Background/Objectives: Atypical femoral fracture (AFF) represents a diagnostic and therapeutic challenge, particularly in autoimmune disease patients receiving long-term bisphosphonate (BP) and glucocorticoid (GC) therapy. Although bilateral AFF is common, the radiographic evolution of asymptomatic incomplete lesions identified at the time of a complete fracture remains insufficiently defined. This study aimed to characterize the natural history and imaging biomarkers associated with progression in this biologically homogeneous high-risk population. Methods: Ten female autoimmune disease patients with complete AFF and asymptomatic incomplete contralateral lesions were retrospectively evaluated over a mean 59 months. Serial radiographs were assessed for cortical beaking, periosteal flaring, and transverse radiolucent lines. All patients discontinued BP therapy postoperatively; teriparatide was administered when tolerated. Results: Six lesions regressed, three remained stable, and one progressed—this progressing case being the only limb with a transverse radiolucent line at baseline. No patient developed symptoms or sustained a complete fracture on the contralateral side. Radiographic remodeling occurred independently of symptoms. BP discontinuation and, when tolerated, teriparatide appeared to contribute to lesion stabilization, although statistical significance was not achieved. Conclusions: In autoimmune patients with severe long-term BP and GC exposure, most asymptomatic incomplete AFF identified at the time of contralateral complete fracture remains stable or improves under conservative management. A transverse radiolucent line is the most decisive imaging biomarker predictive of progression and warrants intensified surveillance or consideration of prophylactic fixation. Larger cohorts are needed to refine risk stratification algorithms and optimize diagnostic and management strategies.

Background/Objectives: Interest in myocardial mapping for cardiac MRI has increased, enabling differentiation of various cardiac diseases through T1, T2, and T2* mapping. This study evaluates the impact of deep learning (DL)-based image reconstruction on the mean and standard deviation (SD) of these techniques. Methods: Fifty healthy adults underwent cardiac MRI, with images reconstructed using the AIR Recon DL prototype. This DL approach, which reduces noise and enhances image quality, was applied at three levels and compared to non-DL reconstructions. Results: Analysis focused on the septum to minimize artifacts. For T1 mapping, mean values were 988 ± 50, 981 ± 45, 982 ± 43, and 980 ± 24 ms; for T2 mapping, mean values were 53 ± 5, 54 ± 5, 54 ± 5, and 54 ± 5 ms and for T2* mapping, mean values were 37 ± 5, 37 ± 5, 37 ± 5, and 38 ± 5 ms for no DL and increasing DL levels, respectively. Results showed no significant differences in mean values for any mappings between non-DL and DL reconstructions. However, DL significantly reduced the SD within regions of interest for T1 mapping, enhancing image sharpness and registration accuracy. No significant SD reduction was observed for T2 and T2* mappings. Conclusions: These findings suggest that DL-based reconstructions improve the precision of T1 mapping without affecting mean values, supporting their clinical integration for more accurate cardiac disease diagnosis. Future studies should include patient cohorts and optimized protocols to further validate these findings.

Objectives: This systematic review aimed to evaluate the effectiveness of currently available methods for the diagnosis and monitoring of skeletal, dental, and soft tissue changes, as well as the adequacy of follow-up protocols, in adolescents and adults treated with miniscrew-assisted rapid palatal expansion (MARPE). Materials and Methods: This systematic review was conducted in accordance with the PRISMA guidelines. A comprehensive electronic literature search was performed across five databases (PubMed, Scopus, Embase, Cochrane, and Web of Science) to identify prospective and retrospective clinical studies evaluating dental, periodontal, and alveolar bone outcomes associated with MARPE in late adolescent and adult patients. Study selection, data extraction, and risk of bias assessment were independently performed by two reviewers. Risk of bias was assessed using the ROBINS-I tool for non-randomized studies and the RoB 2 tool for randomized studies. The certainty of the evidence was evaluated using the GRADE approach. Owing to substantial methodological heterogeneity and limited follow-up duration, a structured qualitative (narrative) synthesis of the results was performed. Results: A total of 20 studies were included in the systematic review. The reported adverse events primarily involved hard and soft tissues and were identified using cone-beam computed tomography (CBCT), clinical and periodontal examination, panoramic and cephalometric radiography, and digital dental casts. Dental effects, including dental tipping, were frequently reported across the included studies. Alveolar bone loss was reported in 11 studies, buccal alveolar bone dehiscence in 3 studies, and failure of palatal suture opening in 6 studies. In most of the included studies, follow-up was either not reported or limited. Conclusions: The MARPE technique appears to be potentially effective in achieving transverse maxillary expansion in late adolescent and adult patients. However, the included studies report possible adverse events affecting periodontal and alveolar bone tissues, such as alveolar bone thinning and gingival hypertrophy, the assessment of which requires an integrated diagnostic approach combining CBCT imaging with clinical and periodontal examination. Overall, the certainty of the available evidence was low to very low, mainly due to a high risk of bias, methodological heterogeneity, and limited or absent follow-up in most studies. Therefore, the results should be interpreted with caution. Well-designed prospective controlled studies with standardized protocols and long-term follow-up are needed to conclusively evaluate the safety and long-term clinical stability of the MARPE technique.

Intraoperative assessment of pancreatic quality, followed by sampling for the potential isolation of Langerhans islets for subsequent autotransplantation, is currently a key component of post-total pancreatectomy diabetes mellitus treatment. The aim of this study was to quantitatively evaluate pancreatic parenchymal stiffness using optical coherence elastography (OCE) imaging, and to investigate the utility of the OCE method as a potential indicator of islet yield after pancreatectomy. A total of 41 freshly excised human pancreatic specimens, containing pancreatic ductal adenocarcinoma (PDAC) and surrounding non-tumorous tissues post-pancreatectomy, were studied. In this research, the stiffness (Young’s modulus, kPa) and its color-coded 2D distribution were calculated for various pancreatic samples using compression OCE. Stiffness values were compared between intact pancreatic parenchyma (islet-poor and islet-rich) and pancreatic lesion groups (parenchymal fibrosis and/or PDAC invasion). The data were confirmed by histological analysis. In addition, the measured stiffness values for various morphological groups of the pancreatic samples were compared with the number of isolated islets obtained from pancreatic samples after collagenase treatment. The study demonstrated that OCE can effectively distinguish areas of pancreatic lesions and identify intact pancreatic parenchyma containing Langerhans islets. A highly significant increase in mean stiffness (p < 0.0001) was observed in postoperative pancreatic samples exhibiting signs of parenchymal fibrosis or PDAC invasion compared to unaffected, intact pancreatic parenchyma. For the first time, a relationship between stiffness values and the number of isolated pancreatic islets was demonstrated; in particular, the number of isolated islets significantly decreased (≤110 pcs/g) in samples exhibiting stiffness values above 150 kPa and below 75 kPa. The optimal stiffness range for the efficient isolation of islets (≥120 pcs/g) from pancreatic tissue was identified as 75–150 kPa. The study introduces a novel approach for rapid and objective intraoperative assessment of pancreatic tissue quality using real-time OCE data. This technique facilitates the identification of regions affected by pancreatic lesions and supports the selection of intact pancreatic parenchyma, potentially enhancing the accuracy of Langerhans islet yield predictions during surgical resection.

Background/Objectives: Subjective refraction is the clinical gold standard but is time-consuming and examiner-dependent. Most artificial intelligence (AI)-based approaches rely on specialized imaging or biometric data not routinely available. This study aimed to predict subjective refraction using only routine, non-cycloplegic autorefraction and keratometric data and to identify factors associated with reduced prediction accuracy. Methods: This retrospective study included 1856 eyes from 1006 patients. A multi-output histogram gradient-boosting model predicted subjective spherical equivalent, cylindrical power, and astigmatic axis. Performance was evaluated on an independent test dataset using R2 and mean absolute error, with circular statistics for axis prediction. Prediction failure was assessed using clinically relevant tolerance thresholds (sphere/cylinder ≤ 0.50 D; axis ≤ 10°) and multivariable logistic regression. Results: The model achieved high accuracy for spherical and cylindrical prediction (R2 = 0.987 and 0.933; MAE = 0.126 D and 0.137 D). Astigmatic axis prediction demonstrated strong circular agreement (ρ = 0.898), with a mean absolute angular error of 4.65° (median, 0.96°). Axis errors were higher in eyes with low cylinder magnitude (<0.75 D) and oblique astigmatism. In multivariable analysis, steeper keratometry (K2; OR = 7.25, 95% CI 1.62–32.46, p = 0.010) and greater objective cylindrical power (OR = 2.79, 95% CI 1.87–8.94, p = 0.032) were independently associated with poor prediction. Conclusions: A machine-learning model based solely on routine, non-cycloplegic autorefractor and keratometric measurements can accurately estimate subjective refraction, supporting AI as a complementary decision-support tool rather than a replacement for conventional subjective refraction.

Background/Objectives: Sarcopenia (Sp) and obesity (Ob) have significant negative effects on steatotic liver disease (SLD). Here, we examined the effects of sarcopenic Ob (SO) on liver fibrosis in patients with SLD. Methods: We included 811 patients who visited our outpatient clinic and underwent FibroScan (Echosens, France). Liver stiffness (LS) was assessed using body mass index (BMI) and grip strength (GS). We conducted a similar analysis by converting the difference in estimated glomerular filtration rate (dGFR) based on creatinine and cystatin C levels into GS. Results: The cutoff values for distinguishing metabolic dysfunction-associated steatotic liver disease (MASLD; 298 patients) with LS > 10 kPa (advanced fibrosis) were set separately for men and women using receiver operating characteristic analysis. BMI was set at >26 kg/m2 in women and >27 kg/m2 in men (modified Ob (mOb)), and GS was set at <16 kg in women and <31 kg in men (modified Sp (mSp)). The ratio of advanced fibrosis was higher in the group with both mSp and mOb (mSpOb) than in the group with mSp alone or mOb alone in MASLD or alcoholic liver disease (ALD, 97 patients). However, this association has not yet been observed in other diseases. The dGFR was used to set the cutoff value corresponding to advanced fibrosis. Sp-dGFR (SpdG) was >1.14 in women and >−0.76 in men in the MASLD group. mSpOb, SpdG and Ob are associated with advanced fibrosis in MASLD logistic regression analysis. Conclusions: SO, assessed using BMI and GS or dGFR, was associated with elevated LS in patients with SLD.

Background: Obesity, defined as an abnormal accumulation of body fat, is becoming a global epidemic. Individuals with obesity may present with increased abdominal fat, which is associated with hypertension, altered respiratory mechanics, higher resting heart rate, and may contribute to an increased cardiovascular risk. Physiological parameters, such as heart rate, blood pressure, respiratory rate, and oxygen saturation, can change hours before the occurrence of a clinically relevant adverse event. Thus, physiological parameters can be considered good predictors of clinical deterioration. Obesity is also associated with physical dysfunctions that can impair physical performance. The non-pharmacological therapeutic strategy for the treatment of obesity involves lifestyle modifications, including a healthy diet and regular physical exercise. Whole-body vibration (WBV) exercise, a type of physical activity, has demonstrated benefits in several specific populations, including obese individuals. Objectives: The objective of this study was to evaluate the immediate effects of a single whole-body vibration (WBV) exercise session, consisting of 15 sets, using a vibration platform (VP) with alternating vertical or lateral displacement, on physiological parameters, perceived exertion, strength, and functionality in obese adults. Methods: Seventy-two obese adult participants were randomly divided into three groups (vertical group, alternating lateral group, and placebo group). Physiological parameters were assessed before, during, and after the intervention, in addition to perceived exertion, functionality, and muscle strength. Results: When comparing the results before and after the intervention, the heart rate–pressure product increased significantly in the alternating lateral group (p = 0.005), and heart rate increased significantly (p = 0.0001) and then decreased significantly (p = 0.030) only in the alternating lateral group. Post hoc analysis revealed a significant increase in perceived exertion in the lateral alternation group, from the period before the intervention to the 10th set (p = 0.006) and from the period before to the period after the intervention (p = 0.011). In the vertical group, a significant increase was observed from the period before the intervention to the 10th set (p = 0.020). Conclusions: In conclusion, considering all the findings of this study, whole-body vibration (WBV) exercise promoted some immediate changes in physiological parameters and perception of effort in obese adults. WBV exercise with the alternating vibration platform induced significant fluctuations in heart rate and increased the heart rate–blood pressure product, although with values within the normal range. Perception of effort increased in all groups. Considering the absence of discrepant changes in physiological parameters, impact on the cardiovascular system, and fatigue, the WBV exercise intervention in side-alternating or vertical vibration vibratory platforms can be considered a viable non-conventional exercise option for the obese population.

Background/Objectives: Interstitial pneumonia with autoimmune features (IPAF) is a recently defined entity characterized by interstitial lung disease (ILD) with clinical, serological, and radiological features suggestive of autoimmunity that do not fulfil the criteria for a defined connective tissue disease (CTD). This study aimed to evaluate the clinical characteristics, treatment modalities, and outcomes of patients with IPAF in a tertiary referral center. Methods: We retrospectively analyzed 72 patients who fulfilled the IPAF classification criteria. Demographic, clinical, serological, radiological, pulmonary function, treatment, and survival data were collected and evaluated. Logistic regression analysis was performed to identify factors associated with mortality. Results: The cohort consisted of 62.5% female patients, with a mean age of 62.7 (SD, 10.4) years at diagnosis. The most frequent radiological pattern was nonspecific interstitial pneumonia (83.3%). Raynaud’s phenomenon (6.9%) and arthritis (2.8%) were the most common rheumatological manifestations. Antinuclear antibodies positivity at titers ≥1:320 was observed in 27.8% of patients. Azathioprine was the most frequently prescribed agent (20.8%), followed by mycophenolate mofetil (11.1%). After a median follow-up of 30.1 months (IQR, 52.8), 16 patients (22.22%) died, with a 5-year survival rate of 70%. Glucocorticoid therapy at doses ≥20 mg/day was independently associated with increased mortality (OR 6.13 (95% CI 1.17–32.21). Conclusions: IPAF predominantly affects middle-aged females. Glucocorticoid use at doses ≥20 mg/day was associated with mortality; however, this observational association may reflect underlying disease severity rather than a causal effect of high-dose treatment. Further prospective studies are needed to optimize management strategies in patients with IPAF.

Background and Clinical Significance: Prader–Willi syndrome (PWS) is an imprinting disorder not typically associated with severe congenital sensorineural hearing loss (SNHL). When profound SNHL is present in an infant with a known syndrome, an independent monogenic etiology should be considered. We report the first molecularly confirmed case of PWS co-occurring with biallelic pathogenic TMC1 variants causing congenital SNHL, outlining diagnostic challenges, cochlear implant (CI) outcomes, and implications for blended phenotypes. Case Presentation: A male infant with PWS due to a paternal 15q11.2–q13 deletion failed newborn hearing screening. Diagnostic auditory brainstem response and auditory steady-state response confirmed bilateral severe-to-profound SNHL. Temporal bone CT/MRI were normal. Comprehensive genetic testing identified compound heterozygous TMC1 variants consistent with autosomal recessive DFNB7/11 hearing loss, plus two variants of uncertain significance in SERPINB6 and EPS8L2. Sequential bilateral cochlear implantation was performed (left ear at 14 months, right at 20 months), followed by auditory–verbal therapy. Over four years, the child showed steady improvements in hearing and early-speech development. Conclusions: Early genomic evaluation is essential when clinical features appear atypical for a known syndrome. Identifying TMC1-related deafness enabled timely cochlear implantation and measurable gains. This case highlights that severe congenital SNHL in a syndromic infant may reflect a distinct monogenic disorder rather than phenotypic expansion of the primary syndrome, emphasizing the importance of recognizing blended phenotypes to guide precision-care strategies in rare disorders.

Background/Objective: Recent North American guidelines suggest that CT is indicated for further evaluation where ultrasound (US) is negative, although the negative predictive value (NPV) of ultrasound in adult patients when the appendix is not seen remains unclear. To assess the negative predictive value (NPV) of ultrasound in adult patients when the appendix is not seen. Methods: A scoping review of MEDLINE and EMBASE was performed from inception to 13 May 2025 using PRISMA-ScR guidelines to identify studies evaluating the outcome of adult patients where the appendix is not seen on ultrasound, with preference for studies where there were no secondary signs of acute appendicitis (right lower quadrant free fluid, abscess, ileus, echogenic fat or regional lymphadenopathy). Original studies with at least 10 patients were included in the review. The reference standard included a combination of clinical follow-up, CT and/or pathology. Data synthesis was provided as a qualitative review of the existing literature. Results: Six studies were included in the review. The number of included patients range from 12 to 179 with a mean age of 29–38 years. Few studies reported the patient BMI. NPVs ranged from 80 to 90% for all indeterminate ultrasounds and 83 to 95% for studies where secondary signs of appendicitis were excluded (90 to 95% when non-surgical reference standards were included). Two studies reported NPVs of 96–100% when the pre-test probability was low. Conclusions: The NPV of indeterminate ultrasound for adult patients with right lower quadrant pain and no secondary signs of appendicitis is likely ≥90%. When combined with a low clinical suspicion, the NPV is likely >95%. The appropriateness of a subsequent CT indication when the appendix is not visualized on ultrasound should be determined on an individualized basis.