Search Results (319)

The study aimed to evaluate the effect of chlorhexidine (CHX), chlorin p6-mediated photodynamic therapy (PDT), magnesium oxide nanoparticles (MgONPs), and Clp6-functionalized MgONPs on smear layer removal and shear bond strength of a two-step etch-and-rinse adhesive to caries-affected dentin. Seventy-five human permanent molars with occlusal carious lesions and ICDAS scores of four and five were included. Twenty-five samples were used to prepare dentin discs 2 mm in thickness. The remaining samples, along with 25 discs, were arbitrarily allocated into five disinfectant groups, with n = 15 per group (10 teeth and 5 discs). Group I: Control, Group II: 2% CHX, Group III: Clp6-mediated PDT, Group IV: MgONPs, and Group V: Clp6-functionalized MgONPs. SL removal assessment, nanoparticle characterization, and EDX were performed using SEM. Fifty CAD were etched, followed by fifth-generation adhesive application and composite build-up. SBS and failure modes were evaluated with a universal testing machine and stereomicroscope, respectively. Group 4 (MgONPs) specimens displayed the maximum cleaning of SL (1.11 ± 0.13) and the highest SBS (10.32 ± 0.18 MPa). However, minimum SL removal (2.87 ± 0.94) and bond strength (7.42 ± 0.25 MPa) were exhibited by Group 1 (No disinfectant) samples. MgONPs possess the potential to be used as a cavity disinfectant, as they efficiently remove SL from CAD and augment the bond integrity outcomes. Full article

(1) Purpose: To compare the fabrication accuracy, internal fit, and marginal adaptation of three-unit definitive resin fixed dental prostheses (FDPs) produced by subtractive milling and additive manufacturing. (2) Materials and Methods: A typodont mandible was prepared for a three-unit FDP, with full crown preparations on teeth mandibular left canine and mandibular left second premolar featuring 1 mm chamfer finish lines. The FDP was designed with a 16 mm² connector and a 100 µm cement gap. Two milling materials (Ambarino High-Class, IPS e.max CAD) and two experimental 3D printing hybrid resins (3D-1, 3D-2) were used. All restorations were scanned using an intraoral scanner and compared to the original STL using reverse engineering software for surface trueness and deviation analysis. The internal fit was evaluated using the triple-scan method, while marginal fit was assessed via micro-CT imaging. Statistical analysis was conducted using one-way ANOVA and Kruskal–Wallis tests (α = 0.05). (3) Results: Milled groups demonstrated a lower prevalence of external, marginal, and overall surface deviations (p < 0.001), while 3D-1 exhibited comparable deviations within the internal region with M-E (p = 0.067). Milled groups had average gap values that were similar to 3D-1 (p > 0.08), but significantly lower than 3D-2 (p < 0.002). In marginal adaptation evaluated by micro-CT, the M-A and M-E groups provided significantly lower gaps, while the 3D-1 and 3D-2 groups exhibited wider marginal and axial gaps. (4) Conclusions: These results indicate that while milling remains a more reliable manufacturing method for achieving external and marginal precision, position 3D-1 is a compelling, chairside alternative to milling. Full article

Pituitary neuroendocrine tumors (PitNETs) are usually benign intracranial neoplasms that may exhibit invasion of the cavernous sinus, complicating surgery and increasing the risk of recurrence. This study aimed to investigate membranous E-cadherin (mE-cad) expression across PitNET subtypes and transcription factor (TF) lineages, including Pit-1 (pituitary-specific positive transcription factor 1), SF-1 (Steroidogenic Factor 1), and TPIT (T-box pituitary transcription factor), and its association with tumor invasiveness in sixty-nine patients. mE-cad expression was evaluated as the percentage of positive cells (0%, 1–10%, >10%) and by immunoreactive score (IRS). Staining intensity was scored as: 0, no staining; 1, weak; 2, moderate; 3, strong. The proportion of positive cells was scored as: 0, none; 1, <10%; 2, 10–50%; 3, 51–80%; 4, >80%. Mean mE-cad expression was 5.2% in gonadotroph, 3.2% in corticotroph, 0.5% in lactotroph, and 17.5% in plurihormonal PitNETs. By TF lineage, the mean expression was 5.3% for Pit-1, 3.2% for TPIT, and 5.1% for SF-1. Low mE-cad expression (IRS 1–2) was associated with higher odds of cavernous sinus invasion compared with IRS 3–6 (adjusted OR = 6.0, 95% CI 1.08–33.4, p = 0.04), independent of tumor volume (adjusted OR = 4.0, 95% CI 1.50–10.7, p = 0.01). After restricting the analysis to the gonadotroph PitNET group, tumors with an IRS of 1–2 showed significantly higher invasiveness compared with those with an IRS of 3–6 (p = 0.012). These findings suggest that mE-cad may serve as a biomarker of PitNET invasiveness, with expression varying according to TF lineage and tumor subtype. Full article

Impellers are critical components in industrial applications, requiring smooth surfaces and precise dimensions. Traditional investment casting methods are often time-consuming and costly. Fused filament fabrication (FFF), an additive manufacturing (AM) technology, offers a faster, more cost-effective alternative. FFF produces 3D-printed sacrificial patterns directly from a CAD file, making it ideal for low-volume and complex patterns. Unlike wax patterns, which can shrink or distort, 3D-printed patterns offer precise tolerances and allow for thin-walled geometries. FFF also eliminates the need for tooling, reducing capital investment. However, achieving the desired surface finish and accuracy remains a challenge. In this study, a semi-open, single-shrouded centrifugal pump impeller was fabricated using FFF with acrylonitrile butadiene styrene (ABS). A Taguchi L9 (3³) design of experiments was employed to investigate the influence of layer thickness (0.08–0.24 mm), extrusion temperature (260–280 °C), and infill density (30–70%) on dimensional accuracy and surface roughness. Dimensional deviations were evaluated for critical features, including outer diameter (OD), inner diameter (ID), blade thickness (BT), shroud thickness (ST), and blade height (BH). Results show that small and thin features (BT, ST, BH) exhibited deviations with standard deviations below 0.08 mm, whereas OD was the most affected feature with a maximum standard deviation of 0.362 mm due to dominant shrinkage effects. The optimal parameter combination for minimum dimensional deviation was identified as 0.08 mm layer thickness, 280 °C extrusion temperature, and 70% infill density. Surface roughness analysis revealed that layer thickness was the most significant factor, with Ra values ranging from 4 to 7 µm, which falls within acceptable limits for investment casting. Surfaces parallel to the XY plane demonstrated superior surface quality compared with XZ/YZ planes, highlighting the feasibility of FFF-printed ABS patterns for investment casting of complex impellers. Full article

Epicardial adipose tissue (EAT) has previously been associated with coronary artery calcium scores, an increased burden of coronary artery disease (CAD), and features of plaque instability. These associations are likely mediated by endocrine and paracrine signaling from bioactive molecules secreted by EAT, which may contribute to coronary atherosclerosis. EAT can be non-invasively quantified on images obtained during coronary computed tomography angiography (CCTA). This study aimed to evaluate the potential association between EAT and non-calcified coronary plaques with severe stenosis using radiomic methodology. Materials and Methods: A total of 128 consecutive patients undergoing CCTA—both with and without contrast—for known or suspected CAD were retrospectively analyzed. EAT features were extracted from contrast scans. Coronary artery plaque features were evaluated using Coronary Artery Disease-Reporting and Data System (CAD-RADS). Results: EAT features showed a statistically significant positive correlation with non-calcified coronary plaques with severe grades of stenosis (CAD-RADS > 4). The Ensemble Machine Learning (EML) model combined with coronary plaque data showed a sensitivity of 1.00 and a specificity of 0.93, with a negative predictive value of 1.00 and a positive predictive value of 0.85, and an accuracy of 0.95 (95% CI: 0.9221–1) in internal validation. Conclusions: EAT may represent a novel imaging biomarker associated with the presence of actionable coronary plaques. Radiomic texture analysis of EAT could enhance the non-invasive prediction of coronary stenoses. These preliminary findings support the clinical utility of EAT evaluation via CCTA in patients with low to intermediate cardiovascular risk. Full article

(1) Background/Objectives: Gap formation contributes to the clinical failure of partial crowns. Therefore, it was analyzed at the interfaces between restoration, luting material, and tooth in partial crowns made of lithium disilicate ceramic (LS2) and nanohybrid composite (RBC) after thermomechanical loading (TCML) using optical coherence tomography (OCT). (2) Materials and Methods: Sixteen human mandibular molars were restored with CAD/CAM partial crowns made of LS2 (IPS e.max^® CAD) or RBC (Tetric^® CAD) using adhesive cementation (Variolink^® Esthetic DC). The restorations were imaged by OCT (1550 nm, 28 kHz) at t0 = 24 h, t1 = 90 days of water, t2 = after TCML with 480,000 loading cycles, and t3 = TCML with 1,200,000 loading cycles. Gap lengths (%) at interface 1 (partial crown-luting material) and interface 2 (luting material–enamel/dentin) were quantified. Groupwise and pairwise comparison of OCT parameters was conducted using the Mann–Whitney U, Friedman, and Conover–Iman tests with Bonferroni correction (α = 0.05). (3) Results: At interface 1, LS2 showed a larger median gap length than RBC (ceramic = 48.4%; composite = 5.2%, p < 0.01). At interface 2, the largest median gap length for LS2 was measured at the dentin (ceramic = 59.7%; composite = 52.5%), while for RBC, the enamel was more affected (ceramic = 26.2%; composite = 36.9%). (4) Conclusions: OCT enables reliable gap detection in partial crowns under functional loading and is therefore suitable for monitoring adhesive interface integrity. Under in vitro conditions, both materials demonstrated stable adhesive performance without debonding, while material-dependent differences in gap formation and distribution were observed. Full article

Background: Artificial intelligence-based computer-aided diagnosis (AI-CAD) systems are increasingly used in breast ultrasonography; however, their diagnostic performance may vary with breast density. Given that dense breasts are highly prevalent among Asian women, understanding this relationship is essential for optimizing AI-assisted imaging strategies. Therefore, this study aims to evaluate the effect of breast density on the diagnostic accuracy of an AI-CAD ultrasound system in BI-RADS category 4 (C4) breast lesions. Methods: Overall, 110 consecutive BI-RADS C4 lesions were reviewed between January and December 2023. An AI-CAD ultrasound system automatically assigned BI-RADS categories and calculated the probability of malignancy (POM) using static ultrasound images. Histopathology served as the reference standard, with atypia and malignancy combined into a non-benign category. Diagnostic performance—including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy—was analyzed based on breast density (BI-RADS B–D), determined using AI-assisted mammography. Results: Overall, the sensitivity and NPV were 81.3% and 87.5%, respectively, while the specificity and PPV were lower at 53.8% and 41.9%. All diagnostic performance metrics improved with increasing breast density. In the density D category, sensitivity (92.3%), specificity (61.5%), NPV (96.0%), and accuracy (69.2%) were highest. Additionally, concordance between AI-assigned BI-RADS categories and histopathologic diagnoses increased with density (B: 50.0%, C: 57.5%, D: 67.3%). Across all density groups, non-benign lesions consistently demonstrated higher POM values. Conclusions: Breast density significantly affects the diagnostic performance of AI-CAD ultrasound in BI-RADS C4 lesions. The AI system demonstrates higher accuracy and concordance in dense breasts, suggesting more consistent lesion interpretation in high-density environments. These findings highlight the potential utility of AI-assisted ultrasound as a diagnostic adjunct, particularly for Asian women, who commonly have dense breast composition. Further multicenter, real-time validation studies are warranted to validate these findings. Full article

This study examined the association between biofilm growth and surface properties of 3D printed, milled, and conventional materials used for manufacturing fixed dental prostheses. Disc-shaped specimens were produced and finished from five 3D-printing resins (VarseoSmile Crown plus [VSC], NextDent C&B MFH [ND], VarseoSmile Temp [VST], Temp PRINT [TP], P Pro Crown & Bridge [P]), two polymer milling blocks (composite: TetricCAD [TC], PMMA: TelioCAD [TEL]), two conventional polymer materials (Tetric EvoCeram [TEC], Protemp 4 [PT]), and zirconia (ZR). Surface roughness (R_a), wettability, interfacial tension (IFT) and surface topography were examined. Three-day biofilms were grown on the specimens using A. naeslundii, S. gordonii, S. mutans, S. oralis, and S. sanguinis in a multi-species suspension. Biofilms were quantified by crystal violet staining and with a plating and culture method (CFU/mL). Linear regression analysis was computed to demonstrate associations between the surface properties and biofilm growth. The strength of this relationship was quantified by calculating Spearman’s ρ. TC exhibited the highest, and TP the lowest IFT. TEC showed the highest R_a, while TEL had the lowest, with significant differences detected particularly between milled and 3D-printed specimens. TP specimens exhibited the highest biofilm mass, while ZR surfaces retained the least. Bacterial viability within the biofilms remained similar across all tested materials. There was a strong negative correlation between total IFT and biofilm mass, and a moderate positive correlation between R_a and CFU/mL. Surface properties are shaped by material composition, microstructure, and manufacturing methods and play a crucial role in biofilm formation on dental restorations. Full article

This in vitro study evaluated the shear bond strength (SBS) of four CAD/CAM (Computer aided design/Computer aided manufacturing) polymer-based indirect composites bonded to dentin and microhybrid composite substrates using two resin cements. Gradia Plus (GP), Ceramage (Ce), Tescera ATL (TA), and Lava Ultimate (LA) were fabricated into cylindrical specimens (3 × 3 mm). Dentin substrates were obtained from extracted molars, while composite substrates were prepared from Filtek Z250 (4 mm × 2 mm). Bonding was performed using either a self-adhesive resin cement (RelyX U200; RU200) or a dual-cure adhesive resin cement (RelyX Ultimate; RU), resulting in 16 experimental groups (n = 12 per group). SBS was measured using a universal testing machine (1 mm/min), and failure modes were assessed under stereomicroscopy. Bond strength was significantly higher on composite substrates than on dentin (p < 0.001), primarily due to favorable polymer–polymer compatibility and matrix interdiffusion, which improved stress accommodation at the adhesive interface. TA and Ce showed superior adhesion when combined with RU, while LA exhibited the lowest values, particularly on dentin bonded with RU200. Overall, the dual-cure adhesive system provided stronger bonding than the self-adhesive system (p < 0.05). These findings highlight the influence of substrate type, composite architecture, and cement chemistry on interfacial performance in indirect polymer-based restorations. Full article

Background/Objectives: Patients with combined cardiovascular and cerebrovascular disease face poorer prognoses. Early, accurate assessment of the risk of cerebral ischaemic events (including transient ischaemic attacks (TIAs) and ischaemic strokes (ISs)) in patients with coronary artery disease (CAD) is therefore vital for clinical guidance. This study aims to develop a comprehensive risk assessment model for early warning in this population. Methods: In this study, we conducted a retrospective multicentre recruitment of CAD patients undergoing concurrent coronary CTA and cervical CTA (n = 326), with follow-up to observe the occurrence of cerebral ischaemic events. We performed an analysis of high-risk plaque (HRP) characteristics and subcomponent plaque in coronary and cervical arteries, measured the pericoronary fat attenuation index (FAI) and cervical perivascular fat density (PFD), and extracted corresponding radiomic features. Five models were constructed to identify the CAD patients who developed IS/TIA, respectively: Model 1—clinical characteristics; Model 2—coronary CTA parameters + Radscore_coronary; Model 3—cervical CTA parameters + Radscore_cervical; Model 4—Model 1 + Model 2; Model 5—Model 1 + Model 2 + Model 3. Results: In the cerebral ischaemia group, the prevalence of coronary and/or cervical HRP was higher than in the non-ischaemia group (28.0% vs. 26.1%, 57.0% vs. 44.0%, p = 0.02). Multivariate logistic regression confirmed that RCA FAI and PFD remained significant independent risk factors for IS/TIA (all p < 0.05). The model prediction results showed that progressively incorporating coronary and cerebral vascular risk factors into the clinical features gradually improved model performance (Model 4 vs. Model 5, AUC: 0.711 [0.645–0.777] vs. 0.821 [0.769–0.873]). Model 5 achieved a sensitivity of 0.788 [0.485–0.909] and specificity of 0.827 [0.385–0.923], demonstrating the best overall clinical benefit. Conclusions: RCA FAI and PFD are independent predictors of cerebral ischaemic events. By integrating clinical characteristics, coronary CTA and cervical CTA parameters, combined with Radscore_coronary and Radscore_cervical, the risk stratification capability for IS/TIA in CAD patients can be significantly enhanced. Full article

This work focuses on wire arc additive manufacturing for the rapid prototyping of shell-type parts such as sealed containers/capsules required in the manufacturing of metal components using hot isostatic pressing (HIP) of powder. The selected material was AISI 316L. The automatic generation step of robot trajectories from the CAD design of the part to be manufactured was addressed first. The mechanical and metallurgical properties of WAAM samples were then evaluated. Finally, a hollow cylindrical capsule manufactured by WAAM was used for the HIP sintering of powder to demonstrate the relevance of the hybrid technology. The main results are as follows: 1. The Ultimate Tensile Strength (UTS) of AISI 316L WAAM samples was measured be-19 tween 540 MPa (longitudinal direction) and 600 MPa (transverse direction). 2. The as-manufactured WAAM parts present a residual (δ) ferrite content of 5–7%. 3. HIP processing permitted to reset a fully austenitic structure within the WAAM wall/shell. 4. The grain size was found to be coarser in the WAAM walls and finer in the core of the part (made of sintered powder). Finally, the suggested hybrid process may become an alternative technology for the manufacture of medium-size metal components in the nuclear industry. Full article

Background/Objectives: Various pathophysiological mechanisms play a role in the development of cardiovascular diseases (CVDs). There is a need for new biomarkers that can complement existing clinical findings, particularly in the early diagnosis and prognostic assessment of coronary artery disease (CAD) and that can also contribute to more effective management of the diagnosis and treatment process. Therefore, both blood and pericardial fluid samples can provide important diagnostic information. This study aims to investigate Stromal Cell-Derived Factor 4 (SDF4) levels and thiol/disulfide homeostasis in the blood and pericardial fluid of patients with established CAD undergoing open-heart surgery with cardiopulmonary bypass (CPB), in order to better characterize oxidative stress-related and redox-mediated pathophysiological processes associated with the development and progression of coronary heart disease. Comparisons with a healthy control group were performed to elucidate disease-related biochemical alterations rather than to propose these markers as diagnostic tools for CAD. Methods: In this study, intraoperatively collected venous blood and pericardial fluid samples from 45 patients undergoing on-pump coronary artery bypass grafting were analyzed. SDF4 levels were measured using enzyme-linked immunosorbent assay (ELISA), while thiol–disulfide homeostasis was assessed via spectrophotometric analysis. Results: The study revealed statistically significant differences in parameters such as SDF-4, native thiol, total thiol, disulfide, and disulfide/total thiol ratio among the control, patient serum, and pericardial fluid groups (p < 0.05). Notably, SDF-4 and disulfide levels were elevated, while thiol levels were reduced in the pericardial fluid group, suggesting increased oxidative stress and disrupted redox balance. Principal Component Analysis (PCA) and Variable Importance in Projection (VIP) analyses successfully demonstrated the discriminative power of these parameters among the groups. Conclusions: The increased SDF-4 levels and disturbances in the thiol–disulfide balance observed in this study indicate elevated oxidative stress and impaired cellular redox homeostasis in CAD. These findings suggest that SDF-4 and thiol–disulfide parameters may serve as important biochemical markers in the pathophysiology of CVD and hold potential as diagnostic and prognostic biomarkers. Full article

Background/Objectives: Patients with peripheral arterial disease (PAD) or carotid stenosis (CS) who do not exhibit symptoms suggesting the coexistence of CAD are often not evaluated for CAD. The aim of this study was to assess the prevalence of asymptomatic CAD identified by coronary angiography in patients with PAD or CS, undergoing peripheral arteriography, and without prior diagnosis of CAD. Methods: A total of 350 PAD patients undergoing peripheral angiography, without a history or symptoms of CAD were prospectively enrolled in this study. These patients underwent simultaneous coronary angiography during scheduled peripheral arteriography. The severity of CAD was assessed using the Jeopardy Score Scale (JSC) and by evaluating the number of major coronary vessels involved. Results: Significant coronary artery stenosis was detected in 52.86%, with 50.00% in the PAD group and 51.43% in the CS group. One-, two-, and three-vessel disease was present in 29.14%, 14.28%, and 10.01% of the study population, respectively. The JSC median for the entire cohort was 2 (0–4) and 4 (2–8) when CAD was diagnosed. The combination of CS and PAD was associated with the highest risk for CAD (73%), with a median JSC of 2 (0–8). Conclusions: The risk of co-occurrence of CAD in patients with PAD, regardless of the presence of CAD symptoms, is high, exceeding 50%. Consequently, (in accordance with the guidelines for the management of chronic coronary syndromes), in all patients with PAD, regardless of CAD symptoms, advanced cardiological diagnostics, including coronary CT angiography or functional imaging, should be considered. Full article

In a situation where the number of non-performing loans (NPLs) increases, lenders may raise interest rates to compensate for potential losses, and the amount of credit granted in the market may decrease, leading to credit rationing. Such actions may become vital based on their potential consequences for the economy, entrepreneurs and consumers, which makes this topic extremely important. This study, by using an empirical VAR analysis, has strived to determine whether credit rationing by banks operating in the Polish banking sector is driven by risky loans (which are the main determinant of credit rationing and are represented by the ratio of NPLs to total loans). According to the results, it has been found that credit rationing, made by Polish banks, is not statistically significant when the risk in the credit market rises due to non-performing loans. Therefore, it can be claimed that the risky structure due to NPL in the credit market may not be one of the determinant factors of credit rationing in the Polish banking sector. The low sensitivity of the Polish banking sector to the risky structure of the credit market may result from the relatively low share of loans in total assets compared to debt instruments. Furthermore, restrictive lending policies and the predominance of mortgage loans secured directly by real estate limit portfolio risk, which may reduce the need for a risk-sensitive lending strategy. Full article

Auger decay of all levels of the double core-hole states $4d^{-2}$ of Xe²⁺, including collective Auger decay (CAD) pathways, is investigated using the relativistic distorted-wave approximation. Large-scale configuration interaction calculations were performed to obtain level-to-level Auger decay rates. In addition to the typical Auger decay final levels associated with the configurations of $4d^{-1}5s^{2}5p^4$, $4d^{-1}5s^{1}5p^5$, and $4d^{-1}5s^{0}5p^6$, evident contributions are identified from excited channels, leading to configurations such as $4d^{9}4f^{1}5s^{2}5p^3$, $4d^{9}5s^{2}5p^{3}5d^1$, $4d^{9}5s^{2}5p^{3}6s^1$, and $4d^{9}5s^{2}5p^{3}6p^1$. These contributions arise from strong electron correlation between the valence electronic orbitals and the $4d$ inner-shell orbital. The CAD rates and branching ratios (BRs) are determined for each double core-hole level with a minimum CAD BR of 1.28% and a maximum of 4.08% among all CAD channels. The configuration-averaged CAD BR is predicted to be 1.93%, which helps explain recent unexplained experimental findings. The inclusion of CAD processes enriches Auger electron spectroscopy, thereby extending potential applications of this important experimental tool in both fundamental and applied research. Full article