Search Results (4,723)

Objectives: The aim of this study was to evaluate the impact of four working heights on lumbar biomechanics during wall construction tasks, focusing on work-related musculoskeletal disorders (WMSDs). Methods: Fifteen young male participants performed simulated mortar-spreading and bricklaying tasks while actual body movements were recorded using Inertial Measurement Unit (IMU) sensors. Muscle activities of the lumbar erector spinae (ES), quadratus lumborum (QL), multifidus (MF), gluteus maximus (GM), and iliopsoas (IL) were estimated using a 3D musculoskeletal (MSK) model and measured via surface electromyography (sEMG). The analysis of variance (ANOVA) test was conducted to identify the significant differences in muscle activities across four working heights (i.e., foot, knee, waist, and shoulder). Results: Findings showed that working at foot-level height resulted in the highest muscle activity (7.6% to 40.6% increase), particularly in the ES and QL muscles, indicating an increased risk of WMSDs. The activities of the ES, MF, and GM muscles were statistically significant across both tasks and all working heights (p < 0.01). Conclusions: Both MSK and sEMG analyses indicated significantly lower muscle activities at knee and waist heights, suggesting these as the best working positions (47 cm to 107 cm) for minimizing the risk of WMSDs. Conversely, working at foot and shoulder heights was identified as a significant risk factor for WMSDs. Additionally, the similar trends observed between MSK simulations and sEMG data suggest that MSK modeling can effectively substitute for sEMG in future studies. These findings provide valuable insights into ergonomic work positioning to reduce WMSD risks among wall construction workers. Full article

Objective: To evaluate the concordance of automated 3D superimposition methods applied to digital models, with a focus on methods that consider stable palatal regions as geometric reference landmarks versus those that do not. Design and setting: This was a prospective, cross-sectional study using digital model files of patients undergoing orthodontic treatment in a university clinical setting. Participants: Sixty-one patients were prospectively enrolled and divided into three groups based on the type of orthodontic treatment they received: (20) non-extractive orthodontic treatment without intermaxillary elastics, (21) intermaxillary elastics, and (20) control subjects with no orthodontic movement. The inclusion criteria included the availability of complete pre- and post-treatment digital casts and the absence of significant craniofacial anomalies. Methods: Three superimposition methods were tested: (1) superimposition according to palate and palatal ridges, (2) best-fit superimposition of arches in occlusion, and (3) best-fit superimposition of individual arches. Discrepancies were identified by comparing the spatial positions derived from each method. Within three spatial axes, deviations of ±0.5 mm and ±1.15° were not considered significant. Bland–Altman plots were used to quantify palatal rugae based and non-based spatial differences between methods. Differences in the superimposition results between the three patient groups were evaluated using ANOVA tests. Results: Differences in spatial position between the superimposition methods often exceeded the acceptable range. The results were compared between the three patient groups with a statistical significance of α = 0.05. In the present study, the high reliability of the superimposition method based on the palate and palatal ridges was observed. Conclusion: Superimposition methods based on the palate and palatal rugae provide superior accuracy in determining treatment-related changes in upper arch digital models. These findings illustrate the need for appropriate selection of superimposition techniques based on the study objective of using clinically relevant techniques. Full article

The ongoing secular changes in human movement development means that an assessment of primitive reflexes is now required not only in disabled but also in neurotypical children. This study had three aims: (1) presenting the TASHUN test battery as suitable for the assessment of primitive reflex activity in normal children and child athletes; (2) analyzing reflex characteristics of neurotypical children; (3) verifying validity and reliability of tests. Spearman’s rank correlation and ROC analysis were used for validation. Intraclass Correlation Coefficient and RM ANOVA analyzed reliability. The test on 242 schoolgirls has demonstrated that retained primitive reflexes are present in almost every individual (84.7–95.7%). Correlations showed strong positive association, with all values exceeding 0.8, and ROC analysis demonstrated excellent predictive strength (AUC values over 0.9). Interobserver reliability showed excellent agreement (ICC values above 0.9). No significant offset was present among the scoring by evaluators. Therefore, testing for primitive reflexes is necessary in neurotypical children in order to obtain a realistic image about the physiology of reflexes and their role in motor development. Our screening could be useful for practicing sport professionals, researchers and academics, to identify deficiencies, to further explore reflexes and to train future PE teachers and trainers. Full article

This study aims to enhance the performance of an innovative steel slag–ceramsite foam concrete (SSCFC) to advance sustainable green building materials. An eco-friendly composite construction material was developed by integrating industrial by-product steel slag (SS) with lightweight ceramsite. Employing a three-factor, three-level orthogonal experimental design at a fixed density of 800 kg/m³, 12 mix proportions (including a control group) were investigated with the variables of water-to-cement (W/C) ratio, steel slag replacement ratio, and ceramsite replacement ratio. The governing mechanisms of the W/C ratio, steel slag replacement level, and ceramsite replacement proportion on the SSCFC’s fluidity and compressive strength (CS) were elucidated. The synergistic application of range analysis and analysis of variance (ANOVA) quantified the significance of factors on target properties, and partial least squares regression (PLSR)-based prediction models were established. The test results indicated the following significance hierarchy: steel slag replacement > W/C ratio > ceramsite replacement for fluidity. In contrast, W/C ratio > ceramsite replacement > steel slag replacement governed the compressive strength. Verification showed R² values exceeding 65% for both fluidity and CS predictions versus experimental data, confirming model reliability. Multi-criteria optimization yielded optimal compressive performance and suitable fluidity at a W/C ratio of 0.4, 10% steel slag replacement, and 25% ceramsite replacement. Full article

Background and Objectives: Total hip arthroplasty (THA) following pelvic osteotomy for developmental dysplasia of the hip (DDH) is technically challenging due to altered acetabular morphology. This study aimed to compare radiographic cup position and perioperative characteristics of THA after three common pelvic osteotomies—periacetabular osteotomy (PAO), shelf procedure, and Chiari osteotomy—with primary THA in Crowe type I DDH. Methods: A retrospective review identified 25 hips that underwent conversion THA after pelvic osteotomy (PAO = 12, shelf = 8, Chiari = 5) and 25 primary THAs without prior osteotomy. One-to-one matching was performed based on sex (exact match), age (within 5 years), and BMI (within 2 kg/m²) without the use of propensity scores. Cup inclination, radiographic anteversion, center-edge (CE) angle, and cup height were measured on standardized anteroposterior radiographs (ICC = 0.91). Operative time, estimated blood loss, and use of bulk bone grafts or reinforcement rings were reviewed. One-way ANOVA with Dunnett’s post hoc test and chi-square test were used for statistical comparison. Results: Cup inclination, anteversion, and CE angle did not differ significantly among groups. Cup height was significantly greater in the PAO group than in controls (29.0 mm vs. 21.8 mm; p = 0.0075), indicating a more proximal hip center. The Chiari and shelf groups showed upward trends, though not significant. Mean operative time tended to be longer after PAO (123 min vs. 93 min; p = 0.078). Bulk bone grafts and reinforcement rings were more frequently required in the PAO group (17%; p = 0.036 vs. control), and occasionally in Chiari cases, but not in shelf or control groups. Conclusions: THA after PAO is associated with higher cup placement and greater need for reconstructive devices, indicating increased technical complexity. In contrast, shelf and Chiari conversions more closely resemble primary THA. Preoperative planning should consider hip center translation and bone-stock restoration in post-osteotomy THA. Full article

Background/objectives: Polycystic ovary syndrome (PCOS) and metabolic dysfunction-associated steatotic liver disease (MASLD) are common co-morbidities in women of reproductive age. PCOS is highly heterogeneous and is, therefore, divided into four phenotypes. MASLD leads to numerous systemic complications. Studies to date have shown an association between PCOS and MASLD. This study was designed to compare the FIB-4 score (based on age, alanine aminotransferase, aspartate aminotransferase and platelet count) and the results of shear wave elastography in assessing the risk of developing MASLD by patients with PCOS divided by phenotypes. Methods: The study enrolled 242 women age 18–35 years with PCOS diagnosed according to Rotterdam criteria, hospitalized at the Department of Gynaecological Endocrinology of the University Clinical Centre in Katowice. The study subjects were assigned to phenotypes A to D. Clinical and biochemical assessments were performed (including androgens and metabolic parameters), and the FIB-4 index was calculated. Liver fibrosis was evaluated by shear wave elastography. To balance the group sizes of phenotypes, oversampling with replacement was applied (PROC SURVEYSELECT, SAS), increasing the number of observations for phenotypes B, C, and D fivefold. Statistical analyses were performed based on data distribution (Shapiro–Wilk test), using ANOVA or the Kruskal–Wallis test with Dunn’s correction. Statistical significance was set at p < 0.05. Results: The FIB-4 score was the highest in phenotype B patients (0.50 ± 0.15), and the lowest in phenotypes A and C (0.42 ± 0.14). The highest rate of positive elastography findings was recorded in phenotype A patients (34.7%) and the lowest in phenotype C group (13.5%). Significant differences between the phenotypes were also found in terms of androgen levels, insulin, HOMA-IR, and the lipid profile. Among patients with positive elastography, the highest FIB-4 scores were recorded in phenotype C group (0.44 ± 0.06), but the differences between the phenotypes were not statistically significant. Conclusions: The FIB-4 score was the highest in phenotype B patients and differed significantly from phenotypes A, C and D. In the elastography exam, the fibrosis index was statistically significantly higher in phenotype A compared to other phenotypes. No correlation was detected between the FIB-4 index and positive elastography. The findings suggest that the FIB-4 index may be used for MASLD screening, but its usefulness as a predictor of eligibility for elastography requires more research. Full article

Background/Objectives: Benign paroxysmal positional vertigo (BPPV) is the most prevalent vestibular disorder encountered in clinical settings and is highly responsive to evidence-based diagnostic and therapeutic interventions. However, variations in practice patterns among physician specialties can compromise timely diagnosis and effective treatment. Understanding these variations is essential for improving clinical outcomes and standardizing care. This study aimed to assess the diagnostic and treatment practices for BPPV among Ear, Nose, and Throat (ENT) specialists, neurologists, general practitioners, and family physicians in Saudi Arabia and to examine how these practices are influenced by clinical experience and patient case exposure. Methods: A cross-sectional, questionnaire-based study was conducted between April 2023 and March 2024 at King Khalid University, Abha, Saudi Arabia. A total of 413 physicians were recruited using purposive sampling. Data were analyzed using IBM SPSS version 24.0. Parametric tests, including one-way ANOVA and chi-square tests, were used to assess differences across groups. A p-value of <0.05 was considered statistically significant. Results: Overall, all physician groups exhibited limited adherence to guideline-recommended positional diagnostic and therapeutic maneuvers. However, ENT specialists and neurologists demonstrated relatively higher compliance, particularly in performing the Dix–Hallpike test, with 46.97% and 26.79% reporting “always” using the maneuver, respectively (p < 0.001, Cramér’s V = 0.22). Neurologists were the most consistent in conducting oculomotor examinations, with 73.68% reporting routine performance (p < 0.001, Cramér’s V = 0.35). Epley maneuver usage was highest among neurologists (86.36%) and ENT specialists (77.14%) compared to family physicians (50.60%) and GPs (67.50%) (p = 0.044). Physicians with 11–15 years of experience and >50 BPPV case exposures consistently showed a greater use of diagnostic maneuvers, repositioning techniques, and guideline-concordant medication use (betahistine 76.67%; p < 0.001). Continuing medical education (CME) participation and the avoidance of unnecessary imaging were also highest in this group (46.67% and 3.33%, respectively; p < 0.001). Conclusions: Significant inter-specialty differences exist in the management of BPPV in Saudi Arabia. Greater clinical experience and higher case exposure are associated with improved adherence to evidence-based practices. Targeted educational interventions are needed, particularly in primary care, to enhance guideline implementation. Full article

There is insufficient evidence regarding the cytotoxicity of restorative 3D-printing resins, used as part of the digital workflow in dentistry. This study presents a novel comparative evaluation of cell viability and adhesion using human Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs), a less commonly used but clinically relevant cell line in dental biomaterials research. The aim of this study was to evaluate the cell viability of WJ-MSCs seeded on 3D-printed resins intended for temporary restorations. Resin discs of three commercial 3D-printing resins (NextDent C&B, Leaf Dental C&B, and UNIZ Temp) and a conventional self-curing acrylic resin (NicTone) were used. WJ-MSCs were cultured on the specimens for 1, 4, and 10 days. Cell viability was assessed using the PrestoBlue assay, Live/Dead immunofluorescence staining, and 7AAD/Annexin V staining. Cell adhesion was evaluated using scanning electron microscopy. Direct exposure to the 3D-printed resins and the self-curing acrylic caused slight reductions in cell viability compared to the control group in both microscopic analyses. 7AAD/Annexin V showed the highest percentage of viable WBCs for the conventional acrylic (34%), followed by UNIZ (35%), NextDent (42%), and Leaf Dental (36%) (ANOVA p < 0.05 Tukey’s post-hoc test p < 0.05). These findings suggest that 3D-printed resins could be considered safe for use in temporary restorations. Full article

The rapidly changing dynamics of the digital age reshape the addiction relationship that high school students establish with technology. While smartphones remove boundaries in terms of communication and access to information, their usage triggers a source of anxiety and nomophobia. The increase in students’ anxiety levels because of their over-reliance on mobile phone use leads to significant behavioral changes in their mental health, academic performance, social interactions and financial dependency. This study examined the nomophobia levels of high school students according to selected socio-demographic indicators. Using the relational screening model, the multistage sampling technique was used to select a sample of 884 participants: 388 from Science High School and 496 from Anatolian High School (459 female, 425 male, Mage = 16.45 ± 1.14 year). Independent sample test and One-way ANOVA were applied. Depending on the homogeneity assumption of the data, Welch values were considered, and Tukey tests were applied as a second-level test from post hoc analyses. Comprehensive analyses of nomophobia levels revealed that young individuals’ attitudes towards digital technology differ significantly according to their demographic and behavioral characteristics. Variables such as gender, physical activity participation, grade level and duration of smartphone use are among the main factors affecting nomophobia levels. Female individuals and students who do not participate in physical activity exhibit higher nomophobia scores. Full article

Recently, 3D-printed resins have been introduced as materials for definitive indirect restorations. Herein, a comparative assessment of the bond strengths of 3D-printed resins to a resin cement was performed. Methods: four definitive restorative materials were selected, i.e., a Feldspar ceramic (VITA Mark II, VM), a polymer-infiltrated ceramic network (VITA Enamic, VE), a nanohybrid resin composite (Grandio Bloc, GB), and one 3D-printed resin (Crown Permanent, CP). VM and VE were etched and silanized, GB was sandblasted, and CP was glass bead blasted; for one further experimental group, this was followed by sandblasting (CPs). A resin cement (RelyX Unicem) was then used for bonding, and then a notched shear bond strength test (nSBS) was performed. Failure modes were observed and classified as adhesive, cohesive, or mixed, and SEM representative images were taken. Data were statistically analyzed with one-way ANOVA, Tukey, and Chi-square tests. Significant differences were detected in nSBS among materials (p < 0.001). The highest nSBS was found in VM (30.3 ± 1.8 MPa) a, followed by CP^b, GB^bc, CP^bc, and VE^c. Failure modes were significantly different (p < 0.001), and with different prevalent failure modes. The bond strength for 3D-printed permanent resin materials was shown to be lower than that of the felspathic ceramic but comparable to that of the resin block and PICN substrates. Full article

Diabetic nephropathy affects approximately 30–40% of individuals with diabetes mellitus (DM) and is a major contributor to end-stage renal disease (ESRD). While angiotensin II receptor blockers (ARBs) have long served as a standard treatment, sodium-glucose cotransporter-2 inhibitors (SGLT2i) have recently gained attention for their renal and cardiovascular benefits. However, comparative real-world data on their long-term renal effectiveness remain limited. We conducted a retrospective, longitudinal study over a 2-year period to compare the impact of ARB monotherapy versus SGLT2i and angiotensin-converting enzyme inhibitor (ACEi) combination therapy on the progression of chronic kidney disease (CKD) in patients with DM. A total of 126 patients were included and grouped based on treatment regimen. Renal biomarkers were analyzed using t-tests and ANOVA (p < 0.01). Albuminuria was qualitatively classified via urinalysis as negative, level 1 (+1), level 2 (+2), or level 3 (+3). The ARB group demonstrated higher estimated glomerular filtration rate (eGFR) and lower serum creatinine (sCr) levels than the combination therapy group, with glycated hemoglobin (HbA1c), potassium (K⁺), and blood pressure remaining within normal limits in both cohorts. Albuminuria remained stable over time, with 60.8% of ARB users and 73.1% of combination therapy users exhibiting persistently or on-average negative results. Despite the expected additive benefits of SGLT2i/ACEi therapy, ARB monotherapy was associated with slightly more favorable renal function markers and a lower incidence of severe albuminuria. These findings suggest a need for further controlled studies to clarify the comparative long-term renal effects of these treatment regimens. Full article

Colibacillosis is a poultry disease caused by the pathogenic bacterium Escherichia coli (E. coli). This study is an experimental cross-sectional study using herbal-based test materials from Javanese cardamom and turmeric rhizome as treatments to replace the role of antibiotics that experience drug resistance in several types of bacteria. A total of 32 samples were utilized in this study, separated into two control groups and six treatment groups. The analysis was carried out by an histopathological examination of the lung organs using H&E and ImageJ staining to calculate the area of the slide image. The data results were analyzed statistically with one-way ANOVA method and qualitatively. The outcome of the statistical test showed that the differences were not statistically significant p value = 0.922 [p > 0.05] in all groups, and findings from qualitative histopathology showed morphological differences in the alveoli, parabronchi, and vasculature in the lung organs. Full article

Background/Objectives: Gastrin-releasing peptide receptor (GRPR) is overexpressed in breast cancer and might be used as a theranostics target. The expression of GRPR strongly correlates with estrogen receptor (ER) expression. Visualization of GRPR-expressing breast tumors might help to select the optimal treatment. Developing GRPR-specific probes for SPECT would permit imaging-guided therapy in regions with restricted access to PET facilities. In this first-in-human study, we evaluated the safety, biodistribution, and dosimetry of the [^99mTc]Tc-DB8 GRPR-antagonistic peptide. We also addressed the important issue of finding the optimal injected peptide mass. Methods: Fifteen female patients with ER-positive primary breast cancer were enrolled and divided into three cohorts receiving [^99mTc]Tc-DB8 (corresponding to three distinct doses of 40, 80, or 120 µg DB8) comprising five patients each. Additionally, four patients with ER-negative primary tumors were injected with 80 µg [^99mTc]Tc-DB8. The injected activity was 360 ± 70 MBq. Planar scintigraphy was performed after 2, 4, 6, and 24 h, and SPECT/CT scans followed planar imaging 2, 4, and 6 h after injection. Results: No adverse events were associated with [^99mTc]Tc-DB8 injections. The effective dose was 0.009–0.014 mSv/MBq. Primary tumors and all known lymph node metastases were visualized irrespective of injected peptide mass. The highest uptake in the ER-positive tumors was 2 h after injection of [^99mTc]Tc-DB8 at a 80 µg DB8 dose (SUV_max 5.3 ± 1.2). Injection of [^99mTc]Tc-DB8 with 80 µg DB8 provided significantly (p < 0.01) higher uptake in primary ER-positive breast cancer lesions than injection with 40 µg DB8 (SUV_max 2.0 ± 0.3) or 120 µg (SUV_max 3.2 ± 1.4). Tumor-to-contralateral breast ratio after injection of 80 μg was also significantly (p < 0.01, ANOVA test) higher than ratios after injection of other peptide masses. The uptake in ER-negative lesions was significantly lower (SUV_max 2.0 ± 0.3) than in ER-positive tumors. Conclusions: Imaging using [^99mTc]Tc-DB8 is safe, tolerable, and associated with low absorbed doses. The tumor uptake is dependent on the injected peptide mass. The injection of an optimal mass (80 µg) provides the highest uptake in ER-positive tumors. At optimal dosing, the uptake was significantly higher in ER-positive than in ER-negative lesions. Full article

Early childhood forest and nature education plays a vital role in shaping values and promoting sustainability throughout life. Conceptualized in Denmark, forest and nature childcare groups have been established in Austria for over 20 years, contributing to mental well-being and supporting both Education for Sustainable Development (ESD) and Early Childhood Education and Care (ECEC). With increasing demand for childcare and a growing disconnect from nature—factors linked to physical and mental health challenges—there is a pressing need to expand these groups and integrate them into formal legal frameworks. This study examines the organization, staffing, infrastructure, risk prevention, and hygiene of 79 Austrian forest and nature kindergarten groups, identifying key areas of improvement to ensure safe access for all children, including those in public childcare. A semi-standardized online survey of 72 groups was analyzed using descriptive and statistical methods, including a Spearman correlation, Kruskal–Wallis test, Chi-square test, and ANOVA. Results revealed three main infrastructure types—house, container/trailer, and tipi—with houses offering the most comprehensive facilities. The ANOVA indicated significant effects of sponsorship type (p < 0.01), caregiver numbers (p < 0.001), and their interaction (p < 0.05) on half-day care costs. Currently, legal frameworks exist only in Tyrol and Salzburg. Broader access requires standardized infrastructure and risk assessment guidelines, collaboratively developed with stakeholders, to ensure safety and inclusivity in Austrian forest and nature childcare groups. Full article

The energy generated from renewable sources has an intermittent nature since solar irradiation and wind speed vary continuously. Hence, their energy should be stored to be utilized throughout their shortage. There are various forms of energy storage systems while the most widespread technique is the battery storage system since its cost is low compared to other techniques. Therefore, batteries are employed in several applications like power systems, electric vehicles, and smart grids. Due to the merits of the lithium-ion (Li-ion) battery, it is preferred over other kinds of batteries. However, the accuracy of the Li-ion battery model is essential for estimating the state of charge (SOC). Additionally, it is essential for consistent simulation and operation throughout various loading and charging conditions. Consequently, the determination of real battery model parameters is vital. An innovative application of the red-billed blue magpie optimizer (RBMO) for determining the model parameters and the SOC of the Li-ion battery is presented in this article. The Shepherd model parameters are determined using the suggested optimization algorithm. The RBMO-based modeling approach offers excellent execution in determining the parameters of the battery model. The suggested approach is compared to other programmed algorithms, namely dandelion optimizer, spider wasp optimizer, barnacles mating optimizer, and interior search algorithm. Moreover, the suggested RBMO is statistically evaluated using Kruskal–Wallis, ANOVA tables, Friedman rank, and Wilcoxon rank tests. Additionally, the Li-ion battery model estimated via the RBMO is validated under variable loading conditions. The fetched results revealed that the suggested approach achieved the least errors between the measured and estimated voltages compared to other approaches in two studied cases with values of 1.4951 × 10⁻⁴ and 2.66176 × 10⁻⁴. Full article