Comparative study of advanced reasoning versus baseline large-language models for histopathological diagnosis in oral and maxillofacial pathology

by Viet Anh Nguyen, Van Hung Nguyen, Thi Quynh Trang Vuong, Quoc Thanh Truong, Thi Trang Nguyen

Large language models (LLMs) are increasingly explored as diagnostic copilots in digital pathology, but whether the newest reasoning-augmented architectures provide measurable benefits over earlier versions is unknown. We compared OpenAI’s o3 model, which uses an iterative planning loop, with the baseline GPT-4o on 459 oral and maxillofacial (OMF) cases drawn from standard textbooks. Each case consisted of two to five high-resolution haematoxylin-and-eosin micrographs, and both models were queried in zero-shot mode with an identical prompt requesting a single diagnosis and supporting microscopic features. Overall, o3 correctly classified 31.6% of cases, significantly surpassing GPT-4o at 18.7% (Δ = 12.9%, P 

Effects of manufacturing modality, primer, and adhesive polymerization on the shear bond strength of customized lingual brackets to glazed zirconia: An <i>in vitro</i> study

by Viet Anh Nguyen, Ngo The Minh Pham, Minh Ngoc Tran, Thi Bich Ngoc Ha, Thi Quynh Trang Vuong

Introduction

Bonding fixed appliances to zirconia restorations is challenging, yet adult orthodontics increasingly involves ceramic crowns and patient-driven esthetic choices such as lingual appliances. Customized lingual brackets may improve fit and reduce adhesive thickness, but evidence on their bonding to zirconia is limited.

Materials and methods

This in vitro study evaluated the shear bond strength of customized lingual brackets bonded to glazed zirconia after airborne-particle abrasion. Bracket manufacturing was either three-dimensionally (3D) printed cobalt-chromium or cast nickel-chromium. Primers were a universal adhesive (Single Bond Universal, 3M) or a primer containing 10-methacryloyloxydecyl dihydrogen phosphate Z-Prime Plus (Bisco), and adhesives were a light-cure orthodontic composite or a dual-cure resin cement. One hundred twenty-eight specimens (n = 16 per group) were tested. Shear bond strength was analyzed with three-way ANOVA, followed by post-hoc Tukey tests. Adhesive Remnant Index (ARI) scores were evaluated with ordinal regression. Significance was set at α = 0.05.

Results

Manufacturing modality significantly affected bond strength, with additively manufactured cobalt-chromium exceeding cast nickel-chromium (P = 0.049). The primer category and polymerization mode showed no significant main effects (P > 0.20) and no significant interactions. Group means clustered 9–10 MPa, and all combinations met the clinically accepted threshold. Additively manufactured brackets exhibited lower ARI scores than cast brackets (P  Conclusions

On glazed, sandblasted zirconia, shear bond strength of customized lingual brackets showed a borderline main effect of fabrication method, whereas primer type and adhesive polymerization mode were not statistically significant. Failures were predominantly located at or near the zirconia–adhesive interface. Within this in vitro model, base manufacturing may warrant attention, whereas primer and curing mode may be selected for handling and workflow considerations, with clinical relevance yet to be established.

Single catheter strategy for transradial angiography and primary percutaneous coronary intervention enhances procedural efficiency, microvascular outcomes, and cost-effectiveness: Implications for STEMI healthcare in resource-limited settings

by Mohajit Arneja, Swetharajan Gunasekar, Dharaneswari Hari Narayanan, Joshma Joseph, Harilalith Kovvuri, Sharath Shanmugam, Pavitraa Saravana Kumar, Asuwin Anandaram, Vinod Kumar Balakrishnan, Jayanty Venkata Balasubramaniyan, Sadhanandham Shanmugasundaram, Sankaran Ramesh, Nagendra Boopathy Senguttuvan

Background

Faster time to reperfusion can be achieved by minimizing various patient and system-level delays that contribute to total ischemic time. Procedural delays within the catheterization laboratory represent a non-negligible and modifiable component in the chain of reperfusion, but remain unquantified by conventional metrics such as door-to-ballon (D2B) time. Universal catheter approaches have rapidly gained traction as an alternative to the traditional two catheter approach for transradial coronary interventions. However, their utility for both diagnostic angiography and subsequent angioplasty is limited, and the impact of this strategy on reperfusion outcomes has remained unexplored. We utilized a procedural metric termed fluoroscopy-to-device (FluTD) time to quantify the efficiency of a single catheter strategy, and assessed its impact on epicardial and myocardial perfusion.

Methods and results

In this retrospective study, consecutive STEMI patients undergoing transradial primary PCI (pPCI) at a tertiary care center in India between May 2022 to October 2024 were analyzed. Patients were divided into two groups: 51 underwent PCI using a single universal guiding catheter (UGC), and 51 underwent the conventional two-catheter (CTC) approach. The primary outcome of the study was a comparison of the FluTD time between the two procedural strategies. Secondary outcomes included myocardial blush grade (MBG), Thrombolysis in Myocardial Infarction (TIMI) flow grade, total fluoroscopy time, radiation dose, device safety and efficacy, and procedural success.The median FluTD time was significantly shorter in the UGC compared to the CTC group (3 minutes [IQR 3–4] vs. 10 minutes [IQR 8–17], p  Conclusion

A single catheter strategy for both angiography and pPCI in STEMI patients was associated with a significant reduction in FluTD time and improved microvascular perfusion, without compromising device safety or efficacy. In low- and middle-income countries (LMICs), where intra- and extra-procedural delays are often more pronounced, inclusion of the single catheter strategy can optimize catheterization workflows and yield substantial cost-savings.

Validation of an instrument to assess knowledge, attitudes, and practices regarding occupational accident prevention among rice farmers

by My Ha Nguyen, Toan Van Ngo, Linh Gia Vu, Dat Cong Truong, Hai Minh Vu

Background

Despite the hazardous nature of rice farming, limited evidence exists regarding farmers’ knowledge, attitudes, and practices (KAP) toward accident prevention, and no standardized instrument is currently available to measure these dimensions in Vietnam or comparable contexts. This study aimed to develop and validate a psychometrically sound instrument for assessing rice farmers’ KAP related to occupational accident prevention.

Methods

Instrument development and validation were carried out in three stages. First, an initial item pool was generated through an extensive review of existing literature. Second, content validity was established through expert consultation involving professionals in agriculture, occupational health, and public health. Third, a pilot study was conducted with 168 rice farmers in Thai Binh Province, Vietnam, to evaluate the instrument’s psychometric properties.

Results

Exploratory factor analysis identified 20 items across five factors in the knowledge domain, nine items forming a single factor for attitudes, and 17 items grouped into four factors for practices, explaining 85.8%, 43.8%, and 72.3% of the total variance, respectively. Confirmatory factor analysis supported these structures, demonstrating satisfactory model fit across domains. The instrument exhibited high internal consistency, with Cronbach’s alpha values ranging from 0.894 to 0.969 for knowledge, 0.833 for attitudes, and 0.805 to 0.933 for practices.

Conclusion

The validated instrument provides a reliable and valid measure of rice farmers’ knowledge, attitudes, and practices concerning occupational accident prevention. It offers a robust foundation for future research, monitoring, and targeted interventions aimed at improving safety behaviors and reducing injury risks among agricultural workers.

High fructose corn syrup ınduced liver and heart damage are not reversed with hazelnut consumption: In vivo study

by Ayça Toprak-Semiz, Efsane Yavuz-Bedir, Hakan Yüzüak, Murat Usta, Demet Şengül

Hazelnut, antioxidant, anti-inflammatory effects, has an important role in a healthy diet. High fructose corn syrup (HFCS), used as a sweetener in ready-made food, beverages; causes hyperlipidemia, fatty liver, cardiovascular system damages; oxidative stress, inflammation play role in these damages. Based on these data, we aimed to examine liver and heart damage caused by HFCS in rats and to investigate possible role of hazelnut enriched food in preventing/improving these damages. During this process, weight change, food, liquid consumption were recorded. Biochemical parameters were measured with standard enzymatic techniques. Inflammatory cytokines were determined by ELISA. Liver and heart tissues were evaluated histopathologically, changes were scored, graded. HFCS decreased food, increased liquid consumption. Feeding with hazelnut reduced fluid consumption. HFCS increased weight gain, hazelnut did not reverse it. LDH, CK values increased in HFCS group due to heart damage. While damage occurred in livers of HFCS group due to increased levels of TNF-α and IL-1ß, feeding with hazelnut did not change it. In heart, inflammatory cytokines were similar between groups. In histopathological analysis, inflammation was observed both in livers, hearts of HFCS group. In hazelnut group, a significant decrease in damage was observed compared to HFCS, HFCS+H groups. According to our results, hazelnut supplementation reduced liquid intake and showed limited cardiac protection, but did not reverse HFCS-induced hepatic or cardiac injury.

Barriers and enablers to help-seeking for common mental disorders among young people in low-income settings: Perspectives from Zimbabwe

by Rufaro Hamish Mushonga, Tarisai Concilia Bere, Rebecca Jopling, Franklin Glozah, Maria Anyorikeya, Tiny Tinashe Kamvura, Suzanne Dodd, Arnold Maramba, Denford Gudyanga, Benedict Weobong, Dixon Chibanda, Melanie Abas, Moses Kumwenda

Methods

We utilised a qualitative research design and conducted 32 semi-structured interviews with young people (15–24 years) across high schools and the Friendship Bench (FB) in Harare between 20 December 2022 and 30 September 2023. Interviews were audiotaped and transcribed verbatim and then coded using an inductive approach to capture patterns grounded in participants’ experiences. Thematic analysis was utilised to develop relevant codes and identify relevant themes.

Results

Nine themes were generated including six themes related to barriers (factors that hinder help-seeking for CMDs) and three themes related to enablers (factors that facilitate help-seeking for CMDs). Barriers identified include perceived stigma, privacy and confidentiality issues, unavailability of services, lack of awareness, financial challenges and lack of incentives. Enablers identified include raising awareness, implementing school based initiatives and enhancing accessibility and affordability of mental health services.

Conclusion

This study revealed significant barriers and enablers to help-seeking for CMDs among young people in Zimbabwe. Addressing these multifaceted barriers and leveraging the identified enablers is key to creating supportive systems that encourage young people in low-resource settings to seek and engage with mental health services, ultimately improving their mental wellbeing and overall quality of life.

Midlife and old-age cardiovascular risk factors, educational attainment, and cognition at 90-years – population-based study with 48-years of follow-up

by Anni Varjonen, Toni Saari, Sari Aaltonen, Teemu Palviainen, Mia Urjansson, Paula Iso-Markku, Jaakko Kaprio, Eero Vuoksimaa

We examined the associations of midlife and old-age cardiovascular risk factors, education, and midlife dementia risk scores with cognition at 90 + years, using data from a population-based study with 48 years of follow-up. Participants were 96 individuals aged 90–97 from the older Finnish Twin Cohort study. Individual cardiovascular risk factors assessed via questionnaires in 1975, 1981, 1990, and 2021–2023 included blood pressure, body mass index, physical activity, and cholesterol, and self-reported educational attainment. The Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) score and an educational-occupational attainment score were used as midlife dementia risk scores. Cognitive assessments included semantic fluency, immediate and delayed recall from a 10-word list learning task, and a composite cognitive score. Regression analyses were conducted with dementia risk factors predicting cognition at 90 + years, adjusting for age, sex, education, follow-up time, and apolipoprotein E genotype (ε4-carrier vs non-carriers). Results showed that higher education and higher educational-occupational score were associated with better cognitive performance in all cognitive measures. Those with high midlife blood pressure scored significantly higher in all cognitive tests than those with normal blood pressure. Conversely, those with high old-age blood pressure scored lower in semantic fluency and composite cognitive score, but not in immediate or delayed recall. Other cardiovascular risk factors and the CAIDE score did not show consistent associations with cognition. Education appears to have a long-lasting protective effect in cognitive aging, whereas midlife and old-age cardiovascular risk factors were not significantly associated with cognition at 90 + years.