Search Results (119)

Background and Objectives: Neonatal respiratory distress syndrome (NRDS), resulting from a deficiency of pulmonary surfactant (PS), can cause alveoli to collapse. Glucocorticoids reduce inflammation and are effective in reducing pulmonary swelling. This study aims to assess the effectiveness of the combination of PS and budesonide in the management of NRDS. Materials and Methods: Publications between 21 May and 24 November were screened through PubMed, Cochrane and Embase. Data analysis was performed on RevMan 5.3 software. Subgroup analysis was performed to evaluate the routes of administrations. Results: The use of budesonide along with pulmonary surfactant for treating NRDS revealed the following results: (1) a reduced duration of invasive mechanical ventilation (standardized mean difference (SMD) = −1.06, 95% confidence interval (CI) = −1.55 to −0.56, p < 0.0001); (2) reduced rate of bronchopulmonary dysplasia (BPD) occurrence (relative risk (RR) = 0.72, 95% CI = 0.60 to 0.86, p = 0.0003); (3) reduced duration for hospital admittance (SMD = −0.38, 95% CI = −0.64 to −0.11, p = 0.005). The occurrence of complications, i.e., sepsis, pneumothorax, retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), rate of mortality, hyperglycemia and intraventricular hemorrhage (IVH), was not significantly different among the intervention and comparison group except for patent ductus arteriosus (PDA) and pulmonary hemorrhage, with their incidence being higher in the control group (p = 0.002 and p = 0.05, respectively). Conclusions: The combination of pulmonary surfactant and budesonide decreases the occurrence of BPD, duration of mechanical ventilation, length of hospital stay and risk of pulmonary hemorrhage and PDA. It does not increase the risk of complications and death and is clinically safe. Full article

This study determines the influence of technological parameters of slide burnishing on the size of surface defects (scratches). The experiment was performed on ring-shaped samples of C45 steel. The samples had scratches made on their surface with a nominal depth from 10 μm to 70 μm. Slide burnishing was carried out using a variable force and feed. It was observed that regardless of the applied force and feed, scratches with a nominal depth of 10 μm and 20 μm were completely removed, and a “crushing” effect occurred. As for other surface defects, they were 2 to 27 times smaller compared to their values before burnishing. The surface roughness parameters Ra, Rt, Rpk, Rk, and Rvk decreased. Their values were 42% to 91% lower than those observed after grinding. The thickness of the strengthened layer ranged from 10 μm to 15 μm, and the degree of strengthening was from 20% to 38% at a depth of 1 μm. Compressive residual stresses occurred in the surface layer. Taking into account the surface layer properties and the effectiveness of surface defect removal, it should be noted that the most beneficial effects were obtained at F = 150 N and f = 0.03 mm/rev. Full article

This study aimed to evaluate prosthetic complications, implant survival rates, and marginal bone loss in implant-supported monolithic restorations compared to metal-ceramic restorations. The study was registered in PROSPERO (CRD420251022336) and conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. A systematic search was conducted in the electronic databases MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to December 2024. The inclusion criteria comprised studies evaluating only randomized clinical trials that evaluated implant-supported monolithic restorations directly compared to metal-ceramic restorations, considering any type of ceramic material and regardless of the fixation system (screw-retained or cemented), with a minimum follow-up of one year. A meta-analysis was performed using RevMan 5.4 software, and the risk of bias and certainty of evidence were assessed using the RoB 2.0 and GRADE tools, respectively. A total of six studies were included, all of which exclusively evaluated monolithic zirconia single crowns over follow-up periods ranging from 1 to 3 years. None of the included studies evaluated fixed partial dentures or restorative materials other than monolithic zirconia. In total, 267 patients (mean age range: 18–57 years) were analyzed, with a total of 174 implant-supported monolithic zirconia crowns and 165 metal-ceramic single crowns in the posterior region (premolars and molars). The meta-analysis revealed that implant-supported monolithic zirconia single crowns exhibited significantly fewer prosthetic complications compared to metal-ceramic single crowns (p < 0.0001; Risk Ratio [RR]: 0.26; Confidence Interval [CI]: 0.14–0.47). However, no statistically significant differences were observed between implant-supported monolithic zirconia and metal-ceramic single crowns regarding implant survival rates (p = 0.36; RR: 1.66; CI: 0.56–4.94) or marginal bone loss (p = 0.15; Mean Difference [MD]: −0.05; CI: −0.11–0.02). The risk of bias assessment indicated that four studies had a low risk of bias. However, the certainty of evidence was classified as low for prosthetic complications and implant survival rates and very low for marginal bone loss. Within the limitations of this review, it can be concluded that implant-supported monolithic zirconia single crowns can be considered a favorable treatment option as they show comparable implant survival and bone stability to metal-ceramic crowns, with a potential reduction in short-term prosthetic complications such as screw loosening and ceramic chipping. However, due to the limited number of studies included and low certainty of evidence, further long-term research is still needed to confirm their clinical performance over time. Full article

(1) Backgroud Astragalus, a traditional Chinese medicine, demonstrates therapeutic effectiveness in acute pancreatitis (AP). Nevertheless, its precise pharmacological mechanism remains unclear, and clinical guidelines have not been established. This study aims to systematically elucidate the active compounds and molecular mechanisms underlying Astragalus’ therapeutic effects in AP, and provide clinical evidence supporting its efficacy. (2) Methods: TCMSP and Swiss Target Prediction identified drug targets; GeneCards, DrugBank, and OMIM provided disease targets. Venny determined the therapeutic targets, while STRING constructed a protein–protein interaction network. Cytoscape 3.10.3 validated core targets. DAVID was used to conduct GO and KEGG pathway analyses, visualized via Bioinformatic platform. Cytoscape 3.10.3 was used to build a “drug–ingredients–targets–pathways–disease” network. AutoDock Vina 1.1.2 and AutoDockTools 1.5.7 was used to performed molecular docking, with PyMOL 3.0 visualizing the results. PubMed, Embase, Cochrane, Web of Science, CNKI, Wanfang, VIP, and CBMdisc were searched. The literature was screened, extracted, and evaluated, followed by a meta-analysis, using RevMan 5.4.1 and Stata 18. (3) Results: We identified 539 targets for the active ingredients of astragalus. Among 1974 disease-related targets, 232 were found to be therapeutic targets. The GO analysis yielded 589 entries, while the KEGG pathway enrichment analysis identified 147 relevant pathways. The top five active ingredients were quercetin, kaempferol, isorhamnetin, formononetin, and calycosin. Molecular docking analysis revealed potential synergistic effects between these components and core targets. The meta-analysis, comprising six randomized controlled trials, demonstrated a significantly higher total effective rate of clinical efficacy in the astragalus group compared to the control group. (4) Conclusions: Astragalus treats AP through the synergistic action of its components, targets, and pathways. Key active compounds, such as quercetin, kaempferol, isorhamnetin, formononetin, and calycosin, engage with pivotal targets, including TP53, AKT1, TNF, IL6, EGFR, CASP3, MYC, and HIF1A, within primary pathways, such as pathways in cancer, PI3K-Akt signaling pathway, and lipid metabolism, and atherosclerosis. Astragalus effectively treats AP and alleviates clinical symptoms by reducing the time for gas or defecation passage, the disappearance time of abdominal pain or distension, and the recovery time of bowel sounds. Full article

Background: Immune checkpoint inhibitors (ICIs) and therapeutic vaccines have emerged as promising immunotherapeutic strategies for solid tumors. However, their comparative efficacy in improving overall survival (OS) remains unclear. This systematic review and meta-analysis aimed to evaluate the efficacy of ICIs and therapeutic vaccines in improving OS in patients with solid tumors. Methods: A comprehensive search was conducted across PubMed, Cochrane Library, Embase, and Clinical Trials.gov for randomized controlled trials (RCTs) published between 1 January 2010 and 31 December 2024. Studies comparing ICIs or therapeutic vaccines against control treatments (placebo, standard of care, or active comparators) in adults with solid tumors were included. The primary outcome was OS, and data were pooled using RevMan (web). Risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Thirteen RCTs involving 10,991 participants were included. A total of 5722 of them were treated with therapeutic vaccines or checkpoint inhibitors. Therapeutic vaccines demonstrated insignificant improvement in OS, with a pooled mean difference of 1.89 months (95% CI: −0.54–4.31; P = 0.13), although with homogeneity (I² = 0%). ICIs showed a statistically significant OS benefit, with a pooled mean difference of 1.32 months (95% CI: 0.62–2.02; P = 0.0002) and low heterogeneity (I² = 12%). Conclusions: Therapeutic vaccines provide a larger but less consistent benefit, whereas ICIs offer modest but more consistent survival advantage. These findings support the need for personalized immunotherapy approaches as well as further research to identify predictive biomarkers and optimize treatment strategies by acquiring deep insights into the TME dynamic and behaviors. Full article

Hard turning is a precision machining process used to cut materials with hardnesses exceeding 45 HRC using single-point tools. It offers an efficient alternative to traditional grinding for finishing operations in manufacturing. This paper explores the machinability of hardened AISI 4340 steel for a hard turning process utilizing dry and cryogenic (Cryo) plus minimum quantity lubrication (MQL) (Cryo+MQL) techniques, focusing on critical machinability aspects such as cutting force, surface roughness, and tool life. The orthogonal dry turning was performed with a cutting speed (V) ranging from 300–400 m/min, a feed rate (f) between 0.05 and 1 mm/rev, and a depth of cut (doc) from 0.1 to 0.3 mm. A statistical analysis of the obtained results revealed that the feed rate was the most influential parameter, contributing 50.69% to the main cutting force and 80.03% to surface roughness. For tool life, cutting speed was identified as the dominant factor, with a contribution rate of 39.73%. Multi-objective optimization using Grey relational analysis (GRA) identified the optimal machining parameters for the hard turning of AISI 4340 alloy steel as V = 300 m/min, f = 0.05 mm/rev, and doc = 0.1 mm. The Cryo+MQL technique was subsequently applied to these parameters, yielding significant improvements, with a 48% reduction in surface roughness and a 184.5% increase in tool life, attributed to enhanced lubrication and cooling efficiency. However, a slight 4.6% increase in cutting force was observed, likely due to surface hardening induced by the low-temperature LN₂ cooling. Furthermore, reduced adhesion and tool fracture on the principal cutting edge under Cryo+MQL conditions justify the superior surface quality and extended tool life achieved. This research highlights the industrial relevance of hybrid lubrication in addressing challenges associated with hard turning processes. Full article

Affected by discontinuities, the hydraulic properties of rock masses are characterized by significant scale dependency and anisotropy. Sampling a rock mass at any scale smaller than the representative elementary volume (REV) size may result in incorrect characterization and property upscaling. Here, a three-dimensional discrete fracture network (DFN) model was built using the joint data obtained from a dam site in southwest China. A total of 504 two-dimensional sub-models with sizes ranging from 1 m × 1 m to 42 m × 42 m were extracted from the DFN model and then used as geometric models for equivalent permeability tensor calculations. A series of steady-state seepage numerical simulations were conducted for these models using the finite element method. We propose a new method for estimating the REV size of fractured rock masses based on permeability. This method provides a reliable estimate of the REV size by analyzing the tensor characteristic of the directional permeability, as well as its constant characteristic beyond the REV size. We find that the hydraulic REV sizes in different directions vary from 6 to 36 m, with the maximum size aligning with the average orientation of joint sets and the minimum along the angle bisector of intersecting joints. Additionally, the REV size is negatively correlated with the average trace length of the two intersecting joint sets. We find that the geometric REV size, determined by the joint connectivity and density, falls into the range of the hydraulic REV size. The findings could provide guidance for determining the threshold values of numerical rock mass models. Full article

Nuclear receptor subfamily 1 group D member 1 (NR1D1 or REV-ERBα) is a crucial element of the circadian clock’s transcriptional and translational feedback loop. Understanding its expression in humans is critical for elucidating its role in circadian rhythms and metabolic processes, and in finding potential links to various pathologies. In a longitudinal survey, we examined REV-ERBα expression at 08:00 using a real-time polymerase chain reaction (qRT-PCR) in blood mononuclear cells from Arctic native and non-native residents during equinoxes and solstices. REV-ERBα expression exhibited a pronounced seasonality, peaking at the summer solstice, and reaching a nadir at the winter solstice in both natives and non-natives, with a relatively higher summer peak in natives. After adjusting for age, sex, and body mass index, the amount and timing of light exposure, the amount of physical activity, and indigeneity emerged as significant predictors of REV-ERBα expression. Full article

Background/Objectives: Structured therapeutic patient education is the key to improving biopsychosocial outcomes in people with type 1 diabetes mellitus. This study aimed to determine the effects of structured therapeutic education on glycemic control and emotional well-being in people with type 1 diabetes mellitus. Methods: This is a systematic review with a meta-analysis (PROSPERO ID: CRD42023390079). Searches were performed in Scopus, MEDLINE, Web of Science, CINAHL, APA PsycInfo, APA PsycArticles, and the Psychology Database (June–August 2024). The eligibility criteria included randomized controlled trials published in English or Spanish within the past 10 years. Data extraction and risk of bias evaluations were independently conducted by two reviewers. The outcomes analyzed included glycated hemoglobin, time in range, emotional well-being, self-management behaviors, and adherence to treatment. Meta-analyses were performed using RevMan with random and fixed effects models. Results: Seventeen studies met the eligibility criteria. There was a significant improvement in glycemic control, stress, anxiety, and treatment satisfaction, although the results for the other emotional outcomes were mixed. Conclusions: Structured therapeutic patient education improves glycemic control and selected emotional outcomes in individuals with type 1 diabetes mellitus. Further trials are needed to refine the characteristics of the intervention and broaden the applicability of the findings to diverse populations. Full article

Purpose: The purpose of this systematic review was to systematically explore improvements in gastrointestinal symptoms 1 week and 1 month following the frenotomy procedure, compared to before the procedure for infants under 12 months of age using meta-analysis calculations. Methods: Studies were selected that presented data on breastfed infants under 12 months of age, with gastrointestinal symptoms and reflux, who underwent surgical correction for restricted maxillary labial frenum and/or ankyloglossia, and/or maxillary buccal frena. Case reports, letters to editors, previous systematic reviews, in vitro and animal studies, and only abstracts were excluded. An integrative literature review was carried out in MEDLINE via PubMed, EBSCOhost, Scopus Embase, Web of Science & Cochrane Library from April 2016 to March 2023. Risk of bias was evaluated using the Modified Newcastle‐Ottawa Scale. GRADE profiler (GRADEpro) was used to rate the quality of evidence. We conducted meta-analysis using random effects modelling with the RevMan Software 5.4. Results: Out of the 90 studies identified, nine studies were included, seven were prospective cohort studies, one was a prospective randomized trial, and one was a retrospective analysis. Gastroesophageal reflux symptoms showed statistically significant improvement in I-GERQ-R scores after 1 week (effect size = 3.40, p < 0.00001) and 1 month (effect size = 6.37, p < 0.00001) as compared to before release. Kotlow Class 3 and Class 4 lip tie, Coryllos Type 3 and Type 4 tongue tie showed maximum symptoms and the greatest improvement after release. Conclusion: Tethered oral tissues should be considered as a potential etiology in the differential diagnosis of gastrointestinal reflux in infants. Full article

In this study, the effects of cutting speed and feed rate on the roughness parameters R_a, R_z, R_sk, R_ku, R_pk, R_vk, and A₂ were examined during machining with coated carbide tools in a dry environment. The authors introduced the R_vk/R_pk ratio, a coefficient that facilitates a simpler evaluation of surface wear resistance. Specifically, if this ratio is greater than 1, the surface is more wear-resistant, while values less than 1 indicate a higher tendency for surface wear. The Taguchi OA method was used to analyze and identify the significance of technological parameters on output characteristics. Based on the results, it was established that feed rate has the greatest impact on all output characteristics. The highest cutting force was measured at a cutting speed of 60 m/min and a feed rate of 0.15 mm/rev, attributed to the fact that at lower cutting speeds, the base material does not soften while the cross-sectional area of the chip increases. To achieve the lowest R_a and R_z surface roughness, a cutting speed of 100 m/min and a feed rate of 0.05 mm/rev are recommended. If the goal is to enhance surface wear resistance and improve oil retention capability, machining with a cutting speed of 80–100 m/min and a feed rate of 0.15 mm/rev is advisable, as the coarser machining increases both the R_vk/R_pk ratio and the oil-retaining pocket size, which together improve the wear resistance of the machined surface. Full article

Background/Objectives: Total hip arthroplasty (THA) planning is crucial for restoring hip function and minimizing complications. The present systematic review and meta-analysis aimed to assess and compare the accuracy of 2D versus 3D preoperative planning in THA. Methods: The inclusion criteria were randomized controlled trials (RCTs) and observational studies (ROSs) published in English comparing the accuracy of 2D and 3D preoperative planning for total hip arthroplasty. We excluded review articles, registers, studies not written in English, studies that did not report the cup sizing accuracy or stem sizing accuracy or give a description of the preoperative planning method used, and non-comparative studies. In June 2024, following the PRISMA 2020 statement, a systematic review and a meta-analysis of the literature were conducted in PubMed, Scopus, and the Cochrane Library. The statistical analysis software Review Manager (RevMan) version 5.4 was used to perform the meta-analysis to compare the accuracy of 2D and 3D planning, and to assess the risk of bias, the ROBINS-I tool was used. Results: The analysis included 777 patients from six studies. The analysis showed that 3D planning offers superior precision compared to 2D planning, both for the cup (96.92% vs. 87.14%) and the stem (94.72% vs. 86.28%). The forest plots assessed a better trend for 3D planning in terms of exact size prediction and accuracy within ±1 size. Conclusions: The three-dimensional method was more precise and accurate than two-dimensional planning, both for the stem and the cup. It offered a detailed three-dimensional view of the patient’s anatomy. The main limitation was the challenge in finding homogeneous data regarding biomechanical parameters, surgical approaches, and different planning systems for both three-dimensional and two-dimensional methods. Full article

This review aims to compare the effect of photobiomodulation therapy (PBMT) using visible and near-infrared diode laser wavelengths to that of the dry needling technique (DNT) on the management of orofacial pain in patients with Temporomandibular Disorder Myofascial Pain Syndrome (TMD/MPS) in term of effectiveness, speed of recovery, and lasting of treatment. A systematic search of multiple electronic databases was carried out to identify the relevant clinical trials published between 1 January 2010 and 1 January 2024. The included studies were limited to human subjects who had orofacial pain associated with Axis 1 of TMD/MPS, involving two genders with age >18 years and were treated either with photobiomodulation using diode laser with wavelengths ranging from 600 up to 1200 nanometer (nm), or with the dry needling (DN) technique (superficial SDN or deep DDN), as a non-pharmacological therapies to decrease the intensity of orofacial pain associated with TMD/MPS. The risk of bias for included studies was assessed using the Cochrane RoB tool (for randomized studies). Three distinct meta-analyses were performed to quantify the pooled effects of PBM and DN in the management of TMD/MPS myofascial pain and deactivation of myofascial trigger points (MTPs). The meta-analyses were performed using Review Manager (RevMan) 5.3 from Cochrane. The confidence interval (CI) was established at 95% and p-values of less than 0.05 (p < 0.05) were considered statistically significant. Statistical heterogeneity was assessed using I2. Qualitative data were extracted and summarized in tables for each group study, while quantitative data were reported as Mean and Standard Deviation (SD) values for assessment variables in each sub-group study. The results among groups were systematically evaluated to draw the final conclusion. A rigorous electronic and manual search revealed 4150 possible articles. Following the application of the inclusion and exclusion criteria, twelve eligible studies were included in the analysis. Both PBMT and DNT were found to be effective in controlling the myalgia pain and primary symptoms associated with TMD/MPS, as well as deactivating the MTPs. DNT was statistically superior in terms of recovery time while PBMT was the more effective long-term therapy. Full article

Basalt is an important geotechnical material for engineering construction in Southwest China. However, it has complicated structural features due to its special origin, particularly the widespread occurrence of hidden cracks. Such discontinuities significantly affect the mechanical properties and engineering stability of basalt, and related research is lacking and unsystematic. In this work, taking the underground caverns in the Baihetan Hydropower Station as the engineering background, the size-dependent mechanical behaviors and excavation responses of basalt with hidden cracks were systematically explored based on a synthetic rock mass (SRM) model combining the finite-discrete element method (FDEM) and discrete fracture network (DFN) method. The results showed that: (1) The DFN–FDEM model generated based on the statistical characteristics of the geometric parameters of hidden cracks can consider the real structural characteristics of basalt, whereby the mechanical behaviors found in laboratory tests and at the engineering site could be exactly reproduced. (2) The representative elementary volume (REV) size of basalt blocks containing hidden cracks was 0.5 m, and the mechanical properties obtained at this size were considered equivalent continuum properties. With an increase in the sample dimensions, the mechanical properties reflected in the stress–strain curves changed from elastic–brittle to elastic–plastic or ductile, the strength failure criterion changed from linear to nonlinear, and the failure modes changed from fragmentation failure to local structure-controlled failure and then to splitting failure. (3) The surrounding rock mass near the excavation face of underground caverns typically showed a spalling failure mode, mainly affected by the complex structural characteristics and high in situ stresses, i.e., a tensile fracture mechanism characterized by stress–structure coupling. The research findings not only shed new light on the failure mechanisms and size-dependent mechanical behaviors of hard brittle rocks represented by basalt but also further enrich the basic theory and technical methods for multi-scale analyses in geotechnical engineering, which could provide a reference for the design optimization, construction scheme formulation, and disaster prevention of deep engineering projects. Full article

(1) Background: This meta-analysis aims to systematically assess the effect size of Schroth three-dimensional exercise training on adolescent idiopathic scoliosis, especially for Cobb angles, angles of trunk rotation, and quality of life. (2) Methods: Randomized controlled trials (RCTs) focused on the effect of Schroth exercise on patients with adolescent idiopathic scoliosis (AIS) were retrieved from six databases, including PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang. All publications until July 2023 were searched. Two researchers screened and evaluated the literature. Review manager (RevMan 5.3) statistical software was used for meta-analyses, and subgroup analysis and sensitivity analysis of the literature with high heterogeneity were further conducted. (3) Results: In total, 14 studies were included, including 538 adolescent idiopathic scoliosis patients. Compared with conventional physical therapy, Schroth 3D exercise training is more effective at reducing the Cobb angle (WMD = −3.32, 95%CI [−4.15, −2.50], p < 0.001) and improving the trunk rotation angle (WMD = −2.24, 95%CI [−3.00, −1.48], p < 0.001), quality of life (SMD = 2.80, 95%CI [1.53, 4.06], p < 0.001), and WRVAS (WMD = −2.92, 95%CI [−3.25, −2.60], p < 0.001), as well as enhancing the strength of the lumbar extensor (SMD = 1.79, 95%CI [1.46, 2.12], p < 0.001). (4) Conclusion: Compared with traditional therapy, Schroth 3D exercises are more effective at decreasing the Cobb angle and ATR in adolescent idiopathic scoliosis, improving patients’ quality of life, as well as enhancing the strength of the lumbar extensor. Full article