Chronological age plays a major role in medical decision-making but has limitations. Biological aging involves variable changes in cells, tissues, and organs across individuals, potentially affecting molecular processes, including mitochondrial and immune changes, vascular changes, epigenetic drift, and metabolic changes that progress at varying rates. Therefore, reliable biomarkers of biologic age could recalibrate medical decision-making and replace chronologic age in evaluating medical and surgical treatments, transplant evaluation, and cancer screening, which are currently based on chronologic age thresholds that do not account for individual variation. Small noncoding RNAs (sncRNAs) regulate gene expression without coding for proteins and have recently been identified as regulators in aging and longevity. Studies of circulating sncRNAs have identified their potential as biomarkers of biological age. A group of sncRNAs, known as PIWI-interacting RNAs (piRNAs), which play roles in germline genome stability, have recently received attention as potential blood-based biomarkers of biological aging in older adults. This editorial aims to highlight the current status of sncRNAs, including piRNAs, in the ongoing quest for circulating biomarkers of biological age and longevity.

Due to an unintentional error, incorrect versions of Tables 2-6 were included in the publication. The correct tables are presented below. Reference: Justyna Leszczak, Natalia Wołoszyn, Justyna Brożonowicz, Krzysztof Bylicki, Gabriela Ciąpała, Joanna Grzegorczyk, Agnieszka Wiśniowska-Szurlej. Evaluation of Hand-Grip Strength Measurement Using the Pablo Virtual Reality System in Young Adults. Med Sci Monit. 2025;31:e949357. DOI: 10.12659/MSM.949357.

BACKGROUND This in vitro study evaluated the effect of different surface treatments on the bond strength of polyetheretherketone (PEEK) and polyether-ketone-ketone (PEKK) polymers to resin cement. MATERIAL AND METHODS CAD/CAM-fabricated PEEK and PEKK specimens (7×7×2 mm) were divided into 8 groups (n=10 per group; total n=80), with 4 groups per material: control, argon plasma, sandblasting with 125-µm Al₂O₃, and sandblasting followed by argon plasma. Surface characteristics were analyzed using scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), and atomic force microscopy (AFM). All specimens were treated with a methyl methacrylate-based adhesive (Visio.link) and luted with resin cement (RelyX U200), then stored in air for 1 h. Shear bond strength was measured using a universal testing machine. Data were analyzed using Kolmogorov-Smirnov, Levene, one-way ANOVA, Bonferroni, and independent t tests (alpha=0.05). RESULTS Surface treatment significantly affected bond strength (P<0.05). The highest bond strengths for both polymers were achieved with sandblasting followed by argon plasma treatment. Although PEKK showed slightly higher bond strengths than PEEK, the difference was not statistically significant (P>0.05). The lowest bond strengths were observed in the control groups (PEEK: 7.1±0.6 MPa; PEKK: 7.6±1.2 MPa), while the highest values were recorded after combined sandblasting and argon plasma treatment (PEEK: 12.2±2.4 MPa; PEKK: 12.6±2.4 MPa). CONCLUSIONS Surface treatment significantly influences the bond strength of PEEK and PEKK to resin cement. Argon plasma application after sandblasting markedly enhanced shear bond strength for both materials.

BACKGROUND Neural tube defects (NTDs) are among the most common congenital malformations and arise from disruption of early neurulation. Phosphoric acid is a widely used food additive; however, its potential effects on early neural tube development have not previously been evaluated in experimental neurulation models. This proof-of-concept study aimed to investigate the embryotoxic and teratogenic effects of phosphoric acid on neural tube development in a chick-embryo model of neurulation, at a single tested concentration. MATERIAL AND METHODS Fertilized pathogen-free chicken eggs (n=30) were randomly allocated into 2 groups. Control embryos (n=15) received no injection, whereas embryos in the experimental group (n=15) were injected beneath the embryonic disc with 0.25 mM phosphoric acid, at Hamburger-Hamilton stage 9. Embryos were incubated for 72 hours, after which survival was recorded and neural tube development was evaluated macroscopically and histopathologically. Statistical comparisons were performed using Fisher's exact test. RESULTS All control embryos survived (15/15, 100%) and exhibited normal neural tube closure. In the phosphoric acid-treated group, survival was significantly reduced (10/15, 66.7%; P=0.0421). Among surviving treated embryos, 80% (8/10) demonstrated NTDs, including cranial and caudal closure abnormalities (P<0.001). Histopathological examination confirmed incomplete neural fold closure, irregular notochord morphology, and disrupted somite organization in affected embryos. CONCLUSIONS Phosphoric acid exposure at the tested concentration and developmental stage markedly reduced embryo survival and induced a high incidence of neural tube closure defects in a chick-embryo model. These findings provide the first experimental proof-of-concept evidence that phosphoric acid can directly disrupt early neurulation in a vertebrate neurulation model. However, vehicle-controlled replication, dose-response analyses, and exposure-bridging studies are required to distinguish teratogenic specificity from general embryotoxicity and to assess potential relevance to human embryogenesis.

BACKGROUND Preoperative mouthwashes are recommended to reduce viral transmission during aerosol-generating procedures (AGP) in dental settings. However, their effectiveness may be compromised due to dilution by continuous water flow from dental unit waterlines (DUWL). This study evaluated the virucidal efficacy of various mouthwashes when delivered through DUWL using a novel 3D-printed dental aerosol model, with human coronavirus OC43 (hCoV-OC43) as a surrogate for SARS-CoV-2. MATERIAL AND METHODS Five mouthwashes - 0.12% chlorhexidine digluconate (CHX), 0.07% cetylpyridinium chloride (CPC), 1% hydrogen peroxide (HP), 0.2% povidone-iodine (PVP-I), and Oral7® - were assessed using suspension and carrier tests at 3 exposure times (30 s, 2 min, and 5 min). Viral infectivity was measured by median tissue culture infectious dose (TCID₅₀/mL), and log reduction values (LRVs) were calculated. The most effective mouthwashes were further evaluated in a novel 3D-printed aerosol model simulating mouthwash delivery through DUWL during AGP. RESULTS All tested mouthwashes significantly reduced viral infectivity within 30 s. CPC, PVP-I, and Oral7® achieved >4 log₁₀ reductions (>99.99%) in suspension and aerosol tests. However, only PVP-I and Oral7® appeared to be non-cytotoxic to the host cells. CONCLUSIONS PVP-I and Oral7® mouthwashes, when delivered via DUWL, rapidly and effectively reduced aerosolized surrogate SARS-CoV-2 within 30 s in this study, while remaining non-cytotoxic to the host cells. These findings support their potential integration into clinical infection control protocols during AGP.

BACKGROUND Intertrochanteric femoral fractures are common in older adults, and proximal femoral nail (PFN) fixation is widely preferred due to its biomechanical advantages. Lag screw cut-out, defined as the progressive migration of the lag screw through the femoral head with loss of fixation, is one of the most serious mechanical complications after PFN fixation. This complication can result in mechanical failure and require revision surgery. Therefore, this study aimed to identify independent risk factors for lag screw cut-out and evaluate lag screw stability in patients without cut-out. MATERIAL AND METHODS We retrospectively reviewed 302 patients treated with PFN between January 2023 and December 2024; 190 met the inclusion criteria. Patients were grouped by fracture stability and surgical approach. Demographic, clinical, and radiographic parameters (tip-apex distance [TAD], calcar TAD, collodiaphyseal angle, Cleveland index, lag screw advancement) were analyzed. Logistic regression identified predictors of cut-out, while sequential radiographs evaluated positional changes in non-cut-out cases. RESULTS Cut-out occurred in 30 patients (15.8%). Unstable fractures and open reduction were independent risk factors for cut-out, while age, sex, TAD, calcar TAD, Cleveland index, and collodiaphyseal angle showed no significant association. In non-cut-out cases, TAD, calcar TAD, and collodiaphyseal angle remained stable, with a mean lag screw advancement of 0.4 cm. CONCLUSIONS Unstable fractures and open surgery independently increase the risk of lag screw cut-out after PFN fixation. In contrast, non-cut-out cases showed radiographic stability, supporting the importance of accurate reduction and proper implant positioning for long-term reliability.

BACKGROUND Unilateral biportal endoscopy (UBE) is a novel surgical treatment for lumbar disc herniation (LDH). Some patients experience persistent residual low back pain (rLBP) after surgery. We aimed to identify risk factors for rLBP after UBE. MATERIAL AND METHODS This retrospective study analyzed 203 patients with LDH who underwent UBE in our department between January 2020 and August 2024. Inclusion criteria were a diagnosis of LDH treated by UBE and at least 1 year of follow-up. Exclusion criteria were severe spinal infection, previous spinal surgery, severe systemic disease, or incomplete follow-up data. Two groups were established based on visual analog scale scores at 1 year postoperatively: rLBP (score ≥3) and non-rLBP (score <3). Demographic characteristics, clinical outcomes, and imaging features were compared between groups. Logistic regression analyses were performed to identify rLBP risk factors. RESULTS There were 44 patients in the rLBP group (mean age, 52.59 years; ~43.2% women) and 159 patients in the non-rLBP group (mean age, 49.66 years; ~55.3% women). Postoperative rLBP was observed in 21.7% (44/203) of patients. Multivariate logistic regression analysis identified severe preoperative low back pain (P<0.001), high-grade facet joint osteoarthritis (FJOA) (P=0.005), and Modic type 1 changes (P=0.04) as independent risk factors for postoperative rLBP. CONCLUSIONS In patients with LDH, severe preoperative low back pain, high-grade FJOA, and Modic type 1 changes are predictive factors for rLBP after UBE. These parameters may be useful indicators for surgical decision-making and providing targeted treatment in high-risk populations.

BACKGROUND The incidence of fragility hip fractures (FHF) is increasing in older adults, and delirium often follows physical stress such as FHF. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the reference standard for diagnosing delirium in Thailand but requires specialized expertise. The Delirium Diagnostic Tool-Provisional (DDT-Pro) - a reliable and valid alternative that does not require specialist training - has not been evaluated in older Thai patients with FHF. This study aimed to translate and cross-culturally adapt the DDT-Pro to create a Thai version (DDT-Pro-TH), then determine its validity and reliability. MATERIAL AND METHODS A multidisciplinary team of nonpsychiatrists (orthopedists, geriatricians, anesthesiologists, physiatrists) and 2 DDT-Pro psychiatry experts performed forward and backward translation. Patients with FHF were informed about and consented to participation in this cross-sectional validation study. The DDT-Pro-TH and DSM-5 were independently utilized for delirium assessment before surgery and on postoperative days 1 and 2. Delirium diagnosed by DSM-5 served as the reference standard; DDT-Pro-TH positivity was defined as a score of 6 or lower. Validity was assessed with the area under the curve (AUC); reliability was measured using Cronbach's alpha and Cohen's kappa statistics. RESULTS One hundred ten patients with FHF participated. Internal consistency reliability (Cronbach's alpha) was 0.819 (95% CI, 0.783-0.851). Inter-rater reliability (Cohen's kappa) was 0.974 (95% CI, 0.962-0.982). Concurrent validity (AUC vs Thai DSM-5) was 0.959 (95% CI, 0.903-0.987). CONCLUSIONS The Thai version of the DDT-Pro is a highly reliable and valid instrument for diagnosing delirium in older patients with FHF.

Visceral pain is often refractory and debilitating. Effective therapy for visceral pain remains undetermined or even elusive. Recently, dexmedetomidine (DEX) has been found to be promising as an adjuvant in relieving visceral pain. DEX, a highly selective alpha-2 adrenoreceptor agonist, is increasingly used during the perioperative period. DEX induces sedation, analgesia, anxiolysis, sympathetic tone inhibition, and intestinal barrier protection. It has shown favorable analgesic effects in clinical and animal studies and is a useful adjuvant treatment for visceral pain. It can be delivered via intravenous injections, intraspinal administration, intraperitoneal spraying, or other routes, and it exerts antinociceptive effects on visceral pain. This article reviews the mechanisms, dose, and modes of administration of dexmedetomidine in managing visceral pain associated with surgery. Moreover, we highlight the clinical evidence of DEX on visceral pain therapy in recent years. We also address the various protocols and routes for using DEX in the treatment of visceral pain, aiming to provide a foundation and direction for clinical practice and basic research.

BACKGROUND Periscapular pain involves the muscles surrounding the shoulder blade, which can result from trauma, overuse or repetitive use, and poor posture. This study aimed to evaluate the prevalence of periscapular pain and the association between it and seating posture while using electronic devices, utilizing the American Shoulder and Elbow Score (ASES). MATERIAL AND METHODS This was a cross-sectional study conducted using an online questionnaire. The calculated sample size required 372 participants. The questionnaire was divided into 3 sections; sociodemographic information, risk factors for periscapular and shoulder pain, and ASES used for periscapular pain and disability assessment. RESULTS We included 379 patients. The lifetime prevalence of periscapular pain was 82.1%, and 48.5% reported current periscapular pain. Females were more likely to experience it (P value <.001). Most respondents who experienced periscapular pain worked in jobs that combined office and fieldwork (away from the office). Periscapular pain was significantly associated with forward tilt of the neck while using electronic devices (P=0.017). The mean ASES was 62.18. As age advances, worse ASESs were reported. CONCLUSIONS Periscapular shoulder pain is a very common and under-acknowledged problem among the general population, and poor posture while using an electronic device is significantly associated with periscapular pain.