Search Results (1,770)

Focal therapy for prostate cancer (PCa) provides approaches to treat PCa patients in a less invasive manner than traditional whole-gland surgical or radiation modalities. This manuscript provides a case series of high-intensity focused ultrasound (HIFU), cryoablation, and irreversible electroporation (IRE) for PCa at a single institution and cost analysis with a review of the literature. All patients who underwent HIFU, cryoablation, or IRE for localized PCa were retrospectively reviewed, excluding patients who received whole-gland therapy. Functional outcomes were erectile dysfunction and lower urinary tract symptoms. Cost data were collected. A total of 45 patients were included in the study with focal therapy ranging from 2023 to 2025 (4 HIFU, 20 cryoablation, 21 IRE). A total of 30 patients had focally treated lesions, and 15 patients had hemi-gland treatment. The mean preoperative PSA was 7.7 ng/mL. On the paired sample t-test, there was no significant difference between pre-focal and post-focal therapy PSA. Three patients experienced biochemical recurrence requiring prostate biopsy after focal treatment. Mean cost was USD 3804.50 and not significantly different by focal treatment. No metastatic events occurred nor deaths at a median follow-up of 6 months. Patients in this series had largely unaltered functional outcomes. Cost analysis in contemporary publications is lacking. Although follow-up was short, cancer control was adequate. Full article

Teaching with technology enhances instructional effectiveness and student engagement, particularly in mathematics, accounting, and ICT education. Digital learning creates an interactive environment that fosters deeper understanding and keeps learners updated with current trends. For teachers, it offers tools to assess student strengths and weaknesses better, guiding them to develop targeted interventions. However, successful technology integration depends on educators’ digital skills, an area where many still face challenges. This paper aims to assess teachers’ technological and pedagogical proficiency and identify barriers to integration. The study employed a mixed-method approach with 60 teacher respondents selected through stratified random sampling from both urban and rural schools. Data was collected through online interviews, classroom observations, and pre- and post-survey questionnaires focusing on confidence, competence, and willingness to use technology. Thematic analysis and paired sample t-tests using SPSS v.20 revealed a significant improvement in teachers’ technological skills following an intervention program. It also identified both internal and external factors hindering technological integration in the classroom. Findings emphasize that sustained support and training are essential for effective technology use in the classroom and recommend that school administrators embed technology in curriculum planning to enhance both instruction and extension activities. Full article

Background: The aim of this study was to evaluate the cervical regeneration process following monopolar electrosurgical conization (MESC), using a multimodal approach including ultrasonographic, cytologic, colposcopic, and histologic assessments, and to determine the relationship between the extent of excision and the capacity for cervical tissue regeneration. Methods: This prospective observational study included 28 patients who underwent MESC due to abnormal cervical cytology or biopsy-confirmed cervical intraepithelial neoplasia. Preoperative, postoperative one month and six month cervical measurements were obtained using two-dimensional transvaginal ultrasonography. Monthly colposcopic evaluations were conducted, cervical biopsies were taken at the third month, and a cytological assessment was performed at the sixth month. Cervical volume and length regeneration were calculated and analyzed in relation to the dimensions of the excised cone. Regeneration percentages and their correlations with excised tissue dimensions were evaluated using paired t-tests and Pearson correlation analysis. Results: Mean cervical volume and length regeneration rates at six months were 84.61% ± 5.64 and 86.36% ± 3.33, respectively. The transformation zone was histologically visible in 32.1% of patients at three months and cytologically in 75.9% at six months. An inverse correlation was observed between both cone volume and length and cervical regeneration (p < 0.005). Patients with larger preoperative cervical dimensions exhibited a higher regenerative capacity. Positive surgical margins were found in only one patient (3.4%), and no high-grade cytologic abnormalities were noted at follow-up. Conclusions: MESC may enable substantial cervical regeneration within six months. Larger excisions impair healing and delay transformation zone reformation, which may inform the optimal timing for initiating gynecological and colposcopic examinations, as well as for performing cervical interventions when indicated. Full article

Background: With increasing involvement of pharmacists in clinical situations and expanding scope of practice, the expectation and management of uncertainty is a desirable component of pharmacy education, leading to improved uncertainty tolerance (UT) as pharmacists. Methods: The purpose of this pilot study was to determine whether an inpatient rounding simulation (IRS) that exposes student pharmacists to a level of uncertainty leads to changes in tolerance of ambiguity scale (TAS) scores and self-reflection comments. A pre-/post-observational, pilot survey study was conducted, including student pharmacists in their second professional year at the United States School of Pharmacy who were enrolled in an associated lab-based course in Spring 2024. Student teams completed a mock IRS and responded to clinical questions in a timed environment. Students completed pre-/post-simulation TAS and self-reflection on uncertainty/UT within the simulation. Pre-/post-simulation TAS scores were analyzed with a paired t-test. Qualitative analysis was used to identify themes in self-reflection. Results: 59 students responded (48% response rate). TAS was not different pre-/post-IRS (63.2 vs. 62.6, p = 0.63). When individual subscales were compared, a statistically significant difference was found in the insolubility subscale (10.5 vs. 9.5; p = 0.02). Themes of uncertainty that emerged during qualitative analysis of pre-simulation included the clinical question posed to the team. Student pharmacists overcame uncertainty pre-simulation by working with their team and relying on the availability of resources. Themes of uncertainty emerging during qualitative analysis of post-simulation included discerning the best answer. Student pharmacists overcame uncertainty post-simulation by working with their team and cited working with their team as a positive aspect of the IRS experience. Conclusions: In this pilot study, student pharmacists had high TAS scores both pre- and post-simulation. Students utilized their teams and cited this as a positive in an uncertain environment. Full article

Background: Movement symmetry in the lower limbs is critical for biomechanical efficiency, injury prevention, and athletic performance. Lateral (sideways) jumping challenges force production and control in the frontal plane and provide a unique assessment of neuromuscular coordination that may not be detected through sagittal-plane tasks such as running or vertical jumping. This study aimed to evaluate limb asymmetries in isometric knee muscle torque and ground reaction forces (GRFs) during lateral jumps in healthy young women, using the Symmetry Index (SI) to quantify differences between limbs. Methods: Twenty right-limb dominant females (mean age: 20.65 ± 4.51 years) participated in the study. Isometric torque of the knee flexors and extensors was measured using a dynamometric testing station. Lateral jumps were performed onto dual force platforms, with GRF components (vertical (PD), anterior–posterior (AP), mediolateral (ML)) recorded separately for rightward and leftward jumps. SI was calculated for all parameters to determine side-to-side asymmetries, and paired Student’s t-tests were used for statistical comparisons. Results: Right-limb dominance was evident in both knee flexor and extensor torque. Significant asymmetries were observed across all GRF components, varying with jump direction. The trailing limb in each jump direction typically generated greater propulsion forces. In lateral jumps, the trailing limb is generally the leg positioned opposite to the direction of travel, playing a primary role in generating propulsion and absorbing forces during take-off. SI values revealed both inter-individual variability and consistent direction-dependent asymmetry patterns. Conclusions: The or-posterior and vertical components, with greater loading on the dominant leg. Muscle torque measurements also revealed imbalances, with flexors showing more symmetry than extensors. These findings underline the importance of assessing load symmetry to prevent injury and guide rehabilitation. Full article

This study aimed to determine whether vagus nerve stimulation is effective in modulating psychological states such as anxiety, depression, and stress in elite shooters. A total of 18 female elite shooters (aged 18–19 years) were randomly assigned to either an experimental group (n = 9) or a control group (n = 9). The experimental group received vagus nerve stimulation for 30 min per session, once daily, seven days a week, over a period of four weeks. Psychological variables were assessed at three time points: pre-test (baseline), mid-test (2 weeks), and post-test (4 weeks). Two-way repeated measures ANOVA revealed significant group × time interactions for stress (p < 0.01), cognitive anxiety (p < 0.001), somatic anxiety (p < 0.01), confidence (p < 0.001), and depression (p < 0.01). Paired t-tests demonstrated significant reductions in stress, cognitive anxiety, somatic anxiety, and depression, as well as a significant increase in confidence within the experimental group. These findings provide compelling evidence that a 4-week course of vagus nerve stimulation can reduce stress, anxiety, and depression while enhancing confidence in elite shooters. Therefore, this intervention may serve as a beneficial strategy for improving mental health in elite shooters. Full article

Background/Objectives: Accurate full-arch impressions are crucial for predictable prosthodontic outcomes. While intraoral scanners (IOSs) are increasingly adopted, evidence comparing their accuracy with conventional analog impressions across full mandibular arches—particularly under both laboratory and clinical conditions using an objective intraoral reference—is limited. Our study aims to evaluate the in vitro and in vivo accuracy of digital impressions compared to conventional methods in full-arch scans using an intraoral reference tool. Methods: In this study, a custom stainless steel transfer aid carrying four 5 mm steel spheres in a trapezoidal configuration, provided with known reference distances, was used. Ten mandibular Frasaco models (in vitro) and ten healthy young adults (18–30 yrs) with intact lower arches (in vivo) received the bonded spheres. Six inter-sphere distances were defined: intermolar (BL-BR), interpremolar (FL-FR), diagonals (BL-FR, FL-BR), and lateral spans (BL-FL, BR-FR). Each arch underwent a digital scan (Medit i700) and a conventional monophase PVS impression, which was poured in Type IV stone and digitized (GOM Scan 1). The inter-sphere linear distances were measured in GOM Inspect, and trueness (deviation from reference) and precision (SD) were calculated. Data normality and homogeneity were verified; parametric t-tests and one-sample tests (α = 0.05) assessed differences between workflows and against reference values. Results: In vitro, analog impressions closely matched reference distances, with only the long-span BL-BR showing minor deviation (0.053 mm, p < 0.001). Digital scans showed significantly greater deviations across all spans (max 0.117 mm), particularly over long distances. In vivo, both workflows demonstrated comparable accuracy: only BL-BR (analog) and BR-FR (digital) differed significantly from the reference, and all AMEs remained within clinical thresholds (≤0.10 mm), except for BL-BR and BL-FL spans. ICC values ranged from moderate to high. Direct paired comparisons revealed statistically equivalent performance across most spans. Conclusions: Analog impressions outperformed digital scans in vitro, particularly across longer spans, confirming their superior dimensional fidelity under controlled conditions. However, in vivo, both workflows delivered statistically comparable and clinically acceptable accuracy. These findings suggest that while analog impressions remain the gold standard for precision-demanding contexts, modern intraoral scanners—when used correctly—can offer reliable full-arch mandibular impressions. The four-sphere reference system proved valuable for objective, anatomy-independent measurement. Full article

Aflatoxins are carcinogenic secondary metabolites produced by Aspergillus species and are common contaminants of many crops including maize. Atoxigenic Aspergillus flavus strains, formulated as biocontrol products such as Aflasafe^® TZ01, that comprises a mixture of four native atoxigenic strains, are used as pre-harvest agents to suppress toxigenic strains and reduce aflatoxin levels. This study assessed the intended and potential unintended impacts of Aflasafe^® TZ01 on mycotoxin contamination in maize. A total of 158 samples 79 from treated and 79 from untreated fields were collected from Chemba and Kiteto districts in Tanzania. Multi-mycotoxin analysis was conducted using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). Detected toxins included aflatoxins (AFB1, AFB2, AFG1, AFG2), trichothecenes, and fumonisins (FB1, FB2, FB3). Non-parametric paired t-test analysis showed significant reductions in AFB1 (62%, p = 0.024) in treated samples. The mean concentrations of Fusarium mycotoxins such as NIV, T2, and ZEN were higher in treated maize. However, statistical analysis showed that these differences were only numerical trends, and were not significant (p > 0.05). These findings confirm the efficacy of Aflasafe^® TZ01 in reducing aflatoxins, while underscoring the importance of continued monitoring for other mycotoxins as part of integrated mycotoxin management strategies to mitigate both aflatoxins and co-occurring toxins. Full article

Background: This review aimed to assess the association between upper molar distalization using clear aligners (CAs) and structural changes in the temporomandibular joint (TMJ). Methods: On February 20, 2025, the following databases were searched: PubMed, Embase, BASE, Web of Science, and Scopus. Studies were included if they reported on orthodontic treatment with CAs involving upper molar distalization and presented TMJ parameter measurements before and after treatment. The JBI Critical Appraisal Checklist for Quasi-Experimental Studies was used to assess the risk of bias. The collected data were analyzed using the paired t-test, mean difference assessment, and Spearman correlation matrix. Results: A total of 4 articles out of 238 records retrieved were included in the review. The mean age of patients was 23.18–29.80 years, and the treatment duration was 1.90–2.21 years. The most important changes were in the posterior and superior joint spaces (PJS and SJS) (p < 0.05), with SJS increasing in two studies (0.56 and 0.7 mm) and PJS increasing in one and decreasing in another (−0.94 and 0.36 mm). Conclusions: Limited evidence suggests that molar distalization with CAs may influence TMJ dimensions to a small extent. However, the results are inconsistent and require further validation with high-quality studies to draw firm conclusions. Registration: The review was pre-registered using the OpenScience Framework (OSF) on 17 April 2025—osf.io/9xyr8. No funding or conflicts of interest were reported. Full article

This study investigates the impact of injuries on National Basketball Association (NBA) player performance over 20 seasons, using large-scale performance data and a statistical evaluation. Injury events were matched with player–game performance metrics to assess how various injury types influence short-, medium-, and long-term performance outcomes, measured across 2-, 5-, and 10-game windows. Using paired sample t-tests and Cohen’s d, we quantified both the statistical significance and effect size of changes in key performance metrics before and after injury. The analysis applies paired t-tests and Cohen’s d to quantify the statistical and practical significance of performance deviations pre- and post-injury. Our results show that while most injury types are associated with measurable performance declines, especially in offensive and defensive ratings, certain categories, such as cardiovascular injuries, demonstrate counterintuitive improvements post-recovery. These patterns suggest that not all injuries have equivalent consequences and highlight the importance of individualized recovery protocols. This work contributes to the growing field of sports injury analytics by combining statistical modeling and sports analytics to deliver actionable insights for coaches, medical staff, and performance analysts in managing player rehabilitation and optimizing return-to-play decisions. Full article

The Internet of Things (IoT) has become an integral part of today’s smart and digitally connected world. IoT devices and technologies now connect almost every aspect of daily life, generating, storing, and analysing vast amounts of data. One important use of IoT is in utility management, where essential services such as water are supplied through IoT-enabled infrastructure to ensure fair, efficient, and sustainable delivery. The large volumes of data produced by water distribution networks must be safeguarded against manipulation, theft, and other malicious activities. Incidents such as the Queensland user data breach (2020–21), the Oldsmar water treatment plant attack (2021), and the Texas water system overflow (2024) show that attacks on water treatment plants, distribution networks, and supply infrastructure are common in Australia and worldwide, often due to inadequate security measures and limited technical resources. Lightweight cryptographic algorithms are particularly valuable in this context, as they are well-suited for resource-constrained hardware commonly used in IoT systems. This study focuses on the in-house developed ChaosFortress lightweight cryptographic algorithm, comparing its performance with other widely used lightweight cryptographic algorithms. The evaluation and comparative testing used an Arduino and a LoRa-based transmitter/receiver pair, along with the NIST Statistical Test Suite (STS). These tests assessed the performance of ChaosFortress against popular lightweight cryptographic algorithms, including ACORN, Ascon, ChaChaPoly, Speck, tinyAES, and tinyECC. ChaosFortress was equal in performance to the other algorithms in overall memory management but outperformed five of the six in execution speed. ChaosFortress achieved the quickest transmission time and topped the NIST STS results, highlighting its strong suitability for IoT applications. Full article

Background/Objectives: Spinal diffusion tensor imaging (sDTI) remains a challenging method for the selective evaluation of key anatomical structures, like pyramidal tracts (PTs) and dorsal columns (DCs), and for reliably quantifying diffusion metrics such as fractional anisotropy (FA), radial diffusivity (RD), mean diffusivity (MD), and axial diffusivity (AD). This prospective, single-center study aimed to assess the reproducibility, robustness, and reliability of an optimized axial sDTI protocol, specifically intended for long fiber tracts. Methods: We developed an optimized Stejskal–Tanner sequence for high-resolution, axial sDTI of the cervical spinal cord at 3.0 T. Using advanced standardized evaluation and post-processing methods, we estimated DTI values for PTs, DCs, and AHs at the level of the second cervical vertebra. Reliability was evaluated through repeated measurements in 16 healthy volunteers and by comparing results from two 3.0 T scanners (Magnetom Skyra and Magnetom Prisma, Siemens Healthineers, Erlangen, Germany). Reproducibility was assessed using paired t-tests, intraclass correlation coefficients (ICCs), Bland–Altman analysis, and coefficients of variation (CVs). Results: The optimized sDTI protocol demonstrated high consistency for FA between test–retest sessions and across scanners. For the Skyra, the DC region showed the highest reliability (average ICC = 0.858) followed by the PT region (average ICC = 0.789). On the Prisma, the PT region reached an average ICC of 0.854, with the DC region at 0.758. Pooled inter-scanner data indicated good-to-excellent agreement, particularly in the PT region (average ICC = 0.860). FA CVs remained low (<10%) across all regions and scanners. RD showed good-to-excellent ICC values for PTs and DCs (average ICC for Skyra 0.642 and 0.769 and 0.926 and 0.830 for Prisma, respectively) but showed a higher CV between 14.6 and 19.4% for these two scanners. Conclusions: Improved sDTI offers highly reproducible FA measurements for all metrics with scanner independence, supporting its potential as a robust tool for detecting and monitoring spinal cord pathologies. Full article

Background: Functional massage is a soft tissue intervention that combines tissue compression with specific joint movements to enhance muscle function, improve joint mobility and reduce pain. The physical working capacity at the fatigue threshold (PWC_FT) uses surface electromyography to determine the highest exercise intensity that can be sustained indefinitely. The purpose of this study, therefore, was to examine the influence of FM on a multi-joint exercise such as cycle ergometry. Methods: Twelve healthy college-aged men volunteered for the current study. On two occasions, separated by seven days and in randomized order, subjects either completed a 14 min FM on both legs prior to an incremental cycle ergometer test to determine PWC_FT, or rested for 14 min before performing the same cycling test. Results: The paired samples t-tests revealed a significant (p < 0.05) difference for the absolute and relative PWC_FT values between the no-FM and FM conditions. Conclusions: These results indicate that FM may delay the onset of neuromuscular fatigue for whole-body exercise. Full article

Boa constrictor snakes represent a suitable model for studying the absorption, metabolism, and elimination of tramadol due to their distinct physiological characteristics. The objective of this work was to provide preliminary data on the pharmacokinetics of tramadol and its active metabolite, O-desmethyltramadol (M1), in the plasma of Boa constrictor using liquid chromatography with fluorescence detection. Ten snakes received tramadol (5 mg kg⁻¹) both into the epaxial musculature (TRIM) and into the paravertebral vein (TRIV) with a 45-day interval between the two administration methods. Blood samples were taken at specified time points to analyze the pharmacokinetics. Data were evaluated with an independent pharmacokinetic model (R software version 4.3.0). A paired Student’s t-test was used for all parametric variables, except clearance, which was analyzed with the Wilcoxon test. A significance level of 5% was applied. The mean (range) maximum concentration of tramadol, volume of distribution, clearance, and elimination half-life for the TRIM group were 2.58 µg mL⁻¹, 10.58 ± 2.91 L kg⁻¹, 0.36 L kg⁻¹ h⁻¹, and 19.96 ± 8.34 h, respectively. For the TRIV group, these values were 3.39 µg mL⁻¹, 5.60 ± 1.69 L kg⁻¹, 0.22 L kg h⁻¹, and 17.32 ± 7.55 h⁻¹, respectively. M1 achieved maximum concentration and elimination half-lives of 0.58 µg mL⁻¹ and 49.89 ± 10.8 h, respectively, for TRIM and 0.59 µg mL⁻¹ and 35.66 ± 10.85 h for TRIV. The bioavailability of intramuscular tramadol was 61%, and M1 remained at similar concentrations for 20 min after tramadol administration in both treatments. Tramadol is rapidly biotransformed into M1 in Boa constrictors, maintaining high concentrations over an extended period. The pharmacokinetic characteristics, particularly the sustained plasma concentrations of M1, suggest potential for effective analgesia in the Boa constrictor. Furthermore, the intramuscular route provides the additional advantage of ease and practicality of administration. Full article

The different macro and micro geometries of dental implants are parameters that directly affect osseointegration, making them an important area for research. The objective of this preclinical study was to compare, through histological and histomorphometric analyses, the biological response of two different dental implant surfaces in osseointegration. Surface morphology and chemistry were characterized by SEM/EDX, optical-emission spectroscopy, protein adsorption (BSA), and adipose-derived stem-cell morphology. For the in vivo arm, ten commercially pure titanium implants (n = 5 LS160 + 5 SBAE) were placed bilaterally in the tibiae of five skeletally mature New Zealand rabbits (one implant of each surface per animal). After six weeks, undecalcified sections were prepared and bone-to-implant contact (BIC) and bone-area-fraction occupancy (BAFO) were quantified histomorphometrically. Data normality was confirmed with the Shapiro–Wilk test; paired two-tailed Student’s t-tests were applied (α = 0.05). Results: The descriptive histological analysis showed a fraction of pre-existing bone in all experimental groups, which probably ensured primary stability. Adjacent to this area, it was possible to observe peri-implant newformed bone in all tested groups. The results of the histomorphometric analysis of BIC and BAFO were considered normal by the Shapiro–Wilk test (p > 0.05); after six weeks of implantation, the BIC values for the LS160 and SBAE groups were 44.13 (15.83–72.43) and 39.24 (10.72–89.21), respectively. The analysis of variance (ANOVA and Tukey’s post-test) showed no statistical differences between the groups tested. Likewise, the bone volume density showed no statistical differences between the groups (ANOVA and Tukey’s post-test) with averages of 41.27 (C.I. 24.00–58.55) and 26.52 (C.I. −17.51–70.54) in the LS160 and SBAE groups, respectively. Although both surfaces showed similar osseointegration after six weeks, the new surface appears to be a promising, eco-friendly alternative to SBAE. Future studies with shorter time points and larger samples are needed to assess early biological responses. Full article