When aquatic exposure ends but effects persist: metal-dependent recovery dynamics.

The most common maxillofacial injury is a fractured mandible. The reduction and fixation of the condyle portion of the mandible are the most critical portions because they are connected to numerous significant anatomical landmarks. IPPTA is a minimally invasive method for treating the base of a condyle fracture and there are several other recognized ORIF techniques for treating different portions of condyle fractures. A 20-year-old male visited a clinic's outdoor department, complaining about an inability to close his mouth properly. He stated that he had a road traffic accident nine days prior. An orthopantomogram revealed a unilateral base of condyle fracture and left parasymphysis of the mandible. Apart from the fracture of the mandible, he did not have any additional injuries. We decided to use the intaroral vestibular technique for the parasymphysis fracture and the IPPTA for the base of the condyle fracture because the patient expressed a great deal of worry regarding the aesthetic aspect of the recovery period. A minimally invasive surgical procedure like IPPTA aids in overcoming postoperative recovery periods involving eating, swallowing and mastication, as well as the duration of maxillo-mandibular fixation.

This study aims to comprehensively investigate the dynamic expression pattern of CXCR4 in human dental pulp stromal cells (hDPSCs) and stromal cells from the apical papilla (SCAPs) and assess the impact of different cell dissociation methods on its precise assessment. On this basis, a standardised CXCR4 detection and cell sorting strategy can be established to ensure the high purity and viability of the sorted population. hDPSCs and SCAPs were collected by the outgrowth method from human third molars from three independent healthy (ASA I) patients (< 18 years old). Cells were characterised as mesenchymal stromal cells (MSCs) and expanded to passage 3-6 for experiments. Three different dissociation methods (Enzymatic digestion, Non-enzymatic digestion, Mechanical collection) were used to collect single-cell suspensions from culture flasks. Afterwards, the cells were resuspended in culture medium and allowed to recover at 37°C/5% CO2 for 0-4 h. Surface expression of CXCR4 on viable cells was assessed using flow cytometry. Cell metabolic activity and senescence after dissociation treatment were tested by XTT Assay and senescence staining. Cell migration capacity was evaluated by wound healing assay. The data were statistically analysed using p < 0.05 as a statistical significance reference. hDPSCs and SCAPs exhibited typical MSC profiles and comparable cell viability under the same dissociation methods and time points. hDPSCs showed higher CXCR4 expression than SCAPs. CXCR4 expression displayed time-dependent fluctuations in both cell types and cell viability was significantly affected by dissociation method and recovery period. Enzymatic digestion resulted in higher CXCR4 expression after 2-h recovery and preserved over 90% cell viability. In contrast, non-enzymatic dissociation and mechanical scraping impaired cell metabolic activity, migration capacity, and induced premature senescence. In invitro expanded hDPSCs and SCAPs, the cell-detachment method and recovery time can significantly affect the CXCR4 membrane detection and subsequent cell-survival performance. To balance optimal cell viability and detection reliability, enzymatic cell dissociation followed by a 2-h recovery time seems to be the best protocol for CXCR4 detection and subsequent downstream experiments within the 0-4 h time frame.

An epidemiological model with arbitrary distributions for infection and relapse stages.

Chronic subdural hematoma (CSDH) is a common neurosurgical condition among older adults. Although surgical success rates are high, many patients experience poor multidimensional functional recovery postoperatively, significantly affecting their quality of life and increasing care burden. The World Health Organization's "intrinsic capacity" framework offers a comprehensive perspective for assessing functional status; however, the dynamic changes in intrinsic capacity after CSDH surgery remain poorly understood. This study applied longitudinal network analysis to dynamically explore the causal interactions among 6 domains of intrinsic capacity-locomotion, cognition, psychology, vitality, vision, and hearing-in CSDH patients from presurgery to 3 months postsurgery. The aim was to identify core driving factors across different recovery phases and to provide a basis for developing time-sensitive nursing interventions. A longitudinal observational study. We assessed a cohort of 172 postsurgical chronic subdural hematoma (CSDH) patients at 4 time points: preoperative (T0), 1-week (T1), 1-month (T2), and 3-month (T3) postoperatively, using a standardized digital tool. For the intervals T0→T1, T1→T2, and T2→T3, we constructed directed, temporal cross-lagged panel networks (CLPNs) through LASSO-regularized regression. Core domains within the networks were identified by computing their out-expected and in-expected influence (out-EI/in-EI). Network stability was rigorously evaluated using bootstrap resampling. The intrinsic capacity network exhibited marked dynamic restructuring throughout the recovery period. In the initial T0→T1 phase, vision emerged as the principal network driver (highest out-EI), exerting a strong positive influence on hearing. Vitality positively predicted cognition while being negatively associated with locomotion. During the T1→T2 interval, hearing superseded vision as the main driver, and psychological status imposed a persistent negative effect on cognition. In the final T2→T3 stage, vitality and hearing served as co-drivers of network effects, while cognition and psychology became the primary receivers of network effects (highest in-EI). The stability was acceptable for the T0→T1 and T2→T3 networks (CS-coefficient >0.25). The post-CSDH recovery of intrinsic capacity was characterized by distinct, stage-specific causal pathways. Early interventions should strategically target sensory function and vitality. In the mid-to-late phase management, it's necessary to proactively address the adverse impact of psychological state on cognition and simultaneously harness vitality as a positive lever. These findings furnish a dynamic evidence base for the implementation of timely, precise, and personalized nursing rehabilitative interventions.

Trends in autoimmune rheumatic disease diagnoses before and after the COVID-19 pandemic in England: a population-based cohort study using OpenSAFELY.

This study investigated the rate of blood lactate accumulation (vLa) across six maximal sprint efforts and identified a breakpoint (vLaBP) in the vLa-power relationship. Twelve physically active males completed 5, 10, 15, 20, 25, and 30-s all-out sprints in randomised order on separate days, with resistances set at 10 to 12.5% of body mass. The vLa was calculated as the change in blood lactate between the resting and peak value (∆La) divided by the test duration. A piecewise linear regression was used to identify the vLaBP and its corresponding power output (P-vLaBP) in the vLa-power relationship. Pulmonary V̇O2 responses were modelled using V̇O2 data obtained from exercise and the subsequent 15-min recovery period. A distinct P-vLaBP was identified at 795 ± 135 W and 11.2 ± 1.5 W·kg-1, corresponding to a vLa of 0.50 ± 0.10 mM·s-1, ∆La of 6.50 ± 1.27 mM, and sprint duration of 13.3 ± 1.9 s. The vLa did not increase significantly during the 30, 25, 20, and 15-s all-out sprint tests (0.41 ± 0.04 to 0.48 ± 0.10 mM·s⁻1; p > 0.05) but increased markedly in the 10 and 5-s tests (0.58 ± 0.14 mM·s⁻1, p < 0.05; 0.7 ± 0.20 mM·s⁻1, p < 0.01). V̇O2 on-kinetics below the P-vLaBP (30 and 15 s) was best described by linear function (R2 ≥ 0.96; SEE ≤ 272 mL·min-1; p < 0.001), while the V̇O2 data could not be modelled for sprints performed above the P-vLaBP (10 and 5 s). The present study demonstrated that the P-vLaBP separates ranges of power outputs with discrete V̇O2 kinetics which are characteristic of different subzones within the extreme intensity exercise domain.

Mitochondrial homeostasis is a central determinant of cellular health and disease. Gold nanoparticles (AuNPs) are widely developed for biomedical applications and have been explored as therapeutic tools for conditions associated with mitochondrial dysfunction. However, their long-term effects on mitochondrial health under more realistic, low-dose human exposure scenarios remain poorly understood. Here, we systematically investigated how low-dose exposure to well-characterized AuNPs impacts mitochondrial function in high-energy-demand primary human dermal fibroblasts. Cells were exposed to AuNPs with distinct physicochemical properties at a subcytotoxic concentration under acute and chronic conditions, followed by a recovery period in nanoparticle-free media. While acute AuNP exposure largely elicited adaptive mitochondrial responses, chronic exposure induced pronounced mitochondrial dysfunction in a physicochemical property-dependent manner. PEGylated AuNPs, largely considered biocompatible, were found free in the cytosol and disrupted mitochondrial membrane potential, increased mitochondrial reactive oxygen species, altered ATP production, and induced redox imbalance. Notably, nanoparticle shape governed the magnitude and persistence of mitochondrial stress as well as the adaptive mechanisms engaged. The absence of PEGylated AuNPs in cells restored several canonical indicators of mitochondrial health. However, mitochondrial respiration profiles remained persistently altered, indicating incomplete recovery of mitochondrial homeostasis and suggesting the potential for delayed cellular consequences. Collectively, these findings demonstrate that low-dose, chronic exposure to PEGylated AuNPs can lead to long-lasting changes in mitochondrial respiration without overt cytotoxicity. This work identifies mitochondria as highly sensitive targets of nanomaterial-induced stress, emphasizing the need to incorporate chronic exposure and postexposure recovery paradigms into safety assessments to guide the rational design of future nanotherapeutics.

Comparison of Deep and Non-Deep Hypothermia in Thoracic and Thoracoabdominal Aortic Surgery: A Systematic Review and Meta-Analysis.

A Systematic Review on the Impact of Postoperative Rehabilitation Programs in Thoracic Surgery Patients.

Repopulating microglia recapitulate developmental characteristics during a period of auditory circuit recovery.

Routine ureteral stenting after flexible ureterorenoscopy (F-URS) remains controversial. While stents are used to secure drainage, their impact on subclinical renal tubular injury is not well defined. This study aimed to evaluate the effect of postoperative Double-J (DJ) stenting on acute and subacute renal injury using urinary Kidney Injury Molecule-1 (KIM-1) as a sensitive biomarker. We conducted a retrospective analysis of a prospectively maintained database including 117 patients who underwent F-URS for renal stones. To minimize selection bias, patients with severe ureteral injury (PULS Grade ≥ 3) were excluded, and a ureteral access sheath (UAS) was utilized in all cases to standardize intrarenal pressure. Patients were stratified into two groups according to the postoperative drainage strategy: Group 1 (DJ stent) and Group 2 (no stent). Urinary KIM-1 levels normalized to creatinine (KIM-1/Cr) were measured preoperatively, at the postoperative 4th hour (acute phase), and on day 14 (subacute phase). Demographic characteristics and operative trauma scores (PULS) were comparable between the groups. In the acute phase (4th hour), both groups exhibited a significant and similar rise in KIM-1/Cr levels compared to baseline (p < 0.001), with no intergroup difference (p = 0.748). However, in the subacute phase (day 14), the stented group had significantly lower KIM-1/Cr levels compared to the non-stented group (0.18 vs. 0.36; p = 0.001). Additionally, the stone-free rate (SFR) was significantly higher in the stented group (89.8% vs. 65.5%; p = 0.002). Postoperative complication rates were similar (p = 0.35). DJ stent placement does not alter the acute biomarker surge associated with surgical stress but is associated with significantly lower KIM-1/Cr levels during the subacute recovery period. This finding suggests that improved drainage, together with more effective stone clearance, may contribute to better tubular recovery in stented patients. Urinary KIM-1 serves as a valuable objective tool for monitoring subclinical renal injury and may guide individualized stenting decisions.

ABSTRACT The COVID-19 pandemic disrupted labour markets globally, intensifying inequalities and reshaping employment structures. In Vietnam, migrants who relocated in search of a higher income were disproportionately affected, and non-migrant workers faced distinct challenges. Using data from the Vietnam Household Living Standards Survey 2018–2022, this study applies propensity score matching to investigate the effect of migration on labour income. Although migrant workers earned more than non-migrant workers, they experienced greater income volatility during the pandemic and recovery periods. Stratified analyses revealed the diverse effects of migration on income. Although the pandemic created short-term job opportunities that were more accessible to migrants owing to their specific characteristics, the surge in demand was temporary. In the post-pandemic period, labour market conditions returned to normal, and a gradual transition towards automation and digitalization shifted labour demand in favour of more skilled and digitally literate workers. Consequently, migration benefits have become more pronounced for high-school graduates than for less-educated individuals. These findings highlight the importance of policies that promote lifelong learning and employment protection alongside investments in education, vocational training, and digital access. Such measures are essential for building adaptive, inclusive, and resilient labour markets.

Excessive biomass retention decouples ammonia-oxidizer abundance and activity in sidestream partial nitritation.

The subacute phase post-stroke is a critical period for recovery, yet it remains unclear how spontaneous use of the paretic upper extremity (UE) increases during this period. This longitudinal study aimed to characterize changes in patterns of UE use during the subacute phase, focusing on unimanual and bimanual use, and to examine the influence of different clinical contexts on UE use. Participants (n = 41; 28.4 [8.0] days since stroke) were assessed at admission to inpatient rehabilitation, prior to discharge, and at 6 months post-stroke. UE use was measured with wrist-worn accelerometers over 7 consecutive days in 3 contexts: daily life, therapy sessions, and functional assessments. Metrics included the use ratio (UR; paretic/non-paretic) and the percentage of unimanual and bimanual use. UR improved from admission to discharge (P < .001), reflecting a more symmetrical UE use, but no further change was observed after discharge (P = .09). Percentage of unimanual non-paretic use decreased while bimanual use increased across all time points (P ≤ .03). Percentage of unimanual paretic use remained low, with no change over time (P = .28). An effect of context was observed for all variables (P ≤ .003), showing more asymmetric UE use outside of supervised clinical contexts (therapies and assessments). The subacute phase is characterized by substantial improvements in bimanual UE use during rehabilitation, followed by subtler changes in UE use patterns during the late subacute phase. The discrepancy between UE use during supervised clinical contexts and spontaneous use in daily life highlights the need for accelerometry-based monitoring in clinical practice.

The aim of this study is to determine the prevalence of healthcare service delay behavior among earthquake survivors living in temporary accommodation centers during the long-term recovery period (between the 26th and 30th months) following the 2023 Kahramanmaraş earthquake, and to assess the impact of post-disaster living conditions on this behavior. This cross-sectional study was conducted with 596 adults living in temporary accommodation centers in Hatay between May 1 and August 30, 2025. The study identified factors affecting healthcare utilization using Andersen's Behavioral Model. Data were collected using an Information Form and the Healthcare Demand Procrastination Scale. Data analysis was performed using descriptive statistics, independent samples t-tests, one-way ANOVA, and multivariate linear regression. The study found that the prevalence of healthcare delay behavior was 48.83%. In the regression analysis, healthcare service delay behavior was found to be influenced by predisposing factors, enabling factors, and need factors (p < 0.05). The established model accounted for 27.3% of the variance in healthcare delay behavior (R² = 0.273). The findings indicate that nearly two years after the 2023 Türkiye earthquake, healthcare delay behavior remains highly prevalent among survivors living in temporary accommodation centers. This persistent delay reflects ongoing structural and access-related inequalities in post-disaster healthcare delivery. The results underscore the importance of strengthening accessible, continuous, and trauma-informed healthcare services, particularly in vulnerable and displaced populations, to reduce long-term disparities in healthcare utilization.

High-intensity exercise (HIE) improves cardiorespiratory fitness but also acutely increases autonomic and hemodynamic stress in hypertensive individuals. L-citrulline augments nitric-oxide bioavailability and buffers these responses. We conducted a robust crossover trial in untreated hypertensive males (n = 12) to test whether short-term L-citrulline supplementation (6g·day⁻¹ for 6 days) modifies cardio-autonomic and hemodynamic responses after HIE. Heart-rate variability (HRV), systolic blood pressure [SBP], diastolic blood pressure [DBP], mean arterial pressure [MAP]), heart rate (HR), pulse pressure (PP), and rate-pressure product (RPP) were assessed. Mixed-effects modelling indicated that L-citrulline improved cardio-autonomic regulation: high-frequency power (HF, an index of vagal modulation) was higher at rest and at 90-min recovery; time-domain index standard deviation of normal-to-normal intervals (SDNN, representing overall autonomic activity) was increased at rest; and low-frequency power (LF) and LF/HF ratios were lower across time (condition and condition × time effects, all p ≤ 0.005). L-citrulline reduced SBP at rest (- 18.7 mmHg, p ≤ 0.005) and immediately after exercise (- 26.3 mmHg, p ≤ 0.005); DBP and MAP were lower across the recovery period (all p < 0.001). HR was reduced from 15 to 90min post-exercise values (p ≤ 0.005), and RPP was lower immediately post-exercise (p ≤ 0.005), indicating reduced myocardial oxygen demand during this period. PP was lower immediately post-exercise (p ≤ 0.005). Supplementation with L-citrulline for six days enhanced cardiovascular recovery after HIE by blunting surges in cardiac, and BP workload, and may assist in improving the clinical efficacy of HIE in hypertensive subjects.

Adaptation of quality control pipeline for Skeletal Muscle 31P MR Spectroscopy at 3T and 7T.

Micro- and nano-sized polyethylene plastics (PE-MPs and PE-NPs) are emerging as potential risk factors for pulmonary disease and risk assessment. Currently, their is no direct evidence suggests this appreciable health risk extends to humans. Furthermore, the toxicological evaluation of PE-MPs and PE-NPs is insufficient to support their safe use. This study was aimed to characterize the toxicity of PE-MPs and PE-NPs after 13weeks of intratracheal instillation in Sprague-Dawley (SD) rats and to assess the reversibility of any effects during a 4-week recovery period. Exposure levels for PE-MPs and PE-NPs were set at 0, 40, 80, and 120μg per rat once a week. The results indicated that the treatment administration resulted in observable lung tissue alterations. Inflammatory cells were present in the perivascular and peribronchiolar regions in both sexes at ≥ 40μg per rat in the PE-MPs and PE-NPs-treated groups, indicating a biological response that can turn into toxicity. Additionally, thickened alveolar ducts and alveolar epithelial hyperplasia were noted in males at 120μg per rat PE-MPs, in males at ≥ 80μg per rat PE-NPs, and in females at ≥ 40μg per rat PE-MPs and PE-NPs-treated groups. Interestingly, when instilled repeatedly with both sizes of polyethylene particles, IL-1β and TNF-α secretion was significantly more enhanced in female rats compared to male rats. At the same time, the pulmonary level of IL-6 increased more clearly in male rats than in female rats. The pulmonary level of C-reactive protein, a marker for acute inflammation, was increased in all treated groups. These findings suggest that the lowest-observed-adverse-effect level (LOAEL) for PE-MPs and PE-NPs based on repeated exposures is below 40μg per rat for both sexes. However, the toxicological data for PE-MPs and PE-NPs remain insufficient to confirm their safety, and further research is necessary to evaluate their potential risks to human health.

Vascular endothelial cells (VECs) play a critical role in tissue and organ homeostasis, wound healing, and immune function. VECs are commonly utilized for in vitro cell culture and in vivo tissue engineering applications which experience intrinsic and extrinsic stressors. Severe stress can overwhelm VECs adaptive stress response mechanisms inducing damage and loss of cell viability. Improving VEC stress tolerance is therefore of increasing interest. In this study we assess the transgenic expression of tardigrade extremotolerance-associated proteins (TEAPs), specifically CAHS3, MAHS, LEAM, and Dsup for improved VEC tolerance to heat shock and hyperosmotic stress. In vitro studies of all TEAP-expressing VECs demonstrate up to 45% decrease in population metabolic activity in response to 24h incubation in hyperosmotic media solution without recovery. Interestingly, acute hyperosmotic stress treatments followed by a 24h recovery period showed significant increase in population metabolic activity for CAHS3 (186%), Dsup (202%), and LEAM (223%), while MAHS (161%) showed non-significant increases. Similarly, heat shock treatments followed by a recovery period showed significant increases for CAHS3 (198%), Dsup (182%), MAHS (195%), and LEAM (156%). Our results demonstrate that TEAP expression in VECs confer context dependent protective effects with respect to heat shock and hyperosmotic stress, motivating further exploration of TEAPs stress tolerance function and mechanism of action in mammalian cells.