Introduction: One-lung ventilation (OLV) through a double-lumen tube is the conventional technique for thoracoscopic esophageal surgery, but it carries risks of hypoxemia, airway trauma and tube malposition. Two-lung ventilation through a single-lumen tube combined with controlled CO₂ insufflation (capnothorax) has been proposed as an alternative, particularly in the prone position. Case presentation: We describe three patients who underwent prone video-assisted thoracoscopic surgery (VATS) for esophageal lesions: a 17-year-old girl with an esophageal duplication cyst, a severely undernourished 60-year-old man (BMI 14.8 kg/m²) with esophageal carcinoma undergoing esophagectomy, and a 45-year-old woman with an esophageal gastrointestinal stromal tumor (GIST). All were managed with a single-lumen endotracheal tube, gravity-assisted lung displacement in the prone position, controlled CO₂ insufflation, and low-tidal-volume ventilation with permissive hypercapnia (maximum recorded end-tidal CO₂ 42–45 mmHg). Regional analgesia (erector spinae plane block or thoracic epidural) was used in two patients. Surgical exposure was adequate in all cases without conversion to OLV; no clinically significant desaturation or hemodynamic instability occurred, all patients were extubated in the operating room, and recovery was uneventful. Conclusion: In these selected patients, single-lumen ventilation with capnothorax was feasible for prone thoracoscopic esophageal surgery. Given the small, heterogeneous sample and exclusive use of the prone position, these observations are hypothesis-generating and do not establish the technique as an equivalent alternative to OLV; controlled studies, including in the lateral decubitus position, are needed.
Background: Anemia, cytopenias and deranged coagulation are common in decompensated liver disease, yet the platelet indices reported with every automated blood count are rarely used for risk assessment. Mean platelet volume (MPV) reflects platelet size and turnover and is available without extra cost. This study examined whether MPV is related to thrombocytopenia and coagulopathy in patients with decompensated liver disease. Methods: In this prospective observational study, 60 consecutive adults with decompensated chronic liver disease were enrolled in the Department of General Medicine of a tertiary teaching hospital in Chennai, India, between May 2024 and December 2025. Complete blood count with MPV, peripheral smear, liver and renal function tests, prothrombin time (PT), international normalized ratio (INR), fibrinogen and abdominal ultrasonography were recorded. Patients were grouped by MPV as <9, 9–11 and >11 fL. Categorical associations were tested with the chi-square test and the chi-square test for linear trend. Results: Men formed 70.0% of the cohort and alcohol was the leading cause (53.3%). Anemia was present in 46 (76.7%), thrombocytopenia in 40 (66.7%) and leukopenia in 22 (36.7%) patients; PT was prolonged in 34 (56.7%). Thrombocytopenia rose from 42.9% in the lowest MPV band to 68.8% and 85.7% in the middle and highest bands (p for trend = 0.017). Coagulopathy increased in the same direction (42.9%, 56.3% and 71.4%), though not significantly (p for trend = 0.130). Anemia was more frequent in patients with coagulopathy (88.2% vs 61.5%; p = 0.015). Conclusion: Higher MPV accompanied a greater frequency of thrombocytopenia in decompensated liver disease. MPV may help identify patients with more marked platelet abnormalities, but its prognostic value needs confirmation in larger outcome-based studies that include Child-Pugh and MELD scores.
Full mouth rehabilitation (FMR) is a complex prosthodontic procedure that aims to restore oral function, occlusal stability, aesthetics, and biological health in patients presenting with extensive tooth wear, multiple missing teeth, altered occlusal relationships, and compromised dentition. Occlusal adjustment is an important component of FMR because premature contacts, occlusal interferences, discrepancies in centric relation and maximum intercuspation, and inappropriate distribution of occlusal forces may compromise the longevity and function of definitive restorations. Conventional occlusal adjustment is largely dependent on clinical examination, articulating paper, shimstock, mounted diagnostic casts, intraoral evaluation, and the experience of the treating clinician. The integration of artificial intelligence (AI) into digital dentistry has introduced new possibilities for automated occlusal analysis and treatment planning. AI-based systems can process intraoral scans, digital articulations, occlusal contact maps, three-dimensional dental models, jaw-tracking information, and other digital records to identify potentially abnormal contacts and generate recommendations for occlusal adjustment. Recent evidence indicates that AI and digital occlusal technologies may improve efficiency and reproducibility; however, their reliability varies according to the data source, scanner, software, clinical situation, and complexity of the occlusal problem. This article discusses the principles of occlusion in full mouth rehabilitation, conventional methods of occlusal adjustment, digital occlusal analysis, applications of AI in occlusal assessment, AI-based occlusal adjustment recommendations, parameters used to assess reliability, clinician–AI agreement, advantages and limitations, and future perspectives. Particular emphasis is placed on the distinction between contact detection and clinical occlusal diagnosis, as these should not be considered equivalent. Current evidence suggests that AI-based recommendations may serve as a useful decision-support tool, but final occlusal adjustment should remain under clinician supervision.
Phishing and deceptive digital content combine URL obfuscation, impersonation, social engineering, and generated content. This paper reviews AI-based detection and presents a modular framework integrating URL, content, behavioral, explainability, and cyber-law intelligence. The framework connects technical threat evidence to candidate legal provisions, jurisdictional information, evidence requirements, and reporting guidance for human review. A reproducible validation protocol is specified for temporal drift, adversarial robustness, multilingual detection, computational efficiency, legal mapping, and human review. No experimental performance is claimed for the proposed integrated framework; the contribution is a structured architecture and an evaluation pathway that can be implemented and tested.
Background: Progranulin (PGRN) is a key regulator of inflammation, controlling tissue damage and various pathophysiological processes. Involved in biological functions from embryonic development to adult tissue maintenance and repair, PGRN presents many opportunities for further study. Tumor necrosis factor α (TNFα) signals through TNF receptors 1 (TNFR1) and 2 (TNFR2). TNFR1 is widely expressed and primarily initiates pro-inflammatory pathways via soluble TNF (sTNF). TNFR2 expression is sparse, mostly on regulatory T cells (Tregs), and its binding to membrane-bound TNF (mTNF) often starts immune regulation and tissue regeneration. Dental pulp is a vascular, innervated mesenchymal connective tissue encased in mineralized dentin. Its primary components are fibroblastic cells and a layer of odontoblasts that produce dentin. The pulp-dentin complex acts as a single unit, providing protective systems against environmental stimuli. Inflammation is the initial response to irritants, with tertiary dentin deposition occurring in response to injury, which can be reactionary or reparative depending on the extent of the disturbance. Material and Methods: Major databases such as Medline were explored detailed literature search in resulting in a systematic review pertaining to progranulin (PGRN) facilitates anti-inflammation and pulpitis repair in vivo and in vitro through TNFR2/14-3-3ε signalling complex. Results: Eight original research scientific articles dated between 2020 – 2024 pertaining to mentioned topic were highlighted. Conclusions: Progranulin (PGRN) influences numerous processes in health and disease. Its immune-regulating and growth factor qualities prevent excessive tissue damage while promoting tissue recovery. This makes PGRN a critical focus for studies in inflammatory diseases and regenerative medicine. Specifically, PGRN stimulates pulp tissue growth, osteogenic differentiation, and mineralization in both healthy and inflamed conditions. Detailed information regarding the is discussed progranulin (PGRN) facilitates anti-inflammation and pulpitis repair in vivo and in vitro through TNFR2/14-3-3ε signalling complex in this systematic review.
