Search Results (253,812)

Background/Objectives: Occlusal disturbances occurring during central occlusion, mandibular movements and mastication may contribute to the development of temporomandibular disorders (TMDs). To reduce the disclusion time (DT) in all mandibular contacts, a procedure known as enameloplasty can be applied. The aim of this study was to evaluate the effect of occlusion-correcting treatments on disclusion time reduction, determination of the center of force, and the distribution of masticatory forces on the right and left side, through digital occlusal analysis in patients with TMD. Methods: The single-centered, prospective study including 106 patients with TMD after 6 months of prosthetic treatment. Digital occlusal analysis was performed before and after the enameloplasty to assess occlusion time, disclusion time and symmetry of occlusal contacts. Results: Selective enameloplasty significantly reduced disclusion time in the whole study population (0.8 vs. 0.4 s; p < 0.001), with greater improvement observed in patients with inappropriate Center of Force (COF) and premature occlusal contacts. Conclusions: Digital occlusal analysis-guided selective enameloplasty effectively reduces disclusion time and can improve occlusal parameters in TMD patients. Full article

As the production of electric vehicles grows, the rare earth elements Pr and Nd become increasingly significant, as they are key in magnetic materials production. In order to achieve the green and efficient recovery of Pr and Nd from the rare earth leachate, this paper selected kaolinite and halloysite as adsorbents to conduct rare earth solution adsorption experiments for exploring the effects of the initial leachate concentration, the solution pH, and the adsorption temperature on the adsorption process. The adsorption characteristics of Pr and Nd by clay minerals were analyzed by quantum chemical calculation. The results showed that the adsorption effects of clay minerals on Pr and Nd decreased with the rise of leachate concentration. When leachate pH increased, the adsorption efficiency of kaolinite and halloysite for Pr firstly increased and then decreased, and the optimal adsorption efficiency was 13.33% and 24.778% at pH 6, respectively. The adsorption effects of kaolinite and halloysite on Nd enhanced gradually with the increase in pH, which increased to 15.925% and 30.482% at pH 7, respectively. With temperature increased, the adsorption of Pr and Nd by kaolinite and halloysite was positively correlated. The isothermal adsorption model was fitted to the experimental data, and it was found that the adsorption of Pr and Nd by kaolinite and halloysite was consistent with the Langmuir model, with R² above 0.96, indicating that the adsorption process was a single molecular layer adsorption. The results provide theoretical support for the effective recycling of Pr and Nd, which is of great significance for the utilization of rare earth resources in permanent magnets. Full article

Physiologically based pharmacokinetic (PBPK) models allow to simulate the behaviour of compounds in diverse physiological populations. However, the categorization of individuals into distinct populations raises questions regarding the classification criteria. In previous research, simulations of the pharmacokinetics of the mycotoxin aflatoxin B1 (AFB1), were performed in the black South African population, using PBPK modeling. This study investigates the prevalence of clinical CYP450 phenotypes (CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4/5) across Sub-Saharan Africa (SSA), to determine the feasibility of defining SSA as a single population. SSA was subdivided into Central, East, South and West Africa. The phenotype data were assigned to the different regions and a fifth SSA group was composed of all regions’ weighted means. Available data from literature only covered 7.30% of Central, 56.9% of East, 38.9% of South and 62.9% of West Africa, clearly indicating critical data gaps. A pairwise proportion test was performed between the regions on enzyme phenotype data. When achieving statistical significance (p < 0.05), a Cohen’s d-test was performed to determine the degree of the difference. Next, per region populations were built using SimCYP starting from the available SSA based SouthAfrican_Population FW_Custom population, supplemented with the phenotype data from literature. Simulations were performed using CYP probe substrates in all populations, and derived PK parameters (C_max, T_max, AUC_ss and CL) were plotted in bar charts. Significant differences between the African regions regarding CYP450 phenotype frequencies were shown for CYP2B6, CYP2C19 and CYP2D6. Limited regional data challenge the representation of SSA populations in these models. The scarce availability of in vivo data for SSA regions restricted the ability to fully validate the developed PBPK populations. However, observed literature data from specific SSA regions provided partial validation, indicating that SSA populations should ideally be modelled at a regional level rather than as a single entity. The findings, emerging from the initial AFB1-focused PBPK work, underscore the need for more extensive and region-specific data to enhance model accuracy and predictive value across SSA. Full article

Background: This study was a cross-sectional online survey aimed at examining health-related quality of life and the effect of different symptoms and lifestyle factors on health-related quality of life in a sample of women with endometriosis in Hungary. Methodology: A cross-sectional online survey was carried out in a sample of women with endometriosis. Self-edited and Hungarian versions of validated questionnaires were used to assess health-related quality of life (Sf-36-Health Survey—SF-36), pain (Numeric Rating Scale-NRS), effect of pelvic pain on everyday life (Pelvic Pain Impact Questionnaire—PPIQ), perceived stress levels (Perceived Stress Scale—PSS), and physical activity (Global Physical Activity Questionnaire—GPAQ). Data analysis was conducted using IBM SPSS Statistics 28.0, and the level of significance was set at p < 0.05. Multivariate linear regression analysis was performed to examine the effect of different lifestyle factors, pain-related, and physical symptoms on the participants’ health-related quality of life (HrQoL). Results: The health-related quality of life of Hungarian women with endometriosis in our sample was significantly lower than the latest Hungarian normative values. Multiple linear regression analyses revealed that psychological, pain-related, and lifestyle factors significantly predicted HrQoL across SF-36 subscales in women with endometriosis (all models, p < 0.001; Adjusted R² = 0.274–0.654). Pain self-efficacy (PSEQ) was a consistent positive predictor that was significantly associated with better scores in five SF-36 domains, including physical and social functioning. Perceived stress (PSS) is a strong negative predictor that particularly affects emotional well-being, energy/fatigue, and social functioning. Pain interference (PPIQ) was linked to poorer HrQoL in seven out of eight SF-36 domains, while average pain intensity (NRS) negatively predicted Physical Functioning and General Health. Vigorous physical activity was positively associated with Social Functioning, whereas moderate activity had no significant effect. Among the demographic factors, only age was negatively associated with Physical Functioning; BMI and education were not significant predictors. Conclusions: Psychological, lifestyle, and symptom-related factors play key roles in health-related quality of life among women with endometriosis. Self-efficacy was a strong positive predictor, whereas perceived stress and pain interference were linked to poorer outcomes. High-intensity physical activity supported better social functioning. These findings highlight the need for multidisciplinary interventions targeting psychological support, pain management, and physical activity to improve quality of life in this population. Full article

Background: Lumbar disk herniation is a common cause of low back pain and radiculopathy, significantly impacting patients’ life quality and functional capacity. Magnetic Resonance Imaging (MRI) remains the gold standard for its assessment due to its superior soft tissue contrast and multiplanar imaging capabilities. However, recent advances in spectral computed tomography (CT), particularly dual-energy CT (DECT), have introduced new diagnostic opportunities, offering improved soft tissue characterization. Objective: To evaluate the diagnostic performance of DECT in detecting and grading lumbar disk herniations using dedicated color-coded fat maps. Materials and Methods: A total of 205 intervertebral levels from 41 consecutive patients with lumbar symptoms were prospectively analyzed. All patients underwent both DECT and MRI within 3 days. Three radiologists with varying years of experience independently assessed DECT images using color-coded reconstructions. A five-point grading score was attributed to each lumbar level: 1 = normal disk, 2 = bulging/protrusion, 3 = focal herniation, 4 = extruded herniation, and 5 = migrated fragment. The statistical analysis included Pearson’s correlation for score consistency, Cohen’s Kappa for interobserver agreement, generalized estimating equations for a cluster-robust analysis, and an ROC curve analysis. The DECT diagnostic accuracy was assessed in a dichotomized model (grades 1–2 = no herniation; 3–5 = herniation), using MRI as reference. Results: A strong correlation was observed between DECT and MRI scores across all readers (mean Pearson’s r = 0.826, p < 0.001). The average exact agreement between DECT and MRI was 79.4%, with the highest concordance at L1–L2 (86.7%) and L5–S1 (80.4%). The interobserver agreement was substantial (mean Cohen’s κ = 0.765), with a near-perfect agreement between the two most experienced readers (κ = 0.822). The intraclass correlation coefficient was 0.906 (95% CI: 0.893–0.918). The ROC analysis showed excellent performance (AUC range: 0.953–0.986). In the dichotomous model, DECT demonstrated a markedly higher sensitivity than conventional CT (95.1% vs. 57.2%), with a comparable specificity (DECT: 99.0%; CT: 96.5%) and improved overall accuracy (98.4% vs. 90.0%). Subgroup analyses by age and disk location revealed no statistically significant differences. Conclusions: The use of DECT dedicated color-coded fat map reconstructions showed high diagnostic performance in the assessment of lumbar disk herniations compared to MRI. These findings support the development of dedicated post-processing tools, facilitating the broader clinical adoption of spectral CT, especially in cases where MRI is contraindicated or less accessible. Full article

Background/Objectives: Malaria remains the most critical parasitic disease globally, responsible for over 600.000 deaths annually. In sub-Saharan Africa, co-infections of Plasmodium falciparum with other pathogens, particularly Staphylococcus aureus, are common in children with severe malaria. Therefore, the design of new compounds targeting both pathogens appears to be an urgent priority. Methods: A small series of hybrid compounds was designed and synthesized by linking the pharmacophore of the antimalarial drug chloroquine with the phenothiazine core. These compounds were tested in vitro against a panel of microbial strains and further analyzed through in silico simulations to predict their physical-chemical properties. Results: Compounds 4b and 5b emerged the most potent candidates of the series, showing a sub-micromolar inhibitory activity on P. falciparum, and a promising micromolar potency on S. aureus alongside with a low toxicity on mammalian cells. Molecular docking followed by molecular dynamics (MD) simulations identified the respiratory membrane NDH-2 enzyme as common target in both pathogens. Conclusions: Both experimental and computational findings provide compelling evidence for the use of the designed compounds in a STOP strategy, i.e., Same-Target-Other-Pathogen, to treat malaria and bacterial infections concurrently. Full article

Introduction: The impact of locoregional treatment (LRT) on survival in de novo bone-only metastatic breast cancer (dnBOMBC) is controversial. This study aims to assess the effect of LRT on survival, utilizing international, prospectively acquired data in this cohort of patients. Materials and Methods: Patients with dnBOMBC were divided into two groups: those receiving systemic therapy only (ST) and those undergoing LRT. Further, patients who received LRT were divided into two subgroups: those who received ST after LRT (LRT+ST group) and those who received ST prior to LRT (ST+LRT group). Factors associated with disease progression, including solitary or multiple bone metastases, were analyzed. Results: There was a total of 744 patients with dnBOMBC treated at each of the participating institutions between 2014 and 2022, with 372 (50%) participants in each arm. Median follow-up was 48 months (32–66, 25–75%). Patients in the LRT group were significantly younger than the ST group [50 (42, 60) vs. 55 (44, 66), p = 0.0001]. There were no significant differences in grade, HER2 status, triple-negative status, receipt of hormonal therapy, or intervention to metastatic sites. During follow-up, 58% (n = 217) of patients in the ST group and 32% (n = 120) of patients in the LRT group died (p < 0.001). Local progression was observed in 20% of the patients in the ST group, whereas 9% progressed in the LRT group (p = 0.0001). Systemic progression occurred more in the ST group; 66% (n = 244) compared to 41% (n = 152) of patients in the LRT group (p < 0.001). The hazard of death was 64% lower in the LRT group than in the ST group (HR: 0.36, 95% CI: 0.29–0.45, p < 0.0001). The burden of metastatic disease differed significantly between the two groups, with a higher rate of solitary bone metastases in the LRT group compared to the ST group (50% vs. 24%, p < 0.001). However, the LRT group had better overall survival (OS) for both solitary (HR: 0.38, 95% Cl: 0.26–0.55) and multiple (HR: 0.38, 95% Cl: 0.29–0.51) bone metastasis patients. Within the LRT group, survival rates were similar whether the breast surgery was performed before or after ST. Multivariate Cox analysis showed that LRT and ER/PR positivity significantly decrease the hazard of death (p < 0.05). Conclusions: Analysis of this large multi-institutional patient cohort provides further evidence that LRT is associated with longer OS and lower locoregional recurrence rates in patients with dnBOMBC. In breast cancer patients with bone-only metastases at presentation, the decision for LRT should be made through a multidisciplinary approach with consideration of surgical therapy at the primary tumor. Full article

Introduction: Dry Eye Syndrome (DES) is a multifactorial disorder of the ocular surface, characterized by complex interactions between environmental factors, immune dysregulation, and potential genetic predispositions. Vitamin D deficiency, known for its immunomodulatory properties, has increasingly been implicated in the pathogenesis of DES; however, the underlying mechanisms remain insufficiently elucidated. Of particular interest is the vitamin D receptor (VDR) gene, whose polymorphisms may influence the bioavailability and biological activity of vitamin D. Objective: The aim of this study was to investigate the association between serum 25-hydroxyvitamin D [25(OH)D₃] levels and selected polymorphisms in the VDR gene (Taq, Fok, Apa, and Bsm) in patients with DES and to analyze their potential clinical and genetic interactions. Methods: This prospective observational study included 60 patients with a confirmed diagnosis of DES. Serum 25(OH)D₃ levels were measured, and genotyping of four VDR single-nucleotide polymorphisms (SNPs) was performed using PCR followed by restriction fragment length polymorphism analysis. Genotype distributions were assessed in relation to vitamin D status using appropriate statistical tests and Hardy–Weinberg equilibrium analysis. Results: Over 85% of patients exhibited insufficient or deficient vitamin D levels. Among the analyzed SNPs, only the ApaI polymorphism (rs7975232) showed a statistically significant association with vitamin D status (p = 0.0384), with the homozygous AA genotype being more prevalent among patients with hypovitaminosis. The remaining polymorphisms (TaqI, FokI, BsmI) did not reach statistical significance; however, potential trends were observed that may warrant further investigation in larger cohorts. Conclusion: The findings suggest a potential role for VDR gene variability in the regulation of systemic vitamin D levels in patients with DES. Identification of specific genotypes may contribute to the development of personalized diagnostic and therapeutic strategies, particularly for patients with treatment-resistant forms of the disease. These results support the integration of genetic biomarkers and nutritional parameters into modern ophthalmologic practice. Full article

Objective: This study explores the associations between parent–child exercise and children’s mental health from the perspective of family physical education. Methods: In total, 527 valid questionnaires were collected from students in grades four to six of three primary schools in Yuhang District, Hangzhou City, including a survey of the status of children’s exercise and family sports and the SCL-90 symptom self-measurement scale. Based on an analysis of practical challenges in family sports engagement and children’s mental health status, the data were analyzed and modeled using structural equation modeling to obtain a model of children’s mental health promotion, with individual children’s exercise as the primary factor and parent–child exercise as the mediator. Results: Both individual children’s exercise and parent–child exercise were significant predictors of children’s mental health promotion. Parent–child activities show a more significant negative correlation with symptoms of anxiety and depression than individual exercise alone. They also partially mediated the relationship between individual exercise and depression/anxiety symptoms. The indirect effects had confidence intervals of [−0.008, −0.001] for depression and [−0.007, −0.001] for anxiety. The direct effects of individual exercise on mental health (depression: β = −0.115; anxiety: β = −0.127) were stronger than the indirect effects and significantly positively correlated with parent–child exercise (β = 0.444, p < 0.05), suggesting that individual exercise may encourage more parent–child exercise. Conclusions: We propose a relational pathways model incorporating parent–child exercise as a mediating variable and individual exercise as the primary activity. This model is more closely aligned with real-life conditions and practical feasibility than approaches lacking such a family-based component. Full article

Background: Acute exacerbation (AE) of idiopathic inflammatory myopathy-associated interstitial lung disease (IIM-ILD) is fatal. Infection is one of the most important triggers of the AE of IIM-ILD. We evaluated the clinical features and prognosis of idiopathic (I-AE) and infection-triggered (iT-AE) acute exacerbation in IIM-ILD patients. Methods: We retrospectively reviewed 278 consecutive patients with IIM admitted to our hospital between January 2014 and December 2020. Among them, 69 patients experienced AE of IIM-ILD, including 34 with I-AE and 35 with iT-AE. Clinical features and short- and long-term outcomes were analyzed in this preliminary study. Results: Compared with I-AE, patients with iT-AE presented with lower hemoglobin and PaO₂/FiO₂ ratios but higher pulse, body temperature, white blood cell count, neutrophil percentage (NEU), C-reactive protein, erythrocyte sedimentation rates, lactate dehydrogenase, and hydroxybutyrate dehydrogenase levels. They also had more extensive ground-glass opacities (GGOs) on high-resolution computed tomography (all p < 0.05). Mortality was significantly higher in iT-AE than that in I-AE at 30 days (28.6% vs. 5.9%), 90 days (34.3% vs. 14.9%), and 1 year (54.3% vs. 17.6%; log-rank test, p = 0.002). Multivariate logistic regression showed that the combination of NEU and GGO extent could help discriminate iT-AE from I-AE (area under the receiver operating characteristic curve: 0.812; 95% confidence interval: 0.711–0.913; sensitivity: 71.4%, specificity: 73.5%, accuracy: 72.5%). Conclusion: This study found that iT-AE patients exhibited more severe hyperinflammation and markedly worse survival than I-AE patients. Combining NEU and GGO extent may assist in differentiating AE subtypes. Larger prospective studies are required to validate these findings. Full article

The complex environment along railway lines, characterized by low imaging quality, strong background interference, and densely distributed small objects, causes existing detection models to suffer from low accuracy in practical applications. To tackle these challenges, this study aims to develop a robust and lightweight insulator detection model specifically optimized for these challenging railway scenarios. To this end, we release a dedicated comprehensive dataset named complexRailway that covers typical railway scenarios to address the limitations of existing insulator datasets, such as the lack of small-scale objects in high-interference backgrounds. On this basis, we present CutP5-LargeKernelAttention-SIoU (C5LS), an improved YOLOv8 variant with three key improvements: (1) optimized YOLOv8’s detection head by removing the P5 branch to improve feature extraction for small- and medium-sized targets while reducing computational redundancy, (2) integrating a lightweight Large Separable Kernel Attention (LSKA) module to expand the receptive field and improve contextual modeling, (3) and replacing CIoU with SIoU loss to refine localization accuracy and accelerate convergence. Experimental results demonstrate that it reaches 94.7% in mAP@0.5 and 65.5% in mAP@0.5–0.95, outperforming the baseline model by 1.9% and 3.5%, respectively. With an inference speed of 104 FPS and a model size of 13.9 MB, the model balances high precision and lightweight deployment. By providing stable and accurate insulator detection, C5LS not only offers reliable spatial positioning basis for subsequent defect identification but also builds an efficient and feasible intelligent monitoring solution for these failure-prone insulators, thereby effectively enhancing the operational safety and maintenance efficiency of the railway power system. Full article

Nucleosides are of significant interest to biomedical and pharmaceutical research and have been successfully separated in hydrophilic interaction liquid chromatography (HILIC). However, there have been few studies focusing on the retention mechanisms, and detailed retention mechanisms are not clearly understood. The quantitative assessment methodology based on the linear relationship between the observed retention factors and the phase ratio has been shown to be a new tool to investigate the retention mechanisms of polar compounds in HILIC. This study evaluated the retention mechanisms of 16 nucleosides on a bare silica column. The retention contributions by partitioning, adsorption, and electrostatic attractions are quantitatively determined, and the main retention mechanism can be unambiguously identified for each nucleoside. The study results indicate that the main retention mechanism can shift with the salt concentration in the mobile phase, but partitioning seems to dominate at higher salt concentrations. In addition, the partitioning coefficients are measured using the quantitative assessment methodology and have a relatively strong correlation with the log P values of the nucleosides. Considering large errors in the log P values for these very polar compounds, the partitioning coefficients measured experimentally in the HILIC system may provide a more accurate measure for polarity assessment. Full article

Swimming research has determined that rounded shoulders, forward head, and scapular dyskinesis are common imbalances that may lead to injury without correction. This case study aimed to evaluate a preventative exercise program designed to reduce injuries, correct postural deviations, and improve shoulder function over one collegiate swimming season. Twenty female NCAA Division I swimmers (average age = 21.6 ± 1.3 years) participated over 25 weeks, completing pre-, mid-, and post-season assessments of injury rates, shoulder range of motion, and stability using standardized tests. Injuries were included as diagnosed and reported by an athletic trainer. Testing included internal rotation, external rotation, the Hawkins-Kennedy test, Neer’s sign, Sulcus sign, and the Closed Kinetic Chain Upper-Extremity Stability Test (CKCUEST). Compared to the season prior with no intervention, swimmers who completed the program were 44% less likely to sustain an upper-extremity injury, as assessed from the CKCUEST scores (p < 0.01 for all metrics), shoulder internal rotation (p < 0.01 for both shoulders), and total range of motion (p < 0.01 for both shoulders). These findings suggest that a targeted corrective exercise program can effectively reduce injury rates and improve shoulder mobility and function in collegiate athletes. The interpretation of these results is limited by the study’s non-randomized design and absence of a control group. Full article

Background/Objectives: Gestational diabetes mellitus (GDM) is one of the most common metabolic complications of pregnancy and is linked to long-term metabolic and cardiovascular risks for both mother and child. Its pathophysiology includes increased generation of reactive oxygen species (ROS) and/or decreased antioxidant defenses; nonetheless, the redox dynamics between mother and fetus are still poorly understood. Our goal was to assess oxidative stress (via derivatives of reactive oxygen metabolites, d-ROMs) and antioxidant capacity (via biological antioxidant potential, BAP) in maternal, umbilical cord, and neonatal blood from women with GDM compared to normoglycemic controls, and to investigate potential associations with clinical and neonatal outcomes. Methods: In this single-center cross-sectional study, 56 women with GDM and 52 matched controls provided maternal venous, umbilical cord, and neonatal blood samples at delivery. Plasma d-ROMs and BAP were measured using colorimetric assays. Clinical and neonatal outcome data were collected. Results: Women with GDM had considerably higher maternal d-ROM levels compared to both the umbilical cord and neonatal compartments. BAP measurements revealed that maternal blood had the lowest antioxidant capacity, while cord and newborn samples had higher levels. GDM mothers had significantly greater maternal d-ROMs and lower BAP compared to controls (both p < 0.05). There were no differences in cord blood d-ROMs or BAP between the GDM and the control group. The maternal BAP/d-ROM ratio decreased significantly in the GDM group (p < 0.01), but the cord ratio remained constant. Notably, neither maternal nor neonatal redox indicators were related to perinatal outcomes, indicating a limited prognostic potential for unfavorable neonatal occurrences. Conclusions: GDM is associated with increased maternal oxidative stress and decreased antioxidant capacity, with no substantial changes in newborn redox status. Redox indicators did not predict perinatal issues across this group. These findings demonstrate the need for larger prospective research to determine whether early changes in redox balance can predict the development of GDM or unfavorable outcomes. Full article

The conceptual design phase in architecture establishes the foundation for subsequent design decisions and influences up to 80% of a building’s lifecycle environmental impact. While Building Information Modeling (BIM) demonstrates transformative potential for sustainable design, its application during conceptual design remains constrained by perceived technical complexity and limited support for abstract thinking. This research examines how BIM tools can facilitate conceptual design through diagrammatic reasoning, thereby bridging technical capabilities with creative exploration. A mixed-methods approach was employed to develop and validate a Diagrammatic BIM (D-BIM) framework. It integrates diagrammatic reasoning, parametric modeling, and performance evaluation within BIM environments. The framework defines three core relationships—dissection, articulation, and actualization—which enable transitions from abstract concepts to detailed architectural forms in Revit’s modeling environments. Using Richard Meier’s architectural language as a structured test case, a 14-week quasi-experimental study with 19 third-year architecture students assessed the framework’s effectiveness through pre- and post-surveys, observations, and artifact analysis. Statistical analysis revealed significant improvements (p < 0.05) with moderate to large effect sizes across all measures, including systematic design thinking, diagram utilization, and academic self-efficacy. Students demonstrated enhanced design iteration, abstraction-to-realization transitions, and performance-informed decision-making through quantitative and qualitative assessments during early design stages. However, the study’s limitations include a small, single-institution sample, the absence of a control group, a focus on a single architectural language, and the exploratory integration of environmental analysis tools. Findings indicate that the framework repositions BIM as a cognitive design environment that supports creative ideation while integrating structured design logic and performance analysis. The study advances Education for Sustainable Development (ESD) by embedding critical, systems-based, and problem-solving competencies, demonstrating BIM’s role in sustainability-focused early design. This research provides preliminary evidence that conceptual design and BIM are compatible when supported with diagrammatic reasoning, offering a foundation for integrating competency-based digital pedagogy that bridges creative and technical dimensions of architectural design. Full article