Search Results (1,114)

Background/Objectives: Complex endodontic lesions characterized by significant periapical bone loss, diverse anatomical variations in the root canal system and apical resorption represent a major therapeutic challenge. Biodentine, a calcium silicate-based bioactive dental restorative material, has gained considerable attention because of its potential to promote and sustain the regeneration of bone tissue. This review aims to evaluate current evidence on Biodentine’s regenerative abilities in treatments of diverse endodontic pathology and highlight the clinical and radiographic outcomes. Material and Methods: A systematic review was conducted in accordance with PRISMA guidelines by searching for articles in three electronic databases: Medline (PubMed), Scopus, and Cochrane Library. Studies describing the application of Biodentine in cases of complex endodontic pathology with destruction of apical bone and apical resorption of roots were considered for inclusion in the study. Quality assessment was carried out using the Cochrane risk of bias assessment tool RoB 2.0. Results: The included clinical and radiographic studies demonstrated positive treatment outcomes after using Biodentine in difficult endodontic lesions, including a reduction in lesion size, improvement in symptoms and progression of periapical bone regeneration after 12 months of follow-up. No significant adverse outcomes were reported in the studies included. Conclusions: Biodentine proved to be an efficient biocompatible material in terms of managing complex endodontic lesions. Due to its bioactive properties and high efficiency as an apical plug, Biodentine is capable of inducing bone regeneration within the affected periapical area. Full article

Background: HER2 status guides targeted therapy in breast cancer but is currently determined by invasive biopsy. Imaging-based HER2 prediction from dynamic contrast-enhanced MRI (DCE-MRI) could provide a non-invasive adjunct decision-support signal, but published models are typically single-center with heterogeneous preprocessing that limits reproducibility. Methods: We trained a Triple-Head Dual-Attention ResNet (THDA-ResNet) that processes three DCE phases (pre-contrast, early post-contrast, and late post-contrast) on the multicenter BreastDCEDL dataset (n = 1149, I-SPY trials), and we compared it with Vision Transformer (ViT) and Convolutional Vision Transformer (CvT) baselines, all ImageNet-pretrained. We benchmarked 14 preprocessing strategies, with and without N4 bias-field correction. External validation used the independent BreastDCEDL_AMBL cohort (43 lesions). AUC confidence intervals used stratified bootstrap; model comparisons used DeLong’s test. Results: THDA-ResNet achieved the highest AUC, 0.74 (95% CI 0.65–0.83), versus 0.66 for ViT and 0.63 for CvT, with the advantage reaching borderline significance over CvT ($p=0.054$) and not significant over ViT ($p=0.14$). At a threshold of 0.7, it retained discrimination (sensitivity 0.41, specificity 0.86), while transformers collapsed to near-trivial classifiers. External AUC was 0.66 (0.49–0.81). N4 correction did not improve performance. Conclusions: Attention-driven CNNs are a strong default for HER2 prediction from DCE-MRI on medium-sized cohorts, and N4 correction can be omitted, simplifying the pipeline. Full article

Pure inertial dead reckoning during short GNSS outages causes rapid drift on low-cost MEMS GNSS/IMU platforms. Most learning-based compensators upgrade a single predictor and rarely address late-outage drift or cross-domain bias mismatch. This paper proposes two enhancements over a Transformer baseline (TF-Base) plus a lightweight inference-time fusion strategy. MGTR (Motion-Guided Transformer with Tail-aware Readout) adds residual motion gating and a tail-aware readout for hard-segment and late-outage response. TAMS (Temporal Attention Multi-Scale) replaces global average pooling with learnable temporal attention and a short-window dual head. Delayed-Switch selects among TF-Base, MGTR, and TAMS without retraining backbones; its classifier needs a one-pass target-domain calibration, so it is not zero-shot. On real 5 Hz GNSS/IMU recordings under a three-tier protocol, where dead reckoning yields a 40.02 m mean RMSE on cross-domain segments, MGTR cuts the 90th-percentile 2D-RMSE by 20.3% over TF-Base, and Delayed-Switch reaches 30.32 m mean RMSE (24.2% below dead reckoning, 9.5% below TF-Base), within 0.51 m of the better-of-two upper bound. Against two recent baselines under the same protocol, only the AT-LSTM gain is significant after multiple-comparison correction; the margins over the strongest predictors are numerically favorable but not significant at this sample size, with gains concentrated on a few hard segments. Full article

At 1 km resolution, NDVI projections for heterogeneous landscapes can appear spatially coherent in aggregate while concealing substantial class-level prediction weaknesses, a limitation that has received limited systematic attention in the NDVI projection literature. This study applies a four-component assessment workflow to Northeast China (NEC) for 2040 under SSP1-2.6, SSP2-4.5, and SSP5-8.5, integrating multi-stage model selection, land-cover-stratified validation, quantile-regression-based uncertainty characterization, and validation-priority ranking. Among three candidate tree-based models evaluated using spatial block cross-validation, temporal holdout validation, long-jump extrapolation, and climatic perturbation tests, LightGBM showed the most balanced and consistent performance, with spatial CV R² = 0.654 ± 0.123, temporal holdout R² = 0.710, and long-jump R² = 0.671, and was therefore selected for the 2040 projection. Projected regional mean NDVI increased modestly from 0.393 in 2020 to 0.414–0.417 across scenarios, with limited divergence among SSP pathways at this near-term horizon. Class-stratified validation of the 2020 holdout prediction revealed that global model performance masked strong class-level heterogeneity, with R² values ranging from 0.576 for Construction land to −0.886 for Unused land. Water bodies and Unused land exhibited negative R² values, indicating weak class-level predictive support relative to a simple class-mean benchmark. Residual decomposition showed that Water bodies combined high random error with elevated systematic deviation, whereas Unused land was mainly characterized by systematic bias, suggesting different needs for class-specific model improvement. The Uncertainty Risk Index (URI), derived from 95% prediction intervals, was highest in Construction land and lowest in Cropland across all scenarios. Integrating historical residuals with future URI-identified Water bodies, Unused land, and Construction land as the highest-priority classes for future targeted validation. These priorities arise from both limited class representation and intrinsic NDVI-related complexity, including low vegetation signal, mixed-pixel effects, and heterogeneous land-surface composition. These results demonstrate that land-cover-stratified error decomposition and uncertainty-informed priority ranking reveal class-specific projection limitations that aggregate accuracy metrics can conceal. Full article

Background/Objectives: Developmental Language Disorder (DLD) is a persistent neurodevelopmental condition with an estimated prevalence of 7% in preschoolers. It is characterized by significant impairments in language acquisition and use, in the absence of an identified biomedical cause. The potential link between DLD and central auditory processing has encouraged the investigation of auditory evoked potentials as research tools; however, the existing literature remains notably dispersed and heterogeneous. To systematically synthesize evidence concerning auditory electrophysiological findings in children with DLD. Methods: Systematic searches were conducted in PubMed, Web of Science, and Scopus for studies published between January 2016 and March 2026. Keywords were combined using AND/OR operators. Two independent reviewers performed screening and data extraction, with discrepancies resolved through consensus. Risk of bias was assessed using the JBI tool for analytical cross-sectional studies. A structured narrative synthesis (SWiM) was applied to the findings. Results: Seven studies were included, with a combined total of 480 participants across all enrolled samples (including DLD, control, and other clinical subgroups), aged 2 years and 11 months to 10 years. The Frequency Following Response (FFR) appeared to show greater sensitivity, with alterations in both temporal components (waves C and D) and spectral components (F0 and F2), particularly under noise conditions. Findings for click-ABR were inconsistent across studies, suggesting limited sensitivity in cases of isolated DLD. Long-latency auditory evoked potentials (N2 and P300) exhibited prolonged latencies, potentially reflecting cortical immaturity and impaired attentional discrimination. The N400 potential suggested delayed or atypical semantic processing in a single investigation. Conclusions: The available evidence points toward a pattern of impairment in individuals with DLD that requires cautious interpretation, potentially encompassing subcortical, cortical, and linguistic encoding. Methodological heterogeneity across studies, combined with the absence of adolescent samples, highlights significant gaps in the current research regarding electrophysiology and DLD. FFR and Long-Latency Auditory Evoked Potentials (LLAEP/P300) assessments may warrant further investigation as auxiliary electrophysiological measures for the characterization of DLD, pending replication in larger and more homogeneous samples. Full article

Per capita household expenditure is widely used to assess realized welfare. However, its variation may reflect not only income differences but also household scale, demographic composition, health-related burdens, and social disadvantage. This study examines the conditional correlates of per capita household expenditure in Binh Dinh Province, Vietnam, with particular attention to household size, demographic composition, illness burden, and ethnic-minority status. Using cross-sectional survey data from 320 households collected in 2025, this study estimates a log-linear ordinary least squares (OLS) model and applies bias-corrected and accelerated (BCa) bootstrap inference based on 2000 replications. The results show a strong but less-than-proportional expenditure–income association, with an estimated income elasticity of 0.687. Household size is nonlinearly associated with expenditure, indicating scale advantages at smaller household sizes and resource dilution beyond a threshold. A higher child share and the presence of severe or chronic illness are positively associated with expenditure, whereas elderly and female shares are not statistically significant. Ethnic-minority status remains negatively associated with expenditure after controlling for income, household composition, illness burden, and locational characteristics. These findings show that per capita household expenditure in a developing provincial economy is jointly related to income, household scale, demographic needs, health-related financial pressure, and social vulnerability. Full article

This systematic review investigated the direct association between biomarkers and cognitive performance in adult athletes exposed to repetitive head impacts. Searches in the APA PsycNet, PubMed, Google Scholar, CAPES, and BVSalud databases (11 April 2026) evaluated adult athletes (≥18 years) who used standardized neuropsychological tests and analyzed the association between biomarkers and cognition. Two reviewers performed selection, data extraction, and risk-of-bias assessment. Certainty of evidence was assessed using an adapted GRADE framework. A total of 10,480 records were identified. After removal of 697 duplicate records, they underwent screening and eligibility assessment, resulting in the inclusion of 10 studies. They showed low risk of bias, but sample imprecision reduced the certainty of evidence in 50% of cases. The cognitive domains assessed were memory, attention, processing speed, reaction time, and executive functions. Axonal biomarkers (70% of studies), inflammatory (40%), and synaptic biomarkers (10%). Eighty percent of the studies found a relationship between biological alterations and cognition. The most promising biomarkers associated with cognitive deficits are NfL and GFAP, but due to high methodological heterogeneity, imprecision of estimates (GRADE), and biases, the conclusions are provisional. Caution is recommended in clinical application until prospective studies with larger samples and active control groups confirm the findings. Full article

Background/Objectives: Borderline personality disorder (BPD) is a severe mental disorder characterised by emotion dysregulation, impulsivity and interpersonal hypersensitivity. Its prevalence ranges from 0.5% to 6.4%. Eye tracking and pupillometry provide objective indices of social attention and inhibitory control, but the BPD literature using these techniques has not been systematically reviewed. The aim of this work was to synthesise the empirical evidence on visuo-attentional and pupillary alterations in BPD. Methods: Following the PRISMA 2020 statement, Web of Science, Scopus and PubMed were searched up to 13 March 2026, with no date or language restrictions. Search terms combined borderline personality disorder and eye-tracking constructs. Two reviewers independently screened records with complete inter-rater agreement at the title-and-abstract stage (Cohen’s κ = 1.00); two generative artificial-intelligence assistants (ChatGPT, NotebookLM) were additionally consulted as a non-systematic plausibility check and returned no eligible studies beyond the database search. Risk of bias was appraised with the framework appropriate to each study design (RoB 2 for randomised trials and Newcastle–Ottawa Scale logic for observational studies, with ROBINS-I held in reserve for non-randomised intervention designs). Results: Seventeen studies met the inclusion criteria, with sample sizes ranging from 19 to 164 participants and predominantly adult female samples. Designs included antisaccade and oculomotor tasks, free-viewing, dot-probe, affective priming and pharmacological challenge. Four findings recurred across studies. First, patients with BPD showed an early reflexive vigilance to the eye region of emotional and neutral faces, followed by reduced time on positive stimuli during longer presentations. Second, self-reported impulsivity was elevated, but laboratory inhibition was largely preserved; the deficits that did emerge were limited to preparatory control and were greater in patients with comorbid ADHD or under induced negative affect. Third, autonomic dysregulation was indexed by lower heart-rate variability and a larger baseline pupil size; in a single longitudinal study, pupillary reactivity was prospectively associated with subsequent symptom change. Finally, intranasal oxytocin reduced amygdala-driven vigilance. Conclusions: Eye-tracking and pupillometric measures appear to capture meaningful aspects of the BPD clinical picture. The two-stage profile of early vigilance followed by reduced sustained engagement is most parsimoniously described as a vigilance–avoidance pattern, which is compatible with, but not uniquely explained by, the hypersensitivity hypothesis of emotion dysregulation. Because thirteen of the seventeen studies recruited women only, these conclusions apply primarily to adult women with BPD. Methodological heterogeneity, the predominance of female samples and the scarcity of longitudinal data justify the need for standardised protocols, transdiagnostic comparisons and the inclusion of male and gender-diverse populations in future research. Full article

Background/Objectives: Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) present high levels of stress. This population may benefit from Mindfulness-based interventions (MBI) to reduce their stress. This systematic review assesses current literature about the efficacy of MBI for managing stress and stress-related outcomes among those parents. Methods: Studies published up to September 2025 were systematically searched in PubMed, Cochrane Library, Web of Science, and Scopus, and complemented with citation tracking. Both randomized and non-randomized studies were included, provided they quantitatively evaluated parenting stress. Bias assessment was performed using Cochrane ROB-2 and ROBINS-I tools and GRADE analysis was performed. A qualitative synthesis is presented due to the substantial heterogeneity among studies. Results: Nineteen studies including nine Randomized Control Trials (RCTs) and ten non-RCTs met the inclusion criteria. Eight studies used an MBI for parents only, ten studies had a parallel intervention for the child/adolescent, and one study used an MBI for parents and teachers. Overall, the studies showed statistically significant stress reduction, either immediately after the end of the MBI (five RCTs and three non-RCTs) and mostly maintained at follow-up or presenting a delayed therapeutic effect which was only evident at the follow-up analysis (one RCT and four non-RCTs). However, some studies reported only mixed findings or no significant differences (three RCTs and two non-RCTs), and one non-RCT reported worsening of stress. Stress-related outcomes varied among different studies. Conclusions: MBI may have a significant role in reducing the stress of parents of children with ADHD and may improve stress-related outcomes, such as quality of life, psychological well-being, and parenting over-reactivity. Further studies with longer follow-up periods and lower risk of bias are necessary to clarify possible effects of MBI in stress reduction in parents with ADHD. Full article

Background/Objectives: Severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP) frequently coexist and are associated with type 2 inflammation, leading to poor symptom control and high healthcare burden. Biologic therapies targeting IL-4Rα and IL-5/IL-5R have shown efficacy in type 2 inflammatory asthma and CRSwNP, but comprehensive evidence on their efficacy, safety, and research trends is limited. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating dupilumab, mepolizumab, benralizumab, or reslizumab in patients with type 2 inflammatory asthma and/or CRSwNP. Primary outcomes included lung function (FEV1), symptom control (ACQ, SNOT-22, nasal polyp score), and serious adverse events (SAEs). Risk of bias was assessed using the Cochrane RoB 2.0 tool. Publication bias was evaluated with funnel plots and Trim-and-Fill analysis. Bibliometric analysis was performed to identify publication trends and emerging research directions. Results: A total of 23 RCTs involving 8758 participants were included. Biologic therapy was not associated with a significant increase in serious adverse events (RR = 1.15, 95% CI: 0.89–1.50). Compared with control treatment, biologics significantly improved FEV1 (MD = 100.67 mL, 95% CI: 65.94–135.40) and ACQ scores (MD = −0.40, 95% CI: −0.54 to −0.25). In patients with CRSwNP and comorbid asthma, biologics also improved SNOT-22 scores (MD = −13.16, 95% CI: −24.85 to −1.47) and nasal polyp scores (MD = −1.31, 95% CI: −1.95 to −0.68). Dupilumab trials showed larger reductions in nasal polyp score than IL-5/IL-5R-targeted trials, although this indirect comparison should be interpreted cautiously. Bibliometric analysis indicated increasing research attention to upstream epithelial targets such as TSLP. Conclusions: Both IL-4Rα and IL-5/IL-5R-targeted biologics are effective and well-tolerated in type 2 inflammatory airway diseases. IL-4Rα inhibition shows favorable upper-airway outcomes in CRSwNP with asthma, but head-to-head trials are needed to clarify its comparative efficacy relative to IL-5/IL-5R-targeted therapies. Emerging research directions are shifting toward upstream epithelial alarmin antibodies. Full article

Implicit bias, automatic attitudes or stereotypes outside conscious awareness, may influence clinicians’ communication, diagnosis, and treatment decisions, contributing to inequities in care. We conducted a scoping review to map measurement strategies used to assess implicit bias among health professionals and students in healthcare and training settings. Using Joanna Briggs Institute guidance and PRISMA-ScR, we searched PubMed, Embase, BVS, Google Scholar, and institutional repositories for studies to November 2025; two reviewers independently screened and charted data (protocol was developed a priori but submitted internal in organization, and then uploaded in OSF. Of 1864 records, 93 studies from 28 countries were included. We identified 57 bias domains, most often race/ethnicity, weight, and sexual orientation. Across studies, 42 unique instruments were reported; the Implicit Association Test was most common, while psychometric validation and administration details were frequently limited, constraining comparability and interpretation. Evidence gap mapping showed concentration in academic and hospital settings, with fewer studies in primary care or community contexts and limited attention to age, disability, and intersectionality-related biases. The evidence base is growing but fragmented; future work should prioritize standardized administration and reporting, stronger validation, and tools that better capture automatic responding across diverse identities and care settings to support education and equity-oriented interventions. Full article

Background: Contraceptive counseling is a critical component of reproductive healthcare, directly influencing method uptake, continuation, and user satisfaction. While global health guidelines increasingly emphasize person-centered, rights-based approaches to counseling, wide variations in practice persist, with significant implications for equity and autonomy. Objective: This narrative review aims to synthesize current evidence on the strengths, limitations, and future opportunities of contraceptive counseling within person-centered care frameworks, with particular attention to adolescents and other populations facing structural or sociocultural barriers to equitable care. Methods: A comprehensive literature search was conducted across six indexed databases (PubMed, Scopus, Embase, Web of Science, CINAHL, and PsycINFO) for peer-reviewed articles published between January 2010 and April 2025. Eligible studies included original quantitative, qualitative, and mixed-methods research examining contraceptive counseling practices, user experiences, provider–client communication, counseling interventions, or implementation strategies in reproductive healthcare settings. Results: Emerging strengths in the field include the increasing adoption of shared decision-making, motivational interviewing, and culturally tailored counseling approaches, all of which contribute to improved client satisfaction and method adherence. Digital tools and mHealth platforms have expanded the reach of counseling and show promise in supplementing in-person care. However, significant gaps remain. Provider bias, limited training, communication barriers, and a lack of socio-cultural tailoring frequently undermine the quality of care, especially for adolescents, migrants, women with disabilities, and socially vulnerable populations. Ethical challenges—such as coercion, inadequate informed consent, and structural inequities—persist in many healthcare settings. Moreover, contraceptive counseling is often treated as a one-time event rather than an ongoing, adaptive process. Conclusions: To maximize its impact, contraceptive counseling must be reframed as a longitudinal, relational, and ethically grounded practice. Future efforts should prioritize the development of structured training programs, integration into broader health services, and qualitative research that centers patient experiences. Embedding counseling within reproductive justice frameworks will be essential for advancing equity and autonomy. High-quality contraceptive counseling, when informed by evidence and empathy, is a strategic tool for reproductive empowerment and public health advancement. Full article

With increasing urban solid waste generation and the advancement of Zero Waste City initiatives, sanitation-facility siting has become central to urban waste governance but continues to trigger Not-In-My-Backyard (NIMBY) conflicts related to perceived environmental risk, spatial equity, and asset-value concerns. Existing studies often explain NIMBY effects through objective exposure or facility distance, while less attention has been paid to the mismatch between objective risk and residents’ subjective fear and its cost implications. Taking Suzhou, China, as a case study, we develop an integrated framework to assess NIMBY effects associated with current and planned sanitation facilities. An objective risk index is constructed based on facility hazard, exposure, and vulnerability. Resident questionnaires are used to measure subjective fear, and the bias between objective risk and subjective fear is quantified. Probit, hedonic price, and welfare models are then combined to evaluate the effects of this bias on facility support, housing prices, and marginal social welfare losses. The results show that (1) sanitation facilities in Suzhou present clear type differentiation and spatial clustering, with terminal treatment facilities mainly located on the urban periphery, and transfer, sorting, and recovery facilities more embedded in daily living spaces; (2) stronger subjective fear, particularly risk perception, significantly reduces residents’ support for facility expansion, especially under the planned scenario; (3) perception bias is negatively associated with housing prices and generates substantial marginal social welfare losses, especially when the planned expansion of facilities is considered at the system level. This study extends the explanatory framework of environmental NIMBY effects and provides evidence for integrating risk communication, spatial equity compensation, and marginal social welfare loss reduction into Zero Waste City governance. Full article

Background: EEG neurofeedback has been proposed as a non-pharmacological approach to enhance attention and cognitive performance in neurodevelopmental conditions. However, its efficacy in individuals with intellectual disability (ID) remains limited. Methods: We conducted a systematic review of treatment studies evaluating EEG-based neurofeedback targeting attention and executive function outcomes in participants with ID. Searches were performed in Embase, Web of Science, Scopus, PubMed, and the Cochrane Library from inception to 12 March 2026. Two reviewers independently completed screening, eligibility assessment, data extraction, and risk-of-bias appraisal, with disagreements resolved by a third reviewer. Due to heterogeneity in study designs, neurofeedback protocols, participant characteristics, and outcome measures, data were synthesized narratively. Results: Six studies met the inclusion criteria, comprising small randomized or controlled experimental studies, case series, and single-case reports. Several studies suggested improvements in attention-related neuropsychological performance and behavioral or task-based outcomes, and in some cases were accompanied by parallel EEG changes. Nevertheless, the overall body of evidence was constrained by small sample sizes, heterogeneous populations, limited blinding, infrequent sham or active controls, variable follow-up durations, and incomplete effect-size reporting. Conclusions: EEG neurofeedback appears to confer benefits for attention-related outcomes in individuals with ID, but current findings are preliminary and warrant larger, well-controlled trials with standardized protocols and reporting. Full article

Synthetic aperture radar (SAR) object detection has long been affected by spatial speckle interference, spectral energy imbalance, and structural bias in cross-scale feature fusion. In this article, we propose the Multi-Domain Interference-Suppressed Detection Transformer (MDIS-DETR), a unified multi-domain interference-suppressed detection framework built on the Real-Time Detection Transformer (RT-DETR) architecture. Specifically, spatial-domain interference is suppressed by learnable fusion of complementary denoising responses at the input stage. Furthermore, frequency-domain interference is suppressed by polarization-guided attention together with adaptive frequency refinement within the encoder. In addition, structural-domain interference is suppressed by non-sequential cross-scale interaction to enhance multi-scale consistency. Extensive experiments on multiple SAR benchmarks demonstrate that MDIS-DETR establishes state-of-the-art (SOTA) performance across datasets. Notably, on SARDet-100K, currently the largest SAR detection dataset with a scale comparable to the Common Objects in Context (COCO) dataset, it achieves 58.82% mAP, surpassing the RT-DETR baseline by 4.58%. Full article