Search Results (796)

Industrial spore production of the probiotic Heyndrickxia coagulans is hindered by its generally low and highly variable sporulation efficiency across strains. To address this, we selected the representative model strain ATCC 7050 and applied an integrated strategy combining statistical medium optimization with genomic analysis. Key factors (glucose, yeast extract, CaCl₂) were screened and optimized using Plackett–Burman and Box–Behnken designs, yielding an optimal formulation that achieved 1.84 × 10⁸ spores/mL in a bioreactor, consistent with the model prediction. Further genomic analysis revealed 112 sporulation-associated genes and identified key homologous genes related to spore resistance and germination. Among them, the successful identification of spoVA, which is implicated in calcium-dipicolinate transport in bacilli, allowed us to hypothesize why calcium ions play a critical role. This work not only enhances the spore yield of a model strain but also provides a framework to tackle the widespread sporulation variability in H. coagulans for industrial applications. Full article

Introduction: Celiac disease (CD) is a prevalent autoimmune enteropathy that remains significantly underdiagnosed due to its multifaceted diagnostic pathway and diverse clinical presentations. While duodenal biopsy has historically served as the diagnostic gold standard, its clinical primacy has been challenged by the burden of invasive endoscopy and potential histological misinterpretation. Material and Methods: We conducted a prospective diagnostic accuracy study involving consecutive adult patients with suspected CD to evaluate the performance of serological markers against histological findings. Results: The study included 139 patients, with a female predominance of 105 (75.5%). Histological evaluation revealed Marsh 3a–c in 100 patients (71.9%), whereas Marsh 1–2 was observed in 39 patients (28.1%). Sixty-one patients (43.9%) presented with high-titer ≥10×ULN tTG-IgA levels, while 78 patients (56.1%) fell below this threshold. To determine the independent predictors of Marsh 3a–c, we performed a logistic regression analysis. In the univariate analysis, both tTG-IgA (OR: 1.880; 95% CI: 1.458–2.426; p < 0.001) and non-smoker status (OR: 1.865; 95% CI: 1.283–2.709; p = 0.002) were significantly associated with VA. After adjusting for confounding variables in the multivariate model, both factors remained highly significant (p < 0.001 and p = 0.014, respectively). The diagnostic performance of the ≥10×ULN tTG-IgA threshold for detecting VA was confirmed by AUROC of 0.737, CI 0.646–0.827, p < 0.001, with a sensitivity of 55.0% and a specificity of 84.6%, a PPV of 90.2% and a NPVof 42.3% (33/78), underscoring that while the ≥10×ULN tTG-IgA threshold is highly specific for atrophy, lower titers do not reliably exclude it in adults. Conclusions: In conclusion, our study demonstrates that the ≥10×ULN tTG-IgA threshold provides a reliable diagnostic surrogate for VA in adult CD. While high cut-off values minimize false positives, a diagnostic gap remains for patients with lower antibody levels or those influenced by modifiers such as smoking. The low sensitivity of the high threshold reinforces the continued necessity of duodenal biopsy for symptomatic patients with lower-range antibody elevations to avoid a significant diagnostic gap. Full article

Background/Objectives: This study evaluated autologous platelet concentrates (APCs), including advanced platelet-rich fibrin (A-PRF+) and concentrated growth factors (CGFs), as biologically active matrices, and photobiomodulation (PBM) as a biophysical stimulus affecting soft and hard tissue regeneration following mandibular third molar extraction. Methods: A six-arm parallel randomised controlled trial was conducted including 135 patients. A total of 122 participants completed follow-up and were analysed: control (n = 22), photobiomodulation (n = 20), A-PRF+ (n = 19), CGF (n = 20), A-PRF+ plus photobiomodulation (n = 22), and CGF plus photobiomodulation (n = 19). The primary endpoint was postoperative pain intensity assessed on postoperative day 3 using an 11-point visual analogue scale (VAS). Secondary outcomes included swelling, trismus, wound healing assessed by the early healing index, and bone regeneration assessed by CBCT-based fractal dimension analysis at 4 months. Results: On postoperative day 3, mean VAS pain was 2.95 ± 2.65 in the control group and 1.00 ± 1.65 in the photobiomodulation group, corresponding to a mean difference of 1.95 VAS points. The overall between-group difference for day 3 pain was statistically significant. In swelling outcomes, no statistically significant between-group differences were observed at days 1, 3, or 7 across facial measurement lines. In CBCT fractal analysis, a significant group effect was detected for the mid socket region, with higher fractal dimension at 4 months in the CGF plus photobiomodulation group compared with the control. Conclusions: Both APCs and PBM positively influenced postoperative healing. Their combined application, particularly CGF with PBM, showed the most consistent regenerative effects, although not all outcomes differed significantly between groups. These minimally invasive strategies may support soft and hard tissue regeneration. Full article

Background: The Temporomandibular Joint Ankylosis Quality of Life Questionnaire (TMJAQoL) is a disease-specific instrument designed to assess quality of life in patients with temporomandibular joint (TMJ) ankylosis. No validated Turkish version of this scale existed prior to this study. The aim of this study was to translate, culturally adapt, and evaluate the Turkish version of the TMJAQoL (TMJAQoL-TR) in patients with severe temporomandibular disorders, including a predefined ankylosis subgroup. Materials and Methods: A total of 120 patients with temporomandibular complaints were included. Test–retest reliability was evaluated in a clinically stable subsample of 72 participants with a one-week interval. Following forward–backward translation and cultural adaptation procedures, the TMJAQoL-TR was administered together with the Oral Health Impact Profile Short Form-14 (OHIP-14), the Short Form-36 (SF-36), and Visual Analog Scale (VAS) pain scores. Reliability was assessed using Cronbach’s α, item-level Weighted Cohen’s Kappa, and test–retest Intraclass Correlation Coefficients (ICC), supported by measurement error indices (Standard Error of Measurement [SEM] and Minimal Detectable Change at 95% confidence [MDC₉₅]). Construct validity was examined using Spearman correlation coefficients. Structural validity was investigated through exploratory factor analysis, followed by a confirmatory structural model in AMOS to evaluate preliminary model consistency. Floor and ceiling effects were analyzed using the 15% criterion. Results: The TMJAQoL-TR demonstrated excellent internal consistency (Cronbach’s α = 0.879) and very high test–retest reliability (ICC = 0.995; 95% CI: 0.992–0.997). Strong correlations were observed with OHIP-14 (r = 0.772, p < 0.01), and moderate correlations with VAS pain scores (r = 0.312, p < 0.01). No significant floor or ceiling effects were detected. A weak but significant negative correlation with the SF-36 physical role subscale suggests that TMJ-related quality of life impairment is associated with role limitations in daily activities, although the magnitude of this association was modest. Exploratory factor analysis supported a clinically coherent two-factor structure, and the AMOS structural model demonstrated acceptable consistency with this framework. Conclusions: The TMJAQoL-TR appears to be a valid and reliable instrument for assessing quality of life in patients with severe TMJ-related functional limitations. Findings from the ankylosis subgroup support potential applicability within the instrument’s original target population; however, further validation in larger ankylosis-specific samples is warranted. Full article

Background/Objectives: Western societies introduce school-based or school-linked programs in order to improve the physical health status of students and prevent the negative impact of the late diagnosis of a series of diseases and conditions. Preschool visual acuity (VA) screening represents an established school-based approach aimed at the early detection of amblyopia risk factors and vision-related learning difficulties. In this study, we report the methods and outcomes of the first officially organized kindergarten-based VA screening program in Greece, implemented using the Democritus Digital Visual Acuity Test (DDiVAT) screening suite and involving trained educators as part of the screening workflow. The present analysis focuses on the operational performance and screening outcomes within this defined setting. Methods: This study was a kindergarten-based screening. Each kindergarten was equipped with the DDiVAT screening framework, which consisted of a 32-inch, 4K, Android Smart TV with the DDiVAT application preinstalled, a site-license granting access to the secure DDiVAT database, and two vouchers for teachers to participate in the official lifelong DDiVAT training program. Results: From 2476 enrolled students, 207 (8.36%) were referred due to suboptimal presenting VA in one or both eyes. Average VA ranged from logMAR 0.11 to 0.07, which is consistent with former reports. Conclusions: No major technical difficulties were encountered, suggesting that DDiVAT may represent a feasible digital approach for preschool VA screening in real-world educational settings. Full article

Background/Objectives: Atlantoaxial posterior fusion has unique characteristics, and it is anticipated that adjacent segment degenerative changes following fusion surgery may present distinctive findings. This study aims to analyze the risk factors for degenerative changes in subaxial levels following the increasingly common atlantoaxial posterior fusion procedure. Methods: A total of 58 patients (19 males, 39 females) who had neutral, flexion, and extension plain lateral radiographs taken and a follow-up record of approximately two years post-surgery were included in the final study cohort. The study analyzed surgical methods, patient demographics, hospitalization-related factors, visual analog scale (VAS) for neck pain, and radiologic parameters. Patients were classified into the radiologic subaxial pathology (RSP) group (n = 34) and the non-RSP group (n = 24) using several radiologic indicators of spinal instability or arthritic changes, and the risk factors for RSP were analyzed. Results: The RSP group showed a significantly higher proportion of females and prevalence of rheumatoid arthritis (RA). At 3 months postoperatively, the C1-7 sagittal vertical axis (SVA) was significantly lower in the RSP group. Multivariate regression analysis using significant variables (p < 0.05) such as sex, RA and 3-month C1-7 SVA showed that RA and 3-month C1-7 SVA were significantly associated with RSP. Among radiologic parameters related to surgery, multivariate analysis identified 3-month C1-7 SVA as the sole risk factor for RSP. To explore its correlation with other radiologic parameters at 3 months postoperatively, linear logistic regression analysis was conducted. Significant positive correlations were observed with the C1-2 Cobb angle. Conclusions: This study identified RA and C1-7 SVA as the most significant risk factors for RSP in atlantoaixal posterior fusion. Full article

Background: Rotator cuff tendinopathy is a major cause of shoulder pain and disability. Focused extracorporeal shockwave therapy (ESWT) is an established conservative treatment option; however, the predictive factors influencing the treatment response remain poorly characterized. Objectives: To identify clinical, demographic, and metabolic predictors of pain reduction and functional improvement at four months following focused ESWT in patients with supraspinatus tendinopathy, with the goal of informing individualized treatment planning and early prognostic counseling. Methods: This retrospective cohort study analyzed patients with supraspinatus tendinopathy (calcific and non-calcific) treated with focused ESWT at a university rehabilitation center between June 2020 and December 2025. Outcomes were assessed at baseline and 4-month follow-up using the Visual Analog Scale (VAS), Roles and Maudsley, and Constant–Murley scores. Change score analysis with covariate adjustment and backward stepwise selection were performed to identify predictors of clinical improvement. Results: A total of 239 patients (97 males [40.6%], 142 females [59.4%]; mean age 60.2 ± 11.5 years; mean BMI 25.5 ± 4.0 kg/m²) were included, of whom 101 (42.3%) had calcific tendinopathy. Significant improvements were observed in all outcomes: VAS decreased from 6.50 ± 1.35 to 3.96 ± 2.09 (p < 0.001; Cohen’s d = 1.24), and Constant–Murley score increased from 60.38 ± 14.53 to 75.88 ± 15.52 (p < 0.001; Cohen’s d = 1.07). Patient-reported satisfaction (Roles and Maudsley score) showed a 91.2% success rate (excellent or good outcomes). Regression analysis identified baseline severity as the strongest predictor of improvement in all models. BMI emerged as a significant predictor of functional recovery (β = −0.95, p < 0.001 for Constant–Murley change), with each 1 kg/m² increase associated with approximately 1-point less improvement. Conclusions: Baseline clinical severity and body mass index were consistent predictors of ESWT effectiveness in rotator cuff tendinopathy. A lower BMI was associated with greater functional improvement, highlighting a potentially modifiable factor for treatment optimization. These findings support personalized treatment planning and early prognostic counseling in clinical practices. Full article

Osteoarthritis is the most common musculoskeletal disorder. It primarily affects people in their mid-40s and older. As the disease progresses, degenerative changes occur in the synovial membrane, subchondral bone, and cartilage. Ultimately, the entire joint and its surrounding tissues become structurally and functionally impaired. Several sets of biochemical markers have been proposed to enable timely diagnosis and anticipate disease progression. However, only a few of these markers are routinely used to evaluate disease activity in subgroups. We conducted a cross-sectional, single-center cohort study of 72 patients with knee osteoarthritis. Diagnoses were established based on clinical data and radiological findings. We examined two Wnt/β-catenin signaling inhibitors, serum DKK-1 and sclerostin, and two bone/cartilage metabolic regulatory factors, RANKL and OPG, correlating these with disease activity and pain scores (WOMAC, VAS, and KOFUS), radiographic stage, inflammatory molecules and indices, and bone mineral density. DKK-1 levels were higher in the intensive pain group (VAS > 5) and positively correlated with the KOFUS throughout the study. This correlation was stronger in individuals with a BMI < 30. Serum DKK-1 levels were higher in patients with lower bone mineral density. No significant modifications in SOST, RANKL, or OPG levels were found in any of the above settings. In our patient cohort with mild-to-moderate knee osteoarthritis (OA), sclerostin, osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-B ligand (RANKL) were not related to pain or disease activity. In contrast, DKK-1 was an indicator of pain and low-grade flare-ups. Furthermore, DKK-1 was associated with the KOFUS and impaired bone turnover in non-obese subgroups. Confirming these relationships in larger groups of patients would contribute to more efficient use of DKK-1 in disease stratification algorithms. Full article

Background/Objectives: Comorbidity and risk factor management and avoiding stroke are pillars of optimal atrial fibrillation management. In this article, the latest literature on additional stroke risk factors not included in the CHA₂DS₂-VA score is reviewed in patients with non-valvular atrial fibrillation (NVAF). The possible clinical impacts of the additional risk factors in NVAF patients with a CHA₂DS₂-VA score of 1 are compiled with insights in an interdisciplinary panel discussion to refine daily clinical practice. Methods: The panel was composed of three cardiologists, one endocrinologist, and a nephrologist. The panel members finalized twenty open-ended questions covering major problems in stroke risk stratification in NVAF patients with a score of 1. The shortcomings of this clinical-based model for stroke prevention and its possible outcomes were discussed with evidence-based recommendations. The meeting outcomes are addressed for daily clinical adaptation in the present article. Results: Recent evidence suggests that the CHA₂DS₂-VA score may have shortcomings in a striking rate of NVAF patients with a score of 1. The growing body of evidence suggests that combining clinical, laboratory, and imaging predictors with the CHA₂DS₂-VA score may further refine stroke risk prediction and aid in decision-making for anticoagulation of NVAF patients with a score of 1. Conclusions: The interdisciplinary expert panel offered several recommendations based on the assessment of additional risk factors, which may enable clinicians to identify individualized patient characteristics and early multidisciplinary prevention of disease progression and personalized improvements in the long-term cardiovascular outcomes in NVAF patients with a CHA₂DS₂-VA score of 1. Full article

Objectives: Type-D personality, characterized by negative affectivity (NA) and social inhibition (SI), has been associated with adverse outcomes in chronic pain and cardiovascular populations. Evidence in spine outpatient settings remains limited. We aimed to assess the prevalence of Type-D personality and its association with pain, disability, and psychological distress in patients presenting to a university spine outpatient clinic. Methods: This exploratory cross-sectional study included 300 consecutive patients (18–85 years) presenting to a university spine outpatient clinic between 2023 and 2025. Patients completed the Type-D Scale-14 (DS14; Type-D defined as NA ≥10 and SI ≥10), the Hospital Anxiety and Depression Scale (HADS), the Visual Analog Scale for pain (VAS, 0–10), and the Oswestry Disability Index (ODI, 0–100). Demographic and clinical characteristics were recorded. Comparisons between Type-D and non-Type-D patients were performed. Results: The prevalence of Type-D personality was 32.3% (95% CI: 27.0–37.6%). Compared with non-Type-D patients, Type-D patients reported higher pain intensity (VAS: 5.23 vs. 3.88), disability (ODI: 38.6 vs. 31.3), anxiety (HADS-A: 10.0 vs. 6.5), and depression (HADS-D: 8.4 vs. 6.4); all p < 0.01. Between-group differences were clinically relevant, with large effect sizes for pain intensity (VAS; Cohen’s d ≈ 1.10) and moderate-to-large effect sizes for functional disability (ODI; Cohen’s d ≈ 0.75). Correlation analyses showed moderate to strong associations between Type-D personality traits (negative affectivity and social inhibition) and psychological distress. In stratified analyses, longer pain duration was descriptively associated with greater disability, particularly among patients with Type-D personality. Conclusions: Type-D personality is common in spine outpatient populations and is associated with greater pain, disability, and psychological distress. These findings underscore the relevance of psychosocial factors in spine outpatient care and highlight the need for further longitudinal research to clarify prognostic implications and potential targets for intervention. Full article

In this study, we used CTS and DMDAAC as raw materials and prepared a novel chitosan graft copolymer, CTS-g-PDMDAAC, through UV initiation in the presence of the photoinitiator VA-044. The synthesis process was systematically optimized, and its structural characteristics and performance in water treatment were evaluated. A single-factor experiment determined the optimal synthesis conditions to be a mass ratio of chitosan to DMDAAC of 1:4, total reactant concentration of 15.5%, ultraviolet light exposure for 5 h, and concentration of VA-044 of 0.2%. CTS-g-PDMDAAC demonstrated superior performance overall to CTS according to various characterization methods, such as FTIR, XPS, XRD, and BET. The coagulation experiment showed that at a dosage of 6.0 mg/L, the removal rates of residual turbidity and chlorophyll a reach 0.58 NTU and 99.37%, respectively, and the generated flocs have a dense structure and exhibit strong shear resistance. Finally, the flocculation mechanism was explored. Compared with traditional flocculants, CTS-g-PDMDAAC has the advantages of efficient algae removal, lower sludge production, no secondary pollution, and potential for the utilization of microalgae. This research provides theoretical support and suggests technical pathways for the development of biobased, environmentally friendly flocculants with broad pH adaptability. Full article

Background: Since 2018, the number of left ventricular assist devices (LVAD) implantations in Korea has been steadily increasing. Consequently, an increasing number of LVAD patients are presenting for non-cardiac surgery (NCS) of varying complexity. However, recent data on the perioperative management and clinical course of these patients remain limited. We share our investigation on patient and perioperative risk factors, as well as perioperative adverse outcomes, including mortality, in LVAD patients undergoing NCS. Methods: We retrospectively reviewed medical records of 36 LVAD patients who underwent NCS at our tertiary care center between 2018 and 2024. Patients requiring VA-ECMO were excluded. The primary end point was in-hospital mortality. The secondary end point was a composite of complications, including postoperative pulmonary complications, acute kidney injury, cerebrovascular accident, postoperative bleeding or thrombosis, and hemodynamic instability. Using univariable and multivariable logistic regression analysis, we examined the correlation between perioperative factors and adverse outcomes. Results: A total of 53 NCS index cases across 40 hospitalizations were analyzed. General surgery was the most common specialty (n = 19, 35.8%), followed by thoracic surgery (n = 13, 24.5%), plastic surgery (n = 7, 13.2%), and neurosurgery (n = 4, 7.5%). Thirteen procedures (24.5%) were classified as major surgeries. Postoperative complications occurred in 24 patients (66.7%), and 8 patients (20%) experienced mortality. Multivariable regression analysis identified major surgery (adjusted odds ratio [aOR] 1.44; 95% CI 1.11–1.86; p = 0.010), and intraoperative transfusion of ≥3 units of packed red blood cells (aOR 1.47; 95% CI 1.05–2.04; p = 0.029) as significant predictors of in-hospital mortality. Undergoing NCS within 180 days after LVAD implantation was associated with an increased risk of composite complications (aOR 1.86; 95% CI 1.53–2.27; p < 0.001). Conclusions: LVAD patients undergoing non-cardiac surgery frequently experience postoperative complications. Major surgeries, significant intraoperative transfusions, and early surgery following LVAD implantation are key predictors of poor outcomes. Careful risk assessment and tailored perioperative management are essential in this population. Full article

This study investigates the thermodynamic and technological aspects of smelting medium-carbon ferromanganese from Zhezdinsky manganese ore using ferrosilicomanganese and lime. The equilibrium distribution of components in the oxide-metal system was calculated using HSC Chemistry 10.0 within the temperature range of 573–2073 K. The modeling results revealed the effect of lime and ore consumption on slag phase composition as well as on manganese and silicon contents in the metallic phase. Experimental validation was performed in a laboratory Tamman resistance furnace and in a 100 kVA large-scale laboratory electric arc furnace. The chemical compositions of metal and slag were determined by bulk chemical analysis, while microstructure and local elemental distribution were examined using SEM-EDS. An increase in slag basicity was found to promote the transfer of silicon into the silicate phase while simultaneously reducing manganese losses to the slag. The large-scale laboratory smelting experiments, with a duration of 100–120 min per heat, enabled the establishment of a stable processing regime and the production of a metal with an average composition of 88.1 wt.% Mn, 1.6 wt.% C, and 0.03 wt.% Si. The corresponding slag contained approximately 15 wt.% MnO and 21 wt.% SiO₂. SEM-EDS analysis showed that the alloy possesses a heterogeneous microstructure consisting of an Fe-Mn metallic matrix with finely dispersed silicide microphases. Local silicon concentrations in these phases reach 15–24 wt.%, which explains the discrepancy between local and bulk chemical compositions. The experimental data are in good quantitative agreement with the thermodynamic modeling results, confirming that slag basicity and composition control are key factors for improving manganese recovery and stabilizing metal composition. The identified relationships can be applied in the development of industrially oriented smelting regimes for producing medium-carbon ferromanganese from Kazakhstan manganese raw materials. Full article

Siberian sturgeon (Acipenser baerii Brandt, 1869), characterized by its rapid mass accumulation and high survival rate under industrial breeding conditions, is one of the most promising aquacultural species. This research aimed to study the growth and development of farmed Siberian sturgeon (Acipenser baerii Brandt, 1869) to improve breeding programs. This research was conducted at the Federal Research Center for Animal Husbandry named after Academy Member L.K. Ernst and focused on the Lena population broodstock of Siberian sturgeon of the April 2022 generation (n = 98), grown in a recirculating aquaculture system (RAS). The experiment took into account body weight (W, g) and eleven morphological measurements: L—absolute length (cm); LR—fish body length increase (cm/day); l—commercial length (cm); L2—fork length (cm); HL—head length (cm); PV—pectoventral distance (cm); VA—ventroanal distance (cm); pl1—peduncle length (cm); H—body height (cm); h—peduncle height (cm); SC—body thickness (cm); GC—body circumference (cm); and Cc—peduncle circumference (cm). These measurements were taken from the same sample of fish at five different time points, all belonging to the same generation and approximately the same age. Measurements were taken every 3 to 9 months: 1 y (group G1), 1 y. 5 m. (group G2), 2 y. 2 m. (group G3), 2 y. 5 m. (group G4), 3 y. 2 m. (group G5), and 3 y. 5 m. (group G6). To evaluate the rate of growth and development, relative speed of growth (SGR) and relative speed of lengthening (SLR) during the observation period were determined. To characterize the fish’s exterior, we evaluated Fulton’s condition factor (KF) and the leanness index (Q). With increasing age, there was a significant (p < 0.01) decline in both SGR (from 0.454 to 0.065 g%/day) and SLR (from 0.132 to 0.028 cm%/day), which reflects changes in the fish’s physiological processes tied to the transition from the growth phase to the puberty phase. Relatively large variability was observed in body weight (C_v = 19.7–30.4%) compared to morphological measurements (C_v = 5.7–14.9%). Correlations between morphological measurements and the body weight of the fish varied from low to high (r = 0.22–0.97). Equations that allow for very precise (coefficient of determination R² = 0.800–0.933) estimation of the fish’s body weight based on morphological measurements were developed. The most preferable predictors were measurements of H (R² = 0.931), SC (R² = 0.933), and L2 (R² = 0.930). These morphological measurements are promising candidates for future development of contactless live weight detection using computer vision and machine learning algorithms. The study of live weight conjugacy at different ages showed that the best time to use this measurement to select fish for reproduction is at the age of 2 y. 2 m. or older. Acquired data can be used for the development and improvement of programs for the selection and breeding of Siberian sturgeon grown in a recirculating aquaculture system. Full article

Background: Nociplastic-like pain features are increasingly recognized as significant contributors to chronic pain and reduced quality of life in patients with rheumatoid arthritis (RA). However, their clinical correlates and relationship with disease activity remain incompletely understood. Objective: To evaluate the prevalence of nociplastic-like pain features in patients with RA and to investigate their associations with disease activity, pain intensity, fatigue, sleep quality, and health-related quality of life. Methods: In this cross-sectional study, 160 patients with RA were enrolled. Nociplastic-like pain features were assessed using the PainDETECT questionnaire. Disease activity was evaluated using the Disease Activity Score in 28 joints (DAS28). Pain intensity, fatigue, sleep quality, and health-related quality of life were assessed using the visual analog scale (VAS), Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36), respectively. Continuous variables were compared using t-tests or Mann–Whitney U tests according to data distribution. Stepwise multivariate linear regression analysis was performed to identify independent factors associated with PainDETECT scores. Results: Pain patterns suggestive of nociplastic-like features were identified in 22.5% of patients. These patients had significantly higher pain intensity, greater fatigue (lower FACIT-F scores), poorer sleep quality (higher PSQI scores), and lower SF-36 scores across all domains compared with patients without these features (all p < 0.001). PainDETECT scores showed a strong positive correlation with VAS pain intensity (r = 0.679, p < 0.001) and a moderate correlation with DAS28 (r = 0.536, p < 0.001). PainDETECT scores were negatively correlated with FACIT-F (r = −0.512, p < 0.001) and several SF-36 domains. In stepwise multivariate regression analysis, pain intensity, tender joint count, and education level emerged as independent predictors of nociplastic-like pain features, whereas inflammatory markers (CRP, ESR) and DAS28 were excluded from the model. Conclusions: Nociplastic-like pain features are common in RA and are independently associated with pain intensity, joint tenderness, and psychosocial factors rather than inflammatory activity alone. Routine assessment of these features is essential for personalized pain management and underscores the importance of considering potential central sensitization mechanisms in addition to traditional anti-inflammatory therapies. Full article