Search Results (334)

Purpose: This study compared the therapeutic efficacy of different bladder monotherapies and multimodal therapy in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Materials and methods: In total, 190 patients with a confirmed diagnosis of IC/BPS were treated with different bladder therapies. The bladder monotherapies included intravesical platelet-rich plasma (PRP) injection (n = 60), intravesical botulinum toxin A (BoNT-A) injection (n = 33), intravesical hyaluronic acid (HA) instillation (n = 36), and low-energy shock wave (LESW) bladder therapy (n = 61). Multimodal therapy (MMT) was provided to patients who had unsuccessful initial bladder treatment targeting chronic inflammation, urothelial dysfunction, bladder pain, pelvic floor muscle pain, psychological stress, and lower urinary tract dysfunction. The treatment outcome was assessed using self-reported Global Response Assessment scores at 3 months and during the follow-up time points after bladder treatment. Results: Thirty-one patients received MMT. The 3-month success rates of bladder therapy were 55.0% for PRP injection, 57.6% for BoNT-A injection, 50.0% for HA instillation, 46.7% for LESW bladder therapy, and 58.1% for MMT. The success rates of bladder monotherapy decreased after 6 months. However, the success rate of MMT increased at 9 (67.7%) and 12 (73.1%) months. Patients treated with MMT exhibited improvement in glomerulation grade after cystoscopic hydrodistention. Only patients with successful treatment outcomes after MMT had improvement in bladder pain severity and pelvic floor muscle pain parameters. Conclusions: Bladder monotherapy such as PRP injection, BoNT-A injection, HA instillation, and LESW bladder therapy had successful treatment outcomes in patients with IC/BPS. In patients who had unsuccessful initial bladder therapy, the 3-month success rate of MMT was 58.1% and sustained improvement with time, particularly in the improvement of bladder pain and PFM pain severity. Full article

Plasma-facing materials (PFMs) for future fusion reactors require advanced mechanical and thermal properties to withstand the extreme challenges of high heat flux, plasma exposure, and neutron irradiation. Tungsten is one of the most suitable materials for use as a PFM in the divertor region. However, considering the high thermal loading/thermal stress combining plasma exposure and neutron irradiation/embrittlement, one of the major concerns for tungsten in PFMs is its intrinsic brittleness. To avoid cracking and components failure, tungsten toughening has been widely investigated, including the development of tungsten fiber-reinforced tungsten composites (W_f/W) using an extrinsic toughening mechanism, which could provide damage resilience against neutron embrittlement. Recently, a type of aligned long-fiber W_f/W (L-W_f/W) based on a powder metallurgical fabrication process was developed, demonstrating advanced fracture toughness while retaining other application-relevant properties. For L-W_f/W, the relatively easy production process suggests the feasibility and basis of industrialization. This work reports on the initial progress in industrializing L-W_f/W, with a focus on adapting the lab sintering process to a sintering process with industrial partner (Dr. Fritsch Sondermaschinen GmbH) and optimizing the process parameters. To improve the sinterability of tungsten and achieve higher density, various tungsten powders were explored, including commercial W powders, bimodal mixtures of different particle sizes, and granulated W powders. At the dedicated yttria interface, the thickness of yttria coating on the fibers was also optimized to ensure effective separation between the fibers and the matrix. Series of samples were produced with different dimensions up to 100 mm × 100 mm × 4 mm. After optimization, samples with 93% density and desired pseudo-ductility were prepared. Similarly to production in the lab, a major challenge in this work involved balancing the densification of the tungsten matrix with controlling fiber recrystallization and mitigating damage to the yttria interface. Full article

Background/Objectives: This study aimed to automatically classify Zirconia-based fixed restorations and porcelain-fused-to-metal (PFM) restorations on panoramic radiographs using an artificial intelligence-based model. Unlike previous studies that mainly focused on classifying types of restorations (e.g., crowns, fillings, implants), this research concentrated on material-based differentiation, aiming to provide a more specific contribution to clinical decision support systems. Method: Panoramic radiographs obtained from the archive of Süleyman Demirel University Faculty of Dentistry were included in this study. Radiographs with poor image quality or insufficient visibility of the restoration area were excluded. A total of 593 cropped region-of-interest (ROI) images, labeled by expert prosthodontists using ImageJ software (version 1.54r; National Institutes of Health, Bethesda, MD, USA), were included in the analysis. In order to reduce class imbalance, data augmentation was applied only for images in the Zirconia-based fixed restorations class. By using various image processing techniques such as rotation, reflection and brightness change, the number of samples in the zirconia-based restorations class was increased and thus a balanced dataset was obtained with a close number of samples for both classes. For model training, the pre-trained VGG16 architecture was used with a transfer learning method, and the final layers were retrained and fine-tuned. The model was configured specifically for binary classification. The entire dataset was randomly split into 70% training, 20% validation, and 10% testing. Model performance was evaluated using accuracy, F1-score, sensitivity, and specificity. Results: The model correctly classified 90 out of 94 images in the test dataset, achieving an overall accuracy rate of 96%. For both classes, the precision, recall, and F1-score values were measured in the range of 95% to 96%. Additionally, the Area Under the Curve (AUC) of the ROC curve was calculated as 0.994, and the Average Precision (AP) score was determined to be 0.995. According to the confusion matrix results, only 4 images were misclassified, consisting of 2 false positives and 2 false negatives. Conclusions: The deep learning model demonstrated high accuracy in differentiating zirconia and metal-supported porcelain restorations on panoramic radiographs, suggesting that material-based AI classification may support clinical decision-making in restorative dentistry. Full article

Plastic film mulching (PFM) is widely used in arid, semiarid, and seasonally arid regions, where it plays a key role in regulating agricultural productivity and CO₂ emissions. Our study aims to clarify the effects of PFM on crop yield, CO₂ emissions, and the associated tradeoffs, providing a theoretical basis for the sustainable use of PFM in agriculture. We conducted a meta-analysis to compare differences in crop yield, CO₂ emissions, and yield-scaled CO₂ emissions (YSC) between mulching and no mulching treatments while identifying factors influencing these outcomes. Our findings demonstrated that PFM enhanced crop yields of maize, wheat, and cotton by 33.2% (p < 0.001), 21.8% (p < 0.05), and 26.3% (p < 0.05), respectively. PFM stimulated CO₂ emissions in maize fields by 36.8% (p < 0.001), while decreasing them in wheat and cotton fields by 11.8% (p < 0.05) and 8.1% (p > 0.05), respectively. Consequently, PFM significantly lowered YSC for maize by 39.3% (p < 0.05) and reduced it for cotton by 27.4% (p > 0.05), but led to a 38.3% increase in YSC for wheat (p > 0.05). For maize and cotton, when crop yields exceeded 6 t/ha, the YSC under plastic film mulching was higher than that under non-mulching. In contrast, for wheat, within the conventional yield range (below 10 t/ha), the YSC under plastic film mulching was lower than that under non-mulching. For cotton, the lowest YSC under PFM was achieved under the combined conditions of water inputs > 500 mm, air temperature > 8 °C, soil pH > 8, and N inputs < 200 kg N ha⁻¹. For wheat, the lowest YSC under PFM was obtained under water inputs < 350 mm, air temperature < 8 °C, light-texture soils, and N inputs < 200 kg N ha⁻¹. For maize, the lowest YSC under PFM was achieved under water inputs < 350 mm, air temperature < 8 °C, heavy-texture soils, soil pH < 8, and N inputs < 200 kg N ha⁻¹. These insights offer guidance for the optimal use of PFM to enhance carbon efficiency and crop yield in agricultural systems. Full article

Sampling-based planners such as RRT* are attractive for robot navigation in complex spaces, but they often suffer from high randomness, low efficiency, slow convergence, and suboptimal path quality in cluttered environments. To address these limitations, this paper proposes PFMS-RRT*, a progress-aware fused-sampling RRT* with a multi-level strategy extension. The method builds on a bidirectional RRT* framework and introduces three main components: (i) a progress-aware fused sampling scheme that adapts an oriented elliptical sampling region based on inter-tree progress and stagnation, mixes locally guided elliptical samples with globally explorative Halton-sequence samples, and dynamically balances exploration and exploitation; (ii) a three-level goal-guided extension mechanism that escalates from direct steering to local probing and then multi-direction detours to maintain forward progress when obstacles block expansion; and (iii) a smooth tangential artificial potential field (APF) extension used as a fallback, with a failure-driven probabilistic switching rule that increases APF usage after repeated extension failures. Simulations in four representative 2D environments (sparse, corridor-like dense, random dense, and narrow passage) show that PFMS-RRT* consistently yields shorter paths, lower and more stable runtime, and fewer nodes than several RRT* variants while maintaining competitive or improved obstacle clearance. Full article

Background and Clinical Significance: Plexiform fibromyxoma (PFM) is a rare benign gastric mesenchymal neoplasm characterized by multinodular plexiform growth of bland spindle cells in a myxoid or fibromyxoid stroma. We report a case of the cellular form of PFM with limited myxoid stroma and aberrant KIT expression, resulting in diagnostic difficulty by biopsy. Case Presentation: A 59-year-old woman presented with a slowly enlarging 15 mm gastric antral submucosal tumor. A resected specimen by laparoscopic and endoscopic cooperative surgery revealed spindle cell proliferation forming plexiform nodules with a myxoid background in limited areas. Positive immunoreactivity of a subset of spindle cells for KIT suggested a diagnosis of gastrointestinal stromal tumor (GIST), although DOG1 was negative. In addition, diffuse staining for CD10, smooth muscle actin, and D2-40 was confusing. MALAT1::GLI1 fusion was detected by next-generation sequencing analysis. Consequently, a diagnosis of PFM was established. Conclusions: This case expands the morphologic and immunophenotypic spectrum of PFM and indicates the possible diagnostic utility and biological significance of D2-40 expression. Although molecular confirmation of MALAT1::GLI1 fusion is definitive for the diagnosis of PFM, the findings of the present case may aid diagnosis in challenging cases that mimic GIST. Full article

Thermal contextual algorithms for 375 m VIIRS active fire detection can produce substantial commission errors over persistent non-wildfire heat sources (e.g., refineries, gas flares, and volcanoes), and globally fixed thresholds may be suboptimal under heterogeneous thermal backgrounds. We present a lightweight spatiotemporal prior layer that augments by applying prior-guided, pixel-level parameter switching during the discrimination stage. The layer combines: (i) a persistent non-wildfire thermal anomaly mask (PFM) derived from multi-year VNP14IMG recurrence and seasonality statistics on a 0.004° grid, and (ii) a short-term heat-source mask (SHM) based on nighttime VIIRS I4/I5 brightness temperature stability to capture newly emerged or rapidly intensifying static sources. Pixels flagged by either prior are processed with a stricter parameter set, while other pixels follow the baseline setting. We evaluate the method using a stratified validation dataset (N = 3435) spanning industrial/urban clusters, volcanic regions, forest/grassland wildfires, and fragmented crop residue burning, with validation supported by independent high-resolution imagery (Sentinel-2/Landsat) and external POI datasets. The framework markedly reduces false positives in high-interference zones (industrial/urban false positive rate from 88.6% to 22.7%; volcanic from 100.0% to 57.3%) while preserving high performance for forest/grassland wildfires (F1 ≈ 0.999). For fragmented residue burning, omission error decreases from 11.2% to 1.3%, improving detection completeness without an apparent increase in commission errors. Overall, the results suggest that integrating long- and short-term spatiotemporal priors via threshold switching can improve the robustness and interpretability of contextual VIIRS fire detection under complex thermal backgrounds in the evaluated scenarios. Full article

This study evaluates the costs and benefits of participatory forest management (PFM) versus non-participatory forest management based on the perceptions and involvement of local communities in the Kilombero Valley Ramsar site, Tanzania. The area hosts ecologically significant wetlands managed through different regimes: forests managed by local communities under PFM and protected areas controlled by national authorities. Using data collected through focus groups, key interviews, household surveys, and direct observations in two villages—Siginali (PFM) and Kilama (non-participatory)—this research explores perceptions of two different forest management approaches. The results revealed: (i) a generally low awareness and participation in forest management activities in both villages; (ii) restrictions on forest resource access, essential for local livelihoods, were common and often poorly accepted in the two villages; (iii) neither approach alleviates poverty, instead, strict regulations have worsened livelihoods by eliminating traditional income sources; (iv) forced participation in patrols and fire control was also noted as an unfair burden without direct compensation; and (v) the “fortress” model is perceived as more effective at improving forest health and stopping illegal activity due to stricter patrols. The study concludes that while PFM supports forest sustainability, it needs enhanced local engagement, benefit-sharing mechanisms, and complementary income-generating initiatives such as ecotourism to sustainably balance conservation and community welfare. Full article

Electric vehicles (EVs) employ high-voltage battery systems to improve drivetrain efficiency, while numerous auxiliary loads still require low-voltage power supplies, typically at 12 V. This creates a demand for isolated DC–DC auxiliary power modules (APMs) with high step-down ratios, wide operating ranges, and high energy conversion efficiency. In this paper, a high-efficiency DC–DC converter based on an input-series output-parallel (ISOP) LLC resonant architecture is proposed for EV auxiliary power applications. The proposed converter adopts dual LLC modules connected in an ISOP configuration to distribute stress, reduce the transformer turns ratio, and inherently achieve output current sharing. Full-bridge and half-bridge LLC operating modes are combined with hybrid pulse-frequency modulation (PFM) and phase-shift modulation (PSM) control strategies to enable wide voltage operation while maintaining soft-switching characteristics. A two-phase interleaved scheme further suppresses output current ripple. A 1000 W prototype demonstrates stable operation over 200–400 V input and 10–16 V output ranges with a peak efficiency of 97.87%. In this paper, PSM denotes phase-shift modulation, defined as the intentional delay between primary-side switching legs for power regulation. Full article

To address the problems of high energy consumption and excessive navigation time in autonomous tugboat operations during cross-regional missions, an Ant Colony Optimization algorithm integrated with Potential Field Maps (PFM-ACO) is proposed. The proposed method is capable of planning routes that satisfy navigation time constraints, thereby improving navigation efficiency while minimizing voyage energy consumption. Specifically, time-based and energy-consumption-based potential field maps are constructed using ocean current data. The initial pheromone matrix and heuristic function are further redesigned to enhance target-oriented guidance. In addition, an adaptive heuristic factor based on a goal-biased strategy is introduced to strengthen the global search capability of the algorithm. Finally, the proposed PFM-ACO algorithm is compared with the A*, A*-DCE and NDACA algorithms. Experimental results demonstrate that, under navigation time constraints, the paths generated by PFM-ACO achieve both the lowest energy consumption and the highest path smoothness. Overall, the proposed algorithm outperforms the comparative methods, indicating its effectiveness and superiority in energy-efficient path planning for tugboat navigation. Full article

Background: Research in pelvic floor muscle-related symptoms (PFM-related symptoms) in Saudi Arabia remains limited. Clearer identification of symptom burden and its predictors is needed to guide physiotherapy strategies for prevention and management. Objective: We aimed to determine the prevalence of PFM-related symptoms among adult Saudi men and identify behavioral and lifestyle predictors associated with symptom burden. Methods: A community-based cross-sectional survey was conducted among 458 men aged >18 years from the Al-Baha region of Saudi Arabia. PFM-related symptoms were assessed using five items adapted from the Pelvic Floor Distress Inventory-20 (PFDI-20), their impact using five items from the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), and urinary incontinence using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI SF). Data were analyzed with descriptive statistics, correlation analysis, one-way ANOVA, and binary logistic regression. Results: Urinary incontinence was reported by 14% (86% reported none), but 19% disclosed regular “preventive” voiding. Symptom incidence increased with age (p < 0.001). Logistic regression identified smoking (OR = 1.34, p = 0.029) and preventive voiding (OR = 1.54, p = 0.002) as significant predictors of greater symptom burden. Conclusions: These results highlight the need for physiotherapy-led strategies in primary care, prioritizing smoking-cessation support and structured bladder training, with escalation when required. Prospective studies are needed to confirm temporality and to develop a practical rehabilitation pathway for men. Full article

This paper proposes a single-stage three-phase AC-DC converter based on an LLC resonant topology utilizing a front-end matrix switch. Unlike traditional two-stage solutions, the proposed topology synthesizes a fluctuating equivalent DC voltage from the three-phase input, achieving direct power conversion with high efficiency. To maintain a stable DC output voltage against the time-varying input, a trajectory-based Pulse Frequency Modulation (PFM) control strategy is developed. By employing State-Plane Analysis (SPA), the operational trajectory is divided into four calculation segments, allowing precise derivation of the switching frequency and duty cycles for both boost and buck modes within a single line cycle. Furthermore, to improve power density and reduce parasitic parameters, a high-frequency planar inductor with interleaved windings and a planar transformer are designed for 500 kHz operation. A pipeline control architecture based on a single DSP is implemented to handle the complex real-time computations. A 500 W prototype is built and tested under 100 V input and 130 V output conditions. Experimental results demonstrate that the converter achieves a peak efficiency of 97%, a power factor of 0.99, and a grid current Total Harmonic Distortion (THD) of 3.95%, validating the effectiveness of the proposed topology and control scheme. Full article

Background: Pelvic floor muscle dysfunction (PFD) is common during pregnancy. To counteract pregnancy-associated PFD, women require sufficient knowledge and structured guidance on correct pelvic floor muscle (PFM) contraction to improve PFM perception and functional control. Identifying pregnant women who are unable to perform correct PFM contraction despite structured teaching may allow early referral for rehabilitative measures. Objective: At measurement stage 1, this study aims to investigate the influence of structured PFM teaching on pregnant women’s ability to perform targeted PFM contraction (tPFMC-A), assess PFM strength, and describe possible early PFD symptoms. Material and Methods: “pelviTrust” is a two-arm randomized, controlled longitudinal study and has been conducted in the Department of Midwifery Science, University of Tuebingen since February 2023. The study sample comprised 221 healthy pregnant women with singleton pregnancy at 18–22 weeks of gestation. The intervention group (IG; n = 113) (69 nulliparous, 40 primiparous and four biparous) completed the validated German Pelvic Floor Questionnaire for Pregnant and Postpartum Women (GPFQppw) and received individualized midwife-led teaching on PFM anatomy, functional activation and PFM-friendly behaviour, followed by visual inspection and vaginal palpation. Objective-targeted PFMC ability (tPFMC-A) and PFM strength (modified Oxford Scale) were compared with self-assessed ability. The control group (n = 101) (61 nulliparous, 38 primiparous, and two biparous) receives routine prenatal and postnatal care and completes the GPFQppw. The present analysis focuses exclusively on the IG at T1. Results: At T1, 88% of the 113 women in the IG believed they could contract their PFM, but only 68% demonstrated a correct tPFMC-A on visual inspection. Following structured teaching with individualized feedback, 97% achieved correct PFM contraction while 2.7% still had deficits. The median PFM strength was three on the modified Oxford Scale (interquartile range: 3–4). Stress urinary incontinence and flatulence were the most frequently reported symptoms. Primiparous and multiparous women reported urinary incontinence and descensus symptoms more often than nulliparous women (p < 0.001). Conclusions: At the first prenatal assessment, pregnant women often overestimate their ability to contract their PFM correctly. A structured, midwife-led PFM teaching improves objectively assessed PFM contraction ability and may be integrated into routine antenatal care to support PFM health in pregnant women. Full article

In the present manuscript, the influence of reaction time on the hexagonal-to-monoclinic phase transition in hydroxyapatite (HAp) nanofibers synthesized via a low-temperature modified hydrothermal method at 100 °C is investigated. The resulting nanofibers were highly crystalline and stoichiometric, with a Ca/P ratio of approximately 1.67. Comprehensive structural and functional characterization, combining X-ray diffraction with Rietveld refinement, Fourier-transform infrared spectroscopy (FTIR), Raman spectroscopy, transmission electron microscopy (TEM), and resonance-tracking piezoresponse force microscopy (RT-PFM), was employed to elucidate the role of the non-centrosymmetric monoclinic P2₁/b phase in governing HAp’s structural and piezoelectric properties. The analyses indicated a time-dependent phase evolution from hexagonal (P6₃/m) to monoclinic (P2₁/b), with exclusive formation of the hexagonal phase at 6 h and a clearly dominant monoclinic fraction (73.56%) after 24 h. Nanofibers synthesized for 48 h comprised approximately 98% monoclinic HAp and exhibited elongated morphologies with an average length of 354.82 nm and diameter of 45 nm. RT-PFM measurements confirmed a pronounced piezoelectric response associated with the monoclinic phase, yielding an effective piezoelectric coefficient (d_eff) of 19.85 pm/V. In vitro MTT assays demonstrated that the high monoclinic content did not compromise biocompatibility, as cell viability and cytotoxicity met the requirements of ISO 10993 and ASTM F895 standards. These findings offer new insights into how monoclinic ordering governs the piezoelectric behavior of HAp and suggest a promising strategy for enhancing its performance in biomedical applications. Full article

Introduction: Fever is one of the most common reasons for Paediatric Emergency Department (PED) visits, often driven by parental anxiety and misconceptions about fever management. This study aimed to evaluate the knowledge, attitudes, and practices of parents regarding childhood fever to identify gaps and guide targeted educational interventions. Understanding parental behaviors is crucial for improving care outcomes and reducing unnecessary PED utilization. Methods: This study is a descriptive cross-sectional study. The sample of this study consists of a total of 440 parents of children admitted to the Paediatric Emergency Department (PED) with complaints of fever. Convenience sampling was used to select the participants. Data were collected using a questionnaire covering sociodemographics, a form surveying the parents’ fever knowledge and attitude, and the validated parents’ fever management scale (Turkish version). The data were analyzed using the SPSS 22.0 statistical program. Results: Most parents (95.5%) reported prior experience with childhood fever, yet 54.1% lacked a regular physician. Common fever detection methods included tactile assessment (56.4%) and thermometers (27.3%). Parental concern arose at 39 °C (48.6%). Cold applications (41.6%) and antipyretics (21.1%) were frequent interventions. The mean PFMS-TR score was high (34.97 ± 4.27), indicating elevated caregiver burden. Scores varied significantly by the child’s age (higher for infants, p = 0.044) and maternal education (higher for educated mothers, p = 0.008). Satisfaction with healthcare staff correlated with higher scores (p = 0.024). Negative correlations emerged between parental age, number of children, and fever management scores (p < 0.05). Conclusions: Parents exhibited high interventionist behaviors and persistent knowledge gaps, underscoring the need for targeted education programs. Educational programs targeting fever management, tailored to parental demographics and misconceptions, are essential. Healthcare providers, particularly pediatric nurses, should prioritize clear communication and evidence-based guidance to empower parents and reduce unnecessary healthcare burdens. Future research should expand to diverse geographic and cultural settings to enhance generalizability. Full article