Search Results (507)

Background/Objectives: This in vitro study evaluated the fracture resistance of computer-aided design and computer-aided manufacturing (CAD-CAM) resin-matrix ceramic crowns cemented with three adhesive resin cements and three novel resin-modified glass ionomer cements. Methods: Ninety crowns representing a maxillary left central incisor were milled from a resin-based nanoceramic hybrid material (Cerasmart, GC) using a chairside CAD-CAM system (Primescan). The typodont preparation included 1.5-mm incisal reduction, 1.5-mm axial reduction, and a 1.0-mm chamfer finish line. Crowns were cemented onto 3D-printed dies of the preparation and assigned to six groups (n = 15 per group) according to cement type: Multilink Automix (ReMu), Panavia V5 (RePa), RelyX Unicem 2 (ReUn), RelyX Luting Plus (GiLu), GC FujiCem Evolve (GiEv), and Meron Plus QM (GiMe). The cemented restorations were subjected to artificial aging with 10,000 thermocycles at 5 to 55 °C with a dwell time of 30 s. Specimens were loaded in compression to fracture. Scanning electron microscopy (SEM) was used to evaluate fracture patterns. Fracture load was analyzed using one-way ANOVA and post hoc Tukey honestly significant difference (HSD) test (p = 0.001). Results: Fracture resistance differed significantly among cement types. Crowns cemented with adhesive resin cements exhibited higher fracture resistance than those cemented with resin-modified glass ionomer cements. The highest fracture resistance was observed for ReUn, followed by RePa and ReMu, whereas GiEv and GiLu showed the lowest values. Conclusions: CAD-CAM hybrid crowns fabricated from a resin composite–ceramic material demonstrated higher fracture resistance when cemented with adhesive resin cements than with the novel resin-modified glass ionomer cements tested. Among the six cements, ReUn produced the highest fracture resistance, whereas GiEv produced the lowest. Full article

Haul-road condition in open-pit mining affects fuel consumption, transport-cycle throughput and dump-truck mechanical loading. This study conducted a quasi-experimental field assessment of local maintenance effects on severely degraded road segments. The full cycle register contained 32,000 entries, of which 30,808 passed quality control and were used for background engineering characterization. The primary difference-in-differences (DiD) analysis used 2634 matched-control cycle–focal-segment observations, while 72,000 one-second telemetry records formed a separate 20 h dynamic validation subset. Relative to matched-control dynamics, maintenance increased RCI by 3.26 points and reduced IRI by 6.24 m/km, the apparent rolling-resistance descriptor by 2.71 percentage points and rut depth by 41.2 mm. Regression-adjusted effects were −10.6 L/cycle for fuel, −0.78 min for cycle time, +10.7 km/h for segment speed, −0.351 g for vibration RMS and −78.2 MPa-eq. for the suspension-stress proxy. A 14-day lead-placebo/event-time diagnostic found no detectable pre-intervention divergence, and non-negative cohort-weighted group-time ATT estimates closely matched the TWFE results. The coefficients are interpreted as site-specific local intervention-window effects rather than annual fleet-wide constants. Full article

Neodymium (Nd) and dysprosium (Dy) are two critical rare earth elements for fabricating NdFeB permanent magnets, which have crucial applications in modern technologies. The increasing global demand for Nd and Dy emphasizes new efficient processes for their recovery and purification, which are technologically challenging due to their close physical and chemical properties. Through systematic exploration, it was found that Lewatit VP OC 1026 resin impregnated with di-(2-ethylhexyl) phosphoric acid (D2EHPA) had a strong adsorption preference for Dy³⁺ over Nd³⁺, which is highly suitable for Dy-Nd separation from their mixed solutions under optimized conditions. The loaded resin could be eluted using dilute sulfuric solutions for recycling to the adsorption process. By employing a multistage adsorption-elution process analogous to distillation, efficient Dy-Nd separation and purification were realized from their mixed solution, with a prospective purity of 99.13% and recovery of 97.45% for Dy and a prospective purity over 99.96% and recovery of above 99.90% for Nd, despite the large concentration disparity between Dy and Nd, where Nd concentration is over 26 times that of Dy. This research demonstrates that efficient recovery and purification of metals from aqueous solutions can be achieved using selective resin adsorption processes analogous to distillation, despite large concentration differences of the metals in the solutions, which presents new alternative approaches. Full article

Background/Objectives: The treatment of multidrug-resistant and hypervirulent Klebsiella pneumoniae is one of today’s biggest healthcare challenges. The depletion of therapeutic options necessities the application of new methods. One promising approach is to use phage-derived enzymes that target the capsule and make the causative more visible to the immune system. As proteins, these enzymes must be optimised by reducing their size and antigenicity to make them suitable for repeated use. Methods: In this study, the recently isolated and cloned K2B1orf61 K2 capsule-specific depolymerase was analysed structurally, and certain amino acid residues were deleted by cloning. The following amino acid residues were removed from the 80th (D2_N80), 115th (D3_N115), and 200th (D4_N200) N-terminal, and 250 (D5_C250) and 20 (D6_C20) from the C-terminal positions of the wild-type molecule (D1_wt). The resulting derivative molecules were compared with in vitro and in vivo tests. Results: In the presence of wild-type depolymerase, human serum was able to eliminate the target bacterium and save the lives of mice challenged with the bacterium in an originally lethal intraperitoneal model. However, the D5_C250 derivative lost all activity, meaning that the bacteria with the K2 capsule in the serum survived and all the mice died. Derivatives D2_N80, D3_N115, and D6_C20 exhibited prolonged activity in the serum killing assay, effectively eliminating bacteria within 5 h. Similar activity differences were revealed in the intraperitoneal experiment: D5_C250 had no rescue effect; however, D1_wt, D2_N80, D3_N115, D4_200, and D6_20 resulted in survival rates of 100%, 60%, 80%, 100%, and 20%, respectively. Conclusions: Our results demonstrate that molecular trimming is a promising procedure for developing ideal therapeutic depolymerases. Full article

One of the primary factors contributing to the impairment of overhead power lines during operation is fatigue damage arising from conductor vibration. Several factors influence the fatigue strength, including chemical composition, strength, surface quality, and residual stresses. One solution to increase the fatigue strength of these lines is to replace aluminium with a higher-strength aluminium alloy. Unfortunately, this option is costly and has a detrimental effect on the electrical conductivity of the wire. Consequently, a further research direction for improving fatigue strength involves modifying the surface quality and reducing residual stresses in wires. This article presents research findings focused on the influence of drawing parameters of aluminium wires—including modification of the die geometry—on fatigue strength. In this study, wires were produced using dies with different geometries via the high-speed industrial wire drawing process. Surface quality (SEM), 3D surface topography, and fatigue strength tests were then carried out on the aluminium wires. Following a thorough review of the research results, it was determined that optimising the die geometry is the most effective way to achieve higher fatigue strength for aluminium wires under industrial conditions. Full article

Background and Objectives: Pediatric-onset metabolic bone diseases, including osteogenesis imperfecta (OI), hypophosphatemic rickets (XLH), hypoparathyroidism, and McCune–Albright syndrome (MAS), require lifelong follow-up because of persistent skeletal fragility, biochemical abnormalities, and functional morbidity extending into adulthood. However, evidence regarding structured transition from pediatric to adult care in these rare disorders remains limited. This study evaluated one-year outcomes of a multidisciplinary transition program for adolescents and young adults with rare metabolic bone diseases. Materials and Methods: This retrospective cohort study included 20 patients aged ≥17 years who underwent evaluation through a structured transition pathway consisting of multidisciplinary team meetings, a joint pediatric–adult transition clinic, and subsequent follow-up in adult endocrinology. Demographic, clinical, treatment, and transition-related data were extracted from medical records. The primary outcome was successful transition, defined as at least one adult endocrinology visit within 12 months. Secondary outcomes included attendance at the transition clinic, follow-up continuity, and treatment modifications. Results: All patients underwent multidisciplinary evaluation, and 85% attended the joint transition clinic. Successful transfer to adult endocrinology was achieved in 90% (18/20), while regular follow-up during the first year was maintained in 75%. Retention was highest in patients with OI, MAS, XLH, vitamin D-dependent rickets, and DiGeorge syndrome (100%). Greater variability was observed in postoperative and primary hypoparathyroidism. Treatment adjustments were required in 40% of patients, including optimization of phosphate/calcitriol replacement and reassessment of bisphosphonate or burosumab therapy. Three patients were lost to follow-up. No acute transition-related complications were observed. Conclusions: In this small exploratory cohort, implementation of a structured multidisciplinary transition pathway was feasible and was accompanied by high transfer and one-year retention rates. Observed differences across diagnostic subgroups should be interpreted cautiously, and larger multicenter comparative studies are needed to evaluate the effectiveness of structured transition frameworks. Full article

Background: High-risk (HR) prostate cancer has a propensity for local and distant progression with ultimate death, mandating aggressive locoregional and systemic treatment approaches to maximize oncologic outcomes. Although brachytherapy (BT) with supplemental therapies has demonstrated favorable biochemical and quality of life outcomes, improvements in overall survival have been hampered by an excessive incidence of non- prostate cancer deaths. In this HR study, we report on biochemical failure (BF), prostate cancer-specific mortality (PCSM), overall mortality (OM) and patterns of death with recommendations for the mitigation of non-prostate cancer deaths. Materials and Methods: From April 1995 to November 2018, 577 consecutive HR patients were treated with LDR BT (97.9% Pd-103). Patients were stratified into three age cohorts: ≤ 59, 60–69 and ≥70 years. The BT prescription dose was prescribed to the prostate gland with generous peri-prostatic margins and the proximal 10mm of the seminal vesicles. 94.6% received supplemental EBRT (45–50.4 Gy) and 63.3% received androgen deprivation therapy (ADT) (median duration 12 months). Post-implant CT-based dosimetry was performed on day 0. BF was defined as a PSA > 0.40 ng/mL after nadir. The cause of death was determined for each patient. Patients with metastatic prostate cancer or non-metastatic castrate resistant prostate cancer who died of any cause were classified as dead of prostate cancer. All other deaths were attributed to the immediate cause. Multiple clinical, pathologic and treatment were evaluated for impact on patient outcomes. Results: Of the patients, 87.5% (median follow-up 8.9 years) presented with a single HR factor. The day 0 D90 was 122.5%. Overall, the 15-year BF, PCSM and OM were 12.4%, 5.6% and 51.7%. When stratified by age, there was no significant difference in BF or PCSM. The median post- treatment PSA in biochemically controlled patients was <0.01 ng/mL. In all three cohorts, OM increased linearly for the first 10 years and then approximately doubled from years 10 to 15. Moreover, 239 patients died: 10.9% due to prostate cancer, 38.1% from cardiovascular (CV) disease and 28.4% from other malignancies (to include one rectal and three bladder cancers). In MVA, BF was most closely related to percent positive biopsies (p < 0.001, SHR 1.018), PCSM to Gleason score (p = 0.004, SHR 2.884) and percent positive biopsies (p = 0.005, SHR 1.021) and OM to age (p < 0.001, HR 1.075) and tobacco (p < 0.001, HR 2.374). Conclusions: Despite high cancer control rates, overall survival was limited by a preponderance of CV and non-prostate cancer deaths, which were 6 times more likely than prostate cancer deaths. The implementation of a comprehensive multidisciplinary survivorship program will be essential to impact longevity in this patient population. Full article

We present a 42-year (1984–2025) Landsat consistent satellite vegetation trajectory for coastal wetlands in the Shell Beach area in the Breton Sound estuary, Louisiana. We applied the Controlled Interrupted Time Series (CITS) analysis to the satellite record to quantify the causal effect of the 2009 Mississippi River Gulf Outlet (MRGO) closure on the coastal wetland vegetation. The analysis used NDVI, kNDVI, and NDII across 88 vegetation transect plots located within five Coastal Reference and Monitoring Systems (CRMS) stations in the Shell Beach wetlands. Vegetation communities identified included Saline, Brackish, Freshwater, and Intermediate marsh. Sentinel-2 data from 2015 to 2025 were retained as an independent parallel record for NDRE analysis only. Quarterly median composites were decomposed using the Seasonal-Trend decomposition using LOESS (STL) to isolate de-seasonalized vegetation anomalies. The CITS design used segmented Ordinary Least Squares (OLS) regression with Newey–West HAC standard errors (lag = 3) at the study area. Northern Barataria Bay was used as an untreated regional control site to remove concurrent climate and sea level rise confounders. Whilst Hurricane Katrina and subsequent years (2005–2008) were excluded from the models, the single group ITS identified significant negative post-closure slope change across three indices. These were NDVI (β3 = −0.0034 yr⁻¹, p = 0.000), NDII (β3 = −0.0032 yr⁻¹), and kNDVI (β3 = −0.0016 yr⁻¹). These values indicated continued site-level decline relative to the pre-closure trend. Community-stratified ITS analysis showed a distinct divergent pattern with Freshwater marshes demonstrating significant recovery, with NDVI β3 = +0.0190 yr⁻¹, p = 0.000, whilst Saline, Brackish, and Intermediate communities continued to decline. CITS Difference-in-Differences (DiD) confirmed that site-level NDII and kNDVI declines were MRGO-specific. The DiD findings were that NDII = −0.00313 yr⁻¹, p < 0.001; kNDVI = −0.00123 yr⁻¹, p = 0.008. These findings isolated that physiological water stress and the non-linear biomass losses were a result of the MRGO-closure. The Freshwater DiD for NDVI (+0.02071 yr⁻¹, p = 0.000) was the strongest evidence of MRGO-specific recovery. Barataria Freshwater declined, whilst the Shell Beach Freshwater recovered. The results demonstrated that multi-index decadal Landsat monitoring with seasonal decomposition and full inter-sensor harmonization is essential for restoration trajectory assessment in managed coastal wetlands. Full article

Background: Medical device-associated infections represent a major component of healthcare-associated infections. Biofilm formation promotes microbial persistence on device surfaces, reduces antimicrobial susceptibility, and contributes to multidrug resistance (MDR), complicating diagnosis and treatment. Materials and Method: This study investigated biofilm production and antimicrobial resistance in microorganisms recovered from 100 indwelling and implantable medical devices, including urinary and venous catheters, urethral stents, catheter tips, and orthopedic or prosthetic materials, collected at a tertiary-care hospital (AOU “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy). Microbiological cultures were performed using direct and enrichment methods. Microbial identification was carried out by MALDI-TOF MS, antimicrobial susceptibility testing by VITEK^® (bioMérieux, Marcy-l'Étoile, France) 2 according to EUCAST criteria, and biofilm production was assessed using the crystal violet tissue culture plate assay. MDR status was defined according to international guidelines. Results: Microbial growth was detected in the majority of analized devices, frequently with polymicrobial contamination. Within the study cohort, coagulase-negative staphylococci (CoNS) were the most frequently recovered microorganisms (20%), followed by Klebsiella pneumoniae (10%), Candida albicans (9%), Staphylococcus aureus (9%), Enterococcus faecalis (8%), and Escherichia coli (8%). A significant association was observed between multidrug resistance and biofilm production, with MDR isolates showing a markedly higher likelihood of being biofilm producers compared with non-MDR isolates (OR 9.50; 95% CI 2.72–42.96; p < 0.005). Biofilm formation also differed significantly among device types (p = 0.028). Conclusions: These findings indicate a high prevalence of biofilm-producing MDR microorganisms among isolated recovered from medical devices in our cohort and highlight a significant association between MDR phenotype and biofilm production. These results provide a microbiological characterization of device-associated isolates that may support future studies on infection dynamics and control strategies. Full article

This study addresses the challenge of separating local damage information from full-field structural responses under complex environmental and noise conditions by proposing a structural damage localization method that integrates piecewise denoising, Robust Principal Component Analysis (RPCA), and a differential damage index. First, full-field responses obtained from vision-based measurement are processed through piecewise denoising and continuous displacement extraction, and then organized into a structural spatiotemporal response matrix. RPCA is subsequently employed to separate low-rank global response components from sparse local anomalies, and a damage index is constructed by differencing sparse-component statistical features between healthy and damaged states. Moving-load tests on a simply supported beam show that the DI peak in the damaged region is approximately 28 times higher than the non-damaged background level, and the identified DI peak accurately falls within the actual damage region. Compared with RMS, kurtosis, curvature index, wavelet energy, PCA residual, and RPCA sparse-energy indicators, the proposed method is the only one that achieves zero regional localization error. Under noise levels of 40–20 dB, all 30 repeated trials achieve a 100% localization success rate, and the success rate remains 93.33% even at 10 dB. Moreover, the localization results remain stable when $\lambda /{\lambda }_0$ varies from 0.50 to 1.50. Even when the number of spatial measurement points is reduced from 3401 to 128, the method maintains zero mean localization error and a 100% localization success rate. These results demonstrate that the synergy among piecewise denoising, RPCA decomposition, and state-difference enhancement effectively highlights damage-induced local anomalies, providing a robust and physically interpretable framework for full-field-response-based structural damage localization. Full article

The rapid reshoring of semiconductor manufacturing in the United States has introduced large-scale, energy-intensive industrial facilities into metropolitan regions increasingly exposed to climate-related infrastructure pressures. While existing research on industrial development often emphasizes agglomeration-driven economic spillovers, less attention has been given to how the early operational period of such facilities corresponds with surrounding commercial activity, particularly in peri-urban and greenfield suburban contexts. This study examines the spatiotemporal dynamics of localized commercial vitality surrounding semiconductor fabrication facilities in Phoenix, Arizona, and Austin, Texas. High-frequency point-of-interest (POI) mobility data are used to measure localized commercial activity, while regional electricity load records provide contextual information on metropolitan-scale demand conditions. Using a comparative Difference-in-Differences (DiD) framework combined with distance-band analysis and sectoral-temporal stratification, the study evaluates activity patterns between 2020 and 2025. The results indicate that the early operational period of the Phoenix facility is associated with a sustained relative divergence in mobility-derived commercial activity compared with the Austin benchmark trajectory. Spatial analysis identifies a clear distance-dependent gradient, with the largest relative reductions concentrated in intermediate suburban zones rather than immediately adjacent to the facility. Sectoral and temporal analyses further show larger reductions in dining and nighttime activity than in routine retail and daytime activity. Overall, the findings suggest that the early operational period of large industrial mega-projects may be associated with differentiated commercial activity trajectories across surrounding suburban environments. More broadly, the study demonstrates how high-frequency mobility data can be used to examine spatiotemporal variation in commercial vitality around major industrial developments. Full article

Background: Cirrhosis is a progressive liver disease often associated with sarcopenia. Vitamin D and IGF-1 alterations may contribute to muscle loss and disease progression. This study evaluated their relationship in cirrhotic patients. Methods: A total of 90 patients with liver cirrhosis were included in this retrospective observational study. Clinical and laboratory data were collected, and disease severity was assessed using Child–Pugh and MELD-Na scores. Sarcopenia was evaluated using CT-based skeletal muscle index at the L3 level with sex-specific cut-offs. Patients with malignancy, acute liver failure, recent surgery, or muscle-affecting conditions were excluded. Vitamin D and IGF-1 levels were classified using standard and age-adjusted reference ranges. Results: A total of 90 patients were included, of whom 42 were alive, and 48 died during follow-up. Gender distribution was similar between groups (p = 0.388). Skeletal muscle area was significantly lower in non-survivors (110 vs. 140 cm², p = 0.002), while body mass index did not differ (p = 0.570). Vitamin D levels were significantly lower (10.0 vs. 17.9 ng/mL, p < 0.001), and hemoglobin levels were reduced in the non-survivor group (10.76 ± 2.13 vs. 12.87 ± 2.57 g/dL, p = 0.001). In multivariate analysis, age (OR 1.046, p = 0.032), MELD-Na score (OR 1.200, p = 0.001), and vitamin D level (OR 0.920, p = 0.024) were independently associated with mortality. Conclusions: CT-based sarcopenia assessment is a useful adjunct in cirrhosis when interpreted with disease severity. Radiological muscle depletion is common and associated with worse outcomes, while vitamin D deficiency independently associated with mortality, highlighting its potential as a biomarker and therapeutic target. Full article

Background: The Farmer FIRST Programme (FFP) introduced scientific rice cultivation technologies to improve productivity among tribal farmers in Chhattisgarh state, India. Methods: A survey of 200 farmers (100 beneficiaries and 100 non-beneficiaries) was conducted using structured interviews and an adoption checklist. A Difference-in-Difference (DiD) model estimated FFP’s impact on yield, supported by Welch’s t-test, chi-square tests, and the Friedman test to assess income gains, adoption constraints, and perceived benefits. Results: Beneficiary yields increased by 9.55 quintals/ha versus 5.02 quintals/ha for controls, yielding a net gain of 4.52 quintals/ha (p < 0.01). DiD regression confirmed significant productivity gains (R² = 0.68). Income increased by ₹30,928.25 for beneficiaries (p < 0.01). Key constraints included limited access to quality seed and delayed information, while farmers ranked knowledge enhancement and yield improvement highest. Implications: FFP significantly improved rice productivity and income. Addressing seed supply and strengthening extension services will be vital for sustaining adoption of improved practices. Full article

Generative artificial intelligence (genAI) enables educators to build custom learning tools, but the feasibility and impact of educator-driven, AI-assisted development (“vibe coding”) in medical education remain unclear. This study describes the rapid development of a custom ECG learning application using Gemini 3.1 Pro, evaluates its association with exam performance using difference-in-differences (DiD) and triple-difference (DDD) analyses, and assesses student perceptions with the user version of the Mobile App Rating Scale (uMARS). The app was implemented at one WWAMI site (intervention) with five sites as controls; aggregate performance from two first-year medical student cohorts (E24 vs. E25) was analyzed, comparing ECG-focused (focal) to non-ECG (baseline) exam items. DDD effects were inconsistent across exams, with no overall pooled effect on focal performance relative to baseline versus controls. In contrast, students rated the app highly (overall uMARS 4.57/5), particularly for quiz customization and waveform annotations. These findings support the feasibility of rapidly building and deploying tailored educational tools via genAI-assisted workflows and suggest strong perceived usability and acceptability among students. However, the study did not demonstrate a definitive short-term learning effectiveness effect on exam performance. Vibe coding is therefore positioned as a practical model for faculty-driven, context-specific educational innovation that requires further evaluation across broader implementations. Full article

Background: The purpose of this in vitro study was to evaluate and compare the fracture resistance of 3D-printed partial veneers with finish lines at three different locations and conventional full veneers with finish lines at the gingival level. All restorations were digitally designed and 3D printed using a nanoceramic filled resin specifically developed for veneer restorations. Methods: Four maxillary right central incisor typodont teeth were prepared for labial veneers with finish lines at different locations: incisal third (InT), middle portion of the middle third (MmT), lower portion of the middle third (LmT), and conventional veneer with the finish line at the gingival level (CoV). Each preparation was scanned, and 15 casts were 3D printed from each scan. A total of 60 3D-printed veneers were fabricated (n = 15 per group) using a nanoceramic-filled resin designed for veneer restorations. The restorations were cemented to the 3D-printed dies using the manufacturer’s adhesive and resin cement. The specimens were artificially aged with 10,000 thermal cycles between 5 °C and 55 °C, with a dwell time of 30 s, and then loaded to failure using a universal testing machine. Fracture load values were analyzed using one-way ANOVA and the Tukey honestly significant difference post hoc test (α = 0.05). In addition, fracture patterns were evaluated using scanning electron microscopy images for descriptive purposes. Results: The mean fracture resistance of the 3D-printed partial and conventional labial veneers differed significantly depending on restoration design (p < 0.05). Among the partial veneers, the LmT group showed the highest fracture resistance (279.86 N), followed by the MmT group (266.92 N), while the InT group showed the lowest value (179.22 N). The conventional veneer group (CoV) demonstrated higher fracture resistance (404.07 N) than all partial veneer groups. Conclusions: The fracture resistance of 3D-printed partial and conventional labial veneers fabricated with nanoceramic-filled resins differed according to finish line location. Conventional veneers demonstrated higher fracture resistance than all partial veneer designs. The smallest partial veneer, with the margin located in the incisal third, showed lower fracture resistance than the partial veneer designs with finish lines in the middle third. Full article