Search Results (333)

Transcatheter aortic valve replacement (TAVR) has evolved over the last two decades into a cornerstone therapy for patients with severe symptomatic aortic stenosis. This therapy was initially reserved for those at high or prohibitive surgical risk but is now firmly established across all surgical risk categories. Its non-inferiority to surgical aortic valve replacement has been demonstrated even in low-risk populations, supporting the rapid worldwide expansion of its use. Nevertheless, despite procedural refinements and the advent of newer-generation prostheses, conduction disturbances leading to permanent pacemaker implantation (PPI) remain one of the most frequent and clinically relevant complications. Reported incidence ranges between 8% and 20% depending on prosthesis type, implantation technique, and baseline patient characteristics. Multiple clinical, anatomical, and procedural factors have been identified as strong predictors of post-TAVR conduction disturbances. Taken together, the integration of anatomical and clinical risk assessment, precise procedural planning, careful device selection, structured monitoring, and emerging therapeutic strategies constitutes a comprehensive, evidence-based approach to reduce the burden of conduction disturbances following TAVR. Such a multimodal framework has the potential not only to lower the incidence of permanent pacemaker implantation but also to improve safety, optimize healthcare resource utilization, and support the broader adoption of TAVR in increasingly younger and lower-risk patient populations. Full article

Restoration of structurally compromised teeth often requires cusp coverage, yet the influence of preparation design and material type on performance remains unclear. This study evaluated the effect of cusp coverage design and hybrid resin–ceramic material on the marginal adaptation and fracture resistance of partial coverage restorations in mandibular molars. Eighty extracted teeth were prepared for indirect restorations and allocated to four groups (n = 20) according to design, either functional cusp coverage (FC) or complete cusp coverage (CC) and material, either GC Cerasmart (CS) or VITA Enamic (EN). Restorations were bonded with dual-cure resin cement, thermocycled, and subjected to cyclic loading. Fracture load, marginal adaptation, and failure mode were evaluated (α = 0.05). CC-CS and CC-EN exhibited significantly higher fracture loads than FC-CS and FC-EN (p < 0.001), while no difference was found between materials within each design. For marginal adaptation, CS showed significantly greater marginal gaps than EN in both designs (p < 0.001). CC designs demonstrated a higher proportion of repairable failures (Type I and II), whereas EN showed more catastrophic fractures. Within the limitations of this in vitro study, cusp coverage design significantly affected fracture resistance, while material type primarily influenced marginal adaptation. Both hybrid resin–ceramics provided acceptable mechanical performance for partial coverage restorations. Full article

This paper presents provides a comprehensive survey of dwarf galaxies, which represent the most numerous and diverse systems in the Universe. We discuss their definitions and morphological classifications, emphasizing the unique properties that distinguish them from globular clusters and giant galaxies. Special attention is given to their formation and evolutionary processes in the framework of hierarchical structure formation and ΛCDM cosmology, including the role of environmental mechanisms and stellar feedback. Star formation histories are explored based on observations and simulations, highlighting both bursty and extended activity across different dwarf types. We further examine the crucial role of dark matter in shaping the dynamics and structure of dwarf galaxies, as well as the core–cusp and missing satellites problems. Finally, we summarize insights from numerical simulations and theoretical models, which provide a bridge between observations and cosmological predictions. This synthesis demonstrates that dwarf galaxies remain essential laboratories for testing galaxy formation theories and probing the nature of dark matter. Full article

This work takes up the task of the determination of the rate of pointwise and uniform convergences to the unit operator of the “normalized cusp neural network operators”. The cusp is a compact support activation function, which is the composition of two general activation functions having as domain the whole real line. These convergences are given via the modulus of continuity of the engaged function or its derivative in the form of Jackson type inequalities. The composition of activation functions aims to more flexible and powerful neural networks, introducing for the first time the reduction in infinite domains to the one domain of compact support. Full article

This study focuses on tunnel construction in fault fracture zones and systematically investigates the energy evolution and damage catastrophe mechanisms of surrounding rock during excavation, based on energy conservation principles and cusp catastrophe theory. A tunnel instability prediction and support optimization framework integrating energy damage evolution and intelligent optimization algorithms was developed. Field tests, rock mechanics experiments, and Discrete Fracture Network (DFN) numerical simulations reveal the intrinsic relationships among energy input, dissipation, damage accumulation, and instability under complex geological conditions. Particle Swarm Optimization–Back Propagation (PSO-BP) is applied to optimize tunnel support parameters. Model performance is evaluated using the Mean Absolute Error (MAE), Mean Squared Error (MSE), Mean Absolute Percentage Error (MAPE), and R-squared (R²). The results show that upon reaching structural mutation zones, the system damage variable (ds), displacement, and dissipated energy increase abruptly, indicating critical instability. Numerical simulation and catastrophe feature analysis demonstrate that energy-related damage accumulation is effectively suppressed, the system damage variable decreases significantly, and crown stability is greatly enhanced. These findings provide a theoretical basis and practical reference for optimizing tunnel support design and controlling instability risks in complex geological settings. Full article

Background: To evaluate the fracture resistance of 3D-printed 3-unit fixed dental prostheses (FDPs) made from tetragonal zirconia polycrystal (3Y-TZP). Methods: Based on a maxillary typodont model with a missing first molar and neighboring teeth with full crown preparations, FDPs differing in wall thickness (d = 0.6 mm / d = 0.8 mm / d = 1.0 mm) were designed. For all test groups, 12 samples were fabricated from 3Y-TZP by either 3D-printing or milling. For 3D-printing, pontic designs were modified by basal slots to enable regular firing times. After luting on CoCr dies, samples underwent artificial aging. Loads tilted by 30° were applied on the mesio-buccal cusp of the pontic, and fracture resistance F_u was assessed. Welch ANOVA and Dunnett-T3 tests were used for statistical evaluation. Results: Significant differences in F_u were identified (Welch ANOVA, p < 0.001). For milled FDPs, fracture originated from connector areas, and F_u increased with increasing wall thickness (d = 0.6 mm: 1536 ± 131 N, d = 0.8 mm: 2226 ± 145 N, d = 1.0 mm: 2686 ± 127 N, significant differences but for the comparison d = 0.8 mm vs. d = 1.0 mm). For 3D-printed FDPs, the loaded cusp fractured, and F_u did not change with FDP wall thicknesses (p > 0.779, F_u = 1110 ± 26 N for all PZ FDPs). Milled FDPs showed significantly higher F_u when compared to 3D-printed FDPs with identical wall thickness. Conclusions: Although 3D-printed zirconia FDPs still show lower fracture resistance values than their milled counterparts, all tested FDP configurations clearly exceed the clinical reference thresholds and can therefore be recommended for clinical use. Full article

The study aimed to optimize an oil-in-water emulsion loaded with the antioxidant extract of Randia monantha using Coccoloba uvifera seed protein (CUSP) as emulsifier and ultrasound-assisted processing. Response surface methodology (RSM) was employed to evaluate the effects of protein concentration (2, 3, and 4%), oil amount (5, 15, and 25%), and ultrasound duration (3, 5, and 7 min) on the polydispersity index (PDI) and droplet size. A total of 21 mg of extract was added to each formulation. The optimal conditions were a 3% protein concentration, 20% oil content, and 7 min of ultrasound. Under these conditions, the emulsion showed low PDI (1.88), D_[3,2] (1.11 µm), and D_[4,3] (1.60 µm). It remained stable at 4 °C for 15 days within a pH range of 6−10, with NaCl concentrations < 200 mM and at temperatures between 25 and 50 °C. Thermal analysis of the emulsion revealed endothermic transitions and decomposition events at higher temperatures, achieving 100% entrapment efficiency and ~83% photoprotection for the extract. This plant protein stabilizes the extract at the oil/water interface, enhancing thermal stability and protecting against photodamage. These qualities are vital in the food industry for preserving thermolabile compounds. The emulsion can enhance antioxidant properties in semi-solid foods or be spray-dried into a powder for functional formulations. Full article

Background: Traditional visual-tactile methods, radiographic interpretation including CBCT imaging, clinical judgement and supplementary aids such as fluorescence-based devices are pivotal components of the restorative diagnostic process in detecting dental caries and defective or failed restorations. However, when evaluating the restorability of a tooth compromised by extensive and deep caries, whether associated with a failed restoration or not, the conventional approach may not provide sufficient diagnostic information to establish a definitive restorative diagnosis without first removing failing restoration, caries or both. Objective: This manuscript presents caries clearance management (CCM) as a novel comprehensive clinical diagnostic restorative procedure designed to assist dentists in making a final restorative diagnosis regarding the restorability of a tooth compromised by extensive caries, fractured tooth cusp(s) or a failed large direct/indirect restoration without caries or a combination of all of them. Practical implications: CCM involves removing the failed direct/indirect restorations and selective removal of carious tissue while preserving the greatest amount of sound tooth structure as possible. Following this clinical diagnostic procedure and an assessment of dental pulp and periodontium, the clinician proceeds through a decision-making process to determine the final restorative diagnosis. This allows the dentist to advise the patient on a suitable complex restorative treatment plan. Conclusions: The manuscript introduces caries clearance management (CCM) as a structured clinical diagnostic procedure, to assist dentists to determine the restorability of compromised teeth by extensive caries, fractured teeth or failed large direct or indirect restorations. Full article

In optics, light rays emitted from a light source form a wavefront (orthotomic) upon reflection by a mirror. The mirror is referred to as an antiorthotomic of the orthotomic. The investigation of the relationship between orthotomics and antiorthotomics constitutes an interesting problem in physics. However, the study becomes ambiguous when the orthotomic exhibits singular points. In this paper, we define generalized antiorthotomics of (n, m)-cusp curves in the Euclidean plane by using the singular curve theory. We demonstrate that the singular points of the generalized antiorthotomic sweep out the evolute of the (n, m)-cusp curve. We also investigate the behavior and singular characteristics of the antiorthotomic of the (n, m)-cusp curve. Moreover, we define parallels for (n, m)-cusp curves and reveal the relationship between parallels and generalized antiorthotomics. Finally, repeated antiorthotomics are studied, which is useful for identifying the characteristics of (n, m)-cusp curves. Full article

Background/Objectives: Cadherin-6 (CDH6), also known as K-cadherin, is a type II classic cadherin molecule that plays an important role in the embryonic development of the kidney but has very limited expression in adult tissues. It is overexpressed in several human malignancies, primarily in ovarian cancer, renal cell carcinoma, as well as, less frequently, cholangiocarcinoma, uterine serous carcinoma, glioma, lung, pancreatic and thyroid cancers. The characteristic of limited expression in normal tissues, high expression in tumor tissues, and rapid internalization upon antibody binding makes CDH6 a well-suited antibody-drug conjugate (ADC) target. Methods: We developed a novel CDH6-targeting ADC, CUSP06, consisting of a proprietary humanized antibody selective for CDH6, a protease cleavable linker, and an exatecan payload, with a drug-to-antibody ratio (DAR) of 8. We further characterized the pharmacological activities of CUSP06 in multiple in vitro and in vivo models. Results: CUSP06 was selectively bound to cell surface CDH6 and was efficiently internalized into CDH6-positive ovarian cancer cells, and led to the induction of DNA damage and apoptosis of CDH6-positive cancer cells. CUSP06 exhibited strong antiproliferative activity against several CDH6-positive cancer cell lines and demonstrated strong bystander cell killing effect in the cell mixing experiments in vitro. CUSP06 exhibits excellent in vivo antitumor efficacy in CDH6-high or -low cell line-derived xenograft (CDX) or patient-derived xenograft (PDX) models from human ovarian, renal and uterine cancers, as well as cholangiocarcinoma. CUSP06 demonstrated a favorable safety profile in GLP-compliant toxicology studies in Sprague Dawley rats and cynomolgus monkeys. Conclusions: The preclinical data highlighted the therapeutic potential of CUSP06 in multiple CDH6-positive human cancers. Full article

An electron optic system (EOS) consisting of a sheet electron beam gun (SEB) and a pole offset periodic cusped magnet (PO-PCM) is reported for 340-GHz frequency. A sheet electron beam with a voltage of 29 kV, beam compression ratio of 16, and a beam waist of size 0.17 mm × 0.044 mm was designed and optimized using computer simulation technology (CST). The EOS was capable of transmitting the beam with a current of 6.9 mA through a beam tunnel of size 0.516 mm × 0.091 mm, having a length of 60 mm with the help of a pole offset periodic cusped magnet. The axial magnetic field generated by the PCM was 0.32 T. The EOS was efficient enough to transmit the beam stably through the beam tunnel with a transmission rate of 100%. Full article

Rydberg atoms play a crucial role in testing atomic structure theory, quantum computing and simulation. Measurements of transition frequencies from the $2^{1,3}S$ states to Rydberg ${}^{1,3}P$ states have reached a precision of several kHz, which poses significant challenges for theoretical calculations, since the accuracy of variational energy calculations decreases rapidly with increasing principal quantum number n. Recently the complex “triple” Hylleraas basis was employed to attain the ionization energy of helium $24{}^{1}P$ state with high accuracy. Different from it, we extended the correlated B-spline basis functions (C-BSBFs) to calculate the Rydberg states of helium. The nonrelativistic energies of $1snp$${}^{1,3}P$ states up to $n=27$ achieve at least 14 significant digits using a unified basis set, thereby greatly reducing the complexity of the optimization process. Results of geometric structure parameters and cusp conditions were presented as well. Both the global operator and direct calculation methods are employed and cross-checked for contact potentials. This C-BSBF method not only obtains high-accuracy energies across all studied levels but also confirms the effectiveness of the C-BSBFs in depicting long-range and short-range correlation effects, laying a solid foundation for future high-accuracy Rydberg-state calculations with relativistic and QED corrections included in helium atom and low-Z helium-like ions. Full article

(1) Aim: To compare transverse dimensions measured on AI-generated intra-oral models and conventional digital intra-oral models. (2) Methods: A group of 38 patients treated with clear aligners was selected retrospectively from those whose records featured both AI-generated and conventional digital intra-oral models taken at the same timepoint. Transverse dimensions (inter-canine, inter-premolar, and inter-molar distances) on both upper and lower arches were evaluated and compared. Intra-class correlation index and paired t-test were applied to test the repeatability of measurements and statistically significant differences, respectively. Statistical significance was set at 0.05. (3) Results: Intra-class correlation index showed good repeatability. Paired t-test showed differences in measurements of the distances between the thicket area of gingiva on the palatal side of the upper first molar (p = 0.002), the gingival margin of the lower first molar (p = 0.014), and the mesio-vestibular cusps of the lower first molars (p = 0.019). (4) Conclusions: Transverse measurements were similar on AI-generated and conventional intra-oral .stl renderings. Statistical differences were found on posterior areas of both upper and lower dental arches, but are unlikely to be clinically significant. Full article

We present the case of a 63-year-old man with severe aortic valve regurgitation and left-ventricular dysfunction. The patient was scheduled for elective surgery. A quadricuspid aortic valve with fibrous thickening and calcification of the cusps was visualized intraoperatively while preoperative surface echocardiography had failed to diagnose this anomaly. The aortic valve was successfully replaced with a biological prosthesis. Full article

For the local oscillation phenomenon of the APF algorithm in the face of static U-shaped obstacles, the path cusp phenomenon caused by the vehicle corner and path curvature constraints is not taken into account, as well as the low path safety caused by ignoring the vehicle volume constraints. Therefore, an APF-Dijkstra path planning fusion algorithm based on steering model and volume constraints is proposed to improve it. First, perform an expansion treatment on the obstacles in the map, optimize the search direction of the Dijkstra algorithm and its planned global path, ensuring that the distance between the path and the expanded grid is no less than 1 m, and use the path points as temporary target points for the APF algorithm. Secondly, a Gaussian function is introduced to optimize the potential energy function of the APF algorithm, and the U-shaped obstacle is ellipticized, and a virtual target point is used to provide the gravitational force. Again, the three-point arc method based on the steering model is used to determine the location of the predicted points and to smooth the paths in real time while constraining the steering angle. Finally, a 4.5 m × 2.5 m vehicle rectangle is used instead of the traditional mass points to make the algorithm volumetrically constrained. Meanwhile, a model for detecting vehicle collisions is established to cover the rectangle boundary with 14 envelope circles, and the combined force of the computed mass points is transformed into the combined force of the computed envelope circles to further improve path safety. The algorithm is validated by simulation experiments, and the results show that the fusion algorithm can avoid static U-shaped obstacles and dynamic obstacles well; the curvature change rate of the obstacle avoidance path is 0.248, 0.162, and 0.169, and the curvature standard deviation is 0.16, which verifies the smoothness of the fusion algorithm. Meanwhile, the distances between the obstacles and the center of the rear axle of the vehicle are all higher than 1.60 m, which verifies the safety of the fusion algorithm. Full article