Search Results (521)

Fetal MRI has been increasingly used in diagnosis and assessment of congenital anomalies and conditions by providing detailed structural information. However, such information is only part of the whole landscape of these genetic disorders. Given that genetic disorders are associated with significant morbidity and mortality in infants, multidisciplinary team management is essential for perinatal management and parental counseling. In the past two decades, there are advances in both fetal MRI and genetic testing for prenatal diagnosis of genetic disorders. This narrative review consolidates the current literature and aims to provide a systematic overview of fetal MRI applications in genetic disorders affecting the central nervous system, craniofacial structures, skeletal system, lungs, and urinary system. Understanding embryological and genetic basis as well as imaging phenotypes of genetic disorders are important in improving perinatal diagnosis and management. Full article

Hypersensitivity reactions to iodinated contrast media (ICM) are traditionally categorized as immediate or delayed reactions, involving IgE-mediated pathways, non–IgE-dependent mast cell or complement activation, or T cell–mediated immune mechanisms. However, we observed that some individuals develop systemic inflammatory responses that do not fit these established categories. We describe here a case series of three patients who developed cytokine release syndrome (CRS)-like reactions following iodinated contrast administration, which were initially difficult to distinguish from sepsis and were only recognized after recurrent episodes. Clinical presentation, laboratory findings, cytokine profiles, allergy investigations, and treatment outcomes were reviewed. All patients developed fever, rigors, and hypotension within 5 to 70 h after exposure, accompanied by leukocytosis and markedly elevated inflammatory markers despite negative microbiological investigations. Serum tryptase levels remained within the normal range with no significant rise, while cytokine analyses demonstrated elevations of pro-inflammatory interleukin-6 and other cytokines in patients 1 and 3 where samples were available. Standard corticosteroid premedication did not prevent recurrence, and one patient developed systemic symptoms following intradermal testing. All patients improved with high-dose systemic corticosteroids and supportive care. These findings suggest that ICM may induce a cytokine-mediated inflammatory phenotype distinct from classical hypersensitivity reactions, highlighting the importance of early clinical recognition to guide diagnosis and management. Full article

Background: Surgical management of adult patients with post-dysplastic coxarthrosis using total hip arthroplasty is technically demanding and carries an increased risk of complications. In cases of high iliac dislocation classified as Crowe type IV, restoring the acetabular component to the anatomical hip centre often requires femoral shortening osteotomy to enable safe reduction in the prosthetic joint. Nevertheless, long-term evidence on functional outcomes and prosthesis survival with this approach is limited. Methods: A retrospective cohort study included 19 patients with 22 cases of Crowe type IV post-dysplastic hip osteoarthritis treated with uncemented total hip arthroplasty (Pinnacle/S-ROM, DePuy, Warsaw, IN, USA) combined with transverse subtrochanteric femoral shortening osteotomy. Patients underwent serial clinical follow-up, including assessment of range of motion, measurement of limb-length discrepancy, and functional evaluation using the Harris Hip Score and the WOMAC questionnaire. Radiological assessment included evaluation of osteotomy union, implant positioning, and osteolysis on standardized radiographs. Vertical distances of the centre of rotation (CR), the tip of the greater trochanter (GT), and the tip of the lesser trochanter (LT) from both reference lines were measured bilaterally, and inter-side differences were calculated. The reference lines consisted of the line connecting the inferior margins of the ischial bones and the teardrop (TD) line. Results: All osteotomies united at a mean of 5.57 months, with a mean follow-up of 129 months. Mean limb-length discrepancy decreased from 5.27 cm to 1.5 cm, and mean hip flexion improved from 82.9° to 106°. Functional outcomes improved significantly, with mean WOMAC increasing from 55.4 to 80.1 (p < 0.001) and mean Harris Hip Score from 49.8 to 84.66 at up to 3 years of follow-up (p < 0.001). Osteotomy length correlated strongly with lesser trochanter–teardrop distance (p = 0.00000048). Complications included distal femoral fissure (27.3%) and revision (18%), with no infection or permanent neurological deficit. Conclusions: Total hip arthroplasty combined with subtrochanteric femoral shortening osteotomy for Crowe type IV post-dysplastic hip osteoarthritis appears to be a feasible and effective procedure in an experienced centre, providing reliable osteotomy healing and significant early functional improvement that is sustained over time. Limb-length discrepancy was reduced and satisfactory biomechanical restoration was achieved, with an acceptable complication profile and implant survival of 81.3% at long-term follow-up. The LT–TD parameter was identified as a potential predictor of osteotomy length, enabling the proposal of a preoperative planning equation. However, given the limited sample size and lack of validation, these findings should be interpreted cautiously. Further studies are needed to confirm their broader applicability. Full article

Background/Objectives: Half of diagnosed unilateral maxillary sinusitis may have odontogenic origin, and root canal treatment (RCT) can be beneficial as a single-mode treatment for full resolution of maxillary sinusitis of endodontic origin (MSEO) symptoms. The aim of the study was to investigate the influence of passive ultrasonic irrigation (PUI) on the healing of MSEO after non-surgical endodontic treatment. Methods: A single-center, retrospective study was conducted on CBCT data and medical records of 240 patients, who underwent non-surgical endodontic treatment, performed by the same operator between 2016 and 2025. One hundred and thirty-six teeth entered the study due to inclusion/exclusion criteria. Results: Complete healing was observed in 75.74% of the cases (n = 103). The tooth most frequently associated with MSEO was the first upper molar (52.21%, n = 71). PUI was applied in 66.91% of the treatments (n = 91). PUI was an independent predictor of MSEO healing (p = 0.001; 95% CI [1.768; 9.136]). When PUI was introduced in RCT, complete healing of MSEO was observed in 84.62% of the cases (n = 77). PUI was independently associated with higher odds of radiological resolution of MSEO in univariate logistic regression (OR = 4.019) and multiple logistic regression (OR = 12.388) models. Conclusions: PUI application in the irrigation protocol was associated with higher rates of MSEO healing after non-surgical endodontic treatment (p = 0.001; 95% CI [1.768; 9.136]). The rate of MSEO healing after non-surgical RCT is high (75.74%); therefore it should be considered as a single-mode treatment option in cases of unilateral maxillary sinusitis. Full article

Background: Healthy dietary behaviours are essential for maintaining health, functional independence, and quality of life in later life. Family members are a key source of social support for community-dwelling older adults, yet the ways in which family support shapes older adults’ dietary behaviours, particularly among those who retain autonomy, remain insufficiently synthesized. Therefore, this review aims to map how family support influences dietary behaviours among community-dwelling older adults by examining the forms, roles, and contextual influences of family support within a Social Support Theory framework. Methods: Following Joanna Briggs Institute guidance and PRISMA-ScR reporting standards, we conducted a scoping review of empirical studies published in English or Chinese. Searches were conducted across PubMed, CINAHL, PsycINFO, Web of Science, and Scopus from inception to 2025. Quantitative and qualitative evidence was synthesised using a convergent–segregated mixed-methods approach. Qualitative findings were deductively mapped to instrumental, informational, emotional, and esteem support domains. Results: Nineteen studies were included. Quantitative evidence indicated that family support, particularly shared meal preparation, joint dietary adherence, and autonomy-supportive encouragement, was generally associated with better diet quality, dietary adherence, and nutritional outcomes. Qualitative findings showed that the influence of family support depended on relationship dynamics and contextual factors, including communication patterns, autonomy negotiation, shared responsibility, and cultural expectations. Conclusions: Family support plays a multifaceted and context-dependent role in shaping dietary behaviours among community-dwelling older adults. These findings can inform the development of family-inclusive strategies and interventions that promote healthy dietary behaviours while respecting older adults’ autonomy and relational contexts. Full article

With the ongoing emergence of SARS-CoV-2 variants, continued surveillance of antiviral susceptibility remains critical for detecting resistance that could compromise treatment efficacy. This study evaluated the activity of 2 SARS-CoV-2 RNA-dependent RNA polymerase (Nsp12) inhibitors against emerging Omicron variants: remdesivir (RDV), an approved antiviral for the treatment of COVID-19, and obeldesivir (ODV), an oral prodrug that shares the same parent nucleoside as RDV. Both RDV and ODV were shown to retain antiviral activity against the Omicron subvariants BA.2.86.1, JN.1.7, KP.2, KP.3.1.1, KP.3.3, LP.8.1, NB.1.8.1, XBB.2, XEC, and XFG compared with wild-type reference strains. Only 1 new lineage-defining Nsp12 substitution, D284Y (detected in NB.1.8.1), was observed. Phenotypic analysis demonstrated that a replicon containing this substitution remained susceptible to both RDV and ODV. These findings are consistent with previous studies showing that RDV and ODV retain potent activity against previously identified Omicron variants, support the continued clinical use of RDV against circulating SARS-CoV-2 variants, and reinforce the potential of ODV as an oral antiviral therapeutic. Full article

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin condition associated with psychological distress and reduced quality of life (QoL). The complex interrelationships among anxiety, depression, and multidimensional QoL in adults with AD remain insufficiently understood. This study aimed to examine these relationships and key factors linking psychological distress and QoL in this population. Methods: In this cross-sectional study, 47 adult participants with AD completed the Hospital Anxiety and Depression Scale (HADS) and the World Health Organization Quality of Life (WHOQOL-BREF). Bivariate and multivariate analyses were used to identify associations and correlates among anxiety, depression, and QoL domains. Results: Participants demonstrated elevated anxiety (mean score: 7.91 ± 3.27) and depression (mean score: 6.28 ± 3.62) scores, with moderate-to-poor QoL reported across all domains. Both anxiety and depression were significantly negatively correlated with all QoL dimensions (p < 0.05). Higher depression and self-reported stress were independently associated with poorer self-perceived QoL (p < 0.001). Self-reported inadequate sleep was associated with lower environmental QoL (p = 0.006), while more self-reported frequent AD flares correlated with reduced psychological QoL (p = 0.007). Conclusions: This study highlights the substantial psychological burden and impaired QoL experienced by adults with AD. Self-reported stress and inadequate sleep were commonly cited as modifiable factors associated with poorer outcomes, alongside elevated depression scores. An integrated care approach addressing both physical and psychological factors is recommended to improve overall outcomes in this population. Future research should prioritize longitudinal designs and AD-specific assessments to further elucidate causal pathways and inform targeted interventions. Full article

Background: This study aimed to evaluate the effect of two shaping systems combined with different irrigant activation methods on the tridimensional distribution of a bioceramic root canal sealer. Methods: Sixty single, round, straight root canals from extracted human teeth were randomized into six groups (n = 10): A1–A3 shaped with RACE NiTi rotary files; B1–B3 shaped with an adaptive XP-Endo Shaper. NaOCl and EDTA irrigation was performed using passive ultrasonic irrigation (PUI, group 1), conventional endodontic needle irrigation (CENI, group 2), or XP-Endo Finisher mechanical activation (group 3). Canals were obturated using the single-cone cold gutta-percha technique with BioRoot RCS bioceramic sealer. Confocal laser scanning microscopy was used to assess sealer penetration (mean and maximum depths and percentage), and sealer integrity on canal walls at coronal, middle, and apical levels. Results: The XP-Endo Shaper combined with the XP-Endo Finisher showed the highest mean sealer penetration depth, while RACE with PUI had the lowest (B3 vs. B2 p = 0.02; vs. A1 p = 0.05). No significant differences were observed in the maximum penetration depth and percentage of penetration across groups. Sealer integrity was significantly lower in the RACE + XP-Endo Finisher group (p < 0.01). Coronal regions consistently showed higher mean and maximum sealer penetration and percentage of penetration compared to apical thirds, with no significant differences in sealer integrity within root regions. Conclusions: The combination of the XP-Endo Shaper and XP-Endo Finisher showed a tendency towards superior sealer tridimensional distribution, particularly in the middle and apical thirds. This in vitro study suggests that adaptive shaping instruments combined with mechanical activation enhance sealer distribution, potentially improving treatment success. Full article

This research investigates the effects of corona plasma treatment on the mechanical properties of jute/epoxy-reinforced composites, particularly within biomedical application contexts. Plant Fibre Composites (PFCs) are attractive for medical devices and scaffolds due to their environmental friendliness, renewability, cost-effectiveness, low density, and high specific strength. However, their applications are often constrained by inferior mechanical performance arising from poor bonding between the plant fibre used as the reinforcement and the synthetic resin or polymer serving as the matrix. This study addresses the challenge of improving the weak interfacial bonding between plant fibre and synthetic resin in a 2/2 twill-weave-woven jute/epoxy composite material. The surface of the jute fibre is modified for better adhesion with the epoxy resin through plasma treatment, which exposes the jute fibre to controlled plasma energy and utilises dry air (plasma only), argon (Ar) (argon gas with plasma), and nitrogen (N₂) (nitrogen gas with plasma) at two different distances (25 mm and 35 mm) between the plasma nozzle and the fibre surface. In this context, “equilibrium” refers to the optimal combination of plasma power, treatment distance, and gas environment that collectively determines the degree of fibre surface modification. The results indicate that all plasma treatments improve the interlaminar shear strength in comparison to untreated samples, with treatments at 35 mm using N₂ gas showing a 35.4% increase in shear strength. Conversely, plasma treatment using dry air at 25 mm yields an 18.3% increase in tensile strength and a 35.7% increase in Young’s modulus. These findings highlight the importance of achieving an appropriate equilibrium among plasma intensity, treatment distance, and fibre–plasma interaction conditions to maximise the effectiveness of plasma treatment for jute/epoxy composites. This research advances sustainable innovation in biomedical materials, underscoring the potential for improved mechanical properties in environmentally friendly fibre-reinforced composites. Full article

Background/Objectives: This study evaluates the penetration of a calcium silicate-based sealer (BC Universal) into dentinal tubules after different final irrigation protocols. Methods: Eighty-four single-rooted extracted teeth were instrumented with ProTaper Gold to size F4 and assigned to four groups (n = 21) according to the final irrigation protocol as follows: conventional needle irrigation (CNI), sonic agitation with EndoActivator (EA), ultrasonic activation (UA), and XP-Endo Finisher (XPF). A total of 20 canals from each group were filled with BC Universal sealer mixed with fluorescein and the single-cone obturation technique. The remaining specimen in each group served as a negative control to assess potential imaging bias. Specimens were sectioned 3 mm from the apex and analyzed under confocal laser scanning microscopy. Sealer penetration was assessed by penetration area (PA), maximum depth (MaxD), mean depth (MeanD), and percentage of canal perimeter infiltrated (P). Data were analyzed using Kruskal–Wallis or ANOVA tests (α = 0.05). Results: All activation/agitation techniques showed significantly higher penetration than CNI across all variables (p < 0.001). No significant differences were found among EA, PUI, and XPF for PA, MaxD, and MeanD. However, XPF exhibited the highest perimeter infiltration, which was significantly greater than EA and UA (p < 0.001). Conclusions: Irrigant activation significantly enhanced dentinal tubule penetration of BC Universal sealer compared to CNI. XPF provided superior P, suggesting superior circumferential distribution. These findings suggest a more effective cleaning of the root canal in the apical third achieved by the tested irrigant activation/agitation techniques, which may improve the sealing potential of BC Universal sealer. Full article

Infectious pathogens pose serious threats to public health, necessitating the development of more antimicrobials. In this study, oligohydroxybutyrates were obtained through the catalyzed polymerization of β-butyrolactone using N, N-dimethyl-4-aminopyridine (DMAP) and aluminum isopropoxide [Al(OiPr)₃] and applied as sustainable antimicrobial agents. The poly3-hydroxybutyrate (PHB) oligomers exhibited broad-spectrum antibacterial activities against both Gram-negative (E. coli) and Gram-positive (S. aureus) model bacteria. Additionally, PHB oligomers displayed robust (inhibiting rate: >95%) and rapid (action time: <20 min) antiviral activity against three notorious single-stranded RNA viruses, that is, influenza A virus (H1N1 and H3N2) and coronavirus (SARS-CoV-2). In particular, a comprehensive set of advanced experimental characterizations, including FT-IR, ¹H- and ¹³C-NMR, and H-ESI-MS/MS, was applied to analyze their chemical structures. The results confirmed the loss of terminal hydroxyl groups in the PHB intermediate and end products associated with theoretical calculations. These findings will also help provide deep insight into the major chain growth mechanism during the synthesis of PHB. The structural variations, which were treated as unwanted side reactions, were identified as a pivotal factor by deactivating the terminal hydroxy during chain growth. Their effective sterilization properties and degradability endowed the as-prepared PHB oligomers with a promising biomedical potential, including for use as disinfectants, sanitizers, and antiseptics. Full article

In this study, we investigate the Suvarṇabhūmi area, corresponding to central–southern Mainland Southeast Asia. We test the hypothesis that this region, located to the south of the Himalayan foothills, can be characterised as a convergence zone in which diverse entities involving humans, animals, and artefacts have significantly diverged from their related counterparts outside the area. We argue that this process of convergence was facilitated by the Maritime Silk Road trade networks, which were particularly active between the 3rd century BCE and the 9th century CE. Comparative data are derived from multiple scientific disciplines, including linguistic typology, onomastics, epigraphy, archaeology, and evolutionary biology. This includes typological features of language, toponyms, inscriptions, glass bead chemistry and related material culture, and phylogenetic data from patterns of endemism to illustrate parallel convergence scenarios observed for each data type. The results reveal recurring patterns of convergence. Linguistic, technological, and biological entities tend to diverge from their original forms and realign with predominant regional types when entering the Suvarṇabhūmi area. The spread of Indic and Sinitic linguistic and cultural elements, the adaptation and development of Brāhmī scripts into distinct local forms, the secondary manufacturing of glass beads, and unique genetic lineages in mammals, amphibians, reptiles, fish, and plants all point to the region’s role as a dynamic interaction sphere. We argue that Suvarṇabhūmi functions as an ecological system, in which trajectories of convergence are notable across a number of individual aspects of cultural and biological diversity. Altogether, these components have contributed to shaping the region’s distinctive natural and cultural history. Full article

The Asia Pacific, led by the resource-dependent ASEAN-5, is the largest carbon contributor, yet its firms exhibit critically low transparency. This study examines the relationship between voluntary Sustainability Assurance (SA) and carbon disclosure transparency using 875 firm-year observations (2018–2022). Applying panel regression and several robustness tests, we find that SA adoption has a positive relationship with the magnitude of disclosed carbon emissions, indicating enhanced transparency. This positive relationship is significantly more pronounced in firms with high environmental performance and greater property, plant, and equipment (PPE) efficiency, suggesting SA aligns with genuine sustainability efforts rather than symbolic reporting. Furthermore, SA increases the likelihood of disclosing the complex Scope 3 emissions. However, the effectiveness of SA is conditional: its transparency benefit is statistically significant only within mandatory sustainability reporting (SR) regimes and in non-environmentally sensitive industries, highlighting crucial variations across regulatory and industrial contexts within ASEAN-5. This research provides evidence on the role of SA in emerging markets, extending Agency Theory by demonstrating its function as a credibility signal that reduces information asymmetry. We offer practical guidance for managers seeking market differentiation, and for regulators aiming to align voluntary SA with IFRS S1/S2 to enhance disclosure quality. Full article

This study presents the first comprehensive techno-economic assessment of wind-based green hydrogen production across Senegal, a country highly dependent on fossil fuel imports. Using a novel integrated approach combining 30 years of ERA5 reanalysis data (1993–2023), turbine performance modeling and electrolyzer comparison, it fills an important gap for renewable hydrogen development in West Africa. Wind resources were analyzed at multiple altitudes, revealing strong potential in both coastal and northeastern regions, particularly during the dry season, with higher wind speeds at higher turbine heights. Four turbines (Vestas_150, Goldwind_155, Vestas_126 and Nordex_N100) and two electrolyzer types (alkaline and PEM) were evaluated. The alkaline system performed best. Vestas_150 and Goldwind_155 achieved the highest hydrogen yields of 241 and 183 tons/year and CO₂ reductions of 2951 and 2241 tons/year, generating carbon credits of 0.118 M$ and 0.089 M$, respectively. Their levelized cost of electricity remained low (0.042 and 0.039 $/kWh), while smaller turbines showed higher costs. Vestas_150 also had the shortest payback period of 2.16 years, making it the most competitive option. Sensitivity analyses showed that longer system lifespans and high-performance turbines significantly reduce the levelized cost of hydrogen. Priority investment zones include Saint-Louis, Matam, Louga and Tambacounda, with levelized cost of hydrogen values as low as 3.4 $/kg. Full article

Background: Osteoarthritis is a leading cause of chronic pain and long-term disability in adults, which commonly affects the hip and knee joints. Joint arthroplasties are one of the management strategies for end-stage osteoarthritis. Periprosthetic fractures after hip or knee arthroplasties have mortality rates comparable to hip fractures. Recent studies assessed bone health optimization and the use of anti-osteoporotic agents in elective hip and knee arthroplasty surgeries. This systematic review and meta-analysis aimed to determine the prevalence of osteoporosis before surgery and the effect of bone health optimization on periprosthetic fractures and revisions. Methods: A systematic search was carried out on three databases, including PubMed, Embase, and Web of Science. The keywords used were (Revision or Periprosthetic fracture) AND (osteop*) and (Total Knee* or Total Hip*). Studies that included subjects aged >50 years with investigated outcomes were included in the review. The quality of selected randomized controlled trials was assessed using the Cochrane Collaboration tool, and non-randomized studies were assessed using the Newcastle–Ottawa Scale. The review was not registered with the International Prospective Register of Systematic Reviews (PROSPERO). Results: A total of 2482 records were identified. Twenty-three studies were included, and eighteen were used for quantitative analysis. Pooled overall prevalence of osteopenia in patients undergoing total knee arthroplasty (TKA)/total hip arthroplasty (THA) surgery was 42.87% (95% confidence interval (CI) 32.65 to 53.09). Pooled overall prevalence of osteoporosis in patients undergoing TKA/THA surgery was 23.99% (95% CI 15.72 to 32.26). The overall mean difference was in favor of anti-resorptive treatment on periprosthetic BMD of the medial calcar region (Gruen zone 7) after THA (12.16% (95% CI 8.78 to 15.53, p < 0.00001). Pooled odds ratio of periprosthetic fracture was 1.27 (95% CI 1.08 to 1.48, p = 0.003) in favor of the control group compared to bisphosphonate treatment. The pooled hazard ratio for all-cause revisions after TKA/THA for both osteopenia and osteoporotic patients was 0.26 (95% CI 0.13 to 0.51, p = 0.0001, I² 76%), signifying an improvement with bisphosphonates. Limitations of this study include the heterogeneity and retrospective nature of the included studies, with the average level of evidence subject to bias. Conclusions: There was a high prevalence of osteopenia/osteoporosis amongst patients undergoing total knee and total hip arthroplasty at 66.86%. Whilst bone health optimization with bisphosphonates may decrease the risk of revisions, the risk of periprosthetic fracture appeared to increase. Further research will be required to evaluate the effects of bone health optimization on the risk of periprosthetic fracture and revisions, and the effects of anabolic agents on periprosthetic fractures. Full article