Height Ratio Research Articles

Prevention of refeeding syndrome: Evaluation of an enteral refeeding protocol for severely undernourished children.

Refeeding syndrome (RS) defines the deleterious clinical and metabolic changes occurring during nutritional support of severely malnourished patients. Pediatric guidelines to prevent and treat RS are scarce and highly variable. This study aimed to evaluate the effectiveness and safety of an enteral refeeding protocol in severely undernourished hospitalized children with anorexia nervosa (AN) or organic diseases (OD). This ancillary study to the Preventing Malnutrition and Restoring Nutritional Status in Hospitalized Children (PREDIRE) trial (NCT01081587), included severely undernourished children hospitalized between January 2010 and June 2018 and treated with an enteral refeeding protocol drafted for the study. The effectiveness was assessed by weight gain and safety by clinical and laboratory abnormality occurrence over the initial 3-week refeeding period, which represents the most critical period for the development of RS. After 3 weeks of refeeding, the mean weight for height ratio increased from 72% to 82%, and half of the patients with severe undernutrition improved their nutritional status. The prevalence of RS was 10.4%. No clinical cardiac or neurological complication occurred. The most frequent laboratory complication was hypophosphatemia in 13.7% of patients; but symptomatic in only two patients (2.5%). Compared with patients with OD, patients with AN improved their weight-for-height ratio faster without significantly more frequent complications, except for hepatic cytolysis which was less prevalent in AN (8.3% vs. 36.8%). The proposed enteral refeeding protocol appears safe for treating severely undernourished children of different etiologies, with a low prevalence of RS and half of the patients recovered from severe malnutrition within a 3-week period.

Critical Filling Height of Embankment over Soft Soil: A Three-Dimensional Upper-Bound Limit Analysis

This paper investigates the critical filling height of embankments over soft soil using three-dimensional (3D) upper-bound limit analysis based on a rotational log-spiral failure mechanism. Soft soils are characterized by low shear strength and high compressibility, making the accurate determination of critical filling height essential for evaluating embankment stability. Unlike conventional two-dimensional (2D) analyses, the proposed 3D method captures the true failure mechanism of embankments, providing more realistic and reliable results. The upper-bound analysis equations are derived using the principle of virtual work and solved efficiently through the genetic algorithm (GA), which avoids the limitations of traditional loop and random searching algorithms. The proposed solution is validated by comparing it with existing studies on slope stability and demonstrates higher accuracy and computational efficiency. Parametric studies are conducted to evaluate the influence of the depth–height ratio (the ratio of soft soil depth to embankment height) on the failure width of the embankment, the critical failure surface, and the critical filling height. Results show that the critical failure surface is tangential to the bottom of the soft soil layer and the critical filling height increases as the depth–height ratio decreases. The findings provide a set of critical filling heights calculated under various soft soil depths, strength parameters, and embankment geometries, offering practical guidance for embankment design.

Yeast cell wall polysaccharides accelerate yet in-feed antibiotic delays intestinal development and maturation via modulating gut microbiome in chickens

BackgroundIt is important to promote intestinal development and maturation of chicks for feed digestion and utilization, intestinal health, and disease resistance. This study aimed to investigate the effects of dietary yeast cell wall polysaccharides (YCWP) addition on intestinal development and maturation of chickens and its potential action mechanism.Methods180 one-day-old male Arbor Acres broilers were randomly assigned to three groups containing control (basal diets without any antibiotics or anticoccidial drug), bacitracin methylene disalicylate (BMD)-treated group (50 mg/kg) and YCWP-supplemented group (100 mg/kg).ResultsCompared with control group, in-feed antibiotic BMD continuous administration significantly decreased crypt depth (d 21) and villus height (d 42) along with mucosal maltase activity (d 42) in the ileum (P < 0.05). Also, BMD markedly downregulated gene expression levels of β-catenin, lysozyme, occludin and FABP-2 (d 21) and innate immune related genes CD83 and MHC-I mRNA levels (d 42, P < 0.05), and decreased goblet cell counts in the ileum of chickens (d 21 and d 42, P < 0.05). While, TLR-2, TLR-6 and iNOS mRNA abundances were notably upregulated by BMD treatment (d 42, P < 0.05). Nevertheless, dietary YCWP addition significantly increased the ratio of villus height to crypt depth (d 21), villus surface area (d 21 and d 42), ileal alkaline phosphatase and maltase activities as well as goblet cell (d 21 and d 42) and IgA-producing plasma cell numbers as compared to BMD treatment (d 21, P < 0.05). YCWP addition also upregulated gene expression levels of Lgr5, Wnt/β-catenin signaling pathway related gene (Wnt3, β-catenin, d 21; β-catenin, d 42), intestinal cells proliferation marker Ki-67 and barrier function related genes (occludin, d 21 and d 42, P < 0.05). Moreover, YCWP significantly increased antigen presenting cell marker related genes (MHC-II, d 21; CD83 and MHC-I, d 42), TLR-1, TLR-2 and TLR-6 mRNA levels (d 21, P < 0.05). Cecal microbiome analysis showed that YCWP addition obviously improved cecal microbial composition, as indicated by increasing relative abundance of Fournierella, Psychrobacter and Ruminiclostridium on d 21, and Alistipes and Lactobacillus on d 42, which were positively related with gut development and maturation related indexes (P < 0.05).ConclusionCollectively, YCWP promoted yet antibiotic BMD delayed intestinal morphological and immunological development linked with modulating gut microbiome in chickens.

An automated algorithm for quantitative morphometry of thoracic and lumbar vertebral bodies in lateral radiographs

Abstract This exploratory study developed and evaluated an AI-based algorithm for quantitative morphometry to assess vertebral body deformities indicative of fractures. To achieve this, 709 radiographs from 355 cases were utilized for algorithm development and performance evaluation. The proposed algorithm integrates a first-stage AI model to identify the positions of thoracic and lumber vertebral bodies in lateral radiographs and a second-stage AI model to annotate six landmarks for calculating vertebral body height ratios (C/A, C/P and A/P). The first-stage AI model achieved a sensitivity of 97.6%, a precision of 95.1%, and an average false-positive ratio of 0.43 per image for vertebral body detection. In the second stage, the algorithm’s performance was evaluated using an independent dataset of vertebrae annotated by two spine surgeons and one radiologist. The average landmark errors ranged from 2.9% to 3.3% on the X-axis and 2.9% to 4.0% on the Y-axis, with errors increasing in more severely collapsed vertebrae, particularly at central landmarks. Spearman’s correlation coefficients were 0.519–0.589 for C/A, 0.558–0.647 for C/P, and 0.735–0.770 for A/P, comparable to correlations observed among human evaluators. Bland–Altman analysis revealed systematic bias in some cases, indicating that the algorithm underestimated anterior and central height collapse in deformed vertebrae. However, the mean differences and limits of agreement between the algorithm and external evaluators were similar to those among the evaluators. Additionally, the algorithm processed each image within 10 seconds. These findings suggest that the algorithm performs comparably to human evaluators, demonstrating sufficient accuracy for clinical use. The proposed approach has the potential to enhance patient care by being widely adopted in clinical settings.

Negative association between 15 obesity- and lipid-related indices and testosterone in adult males: a population based cross-sectional study

BackgroundAn association exists between obesity and reduced testosterone levels in males. The propose of this research is to reveal the correlation between 15 indices linked to obesity and lipid levels with the concentration of serum testosterone, and incidence of testosterone deficiency (TD) among adult American men.MethodsThe study utilized information gathered from the National Health and Nutrition Examination Survey (NHANES) carried out from 2011 to 2016. The condition known as TD is typically characterized by a total serum testosterone level that falls below 300 ng/dL. The analysis used weighted linear and logistic regression methods to announce the association between 15 obesity- and lipid-related factors and serum testosterone levels as well as TD. Subgroup analyses were further carried out to confirm and validate the findings. Additionally, restricted cubic spline plots were utilized to examine non-linear relationships. Receiver operating characteristic (ROC) curves were created for the 15 factors, and the area under the curves (AUC) was calculated to assess the efficacy of each factor in detecting TD.ResultsAmong a group of 3,540 adult males, it was observed that all 15 obesity- and lipid-related indices showed a negative relationship with testosterone concentration and a direct correlation with the presence of TD. After accounting for all covariates, the analysis revealed that individuals within the highest quartile (Q4) for metabolic score for visceral fat (METS-VF) had the excellent probability of developing TD (OR = 13.412, 95%CIs: 4.222, 42.262, P < 0.001). Additionally, a non-linear relationship was detected between the METS-VF with TD. Within the model that incorporated all adjustments, the triglyceride glucose-waist to height ratio (TyG-WHtR) has the best performance for predicting TD (Overall: AUC = 0.762, 95%CIs: 0.743, 0.782, cut-off = 5.186).ConclusionElevated levels of these 15 markers were inversely related to testosterone levels and were indicative of an elevated risk of TD. Among all indices analyzed, TyG-WHtR demonstrated the highest predictive value.Trial registrationNot available.

Effects of dietary supplementation with butyrate glycerides on lipid metabolism, intestinal morphology, and microbiota population in laying hens.

The present study investigated the impact of butyrate glycerides (BG) on lipid metabolism, intestinal morphology, and microbiota of laying hens. Four hundred eighty 54-week-old Hy-line Brown laying hens were randomly selected and divided into five groups. The control group (ND) was fed a basal diet. Meanwhile, the remaining groups were given a basal supplemented with 0.5, 1, 2, and 4 g/kg of the product containing BG and were designated as BG-0.5, BG-1, BG-2, and BG-4 groups, respectively. The findings showed that: (1) BG supplementation significantly decreased (P < 0.001) the blood Glu levels (BG-0.5, BG-1, BG-2, and BG-4) and increased (P < 0.001) the serum HDL-C levels (BG-2, and BG-4). (2) The BG-2 and BG-4 groups showed an increase (P < 0.01) in abdominal lipid HSL activity. (3) The levels of hepatic TC and TG in all BG groups were significantly decreased (P < 0.05). (4) The addition of BG resulted in a significant reduction in the mRNA expression of the liver X receptor alpha (LXRα) (P < 0.05). (5) All BG groups presented a substantial reduction in duodenal crypt depth and a notable increase in the ratio of villus height to crypt depth (V/C) (P < 0.01). Additionally, all BG groups exhibited a significant increase in villus height in the ileum (P < 0.001). (6) Both the BG-1 and BG-4 groups exhibited a significant reduction in the amounts of n-butyric and n-glutaric acids in the cecum contents (P < 0.05). (7) The inclusion of BG did not substantially impact the diversity of cecal microbiota in laying hens. However, it dramatically boosted the proportion of the beneficial bacterium Alistipes (P < 0.05) and reduced the abundance of the harmful bacterium Verrucomicrobiota (P < 0.05). Overall, incorporating BG with glycerol monobutyrate as the diet's primary active component reduces fat accumulation in laying hens' blood and liver. It potentially regulates lipid metabolism via the PPARγ-LXRα-SREBP1c pathway. Additionally, BG has the potential to enhance the structure of the small intestine's mucous membrane and increase the presence of beneficial bacteria. Under the experimental conditions, late-laying hens supplemented with 4 g/kg BG performed best overall.

Association of different insulin resistance surrogates with all-cause and cardiovascular mortality among the population with cardiometabolic multimorbidity

BackgroundThe coexistence of cardiometabolic diseases (CMDs), defined as cardiometabolic multimorbidity (CMM), has been shown to significantly elevate mortality risk. Insulin resistance (IR) is one of the main contributing factors to the pathogenesis of CMM. Although several surrogates for IR are employed in clinical evaluations, their relationship with mortality in individuals with CMM remains unclear. This study aimed to investigate the associations between various IR surrogates and mortality in individuals with CMM, and to evaluate their prognostic value.MethodsThis study enrolled 1093 patients diagnosed with CMM. We developed five surrogate markers to assess IR levels: triglyceride-glucose (TyG) index, TyG-waist circumference (TyG-WC), TyG-waist height ratio (TyG-WHtR), homeostatic model assessment of insulin resistance (HOMA-IR), and metabolic score for insulin resistance (METS-IR). To investigate the associations between different IR surrogates and both all-cause and cardiovascular mortality, multivariable Cox proportional hazards models were applied. We employed restricted cubic splines to examine non-linear associations, and Cox models were developed on either side of the inflection point for additional investigation. Meanwhile, the predictive values of five IR surrogates were further assessed.ResultsOf the 477 all-cause deaths that occurred during a median follow-up of 5.8 years, 197 were related to cardiovascular disease. Among five surrogate markers of IR, the TyG index was the only one that significantly correlates with both all-cause and cardiovascular mortality. The threshold value for both types of mortality was 8.85. A TyG index beneath the inflection point exhibits an inverse correlation with cardiovascular mortality (HR 0.483; 95% CI = 0.281–0.831) and all-cause mortality (HR 0.519; 95% CI = 0.368–0.732). On the other hand, when the TyG index surpassed the inflection point, it demonstrated a positive correlation with cardiovascular mortality (HR 1.413; 95% CI = 1.075–1.857) and all-cause mortality (HR 1.279; 95% CI = 1.070–1.529). Based on the analysis of receiver operating characteristics, the TyG index has been recognized as a dependable predictor of survival outcomes.ConclusionsThis study emphasizes the prognostic significance of IR surrogates, particularly the TyG index, in predicting mortality among individuals with CMM. The TyG index constitutes a crucial element in the development of management and intervention strategies for these patients.Graphical abstract

Nasal septum deviation after rapid maxillary expansion in the early mixed dentition.

To evaluate nasal septum changes after rapid maxillary expansion (RME) during the mixed dentition and to verify the association between quantitative and qualitative assessments of nasal septum deviation (NSD) by ear, nose, and throat (ENT) specialists. The sample comprised 24 patients (11 male, 13 female) with a mean age of 7.62 ± 0.92 years with maxillary transverse deficiencies. Cone-beam computed tomography (CBCT) images were obtained before and after RME. Three CBCT coronal sections passing through the maxillary first molars, 5 mm anterior and 5 mm posterior, were used for quantitative assessment. NSD was calculated using the ratio of nasal cavity height to nasal septum contour. Additionally, five ENT professionals evaluated NSD qualitatively using scores from 1 to 3 through CBCT sequential axial and coronal sections. Absent NSD was scored as zero. Interstage changes were assessed using Wilcoxon tests. Spearman correlation and linear regression were performed to evaluate the association between quantitative and qualitative analyses (P < .05). No significant change was observed in the NSD ratio. In pre-expansion CBCT images, absence of NSD and scores 1, 2, and 3 for NSD were found for 45.8%, 41.7%, 12.5%, and 0%, respectively. In the qualitative assessment, no significant change in NSD was observed after expansion. A strong association was found between NSD ratio and ENT score (r = 0.750). In the mixed dentition, no significant change was observed in the NSD ratio. Qualitative analysis of NSD was associated with quantitative assessment of the ratio between nasal septum contour and nasal cavity height.

Reduced Glutathione Promoted Growth Performance by Improving the Jejunal Barrier, Antioxidant Function, and Altering Proteomics of Weaned Piglets.

Reduced glutathione (GSH) is a main nonenzymatic antioxidant, but its effects and underlying mechanisms on growth and intestinal health in weaned piglets still require further assessment. A total of 180 weaned piglets were randomly allotted to 5 groups: a basal diet (CON), and a basal diet supplemented with antibiotic chlortetracycline (ABX), 50 (GSH1), 65 (GSH2), or 100 mg/kg GSH (GSH3). Results revealed that dietary GSH1, GSH2, and ABX improved body weight and the average daily gain of weaned piglets, and ABX decreased albumin content but increased aspartate aminotransferase (AST) activity and the ratio of AST to alanine transaminase levels in plasma. GSH2 significantly decreased glucose content but increased the content of triglyceride and cholesterol in the plasma. Both GSH1 and GSH2 improved the jejunal mucosa architecture (villus height, crypt depth, and the ratio of villus height to crypt depth), tight junction protein (ZO-1 and Occludin), and antioxidant capacity (CAT and MDA), and the effects were superior to ABX. Dietary GSH improved the jejunal barrier by probably inhibiting the myosin light chain kinas pathway to up-regulate the transcript expression of tight junction protein (ZO-1 and Occludin) and Mucins. Through the proteomics analysis of the jejunal mucosa using 4D-DIA, the KEGG pathway enrichment analysis showed that differentiated proteins were significantly enriched in redox homeostasis-related pathways such as glutathione metabolism, cytochrome P450, the reactive oxygen species metabolic pathway, the oxidative phosphorylation pathway, and the phosphatidylinositol 3-kinase-serine/threonine kinase pathway in GSH2 vs. CON and in GSH2 vs. ABX. The results of proteomics and qRT-PCR showed that GSH supplementation might dose-dependently promote growth performance and that it alleviated the weaning stress-induced oxidative injury of the jejunal mucosa in piglets by activating SIRTI and Akt pathways to regulate GPX4, HSP70, FoxO1. Therefore, diets supplemented with 50-65 mg/kg GSH can promote the growth of and relieve intestinal oxidative injury in weaned piglets.

Optimal age for mandibular distraction osteogenesis in craniofacial microsomia: A systematic review and meta-analysis.

This systematic review and meta-analysis aimed to determine the optimal timing for mandibular distraction osteogenesis in children with craniofacial microsomia based on long-term outcomes and relapse rates. A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science was conducted for studies published up to September 2024. Eligible studies included children aged ≤16 years with CFM who underwent MDO, with follow-up duration exceeding one year. The included population was divided into two groups based on age: children younger than 6 years and those aged 6-16 years. The primary outcome was the relapse rate measured by ramus height ratio, and secondary outcome was occlusal cant. Statistical analyses included heterogeneity assessment, random-effects modeling, and subgroup analysis based on follow-up duration. Ten studies, comprising 175 patients, were included. The pooled relapse rate based on ramus height ratio was 67.8% (CI: 35.8-93.4%) for children under 6 years and 72.5% (CI: 10.5-94.4%) for those aged 6 years or older, with no statistically significant difference. Subgroup analysis showed that relapse rates increased significantly after five years of follow-up, suggesting progressive asymmetry due to slower growth on the affected side. When occlusal cant was used as a metric, higher relapse rates were observed in children over 6 years 95.6% (CI: 28.9-65.1%) compared to younger patients 46.8% (CI: 83.9-100%). Despite early MDO providing psychosocial and developmental benefits, relapse rates remain high across all age groups, complicating the determination of an optimal timing. Long-term monitoring, individualized treatment plans, and refined severity grading systems are essential for improving outcomes in CFM patients. Future research should include standardized methodologies, larger groups, and advanced imaging techniques to optimize treatment strategies.

Comparison between ruptured anterior choroidal artery aneurysms and ruptured intracranial aneurysms in other locations in relation to aneurysm dimensions at rupture

PurposeIt was noticed that anterior choroidal artery (AChoA) aneurysms appear to rupture at relatively smaller sizes compared with aneurysms in other intracranial locations, based on anecdotal clinical experience. We therefore aimed to compare ruptured AChoA aneurysms with other ruptured aneurysms in other intracranial locations, pertaining to aneurysm dimensions. This may help in finding out if the rupture risk stratification, based on the amalgamation of aneurysms of multiple locations in one group, precisely estimates aneurysm rupture risk.Methods255 ruptured intracranial aneurysms, which underwent assessment with catheter angiography with 3D reconstruction, in a single tertiary center between January 2000 and December 2023, were included. 6 aneurysm dimensions were compared.ResultsStatistically significant larger aneurysm maximum diameter, height, width and size ratio (SR) of the ruptured posterior communicating artery (PCOMM) aneurysms were identified when compared with ruptured AChoA aneurysms.No statistically significant difference in the aneurysm maximum diameter, height and width between the ruptured AChoA and ruptured anterior cerebral artery (ACA), anterior communicating artery (Acom), pericallosal artery and basilar tip aneurysms was found.AChoA aneurysms appear to rupture at a relatively small size, which is comparable to other aneurysm locations that are often grouped into different categories in rupture risk stratification.ConclusionMore detailed location-specific rupture risk estimation may be needed. The combination of multiple intracranial aneurysm locations into a single category for risk stratification may not reflect the true aneurysm size at rupture for some aneurysms.

Impact of Early Childhood Malnutrition on Cardiometabolic Risk Factors in Young Adults from Marginalized Areas of Chiapas, Mexico.

The presence of malnutrition in early life is a determining factor in the onset of metabolic alterations and chronic diseases in adults. Therefore, the objective of this study was to determine the impact of malnutrition in early childhood with the presence of cardiometabolic risk factors in adulthood in marginalized populations from Chiapas, Mexico. The present investigation was based on a prospective cohort study that began in 2002, with young adults aged 18 to 25 years belonging to De Los Bosques region in Chiapas, Mexico. Sociodemographic, anthropometric, clinical and biochemical data were obtained in adulthood. Binary logistic regression models with 95% confidence intervals were fitted to assess the association between nutritional status in childhood (≤5 years of age) and cardiometabolic risk in adulthood. Individuals with overweight/obesity in childhood were more likely to have overweight/obesity (OR = 2.65, 95% CI: 1.09-6.45), high waist circumference (3.78, 95% CI: 1.55-9.24), high waist to height ratio (OR = 5.38, CI 95%: 1.60-18.10), elevated total cholesterol (OR = 3.95, 95% CI: 1.36-11.43) and metabolic syndrome (OR = 4.71, 95% CI: 1.49-14.90) in adulthood. In conclusion, malnutrition presented in early childhood increased the probability of developing cardiometabolic alterations in young adults from southern Mexico.

Associations between surrogate insulin resistance indexes and osteoarthritis: NHANES 2003–2016

Insulin resistance (IR) and abdominal obesity are key in osteoarthritis (OA) development. The triglyceride glucose (TyG) index, along with indicators such as the visceral adiposity index (VAI), and lipid accumulation product (LAP), are increasingly used to measure IR. This study aims to explore the associations between surrogate IR indexes and OA, assessing their diagnostic efficacy within American populations. This study included 14,715 adults from the National Health and Nutrition Examination Survey 2003–2016. Logistic regression models and restricted cubic spline were used to explore the relationship between surrogate IR indexes and OA. Receiver operating characteristic curves were constructed to assess the diagnostic efficacy of these indices, with the area under the curve (AUC) as the metric. TyG, glucose triglyceride-waist circumference (TyG-WC), glucose triglyceride-body mass index (TyG-BMI), glucose triglyceride-waist height ratio (TyG-WHtR), VAI and LAP were significantly and positively associated with the prevalence of OA (all p < 0.01). After adjusting for various potential confounders, TyG-WC, TyG-BMI, TyG-WHtR and LAP remained significantly correlated with the prevalence of OA. Furthermore, restricted cubic spline revealed a nonlinear association between TyG-BMI, TyG-WHtR and LAP (all P-non-linear < 0.05). Receiver operating characteristic curves indicated that TyG-WHtR (AUC 0.633) demonstrated more robust diagnostic efficacy. Additionally, the sensitivity analysis produced results consistent with the primary findings. TyG and its combination with obesity indicators and LAP, are positively associated with the prevalence of OA, with TyG-WHtR showing the highest diagnostic efficacy.

Computer-aided design and fabrication of statistically shaped nasal prostheses: A feasibility study.

A nasal prosthesis may compensate for a partial or complete defect of the nose associated with trauma or amputation. However, the design and production is time-consuming, expensive, and expertize-dependent. Computer-generated prosthesis models and 3D printing can optimize the process. The purpose of this pilot study was to evaluate a novel method for nasal prosthesis design utilizing statistical shape modeling (SSM) on a cohort of participants. The prosthesis shapes were generated by a design algorithm and fabricated through a 3-dimensionally (3D) printed mold. Combining a semi-automated algorithm with 3D printing reduced the dependence on expertize. A proof-of-concept assessment was conducted by enrolling 20 participants with total nose amputation with a conventionally created prosthesis (Cp). The faces of the participants were scanned with an optical scanner to acquire 3D surface scans that were loaded into the algorithm to create the statistically shape modeled prosthesis (SSMp). Participants were asked to digitally modify the SSMp by changing 9 parameters using the Scalismo Lab software program, allowing them to shape their preferred nose model, the patient-preferred prosthesis (PPp). The SSMps were fabricated using 3D printed molds and mailed to the participants for testing. They were asked to complete questionnaires comprising three FACE-Q modules: satisfaction with the nose and psychological and social function. In addition, the SSMp and Cp were compared with the PPp using anthropometric measurements. Fifteen participants were able to fit the SSMp and complete the questionnaire. The median satisfaction, psychological, and social function scores were 56, 67, and 62, respectively. All 20 participants filled out the questionnaires on their Cp, with scores of 71, 67, and 62, respectively. Anthropometric measurements comparing the SSMp with the PPp showed that the algorithm generates noses with a wider nasal root, a larger nostril floor width to nasal width ratio, a smaller columella length to nasal width as well as nostril floor width ratio than the patients prefer according to their set PPp. Comparing the Cp with the PPp showed a larger nasal width to nasal height ratio and nasal root width to intercanthal distance ratio. SSM can facilitate the design and fabrication of nasal prostheses. Using the current models, however, patients were less satisfied than with prostheses made by the anaplastologist in consultation with the patient. Improving the SSM algorithm and incorporating patient manipulations into the resulting model should increase patient satisfaction and enable the production of nasal prostheses with minimal expert dependence.

Digital Analysis of Dentogingival Factors Influencing the Gingival Margin Position in the Esthetic Zone.

To investigate the correlation between gingival thickness (GT) and buccal bone thickness (BBT), as well as the effects of GT, BBT, bone crest level (BC), and tooth position on the buccal gingival margin location of maxillary teeth in the esthetic zone. Periodontally healthy subjects with prior cone beam computed tomography and intraoral scans for dental implant planning were included. The hard and soft tissue measurements were retrospectively analyzed digitally. Pearson's correlation and ANOVA were used to evaluate the correlations between clinical/anatomical crown height ratios (CCH/ACH), gingival and buccal bone thicknesses, and the distance between the CEJ and BC (CEJ-BC). Forty-two subjects with 252 teeth were analyzed. A positive correlation was found between GT and BBT (p < 0.001). GT and BBT were negatively correlated with CCH/ACH (p = 0.006 and p = 0.004, respectively), while CCH/ACH showed a positive correlation with CEJ-BC (p < 0.001). Within the limitations of our study, we concluded that gingival and buccal bone thicknesses were positively correlated. A thicker gingival phenotype and higher coronal bone crest were linked to a more coronal gingival margin in the esthetic zone.

Inflammatory markers link triglyceride-glucose index and obesity indicators with adverse cardiovascular events in patients with hypertension: insights from three cohorts

BackgroundAmong hypertensive cohorts across different nations, the relationship between the triglyceride-glucose index (TyG) and its conjunction with obesity metrics in relation to cardiovascular disease (CVD) incidence and mortality remains to be elucidated.MethodsThis study enrolled 9,283, 164,357, and 5,334 hypertensives from the National Health and Nutrition Examination Survey (NHANES), UK Biobank (UKBB), and Shanghai Pudong cohort. The related outcomes for CVD were defined by multivariate Cox proportional hazards models, Generalized Additive Models and Mendelian randomization analysis. Mediation analysis explored the mediating role of inflammatory markers in the above relationships.ResultsFive measures of insulin resistance were linked to CVD and related death in a U-shaped pattern, with the highest group having different risk increases. Higher glucose triglyceride-waist height ratio (TyG-WHTR) was linked to higher all-cause mortality (UKBB: HR 1.21, 95%CI 1.16–1.26, NHANES: HR 1.17, 95%CI 1.00–1.36), CVD mortality (UKBB: HR 1.36, 95%CI 1.23–1.49, NHANES: HR 1.32, 95%CI 1.00–1.72) risks. In the China Pudong cohort, higher triglyceride/high-density lipoprotein-cholesterol (TG/HDL_C) ratio was associated with higher risks of CVD and stroke (HR 1.31, 95%CI 1.00–1.73 and 1.67, 1.06–2.63). Inflammation markers like systemic inflammatory response index (SIRI) and C-reactive protein (CRP) partially explained these links, with CRP having a stronger effect. Genetically predicted TyG was also linked to stroke (OR 1.26, 95%CI 1.10–1.45) risk.ConclusionsAn elevated TyG index and its related indices are significantly correlated with an increased risk of CVD and related mortality across three national cohorts. These indices are anticipated to serve as valid predictors of incident CVD and mortality in individuals with hypertension.Graphical abstract

Anthropometric and Body Composition Profile in Indian Kabaddi Players

Introduction: Kabaddi is a sport in which a player performs diverse skills according to their playing positions. The present cross-sectional study was carried out to understand the anthropometric characteristics and body composition parameters with respect to playing positions in male Kabaddi players. Methods: The study was carried out among 42 male Kabaddi players (10 of which are Pro League Players); raiders (n=25, 18.7 ± 2.44 years) and defenders (n=17, 19.6 ± 1.58 years). Anthropometric parameters viz. Height weight, sitting height, arm span, biacromial breadth, waist &amp; hip circumference were measured according to standard protocols followed by ISAK manual. Body composition of players was assessed using body composition analyser (mBCA). Other variables studied were body mass index (BMI), waist to hip ratio (WHR), and arm span to height ratio. Results: Significant differences were found between raiders and defenders in terms of their anthropometric characteristics and body composition parameters. Raiders exhibit significant higher values in terms of their height (p=0.0009), arm span (p=0.023) and arm span to height ratio (p=0.0018) while defenders exhibit significantly lower values in terms of their body mass index, BMI (p= 0.0015), waist to hip ratio, WHR (p=0.0001) and fat mass (p=0.015). Conclusion: It had been found that raiders were better over defenders in terms of their anthropometric characteristics and body composition parameters. The findings of the study provide valuable insights into the anthropometric characteristics and body composition profile related with playing position of Kabaddi players.

Association Between Rotator Cuff Tears and Shoulder MRI Parameters: Importance of Arthroscopic Validation in Coronal Acromiohumeral Interval Measurement.

Magnetic resonance imaging (MRI) measurement parameters-the standard noninvasive diagnostic method for rotator cuff tears (RCTs)-have been used to compare groups with and without RCTs. Arthroscopy is used in definitive diagnosis and treatment. To evaluate the association between RCT and shoulder angles and distances on MRI in patients with and without arthroscopically validated RCT and to determine whether the degree of rotator cuff fatty degeneration affects the MRI measurements. Cross-sectional study; Level of evidence, 3. Shoulder measurements on MRI were compared between patients with and without RCT as confirmed by shoulder arthroscopy performed by a single surgeon between 2019 and 2024, and non-RCT patients without arthroscopic confirmation. Interobserver reliability (Fleiss kappa coefficient) was calculated for the measurements. The groups were compared using the independent t test or the Mann-Whitney U test. The RCT group was further divided according to the level of fatty degeneration (Goutallier types 0-1-2 vs types 3-4) for subanalysis. In addition to the 368 RCT and 55 non-RCT patients with arthroscopic confirmation, there were 92 non-RCT patients without arthroscopic confirmation. The sagittal acromiohumeral interval (AHI) (8.32 vs 9.24 mm), coronal AHI (7.87 vs 8.96 mm), and coronal AHI/glenoid height ratio (22.63% vs 24.88%) were significantly lower in the patients with RCT (P < .001, P < .001, and P = .001, respectively). In contrast, the critical shoulder angle (CSA) (33.17° vs 31.92°) and the glenoid width/humeral head coverage ratio (57.52% vs 55.7%) were significantly higher in the patients with RCT (P = .037 and P = .017, respectively). Higher rotator cuff fatty degeneration levels (Goutallier types 3-4) further increased these differences within the patients with RCT (P < .001 for all). When the arthroscopically validated and nonvalidated non-RCT patients were compared, coronal AHI and AHI/glenoid height ratio values were found to be significantly lower in the nonvalidated group (P = .034 and P = .047, respectively). In this study, RCT was associated with decreased sagittal AHI, coronal AHI, and coronal AHI/glenoid height ratios and increased CSA and glenoid width/humeral head coverage ratios.

THERMOHYDRAULIC PERFORMANCE ANALYSIS OF ABSORBER TUBE WITH COILED WIRE TURBULATORS IN SMALL APERTURE PARABOLIC TROUGH COLLECTOR

Three-dimensional (3D) simulation using computational fluid dynamics (CFD) has been performed to investigate the impact of a coiled wire turbulator (CWT) on heat transfer and fluid flow in the absorber tube of a small aperture parabolic trough collector (PTC) under a turbulent flow regime. The PTC was modeled with a projected aperture area of 0.64 m&lt;sup&gt;2&lt;/sup&gt; and an optimized value of rim angle 90 degrees using the ray tracing tool SolTrace based on an optimum value of average heat flux (8.58 kW/m&lt;sup&gt;2&lt;/sup&gt;), and this optimum average heat flux was used as one of the boundary conditions in CFD simulation. The CFD-simulated findings for the smooth absorber tube of the PTC model are compared with the Dittus-Boelter equation for heat transfer and the Filonenko equation for friction factor. The simulated result showed an average deviation of 2.54&amp;#37; and 14.68&amp;#37; in the Nusselt number and friction factor, respectively. The effect of a wall-detached type of CWT (D&lt;sub&gt;m&lt;/sub&gt; &amp;#61; 10 mm) on thermohydraulic performance with coil pitch ratios (P/d&lt;sub&gt;h&lt;/sub&gt;) of 1, 1.5, and 2 and height ratios (e/d&lt;sub&gt;h&lt;/sub&gt;) of 0.053, 0.063, and 0.074 is considered for the analysis in the Reynolds number (Re) range of 4000-12000. The optimal value of thermohydraulic performance (&amp;#951;&lt;sub&gt;thp&lt;/sub&gt;) is obtained 1.56 for P/d&lt;sub&gt;h&lt;/sub&gt; &amp;#61; 2, e/d&lt;sub&gt;h&lt;/sub&gt; &amp;#61; 0.053, and Re &amp;#61; 4000, corresponding to which enhancement ratio of Nusselt number (Nu&lt;sub&gt;r&lt;/sub&gt;/Nu&lt;sub&gt;s&lt;/sub&gt;) and friction factor (f&lt;sub&gt;r&lt;/sub&gt;/f&lt;sub&gt;s&lt;/sub&gt;) are 2.28 and 3.14, respectively.

Feasibility and parametric study of a groove-type thermoelectric generator under multiphysics field conditions

In this study, we propose a novel thermoelectric generator (TEG) configuration called the groove-type TEG, which introduces triangular brackets to increase the contact area between thermoelectric semiconductors and conductive strips. Through a thermal-electric-mechanical multiphysics numerical model, the performance of the groove-type TEG under various parameters is evaluated. Our findings reveal that the output power of the groove-type TEG can be effectively improved by increasing the length and height of the grooves, and the total height of the upper and lower grooves should be lower than the height of the thermoelectric semiconductor. Moreover, the groove height ratio and thermoelectric semiconductor height play crucial roles in determining the TEG’s performance and mechanical stability. Considering the allowable thermal stress, the optimal height ratio is 0.125 (or 0.875) when the semiconductor height is less than 1.2 mm (or greater than 1.3 mm). The groove-type TEG reaches the output power and conversion efficiency of 0.84 W and 6.9 %, respectively, at the temperature difference of 200 K and the semiconductor height of 1.3 mm, which are 24.8 % and 0.2 % higher than those of the traditional π-type TEG. This work provides a new approach to enhancing the performance of thermoelectric generators.