Search Results (3,583)

Burnout syndrome, caused by chronic unmanaged stress, is common among health sciences students, and dental students in clinical training are particularly vulnerable due to the intense cognitive, emotional, and practical demands. This multicenter cross-sectional study assessed burnout and related factors in 312 students in their 8th–10th semesters at three Ecuadorian universities using the Maslach Burnout Inventory and a questionnaire on physical and emotional symptoms. High emotional exhaustion affected 79.5% of students, high depersonalization 54.5%, and low personal accomplishment 11.5%, with an overall burnout prevalence of 8.01%. No statistically significant associations were found with university or academic semester, although students studying or working more than 30 h per week showed a non-significant trend toward higher risk (OR = 3.39; p = 0.208), and the model’s predictive capacity was low (AUC = 0.645). Frequently reported physical symptoms included lower back pain (41.35%), neck pain (35.9%), and headaches (30.45%). These findings reveal that burnout, often accompanied by physical discomfort, affects a significant number of dental students, highlighting the need for institutional strategies such as psychological support and curricular adjustments to reduce stress and improve overall well-being. Full article

Simultaneous Localization and Mapping (SLAM) systems require accurate and globally consistent mapping to ensure the long-term stable operation of robots or vehicles. However, for the commercial applications of indoor sweeping robots, the system needs to maintain accuracy while keeping computational and storage requirements low to ensure cost controllability. This paper proposes a dual-point-cloud-registration SLAM based on line features for the mapping of a mobile robot, named DPCR-SLAM. The front-end employs an improved Point-to-Line Iterative Closest Point (PLICP) algorithm for point cloud registration. It first aligns the point cloud and updates the submap. Subsequently, the submap is aligned with the regional map, which is then updated accordingly. The back-end uses the association between regional maps to perform graph optimization and update the global map. The experimental results show that, in the application scenario of indoor sweeping robots, the proposed method reduces the map storage space by 76.3%, the point cloud processing time by 55.8%, the graph optimization time by 77.7%, and the average localization error by 10.9% compared to the Cartographer, which is commonly used in the industry. Full article

Background/Objectives: Chronic low back pain is the leading global cause of disability, with a growing prevalence and socioeconomic burden. Despite strong evidence supporting exercise therapy (ET) as a primary treatment, adherence rates remain low, compromising outcomes and increasing healthcare costs. Research on contributing factors to adherence to ET in non-specific chronic low back pain (nsCLBP) is limited. This systematic review aimed to reconceptualise contributors to adherence, using a conceptual framework to explore their interrelations and complexity by integrating quantitative and qualitative research. Methods: PubMed, Web of Science and Scopus were searched, followed by a two-phase screening process. Risk of Bias (RoB), certainty assessment and level of evidence were assessed independently. Results: Eight qualitative and eleven quantitative studies were included, the latter divided into nine RCTs and two cohort studies. Overall, eight included studies showed low RoB, seven showed some concerns, and four presented high RoB. Synthesis identified internal, external, and intervention-related contributing factors. These factors were presented in a conceptual framework figure, highlighting that adherence should not be viewed as a binary concept but rather as a dynamic behaviour shaped by interrelated factors. Moderate-certainty evidence supports the impact of psychosocial factors, healthcare professional (HCP) characteristics, environmental and time-related factors, program design, progression, home-exercise program (HEP), modalities, and follow-up. Low-to-moderate-certainty evidence suggests beliefs, patient-related characteristics, and treatment setting also impact adherence. Low-certainty evidence indicates that feedback, symptoms and impairments, and confidence possibly impact adherence. Conclusions: This systematic review highlights the complex, context-dependent interplay of factors impacting adherence to ET in individuals with nsCLBP. Overall, these findings underscore the need for personalised, context-sensitive interventions that address the broad spectrum of factors, while future research should focus on validated adherence assessment tools. Full article

This study investigates the risk of developing musculoskeletal disorders (MSDs) in individuals performing standing tasks, with a focus on real-time posture assessment using motion capture technology. Improper body posture and repetitive movements during daily work activities can impose strain on the musculoskeletal system, increasing the likelihood of discomfort and long-term injury. Data were collected from five male and female participants using the Perception Neuron motion capture system, with body-mounted sensors tracking posture and movement. Joint angles were calculated to distinguish between correct and incorrect postures based on ISO 11226:2000 ergonomic guidelines. Key physical risk factors identified included prolonged forward trunk inclination, elevated arm positions, and repetitive actions. The analysis revealed that participants frequently adopted moderate- to high-risk postures, especially when working at non-ergonomic desk heights, suggesting a heightened risk of MSDs such as back and upper limb pain. These findings underscore the importance of real-time ergonomic monitoring and adaptive workstation design to reduce musculoskeletal risks in standing work environments. Full article

Background: Therapeutic exercise (TE) is recommended as the first line of treatment for low back pain (LBP), but questions remain about the true efficacy of TE in the acute phase. This study aimed to evaluate the effectiveness of isolated TE in reducing pain intensity and disability in patients with acute or subacute LBP. Methods: A systematic review with meta-analysis was conducted following the PRISMA guidelines. Randomized controlled trials (RCTs) that analyzed therapeutic exercise alone in one of the intervention groups and assessed pain intensity and disability were included; both outcomes were considered primary in this review. The quality of evidence was assessed using the GRADE tool. Results: Five RCTs were included. Meta-analyses were performed in subgroups according to the comparators: usual care, education, manual therapy, and bed rest. Statistically significant differences in favor of TE were found only when compared to usual care (SMD = −0.23; 95% CI [−0.45, −0.01]; p = 0.04). Conclusions: TE, when prescribed as an isolated intervention, appears to be more effective than usual care in improving short-term disability outcomes in patients with acute LBP. However, the limited quality and number of available studies, together with the typically favorable natural course of acute LBP, suggest that these findings should be interpreted with caution. Current evidence supports the integration of exercise within a comprehensive, multimodal management plan that addresses the physical, psychological, and social dimensions of pain. Full article

This paper explores the feasibility of using a wireless Inductive Resonant Link (IRL) for wearable posture monitoring. The proposed system is based on magnetically coupled textile resonators and is implemented using a Single Input Multiple Output (SIMO) configuration. In particular, the setup consists of four inductively coupled resonators: one transmitting coil integrated into a textile structure and positioned on the back of the neck, and three receiving coils placed on the shoulders. The magnetic coupling between these elements varies as a function of the user’s posture, making it possible to monitor postural changes by analyzing variations in the transmission coefficients of the link. Unlike traditional sensor-based systems that require multiple components and data processing, the proposed method uses the inherent response of the inductive link to detect posture in a simple and efficient way. To validate the concept, experimental measurements of the scattering parameters were carried out using a compact and low-power vector network analyzer. The results show a consistent and measurable relationship between postural changes and variations in the transmission coefficients, demonstrating the effectiveness of the proposed system in distinguishing between different postures. The findings suggest that inductive resonant wireless links, especially when implemented with textile components, represent a promising alternative to traditional wearable sensor technologies for posture tracking. The approach offers significant advantages in terms of wearability, power consumption, and simplicity, making it suitable for applications in ergonomics, rehabilitation, occupational health, and smart clothing. Full article

Background: Chronic pain represents a major therapeutic challenge due to the limited efficacy and tolerability of conventional pharmacological treatments. Equisetum arvense L., a medicinal plant with potent antioxidant properties, and palmitoylethanolamide (PEA), an endogenous fatty acid amide with well-established anti-inflammatory and analgesic effects, are increasingly recognised as promising nutraceutical agents. Methods: This prospective, single-centre clinical trial aimed to evaluate the efficacy and safety of a novel oral supplement (Assonal^®PEA) combining 600 mg of PEA and 300 mg of Equisetum arvense L. in improving the reduction of pain and quality of life in patients with chronic pain, also obtaining information on the patient’s state of satisfaction after the treatment. Fifty patients suffering from chronic pain (low back pain and radiculopathy) for two months were enrolled and received the supplement over eight weeks in a tapered regimen (two tablets daily for two weeks, followed by one tablet daily). Results: Clinical outcomes were evaluated using validated instruments, including the Numeric Pain Rating Scale (NPRS), Verbal Rating Scale (VRS), Short-Form McGill Pain Questionnaire (SF-MPQ), Global Perceived Effect (GPE), and EuroQol-5D-5L. Results showed a significant decrease in pain intensity (NPRS: −3.8 points; VRS: −2.1 points; p < 0.0001), along with meaningful improvements in patient-perceived benefit, pain descriptors, and quality of life (EQ-5D-5L: +35%; p < 0.0001). Conclusions: These findings endorse the use of this novel PEA–Equisetum arvense formulation as a safe, well-tolerated, and potentially effective supplementary intervention for managing chronic pain. No adverse events were reported, and the overall response rate reached 94%. Full article

Background and Clinical Significance: Posteriorly migrated lumbar disc herniation [PMLDH] is a rare entity that may present with atypical clinical and radiological features, often mimicking other spinal pathologies. Migration of sequestered fragments through the interlaminar space is exceptionally uncommon, and diagnostic challenges are further amplified in the presence of spinal instability. While MRI and CT are generally sufficient for diagnosis, undetected lesions on preoperative imaging may complicate clinical management. Case Presentation: A 59-year-old male presented with acute low back pain and left-sided radiculopathy. Examination revealed mild motor weakness in ankle dorsiflexion. MRI showed L4–L5 segmental instability with central canal stenosis but no migrated disc fragment. Owing to neurological deficit, decompressive laminectomy with posterior instrumentation was performed. Intraoperatively, a posteriorly migrated sequestered fragment compressing the thecal sac was excised and confirmed as degenerative disc material. Postoperatively, the patient’s neurological deficit and radicular pain resolved, with no new complaints at 3-month follow-up. Conclusions: This case highlights an unusual presentation of PMLDH in a patient with lumbar stenosis and spinal instability, undetected on preoperative imaging. Recognition of the biomechanical predisposition at the L3–4 and L4–5 levels is important in understanding such rare migrations. Although literature emphasizes early surgical intervention for PMLDH, our patient required urgent surgery due to neurological deficits rather than a definitive preoperative diagnosis. Further studies are warranted to clarify the relationship between instability and posterior migration. Full article

Objectives: The central nervous system plays a fundamental role in chronic pain; however, its behavior in this condition remains unclear, especially when associated with interventions such as kinesiotaping (KT). This study aimed to analyze the effects of KT on the somatosensory cortex of women with chronic low back pain. Methods: This case series involved 15 women with chronic low back pain. Participants underwent a progressive-tension KT protocol for 8 weeks, and electroencephalogram recordings were performed in two positions, namely sitting and standing while load bearing (10% of body weight), in the first and eighth weeks. The following instruments were employed: Oswestry lumbar disability index, fear avoidance beliefs questionnaire, and the numerical pain intensity scale. Results: All participants showed significant pain improvement and a reduction in Oswestry disability index scores from moderate to minimal. Additionally, activity in the alpha band within the somatosensory cortex and insula (central region—represented by the electrode Cz) decreased. This was confirmed by reduced power spectral density, indicating diminished cortical activity in these regions. Conclusions: KT positively affects women with chronic low back pain, providing pain reduction and improved functional capacity, as indicated by the fear avoidance beliefs questionnaire and numerical pain intensity scale. Moreover, KT reduces cortical activity in the somatosensory cortex, which is related to the progression of painful sensations, described above after the intervention. Full article

Background: Chronic low back pain markedly impairs quality of life and imposes a significant economic burden on public health. The complex pathophysiology of chronic low back pain arises from the complex anatomical configuration of the lumbar region, which includes a diverse array of structures. Consequently, etiologies may involve intervertebral disc degeneration, facet joint osteoarthritis, spinal stenosis, spondylosis, and spondylolisthesis. Therapeutic interventions for chronic low back pain are equally varied, ranging from pharmacological treatments to physiotherapy, kinetotherapy, balneotherapy, and image-guided local injectable procedures such as prolotherapy. Prolotherapy is a regenerative injection technique designed to stimulate the body’s healing processes by applying a regenerative treatment (typically dextrose), which aims to modulate neurogenic inflammation and diminish nociceptive signaling. Methods: A systematic review of the literature was performed in alignment with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Studies published within the last ten years evaluating the effects of prolotherapy on pain reduction in individuals with chronic low back pain were included, following a search across six databases. Results: The review revealed several studies evaluating the influence of prolotherapy on pain in chronic low back pain patients. Findings were heterogeneous, with some studies indicating significant pain reduction and others showing minimal or no improvement. Conclusions: The current evidence regarding the efficacy of prolotherapy for pain relief in chronic low back pain remains inconclusive, highlighting the necessity for further in-depth research. Continued and updated investigations into prolotherapy’s role are imperative for enhancing the quality of life of affected patients. Full article

Background: As the growing global population continues to age, the risk of chronic metabolic diseases, including cardiovascular disease, neurodegenerative disorders, type 2 diabetes mellitus, and fatty liver disease, increases considerably. Driven largely by lifestyle factors and metabolic dysfunction, this escalating health crisis is placing mounting pressure on healthcare systems and contributing to significant economic costs. Insulin resistance and hyperinsulinaemia are major drivers of these disorders, emphasising the need for early detection and intervention. Changes in liver enzymes, such as alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT), commonly assessed in routine laboratory testing, can serve as biomarkers of early-stage insulin resistance, offering a potentially underutilised window for intervention and disease prevention. Correspondingly, low-carbohydrate ketogenic diets have shown to be effective in reversing insulin resistance, metabolic disease, and liver disease. Objectives: We chose to explore the relationship between suppressing ketosis and changes in liver enzymes in the Ketosis Suppression and Ageing cohort. Methods: Ten lean (BMI 20.5 kg/m² ± 1.4), healthy young women (age 32.3 ± 8.9 years) who habitually followed a ketogenic diet maintaining nutritional ketosis (NK) for an average of 3.9 years (±2.3) were exposed to a higher carbohydrate diet, in line with standard healthy eating guidelines for a 21-day phase and then transitioned back to a ketogenic diet. Results: Carbohydrate challenge and suppression of ketosis increased insulin resistance score HOMA-IR by 2.13-fold (p = 0.0008), GKI by 22.28-fold (p = 0.0024), and liver markers ALT by 1.85-fold (p = 0.0010), GGT, 1.29-fold (p = 0.0087) and the ALT/AST, 1.30-fold (p = 0.0266), reflecting an adverse pattern suggestive of hepatic insulin resistance. Conclusions: These results support the clinical utility of liver markers as early and directional signs of hyperinsulinaemia. Full article

Background/Objectives: This study aimed to evaluate the effect of sacral epidural laser discectomy (SELD) on clinical parameters in patients with chronic low back and/or leg pain (CLBLP) resistant to conservative treatment. Methods: A total of 75 patients with CLBLP who received SELD treatment were retrospectively included in this study. Patients were assessed for pain (numeric rating scale—NRS) and disability (Oswestry Disability Index—ODI). NRS and ODI scores were recorded before the operation and 1, 6, and 12 months after the operation. Results: Of the 75 patients, with a mean age of 52 ± 11 years (range: 30–78 years), 45 (60.0%) were female and 35 (40.0%) were male. The baseline pain intensity (7.43 ± 0.774) and pain intensities obtained at three time points following the surgeries (1 month [3.93 ± 1.571], 6 months [4.36 ± 1.591], 12 months [5.00 ± 1.716]) showed statistically significant differences (p < 0.001). The baseline pain-related disability (2.92 ± 0.539) and the data obtained at three subsequent time points (1 month [1.76 ± 0.883], 6 months [1.85 ± 0.896], and 12 months [2.01 ± 0.923]) showed a statistically significant difference in pain-related disability (p < 0.001). The most common complications were headache (five patients) and incisional pain (five patients). Conclusions: As a result of this study, we found that SELD reduces pain and disability in patients with conservative-treatment-resistant CLBLP. Although serious complications may rarely occur, the procedure is generally associated with an acceptable and low complication rate. Full article

The aim of this study was to conduct a comparative analysis of the effects of native quinoa grain with a high saponin content and quinoa grain subjected to preliminary saponin removal with low saponin content on growth, meat quality, biochemical blood composition, and the expression of genes related to muscle growth, gut health, and nutrient transport in broiler chickens. The control group of chickens received a standard diet. The SAP group feed contained quinoa grain without saponin removal (saponin level—5.20%) at 3% of the “Starter” feed mass and 5% of the “Grower” and “Finisher” feeds, maintaining the same nutritional values as the control group. The SAP-FREE group feed contained quinoa grain that was pre-treated to remove saponins by washing with water for 60 min at a temperature of 50 °C (saponin level—0.24%) in the same amount as the SAP group. The research results indicated certain advantages of unprocessed quinoa grain in relation to saponin content. Specifically, in the SAP group, the broiler performance index was at the same level as the control, while the SAP-FREE group had a high mortality rate (10%), resulting in a performance index that was 23.82 units lower than the control. The use of quinoa grain with high saponin content promoted better development of thigh muscles by 9.6% compared to the control (p = 0.008) and increased yields of wing, neck, and back muscles by 2.9 abs.% (p = 0.007) compared to the use of purified quinoa grain. The fat yield decreased by 1.7 abs.% (p = 0.015) with saponin-free quinoa compared to the control and by 2% (p = 0.008) compared to the high saponin group, making this feeding system viable for producing dietary meat. Upon stopping the feeding of purified quinoa, chickens showed a 34.0% increase in AST activity (p = 0.019) and a 15.7% increase in creatinine levels (p = 0.008), likely indicating intensified protein metabolism upon cessation of the inhibiting factor of purified quinoa. Molecular genetic studies revealed a 1.6-fold increase in IGF1 gene expression (p = 0.014) in breast muscle and a 69.12-fold increase (p = 0.010) in AvBD9 in the cecum due to high-saponin quinoa grain, while purified quinoa increased GHR gene expression by 3.29 times (p = 0.039) in breast muscle and decreased IRF7 activity to 2^−ΔΔCT = 0.54 (p = 0.017). The expression of transporter protein genes decreased to low or undetectable levels, indicating the presence of anti-nutritional factors and the need for further research on feeding quinoa with the addition of proteases. Thus, high-saponin quinoa grain, unlike purified quinoa, positively influences gut health and bird survival, maintaining performance levels similar to the control, suggesting the feasibility of using unprocessed quinoa in poultry nutrition, thus avoiding additional costs in feed preparation. Full article

Aim of the study: This paper focuses on the correlation of nicotine use with chronic lumbar back pain (CLBP). Methods: This is a cross-sectional observational study involving smoker and non-smoker patients with a diagnosis of chronic low back pain (CLBP), recruited during their initial neurosurgical consultation at the Neurosurgery Clinic over a period of 6 months. All patients were followed for a minimum of 3 months after the start of conservative therapy. Age, sex, smoking habits, and the presence of any comorbidities were noted. Pain severity and discomfort were evaluated using the Numeric Rating Scale (NRS), the DN4 questionnaire, and the Oswestry Disability Index (ODI). Based on imaging (MRI of the lumbosacral spine), diagnoses of disc herniation or vertebral lumbar stenosis were documented. Statistical analysis was performed using IBM SPSS Statistics software (Version 30). A p-value of less than 0.05 was considered statistically significant. Results: Improvement on the CLBP, NRS, and DN4 scales after the same conservative therapy was better in Patients with non-smoking habits improved more on the CLBP, NRS and DN4 scales when compared to smokers (NRS scale 0.001 and DN4 scale 0.027). Conclusions: Patients with smoking habitudes affected by lumbar disk her-niation and stenosis and undergoing conservative therapy had worse pain scores Full article

Optical frequency domain reflectometry (OFDR) is one of the key diagnostic tools for fiber optic components and circuits built on them. A low signal-to-noise ratio, resulting from the low intensity of backscattered signals, prevents the correct quantitative description of the medium parameters. Known methods of signal denoising, such as empirical mode decomposition, frequency filtering, and activation function dynamic averaging, make the signal smoother but introduce errors into its dynamic characteristics, changing the intensity of reflection peaks and distorting the backscattering level. We propose a method to reduce OFDR trace noise using elliptical arc fitting (EAF). The obtained results indicate that this algorithm efficiently processes both areas with and without contrasting back reflections, with zero distortion of Fresnel reflection peaks, and with zero attenuation error in regions without Fresnel reflections. At the same time, other methods distort reflection peaks by 14.2–42.6% and shift the correct level of Rayleigh scattering by 27.2–67.3%. Further work will be aimed at increasing the accuracy of the method and testing it with other types of data. Full article