Prunings of the Suzygium cumini tree were used to produce activated carbon, which was used in a chemical dye adsorption experiment. The characterization analyses of the biomass revealed the following experimental data: moisture 6
Metabolic dysfunction-associated steatotic liver disease (MASLD) is strongly associated with type 2 diabetes (T2D) in adults; however, its epidemiology in the pediatric population remains unclear. We conducted a systematic review and meta-analysis to estimate the prevalence of MASLD among children and adolescents with T2D. We systematically searched PubMed and Embase databases from inception until March 18, 2025 to identify observational studies investigating the prevalence of MASLD (diagnosed by liver biopsy, imaging methods, or blood-based biomarkers) in children and adolescents (aged ≤ 21 years) with T2D. Data from eligible studies were extracted, and meta-analysis was performed using a generalized linear mixed model. This study was registered in PROSPERO (ID CRD420251013625). Eighteen unique studies with 3926 pediatric patients with T2D were included. The pooled prevalence of MASLD in pediatric T2D was 36.61
This study evaluated the diagnostic performance of large language models (LLMs)-ChatGPT 5.0 (OpenAI) and Gemini Flash 2.0 (Google Inc.)-in detecting periapical lesions on periapical radiographs using a standardized multimodal prompt. Seventy-five anonymized periapical radiographs of anterior teeth from the maxilla and mandible were analyzed, evenly distributed between cases with and without lesions. A calibrated endodontic specialist provided the reference diagnosis. Each image was independently assessed five times by both LLMs using the prompt: "Does this image show a periapical lesion? Answer 'Yes' or 'No'. If 'Yes', which tooth?". Balanced accuracy, sensitivity, specificity, and F1-score were calculated with 95% confidence intervals (CIs) obtained via bootstrap resampling. Performance was also stratified by diagnostic difficulty, and the models were compared using the exact McNemar test (α = 0.05). ChatGPT 5.0 showed higher overall performance than Gemini Flash 2.0, with sensitivity of 0.97 (95% CI: 0.95-0.99), specificity of 0.11 (95% CI: 0.07-0.16), and balanced accuracy of 0.54 (95% CI: 0.52-0.57). Gemini Flash 2.0 achieved sensitivity of 0.84 (95% CI: 0.79-0.89), specificity of 0.11 (95% CI: 0.07-0.16), and balanced accuracy of 0.48 (95% CI: 0.44-0.51). Both models showed high false-positive rates and frequent errors in tooth localization. The McNemar test confirmed a significant difference between models (p < 0.05), favoring ChatGPT 5.0. Both LLMs demonstrated high sensitivity but poor specificity, resulting in intermediate diagnostic performance and a bias toward positive classifications. General-purpose LLMs are therefore not yet suitable for radiographic diagnostic use.
Competency-based medical education (CBME) is widely adopted in numerous countries, but many programs struggle to translate its conceptual promises into routine educational and clinical practice. Entrustable Professional Activities (EPAs), a key mechanism to operationalize CBME, have been implemented in different ways with substantial variation across contexts. While implementation challenges are well described, the field lacks explanatory approaches to understand why such variation occurs and how it shapes practice. In this Show-and-Tell contribution we apply Normalization Process Theory (NPT), an implementation theory, to analyze how EPA-based curriculum reforms are taken up, enacted, and sustained across settings. We conducted a comparative, theory-informed analysis of implementation experiences from five regions (in Latin America, Asia, North America, Europe) drawing on materials from an international EPA symposium (Barcelona, 2025). Data sources include a pre-symposium survey, invited presentations, transcripts of plenary discussions, and follow-up reflections. Using NPT’s four core constructs (coherence, cognitive participation, collective action, and reflexive monitoring), we examined how stakeholders make sense of EPAs, engage with implementation, integrate practices into clinical routines, and adapt them over time. The analysis revealed recurring mechanisms shaping implementation across contexts. Challenges included conceptual ambiguity, variable engagement, workflow pressures, and misalignment with existing practices. At the same time, enabling conditions emerged across settings: clear communication of purpose, phased implementation strategies, coordinated faculty development, leadership support, and context-sensitive adaptation. By foregrounding implementation mechanisms rather than outcomes alone, NPT offers a transferable analytic lens to guide, evaluate, and refine curriculum reforms.
To evaluate the combination of composites, adhesive systems, and burs considering artificial accelerated aging (AAA), influence enamel roughness and morphology after attachment removal. One hundred ninety-two bovine enamel specimens were divided according to composite type (Transbond XT, flowable, bulk-fill flowable), adhesive system (Single Bond Universal or Transbond XT primer), and bur for attachment removal (multilaminated carbide or zirconia). Half of the samples were stored for 24 h at 37°C and the other half underwent 300 h of AAA. Surface roughness was measured using confocal laser scanning microscopy before and after attachment removal. Data were analyzed using three-way anova with Bonferroni post hoc tests. Significant differences in enamel roughness were observed according to composite type, adhesive system, and bur used. Multilaminated bur produced higher surface roughness compared to zirconia bur. Transbond composite, particularly when combined with orthodontic adhesive, exhibited greater enamel alteration after AAA. None of the protocols fully restored enamel surface to its original smoothness. Attachment removal inevitably alters enamel morphology, regardless of the materials used. Composite, adhesive, and bur's choice, as well as proper finishing and polishing, is essential to minimize enamel damage after clear aligner treatment.
