Search Results (19,507)

Objective: This study aimed to evaluate the mean age of eruption of permanent teeth and their clinical emergence sequence in a longitudinal sample of children from a multi-ethnic urban population. Methods: A total of 854 children (413 females and 441 males), aged between 4 and 13 years, were examined annually for a minimum of 4 consecutive years, as part of their annual dental screening appointment. The presence of permanent teeth was recorded at each examination. Mean and median ages, with standard deviations, of individual tooth eruption were calculated, in addition to the eruption sequence, and the analysis of the data was performed using the lognormal distribution model. Regarding the error of the method, two examiners reviewed all relevant dental screening forms, and any discrepancies were resolved through consultation with the senior author. Results: The sequence of permanent tooth eruption followed a consistent pattern across sexes, with distinct differences between the maxillary and mandibular arches. In the maxilla, eruption began with the first molar, while in the mandible, it started with the central incisor. Mandibular teeth generally erupted earlier than maxillary teeth, with girls experiencing earlier eruption than boys, with some exceptions, and prolonged eruption periods. No statistically significant differences were found in the timing of eruption between contralateral homologous teeth. Conclusions: Based on the present data, the observed sequence of tooth eruption in a multi-ethnic urban population showed similar patterns across sexes. Mandibular teeth generally erupt earlier than maxillary teeth, with girls experiencing earlier eruption than boys. Full article

Under the global context of climate governance and sustainable development, low-carbon energy transition has become a strategic imperative. As a critical force in resource allocation, the financial system’s impact on energy transition has attracted extensive academic attention. This paper presents the first comprehensive literature review on energy transition research in the context of financial development. We develop a “Financial Functions-Energy Transition Dynamics” analytical framework to comprehensively examine the theoretical and empirical evidence regarding the relationship between financial development (covering both traditional finance and emerging finance) and energy transition. The understanding of financial development’s impact on energy transition has progressed from linear to nonlinear perspectives. Early research identified a simple linear promoting effect, whereas current studies reveal distinctly nonlinear and multidimensional effects, dynamically driven by three fundamental factors: economy, technology, and resources. Emerging finance has become a crucial driver of transition through technological innovation, risk diversification, and improved capital allocation efficiency. Notable disagreements persist in the existing literature on conceptual frameworks, measurement approaches, and empirical findings. By synthesizing cutting-edge empirical evidence, we identify three critical future research directions: (1) dynamic coupling mechanisms, (2) heterogeneity of financial instruments, and (3) stage-dependent evolutionary pathways. Our study provides a theoretical foundation for understanding the complex finance-energy transition relationship and informs policy-making and interdisciplinary research. Full article

In patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), antiplatelet therapy is the cornerstone of treatment for secondary prevention. Although dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y₁₂ inhibitor is the current standard of care, being, respectively, recommended for 6 and 12 months in patients with chronic and acute coronary syndrome without a need for oral anticoagulation, the continuous improvement in PCI technology and pharmacology have significantly reduced the need for long-term DAPT. Mounting evidence supports the administration of P2Y₁₂ inhibitor monotherapy, particularly ticagrelor, after a short period of DAPT following PCI as a strategy to reduce bleeding without a trade-off in ischemic events compared to standard DAPT. In addition, there is a growing literature supporting P2Y₁₂ inhibitor monotherapy also for long-term secondary prevention of ischemic events. However, the data to this extent are not as robust as compared to the first-year post-PCI period, with aspirin monotherapy still remaining the mainstay of treatment for most patients. This review aims to summarize the rationale for long-term antiplatelet therapy, the pharmacology of current antiplatelet drugs tested for long-term administration as monotherapy, and current evidence on the available comparisons between different long-term antiplatelet monotherapies in patients with CAD. Full article

Background: Catheter ablation of the arrhythmogenic substrate has emerged as a promising therapeutic strategy for symptomatic Brugada syndrome (BrS). However, high-quality comparative evidence against conventional implantable cardioverter-defibrillator (ICD)-based management remains limited. Objectives: This meta-analysis aimed to evaluate the efficacy of catheter ablation in reducing ventricular fibrillation (VF) recurrence in symptomatic BrS compared to standard therapy. Methods: Medline, Cochrane Library, and Scopus were systematically searched through 1 June 2025. Study selection, data extraction, and quality assessment were independently conducted by three reviewers. Random-effects meta-analyses were used to pool risk estimates. Results: Three studies (two randomized controlled trials, one observational cohort; 130 symptomatic BrS patients) were included. Over a median follow-up of 3.9 years, catheter ablation was associated with a significantly lower risk of VF recurrence compared to standard therapy [risk ratio (RR) = 0.19, 95% confidence interval (CI) = (0.06, 0.60); I² = 36%, p for heterogeneity = 0.21], with no deaths reported in any group. A sensitivity analysis restricted to randomized trials confirmed similar findings in favor of ablation. Conclusions: Catheter ablation was associated with reduced VF recurrence compared to ICD therapy alone, supporting its potential role as first-line treatment in symptomatic BrS or as an alternative for patients who decline ICD implantation. Full article

Background: Thyroid eye disease (TED) is a rare autoimmune orbital disorder predominantly associated with Graves’ disease. It is characterized by orbital inflammation, tissue remodeling, and potential visual morbidity. Conventional therapies, particularly systemic glucocorticoids, offer only partial symptomatic relief, failing to reverse chronic structural changes such as proptosis and diplopia, and are associated with substantial adverse effects. This review aims to synthesize recent developments in understandings of TED pathogenesis and to critically evaluate emerging therapeutic strategies. Methods: A systematic literature review was conducted using MEDLINE, Embase, and international clinical trial registries focusing on pivotal clinical trials and investigational therapies targeting core molecular pathways involved in TED. Results: Current evidence suggests that TED pathogenesis is primarily driven by the autoimmune activation of orbital fibroblasts (OFs) through thyrotropin receptor (TSH-R) and insulin-like growth factor-1 receptor (IGF-1R) signaling. Teprotumumab, a monoclonal IGF-1R inhibitor and the first therapy approved by the U.S. Food and Drug Administration for TED, has demonstrated substantial clinical benefit, including improvements in proptosis, diplopia, and quality of life. However, concerns remain regarding relapse rates and treatment-associated adverse events, particularly hearing impairment. Investigational therapies, including next-generation IGF-1R inhibitors, small-molecule antagonists, TSH-R inhibitors, neonatal Fc receptor (FcRn) blockers, cytokine-targeting agents, and gene-based interventions, are under development. These novel approaches aim to address both inflammatory and fibrotic components of TED. Conclusions: Teprotumumab has changed TED management but sustained control and toxicity reduction remain challenges. Future therapies should focus on targeted, mechanism-based, personalized approaches to improve long-term outcomes and patient quality of life. Full article

The development of Industry 4.0 has accelerated the adoption of sophisticated technologies, including Digital Twins (DTs), Artificial Intelligence (AI), and cybersecurity, within Additive Manufacturing (AM). Enabling real-time monitoring, process optimization, predictive maintenance, and secure data management can redefine conventional manufacturing paradigms. Although their individual importance is increasing, a consistent understanding of how these technologies interact and collectively improve AM procedures is lacking. Focusing on the integration of digital twins (DTs), modular AI, and cybersecurity in AM, this review presents a comprehensive analysis of over 137 research publications from Scopus, Web of Science, Google Scholar, and ResearchGate. The publications are categorized into three thematic groups, followed by an analysis of key findings. Finally, the study identifies research gaps and proposes detailed recommendations along with a framework for future research. The study reveals that traditional AM processes have undergone significant transformations driven by digital threads, digital threads (DTs), and AI. However, this digitalization introduces vulnerabilities, leaving AM systems prone to cyber-physical attacks. Emerging advancements in AI, Machine Learning (ML), and Blockchain present promising solutions to mitigate these challenges. This paper is among the first to comprehensively summarize and evaluate the advancements in AM, emphasizing the integration of DTs, Modular AI, and cybersecurity strategies. Full article

A reliable geothermal risk assessment methodology is key to any business decision. To be effective, it must be based on widely accepted principles, be easy to apply, be auditable, and produce consistent results. In this paper, we review the key characteristics of a geothermal project and propose a novel approach derived from risk and uncertainty definitions used in the hydrocarbon industry. According to the proposed methodology, the probability of success is assessed by estimating three different components. The first is the geological probability of success, which is the likelihood that the geological model on which the geothermal project is based is correct and that the key fundamental geological elements are present. The second, the temperature threshold, is defined as the probability that the fluid is above a certain reference value. Such a reference value is the one used to design the development. Such a component, therefore, depends on the end use of the geothermal resource. The third component is the commercial probability of success and estimates the chance of a project being commercially viable using the Reverse Enthalpy Methodology. Geothermal projects do not have a single parameter that represents their monetary value. Therefore, in order to estimate it, it is necessary to make an initial assumption that can be revisited later in an iterative manner. The proposed methodology works with either the capital expenditure of the geothermal facility (power plant or direct thermal use) or the drilling cost as the initial assumption. Varying the other parameter, it estimates the probability of having a net present value (NPV) higher than zero. Full article

Long-range underwater gliders (LRUGs) have emerged as essential platforms for sustained and autonomous observation in deep and remote marine environments. This paper provides a comprehensive review of their developmental status, performance characteristics, and application progress. Emphasis is placed on two critical enabling technologies that fundamentally determine endurance: lightweight, pressure-resistant hull structures and high-efficiency buoyancy-driven propulsion systems. First, the role of carbon fiber composite pressure hulls in enhancing energy capacity and structural integrity is examined, with attention to material selection, fabrication methods, compressibility compatibility, and antifouling resistance. Second, the evolution of buoyancy control systems is analyzed, covering the transition to hybrid active–passive architectures, rapid-response actuators based on smart materials, thermohaline energy harvesting, and energy recovery mechanisms. Based on this analysis, the paper identifies four key technical challenges and proposes strategic research directions, including the development of ultralight, high-strength structural materials; integrated multi-mechanism antifouling technologies; energy-optimized coordinated buoyancy systems; and thermally adaptive glider platforms. Achieving a system architecture with ultra-long endurance, enhanced energy efficiency, and robust environmental adaptability is anticipated to be a foundational enabler for future long-duration missions and globally distributed underwater glider networks. Full article

This review explores the biofilm architecture and drug resistance of Enterococcus faecalis in clinical and environmental settings. The biofilm in E. faecalis is a heterogeneous, three-dimensional, mushroom-like or multilayered structure, characteristically forming diplococci or short chains interspersed with water channels for nutrient exchange and waste removal. Exopolysaccharides, proteins, lipids, and extracellular DNA create a protective matrix. Persister cells within the biofilm contribute to antibiotic resistance and survival. The heterogeneous architecture of the E. faecalis biofilm contains both dense clusters and loosely packed regions that vary in thickness, ranging from 10 to 100 µm, depending on the environmental conditions. The pathogenicity of the E. faecalis biofilm is mediated through complex interactions between genes and virulence factors such as DNA release, cytolysin, pili, secreted antigen A, and microbial surface components that recognize adhesive matrix molecules, often involving a key protein called enterococcal surface protein (Esp). Clinically, it is implicated in a range of nosocomial infections, including urinary tract infections, endocarditis, and surgical wound infections. The biofilm serves as a nidus for bacterial dissemination and as a reservoir for antimicrobial resistance. The effectiveness of first-line antibiotics (ampicillin, vancomycin, and aminoglycosides) is diminished due to reduced penetration, altered metabolism, increased tolerance, and intrinsic and acquired resistance. Alternative strategies for biofilm disruption, such as combination therapy (ampicillin with aminoglycosides), as well as newer approaches, including antimicrobial peptides, quorum-sensing inhibitors, and biofilm-disrupting agents (DNase or dispersin B), are also being explored to improve treatment outcomes. Environmentally, E. faecalis biofilms contribute to contamination in water systems, food production facilities, and healthcare environments. They persist in harsh conditions, facilitating the spread of multidrug-resistant strains and increasing the risk of transmission to humans and animals. Therefore, understanding the biofilm architecture and drug resistance is essential for developing effective strategies to mitigate their clinical and environmental impact. Full article

Objectives: To evaluate the association between antidepressant use and the risk of venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism (PE), through a systematic review and meta-analysis of observational studies. Methods: A comprehensive literature search was conducted in Medline, Embase^®, and Web of Science^® up to December 2024. Eighteen studies (cohort, case-control, and nested case-control designs) meeting inclusion criteria were analyzed. Study quality was assessed using the Newcastle–Ottawa Scale. Pooled relative risks (RR) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were performed based on recency of antidepressant use, VTE onset type (first vs. recurrent), and VTE subtype (PE). Results: Antidepressant use was associated with a significantly increased risk of VTE (RR = 1.22; 95% CI: 1.12–1.32; p < 0.001). Subgroup analyses revealed a stronger association for recent use (within 90 days), first-onset VTE, recurrent VTE, and PE. Heterogeneity was high (I² = 87.92%), but sensitivity analysis confirmed result robustness. No publication bias was detected. Conclusions: This meta-analysis indicates a modest but statistically significant increase in the risk of VTE associated with antidepressant use, particularly among recent users, individuals experiencing either first-time or recurrent VTE, and those with PE-type events. These findings highlight the importance of individualized VTE risk assessment when initiating antidepressant therapy. Full article

The construction sector is responsible for over 40% of waste generated in Australia. Construction materials are responsible for around 11% of global carbon dioxide emissions, and a third of these materials can end up wasted on a construction site. Attention in research and industry has been directed towards waste management and recycling, resulting in 78% of construction and demolition waste being diverted from landfill. However, the waste hierarchy emphasises avoiding the generation of waste in the first place. In this paper, the PRISMA approach is used to conduct a systematic review with the objective of identifying waste reduction strategies employed across all stages of projects in the Australian construction industry. Scopus and Web of Science databases were used. The search returned 523 publications which were screened and reviewed; this resulted in 24 relevant publications from 1998 to 2025. Qualitative analysis identifies strategies categorised into five groupings: pre-demolition, design, culture, materials and procurement, and on-site activities. The review finds a distinct focus on strategies within the materials and procurement category. The reviewed literature includes fewer strategies for the avoidance of waste than for any of the other levels of the waste hierarchy, evidencing the need for further focus in this area. Full article

Background: Eating disorders (EDs) and self-harm (SH) are both associated with distress, poor psychosocial functioning, and increased risk of mortality. Much of the literature discusses the complex interplay between SH and ED behaviours where co-occurrence is common. The onset of both is typically seen during teenage years into early adulthood. A better understanding of the functions of these behaviours is needed to guide effective prevention and treatment, particularly during the crucial developmental years. An earlier review has explored the functions of self-harm, but an equivalent review for eating disorder behaviours does not appear to have been completed. Objectives: This evidence synthesis had two objectives. First, to identify and synthesise published first-hand accounts of the reasons why people engage in eating disorder behaviours with the view to develop a broad theoretical framework of functions. Second, to draw comparisons between the functions of eating disorder behaviours and self-harm. Methods: A qualitative evidence synthesis reporting first-hand accounts of the reasons for engaging in eating disorder behaviours. A ‘best fit’ framework synthesis, using the a priori framework from the review of self-harm functions, was undertaken with thematic analysis to categorise responses. Results: Following a systematic search and rigorous screening process, 144 studies were included in the final review. The most commonly reported functions of eating disorder behaviours were distress management (affect regulation) and interpersonal influence. This review identified significant overlap in functions between self-harm and eating disorder behaviours. Gender identity, responding to food insecurity, to delay growing up and responding to weight, shape, and body ideals were identified as functions more salient to eating disorder behaviours. Similarly, some self-harm functions were not identified in the eating disorder literature. These were experimenting, averting suicide, personal language, and exploring/maintaining boundaries. Conclusions: This evidence synthesis identified a prominent overlap between psychological functions of eating disorder behaviours and self-harm, specifically in relation to distress management (affect regulation). Despite clear overlap in certain areas, some functions were found to be distinct to each behaviour. The implications for delivering and adapting targeted interventions are discussed. Full article

Significant progress has been achieved in the treatment of acute aortic dissection over the past 90 years, following the first surgical intervention. This review pays tribute to the dedication of pioneers and innovators who developed advanced medical devices and therapeutic strategies to address this challenging condition. While navigating uncertainties in treatment optimization, the primary focus of the therapeutic strategies has been to save lives by increasing survival rates during the acute phase and to prevent aorta-related lethal events and late-stage thoracoabdominal aortic replacements. From a neutral standpoint, this review traces over 90 years of progress in treating acute aortic dissection. We hope that as many patients as possible will receive treatment rationally, without over- or under-treatment. Full article

Early-career teachers (ECTs) entered the profession during the COVID-19 pandemic, a period that introduced unique stressors to an already-demanding career phase. This systematic review examines empirical studies published between 2020 and February 2025 to explore how the pandemic influenced ECT wellbeing, with particular attention to stressors and protective factors impacting long-term retention and professional sustainability. Guided by PRISMA protocols, databases including Web of Science, ERIC, Google Scholar, and Scopus were searched, screening 470 records and identifying 30 studies that met inclusion criteria: peer-reviewed, empirical, focused on early-career teachers (within the first five years), and situated in or explicitly addressing the pandemic and its ongoing impacts. The results of Braun and Clarke’s thematic analysis (2006) revealed that pandemic-related challenges such as increased workload, professional isolation, disrupted induction processes, and emotional strain have persisted into the post-pandemic era, contributing to sustained risks of burnout and attrition. Regardless, protective factors identified during the pandemic—including high-quality mentoring, structured induction programmes, collegial support, professional autonomy, and effective individual coping strategies—continue to offer essential support, enhancing resilience and professional wellbeing. These findings underscore the necessity of institutionalising targeted supports to address the enduring effects of pandemic-related stressors on ECT wellbeing. By prioritising sustained mental health initiatives and structural supports, education systems can effectively mitigate long-term impacts and improve retention outcomes for early-career teachers in a post-pandemic educational landscape. Full article

Dietary reviews contain rich emotional and objective information; however, existing knowledge extraction methods struggle with low-resource scenarios due to sparse and imbalanced label distributions. To address these challenges, this paper proposes a few-shot supervised learning approach. First, we develop a professional dietary–emotional schema by integrating domain knowledge with real-time data to ensure the coverage of diverse emotional expressions. Next, we introduce a dataset optimization method based on dual constraints—label frequency and quantity—to mitigate label imbalance and improve model performance. Utilizing the optimized dataset and a tailored prompt template, we fine-tune the DRE-UIE model for multivariate knowledge extraction. The experimental results demonstrate that the DRE-UIE model achieves a 20% higher F1 score than BERT-BiLSTM-CRF and outperforms TENER by 1.1%. Notably, on a 20-shot subset, the model on the Chinese dataset scores 0.841 and attains a 15.16% F1 score improvement over unoptimized data, validating the effectiveness of our few-shot learning framework. Furthermore, the approach also exhibits robust performance across Chinese and English corpora, underscoring its generalization capability. This work offers a practical solution for low-resource dietary–emotional knowledge extraction by leveraging schema design, dataset optimization, and model fine-tuning to achieve high accuracy with minimal annotated data. Full article