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A 65-Year-Old Man With Abdominal Pain, Duodenal Ulceration, and Skin Lesions

QuestionA 65-year-old man with hypertension presented to the emergency department with one month of persistent abdominal pain and postprandial distress that had not improved despite two hospitalizations at an outside clinic.One month before the current admission, he had developed...

Feasibility of integrating the VIA survey into medical education: a strengths workshop and longitudinal mentoring curriculum

Medical students experience high rates of stress and burnout, which negatively impact mental health and academic performance. Traditional resilience interventions often emphasize stress management and coping skills without explicitly focusing on the identification and use of pers...

Machine learning prediction of SIRS after percutaneous nephrolithotomy in older adults: role of frailty, malnutrition, and sarcopenia

Systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL) is a critical complication in older adults. However, the impact of frailty, malnutrition, and sarcopenia (F-M-S) comorbidity on postoperative SIRS remains unclear. This study aimed to evaluat...

Trial-level pupil dynamics reflect attention-related variability and medication-associated modulation in ADHD

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often exhibit rapid fluctuations in attention that are difficult to capture using standard behavioural assessments. We investigated whether trial-level pupil dynamics provide a physiological signal associated with task...

Genome-wide association study of estimated glomerular filtration rate using repeated measurements in the Taiwan Biobank

Background: Chronic kidney disease (CKD) is a major global public health issue, with genetic factors playing a significant role in kidney function. Although genome-wide association studies (GWAS) have identified numerous loci associated with estimated glomerular filtration rate (...

Scleral buckling versus combined pars plana vitrectomy and scleral buckling in primary rhegmatogenous retinal detachment: a 20-year retrospective comparative study

Scleral buckling (SB) has been progressively displaced by pars plana vitrectomy (PPV) in the management of rhegmatogenous retinal detachment (RRD); however, this transition appears to be driven more by evolving surgical training patterns than by clear differences in outcome data....

A review and synthesis of the Consultative Group on International Agricultural Research’s work on climate-induced extreme rainfall and floods, 2012–2023

In recent decades, the increased frequency of extreme rainfall events has significantly affected agri-food systems, accounting for 19% of the total crop damage across the world and 18–43% of observed anomalies in global crop yields. Some studies indicate a global weighted mean ri...

The moderating role of organizational intelligence on the relationship between knowledge management and healthcare service quality in Iranian hospitals

Modern healthcare systems face mounting challenges stemming from technological advancements, rising patient expectations, and the growing imperative to integrate evidence-based data into clinical practice. Although effective Knowledge Management (KM) is widely recognized as essen...

Comparative analysis of intraoperative and postoperative outcomes in primary vs. revision meningioma surgery: A propensity score-matched study

PURPOSE: Surgical resection is a critical intervention for meningiomas, but revision surgeries are challenging due to scar tissue, altered anatomy, and increased physiological stress. Our study evaluates differences in intraoperative and short-term postoperative outcomes between...

The association between the histological extent of pulpal inflammation and periapical radiographic findings in teeth with symptomatic irreversible pulpitis

Pulpal and periapical diagnosis of teeth with carious pulp exposure partly relies on patients’ clinical signs and symptoms. Understanding the pulpal histopathological changes is essential to refining therapeutic strategies. Therefore, this study aimed to examine the pathological...

Position-specific lower extremity performance and machine learning-based injury-risk screening classification in adult male basketball players: a random forest and SHAP approach

Basketball imposes high position-dependent neuromuscular demands that predispose athletes to lower extremity injuries. Machine learning offers the potential to identify multivariable risk-screening patterns that single-threshold approaches miss. This study aimed to (1) compare po...

Evaluating sustainability credibility in financial institutions using ESG talk and ESG action indicators

The strategic significance of sustainability disclosures in financial markets has been heightened by the institutionalization of environmental, social, and governance (ESG) reporting. Nevertheless, there are ongoing apprehensions about the extent to which ESG communication accura...

Online peer support in long-term physical health conditions: a feasibility randomised controlled trial

Thirty percent of the UK population live with a long-term physical health condition, and many also experience symptoms of low mood. Limited psychosocial support is currently available for people living with long-term physical health conditions and subthreshold depression, who are...

Roles of lactate and protein lactylation in neurogenesis and neurodegenerative disease

Neurodegenerative diseases are characterized by the gradual deterioration and impaired functionality of neuronal cells, which in turn results in the progressive decline of both cognitive capabilities and motor performance. Over the past few years, accumulating evidence has demons...

Suturing strategies for annular defects following lumbar discectomy: a structured narrative review and a hypothesis-generating functional assessment framework

Residual annular defects after lumbar discectomy may contribute to recurrent disc herniation, and several repair strategies—including direct annulus-to-annulus suturing, bone-anchored repair, and soft-tissue augmentation—have been described. However, evidence directly comparing s...

Thermophysical properties, combustion, performance, and emission analysis of ZnO, TiO₂, and GNP-enhanced WCOME–diesel–DGM triple fuel blends in a CRDI diesel engine

The continuous utilization of non-renewable/conventional fuels for different fields of applications creates intense demand, increasing costs, and hazardous exhaust gases, which cause depletion of these products from the Earth’s source. This scenario urges researchers to find alte...

Autoimmune Gastritis: An Evolving Entity

Autoimmune gastritis (AIG) has long occupied an awkward place in clinical practice.For most of the 21th century, it was viewed mainly through its hematologic endpoint-pernicious anemia-and seen as a rare, late diagnosis of limited relevance to the endoscopist.That perception has...

Disordered eating attitudes in hospitalized schizophrenia patients of Guangdong, China: prevalence, associated factors, and the exploratory mediating role of insight in the depression-eating attitude link

This study aimed to examine disordered eating attitudes and their associated factors among hospitalized patients with schizophrenia. The primary objective was to identify sociodemographic, clinical, and psychological factors associated with eating attitudes. The secondary objecti...

Exploratory association of a composite preoperative myxoma-related clinical burden index with recovery duration after cardiac myxoma resection: a retrospective cohort study

Cardiac myxoma is a benign primary cardiac tumor, but its clinical impact varies with tumor size, mobility, valvular obstruction, pulmonary arterial pressure, and preoperative functional status. Whether an integrated myxoma-related preoperative clinical burden is associated with...

Effects of romosozumab on the peripheral and axial skeleton in postmenopausal women at high fracture risk: real-world evidence from DXA and HR-pQCT data

Evidence on the effects of romosozumab mainly concerns axial aBMD. In 28 postmenopausal women, we found that spine and hip aBMD (DXA) significantly increased, while volumetric BMD, microarchitecture, and strength at the radius and tibia (HR-pQCT) remained unchanged or deteriorate...