratory rate and power of breathing more than symmetrical HFNC. In COPD exacerbation, the asymmetrical HFNC lowered respiratory rate more than the symmetrical HFNC. CLINICAL TRIAL REGISTRATION: This study was registered with ClinicalTrial.gov (registration number: NCT06204276) before enrolment and approved by the Siriraj Institutional Review Board (certificate of approval - Si873/2023).
Journal of colloid and interface scienceLike Wang, Bo Liu, Shuheng Wei, Xiaonan Huang, Peng Tang, Shouwei Yin
Industrial dye pollution poses a significant ecological threat, yet conventional catalytic remediation faces challenges such as catalyst aggregation and the high cost of synthetic supports. Herein, interconnected multicompartment zein porous microspheres (ZPP) were synthesized via salt crystal-induced antisolvent self-assembly to construct a green core-satellite enzyme-photocatalytic platform (ZTFTPS). ZPP exhibits excellent mass transfer and adsorption performance, with its saturated dye adsorption capacity far exceeding that of nonporous solid zein. Glucose oxidase (GOX) was encapsulated in ZPP cavities and stabilized by Fe3+-tannic acid metal-polyphenol network (MPN) coating, which acts as a selective nanofiltration gate to suppress enzyme leakage while allowing substrate transport. With Fe3+ bridging, rutile-phase titanium dioxide nanoparticles were hierarchically assembled on ZPP as satellite units to form integrated ZTFTPS. The platform integrates adsorption enrichment, in-situ H2O2 generation and photocatalytic oxidation, and locally produced H2O2 significantly enhances catalytic activity. Under optimized conditions, ZTFTPS achieves a malachite green (MG) degradation efficiency of 92.14% within 180 min, and its apparent rate constant is 217% higher than that of the unassembled physical mixture. After five consecutive cycles, the system still maintains a degradation efficiency of approximately 71.36%. Moreover, ZTFTPS effectively reduces the aquatic toxicity of dye wastewater, demonstrating outstanding biocompatibility and environmental safety. Overall, this work provides a green, scalable strategy for designing efficient porous bioreactors for organic dye wastewater treatment.
Tannic acid can inhibit Saccharomyces cerevisiae metabolism and cellular integrity during myrtle wine fermentation. Proline has been shown to significantly mitigate the stress effects of tannic acid on the S. cerevisiae. This study aimed to investigate the effects of proline on the volatile profile and sensory properties of tannic acid-rich myrtle wine. The results indicated that proline significantly increased the contents of ethanol, organic acids, and phenolic compounds in myrtle wine. GC-MS analysis showed a 15.8% increase in total VOCs in the proline-treated group (PG) compared with the control group (CG), with rOAV analysis identifying isoamyl acetate, ethyl isovalerate, ethyl octanoate, and phenylethyl acetate as potential aroma-active compounds contributing to fruity and floral characteristics. E-nose showed that the response values of W5S, W1S, W2S, W2W, and W3S sensors in PG were increased by 76.2%, 16.2%, 96.4%, 41.25%, and 9.8% compared with CG, respectively. Ultimately, sensory analysis revealed that proline substantially improved the overall sensory quality of myrtle wine. These findings provide valuable theoretical guidance for enhancing the quality of myrtle wine.