Search Results (1,586)

This study aimed to evaluate how different insertion angles of titanium orthodontic miniscrews (30°, 45°, and 90°) influence stress distribution and displacement in surrounding alveolar bone using three-dimensional finite element analysis (FEA), with a focus on biomechanical outcomes at the titanium–bone interface. The 90° insertion angle generated the highest stress in cortical bone (58.2 MPa) but the lowest displacement (0.023 mm), while the 30° angle produced lower stress (36.4 MPa) but greater displacement (0.052 mm). The 45° angle represented a compromise, combining moderate stress (42.7 MPa) and displacement (0.035 mm). This simulation-based study was conducted between January and April 2025 at the Department of Orthodontics, Kocaeli Health and Technology University. A standardized 3D mandibular bone model (2 mm cortical and 13 mm cancellous layers) was constructed, and Ti-6Al-4V miniscrews (1.6 mm × 8 mm) were virtually inserted at 30°, 45°, and 90°. A horizontal orthodontic load of 2 N was applied, and von Mises stress and displacement values were calculated in ANSYS Workbench. Stress patterns were visualized using color-coded maps. The 90° insertion angle generated the highest von Mises stress in cortical bone (50.6 MPa), with a total maximum stress of 58.2 MPa, followed by 45° (42.7 MPa) and 30° (36.4 MPa) insertions (p < 0.001). Stress was predominantly concentrated at the cortical entry point, especially in the 90° model. In terms of displacement, the 90° group exhibited the lowest mean displacement (0.023 ± 0.002 mm), followed by 45° (0.035 ± 0.003 mm) and 30° (0.052 ± 0.004 mm), with statistically significant differences among all groups (p < 0.001). The 45° angle showed a balanced biomechanical profile, combining moderate stress and displacement values, as confirmed by post hoc analysis. From a biomimetics perspective, understanding how insertion angle affects bone response provides insights for designing bio-inspired anchorage systems. By simulating natural stress dissipation, this study demonstrates that insertion angle strongly modulates miniscrew performance. Vertical placement (90°) ensures rigidity but concentrates cortical stress, whereas oblique placement, particularly at 45°, offers a balanced compromise with adequate stability and reduced stress. These results emphasize that beyond material properties, surgical parameters such as insertion angle are critical for clinical success. Full article

Background/Objectives: Assessing the hydration status (HS) in geriatric patients remains challenging due to multimorbidity, polypharmacy, and cognitive impairment. Common indicators like reduced skin turgor and dry mucous membranes are unreliable. The Hydr-Age-Study is a prospective observational pilot study with a post hoc analysis to evaluate the diagnostic accuracy of clinical, laboratory, and instrumental methods to assess HS in hospitalised older adults. Methods: Upon admission, patients underwent an assessment including their medical history, a clinical evaluation, laboratory tests, ultrasound examination, and bioimpedance analysis. These data were collected and independently reviewed by two experts who diagnosed each patient’s current HS. This diagnosis served as the clinical reference standard for evaluating the diagnostic accuracy of each method. Results: Twenty-six methods were examined, of which four achieved an AUC > 0.8. Axillary dryness showed a high diagnostic accuracy for hypohydration (AUC = 0.854), with a sensitivity of 83.3% and a specificity of 82.8%. Inferior vena cava (IVC) ultrasound effectively detected both hypo- and hyperhydration. A subxiphoid IVC diameter ≤1.95 cm identified hypohydration with 90.9% sensitivity and 50.6% specificity. For hyperhydration, a diameter of ≥2.15 cm provided strong diagnostic performance in both subxiphoid and transcostal views. Conclusions: Axillary dryness and IVC sonography demonstrated the highest diagnostic accuracy. No other methods exceeded an AUC of 0.80. In the absence of a gold standard, a structured clinical consensus provides a feasible and reproducible approach to establish a clinical reference standard. These findings may contribute to the development of a standardised assessment protocol in geriatric medicine. Full article

Background/Objectives: Orthodontic appliances disrupt oral biofilm homeostasis, leading to an increase in plaque and disease risk. Elastomeric modules (EMs) promote bacterial growth due to their material composition. Surface coatings have been developed to reduce bacterial colonization. We evaluated the mechanical, antimicrobial, and cell viability properties of a chitosan coating for EMs. Methods: EMs were coated with chitosan (CS) and chitosan-glutaraldehyde (CS-GTA) to assess antimicrobial and cell viability. Uncoated EMs were used as a control. These surface-coated modules were characterized and analyzed with Fourier transform infrared (FTIR) and Raman spectroscopy, and tensile testing. Antibacterial activity was assessed by colony-forming units (CFU) counts after incubation. Cell viability was tested with gingival fibroblasts using the MTT assay. ANOVA, Tukey, Kolmogorov–Smirnov, and Kruskal–Wallis tests were used for statistical analysis. Results: Raman spectra of the chitosan coatings showed characteristic molecular vibration bands. ANOVA revealed a significant difference in mechanical properties between the materials and between the control and the CS-GTA groups, confirmed by the Tukey post hoc test. No significant difference was observed between the groups in the Yield Stress test. All the coated groups showed reduced CFU counts in the antibacterial assay. The average cell viability of the coated groups was 85% and 89%. Conclusions: We synthesized CS and GTA-cross-linked chitosan coatings. The coatings did not affect the mechanical properties of the elastomeric modules. The chitosan and glutaraldehyde-cross-linked CS coatings inhibited bacterial growth. No significant differences were observed in antibacterial activity between the CS and the GTA-crosslinked chitosan coatings. Full article

Background: Elite athletes are frequently subjected to high-intensity training regimens, which can result in cumulative physical stress, overtraining, and potential health risks. Monitoring autonomic responses to such load is essential for optimizing performance and preventing maladaptation. Objective: The present study aimed to assess changes in autonomic regulation immediately and two hours after training in athletes, using an integrated framework (combining time- and frequency-domain HRV indices with nonlinear and recurrence quantification analysis). It was investigated how repeated assessments over a 4-month period can reveal cumulative effects and identify athletes at risk. Special attention was paid to identifying signs of excessive fatigue, autonomic imbalance, and cardiovascular stress. Methods: Holter ECGs of 12 athletes (mean age 21 ± 2.22 years; males, athletes participating in competitions) over a 4-month period were recorded before, immediately after, and two hours after high-intensity training, with HRV calculated from 5-min segments. Metrics included HRV and recurrent quantitative analysis. Statistical comparisons were made between the pre-, post-, and recovery phases to quantify autonomic changes (repeated-measures ANOVA for comparisons across the three states, paired t-tests for direct two-state contrasts, post hoc analyses with Holm–Bonferroni corrections, and effect size estimates η²). Results: Immediately after training, significant decreases in SDNN (↓ 35%), RMSSD (↓ 40%), and pNN50 (↓ 55%), accompanied by increases in LF/HF (↑ 32%), were observed. DFA α1 and Recurrence Rate increased, indicating reduced complexity and more structured patterns of RR intervals. After two hours of recovery, partial normalization was observed; however, RMSSD (−18% vs. baseline) and HF (−21% vs. baseline) remained suppressed, suggesting incomplete recovery of parasympathetic activity. Indications of overtraining and cardiac risk were found in three athletes. Conclusion: High-intensity training in elite athletes induces pronounced acute autonomic changes and incomplete short-term recovery, potentially increasing fatigue and cardiovascular workload. Longitudinal repeated testing highlights differences between well-adapted, fatigued, and at-risk athletes. These findings highlight the need for individualized recovery strategies and ongoing monitoring to optimize adaptation and minimize the risk of overtraining and health complications. Full article

Anxiety disorders represent a significant global health challenge, yet a substantial treatment gap persists, motivating the development of scalable digital health solutions. This study investigates the potential of integrating passive physiological data from consumer wearable devices with subjective self-reported surveys to predict state–trait anxiety. Leveraging the multi-modal, longitudinal LifeSnaps dataset, which captured “in the wild” data from 71 participants over four months, this research develops and evaluates a machine learning framework for this purpose. The methodology meticulously details a reproducible data curation pipeline, including participant-specific time zone harmonization, validated survey scoring, and comprehensive feature engineering from Fitbit Sense physiological data. A suite of machine learning models was trained to classify the presence of anxiety, defined by the State–Trait Anxiety Inventory (S-STAI). The CatBoost ensemble model achieved an accuracy of 77.6%, with high sensitivity (92.9%) but more modest specificity (48.9%). The positive predictive value (77.3%) and negative predictive value (78.6%) indicate balanced predictive utility across classes. The model obtained an F1-score of 84.3%, a Matthews correlation coefficient of 0.483, and an AUC of 0.709, suggesting good detection of anxious cases but more limited ability to correctly identify non-anxious cases. Post hoc explainability approaches (local and global) reveal that key predictors of state anxiety include measures of cardio-respiratory fitness (VO₂Max), calorie expenditure, duration of light activity, resting heart rate, thermal regulation and age. While additional sensitivity analysis and conformal prediction methods reveal that the size of the datasets contributes to overfitting, the features and the proposed approach is generally conducive for reasonable anxiety prediction. These findings underscore the use of machine learning and ubiquitous sensing modalities for a more holistic and accurate digital phenotyping of state anxiety. Full article

The yellowing effect of camphorquinone (CQ) has led manufacturers to add alternative initiators into resin composites (RCs) to reduce the amount of CQ used. The aim of this study was to investigate the color change in commercial RCs with alternative photoinitiators besides CQ. Color change upon polymerization and aging in air and artificial saliva for up to 3 months was tested for seven commercial RCs (traditional and bulk-fill) with either CQ only or CQ and additional photoinitiators (CQ+). Color measurements were obtained with a spectrophotometer. Color change (ΔE) was calculated using the CIELab and CIEDE2000 formulae. ANOVA and a post hoc SNK test were conducted for statistical analysis. Upon polymerization, the ΔE of CQ+ was greater than that of CQ only, except in the case of dual-cure HyperFIL. The storage conditions did not affect the color change within 24 h for either air or artificial saliva, whereas they did have an influence on color stability when RCs were aged for 1 month and 3 months. The color changes in the RCs aged in artificial saliva were considered clinically acceptable for all RCs tested except HyperFIL. Additional photoinitiator systems tended to result in a greater color change upon polymerization but did not affect color change upon aging. During shade selection, especially when additional photoinitiators besides CQ are used, a guide reflecting the color after polymerization should be used. Full article

As deepfake technology matures, its risks in spreading false information and threatening personal and societal security are escalating. Despite significant accuracy improvements in existing detection models, their inherent opacity limits their practical application in high-risk areas such as forensic investigations and news verification. To address this gap in trust, explainability has become a key research focus. This paper provides a systematic review of explainable deepfake detection methods, categorizing them into three main approaches: forensic analysis, which identifies physical or algorithmic manipulation traces; model-centric methods, which enhance transparency through post hoc explanations or pre-designed processes; and multimodal and natural language explanations, which translate results into human-understandable reports. The paper also examines evaluation frameworks, datasets, and current challenges, underscoring the necessity for trustworthy, reliable, and interpretable detection technologies in combating digital misinformation. Full article

While corticosteroids affect bile acid metabolism in humans and dogs, their impact on serum bile acids in cats is unknown. Moreover, the early effects of corticosteroids on liver enzyme activity in cats are not well understood. We prospectively studied seven healthy cats (4–7 years) treated with oral prednisolone (1.1–1.5 mg/kg, median 1.28 mg/kg PO daily) for 7 days. Serum bile acids and liver enzyme activities (ALT, AST, ALP, GGT) were measured before treatment (day 0) and at days 2, 3, 8, 10, and 14. Statistical analysis used the Friedman test with post hoc comparisons to baseline. At baseline, bile acids were within reference interval (1–6.5 μmol/L) (median 2.1 μmol/L, range 1–3.2) and increased significantly during treatment with prednisolone to a median of 5.3 μmol/L (range 1.8–8.7) at d8, but remained below clinically abnormal levels. In contrast, AST, ALT, and ALP activities decreased significantly during prednisolone administration. GGT activities were undetectable at all times. We conclude that, although prednisolone significantly affected bile acids, the effect is likely of limited clinical relevance, as increases were minimal and remained below thresholds considered abnormal. Unexpectedly, transaminase and alkaline phosphatase activities decreased in the first days after administration. The reasons for this remain unclear. Full article

To examine the relationship between the applicability of the Sarcopenia & Quality of Life (SarQoL) questionnaire and physical fitness factors including living environment, body composition, and exercise function of individuals aged over 60 years were analyzed. The study included 551 older adults (129 men, 422 women) aged 60–100 years, residing in South Korea, and without serious diseases, disabilities, or physical activity limitations. Demographics, health indicators, living conditions, SarQoL survey results, and physical fitness were assessed. Group differences were evaluated using one-way ANOVA with Tukey’s post hoc test. Hierarchical regression analysis explored the relationship between SarQoL scores and various factors, and multiple logistic regression analyzed the association between SarQoL and exercise variables. Statistical significance was set at p < 0.05. Sex (B, 0.200; t, 2.233; p < 0.001), age (B, −0.031; t, −6.574; p < 0.001), education level (B, −0.110; t, 3.067; p = 0.002), and regular physical activity influenced SarQoL scores. Physical fitness measures were significantly correlated with SarQoL scores. Additionally, conditions such as diabetes, sleep disorders, and sarcopenia affected SarQoL outcomes. High SarQoL in older adults is associated with higher educational attainment, presence of medical conditions, and improved physical fitness. This underscores the complex interplay of physical and mental health in the aging process and highlights the importance of preventing and managing sarcopenia to improve the quality of life for older adults. Full article

Hypothyroidism is a multifactorial endocrine disorder where genetic predisposition plays a significant role. The MTHFR, MTRR, and MTR genes influence thyroid hormone regulation via homocysteine remethylation and DNA methylation. This study examined associations between hypothyroidism and polymorphisms in MTHFR (C677T–rs1801133, A1298C–rs1801131), MTRR (A66G–rs1801394), and MTR (A2756G–rs1805087) genes. Eighty-six patients with hypothyroidism and 87 healthy controls were included. Genotyping was performed using PCR-RFLP. Post hoc analysis confirmed adequate statistical power (95% for MTRR A66G, 84.6% for MTR A2756G). The study adhered to STROBE guidelines. MTHFR polymorphisms showed no significant association when considered individually. However, the MTRR A66G AA genotype was significantly more frequent in patients and conferred a markedly increased disease risk (OR: 4.373; 95% CI: 2.174–8.797; p < 0.001), while the MTR A2756G AG genotype was also more prevalent among patients and associated with higher susceptibility (OR: 2.178; 95% CI: 1.156–4.104; p = 0.008). Genotype combination analysis revealed that CT–AA (OR = 6.898; 95% CI: 1.941–24.516; p = 0.001) and AG–AA (OR = 6.892; 95% CI: 1.494–31.797; p = 0.007) conferred high risk. Certain genotypes correlated with clinical features, including hypercholesterolemia, diabetes, and cardiovascular disease. MTRR A66G and MTR A2756G polymorphisms are associated with hypothyroidism and metabolic comorbidities, both individually and in genotype combinations. These findings underscore the value of multilocus genetic models for understanding thyroid disorders and support the potential role of genetic biomarkers in personalized risk assessment and early diagnosis. GRS analysis demonstrated that each additional risk allele increased hypothyroidism risk (OR = 1.58; 95% CI: 1.18–2.10; p = 0.0018), and the total score showed moderate predictive power (AUC = 0.665; p < 0.001). Full article

Background/Objectives: Scapholunate ligament injuries represent one of the most challenging diagnostic problems in wrist surgery, with conventional radiographs often appearing normal despite significant ligamentous disruption. The optimal stress radiographic views for detecting these injuries remain incompletely defined. To systematically evaluate and compare the diagnostic utility of eight different stress radiographic views in detecting isolated scapholunate ligament disruption using a cadaveric model. Methods: Nine fresh-frozen cadaveric wrists underwent complete scapholunate ligament transection while preserving secondary stabilizers. Eight radiographic positions were evaluated: posteroanterior (PA) neutral, PA wrist extension, PA wrist flexion, PA radial deviation, PA ulnar deviation, anteroposterior (AP) clenched fist, AP neutral, and lateral neutral. Scapholunate gap measurements were obtained using calibrated digital software with 20 mm reference markers. Statistical analysis employed repeated-measures ANOVA with post hoc comparisons. Results: PA wrist extension demonstrated the greatest scapholunate gap widening (2.68 ± 0.84 mm, p = 0.006), followed by AP clenched fist views (2.32 ± 1.07 mm, p = 0.036). PA wrist flexion showed significant gap reduction (0.47 ± 0.44 mm, p < 0.001). Twenty-two percent of specimens demonstrated scapholunate angles exceeding 70° on lateral radiographs. Inter-specimen variability was observed, with gap measurements ranging from 1.2 to 4.8 mm across different positions. Conclusions: PA wrist extension and AP clenched fist views demonstrate superior diagnostic utility for detecting scapholunate ligament injuries compared to neutral radiographs. These stress radiographic techniques offer accessible, cost-effective alternatives to advanced imaging modalities for early detection of scapholunate ligament pathology in clinical practice. Full article

Background: The aim of this study was to investigate the effects of matcha on lipid metabolism, insulin resistance (IR), inflammation, and gut dysbiosis in non-alcoholic fatty liver disease (NAFLD) induced by a cafeteria diet. Methods: Forty-eight 7-week-old male Wistar rats were divided into six groups (n = 8), including a control group (C), C + 0.2% matcha group (C + 0.2%), C + 1% matcha group (C + 1%), cafeteria group (Caf), Caf + 0.2% matcha group (Caf + 0.2%), and Caf + 1% matcha group (Caf + 1%). All rats were sacrificed at the end of the 12th week of the experiment. A one-way analysis of variance (ANOVA), followed by a Fisher’s post hoc test, was used to determine the significant differences among each of the groups. Results: The results indicated that plasma experiment triglycerides (TGs) significantly increased in the Caf group compared to the C group, and significantly decreased TG levels were found in the Caf + 1% group compared to the Caf group. In addition, the liver total cholesterol and TG had significantly increased in the Caf group, while the 0.2% Matcha intervention can mitigate hepatic lipid accumulation. Blood sugar, serum insulin, the homeostasis model assessment of IR (HOMA-IR), and plasma leptin significantly increased in the Caf group and were significantly lower in the Caf + 0.2% and Caf + 1% groups. Hepatic cytokines significantly increased in the Caf group, while, on the other hand, significantly lower concentrations were found in the Caf + 1% group. In addition, beneficial bacteria including Akkermansia, Faecalibacterium, and Parabacteroides increased after matcha supplementation. Conclusions: These results suggested that 12 weeks of a cafeteria diet can induce abnormal lipid metabolism, IR, liver inflammation, and an altered gut microbiotic composition, while both the 0.2% and 1% matcha interventions might regulate obesity, lipid accumulation, IR, and inflammatory responses, and help maintain a healthier gut microbiota, which may then ameliorate the development of NAFLD. Full article

Zanthoxyli Pericarpium (ZP), the dried pericarp of mature fruits of Zanthoxylum schinifolium Siebold and Zucc., has traditionally been used in East Asian medicine for its medicinal properties, but its therapeutic potential in periodontitis has not been elucidated. In the present study, we investigated the effects of ZP on ligature-induced experimental periodontitis (EPD) in male Sprague Dawley rats. Animals were assigned to vehicle control, ligature control, ZP-treated (25, 50, and 100 mg/kg), or indomethacin-treated (5 mg/kg) groups (n = 10 per group) and orally administered the respective treatments daily for 10 days after ligature placement. ZP significantly reduced anaerobic bacterial proliferation and inflammatory cell infiltration in gingival tissue. ZP suppressed the production of inflammatory mediators, such as tumor necrosis factor-α and interleukin-1β, in both gingival tissues and lipopolysaccharide-stimulated RAW 264.7 macrophages, through inhibition of the mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) signaling pathways. In addition, ZP decreased myeloperoxidase activity and reduced matrix metalloproteinase-8 expression, thereby preserving collagen areas. ZP also restored the receptor activator of NF-κB ligand/osteoprotegerin (RANKL/OPG) balance, leading to a reduction in osteoclast numbers and their occupancy on the alveolar surface, and it effectively ameliorated horizontal alveolar bone loss. Furthermore, ZP exhibited antioxidant effects by lowering malondialdehyde levels and inducible nitric oxide synthase activity in gingival tissues. Statistical analysis was performed using ANOVA followed by a post hoc test, with significance set at p < 0.05. These findings indicate that ZP mitigates periodontitis through combined antimicrobial, anti-inflammatory, antioxidant, and anti-resorptive actions, supporting its potential as a therapeutic candidate for periodontitis. Full article

Background: Drug combinations with complementary mechanisms of action are able to achieve effective analgesia at lower doses, thereby reducing the risk of adverse effects (AEs). This study evaluated the analgesic efficacy and tolerability of two fixed-dose combinations (FDCs) of ibuprofen/tramadol (IBU/TRA) compared with tramadol and a placebo. Methods: This multicenter, randomized, double-blind, dose-finding, pilot clinical trial compared IBU/TRA (400/37.5 mg and 400/75 mg) with 100 mg of tramadol and a placebo in patients with moderate-to-severe pain following dental surgery. The primary endpoints were pain intensity at 6 h (PI_6h) and the pain intensity difference from baseline to 6 h (PID_6h). PID_7h, the sum of pain intensity differences from baseline to 7 h (SPID_0–7h), pain relief (PAR_7h), total pain relief (TOTPAR_7h), the use of rescue medication and AEs were also assessed. Results: Seventy-two patients were randomized and evaluated. Both FDCs showed superiority over the placebo for PI_6h and PID_6h (p < 0.05) but were not significantly different from 100 mg of tramadol. The statistical superiority of FDCs over the placebo was observed for PID_7h, SPID_0–7h, PAR_7h and TOTPAR_7h. The percentage of patients receiving rescue medication was higher in the placebo (94.1%) and tramadol (52.6%) groups than the FDC groups (35.3% and 36.8% for 400/37.5 mg and 400/75 mg, respectively). A post hoc analysis showed that the FDCs had a superior analgesic efficacy to 100 mg of tramadol in the SPID_0–4h (p < 0.005). The incidence of AEs was comparable between treatment groups. Conclusions: Both FDCs of IBU/TRA provided superior analgesic efficacy compared to the placebo. We propose using SPID_0–4h as the preferred variable for evaluating the efficacy of this type of drug combination. Full article

The proposed research aims to evaluate the histopathological effects of the intra-articular administration of recombinant human proteoglycan 4 (rhPRG4) on an experimental model of induced temporomandibular joint (TMJ) osteoarthritis (OA) in rabbits. An experimental study was conducted on rabbit TMJs. Twenty-four TMJs were included, distributed as follows: (1) TMJ-C, a control group consisting of four healthy TMJs; (2) TMJ-OA, a group consisting of five TMJs with OA; (3) TMJ-OA-WT, a group consisting of five untreated TMJ-OAs; (4) rhPRG4-30, a group consisting of five TMJ-OAs treated with rhPRG4 30 μg/mL; and (5) rhPRG4-100, a group consisting of five TMJ-OAs treated with rhPRG4 100 μg/mL. A histopathological analysis was performed, considering the mandibular condyle, articular disc, and mandibular fossa, comparing the groups. In addition, a quantitative comparative analysis was performed using the Osteoarthritis Research Society International (OARSI) scale. Kruskal–Wallis and Dunn’s post hoc tests were used for statistical analysis, considering a statistical significance of p < 0.05. The histological analysis of TMJ tissue reveals key differences between healthy, osteoarthritic, and rhPRG4-treated joints. The intra-articular infiltration of rhPRG4 in TMJ-OA has a cartilage and articular disc repair effect, reducing the severity of osteoarthritis and promoting a more organized cartilage structure, with slightly better results at the 30 μg/mL concentration. Full article