Heliyon

Robot-assisted hematoma puncture has seen significant development in primary hospitals across the country. Sino Plan software system is the core of the intelligent surgical robot, independently developed by Sinovation.We conducted a comparative study of imaging indicators, such as residual hematoma volume and hematoma clearance rate, as well as prognostic indicators, in patients who underwent hematoma puncture at our hospital over a 9-year period, before and after the introduction of Sino Plan.The results indicated that following the application of Sino Plan, the hematoma clearance rate was significantly enhanced, and the residual hematoma volume was markedly reduced. Regarding patient prognosis, there was no significant difference in GCS scores between the two groups, but the incidence of adverse prognostic events was lower in patients where Sino Plan was utilized.In conclusion, this 9-year retrospective analysis at our hospital reveals that Sino Plan offers distinct advantages. However, its application in certain special cases suggests that further improvements to the software are warranted to better meet the demands of more specific clinical scenarios.

Early identification of promising drug research topics is challenging yet crucial for the scientific community to accelerate the development of novel therapeutics. In this work, we leverage large-scale public data from the biomedical literature to extract predictive features to identify promising therapeutic research topics at an early stage. We divide the global citation graph of biomedical literature into a time series of research topics and extract topic features based on citation activity, publication content, and measurable flocking of scientists into novel research topics. Based on these features, our machine learning model identifies research topics that in the future yield Food and Drug Administration (FDA)-approved drugs years before approval (F1-score of 0.84). 80% of target drugs are predicted in advance, with 65% predicted 8 or more years before approval. This predates the start of phase 2 clinical trials in the vast majority of positive predictions. These results show this approach can efficiently flag research topics generating approved drugs several years prior to approval using public data that would have been contemporaneous at the time of prediction. Thus, reliable forecasting can be accomplished with a high-level view of the publication and citation behavior of scientists, without depending on clinical trial data that may only be deposited with a significant lag. This demonstrates that it is possible to detect early signals of future FDA approved therapies even without any specialized information about these applied research efforts. TeaserLarge-scale data analysis can use the full set of scientific citations to predict which areas of research will yield new FDA approved drugs, years in advance.

Introduction: Women aged 45-49 occupy a heterogeneous late-reproductive-life stage, but population research often treats them as a uniform group. This study examined correlates of Demographic and Health Survey (DHS)-defined infecund/menopausal status among Nigerian women aged 45-49. Methods: This cross-sectional secondary analysis used the 2024 Nigeria Demographic and Health Survey Women Recode dataset. Weighted descriptive statistics summarised reproductive exposure status among 3,237 women. Out of these, 3,110 women classified as either fecund or infecund/menopausal were subjected to Survey-adjusted Chi-square tests and Binary Logistic regression at p<0.05, where pregnant and postpartum amenorrhoeic women were excluded. Results: More than half of women were classified as infecund/menopausal (54.1%), while 41.5% were fecund; 3.2% were postpartum amenorrhoeic, and 1.3% were pregnant. Findings indicated that currently married/cohabiting women (AOR=4.87; 95% CI: 2.24-10.56) and formerly married women (AOR=8.30; 95% CI: 3.69-18.66) had higher odds of infecund/menopausal classification than women never in a union. Secondary education, higher education, middle-to-richest wealth quintiles, and five or more children ever born were associated with lower odds, while Northern minority ethnicity was associated with higher odds. Adding the current contraceptive method attenuated several education, wealth and parity associations; modern-method and traditional-method users had markedly lower odds than non-users. Conclusion: Late-reproductive-life exposure status among Nigerian women aged 45-49 is socially patterned, with union status showing the most stable association. DHS-defined infecund/menopausal status is a demographic exposure category rather than clinically confirmed menopause. It is therefore concluded that the cross-sectional associations should not be interpreted causally.

Introduction: Stroke care is time-sensitive, yet patients in low-resource settings may reach tertiary services only after passing through multiple formal and informal care options. This study examined documented care-seeking pathways and time to presentation among stroke cases recorded at the University of Medical Sciences Teaching Hospital (UNIMEDTH), Ondo State, Nigeria. Methods: A retrospective hospital record review was conducted using secondary data from the Stroke Registry, radiology department records, referral notes, and ambulance records at UNIMEDTH. The analysis included 371 stroke cases with documented time from symptom onset to UNIMEDTH presentation and reconstructable care pathways. First-contact routes were classified as hospital/biomedical, self/informal or traditional/faith-based care, and the number of documented steps defined pathway complexity before and including tertiary presentation. Frequencies and percentages described pathway patterns; median presentation times were compared using Mann-Whitney U and Kruskal-Wallis tests. Results: The median time to tertiary presentation was 24 hours (interquartile range [IQR] 9-72), and 317 patients (85.4%) presented after four hours. Only 30 patients (8.1%) presented directly to UNIMEDTH; 44 distinct care-pathway sequences were recorded. Hospital-facility first contact was documented for 81 patients (21.8%). It was associated with a median presentation time of 3 hours (IQR 2-6), compared with 48 hours (IQR 24-72) among patients whose initial contact was outside a hospital facility (U = 699.50, p < 0.001). The median time also differed across grouped first-contact categories and pathway complexity levels (both p < 0.001). Conclusion: Non-hospital or multi-step care-seeking pathways commonly preceded tertiary stroke presentations in this setting. The findings indicate that delayed tertiary arrival is partly embedded in the pathway followed after symptom onset. Interventions should combine public recognition of stroke warning signs with urgent referral linkages involving hospitals, patent medicine vendors, traditional and faith-based providers, and emergency transport systems.

Cancer is a major global health issue with rising incidence and mortality. Early detection, tumor characterization, and disease surveillance are crucial for timely and effective treatment, ultimately reducing mortality rates. Liquid biopsy (LB) has emerged as a valuable detection tool offering a non-invasive method to determine tumor-derived biomarkers in body fluids with demonstrated translational potential. To increase biomarker sensitivity, high-throughput sequencing platforms deliver massive volumes of data. Artificial Intelligence (AI) is pivotal in enabling huge and complex data integration. This contribution aims to assess the current state of integrative AI-based research in the LB field and provide methodological guidance. First, we conducted a PubMed search and found that the literature is sparse in studies integrating LB features, particularly by applying AI. When adopting the latter approach, defining the study objectives is crucial to guide the subsequent methodological aspects, including study design, patient selection criteria, sample size, nature of the LB features, and metadata to collect. Specifically, we propose strategies and tools for data preprocessing, including normalization and batch correction, as well as handling outliers and missing data. Furthermore, we recommend various Machine/Deep Learning approaches for feature selection techniques to ensure model robustness, and we highlight the importance of undergoing rigorous internal and external validations of the selected models. Assessing clinical utility and interpretability is often overlooked but fundamental for real-world implementation. In conclusion, we provide the LB scientific community with an AI-based methodological guidance to bridge the two fields and enhance the integrative analysis of LB features. Graphical abstractWorkchart for multiomics integrative studies in the liquid biopsy field. Note: CTCs, circulating tumor cells; ctDNA, circulating tumor-DNA; TEPs, tumor-educated platelets; miRNA, microRNA; cfRNAs, cell-free RNAs. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=159 SRC="FIGDIR/small/724535v1_ufig1.gif" ALT="Figure 1"> View larger version (45K): org.highwire.dtl.DTLVardef@1f250b2org.highwire.dtl.DTLVardef@18fe36corg.highwire.dtl.DTLVardef@19c02b9org.highwire.dtl.DTLVardef@176f6e0_HPS_FORMAT_FIGEXP M_FIG C_FIG

Abstract: Background: Acute war-related traumatic wounds present significant challenges due to significant soft-tissue damage/loss, risk of contamination, limited access to antimicrobial therapy, need for delayed closure, and limited access to surgical and wound care. Negative Pressure Wound Therapy (NPWT) has been used effectively to reduce the volume of soft-tissue defects, edema, and infection in traumatic wounds, and to promote growth of healthy granulation tissue. However, conventional NPWT devices are costly and electricity-dependent, limiting their utility in conflict settings. Methods: This retrospective cohort study evaluated the use of PragmaVAC, a manually operated, electricity-independent NPWT device, in patients across three hospitals in Gaza with conflict-related wounds that were deemed by the treating surgeon to be unsuitable for primary closure. Secondary analysis was performed of clinical records of patients treated with the PragmaVac NPWT device to assess ability to achieve a primary outcome of wound bed with healthy granulation tissue, time to primary outcome, and rates of adverse effects. Secondary outcome of wound closure and closure method was also assessed. Results: Treatment with PragmaVAC manual NPWT was prescribed to 88 patients. Of those, 27 (31%) had incomplete documentation of their wound healing or were lost to follow up. The remaining 61 (69%) had complete documentation of their wound healing, complications, and final outcome with 59 (67%) successful closure and 2(2%) failure. Conclusion: The use of the PragmaVAC NPWT device provided a safe, effective wound care option to achieve wound closure for large conflict-related traumatic wounds in resource-limited settings. Future studies may further evaluate such use through prospective trials, evalutions of patients' experiences with manual NPWT, and evaluating outcomes beyond primary wound closure to include medium- and long-term complications, cosmesis, and cost of therapy.

Respectful maternity care [RMC] comprises the primary components of high-quality maternal health services. Evidence on RMC levels and determinants in Ethiopia is still inadequate. This study aimed to examine the reception and its determinants among postnatal women in government hospitals in the East Wallaga Zone, West Oromia. An institution-based cross-sectional study was conducted from June to October 2025, within seven days post-delivery. A structured questionnaire based on the WHO RMC tools was used. The total RMC score proved robust reliability [Cronbachs = 0.808] and was organized using the 75th-percentile threshold. Factor analysis revealed basic RMC dimensions, while logistic regression was used to identify predictors of a promising RMC experience. This study presented that only 46.8% of postpartum mothers received adequate RMC, with significant gaps in care. The main deficiencies comprised poor provider self-introduction, failure to call women by name, and infrequent communication and consent practices. Three key RMC dimensions were identified: privacy and consent, explanation and permission, and respectful communication. Using multivariate analysis, interpersonal caring practices were robust predictors of positive RMC experiences. Explaining procedures with possible events, maintaining privacy, obtaining consent, prompt responsiveness, provider self-introduction, and calling mothers by name were significantly associated factors. Sociodemographic and maternal reproductive factors were not significantly associated after adjusting for confounders. Finally, fewer than half [46.6%] of mothers experienced adequate RMC, which indicated major gaps in woman-centered care. Improving respectful interpersonal communication, informed consent, and maintaining privacy should be prioritized to boost the quality of maternal healthcare in the study area.

Introduction Creativity is important in surgery for problem-solving in the operating room and the development of surgical innovations that improve patient outcomes. However, our limited understanding of what the characteristics and competencies of the highly creative surgeon are has inhibited our ability to develop the tools, programs and interventions necessary for cultivating the creativity of surgeons. We present the protocol for the INSPIRE Study, which aims to identify the factors associated with high creative achievement in surgeons. Methods and Analysis We have designed a sequential mixed-method study, including a cohort study accompanied by qualitative semi-structured interviews. The primary objective of this study will be to identify factors associated with high creative achievement in surgeons, to be assessed through direct involvement in innovation or invention, or a top score (10 out of 10) on any domain in the Inventory of Creative Activities and Achievements questionnaire. We plan to measure 39 different personal, domain-specific, domain-general, and environmental/motivational variables, chosen based on previous literature and on exploratory grounds, to be assessed as possible factors of creative potential. Multivariable logistic regression is planned, with high creative achievement as the dependent variable and all 39 potential factors of creative potential as independent variables. Ethics and Dissemination Ethics approval from the Hamilton Integrated Research Ethics Board has been obtained and no harm is expected due to participation in this study. To facilitate knowledge translation, we plan to publish the feasibility data and results in peer-reviewed journals, and present at international surgical and creativity conferences.

Abstract Background: Mean platelet volume (MPV) is a simple, low-cost biomarker that reflects platelet activation. Its prognostic value in septic shock remains controversial. We aimed to determine whether MPV at intensive care unit (ICU) admission is associated with hospital mortality in patients with septic shock. Methods: Retrospective cohort study of consecutive adults with septic shock (Sepsis-3 criteria) admitted to a single ICU. MPV, severity scores (SOFA, APACHE II, SAPS II), procalcitonin, and clinical data were collected. The primary outcome was in-hospital mortality. Spearman correlation, univariate and multivariate logistic regression (with Firth's correction), ROC curves, and subgroup analyses were performed. Results: Fifty-eight patients were included; mortality was 58.6%. MPV did not differ between non-survivors and survivors (13.09 {+/-} 1.37 vs. 12.66 {+/-} 1.45 fL, p = 0.259). MPV showed a weak correlation with procalcitonin ({rho} = 0.394, p = 0.002) but not with severity scores. In multivariate analysis adjusting for age, sex, SOFA and comorbidity count, MPV was not an independent predictor of mortality (OR 1.075, 95% CI 0.682-1.755, p = 0.749). The area under the ROC curve for MPV was 0.598 (95% CI 0.444-0.752), significantly lower than that of SOFA (0.837) and procalcitonin (0.836). Subgroup analyses showed no significant association between MPV and mortality in any stratum. Conclusions: In this cohort of septic shock patients, MPV at ICU admission was not associated with hospital mortality and had poor discriminative ability. Widely used severity scores and procalcitonin remain superior prognostic markers. MPV should not be used as a prognostic tool in septic shock. Keywords: Septic shock, Mean platelet volume, Mortality, SOFA, Procalcitonin, Biomarker

Engagement is widely recognised as central to learning and academic achievement. Electrodermal activity (EDA) has emerged as an objective physiological indicator of engagement, as it measures sympathetic nervous system activation. However, the high cost of wearable EDA sensors has limited its widespread application. This study answers the call for affordable, high-temporal-resolution engagement measures by validating a video-based quantitative assessment method. Researchers collected 75 minutes of synchronised EDA and video data from 12 upper secondary students (aged 17-18) during regular instruction. Novel software was developed to analyse student movement and sound level for academically relevant content. The OpenPose AI model for pose estimation was also applied. This approach produced six distinct movement variables: two AI-based and four non-AI-based. Six linear models using varying movement variables and sound level were tested to predict tonic EDA levels. All models effectively predicted EDA levels, with non-AI-based movement metrics outperforming AI-based alternatives. The four non-AI-based movement models showed similar performance, indicating that compressed versions reduced computational time without sacrificing predictive power. These findings validate a novel, objective method for comparing engagement across learning activities on short timescales. This method is particularly useful for collaborative learning environments and enables controlling for movement and sound in quantitative classroom analyses.

Background: Literature on the role of thermal discomfort (heat- and cold-stress) on in-vitro fertilization (IVF) outcomes are scarce and inconclusive. This multi-center research examines association between heat stress and IVF treatment outcomes in Andhra Pradesh, which is prone to year around chronic heat stress. Methods: IVF data were abstracted from clinical chart review of all patients from three IVF from centers 2019 to 2023, which included time-stamped data on each IVF procedure, demographics and pre-existing comorbidities. Weather data were acquired from the National Climatic Data Center (NCDC). IVF outcomes were modelled with respect to time-lagged exposure to ambient temperature stratified by hyper- and hypo-thermic conditions using Poisson and logistic regressions depending on the scale of IVF outcomes adjusting for confounders. Results: Heat stress peaked in June, which corresponded with elevated number of spontaneous abortions/miscarriage (SAM). Under hypo- and hyper-thermic conditions a unit increase ambient temperature was associated with an 11% higher and an 8% lower number of oocytes retrieved, respectively. Adjusting for confounders, a 10 degree F increase in two-day lag heat stress was associated with a 30% higher odds of SAM (odds ratio ~ 1.03; 95% CI = 1.001 to 1.068; p-value < 0.043), and odds of PTB were 3 times higher when three day-lagged heat index (HI) was greater than 35 degree C (odds ratio 1.13 to 7.99; p < 0.05). Conclusion. Our findings warrant strategies to engage IVF patients in mitigating their exposure to thermal discomfort before and during the treatment.

Kalanchoe pinnata is a perennial plant that grows wild in tropical regions and is traditionally used as a medicinal plant. Plants of the Kalanchoe genus have been shown to possess several effects, including antibacterial and antihypertensive properties. However, effects such as the induction of apoptosis in cancer cells have not been reported for any substance other than leaf extracts of this plant and remain unexplained. Therefore, in this study, we investigated the effects of extracts from various parts of K. pinnata (flowers, leaves, and roots) on human colon cancer cell death. We conducted the study using three colorectal cancer cell lines (HT-29, SW620, and DLD-1) and three types of extracts derived from the flowers, leaves, and roots of this plant. Each K. pinnata extract significantly reduced cell viability in a dose-dependent manner in all colon cancer cells. In particular, the root extract induced cancer cell death and inhibited proliferation at lower concentrations than the other extracts. For the colon cancer cells examined, caspase-dependent apoptosis was suggested as the primary mechanism, although cell death was observed in some cells without detectable caspase activation. K. pinnata extracts induced both apoptosis and necrosis in colorectal cancer cells. In addition, K. pinnata extracts increased protein level of cleaved caspase-9, caspase-3, and PARP in SW620 and DLD-1 cells. The decrease in mitochondrial membrane potential was confirmed for all extracts, however caspase-mediated apoptosis was not observed in all cell lines, indicating the need for further investigation. Taken together, our results indicate the potential of the plant K. pinnata and the bioactive compounds it contains as new candidates for adjuvant therapy in colorectal cancer. In the future, it will be necessary to examine the relationship with genetic mutations in each cell line and to investigate the details of the cell death mechanism.

Stroke, as an acute cerebrovascular disease with significant public health implications, is influenced by a complex interplay of meteorological conditions, air quality, and socioeconomic factors. However, the inherent challenges of mixed-frequency data from diverse sources and high-dimensional variable spaces limit the effectiveness of traditional regression models. This study develops a Lasso-MIDAS model framework to identify the key multidimensional drivers of stroke admissions. Using this approach, 21 candidate variables encompassing meteorological, environmental, and economic indicators were screened. The empirical results identified 11 core influencing factors. In the meteorological and environmental dimensions, Wind Speed, Carbon Monoxide (CO), and Sulfur Dioxide (SO2) were identified as significant positive drivers, with Temperature Difference also positively correlating with admission risks. Conversely, Nitrogen Dioxide (NO2) exhibited a negative correlation, potentially reflecting behavioral adaptation and exposure reduction during peak pollution periods. In the socioeconomic dimension, the Consumer Price Index (CPI) for Food, Tobacco, and Alcohol emerged as a major risk factor, highlighting the impact of living cost pressures on public health. The findings demonstrate the superiority of the Lasso-MIDAS model in handling large-scale healthcare data. It effectively addresses the frequency mismatch problem while enhancing the robustness of causal identification through variable shrinkage. These conclusions provide a scientific basis for health authorities to establish early warning systems and optimize public health policy interventions.

This cross-sectional study aimed to examine the prevalence of alcohol use and its sociodemographic correlates among adults with cardiovascular disease (CVD). We analyzed data from two large US cohorts: the All of Us Research Program (2017-2023) and the National Health and Nutrition Examination Survey (NHANES, 1999-2016). Both CVD diagnosis and past-year alcohol consumption were self-reported. Risky drinking was defined as exceeding moderate drinking or binge drinking (All of Us), or moderate/heavy drinking (NHANES). Multivariable logistic regression was used to exam associations with sociodemographic and lifestyle factors. Among 32,788 current drinkers with CVD in the All of Us cohort, 15% exceeded moderate drinking thresholds and 26% reported binge drinking. Older age, female sex, and higher socioeconomic status were inversely associated with risky drinking, while smoking was positively associated. In NHANES, moderate drinking rose from 47.3% to 57.2% and heavy drinking from 6.7% to 7.2%. Moderate/heavy drinking was positively associated with age <65 but inversely with age [&ge;]65. Higher education and income were linked to moderate drinking, while current smoking was strongly associated with heavy drinking. These results highlight the need to integrate holistic screening for alcohol use, tobacco use, and social context into routine cardiovascular care.

Introduction: Malaria, primarily transmitted by Anopheles mosquitoes, remains a major public health concern in Maiduguri, Borno State, Nigeria. While conventional control methods (e.g., ITNs) face challenges due to insecticide resistance and accessibility constraints, many communities rely on locally sourced natural products. This study aimed to assess the prevalence, usage patterns, and associated factors of these natural alternatives. Methods: A cross-sectional survey was conducted across three purposefully selected communities in Maiduguri (Mairi, Furi, Lagos Street). A total of 450 household heads were interviewed using a structured questionnaire, collecting data on socio-demographics, specific natural products used, method of application, frequency, and perceived efficacy. Data were analyzed using descriptive statistics and binary logistic regression. Results: Overall usage prevalence of natural products was high at 68.4%. The most common products identified were Neem (Azadirachta indica) extract (45.9%) and burnt Lemon Grass (Cymbopogon citratus) (31.2%). Usage pattern was predominantly indoor fumigation (burning), and over 70% of users prepared the products crudely at home. Logistic regression revealed that rural residence (Odds Ratio (OR): 2.1; p<0.01) and low education level (OR: 1.8; p<0.05) were significant independent predictors of higher natural product reliance. Conclusion: Natural products constitute a widely adopted, community-driven vector control method in Borno State. The high prevalence and association with vulnerable populations suggest an urgent need to standardize the preparation and application of these products for potential integration into regional malaria control programs. Keywords: Anopheles, Adulticides, Borno State, Malaria, Natural Repellents, Vector Control, Usage Pattern.

Background: Accurate evaluation of fine motor abilities is a key aspect of neurological rehabilitation. However, conventional approaches like goniometry are limited by variations among raters and their difficulty in detecting active movement. On the other hand, computer vision-based software delivers non-invasive and quantitative analysis of hand movements. An innovative computer-vision-based software tool, F.A.I.R. Chance(C), was developed to track and analyze individual finger joint movements on a camera-equipped laptop and give real-time numerical feedback. However, its metrics require validation in a healthy population before the tool can be used for clinical purposes. Objective: To assess the reliability and validity of finger movement assessment by the F.A.I.R. Chance computer vision-based tool in healthy adult participants. Methods: An observational cross-sectional study was done at MGM School of Physiotherapy, comprising 30 healthy participants between 18 and 60 years of age. Finger movements like flexion, extension, abduction, and adduction were measured with a standard handheld goniometer. These same finger movements were then measured with the tool at two time points separated by a 30-minute interval to determine the test-retest reliability. The tool's measurements were compared with the goniometric measurements to determine its concurrent validity. Test retest reliability was checked by the Intra-class Correlation Coefficient ICC (2,1), while concurrent validity was tested through Pearson's correlation coefficients. Results: Metacarpophalangeal and proximal interphalangeal joint motions demonstrated moderate to good test-retest reliability (ICC: 0.716-0.953) for the F.A.I.R. Chance tool. However, distal interphalangeal joint movements had lower consistency. Good reliability (ICC: 0.754-0.908) was seen for movements of abduction and adduction in the fingers. Strong concurrent validity for extension movements of the metacarpophalangeal joints (r=0.760-0.914) and moderate concurrent validity for flexion movements of the metacarpophalangeal joints (r=0.427-0.604) was demonstrated for all fingers for the F.A.I.R. Chance tool. Concurrent validity for adduction and abduction movements demonstrated a low to fair correlation with goniometric measurements (r=0.210-0.440). This is consistent with previous research showing poor agreement between goniometry and adduction-abduction movements of the fingers. Conclusion: The F.A.I.R. Chance tool shows good reliability and acceptable concurrent validity to assess fine motor movements in the healthy adult population. This sets a basis for further clinical study of the tool in the target population with fine motor impairments. Keywords: artificial intelligence; assistive technology; computer vision; fine motor evaluation; hand function;

Abstract Background: Management of high sagittal split fractures of the mandibular condyle remains a formidable surgical chal-lenge due to limited visualization, technical difficulties in direct in-situ fixation, and the high risk of secondary avascular necrosis or temporomandibular joint (TMJ) ankylosis. Objectives: To evaluate the clinical outcomes and technical efficacy of the "Motamed Technique, "a standardized protocol involving extracorporeal rigid internal fixation followed by anatomical re-implantation for complex high condylar split fractures. Methods: A retrospective evaluation was conducted on a clinical series of 11 consecutive patients (9 males, 2 females) presenting with severe, displaced high sagittal split condylar fractures secondary to high velocity trauma. In all cases, the fragmented condylar segments were completely retrieved, stabilized ex vivo on a back table using a titanium X-shaped 3D mini-plate system (1.5 mm), and meticulously reimplanted into the glenoid fossa. Total cold ischemia time was strictly maintained between 10 to 20 minutes. The postoperative longitudinal follow-up period ranged from 6 to 11 months (mean duration: 8.6 months). Comprehensive post-operative tracking included clinical parameter checking, 3D Computed Tomography (3D-CT), and high-resolution dynamic Magnetic Resonance Imaging (MRI) to analyze ony union, vertical ramus height restoration, and articular disc kinetics. Results: All 11 patients achieved predictable and stable functional outcomes. At the definitive milestones, the mean maximum mouth opening (MMO) was 37.3 mm (range, 33-45 mm), demonstrating excellent vertical clearance and stable lateral/protrusive excursions. Pre-traumatic stable centric occlusion was perfectly restored and maintained in 100% of cases (n=11), with zero incidence of postoperative open bite or crossbite. Facial nerve motor function was entirely pre-served across the cohort (100% House-Brackmann Grade I at final follow-up). Longitudinal 3D-CT scans confirmed complete osseous union and anatomical alignment in all cases by the 4th postoperative month, with no radiographic evidence of condylar head resorption or hardware failure. Follow-up MRI findings demonstrated the preservation of TMJ dynamics, functional articular disc movement (with stable reduction in 3 cases), and a total absence of avascular necrosis or intra-articular effusion. No cases of TMJ ankylosis were reported. Conclusion: The Motamed Technique provides a reliable, reproducible, and biologically sound approach for managing intricate high condylar split fractures. By utilizing systematic extracorporeal mini-fixation, this protocol effectively overcomes intraoperative spatial limitations while ensuring excellent long-term anatomical stability, stable occlusion, and functional joint mobility without compromising facial nerve integrity.

Background: Multiple myeloma (MM) remains incurable despite therapeutic advances, reflecting limited understanding of the molecular mechanisms underlying disease initiation and progression. MM develops through asymptomatic precursor stages, monoclonal gammopathy of undetermined significance (MGUS) and smouldering multiple myeloma (SMM). This study aimed to investigate protein changes associated with disease progression and, through a further integrative approach, to highlight molecular changes of potential predictive and/or therapeutic value. Methods: We performed a comparative proteomic analysis of 94 bone marrow-derived CD138+-selected plasma cell samples (29 MGUS, 20 SMM, and 45 MM) using LC-MS/MS. Differential protein abundance was assessed using pairwise Mann-Whitney U tests between groups, with Benjamini-Hochberg correction. Pathway enrichment, protein-protein interaction, and co-expression network analyses were also conducted. Selected proteins were further evaluated using public transcriptomic datasets and experimentally validated in independent samples by flow cytometry and enzyme-linked immunosorbent assay (ELISA). Results: Following data processing, proteomic analysis identified 6,203 proteins. Pairwise comparisons revealed significant proteomic differences across disease stages, with 370 differentially abundant proteins exhibiting monotonic changes during disease progression. Pathway analysis showed that monotonically upregulated proteins were mainly associated with gene expression and cell proliferation, whereas downregulated proteins were linked to immune-related processes. Further co-expression network analysis, combined with criteria including detection frequency, biological relevance, and translational potential, highlighted a group of prioritised proteins. Representative examples include nucleolin (NCL) and U3 small nucleolar ribonucleoprotein IMP3 (IMP3), involved in nucleolar organisation, ribosome biogenesis and rRNA processing, as well as the immune-associated lactotransferrin (LTF) and serine protease cathepsin G (CTSG). Transcriptomic support and independent experimental validation by flow cytometry and ELISA confirmed the relevance of selected candidates. Conclusions: Taken together, our findings highlight coordinated changes in immune regulation, RNA processing and ribosome biogenesis during MM progression and identify candidate proteins and their networks, including the emerging pharmacologically tractable target NCL and the underexplored IMP3 of potential therapeutic relevance, opening new avenues for further investigation.

Background: Cervical cancer is the fourth most common cancer in women worldwide and remains a major public health challenge. In Ethiopia, it is the second leading cause of cancer deaths, with around 8,000 new cases and 6,000 deaths each year. Region?specific data on the prevalence and predictors of precancerous lesions remain scarce, yet such information is vital for guiding targeted reproductive health strategies. This study therefore examined the prevalence and predictors of cervical precancerous lesions among women aged 21-60 years undergoing Pap smear screening in public hospitals in Hawassa City, Sidama Region. Methods: An institution-based cross-sectional study was conducted among 241 women attending Pap smear screening at public hospitals in Hawassa City from March to August 2025. Sociodemographic and clinical data were collected via interviews and medical records. Lesions were classified based on the standardized international framework for reporting cervical cytology results from Pap smears per the Bethesda system. Multivariable logistic regression identified predictors p<0.05). Result: Of 241 women screened (mean age 35.3 years), cervical epithelial abnormalities were detected in 52 (prevalence 21.6%). Atypical squamous cells of undetermined significance was the most common abnormality (16.6%). Multivariable analysis showed HIV infection was significantly associated with precancerous lesions (AOR = 3.7, 95% CI: 1.69-8.12, p<0.05), while hormonal contraceptive use was protective (AOR = 0.27, 95% CI: 0.11-0.67, p<0.05). Conclusion: These results underscore the urgent need to strengthen cervical cancer prevention through targeted screening and early intervention. Integrating routine HIV testing with Pap smear programs would be especially valuable. Health authorities should expand accessible screening for women aged 21-60, with particular attention to those living with HIV, to help reduce the burden of precancerous lesions.

Ovarian and colorectal cancers have the highest incidence and mortality in the world, after breast cancer. Despite the initial response to Pt-drugs or 5-fluorouracil (5-FU), many cancer cells develop resistance to these drugs. For this reason, new therapeutic strategies represent an important medical need, in particular for drugs that are being studied in combination with methods that promote their entry into the cell. Among these strategies, electrochemotherapy (ECT), the combination of drugs with electroporation (EP), a physical method that uses high-frequency electrical pulses to create pores into which chemotherapy drugs can permeate, is gaining interest. In this study, we have evaluated the effect of ECT on the growth of both ovarian (A2780 and A2780/CP) and colorectal (HCT116) cancer cell lines using platinum derivatives (Cisplatin, Carboplatin and Oxaliplatin), as DNA alkylating agents, and human thymidylate synthase (hTS) inhibitors, both traditional (5FU) and novel TS destabilizers (compounds E3 and E7). To this aim, synergism quotient-like analysis to determine whether electroporation gives an advantage in terms of cytotoxicity was applied to the relative IC20 and IC50 concentrations of each drug. Results showed that two of the three Pt-drugs have greater efficacy when combined with EP. 5-FU and the new TS inhibitors E3 and E7 also take advantage of ECT because EP increases drug uptake into the cell, even in resistant cells. In conclusion, ECT appears to be a viable strategy to obviate the problem of resistance in ovarian and colorectal cancers, to deliver compounds inside cells overcoming uptake limits, especially for the low lipophilic compounds whose cytotoxic efficacy is hampered by the obstacle of biological membranes.