Background: Work-related musculoskeletal disorders (WRMSDs) remain a major cause of occupational disability and productivity loss worldwide. Traditional statistical methods have identified numerous associated factors; however, they often struggle to capture complex non-linear relationships and interactions across multiple domains of risk. Machine learning (ML) offers an alternative analytical approach for modelling such multidimensional relationships. Methods: Following the PRISMA 2020 guidelines (PROSPERO: CRD420250605234), literature searches were conducted in Web of Science, Scopus, and PubMed for studies published between 2020 and 2025. Eligible studies applied ML methods to identify factors associated with WRMSDs using cross-sectional study designs. Included studies were appraised using the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies. Results: Ten studies met the inclusion criteria, representing workers from healthcare, transport, manufacturing, and service sectors across Asia, Africa, and Europe. Frequently applied ML algorithms included random forest, support vector machine, and artificial neural networks, demonstrating strong internal discriminative performance (area under the receiver operating characteristic curve: 0.80–0.99), although the absence of external validation in several studies suggests a potential risk of overfitting. Commonly identified factors included age, sex, awkward posture, vibration exposure, prolonged working hours, stress, and burnout. Psychosocial factors, including post-traumatic stress disorder, job stress, and depression, were ranked among the most influential predictors within ML models. Conclusions ML models demonstrate strong capability in discriminating WRMSDs risk and identifying multidimensional risk factors compared with traditional statistical approaches. These models highlight complex interrelationships between ergonomic and psychosocial exposures. Future research should incorporate external validation, objective exposure measurements, and standardized ML reporting frameworks to enhance methodological transparency and generalizability.

Oropharyngeal Synovial Sarcoma: A Case Report Synovial sarcoma is a rare and aggressive type of sarcoma that develops from mesenchymal cells and accounts for around 8% to 10% of all cases of soft tissue sarcoma. The presence of synovial sarcoma in the head-and-neck region is characterised by aggressive behaviour and a generally unfavourable prognosis. Understanding the various manifestations of synovial sarcoma, particularly uncommon locations like the oropharynx, significantly improves patient outcomes by facilitating early diagnosis and prompt management. We report a case of a 57-year-old Malay woman who presented with a two-month history of sore throat and odynophagia, complicated with partial airway obstruction. She underwent endoscopic excision of the right oropharyngeal tumour via transoral approach, and the histopathological examination revealed monophasic synovial sarcoma. The surgical management, histopathological characteristics, and rarity of the disease are discussed.

Purpose: To report the factors affecting visual outcomes after small incision lenticule extraction (SMILE) in eyes treated with the Visumax 800. Methods: This is a retrospective study with cross-sectional design of eyes underwent SMILE Pro using Visumax 800 at Jakarta Eye Center. Patients ≤40 years old with a corrected distance visual acuity of >20 / 25, manifest refractive spherical equivalent ≤10.0 diopters (D), and cylinder refraction <5.0 D were included. Evaluation of visual outcomes was conducted at 1 day and 1 month postoperatively. Results: A total of 258 eyes from 132 patients were analyzed. Among the total, 94% achieved an uncorrected distance visual acuity (UDVA) of 20 / 20 at 1 month postoperatively. Of the eyes with high myopia, 81% achieved a UDVA of 20 / 20, followed by 97% and 99% in moderate and low myopic eyes, respectively. Spherical equivalent refraction (r = 0.273, p < 0.01), optic zone (OZ; r = 0.260, p < 0.01), cap thickness (r = 0.209, p < 0.01), and residual stromal thickness (RST; r = 0.256, p < 0.01) showed a significant but weak correlation with UDVA at 1 month postoperatively. There is increasing risk to get <20 / 20 UDVA in right eyes (odds ratio [OR], 3.101; p < 0.045), eyes with high myopia (OR, 9.964; p < 0.01), 100-μm cap thickness (OR, 4.578; p < 0.01), ≤6 mm OZ (OR, 10.556; p < 0.01), and <300-μm RST (OR, 9.100; p < 0.01) at 1 month postoperatively. Conclusions SMILE Pro results in promising visual outcome in early postoperative period. Patients with low to moderate myopia have better visual outcomes than those with high myopia. A small OZ, thin cap thickness, and low RST could increase the risk of not achieving the maximum visual outcome after SMILE. A prospective study with a longer follow-up period that includes comprehensive variables is needed to fully understand the factors affecting visual acuity after SMILE.

Purpose: This study was performed to investigate the pattern of condylar pressure distribution in the discs of a patient diagnosed with disc displacement without reduction. Materials and Methods: This research consisted of a pre- and post-test observational clinical study. A patient diagnosed with disc displacement without reduction underwent treatment with an occlusal splint for 3 months. Finite element analysis employed a 3-dimensional model constructed from magnetic resonance images of the patient, taken both before the application of the splint and 3 months after its use. Results: The post-test model demonstrated a decrease in condylar pressure on the disc, with measurements dropping to 72 MPa from the pre-test level of 143 MPa. In the pre-test, the pressure distribution pattern was concentrated on the lateral posterior border, whereas in the post-test, it shifted toward the intermediate zone of the disc. Conclusion Utilization of a stabilization splint for 3 months resulted in decreased pressure and a marked change in the pressure distribution pattern on the temporomandibular disc.

Background: Vitamin D may enhance immune system function and provide a protective effect against infections. Feto-maternal circulation plays an important role in supplying the developing fetus with nutrients and antibodies for its development and health during pregnancy and for its early years of life after birth. This meta-analysis aimed to determine the effectiveness of maternal vitamin D supplementation in preventing respiratory tract infections (RTIs) in children. Methods: We searched the Central and MEDLINE databases and went through all the reference lists in the related articles. We also searched for ongoing trials at http://www.who.int/ictrp/en/ and www.clinicaltrials.gov. Randomized controlled trials comparing vitamin D supplementation with a placebo or no treatment in pregnant women published in the English language up to March 2019 were included. Two reviewers extracted data independently using a predefined protocol and assessed the risk of bias using the Cochrane risk of bias tool, with differences agreed upon by consensus. The predefined primary outcome was the number of offspring who had RTIs. The secondary outcome was the presence of measurable serum immunoglobulin E levels. Results: Three trials involving 3,224 participants (mother–child pairs) met the inclusion criteria and were included in this review. The present analysis reported that maternal supplementation with vitamin D had no effect on RTIs among children (n=1,486 offspring; risk ratio, 0.95; 95% confidence interval, 0.82–1.11; random effects; I2 statistics, 0%). Conclusion Maternal vitamin D supplementation had no effect on RTIs in children. Therefore, consideration of other prevention methods in this regard is recommended.

Therapeutic dentin regeneration remains difficult to achieve, and a majority of the attention has been given to anabolic strategies to promote dentinogenesis directly, whereas, the available literature is insufficient to understand the role of inflammation and inflammatory complement system on dentinogenesis. The aim of this study is to determine the role of complement C5a receptor (C5aR) in regulating dental pulp stem cells (DPSCs) differentiation and in vivo dentin regeneration. Human DPSCs were subjected to odontogenic differentiation in osteogenic media treated with the C5aR agonist and C5aR antagonist. In vivo dentin formation was evaluated using the dentin injury/pulp-capping model of the C5a-deficient and wild-type mice. In vitro results demonstrate that C5aR inhibition caused a substantial reduction in odontogenic DPSCs differentiation markers such as DMP-1 and DSPP, while the C5aR activation increased these key odontogenic genes compared to control. A reparative dentin formation using the C5a-deficient mice shows that dentin regeneration is significantly reduced in the C5a-deficient mice. These data suggest a positive role of C5aR in the odontogenic DPSCs differentiation and tertiary/reparative dentin formation. This study addresses a novel regulatory pathway and a therapeutic approach for improving the efficiency of dentin regeneration in affected teeth.
Animals ; Cell Differentiation/physiology* ; Cells, Cultured ; Complement C5a/metabolism* ; Dental Pulp/physiology* ; Dentin ; Mice ; Receptor, Anaphylatoxin C5a ; Stem Cells

Foodborne disease is among the primary illness that causes morbidity and mortality in the world. Several studies show that most students do not have adequate food safety knowledge to protect themselves against foodborne diseases. This study aimed to determine the food safety knowledge, behaviour, and beliefs among undergraduate students at a local university in Malaysia. This cross-sectional study involves 121 respondents from three health science-related faculties at the studied institution. The questionnaire was distributed via an online platform. This study used multiple-choiceformat questions for Food Safety Knowledge and a Likert type scale for Food Safety Behaviour and Belief question statements. Most of the respondents were female (78%). About 16% of the respondents have experience working / volunteering in food services, and half of them are involved in food handling during their services. This study recorded a moderate score in all sections (knowledge, behaviour, beliefs) with a total percentage score of 60.3%, 60.3%, and 66.1%, respectively. A strong but not significant correlation between food safety knowledge and beliefs (r = 0.69 p > 0.05) and between food safety knowledge and behaviour (r = 0.83 p > 0.05) were observed. This study is useful as a basis to develop a targeted food safety education program among undergraduate students. Students with high knowledge of food safety will increase food safety beliefs and behaviour, thus preventing them from getting any foodborne illness.

OBJECTIVE: To examine the antiplatelet and antithrombotic activity of Rumex acetosella extract. METHODS: Standard light aggregometry was used for platelet aggregation, intracellular calcium mobilization assessed using Fura-2/AM, granule secretion (ATP release) by luminometer, and fibrinogen binding to integrin α_IIbβ₃ detected using flow cytometry. Western blotting is carried out to determine the phosphorylation of mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/Akt signaling. RESULTS: Rumex acetosella displayed the ability to inhibit platelet aggregation, calcium mobilization, granule secretion, and fibrinogen binding to integrin α_IIbβ₃. Rumex acetosella has also down-regulated MAPK and PI3K/Akt phosphorylation (all P<0.01). CONCLUSION Rumex acetosella extract exhibits antiplatelet activity via modulating GPVI signaling, and it may protect against the development of platelet-related cardiovascular diseases.
Blood Platelets/metabolism* ; Calcium/metabolism* ; Fibrinogen/metabolism* ; Mitogen-Activated Protein Kinases/metabolism* ; Phosphatidylinositol 3-Kinase/pharmacology* ; Phosphatidylinositol 3-Kinases/metabolism* ; Phosphorylation ; Plant Extracts/pharmacology* ; Platelet Aggregation ; Platelet Aggregation Inhibitors/pharmacology* ; Platelet Glycoprotein GPIIb-IIIa Complex/pharmacology* ; Proto-Oncogene Proteins c-akt/metabolism* ; Rumex/metabolism*

Purpose: This study was aimed to assess the feasibility of laparoscopic rectal surgery, comparing quality of surgical specimen, morbidity, and mortality. Methods: Prospectively acquired data from consecutive patients undergoing laparoscopic surgery for rectal cancer, at 2 minimally invasive colorectal units, operated by the same team was included. Locally advanced rectal tumors were identified as T3B or T4 with preoperative magnetic resonance imaging scans. All the patients were operated on by the same team. The 1:1 propensity score matching was performed to create a perfect match in terms of tumor height. Results: Total of 418 laparoscopic resections were performed, out of which 109 patients had locally advanced rectal cancer (LARC) and were propensity score matched with non-LARC (NLARC) patients. Median operation time was higher for the LARC group (270 minutes vs. 250 minutes, P=0.011). However, conversion to open surgery was done in 5 vs. 2 patients (P=0.445), reoperation in 8 vs. 7 (P=0.789), clinical anastomotic leak was found in 3 vs. 2 (P=0.670), and 30-day mortality rates was 2 vs. 1 (P>0.999) between LARC and NLARC, respectively. Readmission rate was higher in the NLARC group (33 patients vs. 19 patients, P=0.026), due to stoma-related issues. There was no statistically significant difference in the R0 resection between the 2 groups (99 patients in LARC vs. 104 patients in NLARC, P=0.284). Conclusion This study demonstrates that standardized approach to laparoscopy is safe and feasible in LARC. Comparable postoperative short-term clinical and pathological outcomes were seen between LARC and NLARC groups.

Objective: To evaluate the antioxidant potential and pancreatic lipase inhibitory action of optimized hydroethanolic extracts of Solanum nigrum. Methods: Optimized extraction for maximum recovery of metabolites was performed using a combination of freeze-drying and ultrasonication followed by determination of antioxidant and antiobesity properties. The ultra-high performance liquid chromatography equipped with mass spectrometry was used to analyze metabolite profiling of Solanum nigrum. Computational studies were performed using molecular docking and electrostatic potential analysis for individual compounds. The hypolipidemic potential of the most potent extract was assessed in the obese mice fed on fat rich diet. Results: The 80% hydroethanolic extract exhibited the highest extract yield, total phenolic contents, total flavonoid contents along with the strongest 2,2-diphenyl-1-picrylhydrazyl scavenging activity, total antioxidant power, and pancreatic lipase inhibitory properties. The 80% hydroethanolic extract not only regulated the lipid profile of obese mice but also restricted the weight gain in the liver, kidney, and heart. The 80% hydroethanolic extract also reduced alanine transaminase and aspartate transaminase concentrations in serum. The effects of plant extract at 300 mg/kg body weight were quite comparable with the standard drug orlistat. Conclusions: Solanum nigrum is proved as an excellent and potent source of secondary metabolites that might be responsible for obesity mitigation.