Search Results (14,174)

Dental caries is one of the most prevalent chronic diseases affecting older adults and remains an important, underrecognized contributor to pain, impaired nutrition, systemic illness, and reduced quality of life. Older adults access medical care more often than dental care, positioning non-dental clinicians to identify risk, initiate prevention, and facilitate timely referral. A narrative review of English-language literature was conducted using PubMed and Google Scholar. Search terms included “dental caries,” “root caries,” and “older adults.” Sources included original studies, clinical guidelines, consensus statements, and high-quality reviews, with an emphasis on relevance to older adults and applicability to non-dental clinicians. Dental caries in older adults commonly presents as root and recurrent decay and isstrongly associated with xerostomia, polypharmacy, chronic disease, functional impairment, cognitive decline, and limited access to dental care. The literature supports fluoride-based prevention, management of salivary dysfunction, dietary counseling, minimally invasive therapies such as silver diamine fluoride, and interprofessional care models. Non-dental providers play a critical role in screening, risk assessment, preventive counseling, symptom triage, and referral. Integrating oral health into routine medical care is an essential and achievable strategy to reduce morbidity and improve health outcomes in older adults. Full article

Biofortification of wheat has emerged as a sustainable strategy to combat global micronutrient deficiencies, particularly iron (Fe) and zinc (Zn) deficiency, while simultaneously improving grain protein quality. Among available approaches, mutation breeding has gained renewed attention as a non-transgenic tool capable of generating novel genetic variability for nutritional enhancement. This review is based on a comprehensive analysis of peer-reviewed literature retrieved from major scientific databases, including Web of Science, Scopus, PubMed, and Google Scholar. Studies published between 2005 and 2025 were critically evaluated to compare the effectiveness, advantages, limitations, and future prospects of wheat biofortification approaches. This review critically evaluates the role of mutation breeding in wheat biofortification and compares its effectiveness with conventional breeding, agronomic biofortification, and genome editing technologies. Evidence from published studies indicates that gamma-induced mutant lines have achieved significant increases in grain Fe and Zn concentrations, as well as improvements in storage protein composition, without regulatory constraints associated with transgenic methods. However, variability in genetic stability, potential yield penalties, and genotype × environment interactions remain important limitations. Overall, integrating mutation breeding with advanced molecular tools and agronomic practices offers a promising strategy for developing nutrient-enriched wheat varieties and enhancing global food and nutritional security. Full article

This study examines how Feng Shui quality of residential property, perceived green building features, and age group are associated with homebuyers’ purchase intention in Taiwan. Drawing on the literature on Feng Shui culture, green building features, and residential purchase decision-making, this study conceptualizes Feng Shui quality and green building features as two residential attributes that may influence homebuyers’ purchase intention. A structured online questionnaire survey was conducted between February and March 2025, yielding 584 valid responses from potential homebuyers in Taiwan. The data were analyzed using reliability analysis, correlation analysis, confirmatory factor analysis, and PROCESS Model 15 moderated mediation analysis. The results show that Feng Shui quality had a significant positive effect on perceived green building features and purchase intention. Perceived green building features were positively associated with purchase intention in most age groups, but the effect was not significant in the reference age group. The conditional indirect effects further indicated that perceived green building features mediated the relationship between Feng Shui quality and purchase intention in some age groups, but not in all groups. However, age group did not significantly moderate the relationship between Feng Shui quality and purchase intention or the relationship between perceived green building features and purchase intention. The indices of moderated mediation were also not significant. These findings suggest that Feng Shui quality may be associated with both green building perceptions and purchase intention, while green building features may serve as a partial explanatory mechanism in some age groups. The study contributes to residential purchase decision research by examining traditional Feng Shui culture and modern green building features within the same empirical framework, while acknowledging the limitations of self-reported, cross-sectional survey data. Full article

Expressway travel demand climbs steeply during public holidays, and the severe congestion that follows has become a principal constraint on both network operating efficiency and the quality of travel services. Dependable forecasting of holiday congestion, coupled with the practical realization of proactive management, accordingly carries considerable theoretical and practical weight for improving how expressways are operated and administered and for safeguarding efficient and safe public travel. Organized around the central theme of congestion prediction and proactive management for expressways over holiday periods, this paper reviews the progress of research across five interrelated areas: traffic speed and flow prediction methods; congestion state identification and forecasting; holiday travel characteristic analysis together with demand prediction; multi-source data fusion and congestion propagation mechanisms; and expressway traffic control together with traveler behavior guidance. Having surveyed the theoretical underpinnings, core technologies, and representative methods of each area, the paper concentrates in particular on the shortcomings and difficulties that existing studies encounter in coping with the hallmark features of holiday traffic, namely demand surges of short duration combined with pronounced spatiotemporal heterogeneity, and proceeds to outline promising avenues for subsequent research. Overall, the review seeks to provide wide-ranging literature support and a theoretical reference for developing technologies that predict and proactively manage congestion on expressways during public holidays. Full article

Camel milk (CM), which is produced by both Camelus dromedarius and Camelus bactrianus, is gaining increasing popularity as a value-added functional dairy product, but the science of managing its shelf life has progressed more slowly than its commercial expansion. Unlike bovine milk, CM lacks β-lactoglobulin (β-LG), has a unique casein (CN) micelle structure with a high β-CN-to-αs1-CN ratio, and low κ-CN protein content, and contains an unusually rich bioactive protein fraction including lactoferrin (LF), immunoglobulin G (IgG), lysozyme (LZ), and peptidoglycan recognition protein (PGRP). These compositional characteristics imbue CM with both significant inherent antimicrobial benefits and place it at risk of processing weaknesses that do not have direct analogs in bovine dairy science. The review discusses three key areas of CM shelf life science that have not been sufficiently addressed in the published literature. The first relates to physicochemical mechanisms of deterioration, including lipid oxidation of polyunsaturated fatty acids (PUFA), destabilization of CN micelles in the structural absence of β-LG, and Maillard browning during thermal treatment and storage of powder. The second addresses the fate of bioactive proteins, with the majority being lactoferrin (LF), immunoglobulin G (Igs), and heavy chain-only antibodies (HCAbs), under both thermal and non-thermal processing conditions. The third looks at new non-thermal preservation methods, such as high-pressure processing (HPP), pulsed electric field (PEF), ultrasonication, ultraviolet irradiation, cold plasma, and electromagnetic (EM) field treatment, and functional packaging innovations, which contribute to longer shelf life. Of the non-thermal options examined, HPP at 200–400 MPa today provides the most mechanistically proven evidence for camel-specific microbial deactivation with satisfactory quality preservation. The latest primary CM research also indicates that processing with EMs in the 850 mT range can potentially be as effective as conventional pasteurization in microbial control and may be more effective than pasteurization in retaining desirable bioactive markers, although this result needs to be independently replicated before more responsible conclusions can be drawn. The review ends with four priority research gaps: standardized kinetic shelf life modeling frameworks, systematic characterization of bioactive protein stability under commercial processing conditions, life cycle assessment of preservation chains across the camel dairy supply continuum, and the urgent validation of camel-specific pasteurization adequacy indicators to replace bovine alkaline phosphatase, which remains active in CM after conventional high-temperature short-time (HTST) pasteurization. Full article

The modern multi-domain battlespace increasingly demands cost-effective, persistent platforms for Forward Air Control (Airborne) (FAC(A)) and Close Air Support (CAS) missions. While utilizing Commercial Derivative Aircraft (CDA) presents a viable alternative to high-maintenance military assets, the specific aerodynamic, ergonomic, and cognitive workload limitations encountered during the transition across the civil–military “airworthiness seam” remain a significantly underexplored gap in contemporary aerospace literature. To address this gap, a comprehensive empirical flight test campaign was executed on the LX7-135 turboprop to evaluate its tactical mission suitability. Employing the Cooper–Harper Handling Qualities Rating and Bedford Workload scales, and guided by military specifications (MIL-HDBK-516C, MIL-F-8785C), the study systematically assessed the aircraft’s pure performance, unaugmented flight dynamics, and human–machine interface during simulated combat scenarios, including dynamic 9-Line briefings and kinetic “Box Pattern” delivery profiles. Flight test data indicated 12 “SATISFACTORY” parameters, highlighting climb rates, extended endurance, and heavily damped short-period and Dutch roll modes optimal for target tracking. Conversely, the evaluation identified 4 “UNSATISFACTORY” and 10 “TOLERABLE” deficiencies—chiefly a single-door egress bottleneck, restricted stick clearance, degraded longitudinal static stability, and the absence of secure tactical communications. Although these constraints elevated pilot cognitive workload during multi-axis tasks, the LX7-135 demonstrates potential suitability for further development for the FAC(A) role, subject to the successful implementation and subsequent flight-test verification of the identified critical engineering modifications and specialized training syllabi. Full article

The aim of this article is to provide a literature review of current approaches and recommendations for medical rehabilitation in stroke patients, with the goal of achieving the best possible outcomes for their condition and improving their quality of life. Materials and Methods: A narrative review was conducted of articles published in the databases available to us (PubMed, ScienceDirect, Google Scholar, PEDro, ResearchGate) that contain information regarding therapeutic management of stroke and, in particular, interventions aimed at motor recovery and improving quality of life. Included in this literature review were: scientific articles, guidelines on stroke and motor rehabilitation, clinical studies, longitudinal clinical studies, controlled clinical studies, systematic reviews, and meta-analyses published before April 2026, covering a ten-year period. Results: Data showing a trend toward higher patient survival rates following acute stroke were identified. For this reason, existing non-pharmacological approaches to motor recovery should be optimized. The rehabilitation process must begin as early as possible. Motor recovery depends on the establishment of motor control and the neuroplastic processes occurring in brain tissue. Rehabilitation is conducted by a rehabilitation team with the patient’s active participation, while monitoring motor rehabilitation potential. Conclusions: Rehabilitation is an essential component of post-stroke treatment. When timely and adequate medical rehabilitation is provided to stroke patients, there is a significant improvement in their overall condition and motor functions, as well as in their independence, self-care, and quality of life. Full article

Background: Tooth auto-transplantation (TAT) is a surgical procedure in which a person’s own tooth is extracted and repositioned in the recipient site. The aim of the study is to evaluate the clinical outcomes, treatment strategies, and methodological characteristics, and to propose a preliminary management algorithm of TAT in patients with cleft lip and/or palate (CLP). Methods: A search of the literature was conducted in PubMed, Google Scholar, ClinicalKey, Web of Science, and Cochrane Library databases until 21 June 2026. The systematic review was written according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Risk-of -bias was assessed by the Joanna Briggs Institute (JBI) tool. Results: Five case series and three case reports were included, with four “low” and four “moderate” JBI reporting-quality ratings (reflecting reporting completeness, not low risk of bias). They presented data about 23 patients and 27 TAT cases. The majority of patients (n = 16) received secondary alveolar bone graft with iliac bone. The most common donor teeth were mandibular premolars (n = 20). The most frequent recipient sites were the maxillary 2nd premolar (n = 9) and maxillary incisors (n = 15). Twenty-six teeth (96.3%) survived, and one tooth (3.7%) was extracted. Conclusion: TAT appears to be a promising treatment option in carefully selected CLP patients; however, further high-quality studies are needed with the application of our proposed algorithm. Full article

Obesity is a multifactorial condition that profoundly affects female reproductive health through endocrine, metabolic, and inflammatory mechanisms that disrupt the hypothalamic–pituitary–gonadal (HPG) axis. Women with obesity frequently develop menstrual irregularities, anovulation, amenorrhea, infertility, polycystic ovary syndrome (PCOS), impaired endometrial receptivity, and adverse pregnancy outcomes. Central obesity and insulin resistance contribute to hyperinsulinemia, reduced sex hormone-binding globulin (SHBG) levels, hyperandrogenism, altered gonadotropin secretion, and impaired folliculogenesis, while adipokines such as leptin and chronic inflammation further impair ovarian steroidogenesis and ovulatory function. Obesity-related oxidative stress and lipotoxicity also negatively affect oocyte quality, embryo development, implantation, and assisted reproductive technology outcomes, increasing the risk of gestational diabetes, preeclampsia, miscarriage, and preterm birth. This review evaluates the therapeutic potential of pharmacological weight-loss therapies in obesity-associated female reproductive dysfunction. A comprehensive literature review was conducted using various databases, focusing on anti-obesity pharmacotherapy on obesity, infertility and fertility in reproductive-aged women. Evidence suggests that several FDA-approved and off-label anti-obesity agents, including orlistat, liraglutide, semaglutide, phentermine/topiramate, bupropion/naltrexone, metformin, exenatide, and tirzepatide, may improve reproductive outcomes primarily indirectly through weight reduction and metabolic improvement. GLP-1 receptor agonists, particularly liraglutide, semaglutide, and exenatide, appear especially promising, demonstrating beneficial effects on insulin sensitivity, menstrual regularity, ovulation, androgen levels, and pregnancy rates in women with PCOS. Tirzepatide, a dual GLP-1/GIP receptor agonist, has shown potent weight-loss and metabolic effects with potential indirect fertility benefits. Metformin improves insulin sensitivity and is widely used in PCOS to regulate androgen levels and restore ovulation, although its effects on pregnancy and live birth rates remain controversial. However, evidence for several agents remains limited, and concerns persist regarding reproductive safety during pregnancy. Overall, anti-obesity pharmacotherapy may represent an important adjunctive strategy for improving reproductive and metabolic health in women with obesity, although larger randomized clinical trials are still required. Full article

Objectives: To estimate the added value of dostarlimab compared to durvalumab and pembrolizumab as first-line treatment for adult patients with primary advanced or recurrent endometrial cancer (EC) in Spain using a Multi-Criteria Decision Analysis (MCDA) framework. Methods: Following the Evidence and Value: Impact on Decision Making (EVIDEM) framework and International Society for Pharmacoeconomics and Outcomes Research (ISPOR) recommendations, 25 Spanish experts (12 medical oncologists and 13 hospital pharmacists) weighted and scored 11 quantitative and 5 qualitative criteria based on an evidence matrix from a literature review. Results: Efficacy and safety were weighted as the most important criteria. Dostarlimab showed positive added value in both comparisons with scores of 0.58 versus durvalumab/durvalumab + olaparib and 0.50 versus pembrolizumab. Dostarlimab and pembrolizumab are the only therapies reimbursed in the Spanish public health system; therefore, their comparative assessment is of clinical and strategic relevance. While pembrolizumab may show longer progression-free survival (PFS) and response duration in specific subgroups, the evidence for dostarlimab—including a statistically significant improvement in overall survival (OS) in the overall population as a primary endpoint, more robust data, and favorable long-term quality-of-life outcomes—was considered by the expert panel to support a more favorable assessment. Conclusions: Within the MCDA framework, experts consider dostarlimab an option with a higher value contribution for adult patients with primary advanced or recurrent EC. Its clinical benefits, improved quality-of-life outcomes, and alignment with healthcare priorities promote treatment continuity and adherence in clinical practice. MCDA provided a transparent approach for multidimensional evaluation of these therapies. Full article

Cachaça is one of Brazil’s most important distilled spirits, and its chemical and sensory quality is strongly influenced by the technological conditions adopted throughout production. Among the physicochemical parameters used to assess quality, volatile acidity has traditionally been regarded as a regulatory criterion; conversely, increasing evidence indicates that its significance extends beyond legal compliance, reflecting microbial control, fermentation performance, distillation practices, storage conditions, and consumer perception. This narrative review critically examines the current knowledge regarding the formation, technological modulation, regulatory relevance, and sensory implications of volatile acidity in Brazilian cachaça. The literature was selected from major scientific databases and official regulatory documents, emphasizing studies addressing fermentation, distillation, aging, chemical quality, and sensory evaluation. The review discusses the biochemical pathways involved in acetic acid formation, the influence of acetic acid bacteria, oxygen availability, hygienic practices, distillation fraction separation, and oxidative processes during storage. It further compares Brazilian regulatory requirements with those adopted for other distilled beverages and examines the relationship between volatile acidity and sensory perception, highlighting the absence of consensus regarding sensory thresholds specific to cachaça and the influence of beverage matrix and volatile interactions on consumer acceptance. Finally, the review proposes volatile acidity as an integrated quality marker capable of reflecting multiple technological stages rather than an isolated analytical parameter. Current knowledge gaps, particularly regarding the integration of chemical, microbiological, and sensory data, are discussed to support future research and contribute to the continuous improvement, standardization, and international competitiveness of Brazilian cachaça. Full article

Owing to its infinite shelf-life under ambient conditions, satisfactory recyclability, and great reparability, carbon fiber-reinforced polyphenylene sulfide (CF/PPS) has been increasingly applied in the near-net-shape manufacture of high-value components. Longitudinal torsional ultrasonic vibration-assisted milling (LTUVAM) shows strong potential as an advanced processing technology for the efficient precision machining of composites. However, studies and models on the explanation of LTUVAM of CF/PPS composites seem to be missing in the literature. This paper proposes a finite element analysis method for LTUVAM of UD-CF/PPS processes. The kinematic analysis of the LTUVAM is proposed first, then the mechanism of surface formation during UD-CF/PPS milling process is provided. A simulation method which could simultaneously achieve both longitudinal and torsional vibration motions is introduced in the finite element model, enabling the simulation of LTUVAM of UD-CF/PPS composites. The experimental validations were conducted under both CM and LTUVAM conditions with three different cutters, demonstrating that cutting force simulations have significant agreement with experimental data, and both simulation and experiment indicate that LTUVAM produces superior surface quality compared to CM; the fiber debonding at the microscopic level could be eliminated and the height of machined surfaces could be significantly reduced when LTUVAM is utilized. These findings could also open avenues for clarification of other scientific queries such as cutting parameters optimization, cutting tool selection, and modeling of the UD-CF/PPS drilling process. Full article

The convergence of Lean Six Sigma and Industry 4.0 has emerged as a critical pathway toward intelligent manufacturing transformation. However, existing integration studies remain fragmented across technologies, DMAIC phases, and industrial contexts, with limited deployment architectures tailored to Electronics Manufacturing Services environments. This study addresses this gap by conducting a systematic literature review of Lean Six Sigma–Industry 4.0 integration research and developing a unified DMAIC-based conceptual framework specifically designed for EMS. Using a PRISMA-guided systematic review methodology, the selected studies were evaluated through quality appraisal, multidimensional analytical coding, quantitative diagnostic analysis, and cross-dimensional synthesis to move beyond descriptive literature mapping toward mechanism-based interpretation. The findings reveal that Industry 4.0 technologies are heavily concentrated in the Measure and Analyze phases, whereas Define and Control remain underdeveloped, resulting in structurally imbalanced maturity. To address these limitations, this study proposes an EMS-oriented conceptual framework that adapts established DMAIC practices by integrating Industry 4.0 technologies, deployment readiness criteria, digital traceability, and data-driven decision support into unified conceptual architecture. Rather than introducing a new DMAIC methodology, the framework contextualizes existing Lean Six Sigma principles for Electronics Manufacturing Services (EMS), providing a structured approach for intelligent continuous improvement in defect-sensitive manufacturing environments. Unlike previous frameworks that primarily associate Industry 4.0 technologies with individual DMAIC phases, the proposed framework introduces deployment readiness assessment, adaptive decision-gate mechanisms, enterprise-specific conceptual guidance, and EMS-oriented operational integration within a unified conceptual architecture. Full article

Background/Objectives: Neuron-specific enolase (NSE) is one of the most extensively investigated biomarkers for neurological prognostication after cardiac arrest. However, uncertainty remains regarding the influence of targeted temperature management (TTM) on NSE kinetics, optimal prognostic thresholds, and predictive accuracy. This systematic review and meta-analysis aimed to evaluate the prognostic performance of NSE and assess the impact of TTM on its clinical utility in contemporary post-resuscitation care. Methods: A systematic search of PubMed/MEDLINE, Embase, and Scopus was conducted to identify studies published between January 2000 and April 2026. Literature screening, data extraction, and quality assessment were performed in accordance with the PRISMA 2020 statement. Methodological quality was assessed using the Newcastle–Ottawa Scale and the Cochrane Risk of Bias tool, when applicable. Quantitative synthesis was performed for studies reporting sufficiently homogeneous area under the receiver operating characteristic curve (AUC) data. Results: Twenty-one studies met the eligibility criteria and were included in the qualitative synthesis, of which seven were eligible for quantitative analysis. NSE demonstrated good overall prognostic performance for predicting neurological outcome after cardiac arrest, with a pooled AUC of 0.868 (95% CI: 0.849–0.885) and no significant between-study heterogeneity (I² = 0%). Prognostic performance was generally highest when NSE was measured between 48 and 72 h after return of spontaneous circulation. Considerable variability was observed in reported prognostic thresholds, particularly across different TTM strategies. Serial NSE measurements and multimodal neuroprognostication approaches consistently improved predictive performance. Conclusions: NSE provides good prognostic accuracy for neurological outcome prediction after cardiac arrest and remains clinically valuable in patients managed with TTM. Serial measurements obtained between 48 and 72 h after return of spontaneous circulation appear to provide the greatest prognostic value. NSE should be interpreted as part of a multimodal neuroprognostication strategy rather than as a standalone predictor. Full article

Population aging is increasing across Arab countries. As a result, loneliness and social isolation among older adults have become important public health concerns due to their impact on well-being. This review aimed to examine research trends on loneliness, isolation, and well-being among older adults in Arab countries; synthesize evidence on their associations with well-being; and identify gaps and priorities for future research. A combined bibliometric analysis and systematic review was conducted. The findings indicate that research on this topic has grown substantially since 2020 but remains limited and concentrated in a small number of countries. Research on the mental health consequences of loneliness dominates the literature. Across studies, loneliness and social isolation were consistently associated with poorer mental health, lower quality of life, greater psychological distress, and adverse physical and nutritional outcomes. However, the literature largely appears to conceptualize loneliness and social isolation as individual or clinical problems, with limited attention paid to their broader social and structural determinants. Research also remains predominantly descriptive, with comparatively little focus on interventions, prevention strategies, or solution-oriented responses. This review makes suggestions for future research, including attention to social and structural factors, protective factors, and intervention-oriented approaches to loneliness and isolation in later life. Full article