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Context: There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Design: Prospective case-control. Methods: Seventy-seven adolescent female athletes aged 12–18 years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Results: Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1–13.8, P =.01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1–15.8, P =.03) compared with female athletes without history of SRC. Conclusions: Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk. [ABSTRACT FROM AUTHOR]

Multiple adjacent gingival recessions (MAGRs) are commonly treated with autogenous grafts. However, several intra- and postsurgical complications have been described following autogenous grafts, leading clinicians to explore the use of different biomaterials to treat these conditions. The aim of the present study was to evaluate the root coverage outcomes of a novel porcine-derived acellular dermal matrix (PADM) in combination with the tunneled coronally advanced flap (TCAF) for the treatment of MAGRs. Ten patients with 33 type 1 recession defects (RT1s) were treated with PADM + TCAF. The outcomes of interest included the mean root coverage (mRC), the frequency of complete root coverage (CRC), changes in keratinized tissue width, volumetric gain at the treated sites (assessed with digital intraoral scanning), and patient-reported outcome measures. All treated sites healed uneventfully, and no complications were noted throughout the study. At 6 months, a statistically significant reduction in recession was noted at the treated sites, exhibiting an overall mRC of 89.14% ± 19.15% and a CRC of 72.7%. The average volume gain after 6 months was 26.28 ± 11.71 mm3, and the mean distance between the surface/mean thickness of the reconstructed volume (DD) was 0.63 ± 0.28 mm. The region-specific volumetric analysis revealed an overall higher linear dimensional gain at the midroot aspect (range: 0.72 to 0.78 mm, assessed 1 to 4 mm apical to the cementoenamel junction) compared to the other regions. The present study presents the clinical and volumetric outcomes of PADM + TCAF for the treatment of MAGRs. A significant amount of volumetric gain was also observed at 6 months as a result of the treatment, along with satisfactory esthetic and patient-reported outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To complete a reanalysis study of two similarly designed prospective controlled studies exploring prognostic factors associated with the surgical outcomes of reconstructive treatment of peri-implantitis. Materials and Methods: Individual patient data of both studies were gathered. The initial study employed a submerged healing approach via primary wound closure with implant suprastructure removal and complete coverage of grafted sites. The second study employed a nonsubmerged healing protocol in which healing abutments were kept in place and the implants were not fully submerged. Both studies measured all prognostic factors at similar time points throughout 1 year and included clinical defect fill (DF) and radiographic defect fill (RDF), reduction of pocket depth (PDR), and bleeding on probing (BoP). Multilevel regression was used for statistical assessment of outcomes relative to the impact of site, local, surgical, and patient-related variables. Results: Overall, 59 implants (30 submerged and 29 nonsubmerged) were treated. Statistically significant higher DF (on average 0.9 mm higher), RDF (1.7 mm), and PDR (1.3 mm) were observed when a submerged reconstructive approach was performed, whereas BoP reduction was similar. After controlling for treatment (submerged/nonsubmerged), there were no other significant associations with patient-related (age, sex, smoking, prior periodontitis etc), or implant-related (previous prosthesis type, arch, keratinized tissue width [KTW], etc) factors. Conclusions: Within the study's limitations, we conclude that a submerged reconstructive approach for surgical management of peri-implantitis leads to significantly enhanced clinical and radiographic outcomes when compared to a nonsubmerged approach. [ABSTRACT FROM AUTHOR]

Context : In March 2020, public health concerns resulted in school closure throughout the United States . The prolonged sport cessation may affect knee injury risk in high school athletes. The purpose of this study was to describe and compare risk of knee injuries in high school athletes during 2019-2020 and 2020-2021 academic years, and stratify by gender, severity, mechanism of injury, injury type, and knee anatomic region . Design : Historical-prospective cohort study . Methods : This historical- prospective cohort study included 176 schools in 6 states matched by sport participation in control and COVID years from July 1, 2019 to June 30,2021. Injury rates per 1000 athletes per year were calculated with 95% confidence intervals. A negative binomial regression was performed to assess potential differences in knee injuries between academic years . Results: 94, 847 and 72,521 high school athletes participated in the 2019-2020(19-20) and 2020-2021 (20-21) seasons. Knee injury risk was higher in the 20-21 season (19-20: 28.89% [27.82-29.96-]; 20-21: 33.82% [32.50-35.14]). Risk increased for male athletes from 2019- 2020 to 2020-2021 (19-20: 29.42% [28.01-30.83]; 20-21 : 40.32% [38.89-41.75]). Female knee injury risk was similar between years (19-20: 25.78% [24.29-27.27]; 20-21: 26.03% [24.31-27.75]). Knee injuries increased by a ratio of 1.2 ([95% CI, 1.1- 1.3], P <.001) during 2020-2021. Conclusions,· Knee injury risk and relative risk increased among males in 2020-2021. Results indicate changes in knee injury risk following return from COVID shelter in place among high school athletes and implicate potential negative downstream effects of interrupted sports training and participation on high school injury risk. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the impact of injectable plateletrich fibrin (iPRF) and concentrated growth factor on postoperative pain, edema, trismus, and quality of life in impacted mandibular third molar surgery. The primary aim of this study was to minimize common sequelae following third molar surgery by using iPRF and concentrated growth factor. The secondary objective was to compare the postoperative effects of these products. Method and materials: This study represents a single-center, randomized prospective clinical trial conducted at the Ordu University Faculty of Dentistry. It involved patients who underwent third molar surgery for various reasons between July and October 2022. The predictor variables were the use of concentrated growth factor and i-PRF. They were categorized as concentrated growth factor, i-PRF, and control groups. The outcome variables include pain levels and analgesic consumption measured on a visual analog scale, distances between predetermined anatomical points, maximum mouth opening capacity, and data from the postoperative symptom severity (PoSSe) scale. Some statistical tests were performed with a 95% confidence interval, which was considered significant. Results: Total analgesic use was notably lower in the concentrated growth factor group (P = .044). Concentrated growth factor and iPRF outperformed the control group in all edema measurements by postoperative day 7 (tragus–pogonion, lateral canthus–angulus, tragus–commissura; P < .05). Concentrated growth factor significantly reduced trismus on days 2 and 7. Quality of life was notably higher in the concentrated growth factor group than in the control group (P = .026), although iPRF group differences were not significant. Conclusion: The results indicate that concentrated growth factor has a limited impact on postoperative pain, but significantly reduces edema, trismus, and enhances quality of life. The iPRF group experienced positive effects on pain, edema, and trismus, although the statistically significant differences observed with concentrated growth factor highlight its potential for use instead of iPRF after third molar surgery. An increased sample size is essential for more comprehensive results [ABSTRACT FROM AUTHOR]

Purpose: This prospective study evaluated the marginal bone level and periodontal parameters 6 years after placement of a convergent transmucosal neck implant. Materials and Methods: In total, 71 implants were placed in 60 patients. Of these, 52 implants were placed with a flapless technique and with the convergent neck exposed by 1 mm (early and delayed placement), while 19 implants were placed immediately after extraction (immediate placement). At least 3 months after insertion, customized abutments were applied and provisional resin crowns were cemented, while being careful to prevent any tissue compression. After 3 weeks, definitive metal-ceramic crowns were designed with the finish line at the soft tissue level and free from any compression. The implant survival rate at 6 years, marginal bone level changes (ΔMBL, mm), and Pink Esthetic Score (PES) were evaluated. Gingival phenotype was determined before the implant surgeries (thin/thick). A three-level hierarchical model was examined with a random intercept and random slope on follow-up time at the patient level and a random intercept at the implant level. Results: In all, 57 patients with 67 implants reached the 6-year point; 3 patients (5.0%) dropped out. The implant survival rate was 100%. ΔMBL from baseline to 24 months was 0.58 mm (95% CI: 0.48, 0.68), while ΔMBL from 24 to 72 months was 0.33 mm (95% CI: 0.19, 0.47). PES improved steadily from 6 to 48 months (+0.96; 95% CI: 0.71, 1.20), with overall stability at 72 months. No correlation between MBL and PES was observed. A significant association was found between thick gingival phenotype and less MBL variation. Greater implant diameter offered more MBL stability after 3 years but resulted in lower PES values. Conclusions: The use of convergent transmucosal neck implants placed with a flapless transmucosal approach with the crown margin positioned at the gingival level preserved marginal bone and guided gingival morphology for up to 72 months. The gingival phenotype was the parameter that most affected the soft and hard tissues. In the long term, implant placement timing was not related to MBL. [ABSTRACT FROM AUTHOR]

Purpose: Previous literature has demonstrated the mediating role of adiposity in the association between cardiorespiratory fitness (CRF) and cardiometabolic risk as well as the potential role of CRF in attenuating the adverse consequences associated with excess weight. This study aimed to evaluate the mediating role of CRF and adiposity in the possible association with cardiometabolic risk. Method: Observational 3-year longitudinal study that included 420 children and adolescents (10.50 [2.05] y of age at baseline; 56.2% girls). Body mass index (BMI) was calculated, and CRF was evaluated using field assessments. A clustered cardiometabolic risk score (cMetS) was calculated from glucose, systolic blood pressure, total cholesterol/high-density lipoprotein cholesterol ratio, and triglycerides z scores. Analyses evaluated the mediating role of BMI in the association between CRF and cMetS as well as whether CRF mediated the association between BMI and cMetS. Results: BMI at baseline was directly associated with the cMetS at follow-up (0.102; 95% confidence interval, 0.020 to 0.181), independently of CRF, whereas CRF was only indirectly associated with cMetS at follow-up through BMI (−0.036; 95% confidence interval, −0.070 to −0.009), meaning that the association between CRF and cMetS was explained via the mediation role of BMI. Conclusions: BMI presented direct association with cMetS, whereas CRF exhibited indirect association with cMetS mediated via BMI. [ABSTRACT FROM AUTHOR]

To investigate how frailty modifies the association of sitting time with all-cause and cardiovascular mortality in Chilean adults. This prospective study included 2,604 participants aged ≥35 from the Chilean National Health Survey 2009–2010. Sitting time was self-reported, while frailty was assessed using a 36-item Frailty Index. Sitting time was categorized as low, medium, and high. Cox proportional hazard models were used to estimate the risk of mortality stratified for the sitting time categories. Over a median follow-up of 8.9 years, 311 participants died, 28% of them due to cardiovascular events. Frail people with prolonged sitting time were at higher risk of all-cause and cardiovascular mortality (hazard ratio 3.13; 95% confidence interval [2.06, 4.71] and hazard ratio 2.41; 95% confidence interval [1.50, 3.64], respectively). The observed risk was higher in women than men. Public health and individual strategies should be implemented to decrease sitting time across the population, with special attention on frail people. [ABSTRACT FROM AUTHOR]

Objective: The evidence base for the use of space maintainers is relatively sparce despite being used for decades after the premature loss of primary molars. This study aims to increase the dental evidence base via investigating retrospectively the success rates of prefabricated fixed and removable space maintainers inserted from 2019 to 2021 and followed up until February 2023 at a specialized university clinic and to identify reasons for any reported minor and major failure. The authors hypothesized that there is no significant difference in failure rates between fixed and removable space maintainers inserted after the premature loss of a single primary molar per quadrant. Method and materials: Patients' digital records were searched yielding 645 space maintainers. After the application of inclusion criteria, 157 (67%) fixed prefabricated space maintainers in 112 children and 77 (33%) removable space maintainers in 61 children were analyzed for an average of 18.4 ± 9.5 months. Results: Kaplan-Meier survival analysis with Mantel-Cox statistics showed an overall cumulative survival time of 31.6 months (SE = 1.15, 95% CI = 29.4 to 33.9). Major failure occurred significantly more in removable maintainers (n = 40/67, 59.7%), mostly due to loss of the appliance, compared to fixed space maintainers (n = 27/67, 40.3%; P < .001). The present study indicates that space maintainers were mainly placed in young children with high caries experience, where treatment was mostly possible using advanced behavior management. Conclusions: Fixed space maintainers had a significantly lower failure rate than their removable counterpart. However, both require continual repairs, preservation, or even replacement till the eruption of the permanent tooth. [ABSTRACT FROM AUTHOR]

Context: Among many unanticipated changes, access to rehabilitation was disrupted during the onset of the COVID-19 pandemic. It is unclear how the timing of late-stage rehabilitation following anterior cruciate ligament with surgical reconstruction (ACLR) during the initial months of the pandemic affected outcomes. The purpose of this study was to compare physical performance outcome measures in patients following ACLR prior to and following COVID-19-related restrictions. Design: Retrospective cohort study. Methods: Data from patients who underwent return-to-sport testing following ACLR were analyzed based on date. December 2018 through March of 2020 (n = 66) was defined as the baseline period, and June through October 2020 (n = 27) was defined as the surveillance period. Outcome measures included single leg hop, triple hop, single leg vertical jump, and the lower-extremity functional test (LEFT). Linear mixed models were used to compare outcome measures before and after the onset of pandemic-related restrictions, clustered by sex and sport. A 1-way analysis of variance was performed to analyze the association between the number of virtual rehabilitation visits and outcome measures for subjects in the surveillance period. Results: Subjects in the surveillance period performed significantly worse in the LEFT (+7.88 s; 95% confidence interval, 1.11 to 14.66; P =.02) and single leg vertical jump on the unaffected side (−4.32 cm; 95% confidence interval, −7.44 to −1.19, P <.01), and performed better with single leg vertical jump symmetry (+6.3%; 95% confidence interval, 1.0% to 11.5%; P =.02). There were no other statistically significant differences. There was no significant association between having virtual rehabilitation visits and any of the performance outcomes. Conclusions: There was a decline in physical performance outcome measures in patients following ACLR who did not attend regular in-person physical therapy sessions in the late-stage rehabilitation due to COVID-19-related restrictions. Other factors during this unique time period, such as access to training facilities or psychosocial stressors, may have also influenced outcomes. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively determine the cumulative survival rate (CSR) and marginal bone level change (ΔMBL) around novel hybrid design tissue-level (TL) dental implants that support multiple-screw-retained restorations. Materials and Methods: Implant CSRs were analyzed at the implant and patient level using Kaplan-Meier estimates. ΔMBL was measured by comparing the periapical loading and follow-up visit radiographs using an improved standardized digital methodology based on image gray levels. ΔMBL outcomes were subject to linear mixed regression to identify potential risk factors. Results: A total of 301 TL implants in 69 patients with an average age of 62.6 ± 11.7 years (range: 36 to 87 years) at the time of implant placement were considered for the analysis. All 301 implants were successfully restored and loaded. The 54-month CSRs at the implant and patient levels were 98.9% (95% CI: 96.7 to 99.6) and 95.3% (95% CI: 86.1 to 98.5), respectively. ΔMBL after a mean follow-up of 22 ± 10.7 months after loading was 0.00 ± 0.57 mm. None of the implant sites showed marginal bone loss exceeding 1.5 mm. Multivariate regression analysis revealed a significant association between ΔMBL and the loading protocol (P = .027) but not between ΔMBL and age or transgingival height. Conclusions: The high CSRs and stable peri-implant marginal bone levels support the use of recent TL implants, which have a hybrid design inherited from the bone-level implant-abutment connection, as a suitable treatment option for restoring partially or fully edentulous patients with a good mid-term prognosis. These results should be complemented by further prospective studies in a real-world multicenter private practice setup that represents the daily realities of implant treatment. [ABSTRACT FROM AUTHOR]

Background: Weakness of the shoulder girdle muscles has been reported in patients with chronic lateral elbow tendinopathy. The aim of this study was to assess the short- and long-term effects of a conventional treatment plus scapular exercises program in patients with chronic lateral elbow tendinopathy. Methods: A single-group prestudy and poststudy were conducted. The primary outcome was the Patient-Rated Tennis Elbow Evaluation questionnaire score. Secondary outcomes were grip strength; Disabilities of the Arm, Shoulder, and Hand questionnaire score; Visual Analogue Scale score at rest and at grip, and presence of scapular dyskinesis. Results: A total of 65 patients (72.3% females), with a mean age of 41.8 years, were analyzed. At the end of 6 weeks, the results showed clinically and statistically significant differences (P< .05). At 1-year follow-up, the differences were: Patient-Rated Tennis Elbow Evaluation -31 points (P<.001); grip strength +33.6% (P<.001); Disabilities of the Arm, Shoulder, and Hand -34.2 points (P < .001); Visual Analogue Scale at rest -2.5 cm (P < .001); and Visual Analogue Scale at grip -2.3 cm (P < .001). Conclusion: At the end of 6 weeks and at 1-year follow-up, conventional treatment plus scapular exercises program showed statistically and clinically significant differences in all functional outcomes assessed in patients with lateral elbow tendinopathy. [ABSTRACT FROM AUTHOR]

Purpose: To determine the accuracy of dental implant placement using haptic robotic guidance in a large clinical series. Materials and Methods: In a prospective single-arm clinical study, 108 patients received 273 individual endosteal implants. A virtual preoperative restorative and surgical plan was created from a CBCT scan and matched to the surgical workspace on the day of surgery via either a tooth-based or bone-based fiducial splint. Intraoperatively, the surgeon manipulated a handpiece attached to a haptic robotic guidance arm. A variety of drills and implants were used. Both the osteotomy and the implant placement were guided by 3D haptic constraints according to the virtual plan. Postoperative CBCT scans permitted the calculation of the actual implant placement deviations compared to the plan for accuracy. Precision was calculated by comparing SDs from published literature. Results: The implants were evenly distributed by arch, with 47% placed in the maxilla and 53% in the mandible. The mean ± SD signed depth deviation was 0.14 ± 0.87 mm proud. The global angular deviation averaged 1.42 ± 1.53 degrees, with 95% confidence limits of 1.24 and 1.60 degrees. The crown of the actual placed implant showed an average deviation from the plan of 1.10 ± 0.69 mm and the apex of the placed implant showed a deviation of 1.12 ± 0.69 mm. Haptic robotic guidance showed greater precision than freehand, static computer-guided, and dynamic computer-guided implant placement. Conclusions: This large clinical series of 273 implants shows a high accuracy of implant placement compared to the published accuracy for angular deviations for any technology, as well as demonstrating statistically greater precision. Long-term clinical studies are necessary to establish the true effect of increased accuracy on clinical outcomes. Using haptic robotic guidance provides accurate implant placement while allowing additional benefits compared to computer-guided surgery, namely full visualization of the surgical field and the ability to change the plan intraoperatively. [ABSTRACT FROM AUTHOR]

Minimally invasive nonsurgical treatment (MINST) aims to remove an etiology with minimal damage to the healthy periodontium and provide the ideal healing environment. This case series introduces the novel protocol of laser-assisted MINST (LAMINST), combining minimally invasive surgery with a dental laser. A total of 25 patients (32 teeth) with advanced periodontal disease were enrolled and received periodontal treatment by following the LAMINST protocol. Probing depth (PD), recession, clinical attachment level (CAL), bleeding on probing (BOP), plaque presence, and site mobility were evaluated preoperatively and at 6 months. Based on the periodontal evaluations, all cases were diagnosed as stage III grade C periodontitis. Six months after LAMINST, the average PD reduction was 4.44 mm and CAL improved by 4.38 mm. Baseline mobility scores of 1 (6 teeth), 2 (9 teeth), and 3 (3 teeth) decreased to 1 (5 teeth) or 0 (13 teeth). The initial prognoses of 5 (hopeless; 15 teeth), 4 (questionable; 13 teeth), and 3 (poor; 4 teeth), improved to 4 (5 teeth), 3 (12 teeth), 2 (fair; 13 teeth), and 1 (good; 2 teeth). The number of BOP sites reduced from 179 to 12, and the number of plaque sites reduced from 173 to 9. All clinical parameters were improved after LAMINST. The application of LAMINST may overcome the traditional limitations of nonsurgical treatment, such as poor accessibility. [ABSTRACT FROM AUTHOR]

This study compared the onset of vascular bleeding between osseodensification and conventional drilling of implant osteotomy sites. Patients with type III trabecular bone requiring a single missing tooth replacement were included and allocated to either Group A (test) or Group B (control). In Group A, the osseodensification group (OD), an implant osteotomy was carried out using Densah Burs (Versah) in the counterclockwise direction; in Group B, the standard drilling group (SD), Densah Burs were run in the clockwise direction. An endoscope was introduced into the osteotomy to visualize and measure the time taken for initiation of bleeding (Bl) and for blood to fill the osteotomy site (BF). A total of 40 osteotomy sites (23 in the maxilla and 17 in the mandible) were included in this cross-sectional study. The mean age of study participants was 50.1 ± 8.28 years. The mean Bl time for Groups A and B was 18.54 ± 2.48 seconds and 16.89 ± 1.92 seconds, respectively (P = .02); the mean BF time for Groups A and B was 41.92 ± 3.19 seconds and 37.95 ± 2.73 seconds, respectively (P < .001). Osseodensification does not seem to negatively affect or induce loss of bone vascularity. Clinicians should note that osseodensified sites might take slightly longer to fill with blood following an osteotomy. [ABSTRACT FROM AUTHOR]

Purpose: Quantifying training intensity provides a comprehensive understanding of the training stimulus. Recent technological advances may have improved the feasibility of using heart-rate (HR) monitoring in swimming. However, the implementation of HR monitoring is yet to be assessed longitudinally in the daily training environment of swimmers. This study aimed to assess the implementation of HR by comparing the training-intensity distribution from an external measure, planned volume at set intensities (PVSI), with the internal training-intensity distribution measured using time in HR zones. Methods: Using a longitudinal observational design, 10 competitive swimmers (8 male and 2 female, age: 22.0 [2.3] y, Fédération Internationale de Natation point score: 842.9 [58.5], mean [SD]) were monitored daily for 6 months. Each session, HR data, and coached-planned and athlete-reported session rating of perceived exertion (Modified Category Ratio 10 scale) were recorded. Based on previously determined training zones from an incremental step test, PVSI was calculated using the planned distance and planned intensity of each swim bout. Training-intensity distributions were analyzed using a linear mixed model (lme4). Results: The model revealed a small to moderate relationship between PVSI and time in HR zone, based on the Nakagawa R-squared value (range.14–.42). Conclusions: Training-intensity distribution differed between the internal measure (ie, HR) and the external measure of intensity (ie, PVSI). This demonstrates that internal and planned external measures of intensity cannot be used interchangeably to monitor training. Further research should explore how to best integrate these measures to better understand training in swimming. [ABSTRACT FROM AUTHOR]

Children and adolescents with cerebral palsy (CP) show a reduced physical activity (PA) level compared with their typically developed peers. This study aimed to identify potential predictors of objectively evaluated habitual PA using data from a national clinical registry—the Cerebral Palsy Follow-Up Program (CPFP)—and proxy-reported questionnaires. Data from the CPFP database showed that female sex was associated with a lower PA level. Additional questionnaire data revealed age, popliteal angle limitation, Pediatric Outcomes Data Collection Instrument–Sports and Physical Functioning Scale score, screen time, Functional Mobility Scale score at 50 m, and fatigue as predictors. The proposed models can be used for the prediction and early detection of the PA level and consequently for the potential improvement among ambulant/semiambulant individuals with CP. Further research should investigate the predictive impact of personal, social, and environmental factors on the PA level and the gap in PA levels between girls and boys. [ABSTRACT FROM AUTHOR]

Purpose: The record power profile (RPP) has gained popularity as a method of monitoring endurance cycling performance. However, the expected variation of cyclists' performance between seasons remains unknown. We aimed to assess the between-seasons variability of peak performance (assessed through the RPP) in male professional cyclists. Methods: The study followed a longitudinal observational design. Sixty-one male professional cyclists (age 26 [5] y) with power output data from both training sessions and competitions were analyzed for a median of 4 consecutive seasons (range 2–12). The highest mean maximum power values attained for different durations (from 10 s to 30 min), as well as the resulting critical power, were determined for each season. Within-cyclist variability between seasons was assessed, and the upper threshold of expected changes (ie, twice the normal coefficient of variation) was determined. Results: All mean maximum power values showed an overall high agreement and low variability between seasons (intraclass correlation coefficient [ICC] =.76–.88 and coefficient of variation [CV] = 3.2%–5.9%), with the lowest variability observed for long efforts (>1 min). Critical power showed an ICC and CV of.79 (95% CI,.70–.85) and 3.3% (95% CI, 3.0%–3.7%), respectively. Upper thresholds of expected variation were <12% for short efforts (≤1 min) and <8% for long efforts. Conclusions: "Real-world" peak performance assessed through the RPP shows a low variability between seasons in male professional cyclists—especially for long efforts—with expected variation being around 6% and 3% for short (≤1 min) and long efforts, respectively, and with changes >12% and >8%, respectively, being infrequent for these effort durations. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effects of a sleep hygiene strategy on parameters of sleep quality and quantity in youth elite rugby union players. Method: Eleven male players (age: 19.0 [1.4] y) undertook a sleep hygiene strategy composed of 2 theoretical sessions and 3 practical sessions over a 4-week period. Sleeping time, time in bed, total sleep time, sleep latency (SL), sleep efficiency (SE), wake after sleep onset, and wake bouts were recorded with an actigraphic device during the 4-week sleep hygiene strategy (baseline) and during 4 weeks after the last intervention (postintervention). Results: At baseline, the overall group reported poor sleep quantity (total sleep time = 6:27 [0:30] min), but sleep quality was considered acceptable (SL = 0:18 [0:08] min and SE = 77.8% [5.8%]). Postintervention, the overall group showed a small improvement in SL (d = −0.23 [−0.42 to −0.04], P =.003) and SE (d = 0.30 [0.03 to 0.57], P =.0004). For individual responses, sleeping time, time in bed, and total sleep time were positively influenced in only 4, 3, and 5 players, respectively. For parameters of sleep quality, SL and SE were positively influenced in a majority of players (n = 7 and 8, respectively). The magnitude of difference between baseline and postintervention was strongly associated with baseline values in SE (r = −.86; P =.0005) and wake after sleep onset (r = −.87; P =.0007). Conclusion: A sleep hygiene strategy is efficient to improve sleep quality but not sleep quantity in young rugby union players. The strategy was more efficient in players with lower initial sleep quality and should be implemented prior to a high cumulative fatigue period. [ABSTRACT FROM AUTHOR]

Context: Early physical activity (PA) after concussion may promote symptom resolution. Prior studies have investigated exercise frequency/duration, yet precise PA intensity or volume required for optimal recovery requires further investigation. moderate to vigorous physical activity (MVPA) is beneficial for physical health. We investigated whether sedentary time, light activity time, MVPA time, or activity frequency in the weeks following concussion are associated with time to symptom resolution among adolescents. Design: Prospective cohort study. Methods: Adolescents 10–18 years of age were tested ≤14 days of concussion and followed until symptom resolution. At the initial visit, participants rated symptom severity and were provided wrist-worn activity trackers to monitor PA for the following week. PA behavior was categorized each day based on heart rate: sedentary (resting), light PA (50%–69% age-predicted max heart rate), and MVPA (70%–100% age-predicted max heart rate). Symptom resolution was defined as the date when participants reported cessation of concussion-like symptoms. Patients were not given specific PA instructions, though some may have received instructions from their physician. Results: Fifty-four participants were included in the study (54% female; mean age = 15.0 [1.8] y; initially assessed 7.5 [3.2] d after concussion). Female athletes recorded more sedentary time (900 [46] vs 738 [185] min/d; P =.01; Cohen d = 0.72), and less time in light PA (194.7 [64.5] vs 224 [55] min/d; P =.08; Cohen d = 0.48) and MVPA (23 [17] vs 38 [31] min/d; P =.04; Cohen d = 0.58) than male athletes. After adjusting for sedentary time, hours per day with >250 steps, sex, and initial symptom severity, more MVPA time was associated with faster symptom resolution time (hazard ratio = 1.016; 95% confidence interval, 1.001–1.032; P =.04). Conclusion: Our findings offer preliminary insight into how varying PA intensities affect concussion recovery, as MVPA may be a higher intensity than what is typically prescribed in concussion care. [ABSTRACT FROM AUTHOR]

Context: Early identification of incoming military personnel at elevated odds for bone stress injury (BSI) is important for the health and readiness of the US military. Design: Prospective cohort study. Methods: Knee kinematic data of the incoming US Military Academy cadets were collected while performing a jump-landing task (The Landing Error Scoring System) using a markerless motion capture system and depth camera. Data on incidence of lower-extremity injury, including BSI, were collected throughout the study period. Results: A total of 1905 participants (452 females, 23.7%) were examined for knee valgus and BSI status. A total of 50 BSI occurred during the study period (incidence proportion = 2.6%). The unadjusted odds ratio for BSI at initial contact was 1.03 (95% confidence interval [CI], 0.94–1.14; P =.49). Adjusted for sex, the odds ratio for BSI at initial contact was 0.97 (95% CI, 0.87–1.06; P =.47). At the instant of maximum knee-flexion angle, the unadjusted odds ratio was 1.06 (95% CI, 1.02–1.10; P =.01), and the odds ratio was 1.02 (95% CI, 0.98–1.07; P =.29) after adjusting for sex. This suggests that there was not a significant enough association for an increase in the odds of BSI based on either degree of knee valgus. Conclusions: Our results did not demonstrate an association between knee valgus angle data during a jump-landing task and future increased odds of BSI in a military training population. Further analysis is warranted, but the results suggests the association between kinematics and BSI cannot be effectively screened by knee valgus angle data in isolation. [ABSTRACT FROM AUTHOR]

Purpose: To assess the survival rate (SR) and probability of postoperative complications at both the implant and patient level for each of the four surgical techniques for zygomatic implant (ZI) placement: Brånemark, sinus slot, extrasinus, and extramaxillary. Materials and Methods: A systematic literature review and meta-analysis of clinical studies that reported the survival rate and postoperative ZI complications for the rehabilitation of atrophic edentulous maxillae was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. Two independent reviewers consulted four databases during the literature search: MEDLINE (PubMed), Google Scholar, Clinicaltrials.gov, and LILACS. Duplicate articles were eliminated. Results: A total of 35 studies were included in the metaanalysis. Subgroup analysis showed that study design (prospective vs retrospective) had no significant impact (P = .10) on the outcomes. The SR was highest for the Brånemark and extrasinus techniques (100%) and lowest for the sinus slot technique (94%; 95% CI = 86% to 102%). The extramaxillary (38%; 95% CI = 1% to 3%) and the Brånemark (29%; 95% CI = 15% to 44%) techniques resulted in the highest occurrence of patient-level complications. Moreover, the extramaxillary technique showed the highest percentage of prothesis-related complications (44%; 95% CI = 27% to 62%). Conclusions: ZI placement was demonstrated to be a reliable technique for the rehabilitation of severely atrophic maxillae, irrespective of the surgical technique evaluated. Accurate case and surgical protocol selection is of paramount importance to reduce technique-related postoperative complications. [ABSTRACT FROM AUTHOR]

Context: The University of Wisconsin Running Injury and Recovery Index (UWRI) was developed to evaluate the key elements that runners use to self-assess their own running ability following common running-related injuries. The aim of this study was to translate and culturally adapt the UWRI and to evaluate the psychometric properties of its Turkish version (UWRI-Tr) in runners. Design: Prospective cohort study. Methods: The study included 129 runners. The UWRI-Tr, the Lower Extremity Functional Scale, the Oswestry Disability Index, the Hip Outcome Score, the International Knee Documentation Committee Subjective Knee Evaluation Form, and the Foot and Ankle Ability Measure were applied for the validation purposes. Internal consistency, reliability, construct validity, and discriminant validity of the UWRI-Tr were tested. Results: The test–retest reliability of the UWRI-Tr was excellent with an intraclass correlation coefficient of.85 and a Cronbach α value of.84. There was a small to strong correlation among the UWRI-Tr and Lower Extremity Functional Scale (r =.278), Oswestry Disability Index (r = −.744), Hip Outcome Score (r =.684), The International Knee Documentation Committee Subjective Knee Evaluation Form (r =.758), and Foot and Ankle Ability Measure (r =.498 and.767), indicating that its construct validity was appropriate for use with Turkish runners. Conclusions: The UWRI-Tr was shown to be a valid and reliable tool to use in clinical and research settings as a sport-specific measurement tool. [ABSTRACT FROM AUTHOR]

Context: Aberrant movement patterns among individuals with concussion history have been reported during sport-related movement. However, the acute postconcussion kinematic and kinetic biomechanical movement patterns during a rapid acceleration–deceleration task have not been profiled and leaves their progressive trajectory unknown. Our study aimed to examine single-leg hop stabilization kinematics and kinetics between concussed and healthy-matched controls acutely (≤7 d) and when asymptomatic (≤72 h of symptom resolution). Design: Prospective, cohort laboratory study. Methods: Ten concussed (60% male; 19.2 [0.9] y; 178.7 [14.0] cm; 71.3 [18.0] kg) and 10 matched controls (60% male; 19.5 [1.2] y; 176.1 [12.6] cm; 71.0 [17.0] kg) completed the single-leg hop stabilization task under single and dual task (subtracting by 6's or 7's) at both time points. Participants stood on a 30-cm tall box set 50% of their height behind force plates while in an athletic stance. A synchronized light was illuminated randomly, queuing participants to initiate the movement as rapidly as possible. Participants then jumped forward, landed on their nondominant leg, and were instructed to reach and maintain stabilization as fast as possible upon ground contact. We used 2 (group) × 2 (time) mixed-model analyses of variance to compare single-leg hop stabilization outcomes separately during single and dual task. Results: We observed a significant main group effect for single-task ankle plantarflexion moment, with greater normalized torque (mean difference = 0.03 N·m/body weight; P =.048, g = 1.18) for concussed individuals across time points. A significant interaction effect for single-task reaction time indicated that concussed individuals had slower performance acutely relative to asymptomatic (mean difference = 0.09 s; P =.015, g = 0.64), while control group performance was stable. No other main or interaction effects for single-leg hop stabilization task metrics were present during single and dual task (P ≥.051). Conclusions: Greater ankle plantarflexion torque coupled with slower reaction time may indicate stiff, conservative single-leg hop stabilization performance acutely following concussion. Our findings shed preliminary light on the recovery trajectories of biomechanical alterations following concussion and provide specific kinematic and kinetic focal points for future research. [ABSTRACT FROM AUTHOR]

While vertical guided bone regeneration (vGBR) is a popular technique for treating alveolar bone deficiency, there are no long-term studies analyzing the longevity of the results and the success of this approach. This retrospective study analyzes the clinical and radiographic outcomes of oxidized implants placed after vGBR with a follow-up period of 4 to 15 years. The study considers 41 vGBR patients who received one or more rough-surface implants between 2001 and 2013 (115 implants total). Clinical and radiographic outcomes were recorded during follow-up visits. A multiple logistic regression model was used to analyze the correlation between peri-implantitis and demographic, surgical, and clinical variables, as well as the length of the follow-up period. The cumulative survival rate of the implants over the mean follow-up period of 9.6 ± 3.4 years was 95.7%, with peri-implantitis observed in 26.1% of the implant sites. The variables that correlated with the occurrence of peri-implantitis were smoking (OR: 8.5, 95% CI: 1.6-44.5, P < .01), posterior mandible implant position (OR: 2.1, 95% CI: 1.2-3.9, P < .01), and the length of the follow-up period (OR: 1.5, 95% CI: 1.1-2.2, P < .01). Along with previous long-term follow-up studies, these results suggest that oxidized-surface implants carry higher risk for peri-implantitis than machined-surface implants. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the relationship between physical activity (PA) levels and short-term changes in skeletal muscle characteristics in patients with subacute hemiparetic stroke. Materials and Methods: This prospective observational study included 76 patients with stroke who received inpatient care in a convalescent rehabilitation ward. The PA level was measured as the duration of daily total PA (≥ 1.5 metabolic equivalents) using a triaxial accelerometer for 7 days after admission. The outcomes were changes in the quadriceps muscle quality and quantity on the affected and unaffected sides, as assessed by ultrasonography at admission and 1 month after admission. Results: Multiple regression analysis indicated that the duration of total PA was significantly associated with a percentage change in quadriceps muscle quality (p = 0.011) and quantity (p = 0.012) on the affected side. However, no significant relationship was observed between the muscle quality and quantity on the unaffected side. Conclusions: The results revealed that PA was associated with changes in the quadriceps muscle quality and quantity on the affected side in patients with subacute hemiparetic stroke. These findings highlight the importance of promoting PA in stroke rehabilitation to improve muscle properties and functional outcomes. IMPLICATIONS FOR REHABILITATION: Improving skeletal muscle quality and quantity is an important goal in post-stroke rehabilitation. We investigated physical activity and post-stroke changes in muscle properties. Physical activity is related to changes in muscle quantity and quality on the affected side. Promoting physical activity is essential for improving muscle quantity and quality on the affected side. [ABSTRACT FROM AUTHOR]

Objective The primary objective was to determine if vaginal progesterone following cerclage for cervical length <10 mm or cervical dilation in patients without a history of spontaneous preterm birth (sPTB) decreased the risk of preterm birth at <34 weeks' gestation compared with cerclage alone. Secondary objectives were to determine if vaginal progesterone following cerclage (1) decreased the risk of preterm birth at <24, <28, and <37 weeks' gestation and (2) increased the latency period from cerclage placement to delivery compared with treatment with cerclage alone. Study Design Multicenter retrospective cohort study from 2015 to 2020 of singleton pregnancies, without prior sPTB, who had cerclage placement <24 weeks' gestation for cervical length <10 mm or cervical dilation. Exposure defined as cerclage plus vaginal progesterone postoperatively (dual therapy) and unexposed as cerclage alone (monotherapy), based on surgeon preference. Results We included 122 patients, 78 (64%) treated with dual therapy and 44 (36%) treated with monotherapy. In the crude analysis, dual therapy was associated with a lower risk of delivery at <28 weeks' gestation (13%) compared with monotherapy (34%; crude risk ratio: 0.38 [95% confidence interval (CI): 0.19–0.75]). When adjusted for preoperative vaginal progesterone, results were attenuated (adjusted risk ratio: 0.45 [95% CI: 0.20–1.01]). In both the crude and adjusted analyses, the risk of sPTB was not statistically different at <24, <34 or <37 weeks' gestation. Dual therapy was associated with a greater pregnancy latency from cerclage to delivery (16.3 vs. 14.4 weeks; p = 0.04), and greater gestational age at delivery (37.3 vs. 35.8 weeks' gestation; p = 0.02) compared with monotherapy. Conclusion While not statistically significant, the risk of sPTB was lower at all gestational ages studied in patients treated with dual therapy compared with monotherapy. Dual therapy was associated with longer pregnancy latency and greater gestational age at delivery compared with monotherapy. Key Points Dual therapy did not decrease preterm birth risk compared with monotherapy. Dual therapy prolonged pregnancy compared with monotherapy. Dual therapy can be considered but further studies are needed. [ABSTRACT FROM AUTHOR]

Background: This study assessed the cost-effectiveness of proton beam therapy (PBT) compared to conventional radiotherapy (CRT) for treating patients with brain tumors in Sweden. Methods: Data from a longitudinal non-randomized study performed between 2015 and 2020 was used, and included adult patients with brain tumors, followed during treatment and through a one-year follow-up. Clinical and demographic data were sourced from the longitudinal study and linked to Swedish national registers to get information on healthcare resource use. A cost-utility framework was used to evaluate the cost-effectiveness of PBT vs. CRT. Patients in PBT group (n = 310) were matched with patients in CRT group (n = 40) on relevant observables using propensity score matching with replacement. Costs were estimated from a healthcare perspective and included costs related to inpatient and specialized outpatient care, and prescribed medications. The health outcome was quality-adjusted life-years (QALYs), derived from the EORTC-QLQ-C30. Generalized linear models (GLM) and two-part models were used to estimate differences in costs and QALYs. Results: PBT yielded higher total costs, 14,639 US$, than CRT, 13,308 US$, with a difference of 1,372 US$ (95% CI, -4,914–7,659) over a 58 weeks' time horizon. Further, PBT resulted in non-significantly lower QALYs, 0.746 compared to CRT, 0.774, with a difference of -0.049 (95% CI, -0.195–0.097). The probability of PBT being cost-effective was < 30% at any willingness to pay. Conclusions: These results suggest that PBT cannot be considered a cost-effective treatment for brain tumours, compared to CRT. Trial registration: Not applicable. Novelty and Impact: This study informs on the cost-effectiveness of proton beam therapy (PBT) versus conventional radiotherapy (CRT) for patients with brain tumors in Sweden. Amidst global concerns regarding the cost-effectiveness of PBT, our investigation fills a notable gap by providing evidence from the Swedish healthcare landscape. Using real-world data, our study demonstrates the application of established health economic methodology to compare PBT and CRT for brain tumors, furthering research in this area. [ABSTRACT FROM AUTHOR]

Background: In spinal surgery adverse events (AE) and surgical complications (SC) significantly affect patient's outcome and quality of life. The duration of surgery has been investigated in different surgical field as risk factor for complications. The aim of this study is to analyze the correlation between operative time and adverse events in spinal surgery. Methods: We retrospectively analyzed data collected prospectively in a cohort of 336 patients surgically treated for spinal diseases of oncological and degenerative origin in a single center, between January 2017 to January 2018. Demographics and clinical data were collected. Adverse events were classified using Spinal Adverse Events Severity System version 2 (SAVES-V2) capture system. Focusing on degenerative patients, bivariate analysis and univariate logistic regression were used to determine the association between operative time and complications. Results: A total of 105/336 patients experienced an AE related to surgery, respectively 38% in the oncological group and 28% in the degenerative group. The average age at surgery was 60.3 years (SD 17.1) and the mean operative time was 164.8 ± 138 min. A total of 206 adverse events (30 intraoperative, 135 early postoperative and 41 late postoperative AEs) were recorded. Early post-operative complications accounted for the most recorded AEs (55.5% in the oncological group and 73.2% in the degenerative group). Univariate logistic regression analyses confirmed that operative time correlated with increased risk of intra-operative (p-value = 0.0008), early post-operative (p-value < 0.001) and late post-operative (p-value < 0.001) adverse events. Conclusions: This study highlights the strong correlation between the occurrence of adverse events in spinal surgery and prolonged operative time and suggests that efforts should be made to minimize the duration of surgical procedures while prioritizing patient's safety, without compromising the technical achievement of the procedure. [ABSTRACT FROM AUTHOR]

Introduction. Disease recurrence in patients with the early hormone receptor‐positive (HR+), human epidermal growth factor receptor 2‐negative (HER2−) breast tumor subtype is particularly challenging to manage due to its complex and very heterogeneous biological nature. Namely, due to primary and secondary resistance, one‐quarter of patients with early‐stage disease will experience disease recurrence. This variability in the timing of recurrence highlights the need to better identify key biomarkers that could predict therapeutic outcomes and guide personalized treatment strategies for these patients. Mutations in the phosphatidylinositol 4,5‐bisphosphate 3‐kinase catalytic subunit alpha (PIK3CA) gene are highly prevalent (30–40%) in HR+/HER2− advanced breast cancer. They lead to activation of the PI3K/AKT/mTOR pathway, promoting cell growth, and proliferation, and are associated with poor prognosis in advanced breast cancer. Our aim was to examine the association between and impact of PIK3CA mutation status on disease‐free survival (DFS) in HR+/HER2− early breast cancer patients. Methods. This cohort study was multicentric and retrospective in nature and was conducted at five Croatian institutions from July 2020 to December 2021. The study included initially early and locally advanced operable HR+/HER2− breast cancer patients who were diagnosed with disease recurrence during adjuvant hormonal treatment or within the first six years of follow‐up. Results. A total of 186 patients were included, 40.9% of whom tested positive for the PIK3CA mutation. Primary and adjuvant treatment, particularly adjuvant endocrine treatment, were similar between the two groups. After adjustment for 14 relevant covariates, we found that patients with a positive PIK3CA status and the H1047 PIK3CA mutation had a significantly lower hazard of disease recurrence than patients with no PIK3CA mutation (HR 0.65; 95% CI 0.45; 0.95; p = 0.024; false discovery rate, FDR <10%). Conclusions. This study highlights the potential impact of PIK3CA mutations on disease recurrence during or following adjuvant endocrine therapy and potentially opens the door for further investigation of possibly more personalized treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Altered meal timing patterns can disrupt the circadian system and affect metabolism. Our aim was to describe sex-specific chrono-nutritional patterns, assess their association with body mass index (BMI) and investigate the role of sleep in this relationship. Methods: We used the 2018 questionnaire data from the population-based Genomes for Life (GCAT) (n = 7074) cohort of adults aged 40–65 in Catalonia, Spain, for cross-sectional analysis and its follow-up questionnaire data in 2023 (n = 3128) for longitudinal analysis. We conducted multivariate linear regressions to explore the association between mutually adjusted meal-timing variables (time of first meal, number of eating occasions, nighttime fasting duration) and BMI, accounting for sleep duration and quality, and additional relevant confounders including adherence to a Mediterranean diet. Finally, cluster analysis was performed to identify chrono-nutritional patterns, separately for men and women, and sociodemographic and lifestyle characteristics were compared across clusters and analyzed for associations with BMI. Results: In the cross-sectional analysis, a later time of first meal (β 1 h increase = 0.32, 95% CI 0.18, 0.47) and more eating occasions (only in women, β 1 more eating occasion = 0.25, 95% CI 0.00, 0.51) were associated with a higher BMI, while longer nighttime fasting duration with a lower BMI (β 1 h increase=-0.27, 95% CI -0.41, -0.13). These associations were particularly evident in premenopausal women. Longitudinal analyses corroborated the associations with time of first meal and nighttime fasting duration, particularly in men. Finally, we obtained 3 sex-specific clusters, that mostly differed in number of eating occasions and time of first meal. Clusters defined by a late first meal displayed lower education and higher unemployment in men, as well as higher BMI for both sexes. A clear "breakfast skipping" pattern was identified only in the smallest cluster in men. Conclusions: In a population-based cohort of adults in Catalonia, we found that a later time of first meal was associated with higher BMI, while longer nighttime fasting duration associated with a lower BMI, both in cross-sectional and longitudinal analyses. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory distress syndrome (ARDS) occurring in patients with hematological malignancies (HM) is a life-threatening condition with specific features. Mortality rate remains high but improvement has been described over the past several years. We aimed to describe characteristics and outcomes of ARDS in HM patients admitted in French ICUs (Intensive Care Units) during a one year-period. Data for this nationwide cohort study were collected from the French national hospital database (Programme de Médicalisation des Systèmes d'Information (PMSI)). All patients (18 years or older) admitted to French ICUs in 2017 and with a diagnosis of ARDS were included. Three groups were compared according to the presence of an HM, a solid cancer or no cancer. The primary endpoint was 90-day mortality. Secondary endpoints were the description of ICU management, etiologies of ARDS and mortality risk factors. Results: A total of 12 846 patients with ARDS were included. Among them, 990 had HM and 2744 had a solid cancer. The main malignancies were non-Hodgkin lymphoma (NHL) (28.5%), acute myeloid leukemia (AML) (20.4%) and multiple myeloma (19.7%). Day-90 mortality in patients with HM was higher than in patients with no cancer (64.4% vs. 46.6% p = 0.01) but was not different from that of patients with solid cancer (64.4% vs. 61.4%,p = 0.09). Intubation rate was lower in patients with HM in comparison with both groups (87.7% vs. 90.4% p = 0.02 for patients with solid cancer and 87.7% vs. 91.3%; p < 0.01 with no cancer). Independent predictors of mortality for patients with HM were a diagnosis of lymphoma or acute leukemia, age, a high modified SAPS II score, a renal replacement therapy, invasive fungal infection, and a septic shock. Bacterial pneumonia, extrapulmonary infections and non-invasive ventilation were protective. Conclusion: Mortality remains high in patients with HM admitted in ICU with ARDS in comparison with patients without cancer. Mortality predictors for this population were a diagnosis of lymphoma or acute leukemia, age, a high modified SAPS II score, a renal replacement therapy, invasive fungal infection and a septic shock. [ABSTRACT FROM AUTHOR]

Background: Accurate assessment of basal bone width is essential for distinguishing individuals with normal occlusion from patients with maxillary transverse deficiency who may require maxillary expansion. Herein, we evaluated the effectiveness of a deep learning (DL) model in measuring landmarks of basal bone width and assessed the consistency of automated measurements compared to manual measurements. Methods: Based on the U-Net algorithm, a coarse-to-fine DL model was developed and trained using 80 cone-beam computed tomography (CBCT) images. The model's prediction capabilities were validated on 10 CBCT scans and tested on an additional 34. To evaluate the performance of the DL model, its measurements were compared with those taken manually by one junior orthodontist using the concordance correlation coefficient (CCC). Results: It took approximately 1.5 s for the DL model to perform the measurement task in only CBCT images. This framework showed a mean radial error of 1.22 ± 1.93 mm and achieved successful detection rates of 71.34%, 81.37%, 86.77%, and 91.18% in the 2.0-, 2.5-, 3.0-, and 4.0-mm ranges, respectively. The CCCs (95% confidence interval) of the maxillary basal bone width and mandibular basal bone width distance between the DL model and manual measurement for the 34 cases were 0.96 (0.94–0.97) and 0.98 (0.97–0.99), respectively. Conclusion: The novel DL framework developed in this study improved the diagnostic accuracy of the individual assessment of maxillary width. These results emphasize the potential applicability of this framework as a computer-aided diagnostic tool in orthodontic practice. [ABSTRACT FROM AUTHOR]

Background: Hypertension affects approximately 1 in 2 adults in the US. Home blood pressure (BP) monitoring programs are effective in the diagnosis and management of hypertension. Free clinics serve as an integral safety net for millions of uninsured and economically disadvantaged patients in the US. The feasibility and effects of a free home BP monitoring and follow-up program in a free clinic setting is not well characterized. Methods: This was a prospective study of the implementation of a pilot BP monitoring and follow-up program between March 2021 and August 2023 at 2 free clinics in the San Francisco Bay Area. A total of 78 hypertensive patients were enrolled in the program and given a free BP monitor. We surveyed via telephone the change in systolic and diastolic BPs and BP monitor use and comfort at 3 weeks. Volunteers in clinic roles involved in the BP monitoring program were surveyed to assess their time spent and perceptions of the program. Results: Of the 78 patients, 37 provided responses to the 3-week survey. A total of 36 of 37 (97%) patients reported using their BP monitor. A total of 35 patients reported using it at least once a week (95%), with the majority reporting at least four uses a week (68%). A total of 36 patients (97%) planned on continuing to use their BP monitor. At 3 weeks, the mean systolic and diastolic BP changed by −6.40 mmHg (95% CI, −10.8 to −2.01 mmHg; P =.00577) and −2.72 mmHg (95% CI, −5.62 to 0.188 mmHg; P =.0657), respectively. The time commitment for this program ranged from 130 ± 51 min for program leaders to 16 ± 14 min per week for patient-facing roles. All volunteer roles (patient-facing, phone follow-up, program leaders) expressed that they had a clear understanding of their responsibilities in the program (median 4 on Likert scale, IQR 3-5). Conclusion: Home BP monitoring and follow-up is feasible to implement in free clinics, resulting in high rates of patient engagement among respondents. Our findings suggest that home BP monitoring and follow-up programs may be beneficial in vulnerable patient populations. [ABSTRACT FROM AUTHOR]

To better understand the impact of Long COVID on an individual, we explored changes in daily wearable data (step count, resting heart rate (RHR), and sleep quantity) for up to one year in individuals relative to their pre-infection baseline among 279 people with and 274 without long COVID. Participants with Long COVID, defined as symptoms lasting for 30 days or longer, following a SARS-CoV-2 infection had significantly different RHR and activity trajectories than those who did not report Long COVID and were also more likely to be women, younger, unvaccinated, and report more acute-phase (first 2 weeks) symptoms than those without Long COVID. Demographic, vaccine, and acute-phase sensor data differences could be used for early identification of individuals most likely to develop Long COVID complications and track objective evidence of the therapeutic efficacy of any interventions. Trial Registration: https://classic.clinicaltrials.gov/ct2/show/NCT04336020. [ABSTRACT FROM AUTHOR]

Background: Delayed neurocognitive recovery (dNCR) can result in unfavorable outcomes in elderly surgical patients. Physical activity (PA) has been shown to improve cognitive function, potentially by reducing systemic inflammatory responses. However, there is a lack of supportive data indicating whether PA has a protective effect against dNCR. Aims: To examine the correlation between dNCR and PA, and to further analyze if pro-inflammatory cytokines mediate this relationship. Methods: This study is a prospective nested case-control investigation of elderly patients who had knee replacement surgery. dNCR was defined as a decline in cognitive function compared with baseline by using a battery of neuropsychological tests. PA was assessed with the Physical Activity Scale for the Elderly (PASE). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentrations of IL-6, IL-1β, and TNF-α. Multivariable logistic regression analysis was conducted to assess the association between PA and dNCR. Mediation analysis was employed to evaluate whether pro-inflammatory cytokines mediate the relationship between them. Results: A cohort of 152 patients was included, resulting in an incidence rate of dNCR of 23.68%. PA was associated with dNCR after full adjustment [OR = 0.199, (95% CI, 0.061; 0.649), P = 0.007]. Mediation analysis showed that the IL-6 mediated the statistical association between PA and dNCR, with mediation proportions (%) of 77.68 (postoperative concentration of IL-6) or 27.58 (the absolute change in IL-6 before and after surgery). Conclusions: PA serves as a protective factor against dNCR, possibly through the reduction of pro-inflammatory cytokine concentrations. The Chinese Clinical Trail Registry: : www.http://chictr.org.cn, Registration No. ChiCTR2300070834, Registration date: April 24, 2023. [ABSTRACT FROM AUTHOR]

In pandemic mitigation, strategies such as social distancing and mask-wearing are vital to prevent disease resurgence. Yet, monitoring adherence is challenging, as individuals might be reluctant to share behavioral data with public health authorities. To address this challenge and demonstrate a framework for conducting observational research with sensitive data in a privacy-conscious manner, we employ a privacy-centric epidemiological study design: the federated cohort. This approach leverages recent computational advances to allow for distributed participants to contribute to a prospective, observational research study while maintaining full control of their data. We apply this strategy here to explore pandemic intervention adherence patterns. Participants (n = 3808) were enrolled in our federated cohort via the "Google Health Studies" mobile application. Participants completed weekly surveys and contributed empirically measured mobility data from their Android devices between November 2020 to August 2021. Using federated analytics, differential privacy, and secure aggregation, we analyzed data in five 6-week periods, encompassing the pre- and post-vaccination phases. Our results showed that participants largely utilized non-pharmaceutical intervention strategies until they were fully vaccinated against COVID-19, except for individuals without plans to become vaccinated. Furthermore, this project offers a blueprint for conducting a federated cohort study and engaging in privacy-preserving research during a public health emergency. [ABSTRACT FROM AUTHOR]

Physical activity or structured exercise is beneficial in a wide range of circumstances. Nevertheless, individual-level data on differential responses to various types of activity are not yet sufficient in scale, duration or level of annotation to understand the mechanisms of discrete outcomes nor to support personalized recommendations. The Apple Heart & Movement Study was designed to passively collect the dense physiologic data accessible on Apple Watch and iPhone from a large real-world cohort distributed across the US in order to address these knowledge gaps. [ABSTRACT FROM AUTHOR]

Background: Sleep problems are common in early childhood and may be affected by parental adverse childhood experiences (ACEs). However, few studies have examined the longitudinal effect of parental ACEs on offspring sleep problems and the underlying mechanism. This study examined parents' psychological distress and harsh discipline (psychological aggression and corporal punishment) as mediators in the longitudinal pathway from parental ACEs to offspring sleep problems. Methods: The participants included 617 3-year-old children (mean age of 43.13 months, SD = 3.82) and their parents (mean age of 33.24 years, SD = 4.01) from Wuhu, China. The participants completed an online questionnaire on ACEs, psychological distress, and demographic characteristics in September 2022 (Time 1). Parents completed another online questionnaire in September 2023 (Time 2) on harsh discipline and offspring sleep problems. A path model was used to examine the associations. Results: Parental ACEs did not directly predict offspring sleep problems. Psychological distress (β = 0.041, 95% CI [0.005, 0.111]) and harsh discipline in the form of psychological aggression (β = 0.019, 95% CI [0.006, 0.056]) separately mediated the relationship between parental ACEs and offspring sleep problems. Psychological distress and psychological aggression also played a serial mediating role in the association of parental ACEs with offspring sleep problems (β = 0.014, 95% CI [0.007, 0.038]). Conclusions: Our findings showed the importance of psychological distress and psychological aggression in the intergenerational effect of trauma on offspring sleep problems. Specific interventions aimed at improving mental health and parenting practices should be provided for parents who were exposed to ACEs. [ABSTRACT FROM AUTHOR]

Objective: To examine primary care (PC) team members' characteristics associated with video use at the Veterans Health Administration (VA). Methods: VA electronic data were used to identify PC team characteristics associated with any video-based PC visit, during the three-year study period (3/15/2019-3/15/2022). Multilevel mixed-effects logistic regression models on repeated yearly observations were used, adjusting for patient- and healthcare system-level characteristics, and study year. We included five PC team categories: 1.PC providers (PCP), which includes physicians, nurse practitioners, physician assistants, 2.Nurses (RN/LVN/LPN/other nurses), 3.Mental health (MH) specialists, 4.Social workers (SW), and 5.Clinical pharmacists (PharmD). Population: 54,494 PC care team members nationwide (61,728,154 PC visits; 4,916,960 patients), including 14,422 PCPs, 30,273 nurses, 2,721 MH specialists, 4,065 SWs, and 3,013 PharmDs. Results: The mean age was 46.1(SD = 11.3) years; 77.1% were women. Percent of video use among PC team members varied from 24 to 84%. In fully adjusted models, older clinicians were more likely to use video compared to the youngest age group (18–29 years old) (example: 50–59 age group: OR = 1.12,95%CI:1.07–1.18). Women were more likely to use video (OR = 1.18, 95%CI:1.14–1.22) compared to men. MH specialists (OR = 7.87,95%CI:7.32–8.46), PharmDs (OR = 1.16,95%CI:1.09–1.25), and SWs (OR = 1.51,95%CI:1.41–1.61) were more likely, whereas nurses (OR = 0.65,95%CI:0.62–0.67) were less likely to use video compared to PCPs. Conclusions: This study highlights more video use among MH specialists, SWs, and PharmDs, and less video use among nurses compared to PCPs. Older and women clinicians, regardless of their role, used more video. This study helps to inform the care coordination of video-based delivery among interdisciplinary PC team members. [ABSTRACT FROM AUTHOR]

Background. This study is to compare the time to pregnancy (TTP) between patients with endometriosis and nonendometriosis undergoing in vitro fertilisation (IVF).Material and Methods.This is an observational retrospective cohort study. We included 291 patients (53 with endometriosis and 238 without endometriosis) achieving biochemical pregnancy, whether singleton or multifetal (serum beta‐hCG >5 mIU/mL), between 1st January 2014 and 31st March 2020. We excluded patients with incomplete case notes and those declining participation. Time to pregnancy is the interval between the time when infertility was established to the date of confirmed biochemical pregnancy, expressed in months. Endometriosis diagnosis includes any form of endometriosis through surgical confirmation. A statistical analysis was done through the Mann–Whitney U test. Time to pregnancy was assessed through the Kaplan–Meier test. A p value <0.05 is considered statistically significant. Results. Endometriosis patients had a shorter infertility duration (4 years vs. 5 years, p = 0.024). Both groups had similar median age and body mass index at presentation. There was no significant difference in the TTP between endometriosis and nonendometriosis groups (57.7 vs. 70.9 months, p = 0.060), further confirmed by a Cox regression test incorporating confounders (IVF protocol (OR: 1.482, 95% CI 0.667–3.292, and p = 0.334) and type of the cycle (OR 1.071, 95% CI 0.803–1.430, and p = 0.640)). The endometriosis group reached the maximum cumulative pregnancy rate at around 169 months postinfertility diagnosis, whilst the nonendometriosis group at around 255 months postinfertility diagnosis. Conclusion. Time to pregnancy between endometriosis and nonendometriosis is not significantly different. However, infertility among patients with endometriosis tends to be shorter. [ABSTRACT FROM AUTHOR]

Background: The onset of the COVID-19 pandemic drove a rapid and widespread shift to virtual care, followed by a gradual return to in-person visits. Virtual visits may offer more convenient access to care for some, but others may experience challenges accessing care virtually, and some medical needs must be met in-person. Experiences of the shift to virtual care and benefits of in-person care may vary by immigration experience (immigration status and duration), official language level, and age. We examined use of virtual care and return to in-person visits in the Canadian province of British Columbia (BC), comparing patterns by age and across immigration groups, including length of time in Canada and language level (official languages English and French) at time of arrival. Methods: We used linked administrative health and immigration data to examine total primary care visits (virtual or in-person) and return to in-person visits during the COVID-19 pandemic (2019/20–2021/2) in BC. We examined the proportion of people with any primary care visits and with any in-person visits within each year as measures of access to primary care. We estimated the odds of any primary care visits and any in-person visits by immigration group and official language level assessed prior to arrival: non-immigrants, long-term immigrants, recent immigrants (< 5 years) with high assessed official language level and recent immigrants (< 5 years) with low assessed official language level (assessed prior to arrival), stratified by age. Results: In general, changes in access to primary care (odds of any visits and odds of any in-person visits) were similar across immigration groups over the study period. However, we observed substantial disparities in access to primary care by immigration group among people aged 60 + , particularly in recent immigrants with low official language level (0.42, 0.40–0.45). These disparities grew wider over the course of the pandemic. Conclusion: Though among younger adults changes in access to primary care between 2019–2021 were similar across immigration groups, we observed significant and growing inequities among older adults, with particularly limited access among adults who immigrated recently and with low assessed official language level. Targeted interventions to ensure acceptable, accessible care for older immigrants are needed. [ABSTRACT FROM AUTHOR]

Background: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by increased intracranial pressure. Whilst lumbar puncture (LP) is necessary for the diagnosis of IIH, its therapeutic effect remains unclear. Our aim was to evaluate the therapeutic effect of a single LP in people with IIH (pwIIH). Methods: In this prospective observational study, we analysed short-term neurological and ophthalmological outcomes in pwIIH before, one (D1) and seven days (D7) after the LP. The primary outcome was the change in papilledema degree from baseline. Secondary outcomes included visual outcomes, morphological changes in optical coherence tomography (peripapillary retinal nerve fibre layer [pRNFL] thickness and ganglion cell layer [GCL] volume) and transbulbar sonography (arachnoid optic nerve sheath diameter [AONSD]), and headache outcomes (peak and median headache severity and burden related to headache). Results: We included 30 pwIIH (mean age 32.8 years [SD 8.4], 93.3% female, median cerebrospinal fluid [CSF] opening pressure 33.0 cmCSF [IQR 26.9–35.3], median body mass index (BMI) 34.8 kg/m2 [IQR 30.9–40.9]). The median papilledema grading at baseline was 2 (Friedman DI (1999) Pseudotumor cerebri. Neurosurg Clin N Am 10(4):609–621 viii); (Mollan SP, Aguiar M, Evison F, Frew E, Sinclair AJ (2019) The expanding burden of idiopathic intracranial hypertension. Eye Lond Engl 33(3):478–485); (Ab D, Gt L, Nj V, Sl G, Ml M, Nj N et al. (2007) Profiles of obesity, weight gain, and quality of life in idiopathic intracranial hypertension (pseudotumor cerebri). Am J Ophthalmol [Internet]. Apr [cited 2024 Jun 2];143(4). https://pubmed.ncbi.nlm.nih.gov/17386271/) and was significantly reduced at D7 (2 [1–2], p = 0.011). Median pRNFL thickness had decreased significantly at D7 (-9 μm [-62.5, -1.3], p = 0.035), with pRNFL thickness at baseline being associated with the pRNFL change (F(1,11) = 18.79, p = 0.001). Mean AONSD had decreased significantly at both D1 (-0.74 mm [0.14], p < 0.001) and D7 (-0.65 mm [0.17], p = 0.01), with AONSD at baseline being associated with the change in AONSD at both time points (D1: β= -0.89, 95% CI -1.37, -0.42, p = 0.002; D7: β= -0.85, 95% CI -1.42, -0.28, p = 0.007). Peak headache severity was slightly lower at D7 (-1/10 [-3, 0], p = 0.026), whereas median headache severity and headache burden remained unchanged. Conclusions: This short-term follow-up study in pwIIH undergoing a single LP suggests a moderate effect on ophthalmological but not headache outcomes. The usefulness of LP as a therapeutic measure in IIH remains controversial and should likely be reserved for patients with limited treatment options, e.g., in pregnancy or intolerability to medication. [ABSTRACT FROM AUTHOR]

Background: The prevalence of heart failure is increasing owing to the aging of the population, resulting in growing medical costs and an increasing number of patients with multimorbidity. The optimal management of heart failure by general physicians in addition to internal medicine physicians, such as cardiologists, is essential, although the specifics are unclear. In this study, we aimed to determine the differences in heart failure management outcomes among older patients between those managed by general physicians and those managed by internal medicine physicians, especially in terms of hospitalization and mortality rates. Methods: This was a retrospective cohort study of patients with heart failure who visited a community hospital in Japan. Patients with heart failure were selected based on International Classification of Diseases codes from electronic medical record data over 9 years, from September 2015 to August 2023. The independent variables were whether a general physician treated the patient; the primary outcome was death; the secondary outcome was hospitalization; and the covariates were patient background, including comorbidities. Multiple logistic regression analysis was used to evaluate the association between being managed by a general physician and death and hospitalization, after adjusting for confounding factors. Results: A total of 1032 patients with heart failure were identified, with a mean age of 82.4 years, and 48.9% were men. Patients treated by general physicians were older, were more likely to have dementia and were more likely to need care than those treated by internal medicine physicians. Being treated by a general physician was significantly negatively associated with death (odds ratio [OR], 0.62) and hospitalization (OR, 0.73). Conclusions: In Japan, where medical specialties are increasingly differentiated, the comprehensive management of older patients with heart failure and multiple comorbidities by general physicians may reduce hospitalization and mortality rates. Appropriate education of general physicians and an increase in their numbers may prove essential for the successful management of patients with heart failure in aging communities. [ABSTRACT FROM AUTHOR]

Background: The Ultra-Low Emission Zone (ULEZ), introduced in Central London in April 2019, aims to enhance air quality and improve public health. The Children's Health in London and Luton (CHILL) study evaluates the impact of the ULEZ on children's health. This analysis focuses on the one-year impacts on the shift towards active travel to school. Methods: CHILL is a prospective parallel cohort study of ethnically diverse children, aged 6–9 years attending 84 primary schools within or with catchment areas encompassing London's ULEZ (intervention) and Luton (non-intervention area). Baseline (2018/19) and one-year follow-up (2019/20) data were collected at school visits from 1992 (58%) children who reported their mode of travel to school 'today' (day of assessment). Multilevel logistic regressions were performed to analyse associations between the introduction of the ULEZ and the likelihood of switching from inactive to active travel modes, and vice-versa. Interactions between intervention group status and pre-specified effect modifiers were also explored. Results: Among children who took inactive modes at baseline, 42% of children in London and 20% of children in Luton switched to active modes. For children taking active modes at baseline, 5% of children in London and 21% of children in Luton switched to inactive modes. Relative to the children in Luton, children in London were more likely to have switched from inactive to active modes (OR 3.64, 95% CI 1.21–10.92). Children in the intervention group were also less likely to switch from active to inactive modes (OR 0.11, 0.05–0.24). Moderator analyses showed that children living further from school were more likely to switch from inactive to active modes (OR 6.06,1.87–19.68) compared to those living closer (OR 1.43, 0.27–7.54). Conclusions: Implementation of clean air zones can increase uptake of active travel to school and was particularly associated with more sustainable and active travel in children living further from school. [ABSTRACT FROM AUTHOR]

Introduction/objectives: Primary health care visits post-discharge could potentially play an important role in efforts of reducing hospital readmission. Focusing on a single or a particular type of visit obscures nuances in types of primary care contacts over time and fails to quantify the intensity of primary health care visits during the follow-up period. The aim of this study was to explore associations between the number and type of primary health care visits post-discharge and the risk of hospital readmission within 30 days. Methods: A register-based closed cohort study. The study population of 6135 individuals were residents of Stockholm who were discharged home from any of the 3 geriatric inpatient departments, excluding those who were readmitted within the next 24 h. The dependent variable was hospital readmission within 30 days of discharge. The key independent variable was the number and type of primary health care visits in 30 days post-discharge. Cox-regression with time-varying covariates was employed for data analyses. Results: Approximately, 12% of the participants were readmitted to hospital within 30 days. There was no statistically significant association between number of primary care visits post-discharge and readmission (HR 1.00; 95% CI 1.00-1.01). Compared to no primary health care visit, no statistically significant association were found for administrative care related visits (HR 0.33, 95%CI 0.08-1.33), clinic visits (HR 0.93, 95%CI 0.71-1.21), home visits (HR 1.03, 95%CI 0.84-1.27), or team visits (HR 0.76, 95%CI 0.54-1.07). Conclusions: There were no associations between primary health care visits post-discharge and hospital readmission after geriatric inpatient care. Further studies using survey or qualitative approaches can provide insights into the factors that are relevant to post-discharge care but are unavailable in this type of register data studies. [ABSTRACT FROM AUTHOR]

Background: Lacunes, a characteristic feature of cerebral small vessel disease (CSVD), are critical public health concerns, especially in the aging population. Traditional neuroimaging techniques often fall short in early lacune detection, prompting the need for more precise predictive models. Methods: In this retrospective study, 587 patients from the Neurology Department of the Affiliated Hospital of Hebei University who underwent cranial MRI were assessed. A nomogram for predicting lacune incidence was developed using LASSO regression and binary logistic regression analysis for variable selection. The nomogram's performance was quantitatively assessed using AUC-ROC, calibration plots, and decision curve analysis (DCA) in both training (n = 412) and testing (n = 175) cohorts. Results: Independent predictors identified included age, gender, history of stroke, carotid atherosclerosis, hypertension, creatinine, and homocysteine levels. The nomogram showed an AUC-ROC of 0.814 (95% CI: 0.791-0.870) for the training set and 0.805 (95% CI: 0.782-0.843) for the testing set. Calibration and DCA corroborated the model's clinical value. Conclusion: This study introduces a clinically useful nomogram, derived from binary logistic regression, that significantly enhances the prediction of lacunes in patients undergoing brain MRI for various indications, potentially advancing early diagnosis and intervention. While promising, its retrospective design and single-center context are limitations that warrant further research, including multi-center validation. [ABSTRACT FROM AUTHOR]

Background: The oral health of refugees and asylum seekers is understudied. However, oral health has important implications for overall health and wellbeing. This study addresses this gap by characterizing oral health care utilization in Médecins du Monde (MdM) clinics across mainland Greece from 2016 – 2017. Methods: A retrospective cross-sectional study design was used to estimate proportional morbidities for caries, extraction, developmental, periodontal disease, preventive, and other oral health outcomes. The association between physical health conditions and consultations of interest – upper respiratory tract infections (URTIs) and reproductive health consultations – and oral health were compared using odds ratios (OR) and 95% confidence intervals (CIs). Oral health outcomes between Afghans and Syrians were compared using odds ratios and 95% CIs. Results: Caries (39.44%) and extractions (28.99%) were highly prevalent in our study population. The utilization of preventive dental consultations (37.10%) was high, particularly among males. Individuals with at least one upper respiratory tract infection (OR = 1.52; 95% CI: 1.30 – 1.77; Or = 1.90; 95% CI: 1.53 – 2.36) and women and girls with reproductive health consultations (OR = 1.30; 95% CI: 1.03 – 1.66; OR = 2.03; 95% CI: 1.49 – 2.76) were more likely to have any dental or caries specific consultations. The observed patterns in oral health needs differed between Afghans and Syrians, with Afghans more likely to have preventive screenings and less likely to have caries, extractions, or other conditions. Conclusions: Displaced populations utilizing MdM dental clinics had high levels of oral health needs, particularly for caries and extractions. The connection between oral and overall health was seen in the study population, and these findings reinforce the public health importance of oral health for improving health and wellbeing of displaced populations. Evidence-informed policy, practice, and programming inclusive of oral health are needed to address both oral and overall health of refugees and asylum seekers in Greece. Future research should investigate not only oral health care needs but also knowledge and beliefs that inform utilization patterns among displaced populations. [ABSTRACT FROM AUTHOR]

Background: Patients with gastric cancer (GC) who underwent radical surgery require long-term follow-up (usually 5 years). The purpose of this study was to explore individualized follow-up strategies for patients with GC. Methods: This is a retrospective cohort study that established a clinicopathologic database of patients who underwent gastrectomy from January 2010 to December 2020 at Ningbo No. 2 Hospital. Follow-up was performed until March 2023. The rate of new-onset recurrence of patients with GC was explored annually according to different pTNM stages, defining a recurrence rate of less than 1% as adequate follow-up time. Results: Of the 1606 patients who were eligible, the total number of patients who completed the 5- and 10-year follow-up was 1107 and 586, respectively. A total of 444 cases were diagnosed with recurrence. The recurrence rate for stage IA patients was consistently less than 1% during the follow-up time. The adequate follow-up time (the rate of new-onset recurrence less than 1%) was 5 years for stage IB and IIA patients, and 8 years for stage IIB and IIIA patients, respectively. In contrast, stage IIIB patients were always at risk of recurrence during the follow-up time (>1%). Time to a new recurrence rate for stage IIIC patients was 6 years. Conclusion: Among patients who underwent radical gastrectomy, the rate of new-onset recurrence varied among patients with different pTNM stages. This study suggests that the follow-up of GC can be individualized and refer to pTNM stage. [ABSTRACT FROM AUTHOR]