Search Results (1,013)

Background: Magnetic resonance imaging (MRI) is the reference standard for evaluating temporomandibular joint (TMJ) disorders, particularly for assessing disc position, joint effusion, and degenerative changes. With increasing imaging demands and advances in deep learning, artificial intelligence (AI) has emerged as a potential adjunct to expert interpretation. This systematic review aimed to compare the diagnostic performance of AI-based models with that of human experts in TMJ MRI analysis. Methods: This review was conducted in accordance with the PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251174127). A systematic search of PubMed/MEDLINE, ScienceDirect, Wiley Online Library, and Springer Nature Link was performed for studies published between 2020 and 2026. Eligible studies included human participants undergoing TMJ MRI and evaluated AI, machine learning, or deep learning models against human expert interpretation. Extracted outcomes included sensitivity, specificity, accuracy, area under the receiver operating characteristic curve (AUC), and agreement metrics. Risk of bias was assessed using QUADAS-2. Due to substantial heterogeneity, a narrative synthesis was conducted. Results: Five retrospective diagnostic accuracy studies were included, comprising sample sizes ranging from 118 to 1474 patients. Target conditions included anterior disc displacement, joint effusion, osteoarthritis, and disc perforation. AI models demonstrated strong discriminative performance, with reported AUC values ranging from 0.79 to 0.98. In direct comparisons, AI achieved diagnostic accuracy comparable to experienced radiologists. AI systems frequently demonstrated higher specificity and similar overall accuracy, whereas human experts often showed higher sensitivity. In osteoarthritis assessment, AI performance approached expert level and exceeded that of less experienced readers. All studies were retrospective and predominantly single-center, with heterogeneous reference standards and limited external validation. Conclusions: AI achieves diagnostic performance comparable to experienced clinicians in TMJ MRI interpretation and shows promise as a decision-support tool. Nevertheless, it should be regarded as complementary to, rather than a replacement for, expert radiological assessment pending further rigorous validation. Full article

In bridge widening projects under uninterrupted traffic conditions, vehicular vibration easily leads to damage in the interfacial transition zone (ITZ) and microstructural degradation of early-age concrete in wet joints. Taking a typical hollow slab-low T-beam widening structure as the object, this study introduces basalt micro fiber (BMF)-based ultra-high-performance concrete (UHPC) as the wet joint material and establishes a refined vehicle–bridge coupled dynamic model considering the time-varying stiffness of the joint material and road roughness excitation. The research indicates that although UHPC possesses excellent ultimate mechanical properties, its early-age setting process is extremely sensitive to vehicle-induced vibration. Numerical analysis reveals that while traditional temporary steel fixtures can effectively control the vertical relative displacement between the new and old girders within the critical value of 5.5 mm, the peak particle velocity (PPV) induced by heavy vehicles (buses and trucks) during the early pouring stage (<12 h) significantly exceeds the safety threshold of 3 mm/s, posing a severe threat to the directional distribution of steel fibers and interfacial bond strength. Therefore, this paper designs a single tuned mass damper (TMD) optimized based on Den Hartog’s fixed-point theory. Simulation results confirm that with the TMD configured, the vibration responses induced by buses across the entire speed range (≤120 km/h) are reduced below the safety limit; the vibration velocity induced by heavy trucks is also effectively controlled when combined with an 80 km/h speed limit. The collaborative strategy of “passive TMD vibration reduction + active traffic speed limit” proposed in this paper provides a theoretical basis for guaranteeing the early-age micro-forming quality of UHPC wet joints and overall traffic efficiency. Full article

Temporomandibular disorders (TMDs) are multifactorial conditions traditionally attributed to excessive mechanical loading on the temporomandibular joint, leading to clinical manifestations ranging from joint sounds to structural deformation. Contributing factors include trauma, occlusal abnormalities, psychological stress, and bruxism. However, immune and molecular alterations associated with early disease activity are not systematically integrated into structure-centered TMD frameworks. Emerging evidence indicates that temporomandibular joint osteoarthritis (TMJOA) involves activation of innate immunity caused by damage-associated molecular patterns (DAMPs) generated through mechanical loading, together with non-antigen-specific adaptive immune responses, including macrophage polarization and T helper 17 (Th17) and regulatory T (Treg) cell imbalance. Inflammatory and mechanical inputs converge through shared signaling modules and mechanoresponsive transcriptional programs, promoting extracellular matrix degradation, fibrotic remodeling, and subchondral bone remodeling. This review synthesizes the current immunopathological and mechanobiological evidence and introduces temporomandibular immunologic disease (TMID) as a mechanism-oriented framework, characterized by a reinforcing cycle between mechanically induced tissue damage and immune activation within the temporomandibular joint (TMJ) microenvironment. TMID complements TMJOA and Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) structural diagnostic categories while excluding antigen-specific autoimmune arthritides such as rheumatoid arthritis, thus functioning as a mechanistic overlay framework for the integration of immuno-mechanical signaling networks in immune-active, mechanically driven TMJ pathology. Full article

Background: Temporomandibular disorders (TMDs) are multifactorial conditions frequently encountered in orthodontic practice, and the independent associations of occlusal and structural variables remain unclear. This case–control study constructed a multivariable model integrating clinical, cephalometric, panoramic, and functional variables to examine their associations with TMD, diagnosed according to the DC/TMD Axis I protocol. Fifty patients with TMD and 50 non-TMD controls were consecutively recruited between October 2024 and December 2025. Occlusal characteristics, lateral cephalometric measurements, and Kjellberg panoramic symmetry indices (SI1/SI2) were assessed using standardized protocols. Candidate variables were initially explored using univariable analyses with false discovery rate adjustment, followed by multivariable Firth penalized logistic regression to reduce small-sample bias and separation. Mandibular deflection (OR = 3.57, 95% CI 1.54–9.09) and deviation (OR = 4.35, 95% CI 1.69–12.50) demonstrated the strongest independent associations with TMD, while SI1 asymmetry (<90%) became significant after multivariable adjustment (OR = 3.57, 95% CI 1.08–14.29). The final model showed apparent discrimination within the study sample (AUC = 0.822; 95% CI: 0.742–0.902). However, this value was calculated using the same dataset and should not be interpreted as validated model performance or compared to other studies. The observed SI1 effect should be interpreted cautiously, as it may reflect model instability due to the relatively small sample size. Within the limitations of this case–control design, functional disturbances showed stronger associations with TMD than static structural variables; however, external validation is required before clinical application. Full article

Temporomandibular disorder (TMD) is recognized as a major public health problem, causing pain and physiological and psychosocial limitations. In this context, the present in vitro study investigated the synthesis of a hyaluronic acid (HA) hydrogel with hydrocortisone (Hyd), designed to enhance joint lubrication by reducing mechanical friction and delivering the anti-inflammatory drug. The hydrogels were prepared with 3% HA (30 mg/mL) and Hyd—0.125% (1.25 mg/mL), 0.250% (2.5 mg/mL), 0.500% (5 mg/mL), or 1% (10 mg/mL). Physicochemical analyses included Fourier transform infrared spectroscopy (FTIR), thermogravimetry (TGA), rheological tests (frequency, amplitude, and temperature ramp scans), and field emission scanning electron microscopy (FESEM), performed before and after sterilization and cycling. In addition, cytocompatibility was evaluated by protocol OECD 129 and confocal microscopy, as well as genotoxicity (OECD487) in mouse macrophages (RAW 264.7 strain) per 24 h of exposure. FTIR demonstrated the spectral signatures of the compounds with no covalent interactions between the drugs, as well thermal stability on TGA. Rheology demonstrated that Hyd protected the HA structure after autoclaving, maintaining viscoelastic properties. SEM confirmed homogeneous porous morphology. Biological assays showed cell viability > 70%, but with a dose-dependent increase in genotoxicity (4–17 micronuclei). Confocal analysis revealed increasing cytotoxicity at high Hyd concentrations, indicating a balance between biocompatibility and adverse effects at concentrations ≤ 0.5%. Among the tested formulations, the 3% HA + 0.250% Hyd hydrogel provided the best balance of viscoelastic stability, cytocompatibility, and low genotoxicity, supporting its potential as a dual-function intra-articular candidate for TMD therapy. Full article

Extracytoplasmic function (ECF) σ factors are central regulators of bacterial adaptation to environmental changes. The genome of Leptospira interrogans encodes 11 such factors, including LIC12757. Previous studies have shown that LIC12757 is regulated by the FecR-like protein LIC12756, forming a regulatory system similar to the Escherichia coli FecI-FecR system. Here, the domain-specific regulatory role of LIC12756 was investigated. Interactions between LIC12757 and several LIC12756 variants, including the N-terminal domain (NTD) alone, NTD with half or full transmembrane domain (NTD-TMD), and full-length LIC12756 (FL, control), were analyzed using the BACTH system. During logarithmic growth, interactions were detected only with FL and NTD-TMD, whereas in the stationary phase, all variants interacted with varying strengths. Pull-down assays using His₆-tagged NTD confirmed its direct binding to LIC12757. Promoter activity analysis revealed that the NTD alone functions as an anti-σ factor in the logarithmic stage of growth. However, it is insufficient for full activation of LIC12757-dependent transcription during the stationary phase, as observed with FL protein. The NTD-TMD variant caused only minor stimulation compared to FL. These results indicate that NTD is a key determinant of LIC12756’s anti-σ activity toward LIC12757, whereas full activation of LIC12757 requires additional extrinsic signals, which are likely sensed by the C-terminal extracytoplasmic region (ECR). These findings provide mechanistic insight into ECF σ factor regulation in L. interrogans. Full article

Objectives: Temporomandibular disorders (TMDs) are common but often underrecognized and inadequately managed in primary healthcare, which may delay diagnosis and appropriate care. This study aimed to compare TMD-related knowledge, awareness, and clinical practices between dentists and physicians working in primary care and to identify factors associated with higher diagnostic confidence. Methods: A cross-sectional survey was conducted among dentists and physicians working in Croatian primary healthcare. TMD-related knowledge, clinical confidence, screening practices, and referral patterns were assessed using a structured questionnaire. Results: Dentists demonstrated significantly higher overall knowledge scores than physicians (15.6 ± 1.7 vs. 13.2 ± 4.1; p < 0.001), as well as greater diagnostic and therapeutic confidence (all p < 0.001). Routine TMD screening was reported by only 21.8% of participants, more frequently by dentists than physicians (36.1% vs. 8.2%; p < 0.001). Most respondents preferred referral rather than independent management. Regression analysis identified profession as the only independent predictor of higher TMD-related knowledge (p = 0.003). Insufficient knowledge, experience, and lack of confidence were the most reported barriers, particularly among physicians. Conclusions: The findings indicate clinically relevant gaps in TMD preparedness within primary healthcare, especially among physicians, despite frequent patient contact. Strengthening undergraduate and continuing education, promoting interdisciplinary training, and establishing clearer referral pathways may enhance early recognition and improve primary-level management of TMD. Full article

Stable wind resources in far-reaching sea areas are important direction for the development of renewable energy, making floating offshore wind turbine (FOWT) a focus of current research. However, the working environment of FOWT is severe. Under the condition of changeable wind and waves, the floating platform exhibits various motion responses, which may reduce power generation efficiency and even lead to structural damage with unpredictable consequences. In this paper, the National Renewable Energy Laboratory (NREL) 5 MW OC4-DeepCwind semi-submersible wind turbine is considered, and a multi-degree-of-freedom (M-DOF) tuned mass damper (TMD) system is designed to simultaneously suppress its roll and pitch motion responses. A multi-objective optimization problem is formulated to unify the frequency tuning accuracy, damping ratio constraints, and mass ratio limits through penalty functions. Then an improved Particle Swarm Optimization algorithm with time-varying acceleration coefficients (TVAC-PSO) is employed to determine the optimal TMD parameters, which dynamically adjusts exploration and exploitation capabilities to overcome the limitations of standard PSO in handling the strongly coupled parameter space. A high-fidelity aero-hydro-servo-elastic simulation model is established using OpenFAST to verify the vibration suppression performance under various sea state conditions. Simulation results demonstrate that the proposed M-DOF TMD system can effectively reduce the roll and pitch motion responses and significantly suppress the resonant peak energy, substantially improving the dynamic performance of FOWT. Full article

A multi-objective tuning framework for optimizing Tuned Mass Damper (TMD) systems is presented. This framework optimizes the controlling parameters of TMDs while considering building resilience. The employed optimizer is the multi-objective HBA. Since TMDs are used in tall structures to mitigate seismic-induced structural responses, the proposed framework must be applicable to real-world scenarios; therefore, it determines both the placement and parameters of TMDs by accounting for the effects of various soil types and multiple earthquake records. Based on the obtained results, the optimal TMDs achieved an average roof-displacement reduction of 17% in soft soil, 7% in fixed-base conditions, and only 4% in dense soil, highlighting the decisive influence of soil–structure interaction on system efficiency. Moreover, there was considerable outcome variability across different earthquake records—ranging from 0.8% to 26% reduction—along with the observed negative effect (response amplification of up to 13.9% in certain fixed-base cases), which occurs when the TMD becomes detuned relative to the dominant frequency of the specific ground motion. This confirms the necessity for a robust design approach that simultaneously considers an ensemble of ground motions rather than optimizing for a single record. Full article

Objectives: To quantitatively assess masticatory function with instrumental measures in a group of patients suffering from temporomandibular joint (TMJ) arthralgia, and to compare the results with symptom-free controls. Methods: Data of bite force, variance-of-hue-based (VOH) chewing efficiency, chewing frequency, the bilateral pressure pain threshold (PPT) of the temporalis and masseter muscles, and mandibular range of motion (RoM) were collected in a sample of TMJ arthralgia patients (n = 14) and controls (n = 19). The diagnosis of arthralgia was obtained following the DC/TMD protocol. Comparison between the groups was conducted using independent samples t-tests (level of significance α = 0.05). Associations within the arthralgia group were assessed using Pearson’s correlation coefficient. Results: In comparison to the controls, arthralgia patients showed significantly restricted pain-free and maximum unassisted mouth opening (p < 0.001, p = 0.022 respectively) as well as a significant decrease in both bite force (p < 0.001) and chewing frequency (p = 0.01). The average chewing efficiency for the arthralgia group was 0.14 ± 0.08 VOH. The PPT for both masseter muscles did not show significant differences in comparison to the control group. Conclusions: In patients with TMJ arthralgia, functional markers such as RoM, bite force, and chewing frequency exhibited significant limitations compared to the control group. The employment of instrumental measurements in the documentation of symptoms in clinical practice provides an objective basis for the assessment of functional limitations. Hence, we recommend integrating them into the longitudinal patients’ observation during therapy. Full article

This paper presents a dynamic model of a top-tensioned riser (TTR) subjected to combined vortex-induced vibration (VIV) and time-varying tension excitation. The model employs a van der Pol oscillator to simulate load excitation caused by vortex shedding and incorporates a tuned mass damper (TMD) to suppress nonlinear vibrations in the riser. The key contributions include, first, employing the Galerkin method to obtain a multi-mode approximate solution and analyzing it using single-mode approximate equations, and subsequently, applying a multi-scale approach to investigate the vibration reduction effect of the TMD under two typical resonance scenarios. By introducing a complex impedance term derived from the complex transfer function, the physical effect of the TMD is transformed into a frequency-dependent dynamic reaction force coupled to the riser’s equation of motion. The first involves 1:1 internal resonance between the structural frequency and vortex-induced frequency, while the second involves 1:2 parametric resonance between the structural frequency and the top tension frequency. Results indicate that when the structural frequency exhibits 1:2 parametric resonance with the top tension frequency, complex bifurcation behavior occurs, leading to large-amplitude structural responses. Findings demonstrate that TMDs effectively alter the system’s stability distribution and exhibit outstanding vibration-reduction efficiency under both typical resonance conditions. Full article

With the development of modern structures in the direction of higher and more complexity, the existence of multiple factors in the design and requirements of structures can lead to structures prone to nonlinear properties. The tuned mass damper (TMD), a widely implemented passive control mechanism, plays a crucial role in the engineering field by effectively reducing vibrations within primary structures. Nevertheless, its deployment frequently induces nonlinear dynamics due to the substantial displacements resulting from TMD operation or the integration of limiting devices. This research delineates a computational framework for a single-degree-of-freedom nonlinear primary system regulated by a nonlinear tuned mass damper (NTMD), designed to emulate near-fault seismic phenomena via a sinusoidal load. The study concentrates on the nonlinear attributes of both the NTMD and the primary system. Utilizing the complex variable averaging method in conjunction with the multiscale technique, complex variable equations and slow invariant manifolds are formulated for the system under 1:1 resonance conditions, with their accuracy and validity substantiated through numerical simulations. Expanding upon the derived complex variable equations and slow invariant manifolds, this study examines the impact of nonlinear coefficients within the NTMD and the primary system on both the damping performance of the NTMD and the stability of the primary system. Furthermore, this research delves into the effects of mass ratio fluctuations on the damping effectiveness of the TMD and the control efficiency of the primary system, as well as the emergence of jump phenomena in the presence of significant nonlinear coefficients. The analytical outcomes underscore the critical need to account for the inherent nonlinearities in both the TMD and the primary system, which can have detrimental effects. By considering the mass ratio as a key design parameter, optimizing it can enhance the TMD’s vibration suppression capabilities and the primary system’s control behavior, while also reducing the likelihood of jump phenomena and improving overall structural stability. Full article

Background/Objectives: Temporomandibular disorders (TMD) are common in pediatric patients, yet limited data exist on orthodontists’ knowledge, confidence, and clinical practices related to pediatric TMD. This cross-sectional study aimed to characterize orthodontists’ perceived knowledge, confidence, training, and practice patterns, and examine associations between routine screening behaviors and perceived confidence. Methods: A 34-item anonymous survey was distributed to orthodontists and orthodontic residents enrolled in or graduated from U.S. Commission on Dental Accreditation (CODA)-accredited programs. The survey assessed perceived knowledge, confidence in screening, diagnosis, and management of pediatric TMD, adequacy of residency training (on 0–10 numerical rating scale), frequency of routine TMD screening and examination practices, and referral patterns. Respondents were compared in study outcomes according to years of clinical practice with ANOVA. Respondents were categorized according to frequency of TMD screening (always/some of the time vs. sometimes/never) and compared in study outcomes using independent t-tests. Results: Out of 83 respondents, perceived knowledge (56.8 ± 26.9), confidence with screening (62.0 ± 30.5), diagnosis (59.4 ± 29.8), and management (50.8 ± 30.9) of pediatric TMD were moderate. Less than half of respondents (45.8%) reported routinely screening pediatric patients using standardized screening questions. Orthodontists who reported routine screening demonstrated significantly greater perceived knowledge and confidence in screening, diagnosis, and management compared with those who screened less frequently (all p’s ≤ 0.018, effect size between 0.57 and 0.78). Greater use of specific history-taking and clinical examination components was also associated with higher perceived confidence (all p’s between 0.001 and 0.046, effect size between 0.53 and 1.01). Confidence differed by years in practice, with lower scores reported among residents and mid-career practitioners (p < 0.05). Conclusions: Variability exists in orthodontists’ perceived knowledge, confidence, and clinical practices regarding pediatric TMD. Routine screening was associated with greater perceived competence. These findings highlight potential alignment between structured screening behaviors and self-reported confidence and may inform educational strategies in orthodontic training. Full article

Background/Objectives: Temporomandibular disorders (TMD) are common causes of orofacial pain, but their clinical course varies, with some patients developing persistent symptoms. Evidence supports a biopsychosocial model of pain chronification, yet prognostic factors for pain persistence in TMD remain insufficiently synthesized. This systematic review aimed to identify biological, psychological, and social predictors associated with pain persistence and chronicity in painful TMD. Methods: This review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420261286566). MEDLINE, Embase, and Web of Science were searched for studies published between January 2010 and December 2025. Eligible studies included adult patients with painful TMD and assessed baseline biopsychosocial predictors of pain persistence or chronicity at follow-up ≥ 3 months. Risk of bias was assessed using QUIPS and PROBAST. Due to heterogeneity across studies, findings were synthesized narratively. Results: Six prospective cohort studies were included, with follow-up durations ranging from 6 to 24 months. Psychological factors, particularly pain catastrophizing and depression, were associated with increased risk of pain persistence. Higher baseline pain intensity and widespread pain also showed prognostic value. Sleep-related and behavioral factors demonstrated inconsistent associations, and social predictors were rarely examined. The certainty of evidence ranged from moderate for catastrophizing and pain intensity to very low for sleep-related and occlusal factors. Conclusions: Pain persistence in TMD is influenced by multiple biopsychosocial factors. Psychological variables, especially catastrophizing and depression, appear to be the most consistent predictors, although this finding should be interpreted with caution, given the small number of included studies. These findings highlight the importance of comprehensive biopsychosocial assessment in patients with painful TMD and the need for further longitudinal research. Full article

Two-dimensional (2D) materials, particularly MXenes and transition metal dichalcogenides (TMDs), have attracted intense interest as supercapacitor electrodes due to their high surface area and tunable electronic structure. However, large discrepancies persist between the quantum capacitance values predicted by density functional theory (DFT) calculations and experimentally measured gravimetric capacitances. In this review, we critically analyze DFT methodologies, surface models, normalization strategies, and electrochemical characterization protocols, and compile an extensive dataset of reported MXene and TMD systems to quantify the degree of experimental–theoretical agreement. We show that MXenes typically achieve less than 20% of their predicted capacitance because of restacking, surface terminations, and limited ion accessibility, whereas TMDs exhibit substantially better correspondence, often approaching or exceeding 70% of theoretical values. These results indicate that the theoretical capacitance predicted by DFT is primarily determined by the electronic structure of the material, which defines the upper limit of charge storage, whereas the experimentally achieved capacitance is largely controlled by morphological factors, surface chemistry, and electrode architecture that limit ion accessibility. Full article