Search Results (10,306)

Background: Interprofessional collaboration is vital for comprehensive, patient-centered care. Despite growing recognition of oral–systemic health links, the integration of dentists into healthcare teams remains limited. This scoping review mapped existing evidence on dental professionals’ roles within interprofessional healthcare, identifying key benefits, barriers, and facilitators. Methods: A systematic search of PubMed, SCOPUS, and Web of Science identified English-language studies (2014 to 2024) focused on collaboration between dental and non-dental providers. Studies addressing oral–systemic health without team-based integration were excluded. Screening and data charting followed the PRISMA-ScR framework using JBI data extraction and critical appraisal tools. Data were synthesized thematically by collaboration model, outcomes, and influencing factors. Results: Nine studies met the inclusion criteria. Integrating dental professionals into healthcare teams improved patient outcomes, quality of life, and satisfaction. Effective models included nurse practitioner–dentist partnerships and medical–dental collaboration in pediatrics and chronic disease care. Barriers included poor communication, lack of interoperable electronic health records, role ambiguity, and limited interprofessional training. Key facilitators were supportive policies, integrated care structures, professional education, and strong team communication. Conclusions: Integrating dentists into interprofessional teams enhances healthcare delivery and patient outcomes. However, significant barriers remain. Addressing communication gaps, implementing shared health records, and expanding interprofessional education are essential steps toward more cohesive care. Future research should evaluate scalable integration frameworks and incorporate patient perspectives to inform team-based care. Full article

Background/Objectives: The relationship between diabetes and pancreatic cancer (PCa) is controversial. In this meta-analysis and systematic review, we investigated diabetes and time since diagnosis as risk factors for PCa. Methods: Cohort and case-control studies were retrieved through a literature search. RevMan 5.4 software and a random effects model were used to estimate summary risks with their 95% confidence intervals (CIs), and the Newcastle–Ottawa Scale (NOS) was used to assess study quality. Results: Included were 23 studies representing 30,875,355 participants and 86,980 cases of PCa. The summary risk for the 14 case-control studies was 2.30 (95% CI: 2.03–2.62) and for the 9 cohort studies was 2.39 (95% CI: 2.09–2.73). The risk decreased with time after diabetes diagnosis: 3.27, 2.25, 1.55, and 1.12 for <2, 2–5, 5–10, and >10 years, respectively, in the case-control studies. The cohort studies also showed an increased risk of PCa in the first 2 years (4.29) and a decrease over time. Quality scores according to the NOS were 6–9 (good and fair quality), for an overall average of 7.82. Conclusions: Diabetes is a risk factor for PCa and this risk is much higher in the 2 years following diabetes diagnosis. In this period, the subgroup of patients who, through clinical follow-up and/or cancer screening, would have better clinical outcomes should be identified. Bearing in mind the poor survival rate for PCa, diabetes interventions focused on preventing onset and delaying progression via modifiable risk factors to reduce PCa incidence. Full article

Pseudomonas fluorescens is a bacterium that has been identified as a significant pathogen in fish from the aquaculture industry. However, the clinical signs and changes caused by the disease have not been studied well yet. This study aimed to determine the survival, morphological, and histopathological changes in zebrafish (Danio rerio) in an experiment involving 180 fish (0.250 ± 0.05 g). The organisms were inoculated intraperitoneally at four bacterial concentrations 1.5 × 10⁶, 1.5 × 10⁷, 1.5 × 10⁸, and 1.5 × 10⁹ CFU mL⁻¹ with respective control groups. Results showed that cumulative mortality at 96 h post infection (hpi) was 0% (1.5 × 10⁶ CFU mL⁻¹), 0% (1.5 × 10⁷ CFU mL⁻¹), 6.66% (1.5 × 10⁸ CFU mL⁻¹), and 33.33% (1.5 × 10⁹ CFU mL⁻¹). The survival curves were not statistically different (p = 1.000). Corresponding to differences between clinical signs and concentrations for 24 hpi (p = 0.7576) there were no significant differences for 48 hpi statistical differences were obtained (p = 0.0008), while for 72 hpi (p = 0.8922) and 96 hpi (p = 0.333) they were not observed. The predominant clinical signs were anorexia, lethargy, erratic swimming, and peritoneal haemorrhage. The acute septicemic clinical form was determined. Histological analyses showed that the gills, liver, and spleen were infected and had severe pathological alterations. These findings indicate that the zebrafish is susceptible to P. fluorescens infection. Full article

Galactic cosmic ray (GCR) radiation is a major barrier to human space exploration beyond Earth’s magnetic field protection. Mesenchymal stem cells (MSCs) are found in all organs and play a critical role in repair and regeneration of tissue. We engineered bone marrow-derived MSCs and evaluated their response to ionizing radiation exposure. Epidermal growth factor receptor (EGFR) expression by certain types of cancers has been shown to induce radioresistance. In this study, we tested the feasibility of transfecting MSCs to overexpress EGFR (eMSC-EGFR) and their capacity to tolerate and recover from X-ray exposure. Quantitative real-time PCR (qRT-PCR) and immunoblotting results confirmed the efficient transfection of EGFR into MSCs and EGFR protein production. eMSC-EGFR maintained characteristics of human MSCs as outlined by the International Society for Cell & Gene Therapy. Then, engineered MSCs were exposed to various dose rates of X-ray (1–20 Gy) to assess the potential radioprotective role of EGFR overexpression in MSCs. Post-irradiation analysis included evaluation of morphology, cell proliferation, viability, tumorigenic potential, and DNA damage. eMSC-EGFR showed signs of radioresistance compared to naïve MSCs when assessing relative proliferation one week following exposure to 1–8 Gy X-rays, and significantly lower DNA damage content 24 h after exposure to 4 Gy. We establish for the first time the efficient generation of EGFR overexpressing MSCs as a model for enhancing the human body to tolerate and recover from moderate dose radiation injury in long-term manned space travel. Full article

Drury reports Wittgenstein telling him, “I am not a religious man but I can’t help seeing every problem from a religious point of view, I would like my work to be understood in this way”. My paper attempts to make sense of this strange claim. I first consider the meaning Wittgenstein gives to ‘religious’ in speaking of questions he explicitly designates as such, and then explain how that (sort of) meaning could also apply to the (other) characterisations he provides of his philosophical work. I also consider the subsidiary question, and suggest two very different reasons as to why Wittgenstein nonetheless did not consider himself ‘a religious man’. While I find much confusion in what Wittgenstein says about religion, his crucial insight is that both religious and philosophical thinking are characterised by the same kind of difficulty. Both spring from our moral–existential confusion and despair over finding, or accepting the sense we find, in our life with others. In the later parts of this paper, I show how the metaphysical I–world perspective of the Tractatus (the first specific form taken by Wittgenstein’s own ‘religious point of view’) exemplifies this very rootedness of philosophical/religious thinking in despair, and how in Wittgenstein’s later philosophy, including in some of his later explicitly religious remarks, an I–You perspective starts to emerge, one where our difficulties in sense-making are seen as the other side of our difficulties in opening ourselves to each other in love. I also suggest, however, that an unresolved tension nonetheless remains in Wittgenstein’s late thinking between an I–You orientation and a focus on collective normativity. Finally, I suggest that foregrounding love tends to dissolve the very idea of specifically ‘religious’ problems quite generally, and so leaves us with a double question about how to understand religion as such, and about whether, or how, we can give coherent sense to Wittgenstein’s idea that his point of view is specifically ‘religious’. Full article

The Poisson distribution is a discrete probability model, widely used in science and engineering to describe various natural and man-made phenomena. It possesses an important feature, namely being inherently asymmetric, but as its parameter becomes large, the distribution becomes approximately symmetric. To broaden its use, multiple extensions and variations have been developed. Determining whether a data set follows a Poisson distribution involves hypothesis testing at a chosen significance level. When sampling from a Poisson distribution, confidence intervals provide an estimated range instead of a single value. Due to the discrete nature of the Poisson distribution, confidence intervals cannot be derived from a simple formula, and are therefore computed using specialized algorithms. In this paper, three alternatives are given and discussed. Full article

Background and Clinical Significance: Immune checkpoint inhibitors (ICIs), a revolutionary class of oncology therapeutics that enhance T cell-mediated antitumor immunity, are associated with various immune-related adverse events (IRAEs). While destructive thyroiditis and hypothyroidism are common, ICI-induced Graves’ disease (GD) is exceedingly rare, and the occurrence of concomitant Graves’ ophthalmopathy (GO) is even rarer. Case Presentation: A 57-year-old man with bladder cancer developed GO after receiving the first dose of the programmed death 1 (PD-1) inhibitor pembrolizumab. He presented with severe proptosis, extraocular muscle enlargement, hyperthyroidism, and significantly increased thyroid-stimulating hormone receptor autoantibodies (TRAb). Following the treatment with glucocorticoids and immunosuppressive therapy, his symptoms improved markedly but relapsed upon dosage reduction. To date, we have not identified any previous reports of GO with confirmed positive thyroid-related antibodies induced by pembrolizumab. Conclusions: This case offers valuable insights into the potential IRAEs, underscoring the importance of thorough clinical evaluation and early recognition to improve patient outcomes and quality of life. A literature review of ICI-induced GO was also performed, with further discussion of the potential pathogenic mechanisms, risk factors, and management strategies. Full article

Foodborne illnesses associated with Bacillus cereus represent a persistent public health concern. In this study, we described the isolation and characterization of a novel bacteriophage, ΦBc24, from mud samples, which showed lytic activity against foodborne pathogen B. cereus. Transmission electron microscopy revealed that ΦBc24 exhibited a myovirus morphotype. Biological assays demonstrated that its narrow host range was restricted to B. cereus strains and efficient lytic activity, characterized by a latent period of 10 min and a burst size of 40 PFU per infected cell. The phage exhibited high physicochemical stability, tolerating pH values of 2–12, temperatures of 4–50 °C, salinity up to 1 M NaCl, and ultraviolet exposure, while effectively suppressing host bacterial growth for up to six hours. Whole-genome sequencing showed that phage ΦBc24 possessed a double-stranded DNA genome of 160,311 bp, with 39.48% GC content, and 269 predicted open reading frames (ORFs). Remarkably, 11 tRNA genes were identified, whereas no genes associated with lysogeny, virulence, or antimicrobial resistance were detected. Phylogenetic analysis suggested that ΦBc24 belongs to the genus Caeruleovirus, subfamily Bastillervirinae, family Herelleviridae. Taken together, these results highlight the biological robustness and genomic safety of ΦBc24, supporting its potential as a biocontrol candidate against the foodborne pathogen B. cereus. Full article

Polystyrene microplastics (PS-MPs) are microplastic particles produced during plastic manufacturing and environmental degradation, accumulating over time and entering ecosystems through various pathways, ultimately affecting organisms and inducing toxic effects. Current research on the impact of PS-MPs on mammalian oocyte quality, along with potential preventive mechanisms and strategies to mitigate toxicity, remains limited. This study investigates the effects of antioxidant melatonin on oocyte quality in the presence of PS-MPs, focusing on their influence on oocyte meiotic maturation and embryonic developmental potential. PS-MPs at a concentration of 30 μg/mL significantly impaired first polar body extrusion and reduced the success rate of parthenogenetic activation of mature oocytes in vitro. Furthermore, exposure to PS-MPs exacerbated oxidative stress, mitochondrial dysfunction, apoptosis, and autophagy impairment. Additionally, PS-MPs exposure led to a reduction in antioxidant gene expression and an increase in apoptosis-related gene expression in porcine oocytes. Immunofluorescence assays revealed that PS-MPs may induce oxidative stress, mitochondrial damage, and inflammation through the NF-KB/Nrf2/JNK MAPK signaling pathway crosstalk. Further investigation demonstrated that melatonin supplementation alleviated the toxic effects of PS-MPs exposure, offering potential as a therapeutic approach for mitigating PS-MP-induced reproductive toxicity and preserving oocyte quality. Full article

Malaria remains a considerable challenge to international health, especially in returning travelers from endemic regions where exposure risk may be downplayed. Prompt and accurate diagnosis is crucial, especially when conventional diagnostic techniques are insufficient. This case report presents a 59-year-old man who developed fever, rash, and myalgia after returning from the Amazon rainforest. Initial laboratory tests demonstrated leukopenia, thrombocytopenia, transaminitis, and hyperbilirubinemia. Despite these abnormal results and a clinically suspicious presentation, malaria smears were negative. Since the symptoms did not resolve, a Karius test—a plasma-based microbial cell-free DNA sequencing assay—successfully detected the presence of Plasmodium vivax, thus establishing the diagnosis. The patient needed several treatment regimens for the recurrent attacks, including chloroquine and primaquine, artemether-lumefantrine, and eventually a combination of quinine and doxycycline together with a prolonged course of primaquine. His symptoms resolved completely after the last treatment regimen, along with the normalization of the blood counts and liver function tests. This case demonstrates the limitations of smear microscopy diagnosis in P. vivax infections, highlights the role of molecular diagnostics like the Karius test, and stresses the importance of preventing relapses with adequate hypnozoite clearance. It further highlights the importance of clinician awareness and diligent follow-up in cases of travel-related Malaria, especially those with unusual presentations or recurrent symptoms. Full article

Background: Varicose veins (VVs) are an overlying manifestation of chronic venous disease, commonly occurring in the lower extremities. While typically linked to primary venous insufficiency, they can occasionally be secondary to systemic disease, e.g., malignancies, by various mechanisms such as tumor compression, hypercoagulability, and paraneoplastic syndromes. Bilateral varicose veins, as a presenting symptom of gastric cancer, are extremely rare and poorly documented. Materials and Methods: A comprehensive literature search was conducted to identify reports and studies linking varicose veins and malignancies, with particular focus on gastric cancer. The search was performed using the PubMed, Scopus, and Web of Science databases covering the last 13 years. Results: Literature Review: A review of the literature in the past decade identified publications, mostly case reports, describing associations between varicose-like venous changes and malignancies such as gastric, pancreatic, hepatic, and small-bowel tumors. The predominant mechanisms reported were inferior vena cava obstruction, tumor-related thrombosis, and paraneoplastic migratory superficial thrombophlebitis (Trousseau’s syndrome). Only a few cases involved gastric cancer as the primary site, with venous changes often being the first clinical sign. There is limited experience with gastric cancer that presents alongside bilateral collateral or varicose veins initially. Apart from the various reports having malignancies and varicose veins we also describe the case of a 50-year-old man who had extended history of bilateral lower-limb varicose veins. Severe, unexplained anaemia without obvious bleeding was discovered during examination. A biopsy verified a gastric adenocarcinoma, while upper gastrointestinal endoscopy revealed an ulcerated mass on the stomach’s greater curvature. Peritoneal dissemination was discovered with additional staging. A palliative subtotal gastrectomy was carried out because of the patient’s ongoing anaemia and suspected chronic bleeding caused by the tumour. The venous symptoms preceded any gastrointestinal issues. Conclusions: Although uncommon, malignancy should be considered in the differential diagnosis for atypical or rapidly progressing bilateral varicose veins, especially when accompanied by systemic symptoms or lab results such as unexplained anemia. Increased suspicion may lead to earlier cancer detection in some patients. Full article

Recent advancements in deep learning have significantly improved fault diagnosis methods. However, challenges such as insufficient feature extraction, limited long-range dependency modeling, and environmental noise continue to hinder their effectiveness. This paper presents a novel mixture of multi-view convolutional (MOM-Conv) layers integrating the Mixture of Experts (MOE) mechanism. This design effectively captures and fuses both local and contextual information, thereby enhancing feature extraction and representation. This proposed approach aims to improve prediction accuracy under varying noise conditions, particularly in rolling ball bearing systems characterized by noisy signals. Additionally, we propose the Mamba-enhanced adaptive self-attention long short-term memory (MASA-LSTM) model, which effectively captures both global and local dependencies in ultra-long time series data. This model addresses the limitations of traditional models in extracting long-range dependencies from such signals. The architecture also integrates a multi-step temporal state fusion mechanism to optimize information flow and incorporates adaptive parameter tuning, thereby improving dynamic adaptability within the LSTM framework. To further mitigate the impact of noise, we transform vibration signals into denoised multi-channel representations, enhancing model stability in noisy environments. Experimental results show that our proposed model outperforms existing state-of-the-art approaches on both the Paderborn and Case Western Reserve University bearing datasets, demonstrating remarkable robustness and effectiveness across various noise levels. Full article

The roles of man-made weirs in flood control during the summer monsoon are well-known, but the function of habitats for wintering water birds has not been explored. This study examined the effects of man-made weirs on the wintering distribution of water birds in Tancheon Stream, Korea, with a focus on the impact of the freeze–thaw process. Data collected from January to February 2003 included thawed water surface ratios, water depths, sandbar areas, and bird distribution under different weather conditions. The analysis revealed a strong positive correlation between thawed surface areas in front of the weir’s drop structures and the abundance of dabbling and diving water birds during severe cold conditions with temperatures below −9 °C. However, it was also observed that the stagnant water impounded by the weirs tended to freeze easily in winter, making it difficult for water birds to inhabit those areas. These results suggest an adaptation of wintering water birds to man-made weirs in urban streams, providing significant insights for enhancing habitat functions in urban stream management. Full article

Matrix metalloproteinases (MMPs) are proteolytic enzymes involved in connective tissue remodeling. Matrix metalloproteinase 3 (MMP3) belongs to the MMP family and is associated with the pathogenesis of tendinopathy. Moreover, MMP3 gene polymorphisms have been associated with the risk of tendinopathy development. The goal of this study was to investigate whether this gene polymorphisms could also affect the effectiveness of platelet-rich plasma (PRP) tendinopathy treatment. 107 patients (132 elbows) with lateral elbow tendinopathy underwent PRP injection and were followed for two years at specific follow-up weeks (2, 4, 8, 12, 24, 52, 104). The effectiveness of the therapy was assessed based on patient-reported outcome measures (PROMs) values, specifically visual analogue scale (VAS), quick version of the disabilities of the arm, shoulder and hand (QDASH), patient-rated tennis elbow evaluation (PRTEE), and the achievement of minimal clinically important difference (MCID). Three MMP3 single nucleotide polymorphisms (SNPs) (rs520540, rs591058, rs679620) were genotyped using the TaqMan method. All studied polymorphisms were found to present strong linkage disequilibrium and were associated with the effectiveness of therapy on the VAS scale (week 4) and PRTEE (week 104), as well as with MCID achievement (PRTEE week 4); however, these were not strong associations. The studied SNPs also showed an association with the frequency of hand pain before treatment. MMP3 gene polymorphisms are associated with pain experienced before PRP therapy, but do not show a clear association with treatment effectiveness. Full article

This research presents the application of Reinforcement Learning (RL) techniques to optimise aerodynamic profiles in real time, within the context of morphing wings. By implementing Proximal Policy Optimisation (PPO), a methodology has been developed that learns to satisfy both aerodynamic objectives and complex geometric constraints, such as internal spatial limitations or payload integration volumes. The approach achieves an effective balance between performance and constraint satisfaction while maintaining low computational cost and millisecond-level optimisation speed. A scalable tool has been developed for real-time optimisation in such contexts, with applications in adaptive design for both manned and unmanned aviation. Full article