Search Results (920)

Rabies, a zoonotic infectious disease causing central nervous system inflammation, remains a threat to public health in regions with limited medical resources. Vaccination effectively reduces rabies incidence and mortality, underscoring the need for vaccines that are cost-effective, immunogenic, protective, and safe. This study constructed a recombinant rabies virus (rRABV)-overexpressing glucocorticoid-induced tumor necrosis factor receptor ligand (GitrL), named rLBNSE-GitrL, using a reverse genetic operating system. rLBNSE-GitrL exhibited similar in vitro phenotypic characteristics and immune safety as the parent RABV (rLBNSE). This recombinant virus stimulated the production of a greater number of activated dendritic cells (DCs) compared to rLBNSE. The enhanced innate immune response induced by rLBNSE-GitrL may be mediated through the activation of innate immune-related signaling pathways, such as the tumor necrosis factor (TNF), and chemokine signaling pathways, and the upregulation of a series of innate immune-related genes, including MMP2, IL-6, CXCL9, TIMP1, IL-17d, and TNF-α. Consequently, rLBNSE-GitrL elicited significantly higher levels of RABV vaccine-induced virus-neutralizing antibodies (VNA), IgG, and IgM compared to rLBNSE as early as 3 days post-immunization (dpi), thereby improving the protective effect in mice. Collectively, the overexpression of GitrL facilitated the induction of early and potent antibody responses following RABV immunization. Full article

Objective: The aim of this study was to examine how transcranial electrical stimulation (tES) modulates intermuscular coherence (IMC) in sprinters and develop an interpretable neural network model for performance prediction. Methods: Thirty elite sprinters completed a randomized crossover trial involving three tES conditions: motor cortex stimulation (C1/C2), prefrontal stimulation (F3), and sham. Sprint performance metrics (0–100 m phase analysis) and lower-limb sEMG signals were collected. A Kolmogorov–Arnold Network (KAN) was trained to decode neuromuscular coordination–sprint performance relationships using IMC and time–frequency sEMG features. Results: Motor cortex tDCS increased 30–60 m sprint velocity by 2.2% versus sham (p < 0.05, η² = 0.25). γ-band IMC in key muscle pairs (rectus femoris–biceps femoris, tibialis anterior–gastrocnemius) significantly heightened under motor cortex stimulation (F > 4.2, p < 0.03). The KAN model achieved high predictive accuracy (R² = 0.83) through cross-validation, with derived symbolic equations mapping neuromuscular features to performance. Conclusions: Targeted tDCS enhances neuromuscular coordination and sprint velocity, while KAN provides a transparent framework for performance modeling in elite sports. Full article

Background/Objectives: Advanced hepatocellular carcinoma (HCC) presents limited treatment options; however, immunotherapy demonstrates encouraging outcomes and acceptable adverse reactions in advanced HCC. This study evaluates the efficacy and safety of combining serplulimab, the bevacizumab biosimilar HLX04, and hepatic arterial infusion chemotherapy (HAIC) as a first-line therapy. Methods: This prospective, observational, single-center phase II trial enrolled untreated HCC patients with Barcelona Clinic Liver Cancer (BCLC) stage C. All patients received serplulimab (4.5 mg/kg) and HLX04 (15.0 mg/kg) every 3 weeks, followed by the HAIC-FOLFOX regimen. The primary endpoint was the objective response rate (ORR). Secondary endpoints included the disease control rate (DCR), progression-free survival (PFS), and safety. Results: A total of 32 patients were enrolled. The best outcomes showed an ORR of 53.1%, including 17 partial responses (PR, 53.1%) and 12 stable diseases (SD, 37.5%), resulting in a DCR of 90.6%. Subgroup analysis showed a higher ORR in patients with a single lesion and those receiving ≥3 treatment cycles, with an ORR of 60.7% in the latter group. Additionally, five patients underwent successful hepatectomy after ≥3 treatment cycles, with postoperative pathology confirming extensive tumor necrosis. Kaplan–Meier analysis estimated PFS rates of 89.9% (95% CI: 79.5–100.0%) at 6 months and 70.8% (95% CI: 54.2–92.4%) at 12 months. No deaths related to adverse events (AEs) occurred; four (12.5%) patients experienced grade IV AEs and twelve (37.5%) patients experienced grade III AEs. Conclusions: Serplulimab, HLX04, and HAIC combined as a first-line treatment for advanced HCC have demonstrated promising efficacy, particularly in patients completing ≥3 cycles, with an acceptable safety profile. Further investigation in larger trials is required. Full article

Impurities in polypropylene random copolymer (PPR) raw materials can seriously affect the performance of the final product, and efficient and accurate impurity detection is crucial to ensure high production quality. In order to solve the problems of high small-target miss rates, weak anti-interference ability, and difficulty in balancing accuracy and speed in existing detection methods used in complex industrial scenarios, this paper proposes an enhanced machine vision detection algorithm based on YOLOv11. Firstly, the FasterLDConv module dynamically adjusts the position of sampling points through linear deformable convolution (LDConv), which improves the feature extraction ability of small-scale targets on complex backgrounds while maintaining lightweight features. The IR-EMA attention mechanism is a novel approach that combines an efficient reverse residual architecture with multi-scale attention. This combination enables the model to jointly capture feature channel dependencies and spatial relationships, thereby enhancing its sensitivity to weak impurity features. Again, a DC-DyHead deformable dynamic detection head is constructed, and deformable convolutions are embedded into the spatial perceptual attention of DyHead to enhance its feature modelling ability for anomalies and occluded impurities. We introduce an enhanced InnerMPDIoU loss function to optimise the bounding box regression strategy. This new method addresses issues related to traditional CIoU losses, including excessive penalties imposed on small targets and a lack of sufficient gradient guidance in situations where there is almost no overlap. The results indicate that the average precision (mAP@0.5) of the improved algorithm on the self-made PPR impurity dataset reached 88.6%, which is 2.3% higher than that of the original YOLOv11n, while precision (P) and recall (R) increased by 2.4% and 2.8%, respectively. This study provides a reliable technical solution for the quality inspection of PPR raw materials and serves as a reference for algorithm optimisation in the field of industrial small-target detection. Full article

Background/Objectives: Sarcopenia, characterized by progressive loss of skeletal muscle mass and strength, significantly impacts physical function and quality of life in older adults. Traditional measurement methods like Dual-energy X-ray absorptiometry (DEXA) are often inaccessible in primary care. This study aimed to develop and validate an AI-driven auto-segmentation model for muscle mass assessment using long X-rays as a more accessible alternative to DEXA. Methods: This was a retrospective validation study using data from the Real Hip Cohort at Inha University Hospital in South Korea. 351 lower extremity X-ray images from 157 patients were collected and analyzed. AI-based semantic segmentation models, including U-Net, V-Net, and U-Net++, were trained and validated on this dataset to automatically segment muscle regions. Model performance was assessed using Intersection over Union (IoU) and Dice Similarity Coefficient (DC) metrics. The correlation between AI-derived muscle measurements and the DEXA-derived skeletal muscle index was evaluated using Pearson correlation analysis and Bland–Altman analysis. Results: The study analyzed data from 157 patients (mean age 77.1 years). The U-Net++ architecture achieved the best segmentation performance with an IoU of 0.93 and DC of 0.95. Pearson correlation demonstrated a moderate to strong positive correlation between the AI model’s muscle estimates and DEXA results (r = 0.72, *** p < 0.0001). Regression analysis showed a coefficient of 0.74, indicating good agreement with reference measurements. Conclusions: This study successfully developed and validated an AI-driven auto-segmentation model for estimating muscle mass from long X-rays. The model provides an accessible alternative to DEXA, with potential to improve sarcopenia diagnosis and management in community and primary care settings. Future work will refine the model and explore its application to additional muscle groups. Full article

Introduction: Evidence on orthodontic interventions for temporomandibular disorders (TMD) is fragmented and inconclusive, creating a gap in guidance for clinical decision-making. This study addresses that gap by evaluating current knowledge on these interventions. Methods: A PRISMA-ScR scoping review was conducted with a systematic search of PubMed, Scopus, and Web of Science (2018–2023). Eligible studies were peer-reviewed, English-language, human studies examining TMD treatment and/or etiology. Three independent reviewers screened records and extracted data and a fourth reviewer performed random audits. Results: Of 899 records, 10 studies met inclusion criteria (non-surgical, n = 7: 4 case reports, 2 prospective, 1 longitudinal; combined orthodontic–surgical, n = 3: 1 case report, 2 longitudinal; participant ages 15–71 years). Diagnostics included imaging, clinical examination, occlusal analysis, and questionnaires, although few used RDC/TMD or DC/TMD criteria. Non-surgical orthodontic modalities (fixed appliances, camouflage, TADs, stabilization splints) showed mixed results, with several studies reporting short-term symptom improvement, while others found no effect on TMD onset or progression. Combined orthodontic–surgical approaches (e.g., bilateral sagittal split osteotomy, Le Fort I) also showed variable outcomes. Conclusions: Low-to-moderate quality evidence suggests that orthodontic-surgical interventions may alleviate TMD symptoms in select patients; however, heterogeneity and limited use of standardized diagnostics constrain the certainty of these findings. Future research should prioritize DC/TMD-based diagnostics, core outcomes, comparative designs, and ≥12–24 months of follow-up to identify prognostic factors and responsive subgroups. Full article

This article presents a method for the optimal design of actuators for electric vessels that utilize DC motors. Typically, these vessels are small, unmanned craft that can be Unmanned Surface Vessels (USVs) or Unmanned Underwater Vessels (UUVs). The propulsion systems for these vessels are currently hindered because most propulsion system research targets large, open ocean vessels. These vessels are either low-speed Diesel or Diesel-electric craft that turn propellers at slow speeds, in the tens or hundreds of revolutions per minute. The smaller vessels, on the other hand, utilize DC motors that operate at thousands or tens of thousands of revolutions per minute. Therefore, there is limited research on the design of propellers that considers the difference in speed and performance of these DC motors. This paper will demonstrate a series of use cases for where traditional propeller performance analysis fails and will demonstrate a method to integrate propeller design and motor performance. The focus of this paper will be on the well-studied Wageningen B-Series propellers due to their known performance characteristics. MATLAB R2022b models will be utilized to demonstrate the performance of the actuator systems. Full article

This paper presents a DC microgrid architecture with autonomous decentralized control that exhibits high resilience against increasingly common threats, such as natural disasters and cyber-physical attacks, as well as its operational characteristics under normal circumstances. The proposed system achieves autonomous decentralized cooperative control by combining a battery-integrated DC baseline, in which multiple distributed small-scale batteries are directly connected to the grid baseline, with a weakly coupled grid architecture in which each power device is loosely coupled via the grid baseline. Unlike conventional approaches that assign grid formation, inertial support, and power balancing functions to DC/DC converters, the proposed approach delegates these fundamental grid roles to the distributed batteries. This configuration simplifies the control logic of the DC/DC converters, limiting their role to power exchange only. To evaluate system performance, a four-family DC microgrid model incorporating a typical Japanese home environment, including an EV charger, was constructed in MATLAB/Simulink R2025a and subjected to one-year simulations. The results showed that with approximately 5 kW of PV panels and a 20 kWh battery capacity per household, a stable power supply could be maintained throughout the year, with more than 50% of the total power consumption covered by solar energy. Furthermore, the predicted battery life was over 20 years, confirming the practicality and economic viability of the proposed residential microgrid design. Full article

Objective: This cross-sectional study analyzed the relationship between maxillary incisor inclination and sagittal condylar guidance in patients with and without temporomandibular disorders (TMD) across different skeletal malocclusions, aiming to enhance orthodontic diagnosis and treatment. Materials and Methods: A total of 154 patients from a private clinic with various skeletal malocclusions were consecutively enrolled in this study. Mandibular kinematics were recorded using Modjaw^® and TMD signs and symptoms were evaluated using the DC-TMD questionnaire. Pearson’s correlation was applied to assess relationships between incisor inclination (U1–NA, U1–APog, U1–PP) and condylar guidance (right and left). Results: TMD signs or symptoms were present in 31.8% of patients. A weak negative correlation was observed between incisor inclination and sagittal condylar guidance for patients with positive overjet and overbite values. Retroclined maxillary incisors were weakly associated with a steeper condylar path (correlation values between R = −0.122 and R = 0.177). No significant relation was found between maxillary incisors’ inclination and the presence of TMD (p > 0.05). No significant association was found between TMD prevalence and skeletal or dental classifications (p > 0.05). Conclusions: Although some correlations reached statistical significance, their magnitude was below the accepted threshold for small effects (r ≥ 0.30), indicating negligible clinical impact. These findings suggest that maxillary incisor inclination does not meaningfully influence condylar guidance and should not be considered a primary determinant in treatment planning. Instead, it should be integrated only as a contextual variable within a multifactorial functional assessment. Full article

Background and Objectives: Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease affecting the upper and lower motor neurons, with a bleak prognosis and few treatment options. Non-invasive brain stimulation (NIBS) techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), represent emerging approaches aimed at modulating cortical hyperexcitability, a relevant pathogenetic mechanism in ALS. Materials and Methods: A systematic review of the literature was conducted following the PRISMA guidelines, exploring the Scopus and PubMed databases from April to June 2025 with terms related to ALS and NIBS. A total of 18 relevant studies were selected from the initial 708 articles, analysing stimulation protocols, clinical and neurophysiological outcomes, and associated biomarkers; their validity was assessed using the revised Cochrane risk-of-bias (RoB2) tool. Results: The selected studies were extremely heterogeneous, with NIBS techniques, including magnetic (rTMS, cTBS, tSMS) and electrical (tDCS) stimulation, showing variable effects. Low-frequency protocols (1 Hz rTMS) and cTBS showed a slight slowing of clinical progression, while prolonged home stimulation with tDCS and tSMS showed more significant improvements in terms of efficacy, tolerability, and adherence. The main limitations concern the heterogeneity of patients and protocols and the lack of standardised biomarkers, which is why the analysis remained at a descriptive level. The use of telemonitoring and caregiver training are essential to ensure safety and accessibility. Conclusions: NIBS represents a promising therapeutic approach for ALS, but further multicentre, standardised studies with prolonged follow-up are needed. Future strategies should include customisation of stimulation, combination with other therapies, and extension of application to pre-symptomatic phases. Full article

Refractory neuropathic pain of the head and neck remains a major clinical challenge, particularly when mediated through the cervicotrigeminal complex (CTC), a unique anatomical hub integrating trigeminal and upper cervical nociceptive inputs. This narrative review synthesizes neuroanatomical, pathophysiological, and clinical evidence to provide a unifying framework for diagnosis and management. A structured search of PubMed, Scopus, and Web of Science identified English-language clinical and mechanistic studies addressing CTC-mediated pain, with case reports excluded unless mechanistically informative. We propose multidimensional refractoriness criteria that integrate pharmacological non-response, failed interventional strategies, and objective functional impairment. Current treatments span pharmacotherapy, peripheral interventions (nerve blocks, radiofrequency ablation), and neuromodulation at multiple network levels (occipital nerve stimulation, spinal cord stimulation, motor cortex stimulation, deep brain stimulation). Non-invasive approaches such as rTMS, tDCS, and vagus nerve stimulation are emerging but remain investigational. Advances in imaging and neurophysiological biomarkers now permit greater precision in detecting CTC dysfunction and tailoring therapy. By combining anatomical precision, mechanistic insight, and multidisciplinary strategies, this review proposes a clinically actionable definition of refractoriness and supports a stepwise, mechanism-based approach to therapy. CTC emerges as a targetable hub for diagnostic and therapeutic strategies in refractory head and neck pain. Full article

Background and objectives: Temporomandibular disorders (TMDs) are common but challenging to diagnose in routine practice due to the complexity of the DC/TMD protocol. The study assesses the diagnostic validity and reliability of the modified Helkimo Index (mHI) in a Romanian patient cohort. Methods: A cross-sectional study of 164 participants (82 TMD patients, 82 controls) evaluated the diagnostic performance and reliability of the mHI against the DC/TMD protocol. Results: The mHI demonstrated high diagnostic accuracy (sensitivity 86%, specificity 84%, AUC = 0.89) and strong agreement with DC/TMD diagnoses (r = 0.83, p < 0.001). Reliability was excellent (inter-examiner ICC = 0.87; intra-examiner ICC = 0.91). Application time was significantly shorter (5–10 min) than the DC/TMD protocol (16–20 min). Conclusions: The mHI is a valid, reliable, and time-efficient tool for TMD diagnosis, supporting its integration into general dental practice and broader screening initiatives. Full article

This paper aims to unveil the symmetry–asymmetry transition mechanisms in transient fault waveforms of offshore wind power AC/DC transmission systems, addressing the critical limitation of traditional simulation methods of the fact that they cannot characterize the dynamic evolution of system symmetry, such as static impedance adjustment failing to capture transient asymmetry caused by parameter imbalance or converter control. It proposes a fault waveform simulation approach integrating mechanism analysis, scenario extraction, and model optimization. Key contributions include clarifying the quantitative links between key system parameters like submarine cable capacitance and inductance and symmetry–asymmetry characteristics, defining the transient decay rate oscillation frequency and voltage peak as core indicators to quantify symmetry breaking intensity; classifying typical fault scenarios into a symmetry-breaking type with synchronous three-phase imbalance and a persistent asymmetry type with zero-sequence and negative-sequence distortion based on symmetry evolution dynamics and revising grid-connection test indices such as lowering the low-voltage ride-through threshold and specifying the voltage type for different test objectives; and constructing a simplified embedded RLC second-order model with symmetry–asymmetry constraints to reproduce the whole process of symmetric steady state–fault symmetry breaking–recovery symmetry reconstruction. Simulation results verify the method’s effectiveness, with symmetry indicator reproduction errors ≤ 5% and asymmetric feature fitting goodness R² ≥ 0.92, which confirms that the method can effectively reveal the symmetry–asymmetry mechanisms of offshore wind power fault transients and provides reliable technical support for improving offshore wind power fault simulation accuracy and grid-connection test reliability, laying a theoretical basis for the grid-connection testing of offshore wind turbines and promoting the stable operation of offshore wind power systems. Full article

Background/Objectives: Little is known about the synergy between intratumoral immunotherapy and cancer ablation. We conducted a Phase II Trial (Abscopal 5001 trial; NCT04713371) in patients with metastatic solid cancer to assess the safety and efficacy of cryoablation with concurrent injection of RPT-01-5001 (combination of low-dose checkpoint inhibitors and cyclophosphamide), a treatment process referred to as Multiplex Intratumoral Immunotherapy (MITI^TM). Methods: Twelve patients with metastatic cancer who had failed standard therapy and one with sacral chordoma received at least one intratumoral treatment of MITI preceded by 3–5 days of oral low-dose cyclophosphamide. MITI consisted of CT-guided cryoablation followed by intratumoral injection of RPT-01-5001. GM-CSF was subcutaneously administered daily for four weeks. Treatment was repeated every four weeks if the tumor burden remained stable or reduced, as noted by the iRECIST criteria. These criteria were modified when follow-up biopsies revealed pathology with minimal or no cancer, despite persistent suspicious masses on imaging. Results: Cancers included prostate (four patients), sarcoma (two), and one each of breast, colon, bladder, uterine cervix, tongue, kidney, and sacral chordoma. Eight patients received three cycles of treatment, two received two, and three received one. All patients tolerated the procedure well and were discharged within 2 h. The adverse event rate was 69%, all of which were grade 1 or 2, except for two grade 3 cases with delayed cryosurgical complications (15%). At completion of up to three cycles of treatment, a complete response (iCR) was observed in one patient (7.7%), partial response (iPR) in four patients (30.8%), and stable disease (iSD) in five (38.5%), with a disease control rate (iDCR) of 77%. Disparity between post-treatment imaging and pathologic findings was observed in four patients (positive vs. negative, respectively), requiring modification of the iRECIST criteria in favor of pathology. The best response ranged from 0 to 91%, with a mean for responding patients of 38%. Median progression-free survival (PFS) and 95% confidence intervals (95% CI) were 5.4 months (1.8 to 23.1 months); and median overall survival (OS) was 20.9 months (9.1 to 22.8 months). The injection site cancer response was observed in nine (69%) patients, and the distal abscopal effect was seen in four (31%), including one sarcoma patient with a complete abscopal response of lung metastases and one bladder cancer patient with biopsy-confirmed complete resolution of lung and liver metastases. Conclusions: MITI with RPT-01-5001 is safe and highly feasible, providing 77% disease control and 31% of the abscopal effect in patients with metastatic cancer who have failed standard therapies. Full article

Addiction remains a persistent public health crisis, marked by poor treatment retention and limited pharmacotherapy options. Emerging treatments, such as psychedelic-assisted psychotherapy and neuromodulation, offer promising avenues for circuit-level interventions in behavioral addictions. This narrative review synthesizes the current landscape of psychedelic compounds and neuromodulation techniques with a focus on their mechanisms of action, applications in specific behavioral addictions, and translational potential. By targeting disrupted reward, executive control, and stress regulation networks, these interventions may facilitate meaningful recovery and long-term remission in otherwise treatment refractory cases. We highlight key findings, current research limitations, and future directions in integrating these novel therapies into the treatment of gambling disorder; internet gaming disorder/gaming disorder, predominantly online; internet use disorder; and compulsive sexual behavior disorder. Full article