Search Results (412)

This study analyses the variety of the language used in textbooks for teaching Italian as a second/foreign language. These books use a language much closer to written than to spoken Italian and do not consider its varieties, providing examples and exercises with a “neutral” standard that speakers rarely use in everyday speech. The aim of this study is to provide a critical review of pronunciation sections in current L2 Italian textbooks, in the light of a renewed and growing interest in the study of the Italian language, not only by students with a migrant background in Italy, but also by second and third-generation emigrants who want to learn Italian to recover their roots. Thirty-two Italian textbooks were examined, considering some geolinguistic variables. The general tendency seems to be the introduction of some neo-standard Italian features. As far as the phonetic–phonological level is concerned, this is probably still insufficient because of the complexity of the Italian linguistic repertoire. Our analysis further suggests the inadequacy of notions such as (neo-)standard Italian for teaching purposes in the linguistic space of global Italian. Full article

Background/Objectives: Interpretation of chest X-rays (CXRs) requires accurate identification of lesion presence, diagnosis, location, size, and number to be considered complete. However, the effectiveness of large language models with vision capabilities (LLMs) in performing these tasks remains uncertain. This study aimed to evaluate the image-only interpretation performance of LLMs in the absence of clinical information. Methods: A total of 247 CXRs covering 13 diagnostic categories, including pulmonary edema, cardiomegaly, lobar pneumonia, and other conditions, were evaluated using Gemini 1.0, Gemini 1.5 Pro, GPT-4 Turbo, and GPT-4o. The text outputs generated by the LLMs were evaluated at two levels: (1) primary diagnosis accuracy across the 13 predefined diagnostic categories, and (2) identification of key imaging features described in the generated text. Primary diagnosis accuracy was assessed based on whether the model correctly identified the target diagnostic category and was classified as fully correct, partially correct, or incorrect according to predefined clinical criteria. Non-diagnostic imaging features, such as posteroanterior and anteroposterior (PA/AP) views, side markers, foreign bodies, and devices, were recorded and analyzed separately rather than being incorporated into the primary diagnostic scoring. Results: When fully and partially correct responses were treated as successful detections, vLLMs showed higher sensitivity for large, bilateral, multiple lesions and prominent devices, including acute pulmonary edema, lobar pneumonia, multiple malignancies, massive pleural effusions, and pacemakers, all of which demonstrated statistically significant differences across categories in chi-square analyses. Feature descriptions varied among models, especially in PA/AP views and side markers, though central lines were partially recognized. Across the entire dataset, Gemini 1.5 Pro achieved the highest overall detection rate, followed by Gemini 1.0, GPT-4o, and GPT-4 Turbo. Conclusions: Although LLMs were able to identify certain diagnoses and key imaging features, their limitations in detecting small lesions, recognizing laterality, reasoning through differential diagnoses, and using domain-specific expressions indicate that CXR interpretation without textual cues still requires further improvement. Full article

Background/Objectives: A key disadvantage of DNA vaccines is ineffective uptake of plasmid DNA, resulting in low immunogenicity. A way to overcome it is forced DNA delivery, which requires specialized equipment and/or reagents. Effective delivery of plasmids without specialized devices or using commonly available ones would significantly increase DNA vaccine applicability. Here, we delivered DNA by intradermal injections, facilitating them by optimized sonoporation (SP) or electroporation (EP), and we compared these methods by their capacity to support the production of foreign proteins in mice. Methods: DNA delivery was optimized using the plasmid encoding firefly luciferase (Luc) (pVaxLuc). Luc production was assessed by bioluminescence imaging (BLI) (IVIS, PerkinElmer, Shelton, CT, USA; LumoTrace Fluo, Abisense, Dolgoprudny, Russia). Female BALB/c mice were injected intradermally (id) with pVaxLuc in phosphate buffers of varying ionic strengths. Injection sites were subjected to SP (Intelect Mobile, Chattanooga, UK) or EP (CUY21EDITII, BEX Co., Tokyo, Japan) or left untreated. Optimal delivery protocols were selected based on the highest in vivo levels of photon flux according to BLI. Optimal protocols for id injections with/without EP were applied to DNA-immunized mice with HIV-1 clade A reverse transcriptase. Antibody response induced by DNA immunization was assessed by ELISA. Results: The optimal phosphate buffers for id delivery had ionic strengths from 81 to 163 mmol/L. The optimal SP regimen included an acoustic pressure of 2.4 W/cm² applied in a duty cycle of 2%. The optimal EP regimen included bipolar driving pulses of 100 V, a pulse duration of 10 ms, and an interval between the pulses of 20 ms. Optimized DNA delivery by id/SP injection was inferior to both id/EP and id alone. DNA immunization with HIV-1 RT by id injections induced anti-RT antibodies in a titer of 10⁴ and by id/EP in a titer of 10⁵. Conclusions: Electroporation of the sites of id DNA injection provided the highest levels of production of luciferase reporters and induced a strong antibody response against HIV-1 RT. Full article

Background: Despite its crucial role in overall health, oral health is frequently overlooked within healthcare systems, partly due to the misconception that oral diseases are neither life-threatening nor directly disabling. This perception has led to an underestimation of the psychological, social, and economic burden associated with oral diseases. Τhe present study aimed to assess oral health status and oral health-related quality of life among dental patients attending a public Special Care Center in Greece. Methods: A cross-sectional study was conducted among 400 dental patients aged 18 years and older who visited a public Special Care Center for a routine check-up or a dental problem between September and October 2024. Data was collected through personal interviews and clinical examinations after informed consent was obtained. Oral health-related quality of life was evaluated using the Oral Health Impact Profile-14 (OHIP-14) and the Oral Impacts on Daily Performance (OIDP) questionnaires. Categorical variables were presented as absolute and relative frequencies, while quantitative variables were summarized as mean, standard deviation, median, minimum, and maximum. Normality was assessed using the Kolmogorov–Smirnov test. Bivariate analyses and multivariate linear regression models were performed, with statistical significance set at p < 0.05. Statistical analyses were conducted using IBM SPSS 23.0. Results: The majority of participants were female (56.3%) with a mean age of 50.4 years (SD = 14.9). Overall oral health-related quality of life was moderate (OHIP-14: Mean = 21.0, SD = 14.8; OIDP: Mean = 14.0, SD = 12.8). Patients who attended the center due to a dental problem reported significantly poorer oral health outcomes than those attending routine check-ups (p < 0.001). Poorer self-rated oral health, having ≥12 missing teeth, prosthetic restoration, and foreign nationality were significantly associated with worse oral health-related quality of life. Conclusions: Dental patients attending the Special Care Center demonstrated moderate oral health status, which was associated with psychological distress, physical disability, and social limitations. These findings underline the need for targeted public oral health interventions, especially for vulnerable population groups. Full article

Background and Objectives: Implant-associated complications, including foreign-body responses and infection risk, remain major concerns in reconstructive and aesthetic breast surgery. Antimicrobial polymer coatings have been proposed as potential preventive strategies, but early-stage development requires simple and ethically refined in vivo models. This pilot study aimed to (i) establish a practical workflow for applying PLGA–vancomycin coatings onto PTFE substrates used as experimental analogs for smooth silicone implants, and (ii) develop a small-animal implantation protocol for short-term evaluation of surgical feasibility and local tissue tolerability. Materials and Methods: PLGA microparticles and PLGA–vancomycin microparticles were prepared using a double-emulsion solvent-evaporation method and applied onto PTFE discs. Particle size and polydispersity were assessed based on dynamic light scattering (DLS), and surface charge was measured via zeta potential. A bilateral subcutaneous implantation model was used in four Wistar rats, each receiving a PTFE disc coated with PLGA-only on one side and a disc coated with PLGA–vancomycin on the other. Animals were monitored for postoperative recovery, wound appearance, and general condition. After four weeks, implants and surrounding tissues were harvested for macroscopic and preliminary histological evaluation. Results: Both PLGA-only and PLGA–vancomycin microparticles showed submicron mean hydrodynamic diameters and moderately polydisperse distributions typical for double-emulsion formulations. All animals recovered normally, maintained stable body weight, and exhibited no macroscopic signs of adverse reactions. Preliminary histology showed early fibrous capsule formation with mild inflammatory infiltrate around both types of coated implants, without qualitative differences observed in this pilot setting. Conclusions: This preliminary study demonstrates the feasibility of applying PLGA-only and PLGA–vancomycin coatings onto PTFE implant analogs and establishes a reproducible, minimal-use rat model for short-term evaluation of local tissue tolerability. The protocol provides a practical foundation for future work on coating stability, drug-release kinetics, antibacterial activity, and long-term tissue responses on medical-grade silicone substrates. Full article

Background: Otitis media with effusion (OME) is a widespread condition that causes hearing impairment, particularly in pediatric populations. Existing non-absorbable tubes often require elective or unplanned removal surgery. Bioabsorbable polylactic acid (PLA) offers a promising alternative due to its inherent biocompatibility and tunable degradation characteristics. In this study, we designed, fabricated, and comprehensively evaluated a novel PLA middle-ear ventilation tube. Methods: Bioabsorbable PLA tubes were designed and fabricated based on commercial models. In vitro biocompatibility was assessed according to ISO 10993 guidelines. A guinea pig model was used to perform in vivo evaluations, including otoscopic examinations, auditory brainstem response (ABR) measurements, micro-computed tomography (micro-CT) imaging, and histological analyses. Results: The PLA tubes were successfully designed and fabricated, exhibiting dimensions comparable to those of commercially available products. In vitro testing confirmed their biocompatibility. In vivo observations revealed that the PLA segments remained stable, with no significant inflammation detected. ABR measurements revealed no adverse impacts on hearing function. Micro-CT imaging confirmed tube integrity and indicated initial signs of degradation over a 9-month period, as evidenced by radiographic morphology. Histological analyses indicated a favorable tissue response with minimal foreign body reaction. Conclusions: The developed PLA middle-ear ventilation tube represents a highly promising alternative to conventional non-absorbable tubes. It demonstrates excellent biocompatibility, preserves auditory function, and exhibits a controlled degradation profile. This preclinical study provides strong support for further investigation and subsequent clinical trials to validate its safety and efficacy in human patients. Full article

Background: To compare clinical outcomes of Lotrafilcon A and Balafilcon A silicone hydrogel bandage contact lenses (BCLs) following transepithelial photorefractive keratectomy (TPRK). Methods: A randomized, double-blind, contralateral eye study enrolled 41 TPRK patients (82 eyes), with each eye randomly assigned one BCL type. Assessments included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, ocular pain and irritation, epithelial healing, limbal and conjunctival hyperemia, lens mobility, and the amount of protein deposition on the BCLs. Results: Postoperative day 1 pain score was lower in Group A (2.80 ± 2.35) than in Group B (4.44 ± 2.46, p = 0.003). Group A had significantly less protein deposition (day 3: 9.92 ± 9.82 vs. 25.75 ± 9.86 μg, p < 0.001; day 4: 9.47 ± 10.06 vs. 32.60 ± 16.71 μg, p = 0.005). No statistically significant differences were observed between the two groups in terms of corneal epithelial defect area, corneal epithelial healing time, UDVA, CDVA, limbal or conjunctival hyperemia, and lens movement. Conclusions: Lotrafilcon A outperformed Balafilcon A in reducing ocular pain, foreign body sensation, and protein deposition, suggesting that Lotrafilcon A may be a more suitable therapeutic BCL option following TPRK. Full article

Background and Clinical Significance: Lymphoepithelial cysts are uncommon benign lesions of the head and neck, rarely encountered within the oral cavity and exceedingly infrequent in the palatine tonsils. Their nonspecific clinical presentation and ability to mimic more common benign entities often render diagnosis challenging. Case Presentation: We report the case of a 68-year-old woman with a four-year history of persistent foreign-body sensation in the oropharynx despite multiple normal otolaryngologic examinations. Flexible nasoendoscopy was non-diagnostic, as the lesion was deeply concealed within the superior tonsillar pole between the palatine pillars. Targeted tonsillar manipulation ultimately revealed a small pedunculated mass and contrast-enhanced computed tomography demonstrated a well-circumscribed, non-enhancing cystic lesion confined to the tonsillar parenchyma. Surgical excision under general anesthesia confirmed an oral lymphoepithelial cyst on histopathologic analysis. The patient remained asymptomatic with no recurrence at four months. Conclusions: This case underscores the rarity of tonsillar lymphoepithelial cysts, highlights the diagnostic limitations of endoscopic evaluation for cryptic superior-pole lesions and emphasizes the importance of meticulous dynamic oropharyngeal examination. Complete surgical excision is both definitive and curative, with an excellent prognosis. Full article

This article reexamines the gold necklace excavated from the Sui-dynasty tomb of Li Jingxun (李静训, 600–608 CE), shifting attention from stylistic attribution to ritual function and funerary context. While previous studies have emphasized Persian, Byzantine, or Indian influences, this study situates the necklace more plausibly within the Iranian–steppe cultural sphere and the Turkic–Sogdian exchange networks active along the Silk Roads in the late sixth and early seventh centuries. Through analysis of its segmented structure, polyhedral gold beads, pearl rondelle, nicolo intaglio clasp, and gemstone arrangement, the article identifies close technical and visual parallels in Central Asia and the wider Iranian world. The necklace is interpreted as an apotropaic object likely worn in life and placed in the tomb to extend its protective and guiding functions after death. Attention to bodily use, clasp orientation, and associated grave goods—especially a stemmed cup with Eurasian ritual associations—clarifies how the necklace operated within a Buddhist burial setting timed to Lichun 立春 (Beginning of Spring). Situating the object within the Li family’s Xianbei 鲜卑 background and documented connections with Sogdian communities, this study demonstrates how foreign ornaments were actively understood and integrated into Sui aristocratic funerary practice, rather than adopted as passive luxuries. Full article

Background: In Canada, 30 percent of the older adult population is foreign-born. Immigrant older adults are more likely to experience significant social isolation due to a variety of factors. However, limited research exists on the influence of specific factors. The objective of this study is to understand the economic factors that contribute to social isolation among older immigrants in the Greater Toronto Area (GTA), Canada. Methods: A qualitative interpretive description method was used. Following research ethics boards’ approval, semi-structured individual interviews were conducted with a total of 47 Arabic, Mandarin, and Punjabi-speaking older immigrants in the GTA. The interviews were conducted in their preferred language, audio-recorded, and translated (when needed) into English and transcribed. Thematic analysis of the data was informed by an ecosystemic framework. Results: Six themes were identified: (1) barriers to finding employment; (2) living a “hand-to-mouth life” due to limited income/pension; (3) housing costs that eliminate choices and options; (4) costs (and availability) of transportation as a barrier to getting around; (5) lack of “essential” healthcare coverage; and (6) costs of community programs that prevent “getting out of the house.” These economic factors at micro, meso, and macro levels of society intersected to create desperate situations that contributed to social isolation among older immigrants in the GTA. Conclusions/Implications: Addressing these economic factors is critical to immigrant older adults’ aging in place. Service providers must advocate for accessible physical and financial resources and services including affordable housing and transportation, old age security, and comprehensive healthcare coverage for older immigrants. Future research should focus on economic challenges faced by older adults across other immigrant communities in the GTA as well as in other cities, provinces, and territories. Full article

The international community has devoted substantial resources to advancing Sustainable Development Goal 4—Quality Education—but achievement gaps persist. In English as a foreign language (EFL) setting, vocabulary acquisition is often regarded as a tedious task. Game-based learning in playful narratives and rule-based interactions has established the premise of enhancing undergraduates’ learning outcomes and motivation; thus, it may also enhance learning outcomes and motivation among students. This study examines the impact of game-based learning on students’ learning outcomes and motivation compared to that of a lecture-based learning context. It also aims to explore the impact of demographic factors, such as gender and prior English proficiency. There are 129 participants: 42 male and 87 female. To ensure that all students benefit from the GBL environment, we explored their demographic background, including their prior English proficiency and gender. The results showed that students had greater gains in the GBL environment, especially those with lower English proficiency. The study finds a gender preference for game types, as well as an association between students’ satisfaction and confidence. The results indicated that integrating board games into English instruction can enhance undergraduates’ motivation and learning outcomes. A game-based context can enhance students’ motivation and learning outcomes regardless of their gender or prior English proficiency. Full article

Background: Nearshoring has risen after shocks and policy shifts. We synthesize evidence in a compact loop linking triggers (trade frictions, supply-chain risk, new agreements) to location choices mediated by multidimensional proximity (geographic, institutional, organizational, social, cognitive, functional) to components (manufacturing footprint, Foreign Direct Investment (FDI), employment) and outcomes (spillovers, productivity, innovation) conditioned by absorptive capacity and institutions. Methods: We conducted a literature review using major bibliographic databases. A staged screening pipeline (deduplication, pre-eligibility, and title–abstract screening) preceded full-text coding aligned with the review framework (triggers, proximity, components, outcomes, mediators). Studies were appraised with a five-criterion checklist, and themes were consolidated with basic bibliometric checks. Results: Evidence is North Atlantic and manufacturing-centric. Supply-chain disruptions dominate triggers; non-geographic proximity strongly moderates relocation. FDI anchors ecosystems, while employment effects are lagged and compositional. Strong capability and policy mixes yield broader spillovers; otherwise, benefits remain enclave-like. Sustainability and transformative outcomes are rarely assessed. Conclusions: The loop clarifies feedback from outcomes to future siting. Firms should build proximity beyond geography and pair early FDI with supplier and skills upgrading; policymakers should align instruments to governance, capability formation, and logistics. Research should expand Global South coverage and integrate environmental and inclusion metrics. Full article

Background: To evaluate the short-term effects of a dietary supplement containing curcumin, bromelain, glucosamine, chondroitin sulphate, sodium hyaluronate, type II collagen, and vitamin C on symptomatic vitreous floaters (SVFs) following Nd:YAG laser capsulotomy. Methods: Forty eyes with SVFs on the first postoperative day were randomized into a control group (standard topical therapy, n = 20) and a treatment group (oral supplement plus standard therapy, n = 20). Outcomes included best-corrected visual acuity (BCVA), contrast sensitivity (CS), and subjective scores from a non-standardized questionnaire on floater perception (QS1), interference with daily activities (QS2), and foreign body sensation (QS3). Objective evaluation was performed using two novel ultrasound-based methods: mean number of vitreous peaks (MVP) from A-scans and mean grey intensity (MGI) from B-scan images processed with ImageJ. Results: At 2 months, the treatment group showed greater improvement in CS (Δ = 0.26 LogCS, CI, 0.14–0.38; p < 0.01), QS1 (Δ = 1.10; 95% CI, 0.60–1.60; p < 0.01), QS2 (Δ = 0.90; 95% CI, 0.40–1.40; p < 0.01), QS3 (Δ = 0.90; 95% CI, 0.44–1.36; p < 0.01), MVP (Δ = 1.10; 95% CI, 0.60–1.60; p < 0.01), and MGI (Δ = 12.89 units; 95% CI, 7.84–17.93; p < 0.01). BCVA was comparable between groups (p = 0.478). Conclusions: Short-term dietary supplementation with vitreous-specific nutrients is well tolerated and associated with improvements in reducing SVFs and foreign body sensations after Nd:YAG capsulotomy and may represent a promising non-invasive therapeutic option. Full article

Background: Aorto-esophageal fistula (AEF) is a rare but life-threatening condition in children following foreign body (FB) ingestion, with button batteries (BB) being the most dangerous. These batteries involve severe tissue necrosis due to chemical and electrical reactions, often leading to fistula formation and catastrophic hemorrhage. Appropriate treatment for AEF is still undefined. Method: This report presents a novel case of AEF closure using a covered stent in a 4-year-old boy, complemented by a narrative review of 36 reported pediatric AEF cases from 1988 to 2024. Results: The review revealed that BB ingestion accounted for 67% of AEF cases, with a high mortality rate of 43%, underscoring the critical nature of this condition. Early symptoms are often nonspecific, leading to delayed diagnoses, which worsen outcomes. Computed tomography (CT) is the key imaging modality for detecting vascular complications such as AEF, while X-ray may help identify the foreign body, but is often insufficient to assess associated injuries. While surgical repair remains the mainstay of treatment, minimally invasive techniques, such as endovascular approaches, are emerging as viable options. Conclusions: This study highlights the need for heightened public awareness, safer battery designs, and prompt, multidisciplinary interventions to improve patient outcomes. Future research should focus on refining diagnostic protocols, evaluating innovative management strategies, and establishing comprehensive registries to inform evidence-based guidelines and optimize care. Full article

Background: Chronic maxillary sinusitis is most often linked to dental, allergic, or anatomical etiologies, with foreign body-induced forms remaining rare. This case report describes a unique occurrence of chronic maxillary sinusitis resulting from misplaced hyaluronic filler due to a facial esthetic procedure. Case presentation: A 60-year-old woman experienced right-sided maxillary sinusitis symptoms for three years after hyaluronic filler injections. Multi-slice computed tomography showed total sinus opacification, a vermicular foreign body, and a small anterior wall perforation. The patient underwent Caldwell-Luc surgery for foreign body removal and mucosal excision, followed by histopathological analysis. Results: The procedure was successful, with complete extraction of the foreign body compatible with hyaluronic filler. Postoperative recovery was uneventful, and symptoms resolved. This rare complication likely resulted from accidental filler penetration into the maxillary sinus during the injection. Conclusions: To the best of our knowledge, after a detailed search of the available literature, this is the first reported case of chronic maxillary sinusitis caused by material that is compatible with misplaced hyaluronic filler. It stresses the critical need to minimize serious complications in the facial esthetic procedures through detailed anatomical knowledge, technical skill, and a strict credentialing protocol of practitioners. Further awareness and regulations could improve patient safety. Full article