Search Results (14,018)

Objectives: Clinical trials are essential for therapeutic innovation in rheumatology. A recent decline in clinical trial activity in Hungary has highlighted the need to better understand patient experiences and motivations. This study assessed patient satisfaction and motivation in clinical trials, compared these with routine specialist care, and evaluated healthcare professionals’ motivations. Methods: In this single-center, cross-sectional study, 129 patients completed self-administered questionnaires (61 trial participants and 68 receiving routine care) primarily using a 6-point Likert scale; additionally, 21 healthcare professionals rated their motivations on a Visual Analog Scale (VAS 0–10). Categorical variables were analyzed using chi-square or Fisher’s exact tests, and continuous variables using paired two-tailed t-tests. Results: The main drivers of trial participation were physician recommendations (100%) and trust in the treating physician (100%). Access to novel therapies (98%), closer monitoring (83%), and additional diagnostic procedures (95%) were also significant motivators. Trial participants reported significantly higher satisfaction compared with routine care in terms of consultation time (97% vs. 36%, p < 0.001), staff availability (95% vs. 41, p < 0.001), assistance (93% vs. 36%, p < 0.001), and visit organization (98% vs. 34%; p < 0.001). Overall satisfaction with routine care remained high in both groups. In the control group, fears of disease worsening and the burden of frequent visits were key deterrents. Among healthcare professionals, access to innovative treatments was the strongest motivator, while administrative workload and documentation demands were the primary barriers. Conclusions: Clinical trial participation is associated with high patient satisfaction, driven by physician–patient trust and structured, personalized care. Reducing administrative burdens may be crucial for sustaining clinical research in academic settings. Full article

Background: Oral squamous cell carcinoma (OSCC) is an aggressive cancer closely associated with smoking and alcohol consumption, with a higher incidence in men. Despite changes in treatment strategies, poor survival persists in most patients, highlighting the need for novel and improved therapeutic options. Naphthoquinone analogs are being investigated because of their active redox structure and broad pharmacological profile; they demonstrate cytotoxic antitumor activity, making them potential candidates for new drug agents. Objective: This study investigated new benzyl-naphthoquinone compounds as potential anticancer agents for various genotypes of oral squamous cell carcinoma (OSCC) and other cancer cells. Methods: This study reports the synthesis and evaluation of a series of eight benzyl-naphthoquinone compounds against oral squamous cell carcinoma. Results: Four compounds 1–4 showed the best cytotoxic profiles, with a selectivity index ≥ 3 for all OSCC cell lines tested. Compound 1 was the most selective compound in all OSCC models, showing a higher selectivity index than both carboplatin and shikonin. Furthermore, compound 1 induced DNA fragmentation, cell-cycle arrest, and caspase-3/7 activation, changes consistent with apoptosis, and time-lapse imaging corroborated the apoptotic phenotype. Hemolysis assays showed minimal toxicity in human erythrocytes, and acute in vivo evaluation in mice revealed no evident adverse effects under the conditions tested, indicating low acute toxicity, although more detailed histopathological and biochemical studies will be required to fully establish the safety profile. Molecular modeling suggested that compound 1 may interact with topoisomerase II, RSK2, and PKM2, which could contribute to the activation of apoptotic pathways, although these interactions remain predictive and require biochemical validation. Finally, in silico analysis of physicochemical and ADMET parameters indicated properties compatible with oral absorption and systemic exposure, together with predicted low toxicity; however, these results are model-based and should be confirmed experimentally. Conclusions: Based on these findings, compound 1 emerges as a promising lead candidate for the development of a novel chemotherapeutic agent against OSCC, with potential therapeutic efficacy against other cancer types. Full article

The brain’s primary sensory processing areas often present a topographical organization and are distributed following hierarchical architecture, permitting the integration of the information in higher levels of its hierarchy: a process referred to as multisensory integration. A system with such characteristics naturally computes in a parallel and distributed manner and is based in associations between the different symbols built from our perceptions of the environment. In this work, we take inspiration from the sensory processing areas of the brain and propose proof-of-concept of a multi-layered neuromorphic system with parallel and distributed computing capabilities by means of simulation. The proposed neuromorphic architecture is constituted by identical self-organizing modules which are trained with on-line unsupervised-friendly learning rules, such as the spike-timing-dependent plasticity (STDP). These self-organizing modules are constituted by oxide-based resistive random access memory (OxRAM) devices, which play the analog synaptic role. The different modules display a topographical organization according to the input dataset features they have been trained with and are organized following a hierarchical system. The system exhibits conceptual associative behavior between inputs with clustering capabilities, able to classify inputs which have never been seen before by the system, according to their similarity with the ones it has been trained with. Full article

Rational design of high-performance viscosifying polymers is critical for enhancing supercritical CO₂ flooding efficiency in enhanced oil recovery (EOR). Traditional experimental and simulation approaches are limited in exploring the vast design space of polymer architecture, flexibility, and intermolecular interactions. This work presents an integrated machine learning (ML) and mesoscopic simulation framework using Dissipative Particle Dynamics (DPD) to accelerate the development of tailored polymeric thickeners. We systematically investigate synergistic effects of linear and branched polymer blends on solvent viscosity under Poiseuille flow, representative of flow in micro-fractures and pore throats. Key molecular descriptors are varied to generate a comprehensive rheological database. This data trains a deep neural network (DNN) surrogate model linking molecular parameters to macroscopic viscosity. The DNN is coupled with gradient ascent optimization for inverse design, enabling rapid virtual screening of thousands of formulations. A focused case study demonstrates that the star-like architectures with associative cores and semi-flexible backbones outperform linear analogs for supercritical CO₂ viscosity enhancement. The optimal candidate—a four-arm star polymer with linear side chains—was validated by DPD simulation. This multiscale “simulation-to-surrogate” methodology bridges molecular design with continuum-scale flow behavior, offering a transformative tool for formulating cost-effective, efficient, and sustainable next-generation EOR chemicals. Full article

There are four representative commentaries on the Duren jing from the Southern Song and Yuan Dynasties, authored by Qingyuan Zhenren, Xiao Yingsou, Chen Guanwu, and Xue Jizhao. These four commentaries combine both philological interpretation and philosophical interpretation, but each emphasizes one over the other. The Qingyuan and Xue focus on philological interpretation, aiming to reveal the original meaning of the text. The former offers detailed and in-depth philological analysis, occasionally integrating ideas on self-cultivation; the latter provides concise explanations, avoiding speculation and forced analogies. The Xiao and Chen commentaries, on the other hand, emphasize philosophical interpretation. Though grounded in philology, they primarily use the scripture as a medium to construct and develop the theory of internal alchemy. Xiao’s commentary pioneered a systematic approach to internal alchemy, while Chen’s work inherited and further developed this approach. In terms of interpretive strategy, the Qingyuan and Xue commentaries primarily use Taoist texts to support philological mutual verification, while the Xiao and Chen commentaries widely reference Confucian, Buddhist, and Taoist resources to conduct philosophical mutual verification. The differences in their interpretive approaches essentially originate from the commentators’ distinctly different pre-understandings. Through textual interpretation, they achieved varying degrees of “fusion of horizons” between the text’s original historical horizon and the contemporary horizon of the Song and Yuan Dynasties. The evolution from “explaining the text based on its original meaning” to “elucidating new philosophical ideas through the scripture” not only reflects a shift in Taoism from external ritual practices to internal alchemical cultivation, but also demonstrates the dialectical relationship between objective explanation and creative understanding, and provides significant intellectual resources for the development of contemporary Chinese hermeneutics. Full article

Low-salinity water flooding (LSWF) has been widely investigated as an enhanced oil recovery (EOR) method for carbonate reservoirs; however, the relative contributions of wettability alteration and oil–brine interfacial tension (IFT) reduction remain poorly understood, particularly under strongly oil-wet conditions. This study systematically investigates the physicochemical mechanisms governing oil recovery during hybrid LSWF–surfactant flooding in oil-wet carbonate systems. Oil-wet Indiana limestone cores were used as representative carbonate reservoir rocks. Seawater and its diluted analogs were employed as base brines and combined with anionic and cationic surfactants at varying concentrations. Zeta potential and pH measurements were conducted to characterize electrostatic interactions at the rock–brine and oil–brine interfaces, while dynamic contact angle and pendant-drop IFT measurements were used to quantify wettability evolution and fluid–fluid interactions. Core flooding experiments were subsequently performed to link interfacial phenomena to macroscopic oil recovery behavior. The results demonstrate that brine dilution induces more negative surface charges at both interfaces, promoting double-layer expansion and electrostatic repulsion, which stabilizes the aqueous film and drives wettability alteration toward a water-wet state. The addition of anionic surfactants further amplifies this effect by increasing surface charge negativity, whereas cationic surfactants preferentially adsorb onto the negatively charged rock surface, limiting wettability alteration despite producing greater IFT reduction. Sulfate ions enhance wettability alteration by facilitating divalent cation interactions with adsorbed oil components; however, excessive sulfate concentrations lead to precipitation-induced flow impairment. Core flooding results reveal that diluted seawater combined with an anionic surfactant yields the highest incremental oil recovery. Our findings conclusively demonstrate that wettability alteration—rather than IFT reduction—is the more dominant recovery mechanism in oil-wet carbonate reservoirs under the investigated conditions. These results provide mechanistic guidance for optimized brine and surfactant design in hybrid LSWF–chemical EOR applications. Full article

The preservation of biological control agents in agroecosystems while simultaneously ensuring the use of insecticides with selective chemical profiles is crucial for sustainable pest management. In this study, we aimed to evaluate the selectivity of insecticides used in the management of Phthorimaea (Tuta) absoluta in tomato crops during the adult stage of Trichogramma pretiosum. The selectivity tests were conducted according to the standards of the International Organization for Biological and Integrated Control/West Palearctic Regional Section. The bioassay was used to assess the direct effects of treatments on T. pretiosum adults through tarsal contact. Specifically, 42 chemical and/or biological insecticides commonly applied in tomato cultivation were used to manage P. absoluta. The insecticides identified as selective (Class 1) for adult T. pretiosum under laboratory conditions were recommended for use in integrated pest management (IPM) programs in tomato crops. These included Hayate^®, Agree^®, Dipel^®, Xentari^®, Tarik^®, Bioexos^®, Verpavex^®, Spodovir^®, Verpavex^® + Spodovir^®, Tuta Vir^®, BioBrev^®, Diplomata^®, VirControl C.i^®, and VirControl S.F^®. Insecticides belonging to the following chemical groups were not selective, that is, they were harmful to T. pretiosum adults: avermectins, milbemycins, diacylhydrazines, oxadiazines, semicarbazones, spinosyns, diamides, chlorfenapyr, nereistoxin analogs, pyrethroids, carbamates, butenolides, isoxazoline, azadirachtin, quinolizidine alkaloids, METI, and benzoylureas. Therefore, these insecticides should be used with caution in IPM programs that target P. absoluta in tomato crops. Full article

The Earth’s climate is an open nonlinear system, sustained far from thermodynamic equilibrium by solar radiation and energy and matter exchange among its four major subsystems: atmosphere, ocean, land, and cryosphere. Among these four subsystems, the ocean significantly influences and sustains Earth’s climate over decadal to millennial timescales. Although modern numerical models increasingly capture intricate dynamical details, the fundamental concepts of large-scale ocean variability are less frequently explored. This study revisits ocean circulation through the lens of self-organization theory and synergetics. The key synergetic concepts of mode competition, order parameters, and the slaving principle are interpreted within the framework of general ocean circulation and the Atlantic Meridional Overturning Circulation (AMOC). The Brusselator, a simplified model of a nonlinear dynamical system initially developed in chemical kinetics, serves as a conceptual analog for ocean circulation energy conversion. Despite its high abstraction, this proxy model effectively captures essential bifurcation behaviors, such as Hopf bifurcation transitions and limit-cycle behaviors. This clarifies feedback regulation, instability, and potential regime transitions in the AMOC. The synthesis in this study is intended for an interdisciplinary readership and highlights the broader applicability of synergetic principles to the complex Earth climate system maintained far from equilibrium. Full article

NASA intends to return humans to the Moon, where partial gravity will put them at risk of musculoskeletal deconditioning. Resveratrol (RSV) is a promising nutritional countermeasure that may protect muscle health during disuse; however, its efficacy and mechanism in simulated lunar gravity are unknown. Forty adult male Wistar rats underwent 14 days of normal loading or partial weight-bearing at 20% of normal loading (PWB20). Unloaded animals received daily RSV supplementation with or without an ERα antagonist to test whether ERα was required to mediate RSV benefits. Muscle function was longitudinally assessed, and a Western blot was used to quantify key signaling proteins in the soleus muscle. PWB20 led to a significant reduction in grip strength (−14.2%) associated with marked changes in electrophysiological muscle properties. RSV-supplemented animals performed better throughout the study, but not when Erα was inhibited. RSV supplementation resulted in a greater ERα phosphorylation ratio compared to PWB20 alone (3.5 vs. 1.91). These results suggest that RSV can mitigate muscle deconditioning in a lunar gravity analog and that ERα signaling is required. Full article

Background and Objectives: Low back pain (LBP) represents a major cause of disability worldwide, with a significant impact on quality of life and functional capacity. Standard physiotherapy is widely used for LBP, whereas comparative short-term evidence on balneotherapy and prolotherapy remains limited. This study aimed to compare clinical outcomes across therapeutic approaches in patients with LBP. Materials and Methods: This non-randomized, three-group interventional cohort study included adult patients diagnosed with LBP lasting more than three months and presenting a baseline Visual Analog Scale (VAS) score ≥ 4. 84 patients were allocated to one of three treatment groups: standard physiotherapy (CG) (25 patients), balneotherapy plus physiotherapy (BG) (28 patients), or prolotherapy (PG) (31 patients). Outcome measures included pain intensity, functional disability, lumbar mobility, quality of life, and psychological status. This clinical study has been officially registered on ClinicalTrials.gov under the identifier NCT07399145. Results: Statistical analyses were performed to assess within- and between-group differences over time. At the 4-week follow-up, all three treatment groups showed significant improvements compared to baseline in pain intensity (VAS; p < 0.001 for PG, BG, and CG) and lumbar mobility (Schober test; p < 0.001 for PG, BG, and CG), and functional disability (RMDQ; p < 0.001 for PG, p = 0.027 for BG, and p = 0.016 for CG). Between-group analyses at T1 revealed significant differences for RMDQ, ODI, Schober, and EQ-5D-5L. In contrast, no significant intergroup differences were observed for VAS, PPT-RS, PPT-LS, total PPT, HADS-A, HADS-D, BDI-II, or PHQ-9. Conclusions: All evaluated interventions improved clinical, functional, and psychological outcomes in patients with LBP. Prolotherapy showed a pattern of more consistent improvements, particularly in disability, spinal mobility, and health-related quality of life. These findings should be interpreted cautiously, given the non-randomized design and baseline differences between groups. Further randomized studies with larger samples and longer follow-up are warranted to confirm these results. Full article

Background and Objectives: To evaluate and compare the accuracy (trueness and precision) and scanning speed of three intraoral scanners: Medit i700, Primescan 1, and COXO DL-300P, under standardized clinical conditions, using a digitized high-precision analog impression as the reference. Materials and Methods: A patient requiring fixed prosthetic treatment on natural abutments (2.5, 2.7, 3.5, 3.8) was selected. Ten sequential full-arch scans were performed with each scanner in rotating order. Scanning time was recorded for each full-arch acquisition. Accuracy analysis focused on regions of interest: the upper jaw included abutments with adjacent mucosa, the lower jaw included only abutment surfaces. A VPS impression was taken, poured in type IV stone, and digitized with a high-accuracy desktop scanner to serve as the reference. All datasets were analyzed in Geomagic Control X, and statistics were performed using MedCalc (α = 0.05). Results: Upper Jaw (Abutments and Mucosa): The Medit i700 achieved the highest trueness (100.3 ± 6.6 µm), outperforming Primescan and COXO (p = 0.008). COXO showed the best precision, while Primescan demonstrated the greatest variability (p < 0.0001). Primescan produced the fastest scans (72.5 ± 3.8 s) (p = 0.001). Lower Jaw: (Abutment Surface Only): Medit yielded superior trueness (193.1 ± 63.4 µm) compared with Primescan and COXO (p = 0.005). Precision varied significantly among devices, with COXO presenting the greatest inconsistency (p = 0.0004). Scan times did not differ significantly (p = 0.068). Conclusions: Medit i700 demonstrated the highest trueness, Primescan delivered the fastest scans but variable results, and COXO showed acceptable but inconsistent precision. Full article

This study investigated the effects of mental fatigue induced by social media (SM) use and the Stroop task on decision-making, visual search strategies, and reaction time in elite collegiate handball players (n = 16). Using a randomized, counterbalanced cross-over design, both interventions successfully induced subjective mental fatigue, as confirmed by visual analog scale (VAS) ratings. Decision-making accuracy and reaction time improved following the Stroop task, likely due to compensatory mechanisms described in the regulatory-control model. In the SM condition, no significant impairments were observed in decision-making performance; however, visual reaction time was specifically delayed, while auditory reaction time remained unaffected, suggesting modality-specific effects of SM-induced fatigue. Visual search behaviors remained largely stable, with only marginal alterations observed in non-task-relevant areas following the Stroop task. These findings highlight the cognitive resilience and adaptive control mechanisms of elite athletes in maintaining and, in some cases, enhancing performance under mental fatigue. Future studies should integrate neurophysiological indices and manipulate motivational factors to further clarify these mechanisms across diverse athletic populations. Full article

Background: Laser hair removal (LHR) is a widely used cosmetic procedure; however, misconceptions and anxiety regarding its safety and effectiveness remain common and may influence treatment decisions. Objective: The aim of this study was to assess attitudes, misconceptions, and anxiety related to LHR among adult dermatology clinic attendees in Saudi Arabia and to identify factors associated with LHR-related anxiety and knowledge levels. Methods: A cross-sectional clinic-based survey was conducted among adults in Saudi Arabia between August and December 2025 using a structured Arabic/English questionnaire. Data collected included sociodemographic characteristics, LHR-related anxiety measured on a visual analog scale (VAS), and LHR knowledge. Anxiety was analyzed as both a continuous score and a categorical variable, while knowledge was scored using an 11-item questionnaire. Associations were examined using chi-square tests, and independent predictors were assessed using multinomial logistic regression. Results: A total of 400 participants were included (mean age 24.5 ± 7.9 years; 89.5% female). Overall anxiety was low (mean VAS 2.5 ± 2.9), although 32.2% reported moderate-to-severe anxiety. Adequate knowledge was observed in 39.5% of participants. In adjusted analyses, adequate knowledge was independently associated with lower likelihood of severe anxiety. Female sex and Saudi nationality were strong predictors of higher knowledge levels. Conclusions: In this clinic-based sample, LHR-related anxiety was generally low, although misconceptions persisted in a substantial proportion of participants. Improving patient knowledge through targeted, evidence-based education may help reduce anxiety, support realistic expectations, and promote informed decision-making regarding LHR. Full article

In many cases, the pieces of information at our disposal (messages) come from a recommender source, which can be either an official news system, a large language model or simply a social network. Often, also, these messages are build so as to promote their active spreading, which, on the other hand, has a positive effect on one’s own popularity. However, the content of the message can be false, giving origin to a phenomenon analogous to the spreading of a disease. In principle, there is always the possibility of checking the correctness of the message by “investing” some time, so we can say that this checking has a cost. We develop a simple model based on the mechanism of “risk perception” (propensity to check the falseness of a message) and mutual trustability (affinity), based on the average number of fake messages received and checked. On the other side, the probability of emitting a fake message is inversely proportional to one’s risk perception and the affinity among agents is also exploited by the recommender system. We aim at investigating this process with the goal of deriving methods for identifying the penetration level of fake news from behavioral patterns of users. This model represents an integration of cognitive psychology with computational agent-based modeling. Full article

Environmental scientists are increasingly monitoring therapeutic drugs and their metabolites in water systems, requiring knowledge of human drug metabolism and excretion. Many published studies, however, rely on data from small-scale human metabolism trials, typically involving around six (healthy, young, male) volunteers. Their generalizability to real-world drug users may be limited, potentially biasing environmental monitoring efforts. Here, we leveraged untargeted LC-SWATH/MS pharmacometabolomics data from 283 potential living kidney donors and 688 kidney transplant recipients to characterize the 24 h urinary excretion profiles of two widely used diuretics frequently monitored in wastewater, hydrochlorothiazide and furosemide. Both are expected to be excreted largely unchanged, which our analyses confirmed. For hydrochlorothiazide, however, we also identified (using reference standards) the previously underreported transformation products chlorothiazide and salamide. These findings highlight the relevance and capability of using untargeted metabolomics data from human excreta to provide insights from large, real-world cohorts into which chemicals enter wastewater systems, with both drugs serving as exemplary case studies for analogous analyses of other drugs. In particular, the qualitative information obtained (e.g., accurate mass, retention time, fragment spectra) may inform targeted biomonitoring and highlight cases where consensus-based estimates of excreted drug or metabolite fractions are overestimated. Full article