The association of gestational phthalate exposure with social skills and problem behaviors in adolescents.

Sleep duration is a well-established factor associated with all-cause mortality and cardiovascular mortality. Poor sleep quality was also suggested to affect all-cause mortality risk among adults. The Cardiovascular Occupational Risk Factor determination in Israel Study (CORDIS) is a prospective cohort study of industrial workers who entered the study during 1985-1990 and have been followed for 36 years. We examined the relationship between sleep duration, sleeping problems and difficulties, and all-cause mortality in the CORDIS cohort. Self-reported data, including sleep duration and sleeping problems, from 7287 participants were merged with data on all-cause mortality obtained from the National Death Registry and the Central Bureau of Statistics. Over the 36-year follow-up, 2159 participants died: 445 were < 45 years and 1714 were ≥ 45 years. Sleep duration of ≤ 5 h significantly increased mortality risk (hazard ratio [HR] = 1.30, p = 0.0032), with a more pronounced effect in those < 45 years (HR = 1.55, p = 0.0028). Sleeping problems also increased mortality risk (HR = 1.30, p = 0.0088), with a stronger association among younger individuals (HR = 1.63, p = 0.0399). Conversely, difficulty sleeping when anticipating something unpleasant was linked to increased mortality only in those aged ≥ 45 years (HR = 1.17, p = 0.0440). Our analysis showed that short sleep duration and sleeping problems are significant predictors for all-cause mortality, particularly in younger individuals (< 45 years). These results emphasize the importance of addressing sleep problems among different age groups to potentially reduce mortality risk.

The joint effect of cardiometabolic index and high-sensitivity C-reactive protein on incident cardiovascular disease: A prospective cohort study.

To determine whether the ratio of human nonmercaptalbumin to total albumin (HNA%) and serum bilirubin-two oxidative stress-related biomarkers-predicts incident disability in activities of daily living (ADL) among older adults with type 2 diabetes. In this longitudinal cohort study, we followed 101 adults aged ≥70 years with type 2 diabetes who had no baseline ADL disability. The primary outcome was incident ADL disability requiring long-term care certification, a standardized national system in Japan indicating clinically significant physical impairment. Cox proportional hazards models, restricted cubic splines, and nonparametric bootstrap resampling (1,000 iterations) were used to assess associations. During the 7-year follow-up, 28 participants (27.7%) developed ADL disability. Those who became disabled had higher HNA% and older age, and lower serum bilirubin and albumin at baseline. Restricted cubic splines demonstrated linear increases in disability risk with higher HNA% and linear decreases with higher bilirubin. In the primary multivariable model including HNA%, bilirubin, and age, all remained independent predictors (HNA%: HR 1.063, 95% CI 1.005-1.124; bilirubin: HR 0.740, 95% CI 0.562-0.975; age: HR 1.115, 95% CI 1.032-1.206). This model improved discrimination compared with age alone, demonstrated the lowest Akaike's Information Criterion, and showed good calibration. Bootstrap analyses confirmed the robustness and stability of the model. Higher HNA%, lower serum bilirubin, and their combined assessment predicted future ADL decline in older adults with type 2 diabetes. These complementary redox biomarkers may contribute to improved risk stratification for functional deterioration.

Aim: To evaluate the long-term impact of obstructive sleep apnea (OSA) risk profile on atrial fibrillation (AF) recurrence after catheter ablation in patients with paroxysmal AF. Methods: This prospective study enrolled 161 patients with paroxysmal AF undergoing initial ablation. Patients were stratified by the Berlin Questionnaire (BQ) into high-risk (n = 94) and low-risk (n = 67) OSA groups. Atrial tachyarrhythmias occurring within the initial three months were defined as early recurrence, whereas recurrence beyond three months was defined as late recurrence. A subgroup of 71 patients with recurrence underwent a redo ablation. Results: After 16.1 ± 0.4 years, multivariable models revealed that a BQ-defined high OSA risk was independently associated with early recurrence (odds ratio [OR] 1.99, 95% confidence interval [CI] 1.02-3.86, P = 0.043), whereas it was not independently associated with late recurrence after the initial procedure (hazard ratio [HR] 1.05, 95%CI: 0.70-1.57, P = 0.810). Cox regression identified early recurrence (HR 2.95, 95%CI: 1.99-4.39, P &lt; 0.001) and baseline high-sensitivity C-reactive protein (hs-CRP; HR 1.02, 95%CI: 1.00-1.03, P = 0.022) as independent predictors of late recurrence after the initial procedure. Following redo ablation, early recurrence remained a strong independent predictor (HR 5.93, 95%CI: 2.13-16.50, P &lt; 0.001). Conclusions: The BQ-defined high OSA risk was an independent predictor of early recurrence; however, it was not significantly associated with late recurrence after AF ablation. Early recurrence was the strongest predictor of long-term outcome, highlighting the importance of management during the post-procedural blanking period.

Various pathologic conditions can cause oral mucosal changes. However, data regarding the prevalence and sociodemographic distribution of oral mucosal changes are insufficient. The 6th German Oral Health Study (DMS • 6) not only provides cross-sectional analyses of oral mucosal changes but also longitudinal analyses after a 9-year follow-up. For cross-sectional analysis, data from 797 younger seniors (65- to 74-year-olds) from the DMS • 6 cross-sectional component were employed. Longitudinal analysis was performed on data from the DMS • 6 senior cohort including 373 participants from 2014 (baseline) who were reexamined in 2023 (follow-up). The most frequent oral mucosal changes were documented based on the DMS V protocol. Each lesion was photographed and verified by two independent experts, and no other diagnostic tests were performed. Among younger seniors, the overall prevalence of oral mucosal changes was 13.3%. Furthermore, the prevalence of leukoplakia was 4.3%. These rates are consistent with those previously reported. Regarding gender distribution, men were affected more frequently than women. Longitudinal analysis revealed that the majority (68%) of oral mucosal changes detected at baseline were not detected at follow-up. However, three participants showed persistent prosthesis-related changes. Approximately 10% of those who were healthy at baseline presented one or more incident oral mucosal changes over the observation period. In detail, 2.8% developed new serious lesions (carcinomas and leukoplakias). The progression of oral lichen planus and smoker's keratosis could not be determined because individuals with these findings in previous studies were no longer part of the longitudinal sample. Documentation of malignant lesions plays an important role in research and for those affected. However, non-malignant lesions, such as leukoplakia, oral lichen planus, and smoker's keratosis should also be documented in epidemiologic studies, particularly their risk of degeneration and correlation with tobacco consumption. (Quintessence Int 2026;57(Suppl):S76-S81; doi: 10.3290/j.qi.b6955533).

Epidemiologic evidence on oral health in Germany was updated in 2025 by the 6th German Oral Health Study (DMS • 6). However, epidemiologic data describing changes and progression of dental restorations over time under real-world conditions are lacking at the population level. This analysis of DMS • 6 data therefore aimed to assess the clinical development of caries-related dental restorations and the materials used, and to quantify their rates of change, including the development of secondary caries, after a 9-year follow-up. First, a cross-sectional analysis of caries-related dental restorations was conducted. A total of 958 younger adolescents (12-year-olds), 927 younger adults (35- to 44-year-olds), and 797 younger seniors (65- to 74-year-olds) underwent standardized clinical examinations. Restorations were classified as direct and indirect restorations, and by restorative material (tooth-colored, casting alloy, and cement). Secondary (dentin) caries at the restoration margins were also assessed. Second, 371 individuals from the adolescent cohort (12-year olds at baseline; 20-year-olds at follow-up), 342 individuals from the adult cohort (35- to 44-year-olds at baseline; 43- to 52-year-olds at follow-up), and 350 individuals from the senior cohort (65- to 74-year-olds at baseline; 73- to 82-year-olds at follow-up) were reexamined after 9.1 (± 0.3) years for longitudinal analyses (incidence and progression). Younger adolescents predominantly presented with tooth-colored restorations, whereas amalgam fillings and indirect restorations were virtually absent. In adulthood, the prevalence of amalgam restorations increased continuously with age, reaching a maximum of 42% in seniors. The prevalence of indirect restorations also increased with age. The proportion of secondary caries increased to 10.5% in senior age. During the 9-year observation period, the prevalence of dental restorations among adolescents increased from 13.2% to 47.7%. The progression rates of dental restorations (per 100 person-years) were 16.4 and 15.8 in adults and seniors, respectively. The prevalence of dental restorations increased markedly across the life course, with indirect restorations being more frequent in older age groups. The development of secondary caries also appears to be age-dependent. Under real-world conditions, tooth-colored restorations did not exhibit a higher risk of secondary caries than amalgam restorations. (Quintessence Int 2026;57(Suppl): S24-S33; doi: 10.3290/j.qi.b6955480).

Impaired pulmonary function and physical inactivity are established risk factors for cerebrovascular disease, yet their combined contribution to stroke risk has not been systematically evaluated across diverse populations. This study aimed to evaluate the joint association of peak expiratory flow (PEF) and physical activity (PA) with incident stroke risk in US and Chinese adults. This prospective cohort study enrolled 10,620 stroke-free participants aged 50 years or older from the Health and Retirement Study (HRS, n = 6,700) and the China Health and Retirement Longitudinal Study (CHARLS, n = 3,920). Participants were categorized into four groups based on cohort-specific median PEF and self-reported PA. Multivariable Cox proportional hazards models estimated hazard ratio (HR) for incident stroke over a 7-year median follow-up. Among HRS participants (n = 6,700, mean age 66.0 ± 10.3 years) and CHARLS participants (n = 3,920, mean age 61.5 ± 7.8 years), 590 incident strokes were recorded. Compared to the low PEF/inactive group, those with both high PEF and regular PA exhibited the lowest stroke risk in both cohorts (HRS: HR, 0.56 [95% CI, 0.38-0.82]; CHARLS: HR, 0.62 [95% CI, 0.44-0.89]). Participants with only one favorable factor showed attenuated and inconsistent risk reductions. No significant interactions were found by age, sex, or comorbidities (all P for interaction > 0.05). Preserved pulmonary function combined with regular physical activity is associated with a significantly lower stroke risk across diverse populations. Integrated assessment of these factors may improve stroke risk stratification and inform targeted prevention strategies.

Thyroid hormones (TH) are among the most prescribed medications worldwide, and regular monitoring of thyroid function is required to ensure optimal management. Both over- and undertreatment with TH is associated with health risks, including increased cardiovascular morbidity and mortality, as well as higher socioeconomic costs. We investigated how changes in treatment concepts and guideline recommendations over two decades have influenced the frequency and quality of TH treatment in a high-income country. Data from 7,711 participants In the German population-based Heinz Nixdorf Recall (HNR) study were descriptively analysed to assess the prevalence of reported thyroid disease, TH therapy, and thyrotropin (TSH) concentrations measured by immunoassay over the period 2000-2023. The mean age differed from 53.8 ± 15.1 years to 68.7 ± 7.3 years (45.8 to 49.6% males). Descriptive analyses were also stratified by age, sex and educational attainment. The prevalence of reported thyroid disease remained stable throughout the study period, whereas TH prescription increased from 9.2% to 15.3% over two decades. TH therapy was more common among women and older participants. Compared with individuals without thyroid disease or those with thyroid disease not treated with TH, median TSH concentrations were lower in participants receiving TH therapy, with the greatest reduction observed in elderly individuals. At study baseline, 35% of participants with TSH concentrations <0.45 mIU/L reported TH treatment, and this proportion remained high (25%) during the 20-year follow-up. TH therapy in the study population increased over the past two decades. TSH measurements revealed persistent overtreatment, particularly among older individuals. These findings highlight a concerning gap between updated guideline recommendations for TH therapy and its implementation in routine clinical practice. Greater emphasis is needed on translating scientific evidence into patient care through improved education of both physicians and patients, promoting a more restrictive approach to thyroid function testing, TH therapy, regular review of ongoing TH treatment, and age-adjusted TH dosing.

Osteopathia striata with cranial sclerosis (OSCS) is a rare X-linked dominant genetic disorder mediated by variants in the AMER1 gene, characterized primarily by generalized skeletal sclerosis and striated changes. However, research on its craniofacial phenotypes has long been fragmented, lacking systematic pedigree construction and basis for precise management. This study integrates a 16-year follow-up patient carrying a novel AMER1 frameshift variant (c.966delT; p.Phe322Leufs*3) with 66 literature-confirmed patients, and systematically analyzes craniofacial phenotypic characteristics and genetic associations using Spearman correlation analysis, two-step clustering, and gene function prediction. The results show that orofacial clefts have the highest incidence (72%), with synergistic associations between retained deciduous teeth and impacted permanent teeth; two-step clustering identified four heterogeneous "genetic abnormality-phenotype" subtypes, with DNA/protein functional status as the core factor; it confirms that c.966delT is a pathogenic de novo variant, mediating Wnt pathway abnormalities as the core mechanism of phenotypes, and proposes a multidisciplinary management strategy. This study is the first to establish a quantitative pedigree and subtype classification for OSCS craniofacial phenotypes, deepening the understanding of molecular mechanisms and providing key basis for precise diagnosis, stratified intervention, and prognosis improvement.

To determine the prevalence of depressive and anxiety symptoms among young people 7 years and 9 years after inclusion in the multicentre, prospective inception cohort (ICON) of newly diagnosed patients with juvenile idiopathic arthritis (JIA) in Germany, and to identify factors associated with mental health problems at study inclusion and in the course of the disease. Patients and controls (healthy peers, eg, friends of the same age and sex) from the ICON cohort (both ≥13 years) were assessed for mental health using the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder Scale-7 at 7-year and 9-year follow-ups. Demographic and clinical characteristics, treatments and health-related quality of life (HRQoL) (Pediatric Quality of Life Inventory (PedsQL)) were documented at baseline and follow-up visits. Cross-sectional (analysis of variance or χ² tests at 7-year/9-year follow-up) and longitudinal analyses (generalised linear mixed models for PedsQL in follow-up from baseline) were conducted, respectively. A total of 344 patients (age 18.7±3.5 years, disease duration 9.2±1.8 years, 42% polyarthritis) and 224 controls (age 18.2±3.6 years) were evaluated. Moderate to severe symptoms of depression and anxiety were present in 13% and 10% of patients, respectively, compared with 7% and 2% of controls. Patients with moderate to severe psychological distress did not exhibit significantly higher physician-reported disease activity at inclusion and follow-up but reported worse patient-reported outcomes. These patients already showed reduced emotional functioning 3 months after diagnosis (p<0.001) and reported lower physical and emotional functioning (p<0.001) after the first year of specialised care compared with those without relevant mental health problems at long-term follow-up. Poor emotional functioning at the start of care for JIA may be an indicator of future mental health issues. Therefore, HRQoL should be routinely assessed at treatment initiation to identify at-risk patients early and provide targeted support.

Molar socket shield technique with immediate implant placement maintains stable tissue architecture at 5- to 7-year follow-up: A clinical series.

The AI-CVD initiative aims to extract actionable insights from coronary artery calcium (CAC) scans beyond the traditional CAC score. Although AI-derived cardiac chamber volumes predict atrial fibrillation (AF) and stroke, the long-term prognostic value of chamber ratios is less established. We evaluated the predictive value of AI-derived left atrial volume index and related chamber ratios (left atrial [LA]/right atrial [RA], LA/left ventricular) from routine CAC scans for incident AF and stroke, and their incremental value beyond established risk scores. Pooled participant-level data from 2 prospective cohorts, the MESA (Multi-Ethnic Study of Atherosclerosis, 2000-2002, n=5670) and the FHS (Framingham Heart Study Offspring cohort, 1998-2001, n=1142), were analyzed. Primary outcomes were incident AF and incident stroke. AI-enabled volumetry (AutoChamber, AI-CVD platform) quantified cardiac chamber metrics from noncontrast CAC scans. Cox proportional hazards models, net reclassification improvement, time-dependent area under the curve, calibration metrics, and least absolute shrinkage and selection operator regression were applied to evaluate predictive performance. Over a median 17-year follow-up, 1302 participants developed AF, and 365 experienced stroke events. Individuals in the ≥95th percentile of chamber metrics had a significantly increased risk. Adjusted hazard ratios for AF were 2.66 (95% CI, 2.23-3.17) for left atrial volume index, 2.04 (95% CI, 1.71-2.45) for LA/left ventricular (LV) ratio, and 1.87 (95% CI, 1.55-2.26) for LA/RA ratio. For stroke, corresponding hazard ratios were 1.96 (95% CI, 1.38-2.77), 1.64 (95% CI, 1.15-2.33), and 1.83 (95% CI, 1.29-2.59), respectively. AI-derived metrics improved reclassification beyond Cohorts for Heart and Aging Research in Genomic Epidemiology Atrial Fibrillation risk score and Framingham Stroke Risk Profile, with greatest improvements for AF from left atrial volume index (net reclassification improvement, 0.48) and stroke from LA/RA ratio (net reclassification improvement, 0.39), driven mainly by nonevent classification. Although discrimination improvements (area under the curve ) were modest, chamber measurements substantially improved Framingham Stroke Risk Profile calibration (slope, 0.448 to 0.834-0.902). Among all chamber metrics (including volumes and ratios), the least absolute shrinkage and selection operator identified left atrial volume index as the strongest predictor for AF, and LA/RA ratio as the strongest for stroke. AI-enabled left atrial volumetric and ratio-based metrics derived opportunistically from CAC scans provide incremental predictive value for AF and stroke prediction.

Exercise unmasks limitations in multi-organ system reserve capacity characteristic of heart failure with preserved ejection fraction (HFpEF). However, the metabolic and genetic underpinnings of exercise deficits, and their cumulative contribution to HFpEF severity and prognosis, remain incompletely understood. We used invasive cardiopulmonary exercise testing (iCPET), metabolite profiling, and genomics to simultaneously characterize seven exercise physiologic deficits in HFpEF patients: reduced exercise stroke volume and heart rate, steep pulmonary capillary wedge pressure/cardiac output (PCWP/CO) slope, elevated pulmonary vascular resistance, pulmonary mechanical limitation to exercise, impaired peripheral oxygen extraction, and obesity-related exaggerated metabolic cost of initiating exercise. We first mapped the distribution, functional, and prognostic significance of these exercise deficits. We then applied LASSO regression to identify metabolite signatures of each exercise deficit, and measured the relation of these signatures with clinical-demographic features, cardiac magnetic resonance imaging, and incident HF in 6345 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA) study with ≈20-year follow-up. Finally, we mapped deficit-implicated metabolites to tissue-specific genetic variation in ≈2M individuals with HF, and in the largest genome-wide association study (GWAS) studies of HFpEF comorbidities (obesity, renal disease, diabetes) to evaluate shared metabolic mechanisms of HFpEF pathophysiology. Our iCPET HFpEF cohort (61.7±14.1 years, 54% female, BMI 30.6±6.7 kg/m2 ) exhibited a broad range of compound cardiac and extra-cardiac exercise deficits. Individuals with ≥5 exercise deficits had a nearly 4-fold higher hazard of incident cardiovascular event or mortality (HR 3.90, 95% CI 1.74-8.75, P<0.0001). The metabolite signature of exercise PCWP/CO slope conferred a HR of 1.43 per SD increment, 95% CI 1.20-1.71, P<0.001 for incident HF in MESA. Addition of all iCPET deficit metabolic signatures in a single model yielded ≈20% continuous net reclassification improvement over traditional HFpEF risk factors. Genes implicated by the exercise deficit metabolome were enriched in the HF GWAS (≈2M) and shared with obesity, renal dysfunction, and diabetes, highlighting a lifelong shared predisposition to HF (including HFpEF) and its comorbidities. Organ-specific responses to exercise and their circulating metabolite signatures are strongly linked to HFpEF development and prognosis. These results offer a paradigm for parsing HFpEF subphenotypes and prioritizing metabolic mechanisms of HFpEF.

Body mass index (BMI) trajectories and transitions across adulthood are dynamic processes influenced by aging and social- and health-related factors, yet long-term patterns in older adults from middle-income countries remain insufficiently characterized. The objective of this study was to characterize long-term BMI trajectories and transitions, and to identify sociodemographic and clinical factors associated with adverse BMI patterns among Mexican adults aged ≥50 years followed over 20 years. This study used data from the Mexican Health and Aging Study (ENASEM), a nationally representative longitudinal cohort. Participants aged ≥50 years with repeated BMI measurements across survey waves were included. BMI trajectories and transitions between BMI categories were described, and multinomial regression models were used to examine factors associated with upward transitions and unstable high-BMI patterns. Distinct BMI trajectory patterns were identified over the 20-year follow-up. Participants in stable normal-weight trajectories were younger, more frequently female, and had higher educational attainment and income. In contrast, those with stable overweight/obesity or fluctuating-adverse BMI patterns had higher baseline BMI and a greater prevalence of diabetes, hypertension, and multimorbidity. In multivariable analyses, age contributed to trajectory differences; however, sex, socioeconomic factors, baseline BMI, and chronic conditions remained independently associated with adverse BMI patterns. BMI trajectories in later life are heterogeneous and reflect the combined influence of aging, socioeconomic conditions, and chronic disease burden. Identifying groups at risk of adverse BMI patterns may support the development of targeted interventions to reduce obesity-related health consequences in older adults.

The presence of a bunion (hallux valgus) deformity is a recognized risk factor for falls among older adults; however, it is uncertain whether surgical correction of the foot deformity can help mitigate this risk. We conducted a retrospective cohort study of US adults aged 50 and over with hallux valgus using commercial, state, and federal healthcare claims obtained from a national database (PearlDiver, Inc.). Patients who underwent bunion surgery were compared to those treated nonoperatively for their bunion deformities from January 2011 to April 2022. Claims-based falls (all-cause) were tracked using diagnosis codes for up to 11 years. Group differences in fall risk were examined using both one-year and long-term adjusted hazard ratios (aHR) and corresponding absolute risks. 127,990 people were diagnosed with hallux valgus and 17,406 (13.6%) underwent surgery. The median follow-up time was 2905 and 2298 days for the surgery and non-surgery groups, respectively. A smaller proportion of people fell in the surgery versus non-surgery group (5 vs 8% at one year; 16 vs 21% over total follow-up). Furthermore, after controlling for important covariates, patients who underwent bunion surgery were 16% less likely to fall in the first year (aHR 0.84, 95% CI 0.76 to 0.92) and 42% less likely to fall over the 11-year follow-up (aHR 0.58, 95% CI 0.52 to 0.63) compared to those with uncorrected hallux valgus deformity. Among older adults in whom surgery is already indicated, a potential ancillary benefit may be a reduction in injurious falls over time.

Background and aimsThe present study aimed to: (i) compare a patient group with solely alcohol use disorder (AUD) to a group with poly-substance use disorder (poly-SUD) regarding sociodemographic background, morbidity, mortality, and the prevalence of the A1 allele of the Taq1A polymorphism. (ii) Investigate whether gender, age, poly-SUD, and the prevalence of the A1 allele or interactions among these factors, are associated with mortality risk over an 18-year follow-up period.MethodsThis study comprised 360 individuals treated for severe alcohol withdrawal symptoms in 1997 at a treatment unit in Sweden. Genotyping was performed during their hospital stay, and participants were followed annually for up to 18 years using data from Swedish registers.ResultsFifty-three percent of the participants had died over the 18 year period. Poly-SUD patients exhibited higher rates of psychiatric disorders, gastrointestinal diseases, and intoxication as the primary diagnosis. Patients with AUD exhibited a higher prevalence of cardiac diseases. Traumatic causes of death were more prevalent in the poly-SUD group, whereas somatic diseases were more common among individuals with AUD. Male sex and age were the strongest predictors of premature death among individuals with AUD. The A1 allele of the Taq1A polymorphism showed a borderline association with an increased hazard of death.ConclusionsMale sex and age are the strongest predictors of premature death. Patients with poly-SUD may represent a distinct subgroup with different comorbidities and causes of death. To determine whether there is a genetic vulnerability as indicated by the findings, research using larger samples with sufficient statistical power is needed.

Prospective data on the joint impact of adiposity and systemic inflammation on incident metabolic dysfunction-associated steatotic liver disease (MASLD) in type 2 diabetes (T2D) are limited. We examined the individual and combined associations of body mass index (BMI) and high-sensitivity C-reactive protein (hsCRP) with incident MASLD in patients with T2D. This prospective cohort study included 2796 adults with T2D free of MASLD from the Kailuan study (China). Over a 14-year follow-up, participants were classified by baseline BMI: (<24 vs. ≥24 kg/m2) and hsCRP (<3 vs. ≥3 mg/L). Multivariable Cox models estimated hazard ratios (HRs) for incident ultrasonographic steatosis. The cumulative incidence of MASLD was 53.9%. Higher BMI: and hsCRP were independently associated with increased risk. In joint analyses, the high BMI/high hsCRP group had the highest risk [adjusted HR: 2.31; 95% confidence interval (CI): 1.94-2.74] compared with the low BMI/low hsCRP group. This risk was greater than isolated high hsCRP (HR: 1.37) or isolated high BMI: (HR: 1.93). Elevated BMI: and hsCRP are independently associated with incident MASLD in T2D. Co-elevation of both factors confers the greatest risk, suggesting that incorporating both adiposity and inflammatory markers improves risk stratification for targeted preventive strategies.

Survivorship of Highly Cross-Linked Polyethylene in Total Hip Arthroplasty: 20-Year Follow-Up.

Functional results of septic arthritis after anterior cruciate ligament reconstruction treated by arthroscopic lavage with preservation of the graft: Case-control study at 7 years follow-up.