Search Results (2,450)

Background/Objectives: Caries adjacent to restorations remain a leading cause of restoration failure and replacement. Conventional diagnostic methods are limited by subjectivity and restricted visualization. Fluorescence-enhanced three-dimensional (3D) imaging has been proposed to improve detection accuracy, but evidence on its clinical perception and usability remains scarce. The objective of this study was to evaluate the perceived diagnostic value of fluorescence-enhanced 3D imaging in detecting caries adjacent to direct restorations. Methods: A cross-sectional questionnaire-based survey was distributed to undergraduate dental students and licensed dentists (n = 94). Participants assessed images of extracted teeth with direct restorations presented in three formats: conventional photographs, monochromatic 3D models, and 3D models with fluorescence. Responses were analyzed using descriptive statistics, chi-square tests, and Cohen’s kappa to measure inter-rater agreement. Results: Overall, 64.9% of respondents reported that fluorescence-enhanced images improved their diagnostic decision-making, while 29.8% reported partial benefit. Fluorescence was mainly perceived as helpful in defining cavity margins (53.3%) and assessing lesion volume (42.4%). Most participants preferred 3D models with fluorescence over conventional images for diagnostic value. However, inter-rater agreement was generally poor (κ range: –0.05 to 0.25; median κ = 0.02; only 4 images showed weak but statistically significant agreement), with only a few images demonstrating weak but statistically significant agreement. Notably, 39.3% of participants reported prior experience with 3D imaging, which was associated with greater confidence in interpreting fluorescence-enhanced images. Participants with prior 3D imaging experience reported greater confidence in fluorescence interpretation. Conclusions: While fluorescence-enhanced 3D imaging is perceived as a useful adjunct for visualizing lesion margins and depth, it does not currently yield consistent diagnostic agreement across clinicians. Training, calibration, and integration of artificial intelligence support may enhance the clinical reliability of this technology. Full article

Background/Objectives: Greater than 50% of surviving very preterm infants are affected by postnatal growth failure and are at high risk of associated development of bronchopulmonary dysplasia (BPD). Given the influence of enteral feeding on growth failure, we aimed to determine the impact of type, volume, and time of introduction of enteral feeds on mitigating the risk of postnatal growth failure and BPD risk. Methods: This was a retrospective chart review of mothers’ own milk (MOM), pooled pasteurized donor human milk (PDHM) feeding, postnatal growth, and BPD severity in preterm infants <33 weeks of gestation admitted to the Children’s Hospital of Richmond at VCU neonatal intensive care unit between 2021 and 2024. Statistical analysis included linear regression with moderation analysis using the Hayes Process model, chi-square tests, linear and multinomial logistic regression, with p-value < 0.05 considered significant. Results: After controlling for the percentage of MOM received at 34 weeks corrected gestational age (cGA), greater severity of BPD was associated with lower infant weight and growth failure, p < 0.001. Early introduction of MOM (3 days of life) and greater volume of MOM showed better linear growth and decreased risk of severe BPD, respectively (p < 0.001). Conclusions: Provision of MOM to preterm infants within 3 days of life was associated with a moderation of the relationship between gestational age and growth velocity, with improved growth velocity trajectory. Preterm infants who received a greater volume of MOM through 34 weeks cGA experienced less severe BPD compared to those fed higher volumes of PDHM. As the incidence of growth failure paralleled the incidence of BPD severity, identification of key MOM components becomes important to address and augment the value of PDHM in the management of preterm infants. Full article

Background: Prostate cancer remains a significant public health burden globally, particularly in sub-Saharan Africa, where rising incidence rates are compounded by limited screening, late-stage diagnosis and disparities in healthcare access. In South Africa, the Eastern Cape Province reports high prostate cancer prevalence, with many patients presenting at advanced stages. Understanding the epidemiological profile of affected individuals is critical for developing targeted health strategies. Objectives: This sub-study aims to describe the epidemiological characteristics of patients diagnosed with prostate cancer, using secondary data from Nelson Mandela Academic Hospital (NMAH), focusing on patients seen between March 2020 and November 2021. Methods: A quantitative cross-sectional study design is employed. De-identified secondary data extracted from clinical records of male patients diagnosed with prostate cancer and managed at NMAH during the study period. Variables include demographic information, clinical characteristics, health service utilization indicators. Analysis: Data will be captured and coded in Microsoft excel 2013 (Microsoft corporation, Seattle, WA, USA). The data will then be exported to STATA 18 for analyses. Descriptive statistics will be used to summarize the data. Inferential analyses such as logistic regression and chi-square tests will be used to explore associations between variables and treatment outcomes. The study provides insights into the demographic and clinical profiles of prostate cancer patients in a high-burden setting. It is anticipated that findings will highlight the age distribution, stage at diagnosis, and treatment patterns among patients diagnosed with prostate cancer. This will inform future prevention and intervention strategies in the Eastern Cape Province. Conclusions: By mapping out the epidemiological patterns of prostate cancer in the Eastern Cape through this sub-study, the research contributes to evidence-based planning and resource allocation, ultimately supporting efforts to reduce prostate cancer morbidity and mortality in rural South Africa. Full article

Aim: Traumatic dental injuries (TDI) in children are a common but often underestimated emergency. Parental knowledge and timely response are crucial for successful treatment. This study aimed to evaluate parental knowledge, experiences, and awareness regarding dental trauma management and the use of protective mouthguards. Methods: A cross-sectional study was conducted using a self-administered questionnaire among 333 parents in dental clinics in Split and Zagreb, Croatia. The questionnaire assessed sociodemographic data, parental knowledge of TDIs, and prior experience with dental trauma. Statistical analysis included chi-square test (p < 0.05). Results: The overall level of parental knowledge regarding traumatic dental injuries was generally low (7.6 out of 15 points). Almost all parents correctly identified the age when children have primary or permanent teeth. However, less than half knew that an avulsed primary tooth should not be replanted, while about three-quarters recognized that professional help should be sought within 30 min after trauma. Overall, 43.5% of parents reported that their child had experienced dental trauma, most often affecting primary teeth (60.7%), particularly the maxillary central incisor (76.6%). Mothers demonstrated significantly higher knowledge than fathers (p = 0.025), and prior experience or information about dental trauma significantly improved awareness (p < 0.001). Although 54.3% of respondents were unaware of the purpose of dental shields, 82.3% considered them necessary during contact sports, yet only 12.9% reported that their child actually uses them. Conclusions: Within the limitations of this clinic-based study, the findings indicate gaps in parental knowledge regarding the appropriate management of dental trauma. Strengthening parents’ understanding of emergency response and preventive measures may support timelier and appropriate care and contribute to improved outcomes for children experiencing traumatic dental injuries. Full article

The study investigates repetitive and time-consuming professional activities performed by occupational health and safety (OHS) specialists in the construction sector in Poland and their attitudes toward the use of modern digital tools, including solutions based on artificial intelligence (AI). The research was conducted using a questionnaire survey, with a purposive sample and a snowball method. A total of 102 individuals participated in the study, of whom 94 valid responses were included in the analysis. The data were examined using descriptive statistics and chi-square tests. The results showed that the most repetitive and time-consuming activities include documentation analysis, report preparation, inspections, and communication. Nearly 46% of respondents indicated that selected elements of their work could be automated or supported by digital tools, while 33% reported using AI-based solutions in everyday practice. Statistically significant relationships were identified between respondents’ age and both their level of concern about new technologies and their perception of technological support potential. No significant relationships were found for enterprise ownership or size. The findings indicate substantial potential for the implementation of digital and AI-supported tools in routine OHS activities. Future research should involve larger and more homogeneous samples, incorporate probabilistic sampling, and explore organisational and competence-related factors influencing technology adoption. Full article

Urban tree planting is widely promoted for its benefits, but the long-term condition of trees is poorly documented, especially as changing and often incompatible conditions, intensified by climate change, affect their ability to deliver those benefits. A case study in Topčider Park (since 1836) was conducted during 2025 through the evaluation of diversity, growth parameters, ornamental value, vitality, and total fresh biomass and the identification of tree taxa with high carbon-sequestration potential in Belgrade (Serbia). The data were statistically processed using descriptive statistics, the Shannon diversity and the Pielou evenness index, PCA, Spearman rank and Chi-square tests. The results indicated a wide distribution and high homogeneity of taxa, greater stability within Angiospermae and moderate stability within Gymnospermae, with PCA showing no correlations between growth parameters, vitality, and ornamental value, confirming the close proximity of all taxa. At the taxon level, London plane, English oak, Ginkgo and Bald cypress stood out in growth parameters, while the assessment of total fresh biomass for all 51 taxa highlighted London plane, Scots pine and Bald cypress as particularly productive and adaptive. Carbon sequestration and CO₂ reduction varied with total fresh biomass. The study offers evidence-based recommendations for selecting urban tree taxa to enhance ecosystem services and support climate-adaptation efforts in urban planning. Full article

To evaluate the influence of different surface conditioning protocols—sandblasting (SB), tribochemical silica coating (TBC), CO₂ laser irradiation, and plasma-enhanced chemical vapor deposition (PECVD-Si coating for 49 min) on surface roughness (Ra), surface morphology, and composite-to-zirconia shear bond strength (SBS). Eighty 3Y-TZP plates were randomly allocated into four groups (n = 20) based on surface conditioning protocol: Group 1 (SB), Group 2 (CO₂ laser), Group 3 (TBC), and Group 4 (PECVD-Si coating for 49 min). From each group, five specimens underwent Ra assessment using a contact profilometer, and five specimens were examined for surface morphology via scanning electron microscopy (SEM). The remaining ten specimens received resin composite buildup, followed by artificial aging. Subsequently, SBS testing was performed using a universal testing machine, and failure modes were evaluated under a stereomicroscope. Statistical analysis was conducted using one-way ANOVA with post hoc Tukey test and chi-square for fracture assessment(α = 0.05). Group 1 (SB) demonstrated the lowest Ra (0.844 ± 0.063 µm) and SBS (12.21 ± 4.6 MPa), whereas Group 4 (PECVD-Si coating for 49 min) exhibited the highest Ra (1.388 ± 0.098 µm) and SBS (30.48 ± 2.5 MPa). Intergroup comparison revealed no statistically significant differences between Groups 2 and 3 for both Ra and SBS values (p > 0.05). However, Groups 1 and 4 differed significantly in both parameters (p < 0.05). PECVD-based silica coating for 49 min demonstrated superior surface conditioning efficacy for 3Y-TZP, yielding significantly higher Ra and SBS values compared to sandblasting, tribochemical silica coating, and CO₂ laser irradiation. Full article

Background: Autism Spectrum Disorders (ASD) are neurodevelopmental disorders characterized by repetitive behaviors and social interaction deficits. While the severity of ASD is classified into levels (1–3) by the DSM-5, reliable circulating biomarkers to differentiate these levels are lacking. This retrospective pilot study examines plasma amino acid levels in children with ASD to identify the potential biomarkers of disease severity. Methods: Plasma samples from 30 children diagnosed with ASD (24 males, 6 females, aged 3–12 years) were analyzed. Participants were stratified into two groups based on the Autism Diagnostic Observation Schedule Calibrated Severity Score (ADOS CSS): Group 1, presenting with mild symptoms (Level 1, n = 11), and Group 2, characterized by moderate-to-severe symptoms (Levels 2–3, n = 19). This was further confirmed by the identification of electroencephalogram (EEG) anomalies (21.1%) and magnetic resonance imaging (MRI) abnormalities (5.3%), which were detected exclusively in Group 2 and absent in Group 1. Amino acid levels were measured by ion-exchange chromatography. Statistical analyses (Mann–Whitney U test and chi-square test) were used to compare AA levels between groups. Results: Statistically significant differences were observed in the levels of phosphoethanolamine, aspartic acid, and glutamic acid between the two groups. These amino acids (AA) were significantly higher in the moderate-to-severe symptoms group (Levels 2–3) compared to the mild symptoms group (Level 1) (p < 0.05). All AA values remained within age-appropriate reference ranges. Conclusions: Plasma levels of phosphoethanolamine, aspartic acid, and glutamic acid may serve as potential biomarkers for ASD severity in children. Results from this exploratory analysis suggest that AA profiling could differentiate ASD severity and identify specific metabolic pathways, such as excitatory neurotransmission and phospholipid turnover. Further studies with larger cohorts are necessary to validate these findings and explore the role of AAs in ASD pathophysiology. Full article

Background: Cigarette smoking remains one of the most important preventable causes of respiratory morbidity, exerting detrimental effects even in young adults. Medical students represent a particularly relevant population, as the lifestyle habits they adopt during their training years may influence both their personal health and professional credibility. Methods: We conducted a cross-sectional analysis of 264 medical students from the University of Medicine, Pharmacology, Science and Technology of Târgu-Mures, aged 18–30 years, stratified according to smoking status, type of tobacco product used, and lifestyle characteristics (athletic vs. sedentary). Standardized spirometry was performed to assess FVC, FEV₁, FEV₁/FVC ratio, PEF, and small airway flow parameters (MEF₂₅, MEF₅₀, MEF₇₅). Statistical comparisons between groups were performed using t-tests, Mann–Whitney U tests, chi-square tests, and correlation analyses, with p < 0.05 considered statistically significant. Results: Smokers demonstrated significantly lower values for FEV₁, PEF, and MEF parameters compared with non-smokers, confirming early functional impairment of both large and small airways. Within the smoking group, users of e-cigarettes or heated tobacco products exhibited more favorable FEV₁ and small airway flow values than conventional cigarette smokers. However, differences in FVC were less pronounced. Significantly, athletes consistently outperformed their sedentary peers across all respiratory parameters, regardless of smoking status, with markedly higher FEV₁, FVC, and MEF values and a lower prevalence of obstructive patterns. Cumulative smoking exposure (pack-years) was inversely associated with small airway function, whereas higher levels of physical activity were independently linked to a pronounced protective effect. Conclusions: Even in early adulthood, smoking is related to measurable declines in lung function, particularly affecting small airway dynamics. Although alternative products may appear less harmful than conventional cigarettes, they cannot be considered risk-free. Conversely, regular physical activity demonstrated a protective association in the case–control analysis, attenuating functional decline and supporting the preservation of long-term respiratory health. These findings underscore the importance of integrated prevention strategies in medical universities, combining smoking cessation initiatives with the systematic promotion of physical activity to safeguard the health of future physicians and reinforce their role as credible health advocates. Full article

Objectives: This cross-sectional study aimed to evaluate oral health knowledge, self-perceived oral status, hygiene behaviors, prevalence of dental injuries, and mouthguard use among Croatian basketball players and coaches. Materials and Methods: A total of 414 participants of both sexes, spanning various levels of basketball participation in Croatia, completed an anonymous online questionnaire assessing oral health knowledge, hygiene habits, trauma history, and preventive practices. Data was analyzed using descriptive statistics, Chi-square, Mann–Whitney, and Kruskal–Wallis tests. Results: Participants demonstrated generally poor oral health knowledge, with coaches scoring significantly higher than players (p < 0.05), and knowledge levels varying according to education and socioeconomic status (p ≤ 0.001). A majority reported no prior dental trauma (69.6%), and mouthguard use was notably low (20.8%). While regular toothbrushing was prevalent (87%), the use of dental floss was limited (39.9%). The most reported oral health problems included gingival bleeding (37.9%), dental calculus (35.0%), and tooth sensitivity (34.3%). Conclusions: Despite relatively good hygiene habits, Croatian basketball players demonstrated low oral health knowledge and insufficient preventive practices, particularly regarding mouthguard use. These findings indicate the need for targeted education and preventive strategies within the basketball community. Full article

Background/Objective: This study aimed to translate the Fullerton Advanced Balance Scale (FAB) into Arabic and assess the instrument’s reliability and validity. Methods: The study was carried out in two distinct stages: (i) the translation and adaptation process utilizing the ‘forward-back’ translation method and (ii) the psychometric evaluation of the Arabic version of the FAB-A among a sample of 68 older persons residing in the community. Results: The internal consistency of the FAB-A was excellent (Cronbach’s alpha = 0.86). The Intraclass Correlation Coefficient (ICC) for the inter-rater tests (ICC = 0.96, p ≤ 0.001) and the intra-rater tests (ICC = 0.95, p ≤ 0.001) were excellent and significant. The scale showed a strong correlation with the Berg Balance Scale (r = 0.75). The sampling adequacy for factor analysis was proven by a Kaiser–Meyer–Olkin value of 0.84. The goodness of fit (GFI) statistics for the model were in the acceptable range (Chi-square/Degree of freedom (CMIN/DF) = 1.38, Goodness-of-Fit Index (GFI) = 0.88, Comparative Fit Index (CFI) = 0.95, Root Mean Square Error of Approximation (RMSEA) = 0.07). Conclusions: The FAB-A has demonstrated excellent psychometric qualities for measuring balance in older adults. Full article

Background: Compressive cryotherapy, which combines cold therapy with compression, has gained attention to relieve pain and swelling after the Knee arthroscopy. However, there is still limited evidence specifically related to its use after knee arthroscopy. Objective: This study investigated the efficacy of compressive cryotherapy in decreasing postoperative pain and swelling in patients following knee arthroscopy. Methods: A quasi-experimental study was conducted at the Kasr Al-Ainy Hospital. Sixty patients scheduled for knee arthroscopy were divided into two groups. The intervention group (n = 30) received compressive cryotherapy using a cold-pack knee wrap set at 2 to 5 °C for 15 to 20 min, three times daily. The control group (n = 30) received standard postoperative care. Pain was assessed with the Numerical Rating Scale. Swelling was measured by assessing knee circumference at the mid-patella. Assessments occurred immediately after surgery (baseline), and on the first and second postoperative days. Non-parametric tests used in the analysis included the Chi-square test, the Mann–Whitney U test, the Friedman test, and the Wilcoxon signed-rank test with Bonferroni–Holm correction. Results: Patients in the compressive cryotherapy group experienced a greater reduction in pain than those in the control group. By the first postoperative day, none of the patients in the intervention group reported severe pain (p < 0.001). Knee circumference decreased significantly in the intervention group, from a median of 51.05 cm [IQR: 49.1–53.2] at baseline to 40.90 cm [39.8–42.1] by the second day. In comparison, the control group showed a smaller reduction, from 52.70 cm [50.8–54.5] to 48.55 cm [46.8–50.9]. Between-group differences in swelling were significant at the first postoperative assessment (U = 105.0, p < 0.001) and on day 2 (U = 62.5, p < 0.001). Overall, differences in both pain intensity and knee swelling between groups were statistically significant across all time points (p < 0.001). Conclusions: Compressive cryotherapy is an effective non-pharmacological intervention for reducing pain and swelling in the early postoperative period following knee arthroscopy. These results suggest that it could be a valuable addition to routine postoperative care, helping patients recover more comfortably and quickly. Full article

Systemic Lupus Erythematosus (SLE) and primary Sjögren’s Disease (SjD) are autoimmune diseases characterized by the presence of autoantibodies that lead to damage in healthy tissues. The production of autoantibodies requires the activation and differentiation of B-lymphocytes into plasma cells. To achieve this effect, BAFF (B-lymphocyte activating factor), APRIL (A proliferation-inducing ligand), and their receptors are key factors. BAFF is a cytokine recognized by BAFF-R (BAFF receptor), which is increased and related to disease activity in both SLE and SjD patients. The H159Y mutation (rs61756766) in the gene encoding the BAFF-R, TNFRSF13C (Tumor Necrosis Factor Receptor Superfamily) has been shown in vitro to cause receptor hyperactivation via the NF-κB2 pathway. This study evaluated the frequency of this variant in a western Mexican population and its association with the risk of developing SLE and SjD. Genotypes of the TNFRSF13C H159Y (rs61756766) variant were determined by PCR-RFLP assay. sBAFF levels were measured by ELISA. The study included 300 SLE patients, 110 SjD patients, and 300 healthy subjects (HS). HS were in Hardy–Weinberg equilibrium. The data distribution was assessed using the Kolmogorov–Smirnov test. Group comparisons were conducted using the Chi-square test, Fisher’s exact test, or the Mann–Whitney U test, as appropriate. A p-value of <0.05 was considered statistically significant. In the Mexican population, allelic and genotypic distribution frequencies of the H159Y variant (rs61756766) were similar between SLE patients and HSs, while the variant was not found in SjD patients. SLE patients carrying the heterozygous CT genotype showed a trend toward higher soluble BAFF (sBAFF) levels than wild-type genotype patients. This variant does not confer risk to SLE or SjD in the Mexican population. However, the heterozygous genotype may be associated with high levels of sBAFF in SLE patients. Full article

Categorical data analysis offers valuable tools for evaluating school-based prevention programs, yet these methods remain rarely applied in cyberbullying research. This literature review examined how categorical approaches, including contingency tables and related techniques, have been used in studies evaluating school-based cyberbullying prevention. A comprehensive search was conducted in Web of Science covering publications from 2020 to 2025, yielding 100 articles. After applying predefined inclusion and exclusion criteria, 24 studies were reviewed in full, of which 8 met all requirements for final analysis. The results revealed a predominant reliance on linear statistical techniques, such as t-tests, ANOVA, and regression models, applied mainly to continuous variables. By contrast, categorical analyses were seldom employed. The chi-square test appeared as the most frequent approach, but its use was generally restricted to descriptive purposes, with little application of complementary methods such as standardized residuals, effect size measures, or logistic models. This restricted application reduced the ability to capture response patterns, subgroup differences, and categorical associations essential for evaluating program outcomes. The findings highlight a methodological gap in cyberbullying prevention research and emphasize the potential of categorical data analysis to enrich interpretation. Incorporating these methods could increase methodological rigor, reveal nuanced behavioral patterns, and provide actionable evidence for educators, policymakers, and program designers seeking to strengthen school-based prevention strategies. Full article

Background: Menstrual hygiene management (MHM) is a vital aspect of adolescent girls’ health and well-being. However, in many Gulf countries, including Saudi Arabia, this issue has received less attention because of cultural taboos, misconceptions, and a lack of knowledge about factors affecting menstrual hygiene practices. Thus, it is crucial to promote adolescent health and develop effective school-based interventions. Aim of the Study: Our aim was to assess menstrual hygiene practices and their determinants among adolescent girls in secondary schools in Bisha, Saudi Arabia. Methods: A cross-sectional descriptive approach was used to study 320 female secondary school students in Bisha City, southwestern Saudi Arabia. Sample: The subjects were selected by using a stratified random sampling procedure. Information was obtained using a previously validated and culturally sensitive self-administered questionnaire on knowledge and menstrual hygiene. Descriptive statistics, chi-square tests, and binary logistic regression analyses were conducted to determine factors associated with good menstrual hygiene practices. Results: A total of 320 adolescent girls participated, of whom 53.8% demonstrated good menstrual hygiene practices. In the multivariable analysis, independent predictors of good practices were increased age (AOR = 2.69, 95% CI:1.59–4.56), urban residency (AOR = 2.62, 95% CI: 1.46–4.69), and good menstrual knowledge (AOR = 2.13, 95%CI: 1.24–3.67). Maternal primary education (AOR = 8.033, CI: 1.44–44.99) and maternal employment in the government sector (AOR = 7.346, CI: 2.29–23.54) also showed strong positive associations with good menstrual hygiene practices. Conversely, experiencing menarche after age 12 was associated with lower odds of good menstrual hygiene (AOR = 0.49). Conclusions: Although a good proportion of girls practiced adequate menstrual hygiene, major knowledge and behavior gaps persist. Providing strong menstrual education in schools and through community-based efforts is critical for supporting the health of adolescent girls and promoting menstrual equity in Saudi Arabia. Full article