This study investigated whether umbilical subcutaneous fat thickness (USFT), measured opportunistically on abdominal computed tomography (CT) images obtained for clinical indications, was associated with perioperative obstructive sleep apnea (OSA) risk assessed using the STOP-BANG questionnaire. In this cross-sectional observational study, 64 adult participants completed the STOP-BANG questionnaire, and USFT was measured on existing abdominal CT images using a standardized protocol. Associations between USFT and continuous variables were assessed using Spearman correlation, while comparisons across STOP-BANG risk categories were performed using the Kruskal-Wallis test. Exploratory logistic regression was used to assess the association between USFT and high STOP-BANG risk after adjustment for age. No significant correlation was observed between USFT and STOP-BANG score (ρ = 0.142, p = 0.264), and USFT did not differ significantly across STOP-BANG risk categories (p = 0.677). USFT was significantly higher among participants reporting snoring (p = 0.026) and showed positive correlations with body mass index (BMI; ρ = 0.663, p < 0.001) and neck circumference (ρ = 0.544, p < 0.001). USFT was not significantly associated with high STOP-BANG risk after adjustment for age. Overall, CT-measured USFT was not associated with STOP-BANG-based OSA risk in this study. Larger studies incorporating polysomnography (PSG)-confirmed OSA and adequately powered multivariable analyses are needed to determine the potential role of CT-derived adiposity measures in perioperative OSA risk assessment.

In older patients with fall-related injuries, chest computed tomography (CT) can detect acute rib fractures after chest radiography (CXR) showed no evidence of acute fracture. We evaluated clinical factors associated with CT-reported acute rib fracture within this clinician-selected imaging pathway. In this single-center retrospective observational study, we included patients aged ≥65 years who presented to the emergency department after a slip or fall between February 2021 and January 2024 and underwent same-visit chest CT after initial CXR without a definite, possible, or suspected acute rib fracture. The primary multivariable logistic model included age category (65-74, 75-84, or ≥85 years), male sex, fall from an elevated surface, non-alert mental status, head trauma, and localized chest wall pain. Covariates were entered simultaneously without automated selection, and all 739 patients were included. Sensitivity analyses examined alternative age specifications, sparse focal findings, and selectively ordered laboratory testing. Among 739 patients, 224 (30.3%) had a CT-reported acute rib fracture. Relative to ages 65 to 74 years, adjusted odds ratios (aORs) were 2.236 (95% confidence interval [CI], 1.443-3.465) for ages 75 to 84 years and 8.391 (95% CI, 4.354-16.172) for ages ≥85 years. Male sex (aOR, 1.791; 95% CI, 1.187-2.701), fall from an elevated surface (aOR, 2.415; 95% CI, 1.561-3.734), non-alert mental status (aOR, 1.891; 95% CI, 1.017-3.514), and localized chest wall pain (aOR, 11.541; 95% CI, 7.584-17.562) were also associated with acute rib fracture. Head trauma was not significantly associated with acute rib fracture. A 3-knot restricted cubic spline sensitivity analysis showed no evidence of departure from a linear age effect (P = .875); the estimate for non-alert mental status was attenuated when age was modeled continuously (P = .068). Within this clinician-selected CT pathway, older age, male sex, fall from an elevated surface, and localized chest wall pain were associated with CT-reported acute rib fracture after adjustment in the primary full-cohort model; the association with non-alert mental status was less stable across age specifications. These findings do not define a CT decision rule or support routine CT after negative CXR.

Background: Sarcopenia, systemic inflammation, and malnutrition are established poor prognostic factors in renal cell carcinoma (RCC). This study investigated the utility of a novel preoperative score combining psoas muscle density (PMD)-an imaging-based indicator of muscle quality-and the albumin-bilirubin (ALBI) grade-a blood-based biomarker of liver reserve and systemic nutritional status-for predicting disease-free survival (DFS) and overall survival (OS) in patients undergoing curative surgery for RCC. Methods: This retrospective observational study included 274 patients with non-metastatic RCC treated with radical or partial nephrectomy. Preoperative computed tomography was utilized to measure PMD, defining "low PMD" as a value below the sex-specific median (males: 47.75 Hounsfield Units [HU]; females: 46.25 HU). "Worsened ALBI" was defined as an ALBI grade ≥ 2. Patients were stratified into three risk categories: Score 0 (both normal, n = 122), Score 1 (either abnormal, n = 114), and Score 2 (both abnormal, n = 38). Results: Kaplan-Meier analysis revealed a highly significant, stepwise decline in both DFS and OS as the risk score increased (log-rank p < 0.001 and p = 0.004, respectively). Multivariate Cox regression identified the combined risk score as a robust, independent prognostic factor for DFS (Score 1: HR 1.93, 95% CI 1.11-3.37, p = 0.020; Score 2: HR 3.58, 95% CI 1.82-7.02, p < 0.001). Furthermore, after adjusting for age and comorbidities, the score remained an independent predictor of poor OS (Score 1: HR 2.35, 95% CI 1.08-5.13, p = 0.032; Score 2: HR 3.01, 95% CI 1.16-7.82, p = 0.024). The combined model synergistically enhanced risk stratification accuracy compared to evaluating either factor independently. Conclusions: The concurrent presence of preoperative low PMD and a worsened ALBI grade is a powerful, independent predictor of poor prognosis in localized RCC. Derived solely from routine preoperative imaging and laboratory tests, this straightforward scoring system effectively captures the structural and immunometabolic dimensions of cancer cachexia and host vulnerability. This tool can significantly aid in personalizing postoperative surveillance strategies and identifying high-risk patients who may warrant closer postoperative surveillance or who might be considered as high-risk candidates for adjuvant therapy discussions.

We report early toxicity outcomes after institutional implementation of prostate SBRT using 42.7 Gy in seven fractions delivered with either MR-guided adaptive SBRT (MRgSBRT) or CT-guided non-adaptive SBRT (CTgSBRT). Between July 2019 and May 2023, 216 patients received this regimen. Genitourinary (GU) and gastrointestinal (GI) toxicities were retrospectively assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. Most patients had intermediate-risk disease (86%), and 14% had high-risk disease. Median prostate volume was 40 mL, and median baseline International Prostate Symptom Score (IPSS) was 8 among patients with available data. MRgSBRT and CTgSBRT were used in 100 (46%) and 116 (54%) patients, respectively. At a median follow-up of 19 months, 12- and 24-month grade ≥ 2 GU toxicity rates were 20.0% and 18.2%, while grade ≥ 2 GI toxicity rates were 3.5% and 3.6%, respectively. No statistically significant platform-related differences were detected; however, these comparisons were exploratory and potentially confounded by nonrandomized platform selection, treatment era, rectal-spacer use, adaptive workflow and differing PTV margins. On univariable analysis, baseline GU symptoms were associated with higher 12-month grade ≥ 2 GU toxicity (OR, 3.68; 95% CI, 1.52-10.37; p = 0.007), while prostate-volume category was not significantly associated with this endpoint.

Faggian, S, Lei, LW, Ghezzo, E, Bucciol, M, Airale, M, Del Giudice, M, Breban, SG, Bozzato, M, Costa, I, Cutti, AG, Petrone, N, and Marcolin, G. The flying phase in sprint runners: Exploring biomechanical factors associated with performance. J Strength Cond Res XX(X): 000-000, 2026-Biomechanical parameters of sprint performance are intertwined, yet no single variable has been clearly linked to performance. Moreover, existing training guidelines largely rely on the practical experience of world-leading coaches. This study examined the contribution of biomechanical parameters used by high-level sprint coaches to flying-phase performance and season's best running time (SBRT). Eighteen male sprinters performed all-out 60-m sprints on a track instrumented with a 10-camera motion-capture system and 7 embedded force platforms. Parameters recorded between 30 and 50 m were grouped into 4 categories: temporal (swing and contact time), spatial (step and stride length, hip displacement), kinematic (sagittal absolute angle of thigh, shank, and ankle at maximum knee height; push angle at foot-off; support angle at midstance), and kinetic (horizontal -net, braking, and propulsive- and vertical impulses; peak vertical and horizontal forces). Flying time (FT) and SBRT were the dependent variables of stepwise multiple linear regression models. Stride length and horizontal hip displacement were the strongest determinants of SBRT (adjusted R2: 0.350, p < 0.05) while stride length of the FT (adjusted R2: 0.293, p < 0.05). Support angle solely contributed to SBRT (adjusted R2: 0.303, p < 0.05), whereas braking impulse and peak vertical force contributed as kinetic factors (adjusted R2: 0.609, p < 0.001). Only braking impulse was associated with FT (adjusted R2: 0.228, p < 0.05). Contact time and support angle correlated with peak vertical force (p < 0.05). Overall, kinetic variables outweigh kinematic and spatiotemporal parameters in explaining flying performance. When force platforms are unavailable, coaches may rely on stride length, contact time, and support angle.

Cremation is among the most destructive funerary practices. Over the past 30 years, radiographic imaging has increasingly been used to non-destructively extract information from cremation burials. Advances in scanners and imaging software have enhanced the quality of data retrievable through this method. However, scanning cremated remains, particularly when urned, presents challenges due to their fragility, size, material density overlaps, and the high cost of imaging equipment. These factors often result in low-quality images where distinguishing different materials becomes difficult and time-consuming. This exploratory research aims to provide and assess qualitative and quantitative information from tomographic images on burials' taphonomy, biological profiles (sex and age at death), Minimum Number of Individuals (MNI) and thermal alterations to the bones and to evaluate a relatively simple segmentation strategy to analyse the spatial distribution of the remains in the vessels. For this purpose, 10 non-micro-excavated urns from the Middle-Late Bronze Age necropolis of Vicofertile (Parma, Italy) were scanned using Computerised Tomography (CT), subsequently micro-excavated, and the remains analysed to compare the information obtained from the two approaches. When extracted, data about the age classes, burial taphonomy, and heat-induced changes to the bones (e.g., fractures) were confirmed by the physical analysis, while the MNI, hypothesised to be 10 from the scans, was increased by one. Sex estimation was not possible from the scans. The vertical and horizontal distribution of the remains was estimated for cranial, long, spongy bones, upper, lower limbs, and trunk elements, with the vertical cranial distribution being the most accurately predicted category. Overall, the physical analysis proved essential to refine the results of virtual analysis and deal with the drawbacks of low-quality images. Despite the limitations discussed here, this research presents the largest systematic comparison of tomographic imaging and physical analysis of urned cremations to date, highlighting both the potential and the current limitations of CT-based investigation.

Distal radius fractures are common fragility fractures in women, but exercise-related evidence has focused mainly on the hip and spine. This review and meta-analysis examined whether exercise improves upper-limb bone outcomes and whether exercise modality and intensity influence the response.