Search Results (2,386)

Objective: The aim of this study was to evaluate and compare the clinical behavior of indirect onlays/overlays made of lithium disilicate and composite resin and to investigate risk factors associated with restoration failures. Methods: 112 indirect partial coverage posterior restorations (onlays and overlays) placed in 51 adult patients between January 2014 and December 2020 were examined. The restorations were evaluated using selected FDI criteria (color match, surface gloss, anatomic form, fracture of restorative material, tooth cracks and fractures, marginal discoloration, marginal integrity and recurrence of initial pathology). The survival of the restorations was analyzed using Kaplan–Meier method. Risk factors (type of restoration, type of tooth, tooth vitality, smoking) were investigated using Cox regression analysis. Risk estimation was conducted for each evaluated criterion (p < 0.05). Results: For composite restorations, the estimated survival rate was 94.2% after 5 years, dropping to 74.3% in 7.9 years and continued falling to less than 60% after 8.2 years. On the contrary, for lithium disilicate restorations the estimated survival rate was 90.9% after 5 years, dropped to 85.2% after 5.5 years remaining stable thereafter. Lithium disilicate onlays demonstrated significantly better performance than lithium disilicate overlays. Cox regression analysis did not reveal any significant association between the survival of the indirect partial restorations and restoration material, tooth type, restoration type and history of endodontic treatment. However, smoking was found to be a statistically significant risk factor (p < 0.05). Conclusions: Lithium disilicate and composite indirect restorations exhibited comparable survival rates at the early observation period. However, lithium disilicate partial coverage restorations demonstrated more favorable clinical behavior compared to composite in the long term, with statistical significance observed in ceramic vs. composite onlays. Full article

Rheumatoid arthritis (RA) is a highly prevalent chronic inflammatory rheumatic disorder leading to functional impairment and sequels. The search for new biomarkers helping in detecting RA subjects of high risk of functional disability is required. Studies showing high follistatin levels in RA have been described; however, none of them have placed focus on the role of follistatin as marker of deteriorated functionality. We aim to identify whether follistatin concentrations could be a potential biomarker of physical disability and disease activity in RA patients. Fifty-seven female RA subjects and 20 age–gender-matched controls were included in a cross-sectional evaluation. An assessment of clinical characteristics, grip strength, gait speed, and muscle mass was conducted. In RA subjects, disability was assessed using HAQ-DI and active disease using the DAS28-ESR. Follistatin levels were measured by ELISA. We compared (a) RA + functional disability and (b) RA + preserved physical function. Serum follistatin levels were increased in RA subjects compared to controls (175 ± 119 vs. 133 ± 47; p = 0.030). Follistatin levels correlated with deteriorated physical function levels (r = 0.491; p < 0.001) and severe activity (r = 0.344; p = 0.009). The RA + functional disability group, as compared to the RA + preserved physical function group, had higher serum follistatin levels (218 ± 159 vs. 141 ± 59; p = 0.030), lower grip strength (7.9 ± 4.6 vs. 14.5 ± 5.1; p < 0.001), reduced gait speed (0.77 ± 0.20 vs. 0.92 ± 0.20; p = 0.010), as well as higher proportions of tender joints ≥4 (48% vs. 16%; p = 0.008), and higher disease activity scores (3.8 ± 1.5 vs. 2.8 ± 1.2; p = 0.008). We concluded that higher follistatin levels are associated with physical functional impairment and the severity of disease activity in women with RA. Future studies are required to evaluate whether these follistatin levels can be related to other outcomes such as labor disability, hospitalization, and falls. Full article

Background/Objectives: Metabolic syndrome (MetS) comprises a cluster of cardiometabolic risk factors that vary dynamically under environmental and behavioral influences. Although there are data suggesting seasonal variability in individual metabolic components, few studies have comprehensively assessed MetS as a composite condition across seasons using a large, nationally representative population. In this study, we aimed to evaluate the seasonal and monthly patterns of MetS prevalence and component burden, with a focus on sex-specific differences. Methods: We analyzed 5,507,251 health screening records from 2,057,897 Korean adults aged ≥40 years between 2013 and 2022, obtained from the National Health Insurance Service database. Seasons were categorized as: spring (March–May), summer (June–August), fall (September–November), and winter (December–February). Trends in MetS prevalence and its components were evaluated monthly and seasonally, stratified by sex. Results: MetS prevalence significantly varied by season in both sexes (p < 0.001), ranging from 30.2% to 34.5% in men and from 21.5% to 25.5% in women. Among men, a U-shaped pattern was observed, with the lowest prevalence during summer and a progressive increase through winter. Women showed a steady decline in prevalence from January to September, followed by a slight rebound. Winter was associated with increased odds of MetS in both sexes. A significant interaction between sex and season (p for interaction <0.001) indicated the presence of sex-specific temporal patterns. Conclusions: This nationwide study revealed clear seasonal variation in MetS prevalence and component burden, with sex-specific patterns. These findings highlight the importance of incorporating seasonality and sex in cardiometabolic risk assessments and public health interventions. Full article

This narrative review examines the complex relationship between sleep changes during the menopausal transition and cardiometabolic risks. The most common complaint about sleep is increased awakenings during sleep. Other complaints include having trouble falling asleep, waking up too early, insufficient and non-restorative sleep, and overall poor quality. Sleep determined using objective methods also indicates that greater awakenings after sleep onset are associated with the period of menopausal transition. Polysomnography recordings suggest physiological hyperarousal during sleep. Changes in other sleep metrics, such as sleep latency and sleep duration, are less consistent, and some studies suggest they may not worsen during the menopausal transition. These sleep issues are influenced by multiple factors, such as hormonal fluctuations, vasomotor symptoms, and psychosocial factors, and evidence suggests that hypothalamic kisspeptin/neurokinin B/dynorphin (KNDy) neurons are key underlying mechanisms for these associations. The menopausal transition is also associated with increases in cardiometabolic risk factors, such as body fat, altered lipid profiles, blood pressure, and vascular health. Emerging evidence suggests that poor sleep health during this period is associated with increased cardiometabolic risks and adverse cardiovascular outcomes. Thus, addressing sleep disturbances is crucial for comprehensive healthcare during the menopausal transition to safeguard long-term cardiometabolic health. Future research is needed to investigate interventions that can improve sleep and their impact on cardiometabolic health in this population experiencing increases in cardiometabolic risk. Full article

As people spend most of their time indoors, the quality of the indoor lighting environment plays a crucial role in occupant health, mood, and productivity. While modern glazed curtain walls improve daylighting potential, they also heighten the risks of glare and associated solar heat gains that may result in occupant discomfort and overheating. To continuously ensure visual comfort while providing shading, kinetic responsive facades controlled by sensors and actuators can change the angles of the elements. Conventional control methods for shading devices mainly involve the unified control of each element. However, as each element of the kinetic responsive facade can be controlled independently, the number of potential control actions increases exponentially with the number of facade elements and possible angles. Traditional rule-based methods are challenging for handling this multi-objective high-dimensional control problem. This paper introduces a novel self-learning, real-time reinforcement learning (RL) controller that can interact with the environment to find a globally optimal control solution for each element in kinetic responsive facades, thereby meeting visual quality and shading goals. The configuration and workflow of the proposed RL controller are introduced and tested vertically, diagonally, and radially folding responsive facades. The results demonstrate that the proposed RL controller effectively maintains horizontal and vertical illuminance, with 72.92% of test points in occupied spaces falling within the defined comfort range. Additionally, it keeps the daylight glare probability (DGP) below 0.35, a level generally considered imperceptible. Full article

Industrial processes like farming, food processing, petroleum refinery, and leather manufacturing produce a lot of high-salinity wastewater. This wastewater presents serious environmental risks, such as soil degradation, eutrophication, and water salinization, if it is released without adequate treatment. The sources and features of high-salinity wastewater are outlined in this review, along with the main methods for removing organic pollutants, such as physicochemical, biological, and combined treatment approaches. Membrane separation, coagulation–flocculation, and advanced oxidation processes are the primary physicochemical techniques. Anaerobic and aerobic technologies are the two categories into which biological treatments fall. Physicochemical–biological combinations and the fusion of several physicochemical techniques are examples of integrated technologies. In order to achieve sustainable and effective treatment and resource recovery of high-salinity wastewater, this review compares the effectiveness and drawbacks of each method and recommends that future research concentrate on the development of salt-tolerant catalysts, anti-fouling membrane materials, halophilic microbial consortia, and optimized hybrid treatment systems. Full article

Human pose estimation (HPE) in privacy-sensitive environments such as healthcare facilities and smart homes demands non-visual sensing solutions. Millimeter-wave (mmWave) radar emerges as a promising alternative, yet its development is hindered by the scarcity of high-fidelity datasets with accurate annotations. This paper introduces mmFree-Pose, the first dedicated mmWave radar dataset specifically designed for privacy-preserving HPE. Collected through a novel visual-free framework that synchronizes mmWave radar with VDSuit-Full motion-capture sensors, our dataset covers 10+ actions, from basic gestures to complex falls. Each sample provides (i) raw 3D point clouds with Doppler velocity and intensity, (ii) precise 23-joint skeletal annotations, and (iii) full-body motion sequences in privacy-critical scenarios. Crucially, all data is captured without the use of visual sensors, ensuring fundamental privacy protection by design. Unlike conventional approaches that rely on RGB or depth cameras, our framework eliminates the risk of visual data leakage while maintaining high annotation fidelity. The dataset also incorporates scenarios involving occlusions, different viewing angles, and multiple subject variations to enhance generalization in real-world applications. By providing a high-quality and privacy-compliant dataset, mmFree-Pose bridges the gap between RF sensing and home monitoring applications, where safeguarding personal identity and behavior remains a critical concern. Full article

Background: Older adults with mild cognitive impairment are at increased risk for physical decline and falls due to decreased strength, flexibility, balance, and gait. Dance-based aerobic training has emerged as a promising and enjoyable intervention to promote physical function and cognitive stimulation. This study aimed to evaluate the efficacy of a 12-week structured dance-based aerobic program, based on line dancing and Latin rhythms (e.g., salsa, merengue, and bachata), in improving functional capacity and reducing the risk of falls in older adults with mild cognitive impairment. Methods: A randomized controlled trial was conducted with 92 participants aged ≥65 years diagnosed with mild cognitive impairment. The participants were randomly assigned to an experimental group (dance-based training, twice weekly for 12 weeks) or a control group (usual activity). Outcomes included muscle strength (grip dynamometry), flexibility (back scratch and chair sit-and-reach tests), gait speed (Timed Up and Go test), balance (Tinetti scale), and total falls risk score (Tinetti). Mixed ANOVA and Cohen’s d were used for statistical analysis. Results: Significant improvements were observed in the experimental group on all variables compared to the control group. Muscle strength (p < 0.001, d = 0.86), gait speed (p = 0.026, d = 0.48), and upper and lower extremity flexibility (d = 0.43–0.79) improved significantly. The balance and gait components of the Tinetti scale also increased (p = 0.007 and p = 0.048, respectively), as did the total Tinetti score (p = 0.002, d = 0.67), indicating a reduction in the risk of falls. Conclusions: These findings suggest that, under structured conditions, dance-based aerobic training may serve as a promising non-pharmacological strategy to support healthy aging in older adults with mild cognitive impairment, although further validation in larger cohorts is needed. Full article

The ageing of the global population, especially in developed countries, is driving significant societal changes. In Portugal, demographic data reflect a marked increase in the ageing index. Understanding gait alterations associated with ageing is essential for the early detection of mobility decline and fall risk. This study aimed to analyse gait patterns in older adults to contribute to a biomechanical ageing profile. Thirty-six community-dwelling older adults (29 female, 7 male; mean age: 74 years) participated. Gait data were collected using the Xsens full-body motion capture system, which combines inertial sensors with biomechanical modelling and sensor fusion. Spatiotemporal and kinematic parameters were analysed using descriptive statistics. Compared to younger adult norms, participants showed increased stance and double support phases, reduced swing phase, and lower gait speed, stride length, and cadence, with greater step width. Kinematic data showed reduced peak plantar flexion, knee flexion, and hip extension, but increased dorsiflexion peaks—adaptations aimed at stability. Despite a limited sample size and lack of clinical subgroups, results align with age-related gait literature. Findings support the utility of wearable systems like Xsens in capturing clinically relevant gait changes, contributing to normative biomechanical profiling and future mobility interventions. Full article

Background: Aging is associated with reduced joint flexibility and balance, which increases the risk of falls, especially during stair descent where motor control is critical. Stretching has been shown to improve ankle range of motion and gait speed. This study investigated the effects of a 4-week training program combining stretching plus resistance training (RT) with elastic bands on functional capacity and ankle stability during stair descent in older women. Methods: Twenty-four active older women (mean age: 73.1 ± 0.97 years) were randomly assigned to static stretching (SS), dynamic stretching (DS) and control (CG) groups. All participants completed two weekly 60 min sessions consisting of progressive RT preceded by three different warm-ups. The SS and DS groups completed static or dynamic stretching, while the CG walked. Assessments included 30s-Chair Stand (30s-CS), Handgrip Strength (HGS), Time Up and Go (TUG), Chair Sit and Reach (CSR), Rating of Perceived Exertion (RPE), and ankle kinematics during stair descent. Results: All groups improved 30s-CS and TUG (p < 0.05). Only the SS group improved CSR in both legs and the ankle dorsiflexion angle during stair descent at final foot contact (p = 0.002). RPE increased over time across all groups (p < 0.0001); however, the SS and DS groups reported lower exertion than the CG group in first–second weeks (p = 0.0001–0.003). Conclusions: SS prior to progressive RT improved flexibility and ankle kinematics during stair descent, thus reducing the perception of effort particularly during the initial training phase. These findings indicate the effectiveness of SS as a warm-up strategy for increasing ROM and potentially reducing the risk of falls in this population. Full article

Polypharmacy in older adults increases risks of adverse drug reactions (ADRs), hospitalisations, and mortality. Pharmacist-led interventions using validated tools (e.g., STOPP/START, MAI, STOPPFrail) aim to optimise prescribing, yet their impact on clinical and economic outcomes in UK/Ireland health systems remains underexplored. This systematic review aimed to critically assess the impact of pharmacist-led deprescribing interventions on PIP, clinical outcomes, and costs in older adults (≥65 years) across the UK and Ireland. Following PRISMA 2020 guidelines, four databases (PubMed, Scopus, Web of Science, Cochrane Library) were searched for studies (2010–2024). Eligible studies included randomised trials, observational designs, and intervention studies in hospitals, care homes, community pharmacies, and intermediate care settings. Fourteen studies met the inclusion criteria. The risk of bias was assessed using CASP checklists. Narrative syntheses and heat maps summarised the findings. Twelve of fourteen studies reported positive outcomes: reductions in potentially inappropriate medications, ADRs, medication burdens, and falls/fall risks. Medication appropriateness improved significantly in 35% of studies using the MAI. STOPPFrail reduced PIMs in care homes, while the MAI enhanced complex hospital reviews. Community interventions improved adherence and reduced the use of fall risk drugs. No studies demonstrated a reduction in hospitalisations, mortality, or the length of stays. Economic analyses showed mixed cost-effectiveness. Key barriers included low uptake of pharmacist recommendations and short follow-up periods. Pharmacist-led interventions have significantly improved the prescribing quality and reduced medication-related risks, but they fail to impact hospitalisations or mortality due to implementation gaps. Context-specific tools and policy reforms—including expanded pharmacist roles and electronic decision support—are critical for sustainability. Future research should focus on long-term outcomes, cost-effectiveness, and multidisciplinary integration. Full article

Trees play a vital role in supporting biodiversity, particularly in regions where human demand for resources is increasing and many species are experiencing population decline. Native orchids, especially those that are endemic, are particularly vulnerable to population decreases in biodiversity hotspot areas, with anthropogenic factors playing an increasingly significant role in this trend. A substantial portion of the northern district of Kerala, situated in southern India, falls within the biodiversity hotspot of the Western Ghats. The road network traversing the Western Ghats provides refuge for native orchids on various tree species. The present study examined a 60 km perimeter area encompassing 15 different sites located near small towns and built-up areas, regions where trees have already been lost due to settlement and infrastructure development. These roadside areas are lined with a mixture of native and exotic trees, including both naturally recruited fruit trees and exotic species. Approximately 600 trees, representing 72 different tree taxa, were recorded from the sampled areas in Wayanad. Nearly 10,000 orchids encompassing 13 species were observed, with 6 of these species, constituting 46%, being endemic to the region. This study revealed variations between sites, with some locations exhibiting high diversity and abundance of both trees and orchids. The diversity and abundance of native orchids, risks, and prospects of development mitigation are discussed in detail. Full article

The impact of cycling-related traffic crashes on public health has increased significantly in recent decades, with cyclists being among the most vulnerable road users. The risk of severe injury in traffic crashes is notably high for cyclists, especially when distracted. Research indicates that distraction while cycling significantly increases the crash risk. This study investigates cycling distraction through a field operational test involving 100 participants. Riders followed a predetermined course while being exposed to external visual and auditory stimuli, including alarms, advertising signs, and car horns. Distraction levels were measured using eye-tracking technology. Data were analyzed by means of descriptive statistics, cluster, and correlation analyses. Our findings showed that auditory stimuli distract a higher percentage of cyclists, while audiovisual stimuli from road-related factors cause longer-lasting distractions. Additionally, five distraction clusters were identified based on stimulus duration. Lastly, it was found that males were more likely to belong to high-distraction clusters, whereas females and daily cyclists were more likely to fall into the lowest-distraction group. Full article

This study models a three-level supply chain (farmer–retailer–government) incorporating farmer risk aversion. Under land capacity and fiscal budget constraints, it analyzes two subsidy strategies: area-based subsidies to farmers (SF) and volume-based subsidies to retailers (SR). Key findings include that when farmer land capacity exceeds a critical threshold and the fiscal budget is constrained, SF yields superior performance to SR. Conversely, with sufficient budgets, SR outperforms SF under high land capacity. Under moderate land capacity and unlimited budgets, both strategies exhibit equivalent effects. When land capacity falls below a critical threshold, government subsidies become unnecessary. The SF strategy demonstrates greater resilience against output uncertainty compared to SR. Under constrained budgets, SF is preferable; SR becomes more advantageous with abundant budgets. Critically, increasing risk aversion significantly reduces social welfare under both SF and SR strategies. This indicates neither subsidy mechanism effectively mitigates the adverse effects of farmer risk aversion. Full article

Background: Stair ambulation is a complex motor task that presents a substantial fall risk for people with Parkinson’s disease (PwPD) who often have postural instability and gait difficulty (PIGD) and experience unpredictable freezing of gait (FOG) episodes. While dual-task (DT) interference during level walking is well-documented, its impact on stair ambulation, an everyday, high-risk activity, remains poorly understood. Objective: The aim of this study was to quantify the impact of dual tasking on patterns of motor control during stair ambulation using kinetic data from The Stair Ambulation and Functional Evaluation of Gait (Safe-Gait) system. Methods: Seventeen individuals with Parkinson’s disease (PD) completed three single-task (ST) and three dual-task (DT) trials on the Safe-Gait system, which sampled kinetic data via embedded force plates during stair ascent and descent. The force plate data were used to quantify step time, braking and propulsive impulses, and center of pressure (CoP) displacement and sway speed to assess DT effects on stair ambulation kinetics. Results: Dual-task conditions led to significant increases in step time (p < 0.001), braking impulse (p < 0.01), anteroposterior center of pressure (CoP) range (p < 0.05), and a decrease in mediolateral CoP speed (p < 0.01). Conclusions: Dual tasking during stair ambulation altered gait kinetics in PwPD, evidenced by slower, less stable movement patterns. These findings highlight the impact of cognitive motor DT interference on functional mobility and support the use of instrumented stair assessments to guide therapeutic care and fall risk interventions. Full article