Search Results (5,868)

Objective: This study aimed to compare the clinical and radiological outcomes between microscopic and unilateral biportal endoscopic (UBE) posterior cervical foraminotomy (PCF). Methods: This study included 73 patients who underwent microscopic PCF (n = 40) or UBE PCF (n = 33) for single-level cervical foraminal disc herniation or stenosis between January 2018 and December 2021. Clinical outcomes were measured using the Visual Analog Scale (VAS) and Neck Disability Index (NDI). Radiologic outcomes were evaluated with cervical range of motion (ROM) using computed tomography and flexion-extension dynamic radiography. Results: The mean follow-up period for microscopic and UBE PCF was 33.0 ± 7.6 months and 29.9 ± 5.9 months, respectively. The postoperative neck VAS until postoperative 2 weeks was significantly lower in the UBE PCF group than in the microscopic PCF group (p < 0.05). The estimated blood loss and operative time were significantly lower in the UBE PCF group than in the microscopic PCF group, while the length of hospital stay was numerically shorter but did not reach statistical significance. The two groups had no significant difference in the NDI on the preoperative and postoperative 3 months. The recurrence occurred in 1 patient (2.5%) of the microscopic PCF group and 1 patient (3%) of the UBE PCF group. The revision surgery was performed in 2 patients (5%) of the microscopic PCF group and in 1 patient of the UBE PCF group. There were no significant differences in motion and instability between the two groups. Conclusions: Both microscopic and UBE PCF are effective and safe procedures for treating cervical radiculopathy due to cervical foraminal disc herniation or stenosis. The UBE approach may provide advantages mainly in early postoperative recovery, including lower early postoperative neck pain, while long-term clinical and radiologic outcomes appear comparable to those of microscopic PCF. Full article

Background/Objectives: The relationship between cervical central canal and neural foraminal dimensions remains undefined. This study examined correlations between these structures in a young adult CT cohort screened to exclude apparent cervical spinal pathology. Methods: We retrospectively reviewed computed tomography images of 1000 patients aged 18 to 35 years screened to exclude apparent cervical spinal pathology. Central canal dimensions included anteroposterior diameter, interpedicular distance, and cross-sectional area. Neural foraminal dimensions included axial width, craniocaudal height, and area. Pearson correlation tests were used to assess associations between the central canal and neural foraminal dimensions. Results: Neural foraminal area showed the most consistent associations with interpedicular distance bilaterally, though these relationships were modest-to-moderate in magnitude. Axial width and craniocaudal height exhibited no consistent correlations with central canal dimensions. No strong correlations were observed between any combination of central canal and neural foraminal dimensions at any disc level. Conclusions: In this young adult CT cohort without apparent cervical spinal pathology, cervical central canal and neural foraminal dimensions demonstrated no strong correlations across levels. These findings suggest that central canal dimensions should not be used as a surrogate for neural foraminal dimensions in quantitative morphometric assessment. Full article

Fruit tree leaves are an abundant agro-waste material with promising yet underexplored biological potential. This study compared the biological activity of aqueous extracts obtained from apple (Malus domestica), apricot (Prunus armeniaca), and cherry (Prunus cerasus) leaves and their kombucha-fermented counterparts in the context of cosmetic and dermatological applications. Phytochemical composition before and after fermentation was analyzed chromatographically. Antioxidant activity was evaluated using DPPH, ABTS, and FRAP assays, while intracellular reactive oxygen species (ROS) levels in keratinocytes and fibroblasts were assessed using the H₂DCFDA probe. Cytotoxicity was determined by Alamar Blue and Neutral Red assays. Antimicrobial activity against seven bacterial strains was investigated using minimum inhibitory concentration and disc diffusion methods. Anti-inflammatory activity was evaluated in LPS-stimulated THP-1 cells by measuring TNF-α, IL-1β, and IL-6 levels using ELISA. The influence of the samples on collagenase, elastase, and hyaluronidase activity was also analyzed. Fermentation increased the content of selected phenolic compounds and enhanced antioxidant, antimicrobial, anti-inflammatory, and anti-ageing properties. Ferments more effectively reduced oxidative stress in skin cells and showed no cytotoxicity within the tested concentration range. These findings indicate that kombucha fermentation may support the valorization of fruit tree leaf agro-waste as multifunctional ingredients for skincare formulations. Full article

Multidrug-resistant bacterial pathogens pose a critical global health challenge, necessitating safe and effective antimicrobial alternatives. Plant-derived nanoparticles represent promising candidates due to their bioactivity and biocompatibility. Magnesium nitrate nanoparticles were synthesized using Momordica charantia peel extract through green chemistry. Phytochemical screening identified flavonoids, phenolics, tannins, and terpenoids that facilitated nanoparticle formation and stability. Characterization via scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffraction, and Fourier transform infrared spectroscopy confirmed polydisperse size distribution (1–100 nm), crystalline structure, and functional group capping. Disc diffusion assays demonstrated concentration-dependent antibacterial activity against multidrug-resistant strains, with maximum inhibition zones of 17.6 ± 1.1 mm against Gram-positive bacteria. Minimum inhibitory concentration and minimum bactericidal concentration assays revealed high bactericidal activity, particularly against Gram-positive bacteria. Time-kill kinetic studies showed concentration- and time-dependent killing with ≥3 log₁₀ reduction in viable bacterial counts at higher concentrations. Nanoparticle–antibiotic combinations exhibited markedly enhanced activity against multidrug-resistant strains compared to free antibiotics, indicating synergistic effects. Toxicity assessment using Brine Shrimp Lethality Assay revealed low toxicity (LC₅₀ > 1000 µg/mL). Green-synthesized magnesium nitrate nanoparticles demonstrate potent antibacterial properties and effectively enhance antibiotic potency against multidrug-resistant bacteria. Further studies are required to validate therapeutic applicability. Full article

Background: Twin-screw wet granulation (TSWG) is a promising continuous manufacturing technology, featuring high operational flexibility, short residence time and consistent quality. The process development of TSWG relies on the synergy of material characterization, screw configuration, and process parameter optimization. Objective: In order to fully combine various design variables, and to accelerate the process development of TSWG, a material–process–equipment integrated design (MPEID) methodology is first applied to the TSWG process of Guizhi Fuling capsule, a botanical drug product. Methods: First, an equivalent formulation was designed to save trial costs. Second, 3D printing technology was used to customize both conveying and kneading elements with the lead, with the kneading discs stagger angle (SA) and the thickness (thick) as screw element variables. The position of fabricated kneading elements was varied to generate different screw configurations. Then, the critical screw parameters (CSPs) and critical process parameters (CPPs) were identified by a two-step design of experiment (DOE) toward optimizing granule quality. Results: As a result, the SA and thick were identified as CSPs, and the liquid-to-solid ratio was the CPP. Under the optimal TSWG process conditions, the twin-screw granulator could be operated under low torque (i.e., average torque = 1.48 ± 0.06 Nm). The dried granules exhibited superior flowability, as well as highly consistent particle size distribution with industrial batches. After capsule filling, the dissolution test results showed the prepared Guizhi Fuling capsules reached 93.7% cumulative dissolution at 15 min, which approached that of commercial capsules (i.e., 93.0%). Conclusions: This study demonstrated the feasibility of proposed MPEID methodology, supporting the efficient and cost-effective process development of TSWG. Full article

Train brake systems are characterized by strong friction and open-system features during the service process. Low environmental temperatures significantly affect the contact interface and the attrition characteristics of the braking frictional couple, thus intensifying friction-induced vibration and threatening operational safety. To elucidate the impact of environmental temperature on the frictional vibration characteristics of train brake systems, braking deceleration tests under different environmental temperatures were first conducted to obtain the evolution of vibration, noise, and friction coefficient with environmental temperature and brake disc rotational speed. Then, the Stribeck friction parameters under different environmental temperatures were identified using a genetic algorithm. On this basis, a brake system dynamic model was developed, incorporating disc–pad friction, wheel–rail adhesion, and the relative torsion between the brake disc and the wheelset, enabling accurate examination of the vibrational behaviour arising from friction under different environmental temperatures. And the dynamic relationship among environmental temperature, interface friction parameters, and vibration characteristics of the brake system during braking deceleration was elucidated. The findings indicate that as the environmental temperature decreases, the dynamic friction coefficient increases during the relatively high-speed braking phase, intensifying high-frequency unstable vibrations of the braking assembly. During the relatively low-speed braking phase, the friction coefficient exhibits an obvious negative-slope relationship with vehicle speed that means the friction coefficient increases as the speed decreases, and this negative slope effect is enhanced under low-temperature conditions. Consequently, it triggers intense stick–slip motion at the disc–pad interface and even severe vibrations of various components in the brake system, leading to a sudden increase in vibration intensity in the relatively low-speed range. Full article

(1) Background: Mandibular condylar fractures continue to be a subject of debate, traditionally framed as a choice between open and conservative management. However, this binary approach fails to adequately account for fracture-level anatomy, Temporomandibular joint (TMJ) involvement, and functional outcomes. (2) Purpose: To present an imaging-guided, fracture-level-based algorithm that integrates radiologic evaluation, surgical approach selection, fixation biomechanics, and functional rehabilitation. (3) Review Strategy: This invited review combines current evidence with a 13-year institutional experience involving 495 joints. High-resolution Computed Tomography (CT) Imaging was used to assess fracture morphology, displacement, and ramal height, while Magnetic Resonance Imaging (MRI) was selectively employed in intracapsular fractures to evaluate disc–condyle relationships when intra-articular involvement was suspected. Management decisions, including surgical approach and fixation strategy, were guided by an institutional algorithm tailored to fracture characteristics. (4) Results: Implementation of this approach yielded consistent and predictable outcomes. Mouth opening improved from approximately 18.77 mm preoperatively to 40 mm at 6 months. Lateral excursions became symmetrical (~9.6 mm), occlusion was restored in all patients, and bite force returned to near-physiological levels. Pain scores showed near complete resolution within 1 month. Postoperative morbidity remained low, with predominantly transient facial nerve weakness. (5) Conclusions: This imaging-guided, algorithmic framework provides reproducible functional outcomes and signifies a shift toward structured, anatomically driven management of condylar fractures. Full article

Background: Long-duration spaceflight (LDSF) poses unique challenges to ocular health as microgravity, radiation, and environmental changes can cause lasting visual and structural impairments that affect astronaut performance. Objective: This review synthesises current evidence on in- and post-flight ocular complications. It integrates clinical findings, terrestrial analogues, animal studies, and theoretical models to characterise the pathophysiology, risk factors, and countermeasures associated with spaceflight-induced ocular changes. Methods: A review of peer-reviewed literature was conducted, focusing on dry eye disease, corneal edema, ocular biometric shifts, spaceflight associated neuro-ocular syndrome (SANS), and radiation-induced cataractogenesis. Data from in-flight imaging, post-flight assessments, and ground-based analogues were analysed. Results: Spaceflight induces multifactorial ocular changes, including tear film instability, optic disc edema, posterior globe flattening, and hyperopic refractive shifts. These effects are thought to result from cephalad fluid shifts compartmentalised cerebrospinal fluid pressure, venous congestion, and impaired glymphatic system. Long-term risks, such as cataractogenesis, are linked to radiation exposure and genetic susceptibility. Although several countermeasures are being explored, no single approach fully prevents these complications. Conclusions: Ocular complications during LDSF remain a significant challenge for astronaut health and mission performance. A multimodal approach combining mechanical, nutritional, and diagnostic strategies will be essential for future exploration-class missions. Further research is needed to refine countermeasures and preserve astronauts’ visual function. Full article

The paper outlines soil–tool interaction investigations according to parameters of the trencher disc cutter with a variable installation angle relative to the rotation axis that ensure the required trench shape and dimensions. The research results make it possible to improve the quality of the technological process for obtaining the needed trench shape. The movement of soil particles on the knife surface and after their removal was considered using the principles of soil mechanics, mathematical analysis, and computer (3D) modelling taking into account centrifugal force, gravity and friction. Research has shown that the soil particles’ movement is spatially complex and can be described by parabolic dependencies when projected onto coordinate planes. It is proved that changing the angle of installation of the disc in the range of 90–80° allows the furrows’ width to be adjusted within the range of 0.1–0.5 m while maintaining the required depth of cultivation. The reduction indicators of trench depth that are dependent on changing the disc installation angle were also determined. The obtained dependencies, design and technological recommendations can be used in designing of planting machines for garden and forest crops, as well as in the justification of rational operating modes for them in intensive horticulture conditions. Full article

The aim of this study was to evaluate the effect of two laser-assisted disinfection techniques on the porosity and bond strength (BS) of a new premixed calcium silicate sealer. Forty extracted human single-rooted premolars with one root canal were prepared up to 50/.05. Samples were randomly assigned to the groups (n = 10 each): 1. shock wave-enhanced emission of photoacoustic streaming (SWEEPS) (20 mJ, 15 Hz, 0.60 W, pulse duration 25 µs), 2. diode laser (975 nm, 1.5 W), 3. conventional needle and syringe irrigation (CI), and 4. control (C), with no final irrigation protocol. Root canals were filled with a premixed calcium silicate sealer using the single-cone obturation technique. Micro-CT scans were performed after two weeks to determine the presence of voids in the filling. Dentinal discs from the middle third were prepared for push-out testing. Kruskal–Wallis and post hoc Dunn tests were used, with significance set at 5%. Micro-CT analysis detected porosity in all samples, with no significant differences among the groups (p > 0.05). SWEEPS showed the highest BS values (median 3.233 MPa) and outperformed CI and C (median 1.923 and 1.989 MPa) (p < 0.05) overall. SWEEPS enhanced the BS compared with CI. Voids were present in all experimental groups. Full article

(1) Background: Intervertebral Disc Disease (IVDD) represents one of the most frequently encountered neurological disorders in canine patients and often necessitates surgical decompression by means of hemilaminectomy. Objective methods for evaluating postoperative inflammatory response and tissue healing remain limited. This study aimed to evaluate temporal changes in local cutaneous temperature and thermal patterns in dogs undergoing hemilaminectomy for thoracolumbar intervertebral disc extrusion using Infrared Thermography; (2) Methods: Fifteen dogs diagnosed with Hansen type I thoracolumbar intervertebral disc extrusion were included. Diagnosis was established through neurological examination and computed tomography. Thermographic assessment of the thoracolumbar region (T11–L3) was performed preoperatively (Day 0), 24 h postoperatively (Day 1), and 7 days after surgery (Day 7) using an FLIR E50 thermal camera. Mean cutaneous temperature and thermal distribution patterns were analyzed. Statistical evaluation was performed using Repeated Measures ANOVA and the Friedman test; (3) Results: Significant temporal differences in local cutaneous temperature were identified between the evaluated time points (p < 0.001). Thermographic assessment demonstrated progressive modifications in thermal distribution throughout the postoperative period. No postoperative complications, including seroma formation, wound dehiscence, or fistula development, were observed; (4) Conclusions: Infrared thermography enabled identification of significant postoperative thermal changes following hemilaminectomy and may represent a useful complementary non-invasive method for postoperative monitoring of tissue healing in dogs. Full article

Background: Giant retroperitoneal schwannomas with vertebral body erosion are exceedingly rare, and the decision regarding spinal instrumentation following tumor resection remains controversial in the absence of established guidelines. A 25% vertebral body involvement threshold has been proposed as an indication for fixation, yet this criterion does not account for bone quality or the potential biological adaptation of bone to chronic mechanical loading. Case Presentation: A 56-year-old man presented with bilateral gluteal pain and urinary urgency secondary to a giant retroperitoneal lumbar schwannoma (97 × 67 mm) with 36.6% erosion of the L5 vertebral body, confirmed by CT-guided biopsy (S100+, SOX10+, Ki-67 < 5%). Despite erosion exceeding the proposed instrumentation threshold, complete tumor resection was performed via an anterior laparotomic approach without spinal fixation, based on the absence of clinical or radiological signs of instability and the integrity of the intervertebral disc and posterior ligamentous complex. Intraoperative neurophysiological monitoring guided sacrifice of the tumor-origin root. The postoperative course was uneventful, with complete resolution of symptoms and no new complaints or neurological deficits at one-year follow-up. Conclusions: Post-hoc Hounsfield Unit measurements on pre-operative CT demonstrated markedly elevated bone density at the eroded L5 vertebral body (480 HU) compared with the adjacent L4 vertebra (317 HU), consistent with compensatory sclerosis induced by chronic mechanical compression. Pre-operative HU assessment may represent a valuable, readily available adjunct to anatomical erosion criteria in the surgical decision-making process for giant schwannomas with vertebral body involvement. Full article

Background: Cage subsidence after minimally invasive transforaminal lumbar interbody fusion raises revision risk and costs. Intraoperative computed tomography (CT) provides high-resolution, three-dimensional visualization of the endplate–cage interface and serves as a practical—though itself imperfect—reference standard for early subsidence, but it is not available at all institutions. Plain X-ray is widely available and inexpensive, but lower in resolution. The clinically relevant question is therefore not whether CT and X-ray are equivalent, but rather which X-ray protrusion depth measurement most reliably identifies CT-confirmed subsidence, and whether a positive intraoperative CT meaningfully predicts later radiographic subsidence. Objective: Using intraoperative CT as reference, we aimed to (1) determine the optimal X-ray protrusion depth threshold for CT-confirmed early subsidence; (2) test whether intraoperative CT predicts late radiographic subsidence; and (3) examine how early X-ray depth relates to intervertebral disc height (IVDH) and segmental lordosis (SL) loss. Methods: In a retrospective single-surgeon cohort (March 2015–July 2023), subsidence was defined as ≥2.0 mm endplate penetration on CT and measured on X-ray by parallax technique. Sensitivity, specificity, accuracy, and Cohen’s κ were calculated. Receiver operating characteristic (ROC) analysis evaluated X-ray depth as a continuous predictor and identified the Youden-optimal cutoff. Intraoperative CT was tested against late radiographic subsidence; no-intercept linear models estimated per-millimeter IVDH and SL loss. Results: Of 100 patients, 93 had paired imaging (mean age 66.7 years; body mass index 26.8 kg/m²). Subsidence appeared on CT in 16.1% and on X-ray in 15.1%. X-ray showed 80.0% sensitivity, 97.4% specificity, 94.6% accuracy, and κ = 0.80; ROC analysis demonstrated strong discrimination (area under the curve 0.91; 95% confidence interval 0.81–1.00), Youden-optimal cutoff 1.90 mm. Intraoperative CT predicted late subsidence (n = 76) with only 45.8% sensitivity and 96.2% specificity; missed cases had penetration depths indistinguishable from non-subsiders. Each 1 mm of early X-ray depth corresponded to 0.45 mm IVDH and 0.37° SL loss. Conclusions: An X-ray protrusion depth of 2.0 mm reliably identifies CT-confirmed early subsidence, providing a preliminary diagnostic cutoff for use when CT is unavailable. Intraoperative CT is highly specific but insensitive for late subsidence; meaningful risk stratification will require additional inputs. These hypothesis-generating findings warrant prospective validation. Full article

Lower back pain (LBP) is a leading cause of disability globally, characterized by multifactorial origins that complicate accurate diagnosis and effective treatment planning. Artificial intelligence (AI), including machine learning (ML), deep learning (DL), and radiomics, has shown promise for improving the reproducibility and quantitative assessment of spine neuroimaging. This narrative review synthesizes current evidence on AI-derived imaging biomarkers in magnetic resonance imaging (MRI) and computed tomography (CT), with emphasis on disc degeneration, spinal stenosis, endplate signal abnormalities, paraspinal muscle composition, vertebral fractures, and spinal alignment. AI-based reconstruction, segmentation, and classification methods may reduce reader variability and enable standardized quantification of imaging features. However, the current evidence base remains dominated by technical and retrospective validation studies, and high diagnostic performance should not be interpreted as proof of improved patient-centered outcomes. The present review distinguishes technical feasibility, diagnostic assistance, prognostic association, and clinical utility, and highlights the persistent efficacy-effectiveness gap in AI-based spine imaging. Although multimodal models integrating imaging, clinical, biomechanical, and patient-reported data may improve future risk stratification, clinical translation remains constrained by heterogeneous datasets, limited external validation, incomplete interpretability, and evolving regulatory frameworks. Prospective multicenter validation and outcome-linked evaluation are required before AI-derived imaging biomarkers can be considered established tools for routine LBP management. Full article