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The 2025 AHA/ACC/AANP/AAPA/ABC/ACCP/ACPM/AGS/AMA/ASPC/NMA/PCNA/SGIM guideline for the prevention, detection, evaluation, and management of arterial hypertension introduces important updates compared with the 2017 version. Given the global impact of hypertension as a major cause of cardiovascular morbidity and mortality, and the coexistence of multiple international and national recommendations, the Mexican Expert Group on Arterial Hypertension (GREHTA) conducted a structured review and comparative analysis. We contrasted the 2025 AHA/ACC recommendations with those of the European Society of Hypertension (ESH 2023), the European Society of Cardiology (ESC 2024), the Latin American Society of Hypertension (LASH 2024), and the National Medical Care Protocol of Mexico (PRONAM 2025). Our goal is to provide clinicians with a clear, evidence-based synthesis to guide practical decision-making. Key topics include definitions and thresholds, diagnostic methods, cardiovascular risk stratification, therapeutic strategies, special populations, and resistant hypertension. GREHTA emphasizes a pragmatic, regionally adapted approach, highlighting early combination therapy, risk factor integration, and systematic follow-up.

Introduction: Forensic odontology is a specialized field at the crossroads of dentistry and law, focusing on the analysis of dental evidence in legal investigations. Due to their resistance to decay and environmental degradation, teeth serve as a vital resource in age estimation and gender determination. Various techniques, including microscopic examination of the incremental lines in enamel and cementum, neonatal lines, and dentin translucency, are commonly employed for forensic analysis. To enhance the accuracy and ease of examination, there is an increasing demand for high-quality, non-demineralized tooth sections that are durable, easy to handle, and maintain uniform thickness. Aims and objectives: 1. Evaluate the effectiveness of the Rosin stain in identifying incremental lines in hard dental tissues. 2. Compare Rosin stain with Haematoxylin and Eosin stain as well as with unstained sections. Materials and methods: Sixty sound teeth were included in the study. Thin longitudinal sections of 2 mm were prepared using a diamond disc, and ground sections of 25 µm were prepared on Arkansas stone. The sections were divided into three groups: (A) sections stained with Rosin, (B) sections stained with H&E, and (C) unstained sections. The longitudinal ground sections were examined under both the Light Microscope and the Phase Contrast Microscope. The Microstructures of the teeth, such as incremental lines of enamel, dentin, and cementum, were assessed.Result  and conclusion: Rosin-stained ground sections observed under phase contrast microscopy provided better visualisation of dental microstructures than unstained or H&E-stained ground sections, suggesting Rosin enhances the identification of incremental lines in forensic dental analysis.

Background: Employee performance appraisal is essential for improving healthcare service delivery through systematic staff evaluation. In the health sector, effective appraisals support decision-making and professional development.Objective: This study aims to map and categorize existing employee performance appraisal methods in the health system using a scoping review approach.Methods: This scoping review was conducted using the JBI 2024 protocol. Articles published up to December 2024 were identified through four databases: PubMed, Scopus, Web of Science, and Google Scholar. The keywords used were “Personnel appraisal,” “Health workers,” and “Health workforce.” The inclusion criteria focused on studies assessing employee appraisal methods in health systems.Results: Of the 1,245 articles initially identified, 18 met the inclusion criteria. Appraisal methods were classified into traditional and modern categories. Traditional methods included ranking, critical incidents, and graphic rating scales. Modern approaches involved 360-degree feedback, Management by Objectives (MBO), and Behaviorally Anchored Rating Scales (BARS).Conclusion: No single appraisal method suits all healthcare environments. A hybrid approach tailored to organizational context and job roles is recommended. Emphasis should be placed on objective evaluation, customization, and the degree of scientific connection between the evaluator and the evaluated person to improve performance outcomes.

Sagittal split osteotomy (SSO) of the mandible is still an important part of orthognathic surgery, but “bad split” fractures that happen during the surgery are still a big problem. This report describes a rare case of bilateral bad split associated with highly compact mandibular bone (D1–D2 type) in a 53-year-old male undergoing mandibular advancement. The bone was too hard for the piezoelectric and rotary tools to work, and there was very little bleeding. This caused fractures in the cortex and lingual. Postoperative computed tomography confirmed the presence of highly dense bone, correlated with delayed healing and recurrence. Consistent pre-surgical CT scanning for an assessment of the density of the mandibular bone can provide essential information about the potential risk of the osteotomy procedure in the patient. Performing a careful bone quality and density examination pre-operatively will allow the surgeons to select the most appropriate instruments and surgical techniques that will fit the patient’s individual anatomy. Such a point escalates to being very significant when dealing with the geriatric population, as bone density increase can not only alter the fracture behavior but also the recovery process during and after surgery. The inclusion of regular CT-based bone density evaluations into the preoperative routine not only facilitates the anticipation of surgical difficulties but also results in safer and more efficient osteotomies.

Medical postgraduate trainees are given increasing levels of responsibility during training in the apprenticeship-model of training [1-3]. Responsibility is said to be a key driver of deep learning and understanding [4-7]. Trainees with greater levels of responsibility for decision making have higher levels of motivation to learn compared with trainees who self-assess as having less autonomy [5]. The Royal College of Pathologists (RCPath) indicate that ‘graded responsibility’ is part of training histopathologists and provided a framework for implementation with increasingly complex specimens suitable for reporting by more senior trainees [8,9]. 

The limits of classical equivalent computation based on time, dose, and fractionation (TDF) and linear quadratic models have been known for a long time. Medical physicists and physicians are required to provide fast and reliable interpretations regarding the delivered doses or any future prescriptions relating to treatment changes. In this letter, we propose an outline related to the different models usable for equivalent and biological doses that are likely to be the most appropriate. The used methodology is based on: the linear-quadratic-linear model of Astrahan, the repopulation effects of Dale, and the prediction of multi-fractionated treatments of Thames.

We investigate how the UV spectra of pyruvic acid (PA) and pyruvate are impacted by interactions with water molecules. In particular, we would like to understand the mechanistic origin of the blue shift in the n →− π∗ transition. Pyruvic acid is the simplest α-keto organic acid and is common in the environment. We use density functional theory to optimize geometries to determine excitation energies and find that the excitation energies of the two main pyruvic acid conformers and pyruvate blue shift when interacting with 1 to 4 water molecules, both in vacuo and in a solvent. The excitation wavelength is blue-shifted by 0.9-9.2 nm when adding water molecules to the lowest energy conformer of PA. Calculations of the UV spectra of pyruvic acid (PA) and pyruvate are crucial for understanding the impact of the interactions with water molecules.

Prothrombin Time (PT), also called Quick’s Time (QT), is a coagulation test expressed in seconds, measured in the presence of tissue thromboplastin and calcium ions. Similarly, Activated Partial Thromboplastin Time (APTT) is measured in the presence of phospholipids, an activator, and calcium ions. These two tests are among the most commonly used in hemostasis. Their execution absolutely requires plasma samples used as quality controls, whether commercial or prepared locally (“pooled” in the laboratory).This descriptive study aimed to determine the stability duration of an in-house control pool for PT and APTT tests, prepared in the laboratory of the Hematology and Blood Bank service of the Yaoundé University Teaching Hospital, Cameroon.Plasma was collected after centrifugation, mixed, and then frozen at a temperature of -30 °C to preserve the coagulation factors, especially the most labile ones. The plasma pool was then aliquoted, stored at -30 °C protected from light in a domestic freezer, and kept for a period of two weeks. A portion of the pool was tested within four hours of collection: 30 PT and APTT analyses were performed.The assay was performed manually using the tube tilt method. The means obtained were 12.71 seconds for PT and 30.66 seconds for APTT. The acceptability limits (mean ± 2 standard deviations), calculated from the standard deviation, were 11.38 to 14.04 seconds for PT and 27.96 to 33.37 seconds for APTT.The plasma pool was then analyzed daily in duplicate. The average of the results for each day was plotted on a Levey-Jennings chart and interpreted according to Westgard rules. The results showed that the stability duration of the normal control pool is eight (8) days for PT and seven (7) days for APTT.In a context marked by a recurrent shortage of quality control reagents, for various logistical and economic reasons, these results offer a reliable alternative to commercial control samples, which are often expensive or unavailable. The use of locally prepared control pools could thus compensate for stock-outs of normal or pathological control reagents supplied by manufacturers.

Bifurcation analysis and Multiobjective Nonlinear Model Predictive Control (MNLMPC) calculations were performed on a model of circadian oscillations of the Period (PER) and Timeless (TIM) proteins in Drosophila. The MATLAB program MATCONT was used to perform the bifurcation analysis. The optimization language PYOMO was used along with the state-of-the-art global optimization solvers IPOPT and BARON for the MNLMPC calculations. The bifurcation analysis revealed oscillation causing Hopf bifurcations while the MNLMPC calculations revealed the existence of spikes in the control profiles. Both Hopf bifurcation points and the control profile spikes were eliminated using an activation factor involving the hyperbolic tangent function.

Background: Plain X-rays are frequently utilized as diagnostic radiological procedures. However, their usefulness can change based on the situation, such as rib fractures. Moreover, the lack of a uniform procedure in medical facilities, poor image quality resulting from operator error or insufficient training, financial incentives, and insurance reimbursement regulations can all contribute to an overuse of X-rays. Aim: This study presents the changes in the use of X-rays over the past five years (2019-2023) in the Oman Ministry of Health institutions and identifies interventions that assist in the improvement of the quality of care and patient satisfaction. Methods: The study used a mixed-method design, integrating quantitative (retrospective cross-sectional) and qualitative data collection and analyses. Quantitative data were collected from the Nabdh Al-Shifa and the annual health report over five years. Focus group interviews were used for Qualitative data collection. Results: a positive core relationship exists between population size and use of X-rays, and there were underlying contributing factors for over X-rays. The rate at which X-ray consumption has increased over the last two years has been deemed reasonable based on several variables, such as shifts in clinical practice or population growth. Conclusion: This study demonstrated that patients aged from 0-4 years had the highest X-ray utilisation service rate over the past five years, which raises concerns about the long-term risks associated with repeated radiation exposure. Clinical rotations and appropriate training for physicians at primary health care institutions, and strategies to reduce the significant financial implications, are recommended to address the high rate of X-ray utilisation.