Search Results (87)

Cavitation-induced degradation of metallic materials presents a significant challenge for engineers and users of equipment operating with high-velocity fluids. For any metallic material, the mechanical strength and ductility characteristics are controlled by the mobility of dislocations and their interaction with other defects in the crystal lattice (such as dissolved foreign atoms, grain boundaries, phase separation surfaces, etc.). The increase in mechanical properties, and consequently the resistance to cavitation erosion, is possible through the application of heat treatments and cold plastic deformation processes. These factors induce a series of hardening mechanisms that create structural barriers limiting the mobility of dislocations. Cavitation tests involve exposing a specimen to repeated short-duration erosion cycles, followed by mass loss measurements and surface morphology examinations using optical microscopy and scanning electron microscopy (SEM). The results obtained allow for a detailed study of the actual wear processes affecting the tested material and provide a solid foundation for understanding the degradation mechanism. The tested material is the Ni-based alloy INCONEL 625, subjected to stress-relief annealing heat treatment. Experiments were conducted using an ultrasonic vibratory device operating at a frequency of 20 kHz and an amplitude of 50 µm. Microstructural analyses showed that slip bands formed due to shock wave impacts serve as preferential sites for fatigue failure of the material. Material removal occurs along these slip bands, and microjets result in pits with sizes of several micrometers. Full article

Background and Objectives: Uterine cancer is the most common gynaecologic malignancy in developed countries, yet the psychosocial sequelae of treatment are incompletely described. This prospective, single-centre study quantified six-month changes in the quality of life (QoL) and perceived stress in women with newly diagnosed uterine cancer and explored clinical moderators of change. Methods: Participants completed four validated self-report questionnaires: the 36-item Short-Form Health Survey (SF-36), the 26-item World Health Organization Quality-of-Life-BREF (WHOQOL-BREF), the 30-item EORTC QLQ-C30 and the 10-item Perceived Stress Scale (PSS-10) before therapy and again six months after surgery ± adjuvant chemoradiation. Subgroup analyses were performed for stage (FIGO I–II vs. III–IV). Results: Mean SF-36 Physical Functioning improved from 58.7 ± 12.1 to 63.1 ± 12.6 (Δ = +4.4 ± 7.3; p = 0.000, d = 0.36). PSS declined from 24.1 ± 5.6 to 20.8 ± 5.4 (Δ = −3.3 ± 5.0; p < 0.001, d = 0.66). The WHOQOL-BREF Physical and Psychological domains rose by 4.4 ± 6.9 and 3.5 ± 7.3 points, respectively (both p < 0.01). EORTC QLQ-C30 Global Health increased 5.1 ± 7.6 points (p < 0.001) with parallel reductions in fatigue (−5.4 ± 9.0) and pain (−4.8 ± 8.6). Advanced-stage patients showed larger reductions in stress (ΔPSS −3.5 ± 2.5 vs. −2.3 ± 2.3; p = 0.036) but similar QoL gains. ΔPSS correlated inversely with ΔWHOQOL Psychological (r = −0.53) and ΔSF-36 Mental Health (r = −0.49) and positively with ΔEORTC Global Health (r = −0.42) (all p < 0.001). Conclusions: Over six months, multimodal uterine cancer treatment was associated with clinically meaningful QoL improvements and moderate stress reduction. Greater stress relief paralleled superior gains in psychological and global health indices, highlighting the importance of integrative survivorship care. Full article

Background: Pain manifestations as well as increased muscle tone and stiffness noted in the course of delayed-onset muscle soreness (DOMS) are reflected in altered values of the biomechanical and visco-elastic parameters of muscles. This study aimed to compare the effects of soft tissue mobilization with foam rolling and percussive massage on symptoms of DOMS induced by a standardized muscle fatigue protocol. Methods: Healthy volunteers (n = 60) were divided into three groups: FR group—foam rolling (n = 20), PM group—percussive massage (n = 20) and CON group—control/passive rest (n = 20). The fatigue protocol for the gastrocnemius muscle was carried out for development of DOMS in subsequent days. Therapeutic procedures were applied to participants for 3 consecutive days. The results of therapy were assessed by means of myotonometry, performed five times (before, three times during the treatment procedure, and after the end of the procedure). Results: Foam rolling significantly reduced the onset and duration of increased muscle tone (p = 0.006) and stiffness (p < 0.001), unlike percussive massage. The control group exhibited higher tone and stiffness after 48 h, at the peak of DOMS-related pain symptoms. Only foam rolling improved elasticity (decrement, p < 0.001), while visco-elastic properties (relaxation, creep) varied inversely with tone and stiffness. Foam rolling led to significantly lower stiffness (day 2) and reduced decrement and relaxation (day 4) compared to the control. Neither therapy was more effective than passive rest for pain relief during the observation period. Conclusions: Foam rolling and percussive massage accelerate recovery of muscle tone, stiffness, and elasticity after DOMS as compared to passive rest but offer no added benefit for pain relief. Full article

Background/Objectives: Vibration foam rolling (VFR) has emerged as a popular intervention in sports and rehabilitation settings to enhance recovery and flexibility. This systematic review aimed to evaluate the effects of VFR on pain, fatigue, and range of motion (ROM) in individuals experiencing exercise-induced muscle fatigue and to assess its clinical applicability. Methods: A systematic literature search was conducted across five databases: PubMed, Cochrane Library, Embase, Web of Science, and CINAHL. Studies were included if they involved participants with muscle fatigue, applied VFR as an intervention, and measured outcomes related to pain, fatigue, or ROM. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Results: Eight studies published between 2019 and 2024 met the inclusion criteria. VFR showed beneficial effects in reducing delayed onset muscle soreness, improving pressure pain threshold, and lowering subjective fatigue. Several studies also reported increased ROM in specific joints, including the hip and knee. However, findings across studies were inconsistent, particularly in physiological markers such as muscle oxygen saturation and blood flow parameters, where statistically significant differences were not always observed. Conclusions: VFR may offer potential benefits for pain relief, fatigue recovery, and ROM improvement in fatigued individuals. Nonetheless, its effects remain difficult to isolate from those of mechanical pressure and friction associated with foam rolling. Future studies with standardized intervention protocols and long-term follow-up are needed to clarify the independent role of vibration in recovery outcomes. Full article

Objectives: This study evaluated peripheral nerve stimulation (PNS) as a treatment for vertebra plana fractures, focusing on its impact on pain intensity, physical function, anxiety, depression, fatigue, social role participation, and pain interference. The goal was to assess whether PNS could serve as a minimally invasive alternative for managing pain in patients with severe vertebral fractures. Methods: Four patients with lumbar vertebra plana fractures received PNS implants for 60 days. Pain scores and PROMIS-29 domains (physical function, anxiety, depression, fatigue, social participation, and pain interference) were assessed at 30, 60, 90, 180, and 365 days post-implantation. Data analysis included mean and standard deviation calculations. Results: PNS led to marked improvements in pain-related outcomes. The average pain intensity scores dropped from 8.5 at baseline to 4.25 at one year, and pain interference scores declined from 61.75 to 54.75. Physical function initially decreased but improved from 38.5 at three months to 46.75 at one year. Changes in depression, anxiety, fatigue, and social participation were minimal, reflecting their multifactorial nature and limited response to pain relief alone. Conclusions: This case series suggests that PNS may significantly reduce pain and pain interference while enhancing physical function in patients with vertebra plana fractures. Its sustained benefits highlight PNS as a promising minimally invasive treatment, especially for those ineligible for traditional procedures. However, the limited improvement in psychological and social domains underscores the need for comprehensive care strategies. Further research is warranted to explore the broader role of PNS in managing vertebral fracture pain. Full article

Objective: This study aimed to explore the unmet palliative care needs among young and middle-aged (YMA) Chinese patients with advanced cancer. Methods: We used the principle of maximum difference. A total of 16 YMA patients with advanced cancer from cancer hospital were recruited. Semi-structured, in-depth, and face-to-face interviews were conducted from 28 August 2023 to 23 October 2023. The recorded audio of each interview was typed into Word software with each personal code. The interview transcripts were coded using the method of inductive content analysis. Results: Four themes and 14 sub-themes were identified in participants’ descriptions of care needs: (1) symptom management needs: need for pain relief, need for anti-emetics, and need for aid in managing fatigue; (2) psychological support needs: help reducing fear of pain, help achieving a better death, and help with parents’ negative reactions; (3) social support needs: taking care of children, emotional support from family members, consultation and emotional support from other cancer patients, and company and guidance of healthcare personnel; (4) information needs: better understanding of disease trajectory and future care needs, better access to palliative care information, and more participation in medical decision-making. Conclusions: According to the results of this study, the unmet palliative care needs of YMA patients with advanced cancer are diverse, but they have not been fully recognized and met. Therefore, medical staff should develop effective management strategies and explore patients’ needs in an all-around way. Future studies will further develop the scale of unmet needs for palliative care to accurately identify needs and improve patients’ quality of life. Full article

Chronic widespread pain (CWP) is characterized by persistent pain across multiple body regions, often accompanied by fatigue, cognitive difficulties, and psychological distress. Background/Objectives: Affecting approximately 10% of the general population, CWP disproportionately impacts women, individuals from lower socioeconomic backgrounds, immigrants, and those with a family history of chronic pain. Standard treatments, including cognitive–behavioral therapy, exercise, and pharmacotherapy, often provide insufficient relief. This study explores a novel approach to treating treatment-resistant CWP: high-dose subcutaneous lidocaine infusions administered over extended periods. Methods: The research included a retrospective chart review and patient survey to evaluate safety and tolerability. The protocol started with a dose of 10–12 mg/kg of adjusted body weight, increasing by 10–15% per month, with a maximum dose of 2000 mg. Results: The chart review of 27 patients revealed mild to moderate adverse events (AEs) in seven patients, with no severe AEs. A survey of 15 patients indicated a higher incidence of AEs; however, all patients reported that the benefits outweighed the negatives. On average, patients experienced 61% pain relief, lasting 19 days per infusion. Conclusions: This study demonstrates that subcutaneous lidocaine infusions are a well-tolerated treatment for CWP, offering substantial pain relief and improving patients’ quality of life. Full article

This review paper investigates the comprehensive impact of various nanomaterials on the mechanical properties and durability of pavement-quality concrete (PQC) with a specific focus on compressive strength, flexural strength, split tensile strength, permeability, abrasion resistance, fatigue performance, and crack relief performance. Despite significant advancements in the use of nanomaterials in concrete, existing research lacks a comprehensive evaluation of their comparative effectiveness, optimal dosages, and long-term durability in PQC. While conventional PQC faces challenges such as low fatigue resistance, high permeability, and susceptibility to abrasion, studies on nanomaterials have largely focused on individual properties rather than a holistic assessment of their impact. Nano SiO₂ and graphene oxide (GO) emerged as the most effective, with optimal dosages of 2% and 0.03%, respectively, leading to substantial improvements in compressive strength (up to 48.88%), flexural strength (up to 60.7%), and split tensile strength (up to 78.6%) through improved particle packing, reduced permeability, and refined microstructure. Nano TiO₂, particularly at a 1% dosage, significantly enhanced multiple properties, including a 36.30% increase in compressive strength, over 100% improvement in abrasion resistance, and a 475% increase in fatigue performance. However, a critical research gap exists in understanding the combined effects of multiple nanomaterials, their interaction mechanisms within cementitious systems, and their real-world performance under prolonged environmental and loading conditions. Most studies have been limited to laboratory-scale investigations, with minimal large-scale validation for pavement applications. The findings indicate that nanomaterials like nano TiO₂, nano CaCO₃, nano Al₂O₃, nano clay, and carbon nanomaterials play crucial roles in improving characteristics like permeability, abrasion resistance, and fatigue performance, with notable gains observed in many cases. This review systematically analyzes the influence of these nanomaterials on PQC, identifies key research gaps, and emphasizes the need for large-scale field validation to enhance their practical applicability. Full article

This study investigates the impact of low-temperature stress-relieving treatment on the fatigue life of AlSi10Mg components produced by Laser Powder Bed Fusion (L-PBF). The research focuses on a bicycle crank arm, comparing its performance in as-built and heat-treated conditions. The heat treatment involved stress-relieving at 250 °C for 2 h, followed by water quenching. The study found that the as-built condition exhibited a supersaturated Si cellular-dendritic microstructure, while the heat-treated condition showed coarsening of β-Mg₂Si phases and Si precipitates. This morphological change led to a decrease in hardness and an increase in ductility. Fatigue tests demonstrated that the heat-treated crank arms achieved the target of 100,000 cycles without failure, unlike the as-built samples, which failed prematurely. The fractography analysis identified surface porosity as the primary crack initiation site. The findings suggest that low-temperature stress-relieving treatment can enhance the fatigue performance of L-PBF AlSi10Mg components by reducing residual stresses and improving defect tolerance. Full article

Background: Hyperthyroidism, characterized by excessive thyroid hormone production, presents in diverse clinical forms, including overt and subclinical disease. Accurate and timely diagnosis is critical to prevent complications such as cardiac dysfunction, osteoporosis, and thyroid storm. Objective: To provide a comprehensive review of the clinical presentation, diagnostic methods, and management strategies for hyperthyroidism, focusing on current practices, advancements, and challenges in treatment. Methods: This review synthesizes findings from peer-reviewed literature on the diagnosis and management of hyperthyroidism. Results: Thyroid function tests (TFTs) are the cornerstone of hyperthyroidism diagnosis, with suppressed TSH levels and elevated T3 and/or T4 levels confirming overt disease. Thyroid receptor antibodies (TRAb) are critical for diagnosing autoimmune hyperthyroidism and predicting relapse risk. Iodine scintigraphy is utilized in specific cases, such as suspected toxic adenoma or multinodular goiter. Management strategies include beta-blockers for symptomatic relief, though side effects such as bradycardia and fatigue may occur. Antithyroid medications, including methimazole and propylthiouracil, inhibit hormone synthesis, with remission more likely in patients with low TRAb levels and small goiters. Definitive treatments include radioactive iodine therapy (RAI), which effectively reduces thyroid activity but often results in hypothyroidism, and thyroidectomy, a surgical option for large goiters or malignancy, with potential complications like hypocalcemia and recurrent laryngeal nerve injury. Conclusions: The management of hyperthyroidism necessitates a personalized approach integrating diagnostic precision, emerging innovations, and patient-centered care. Full article

Electrical stimulation can be used in several applications such as fatigue reduction, muscle rehabilitation, neurorehabilitation, neuro-prosthesis and pain relief. Moreover, electrical stimulation can be used for drug delivery applications or body fluids extraction (e.g., sweat and interstitial fluid) to successively monitor several parameters, such as glucose, lactate, etc. All these applications are performed using electrical stimulator devices capable of applying constant voltage pulses or constant current pulses via electrodes to human tissues. Usually, constant current stimulators are most widely used because of their safety, stability, and repeatability. Thus, the aim of this work was to design, realize and test a mixed-signal electronic interface capable of producing current pulses with custom amplitude, duration, frequency, polarity and symmetry with extended voltage compliance. To achieve this result, we developed a high-voltage current stimulator suitable for iontophoresis applications. Current stimuli can be applied setting the intensity, frequency and duty cycle of the stimulation patterns through a µC. A custom electronic interface was designed to allow the control of the injected current in real time and to prevent electrical injuries to the patient by avoiding potential unwanted short circuits. Moreover, the system was tested in a simulated environment demonstrating its effectiveness and applicability for transdermal monitoring applications. The obtained results show that the device is able to apply monophasic and biphasic pulses, ranging from 0.1 to 10 mA, with a maximum error of about 10% at the minimum intensity; in addition, current stimuli can be applied up to a maximum frequency of 100 kHz with a voltage compliance of 120 V. Full article

The fatigue behavior of a fully processed, non-oriented electrical steel sheet is investigated in dependence on shear-cutting parameters and a subsequent heat treatment. For this, stress-controlled fatigue tests are performed before and after annealing at 700 °C for a total of six different shear-cutting settings. For all parameters, the fatigue strength of shear-cut sheets is improved by the heat treatment. This is due to reduction in a large part of the strain hardening region as well as the reduction in tensile residual stresses. Both were introduced during shear cutting and act detrimental to the fatigue strength. However, the intensity of this improvement depends on the shear-cutting parameters. This is related to the corresponding edge surfaces characteristically being formed during shear cutting. Specimens cut with a worn cutting tool show a more pronounced increase in fatigue life. In contrast, specimens produced with a sharp-edged cutting tool and high cutting clearance hardly benefit from the heat treatment. This appears to be caused by differences in surface topography, in particular coarse topographical damage in the form of grain breakouts. If these occur during shear cutting, the crack formation is not significantly delayed by additional annealing. Full article

Background: The prevalence of both inflammatory bowel diseases (IBD) and Irritable Bowel Syndrome (IBS) is increasing, with persistent digestive symptoms, an altered quality of life, and higher rates of anxiety, chronic fatigue, and sleep trouble than the general population. Methods: This scoping review will analyze the latest clinical practice recommendations and clinical studies on non-pharmaceutical interventions such as diet adaptations, physical activity, cognitive behavioral therapies, and medical nutrition therapies such as probiotics, soluble fibers, chitin-glucan, and micronutrients for digestive symptoms relief, quality of life improvement and nutritional deficiencies correction in IBS and IBD patients. The objective is to help healthcare practitioners and dietitians to build personalized care program for IBD and IBS patients. Results: Mediterranean diet, physical activity, cognitive behavioral therapies and medical nutrition therapies such as selected probiotics, soluble fibers, chitin glucan, peppermint oil and micronutrients are effective as adjunct therapies. Conclusions: These adjunct therapies may help to reduce persistent digestive symptoms, correct nutritional deficiencies and improve quality of life of IBS and IBD patients. Full article

Fibromyalgia is a chronic illness usually accompanied by long-lasting, general pain throughout the body, often accompanied by anxiety, depression, fatigue, and sleep disruption. Meanwhile, doctors and scientists have not entirely discovered detailed mechanisms; patients always have an exaggerated sensation to pervasive pain without satisfied medical service. Given the lack of knowledge on its underlying mechanism, current treatments aim to provide pain and/or symptom relief. The present study aimed to clarify the role of cannabinoid receptor 1 (CB1) signaling in a mouse fibromyalgia pain model. To develop the mouse fibromyalgia model, mice were subjected to intermittent cold stress (ICS). Our results indicated that mechanical (2.09 ± 0.09 g) and thermal hyperalgesia (4.77 ± 0.29 s), which were evaluated by von Frey and Hargraves’ tests, were induced by ICS, suggesting successful modeling. The hurting replies were then provoked by electroacupuncture (EA) but not for sham EA mice. Further, in a Western blot analysis, we found significantly decreased CB1 protein levels in the thalamus, somatosensory cortex, and anterior cingulate cortex. In addition, the levels of pain-related protein kinases and transcription factor were increased. Treatment with EA reliably increased CB1 expression in various brain regions sequentially alleviated by nociceptive mediators. Furthermore, the administration of a CB1 agonist significantly attenuated fibromyalgia pain, reversed EA analgesia by the CB1 antagonist, and further reversed the chemogenetic inhibition of SSC. Our innovative findings evidence the role of CB1 signaling in the interaction of EA and fibromyalgia, suggesting its potential for clinical trials and as a treatment target. Full article

Background/Objectives: Acute intermittent porphyria (AIP) is a metabolic disease characterised by neurovisceral crises with episodes of acute abdominal pain alongside life-altering, and often hidden, chronic symptoms. The elimination of precipitating factors, hemin therapy, and pain relief are strategies used to treat porphyria symptoms, but are often reserved for patients suffering recurrent, acute attacks. Givosiran (siRNA) is an emerging AIP therapy capable of silencing delta-aminolevulinic acid synthase-1 (ALAS1) and, in turn, reducing the accumulation of delta-aminolevulinic acid (ALA) and porphobilinogen (PBG) that precede porphyria symptoms. The aim of this study was to investigate the efficacy and safety of givosiran administration in patients with both acute and chronic AIP burden, who were poorly responsive to current therapies, using a personalised medicine approach. Methods: Real-world data were collected in consecutive patients treated with givosiran at an accredited German Porphyria Clinical Center. Biochemical, clinical, and HR-QoL outcomes were monitored alongside adverse events (AEs). Results: Twenty-eight patients treated between 2018 and 2024 were sub-categorised into groups corresponding to Ipnet terms 13 ‘Sporadic Attacks, 5 ‘Symptomatic High Excretors’, 5 ‘Prophylactic Heme’, and 5 “Recurrent Attacks’. The mean time from diagnosis to treatment was 9.2 years (range in months 1–324), and the mean duration of treatment was 30 months (range 3–68). After 6 months of monthly givosiran injection (2.5 mg/kg), all patients’ ALA levels reached <2ULN, and 60% of patients attained PBG levels < 2ULN (p < 0.001). These biochemical responses were not different between sub-groups (p > 0.05). Clinically, 75% of patients’ chronic and acute porphyria symptoms improved. The total patient populations’ annualised attack ratio (AAR) improved; Historical AAR: 2.9 (0–12.0) vs. Givo AAR: 0.45 (0–3.0) (p < 0.01). During follow-up, nine patients experienced minor breakthrough episodes. Of these, three patients required hemin infusion. An association between clinical success and a shorter interim period between diagnosis and treatment was evident (r = −0.522, p = 0.0061). All patients’ indices of HR-QoL improved under givosiran, including mental health (38%, p < 0.0001) and pain (38%, p < 0.0001). Patient-reported health (givosiran 77.9% vs. baseline 37.1%, p < 0.0001) and clinical outcome scores (86.9%: good–very good) were also positive. Two patients withdrew from treatment <6 months, citing fatigue, which was a common side effect. A mild elevation in liver enzymes (AST and/or ALT < 1.5ULN, 15.4%) and reduced glomerular filtration rates (GFR, 11.5%) were also evident, but no life-threatening adverse events (AEs) were attributed to givosiran treatment. Conclusions: Givosiran is effective in preventing severe acute attacks and reducing the chronic health burden in patients with acute intermittent porphyria. Importantly, HR-QoL improved in patients suffering chronic AIP burden with few incidences of historical attacks. All patients experienced substantially improved mental health, ease of living, and self-perceived health. Full article