Search Results (46,248)

Background/Objectives: Growth prediction may be used by the clinical orthodontist in growing individuals for diagnostic purposes and for treatment planning. This process appraises chronological age and determines the degree of skeletal maturity to calculate residual growth. In developmental deviations, overlooking such diagnostic details might culminate in erroneous conclusions, unstable outcomes, recurrence, and treatment failure. The present review aims to systematically present and explain the available means for predicting growth in humans. Traditional, long-known, popular methods are discussed, and modern digital applications are described. Materials and methods: A search on PubMed and the gray literature up to May 2025 produced 69 eligible studies on future maxillofacial growth prediction without any orthodontic intervention. Results: Substantial variability exists in the studies on growth prediction. In young orthodontic patients, the study of the lateral cephalometric radiography and the subsequent calculation of planes and angles remain questionable for diagnosis and treatment planning. Skeletal age assessment is readily accomplished with X-rays of the cervical vertebrae and the hand–wrist region. Computer software is being implemented to improve the reliability of classic methodologies. Metal implants have been used in seminal growth studies. Biochemical methods and electromyography have been suggested for clinical prediction and for research purposes. Conclusions: In young patients, it would be of importance to reach conclusions on future growth with minimal distress to the individual and, also, reduced exposure to ionizing radiation. Nevertheless, the potential for comprehensive prediction is still largely lacking. It could be accomplished in the future by combining established methods with digital technology. Full article

Background: We aimed to analyze radiographic sagittal balance parameters in patients who underwent a TLIF procedure for single-level degenerative spondylolisthesis with a mean follow-up of 8.6 years and to determine whether lumbar lordosis affects long-term clinical outcomes. Methods: This prospective study included 32 patients who underwent single-level TLIF surgery for degenerative spondylolisthesis. Radiographic analysis of sagittal balance parameters and clinical examination including Oswestry Disability Index (ODI) scores were performed preoperatively, postoperatively, and at the last follow-up. A minimal clinically important difference threshold of 30% was accepted as clinically relevant. Results: Mean postoperative lumbar lordosis (LL) and segmental lordosis (SL) failed to improve postoperatively; nevertheless significant improvements in short- and long-term postoperative ODI scores were demonstrated (p < 0.001). Thoracic kyphosis (TK) and global sagittal balance parameters shifted anteriorly after 8.6 years (p < 0.001), but this increase did not affect clinical outcomes. Conclusions: Adequate decompression and solid bone fusion are foremost required to achieve improved long-term clinical outcomes in single-level TLIF procedures. In our studied cohort, failure to improve lordosis did not impair clinical outcomes postoperatively. With aging, thoracic kyphosis and anterior malalignment increase, and after 8.6 years, clinical improvements are starting to become insignificant. Full article

Background: Acute kidney injury (AKI) frequently occurs following major liver resection, adversely affecting both short- and long-term outcomes. This study aimed to determine the incidence of AKI post-hepatectomy and identify relevant pre- and intraoperative risk factors. Our secondary objectives were to develop a predictive score for postoperative AKI and assess the associations between AKI, chronic kidney disease (CKD), and 1-year mortality. Methods: This was a retrospective study in a cancer referral center in Marseille, France, from 2018 to 2022. Results: Among 169 patients, 55 (32.5%) experienced AKI. Multivariate analysis revealed several independent risk factors for postoperative AKI, including age, body mass index, the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, time to liver resection, intraoperative shock, and bile duct reconstruction. Neoadjuvant chemotherapy was protective. The AKIMEBO score was developed, with a threshold of ≥15.6, demonstrating a sensitivity of 89.5%, specificity of 76.4%, positive predictive value of 61.8%, and negative predictive value of 94.4%. AKI was associated with increased postoperative morbidity and one-year mortality following major hepatectomy. Conclusion: AKI is a common complication post-hepatectomy. Factors such as time to liver resection and intraoperative shock management present potential clinical intervention points. The AKIMEBO score can provide a valuable tool for postoperative risk stratification. Full article

Lightweight steel-framing (LSF) systems have become increasingly prominent in modern construction due to their structural efficiency, design flexibility, and sustainability. However, traditional facade materials such as stone are often cost-prohibitive, and brick veneers—despite their popularity—pose seismic performance concerns. This study introduces an innovative porcelain sheathing system for cold-formed steel (CFS) shear walls. Porcelain has no veins thus it offers integrated and reliable strength unlike granite. Four full-scale CFS shear walls incorporating screwed porcelain sheathing (SPS) were tested under combined cyclic lateral and constant gravity loading. The experimental program investigated key seismic characteristics, including lateral stiffness and strength, deformation capacity, failure modes, and energy dissipation, to calculate the system response modification factor (R). The test results showed that configurations with horizontal sheathing, double mid-studs, and three blocking rows improved performance, achieving up to 21.1 kN lateral resistance and 2.5% drift capacity. The average R-factor was 4.2, which exceeds the current design code values (AISI S213: R = 3; AS/NZS 4600: R = 2), suggesting the enhanced seismic resilience of the SPS-CFS system. This study also proposes design improvements to reduce the risk of brittle failure and enhance inelastic behavior. In addition, the results inform discussions on permissible building heights and contribute to the advancement of CFS design codes for seismic regions. Full article

Background/Objectives: Iron deficiency (ID) is a common and prognostically relevant comorbidity in heart failure with reduced ejection fraction (HFrEF). It contributes to reduced functional status, exercise capacity, and survival. Intravenous ferric carboxymaltose (FCM) improves symptoms, but its effect on cardiac structure and function remains incompletely understood. The aim of this study was to assess the impact of intravenous FCM on echocardiographic indices of left ventricular (LV), left atrial (LA), and right ventricular (RV) morphology and function in HFrEF patients with ID and determine whether these changes correlate with improvements in exercise capacity. Methods: This sub-analysis of the RESAFE-HF registry (NCT04974021) included 86 HFrEF patients with ID (median age 71.8 years, 83% male). Transthoracic echocardiography was performed at baseline and 12 months post-FCM. Parameters assessed included LV ejection fraction (LVEF), LV global longitudinal strain (GLS), LV diastolic function grade, LAVi, LA strain, TAPSE, and RV free wall strain (FWS). Peak VO₂ was measured to assess exercise capacity. Results: LVEF improved from 29.3 ± 7.8% to 32.5 ± 10.6% (p < 0.001), LV GLS from −7.89% to −8.62%, and the LV diastolic dysfunction grade improved (p < 0.001). LAVi, peak LA strain, TAPSE, and RV FWS also showed significant improvement. Peak VO₂ increased from 11.3 ± 3.2 to 12.1 ± 4.1 mL/min/kg (p < 0.001). Improvements in LVEF, RV FWS, and LV GLS were independent predictors of VO₂ increase (p < 0.001, p < 0.001, and p = 0.01, respectively), explaining 42% of the variance. Conclusions: FCM therapy improves biventricular and atrial function, with echocardiographic gains correlating with an enhanced exercise capacity in HFrEF patients with ID. Full article

Change point models are widely used in medical and epidemiological studies to capture the threshold effects of continuous covariates on health outcomes. These threshold effects represent critical points at which the relationship between biomarkers or risk factors and disease risk shifts, often reflecting underlying biological mechanisms or clinically relevant intervention points. While most existing methods focus on right-censored data, interval censoring is common in large-scale clinical trials and follow-up studies, where the exact event times are not observed but are known to fall within time intervals. In this paper, we propose a semiparametric transformation model with an unknown change point for interval-censored data. The model allows flexible transformation functions, including the proportional hazards and proportional odds models, and it accommodates both main effects and their interactions with the threshold variable. Model parameters are estimated via the EM algorithm, with the change point identified through a profile likelihood approach using grid search. We establish the asymptotic properties of the proposed estimators and evaluate their finite-sample performance through extensive simulations, showing good accuracy and coverage properties. The method is further illustrated through an application to the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial data. Full article

Background: Senescence, a state of permanent cell cycle arrest, is a complex cellular phenomenon closely affiliated with age-related diseases and pathological fibrosis. Cellular senescence is now recognized as a significant contributor to organ fibrosis, largely driven by transforming growth factor beta (TGF-β) signaling, such as in metabolic dysfunction-associated steatohepatitis (MASH), idiopathic pulmonary fibrosis (IPF), chronic kidney disease (CKD), and myocardial fibrosis, which can lead to heart failure, cystic fibrosis, and fibrosis in pancreatic tumors, to name a few. MASH is a progressive inflammatory and fibrotic liver condition that has reached pandemic proportions, now considered the largest non-viral contributor to the need for liver transplantation. Methods: We previously studied Oxy210, an anti-fibrotic and anti-inflammatory, orally bioavailable, oxysterol-based drug candidate for MASH, using APOE*3-Leiden.CETP mice, a humanized hyperlipidemic mouse model that closely recapitulates the hallmarks of human MASH. In this model, treatment of mice with Oxy210 for 16 weeks caused significant amelioration of the disease, evidenced by reduced hepatic inflammation, lipid deposition, and fibrosis, atherosclerosis and adipose tissue inflammation. Results: Here we demonstrate increased hepatic expression of senescence-associated genes and senescence-associated secretory phenotype (SASP), correlated with the expression of pro-fibrotic and pro-inflammatorygenes in these mice during the development of MASH that are significantly inhibited by Oxy210. Using the HepG2 human hepatocyte cell line, we demonstrate the induced expression of senescent-associated genes and SASP by TGF-β and inhibition by Oxy210. Conclusions: These findings further support the potential therapeutic effects of Oxy210 mediated in part through inhibition of senescence-driven hepatic fibrosis and inflammation in MASH and perhaps in other senescence-associated fibrotic diseases. Full article

Rural roads are critical for connecting isolated communities to essential services such as education and health and administrative services, as well as production and market opportunities in low-income countries. More than 70% of movements of people and goods in Sub-Saharan Africa are heavily reliant on rural transport systems, using both motorised but mainly alternative means of transport. However, rural roads often suffer from poor construction due to the use of low-strength, in situ soils and limited financial resources, leading to premature failures and subsequent traffic disruptions with significant economic losses. This study investigates the use of rice husk ash (RHA), a waste byproduct from rice production, as a sustainable supplement to Ordinary Portland Cement (OPC) for soil stabilisation in order to increase durability and sustainability of rural roads, hence limit recurrent maintenance needs and associated transport costs and challenges. To conduct this study, soil samples collected from Mulungushi, Zambia, were treated with combinations of 6–10% OPC and 10–15% RHA by weight. Laboratory tests measured maximum dry density (MDD), optimum moisture content (OMC), and California Bearing Ratio (CBR) values; the main parameters assessed to ensure the quality of road construction soils. Results showed that while the MDD did not change significantly and varied between 1505 kg/m³ and 1519 kg/m³, the OMC increased hugely from 19.6% to as high as 26.2% after treatment with RHA. The CBR value improved significantly, with the 8% OPC + 10% RHA mixture achieving the highest resistance to deformation. These results suggest that RHA can enhance the durability and sustainability of rural roads and hence improve transport systems and subsequently improve socioeconomic factors in rural areas. Full article

High-mobility group box 1 (HMGB1) is a nuclear protein that can interact with a transmembrane cell surface receptor for advanced glycation end products (RAGEs) and mediates the inflammatory pathways that lead to various pathological conditions like cancer, diabetes, cardiovascular diseases, and neurodegenerative disorders. Blocking the HMGB1/RAGE axis using various small synthetic or natural molecules has been proven to be an effective therapeutic approach to treating these inflammatory conditions. However, the low water solubility of these pharmacoactive molecules limits their clinical use. Pharmaceutically active molecules with low solubility and bioavailability in vivo convey a higher risk of failure for drug development and drug innovation. The pharmacokinetic and pharmacodynamics parameters of these compounds are majorly affected by their solubility. Enhancement of the bioavailability and solubility of drugs is a significant challenge in the area of pharmaceutical formulations. This review mainly describes various technologies utilized to improve the bioavailability of synthetic or natural molecules which have been particularly used in various inflammatory conditions acting specifically through the HMGB1/RAGE pathway. Full article

Variations in damper configuration strategies have a direct impact on the seismic damage patterns of long-span deck-type concrete-filled steel tube (CFST) arch bridges. This study developed an analysis and evaluation framework to identify the damage category, state, and progression sequence of structural components. The framework aims to investigate the influence of viscous dampers on the seismic response and damage patterns of long-span deck-type CFST arch bridges under near-fault pulse-like ground motions. The effects of different viscous damper configuration strategies and design parameters on seismic responses of long-span deck-type CFST arch bridges were systematically investigated, and the preferred configuration and parameter set were identified. The influence of preferred viscous damper configurations on seismic damage patterns of long-span deck-type CFST arch bridges was systematically analyzed through the established analysis and evaluation frameworks. The results indicate that a relatively optimal reduction in bridge response can be achieved when viscous dampers are simultaneously installed at both the abutments and the approach piers. Minimum seismic responses were attained at a damping exponent α = 0.2 and damping coefficient C = 6000 kN/(m/s), demonstrating stability in mitigating vibration effects on arch rings and bearings. In the absence of damper implementation, the lower chord arch foot section is most likely to experience in-plane bending failure. The piers, influenced by the coupling effect between the spandrel construction and the main arch ring, are more susceptible to damage as their height decreases. Additionally, the end bearings are more prone to failure compared to the central-span bearings. Implementation of the preferred damper configuration strategy maintains essentially consistent sequences in seismic-induced damage patterns of the bridge, but the peak ground motion intensity causing damage to the main arch and spandrel structure is significantly increased. This strategy enhances the damage-initiation peak ground acceleration (PGA) for critical sections of the main arch, while concurrently reducing transverse and longitudinal bending moments in pier column sections. The proposed integrated analysis and evaluation framework has been validated for its applicability in capturing the seismic damage patterns of long-span deck-type CFST arch bridges. Full article

Hydraulic actions may compromise dam foundation stability. Helical anchors have been used in dam foundation reinforcement projects because of the advantages of large uplift and compression bearing capacity, fast installation, and convenient recovery. However, the research on the anchor plate, which plays a key role in the bearing performance of helical anchors, is insufficient at present. Based on the finite element model of helical anchor, this study reveals the failure mode and influencing factors of the anchor plate and establishes the theoretical model of deformation calculation. The results showed that the helical anchor plate had obvious bending deformation when the dam foundation reinforced with a helical anchor reached large deformation. The helical anchor plate can be simplified to a flat circular disk. The stress distribution of the closed flat disk and the open flat disk was consistent with that of the helical disk. The maximum deformation of the closed flat disk was slightly smaller than that of the helical disk (less than 6%), and the deformation of the open flat disk was consistent with that of the helical disk. The results fill the blank of the design basis of helical anchor plate and provide a reference basis for the engineering design. Full article

To address the inefficiency of traditional concrete crack detection methods and the heavy reliance of supervised learning on extensive labeled data, in this study, an intelligent assessment method of concrete damage based on pseudo-label semi-supervised learning and fractal geometry theory is proposed to solve two core tasks: one is binary classification of pixel-level cracks, and the other is multi-category assessment of damage state based on crack morphology. Using three-channel RGB images as input, a dual-path collaborative training framework based on U-Net encoder–decoder architecture is constructed, and a binary segmentation mask of the same size is output to achieve the accurate segmentation of cracks at the pixel level. By constructing a dual-path collaborative training framework and employing a dynamic pseudo-label refinement mechanism, the model achieves an F1-score of 0.883 using only 50% labeled data—a mere 1.3% decrease compared to the fully supervised benchmark DeepCrack (F1 = 0.896)—while reducing manual annotation costs by over 60%. Furthermore, a quantitative correlation model between crack fractal characteristics and structural damage severity is established by combining a U-Net segmentation network with the differential box-counting algorithm. The experimental results demonstrate that under a cyclic loading of 147.6–221.4 kN, the fractal dimension monotonically increases from 1.073 (moderate damage) to 1.189 (failure), with 100% accuracy in damage state identification, closely aligning with the degradation trend of macroscopic mechanical properties. In complex crack scenarios, the model attains a recall rate (Re = 0.882), surpassing U-Net by 13.9%, with significantly enhanced edge reconstruction precision. Compared with the mainstream models, this method effectively alleviates the problem of data annotation dependence through a semi-supervised strategy while maintaining high accuracy. It provides an efficient structural health monitoring solution for engineering practice, which is of great value to promote the application of intelligent detection technology in infrastructure operation and maintenance. Full article

Aims: Sinus tachycardia after heart transplantation (HTX) due to cardiac graft denervation is associated with reduced post-transplant survival and requires adequate treatment. We analyzed the long-term effects of heart rate control with ivabradine or metoprolol succinate in HTX recipients. Methods: This observational retrospective single-center study analyzed the ten-year results of 110 patients receiving ivabradine (n = 54) or metoprolol succinate (n = 56) after HTX. Analysis included comparison of demographics, medications, heart rates, blood pressure values, echocardiographic features, cardiac catheterization data, cardiac biomarkers, and post-transplant survival including causes of death. Results: Both groups showed no significant differences concerning demographics or medications (except for ivabradine and metoprolol succinate). At 10-year follow-up, HTX recipients with ivabradine showed a significantly lower heart rate (72.7 ± 8.5 bpm) compared to baseline (88.8 ± 7.6 bpm; p < 0.001) and to metoprolol succinate (80.1 ± 8.1 bpm; p < 0.001), a significantly lower NT-proBNP level (588.4 ± 461.4 pg/mL) compared to baseline (3849.7 ± 1960.0 pg/mL; p < 0.001) and to metoprolol succinate (1229.0 ± 1098.6 pg/mL; p = 0.005), a significantly lower overall mortality (20.4% versus 46.4%; p = 0.004), and mortality due to graft failure (1.9% versus 21.4%; p = 0.001). Multivariate analysis showed a significantly decreased risk of death within 10 years after HTX in patients with post-transplant use of ivabradine (HR 0.374, CI 0.182–0.770; p = 0.008). Conclusions: In this single-center trial, patients with ivabradine revealed a significantly more pronounced heart rate reduction, a lower NT-proBNP level, and a superior 10-year survival after HTX. Full article

In this paper, SiC and Si/SiC ceramics were fabricated using direct laser powder bed fusion with chemical vapor infiltration. Their microstructure, mechanical properties and the impacts of silicon addition were analyzed. The incorporation of silicon led to an increase in the relative density of the silicon carbide ceramics from 76.4% to 78.3% and the compression strength increased from 39 ± 13 MPa to 90 ± 8 MPa after laser powder bed fusion with chemical vapor infiltration. The melting and re-solidification of silicon allows the silicon to encapsulate the silicon carbide grains, changing the microstructure and the failure mechanism of the silicon carbide ceramics, resulting in a small amount of silicon residue. In the LPBF-CVI SiC ceramic specimen, the LPBF-formed SiC exhibits a microhardness of 24.2 ± 1.0 GPa. In LPBF-CVI Si/SiC, the spherical dual-phase structure displays a moderately increased hardness (25.9 ± 4.4 GPa), and the CVI-formed SiC exhibits a hardness of 55.3 ± 9.3 GPa. Full article

Background/Objectives: Radial head arthroplasty is a commonly preferred treatment for complex, unreconstructable radial head fractures. Recent studies have raised the question of whether factors such as bone resorption may be related to failure. This observational, retrospective, multicenter, spontaneous, and non-profit study aims to assess radiological outcomes, focusing on bone resorption around the stem, for radial head replacement using a modular, cementless radial head prosthesis with interconnected porosity. Methods: A series of 42 cases was available for review. Patients underwent radial head arthroplasty using a three-dimensional-printed radial head prosthesis. Patients were eligible for inclusion if they had undergone at least one follow-up between 6 and 15 months post-operatively. A scoring system to detect bone resorption was developed and administered by two independent evaluators. Results: Forty-two patients (14 males, 28 females), with an average age of 59 ± 11 years (range: 39–80 years), were analyzed with a minimum of six months’ and a maximum of 32 months’ follow-up. At follow-up, 50 radiological evaluations were collected, with 29 showing ≤3 mm and 12 showing 3–6 mm resorption around the stem. The average resorption was 3.5 mm ± 2.3. No correlation was found between the extent of resorption and the time of follow-up. The developed scoring system allowed for a high level of correlation between the evaluators’ measurements of bone resorption. Conclusions: Radial head prosthesis with interconnected porosity provided a low stem resorption rate for patients after a radial head fracture at short-to-mid-term follow-up after the definition of a reliable and easy-to-use radiological-based classification approach. (Level of Evidence: Level IV). Full article