Search Results (51)

With Generative AI (GenAI) entering medicine, understanding its decision-making under uncertainty is important. It is well known that human subjective risk appetite influences medical decisions. This study investigated whether the risk appetite of GenAI can be evaluated and if established human risk assessment tools are applicable for this purpose in a medical context. Five GenAI systems (ChatGPT 4.5, Gemini 2.0, Qwen 2.5 MAX, DeepSeek-V3, and Perplexity) were evaluated using Rheumatoid Arthritis (RA) clinical scenarios. We employed two methods adapted from human risk assessment: the General Risk Propensity Scale (GRiPS) and the Time Trade-Off (TTO) technique. Queries involving RA cases with varying prognoses and hypothetical treatment choices were posed repeatedly to assess risk profiles and response consistency. All GenAIs consistently identified the same RA cases for the best and worst prognoses. However, the two risk assessment methodologies yielded varied results. The adapted GRiPS showed significant differences in general risk propensity among GenAIs (ChatGPT being the least risk-averse and Qwen/DeepSeek the most), though these differences diminished in specific prognostic contexts. Conversely, the TTO method indicated a strong general risk aversion (unwillingness to trade lifespan for pain relief) across systems yet revealed Perplexity as significantly more risk-tolerant than Gemini. The variability in risk profiles obtained using the GRiPS versus the TTO for the same AI systems raises questions about tool applicability. This discrepancy suggests that these human-centric instruments may not adequately or consistently capture the nuances of risk processing in Artificial Intelligence. The findings imply that current tools might be insufficient, highlighting the need for methodologies specifically tailored for evaluating AI decision-making under medical uncertainty. Full article

Background/Objective: Diagnostic trial restorations play a crucial role in restorative dentistry by allowing clinicians to evaluate aesthetics, function, and phonetics before finalizing definitive restorations. These restorations facilitate communication between patients, clinicians, and dental technicians, ensuring treatment alignment and predictable outcomes. The accuracy of transferring diagnostic trial restorations to the oral cavity is essential to maintain the integrity of the planned design. Various fabrication techniques, including conventional silicone matrices and computer-aided design/computer-aided manufacturing (CAD-CAM)-based methods, have been developed to improve transfer precision. However, there is limited evidence directly comparing their dimensional accuracy. This randomized in vivo study aimed to evaluate and compare the accuracy of four commonly used techniques—condensation silicone, addition PVS silicone, transparent PVS silicone, and CAD-CAM combination matrices—by assessing their linear and volumetric discrepancies. Methods: Twenty patients requiring aesthetic rehabilitation of their anterior maxillary teeth participated. The sequence of matrix usage was determined through randomization. Four techniques for transferring diagnostic trial restorations were evaluated: (1) condensation silicone matrix, (2) addition polyvinyl siloxane (PVS) silicone matrix, (3) transparent PVS silicone matrix, and (4) CAD-CAM combination matrix. Dimensional accuracy was assessed by comparing intraoral scans (IOSs) of the transferred restorations to the original diagnostic wax-up. Linear discrepancies were measured at four buccal landmarks (cervical, medial, lower medial, and incisal), and volumetric deviation was evaluated using reverse engineering alignment software. Results: Significant differences were observed among the groups in both linear and volumetric discrepancies (p < 0.05). The CAD-CAM combination matrix showed superior volumetric accuracy, with minimal deviations from the diagnostic wax-up. The addition PVS silicone matrix demonstrated consistent linear accuracy, particularly at the cervical and medial landmarks. The condensation silicone matrix exhibited moderate performance across both linear and volumetric accuracy. The transparent PVS silicone matrix showed the highest variability, with greater volumetric deviations. Conclusions: The study highlights that the choice of matrix material and technique significantly impacts the dimensional accuracy of diagnostic trial restoration transfers. The CAD-CAM combination matrix and the addition PVS silicone matrix demonstrated superior advantages compared to the other techniques. Clinicians should consider the specific requirements of each case, including accuracy and ease of use, when selecting a transfer technique for aesthetic rehabilitations. Full article

Accurate and reliable land cover data are essential for environmental monitoring, climate research, and sustainable land management. However, the proliferation of multi-source global land cover datasets with long time series poses challenges for selecting the best products for specific applications. Existing assessments often lack systematic comparisons of classification accuracy and time consistency across geographic areas. This study addresses the critical gap in cross-product comparability by systematically comparing five recent global time-series land cover products (GLC_FCS30D, Esri Land Cover, MCD12Q1, ESA CCI, and Dynamic World) against a reference dataset (CGLS-LC100). Through a unified classification system, resolution resampling, and random sampling validation, we assessed their classification accuracy and time-series change accuracy across three transitional regions representing diverse environmental contexts: rapidly urbanizing regions, agriculturally intensive zones, and high-latitude forested areas. The results indicate that while datasets exhibit spatial consistency, significant discrepancies exist in land cover classification, with each dataset demonstrating varying levels of accuracy depending on the environmental context and land cover type. High-resolution products (e.g., GLC_FCS30D, Dynamic World) are optimal for monitoring fragmented landscapes and urban expansion, whereas long-term datasets (e.g., ESA CCI, MCD12Q1) suit climate trend analysis in stable ecosystems. Based on the evaluation, we provide generalized guidance for dataset selection aligned with land cover types and monitoring objectives, emphasizing the need for region-specific and application-oriented choices. This study highlights challenges in dynamic datasets, including classification system discrepancies, resolution effects, and reference data limitations, and suggests that future advancements should focus on improving classification algorithms, refining sampling methods, and developing assessment systems that incorporate high-precision, real-time validation data. Full article

Background: Lithium disilicate ceramic veneers are considered the gold standard in aesthetic dentistry due to their translucency, strength, and adhesive bonding properties. This clinical case report details the aesthetic rehabilitation of a patient through the use of pressed lithium disilicate veneers, highlighting the treatment workflow, material selection rationale, and the long-term functional and aesthetic outcomes achieved. Methods: A review was conducted to evaluate the long-term success of lithium disilicate. A case study is presented that involves a 32-year-old female patient with anterior tooth discoloration, minor morphological discrepancies, and a desire for smile enhancement. A conservative approach using pressed lithium disilicate was chosen to restore harmony and enhance natural aesthetics. The treatment involved minimally invasive tooth preparation, digital smile design, and adhesive cementation using a total-etch technique with light-cured resin cement. High-resolution intra-oral and extra-oral photographs documented the case, capturing the preoperative, preparation, and final restoration stages. These images highlight shade matching, margin adaptation, and smile transformation after veneering. Results: Postoperative evaluation showed excellent aesthetic outcomes, color integration, and marginal adaptation, with the patient expressing high satisfaction. The veneers exhibited optimal translucency and strength, ensuring long-term durability. A one-year follow-up revealed no debonding, marginal discoloration, or surface degradation, confirming the clinical reliability of lithium disilicate veneers. Conclusions: Lithium disilicate provides predictability, durability, and high aesthetic results, making it an ideal choice for minimally invasive smile enhancement. The use of photographic documentation emphasizes the importance of case planning, precise preparation, and adhesive bonding for successful outcomes. Future research should focus on long-term survival rates and complication prevention to further refine material selection and bonding protocols. Full article

The ANB angle, the cephalometric parameter of choice for assessing the anteroposterior relationship between the maxilla and mandible, is subject to several limitations, prompting the investigation of alternative parameters. Objective: This study aimed to investigate the ABwise measurement as an alternative to the ANB angle for evaluating maxillomandibular relationships in orthodontics, particularly addressing the impact of skeletal discrepancies on conventional methods. Methods: A retrospective analysis was performed on a CBCT dataset of patients attending the University of Milan’s Department of Orthodontics and Maxillofacial Surgery, selected based on high-quality imaging, a full-cranium field of view, and a slice thickness between 150 and 300 μm. Eight craniofacial landmarks were annotated using the 3D Slicer software to calculate the ANB values and the new ABwise measurement. Statistical analyses included Spearman’s correlation (ρ), linear regression, and inter-rater agreement (Cohen’s κ score), with data classified into skeletal Classes I, II, and III based on defined thresholds. Results: 354 CBCT were selected and analyzed (mean age: 18.6 years). ABwise showed a strong correlation with the ANB angle (ρ = 0.805) and new normative ranges for ABwise were established: Class I (−1.4 ± 2.3 mm), Class II (>0.9 mm), and Class III (<−3.7 mm). Moderate agreement was observed between the ABwise and ANB classifications (κ = 0.527). ABwise effectively addressed limitations associated with divergence and vertical discrepancies, providing a more reliable assessment of skeletal sagittal relationships. Conclusions: ABwise presents a viable alternative to the ANB angle for three-dimensional cephalometric analysis, offering improved accuracy and alignment with radioprotection principles by reducing the CBCT field of view needed for its measurement. Further research is required in order to validate these findings across diverse populations and clinical scenarios. Full article

Friend selection is a crucial aspect of social development, particularly during preschool years. This study investigated the role of the liking gap in shaping preschoolers’ friend selection mechanisms through two experiments. In Experiment 1 (N = 120), a liking gap task was used to examine whether preschoolers perceive a discrepancy between how much they like familiar friends and how much they believe those friends like them in return. The results indicated that preschoolers tend to assume that their most liked peers evaluate them less positively than they do in return, whereas they believe their least liked peers evaluate them more favorably than expected. In Experiment 2 (N = 117), a friend selection task was conducted to assess whether the liking gap influences preschoolers’ choices of friends among unfamiliar peers. The findings revealed that while preschoolers prefer to befriend individuals they like or who like them, their decisions also reflect an awareness of how they are perceived by others. These results suggest that by ages 5 to 6, preschoolers develop an emerging sensitivity to social evaluations, which plays a role in their friend selection process. Full article

Standard driving cycles have been the method of choice for testing vehicle performance for decades, both in research and at the regulatory level. These methodologies offer the significant advantage of test reproducibility, allowing for consistent comparisons between vehicles. However, their inability to reflect real-world driving conditions has become increasingly evident. This issue was first exacerbated by the advent of hybrid and plug-in hybrid vehicles, which introduced new complexities in powertrain operation. Legislators attempted to adapt testing procedures to account for electric energy usage in emissions assessments, but these efforts have largely failed to address the technical challenges posed by modern vehicles. As a result, the gap between real-world fuel consumption and type-approval values has continued to grow. The introduction of ADAS technologies has further widened this discrepancy, as standard driving cycles are no longer capable of accurately representing modern vehicle performance. In light of these challenges, this paper critically evaluates the limitations of standard drive cycles and on-road testing procedures, explores how hybrid and connected vehicles further complicate performance assessment, and proposes directions for improving these methodologies. Full article

Background: Retrospective studies are often criticized for their susceptibility to case selection bias compared to prospective studies, which include all patients consecutively and are thus less prone to such limitations. However, the larger sample sizes typical of retrospective studies can sometimes offset this drawback. On behalf of the Fondazione Italiana Linfomi (FIL), a substantial retrospective study involving 946 patients was conducted to examine the use of non-pegylated liposomal anthracycline (Myocet). This was followed by a prospective study, the Prospective Elderly Project, which enrolled 308 patients treated with the same liposomal anthracycline regimen. Methods: The objective of this analysis was to determine whether the patient cohort from the retrospective study significantly differed from the cohort in the prospective study. Statistical hypothesis testing was applied to assess whether the samples from both studies originated from the same underlying population. The Anderson–Darling test, a non-parametric statistical method, was utilized to evaluate and compare the overall survival distributions between the two patient cohorts. Results: The statistical tests produced conflicting results, suggesting a potential selection bias in the retrospective study or the possibility that the two groups were from the same population. These discrepancies may have arisen due to the choice of statistical methods or the quality of the data analyzed. Conclusions: This study highlights the challenges of comparing retrospective and prospective cohorts and underscores the importance of selecting appropriate statistical methodologies. The findings provide valuable insights and lay the groundwork for developing innovative approaches to improve such comparisons in future research. Full article

Introduction: Vascular access device (VAD)-associated infections, including catheter-related (CRBSI) and catheter-associated bloodstream infections (CABSI), present significant challenges in patient care. While multidisciplinary VAD teams (VATs) are equipped with protocols for managing these infections, adherence to these guidelines in real-life practice is inconsistent. This study aims to evaluate the alignment between actual VAD infection management practices and VAT-recommended protocols. Methods: We conducted a retrospective, single-center study at Luigi Sacco Hospital (May 2021–October 2023) involving non-ICU adult patients with diagnosed CRBSI or CABSI. VAT experts independently reviewed infection management choices, which were divided into eight specific procedural options. These options included variations in VAD removal, timing of repositioning, and combinations of antimicrobial lock therapy and systemic therapy. Concordance between real-life practices and VAT recommendations was evaluated using Cohen’s kappa coefficient. Results: Of 2419 VAD placements, 146 (6%) developed infections (84 CABSI, 62 CRBSI). Clinicians removed VADs in 66.4% of cases compared to 62.3% per VAT recommendations, with moderate overall agreement (Cohen’s kappa = 0.58). Analysis of the eight management categories revealed moderate to low alignment (unweighted kappa = 0.44, weighted kappa = 0.30) between real-life practices and VAT guidance, with slightly improved concordance in CRBSI cases. Conclusions: Our findings underscore a discrepancy between real-life VAD infection management and VAT-recommended protocols, suggesting a need for clearer, more accessible guidelines and increased multidisciplinary collaboration. Enhanced VAT consultation and simplified protocol dissemination may improve consistency in infection management and ultimately lead to better patient outcomes. Full article

Microarray and Single-Molecule Molecular Inversion Probe (smMIP)-based targeted RNA sequencing are two RNA profiling platforms for identifying disease-associated biomarkers. The microarray uses a GeneChip array with oligonucleotide probes to measure expression levels across thousands of genes, while smMIPs capture and quantify RNA transcripts and transcript variants via next-generation sequencing. To evaluate the strengths and weaknesses of both platforms, a comparative gene expression profiling study was conducted using RNA samples from 52 prostate tissues (normal, benign prostatic hyperplasia (BPH) and various prostate cancer (PCa) grades). Of all genes covered by both platforms, only 35% of the expression levels aligned, with 45% showing discrepancies. Both platforms identified the same 17 genes as potential PCa biomarkers. Microarray analysis identified an additional 253 genes that were not covered or not identified by smMIP technology, while smMIP technology identified eight markers not covered or not identified in the microarray core gene analysis, including fusion genes and splice variants. For high-grade prostate cancer (HG-PCa), the smMIP-method identified 8 markers, and the microarray identified 17 markers, with FOLH1, FAP and CLDN3 being common across both platforms. The choice of RNA expression analysis technology depends on research objectives; microarray technology is useful for the evaluation of a wide range of genes but has low throughput. In contrast, smMIP-based RNA sequencing enables sensitive analysis with minimal RNA in a medium- to high-throughput setting. Full article

Excessive nitrate loading from agricultural runoff leads to substantial environmental and economic harm, and although hydrological models are used to mitigate these effects, the influence of various satellite precipitation products (SPPs) on nitrate load simulations is often overlooked. This study addresses this research gap by evaluating the impacts of using different satellite precipitation products—ERA5, IMERG, and gridMET—on flow and nitrate load simulations with the Soil and Water Assessment Tool Plus (SWAT+), using the Tar-Pamlico watershed as a case study. Although agricultural activities are higher in the summer, this study found the lowest nitrate load during this season due to reduced runoff. In contrast, the nitrate load was higher in the winter because of increased runoff, highlighting the dominance of water flow in driving riverine nitrate load. This study found that although IMERG predicts the highest annual average flow (120 m³/s in Pamlico Sound), it unexpectedly results in the lowest annual average nitrate load (1750 metric tons/year). In contrast, gridMET estimates significantly higher annual average nitrate loads (3850 metric tons/year). This discrepancy underscores the crucial impact of rainfall datasets on nitrate transport predictions and highlights how the choice of dataset can significantly influence nitrate load simulations. Full article

African Swine Fever (ASF) is an infectious disease affecting pigs and wild boars, causing significant economic losses. Epidemiological surveillance plays an important role in minimizing its impact. The aim of this study was to evaluate the usefulness of β-actin DNA and mitochondrial DNA (mtDNA) levels in determining the age of animal remains from the Suidae family, which could be helpful in epidemiological investigations. The study included selected tissues and internal organs of Sus scrofa domesticus, exposed to natural environmental conditions or kept in stable 4 °C conditions, to assess the levels of β-actin and mtDNA over a period of 18 months. The levels of both tested parameters exhibited the expected decreasing trend over time. However, in most tissues, some discrepancies from this general pattern were observed. The results obtained for bone marrow showed a consistent downward trend and a strong correlation between mtDNA and β-actin, with long-term detectability (up to the 13th month of the study). Therefore, bone marrow could be considered a matrix of choice for age assessment. However, due to various influencing factors, further studies are required. Full article

In traffic engineering, vehicle speed is a critical determinant of both the risk and severity of road crashes, a fact that holds particularly important for signalized intersections. Accurately selecting vehicle speeds is crucial not only for minimizing accident risks but also for ensuring the proper calculation of intergreen times, which directly influences the efficiency and safety of traffic flow. Traditionally, the design of signal programs relies on fixed speed parameters, such as the posted speed limit or the operational speed, typically represented by the 85th percentile speed from speed distribution data. Furthermore, many design guidelines allow for the selection of these critical speed values based on the designer’s own experience. However, such practices may lead to discrepancies in intergreen time calculations, potentially compromising safety and efficiency at intersections. Our research underscores the substantial variability in the speeds of passenger vehicles traveling intersections under free-flow conditions. This study encompassed numerous intersections with the highest number of accidents, using unmanned aerial vehicles to conduct surveys in three Polish cities: Toruń, Bydgoszcz, and Warsaw. The captured video footage of vehicle movements at predetermined measurement sections was analyzed to find appropriate speeds for various travel maneuvers through these sections, encompassing straight-through, left-turn, and right-turn relations. Our analysis focused on how specific infrastructure-related factors influence driver behavior. The following were evaluated: intersection type, traffic organization, approach lane width, number of lanes, longitudinal road gradient, trams or pedestrian or bicycle crossing presence, and even roadside obstacles such as buildings, barriers or trees, and others. The results reveal that these factors significantly affect drivers’ speed choices, particularly in turning maneuvers. Furthermore, it was observed that the average speeds chosen by drivers at signalized intersections did not reach the permissible speed limit of 50 km/h as established in typical Polish urban areas. A key outcome of our analysis is the recommendation for a more precise speed model that contributes to the design of signal programs, enhancing road safety, and aligning with sustainable transport development policies. Based on our statistical analyses, we propose adopting a more sophisticated model to determine actual vehicle speeds more accurately. It was proved that, using the developed model, the results of calculating the intergreen times are statistically significantly higher. This recommendation is particularly pertinent to the design of signal programs. Furthermore, by improving speed accuracy values in intergreen calculation models with a clear impact on increasing road safety, we anticipate reductions in operational costs for the transportation system, which will contribute to both economic and environmental goals. Full article

The precision of the luting protocol plays a crucial role in the success and survival rate of porcelain laminate veneers (PLVs). This in vitro study aimed to evaluate the influence of different luting techniques on the positioning of PLVs through a novel, noninvasive, scanning-based technique. A total of 45 ceramic PLVs were milled and cemented on human tooth replicas. Specimens were divided into three groups of 15, each subjected to a different luting protocol: flowable composite (Group A), dual-cure resin cement (Group B), and preheated composite resin (Group C). After luting procedures, specimens were scanned, and every STL file was superimposed with the original tooth design in Geomagic Control X version 2022.1 software to assess linear (incisal, mid, cervical) and angular discrepancies. Statistical analysis was performed using one-way ANOVA, Tukey’s HSD tests, and regression analysis. ANOVA results showed no statistically significant differences for incisal (F = 0.327, p = 0.723), mid (F = 0.287, p = 0.752), cervical (F = 0.191, p = 0.827), and angular (F = 0.026, p = 0.975) measurements. Tukey’s HSD post hoc tests confirmed the lack of significant pairwise differences between groups. The study demonstrated that the type of luting agent used does not significantly impact the final position of PLVs. This suggests flexibility in the choice of luting agents without compromising the accuracy of PLV placement. Full article

Background: Antiphospholipid antibody (aPL) testing is critical for the classification of antiphospholipid syndrome. The 2023 ACR/EULAR classification criteria recommend the use of enzyme-linked immunosorbent assays (ELISAs) and specific thresholds for aPL positivity. Since non-ELISA methods are increasingly used, we compared and evaluated ELISA and non-ELISA aPL assays in a real-world maximum care hospital setting. Methods: Between January 2021 and June 2024, anticardiolipin (aCL; IgG and IgM) and anti-beta2 glycoprotein I (aß2GPI; IgG and IgM) antibodies were measured using ELISA (n = 5115) and a chemiluminescence-based automated immunoassay (CLIA) (n = 3820). Results of parallel testing were compared, and associations with clinical and laboratory characteristics were evaluated. Results: A total of 946 samples were tested using ELISA and CLIA in parallel. A total of 136 (14%) specimens were positive for at least one aPL, and 55 (6%) specimens were from patients diagnosed with APS. Among the latter, 47 (85%) and 41 (75%) patients were positive when ELISA- or CLIA-based aPL assays were used, respectively. After applying the >40 units threshold of the new classification criteria, the number of aPL-positive specimens was significantly lower. In the entire cohort, the agreement between ELISA and CLIA aPL assays was acceptable only for aß2GPI IgG; the results from the two methods did not agree for aCL IgG/IgM and aß2GPI IgM. In APS patients, the agreement between ELISA and CLIA aPL assays was acceptable for aß2GPI IgG and IgM but poor for aCL IgG and IgM. Antibody levels in APS patients were significantly higher using CLIA compared to ELISA. Conclusions: The method-dependent discrepancies between ELISA- and CLIA-based aPL assays regarding the quantitative and qualitative results are substantial. Both methods are suitable for APS classification, but the choice of aPL assay may influence the classification, and therefore, aPL results should be interpreted carefully in the clinical context. Full article