Search Results (308)

Chronic pain is increasingly understood as a multidimensional condition in which, in a substantial subgroup of patients, a protective symptom can evolve into a persistent maladaptive disorder of the nervous system, while in others it may remain closely tied to ongoing mechanical or structural factors. Central sensitization (CS) represents a key mechanism underlying this transition, characterized by enhanced neural responsiveness and impaired endogenous pain inhibition, leading to a dissociation between pain and tissue pathology. The aim of this narrative review is to critically discuss current evidence on CS as a mechanism-based explanation for persistent pain, using lumbar disk herniation (LDH) as a clinical model of the radiological-clinical mismatch, and to discuss its direct implications for identifying sensitized phenotypes, multimodal assessment, and rehabilitation strategies. A total of 77 sources published between 2006 and 2026 were synthesized. These reviewed sources demonstrate that identification of the sensitized phenotype requires a multimodal assessment approach combining self-report measures, such as the Central Sensitization Inventory (CSI), with psychophysical methods including quantitative sensory testing (QST) and conditioned pain modulation (CPM). Cognitive-emotional factors are also critical, as postoperative kinesiophobia affects approximately 38.3% of LDH patients and is associated with increased pain intensity and reduced self-efficacy. Management strategies reported in these publications focus on mechanism-based interventions, particularly pain neuroscience education (PNE) and graded, time-contingent exercise, which aim to modify pain-related cognitions and restore endogenous inhibitory processes. These approaches may be supported by adjunctive therapies, including dry needling (DN), electro-dry needling (EDN), centrally acting pharmacological agents (e.g., serotonin–norepinephrine reuptake inhibitors [SNRIs] and gabapentinoids), and psychologically informed treatments such as cognitive behavioral therapy (CBT). While surgical decompression may reduce CS-related symptoms, preoperative sensitization does not necessarily predict poorer outcomes, highlighting the interaction between peripheral and central mechanisms. Adopting a sensitization-informed perspective may encourage a broader integration of contemporary pain models alongside traditional structural views in lumbar disc herniation clinical care. Full article

Cone-beam computed tomography (CBCT) is widely used in dentomaxillofacial imaging, but its expanding use requires cautious appraisal of stochastic risk and dose optimization. This updated structured narrative review summarizes evidence on organ dose, effective dose, modeled cancer-risk estimation, cumulative exposure, diagnostic reference levels, and patient shielding in dental CBCT. PubMed/MEDLINE and Scopus searches were updated to 15 May 2026. Overall, 24 primary studies were synthesized: 9 addressing dose, diagnostic reference levels, cumulative exposure, or cancer-risk modeling, and 15 evaluating shielding or radiation-protection strategies. Dose and modeled risk varied markedly according to scanner type, field of view, exposure parameters, anatomical region, age, sex, and repeat imaging. The salivary glands, oral mucosa, thyroid, and eye lens were the most relevant exposed organs; children, female patients, and patients undergoing repeated imaging represented the most vulnerable groups. Shielding studies reported substantial dose reductions in selected protocols, but the benefit depended on shield design, positioning, field of view, and image-quality impact. Dental CBCT should be prescribed only when three-dimensional information is expected to change management and should be optimized through the smallest adequate field of view, low-dose protocols, cumulative-dose awareness, and selective shielding when diagnostically appropriate. Full article

In the face of the raw materials crisis and environmental concerns, sustainable waste management has become a priority for current and future generations. Recycling waste from wastewater treatment plants in a closed loop protects natural resources, reduces landfill volumes, and lowers disposal costs. This paper presents the results of tests on the physical, filtration, and mechanical properties of mixtures of washed mineral waste (WMW) from grit chambers with fly ash from the thermal treatment of municipal sewage sludge (SSA) in a fluidized bed furnace. Additionally, radiological tests of the mixture components were conducted. Based on the conducted tests, the possibility of sustainable use in civil engineering, such as soil backfills and embankment construction materials, was assessed. The possibility of safely using waste materials in the indicated construction solutions was demonstrated for mixtures with dominant WMW content (90% and 70% by total weight). The waste mixtures correspond to poorly or medium-grade sands with a small amount of silt (uniformity coefficients of 3.33, 3.50, and 8.00). They are characterized by maximum dry densities of 1.542, 1.770, and 1.780 g/cm³; optimal moisture contents of 12.54, 12.86, and 20.25%; permeability coefficients of 0.08, 0.22, and 0.39 m/d; and internal friction angles of 38.4, 39.5, and 40.1°. The values of the determined parameters of some mixtures are similar to those of natural sands used as construction aggregates. All mixtures meet the geotechnical criteria for use in road embankments, below frost depth, and in flood embankment bodies. Mixtures with a 90% mass fraction of WMW were also approved for application as backfill for installation trenches. However, none of the mixtures met the hydraulic conductivity threshold required for the upper layers of embankments nor for backfill of abutments and retaining structures without the use of an additional binder (cement or lime), which is considered a prerequisite for these applications. Full article

When pregnant patients undergo diagnostic and therapeutic radiological procedures, the unborn child is exposed to an increased risk due to the use of ionizing radiation; therefore, the fetal dose must be estimated and optimized. Tools and methods routinely used for fetal dose estimation lack better personalization of patients. To address this, we developed a software tool for creating phantoms at different pregnancy stages and with varying patient anatomies to further personalize fetal dose estimation using measurements and Monte Carlo simulations. The tool is developed and incorporated into 3DSlicer version 5.6.2 as a plugin. Phantoms are created based on a real patient phantom, Tena, and physiological data for use in radiological protection. Phantoms are developed with only soft, lung, and bone tissue substitutes, represented for the mother and unborn child. This enables the construction of segmented voxel models as well as mesh models (with the ability to export geometries to DICOM format) of the anatomical structures of pregnant women. Additionally, it allows real patient image registration to enable better personalization of the phantom. The tool can help decrease uncertainty in fetal dose estimation, as well as simplify and accelerate the process of fetal dose estimation. It is released publicly to enable further research. Full article

Complicated community-acquired pneumonia (cCAP) remains a major cause of morbidity in children. Although pneumococcal conjugate vaccines (PCVs) have reduced invasive disease, severe complications such as empyema and lung abscess persist. A retrospective analysis was conducted on 69 children treated at the University Children’s Hospital Belgrade between 2019 and 2024. Data included demographic characteristics, pneumococcal vaccination status, and radiologically confirmed complications. Patients were classified by residence and vaccination status. Statistical analysis included chi-square (χ²) tests, odds ratios (ORs) with 95% confidence intervals, and multivariable logistic regression. Pleuropneumonia and pleural effusion were the most frequent complications, while empyema and lung abscess were the most severe. Both occurred significantly more often in unvaccinated children (p = 0.0054 and p = 0.0027). Multivariable analysis confirmed vaccination as an independent protective factor against empyema (adjusted OR = 0.19, 95% CI 0.06–0.61). No significant regional differences were observed after accounting for vaccination status. Vaccination showed a strong protective effect against empyema and lung abscess (OR = 0.24 and 0.04, respectively). Unvaccinated children had significantly longer hospital stays, indicating a more severe clinical course. Prolonged hospitalization was associated with intensified antibiotic therapy, reflecting underlying disease severity. Lack of pneumococcal vaccination is strongly associated with severe complications in children with cCAP. Maintaining high PCV coverage remains essential, alongside early recognition and timely management of pleural disease. Full article

Anthropogenic pollution may impose additional pressure on European populations of large protected carnivores due to the systemic toxicity of contaminants such as cadmium, lead, and radiocaesium (¹³⁷Cs). Our aim was to carry out ¹³⁷Cs, radiopotassium (⁴⁰K), and stable element distribution analysis through seven tissues of grey wolves (Canis lupus) from temperate forests of Croatia using ultra-low background gamma-ray spectrometry and ICPMS, respectively. In addition, radiolead (²¹⁰Pb) massic activity was quantified in femoral bone. The massic activity of ¹³⁷Cs in the heart, kidney, liver, spleen, lungs, and femoral bone (in decreasing order) ranged from 9–61% relative to muscle and showed strong inter-tissue correlations. However, correlations between radionuclides and their stable analogues in wolf tissues indicated considerable uncertainty in the use of stable element data for radiological risk assessment. In addition, concentration ratios (CR_{whole organism-soil}) derived from stable element data should be applied with caution when radionuclide data are lacking. Overall, radionuclide activities and element levels not subject to homeostatic regulation in grey wolves were comparable to or lower than those reported for other populations, particularly those from sub-Arctic regions. Despite being apex terrestrial predators, wolves inhabiting temperate ecosystems do not currently appear to be at risk of adverse health effects from exposure to the most relevant inorganic anthropogenic pollutants. Full article

Objectives: This study evaluated the prevalence of periapical lesions in endodontically treated teeth restored with cast post-and-core systems after a minimum two-year follow-up, and identified restorative and clinical factors influencing periapical health. Methods: A cross-sectional study was conducted at the dental clinic of the International University of Rabat. Of 224 contacted patients, 91 met the inclusion criteria (completed endodontic treatment and post placement > 2 years), yielding 118 post-restored teeth. Radiographs were obtained using a phosphor plate system and analyzed with DBSWIN software, applying Ørstavik’s PAI index. Statistical analysis was performed with Jamovi (v2.3.24, Australia). Quantitative data were expressed as mean and standard deviation, and qualitative data as numbers and percentages. The Chi-square test was used with a significance level of p < 0.05. Results: The study found that 31.4% of the teeth presented a radiologically detectable periapical lesion (PAI ≥ 3). Maxillary incisors and premolars were the most frequently affected. Lesion prevalence was significantly associated with post/filling gaps ≥ 2 mm (p = 0.008) and low-density root fillings (p < 0.001). Although short filling length (<4 mm) was common in teeth with periapical lesions, no significant association was observed (p = 0.550). Systemic conditions, such as diabetes, showed a trend toward higher lesion prevalence (p = 0.056). Conclusions: The findings highlight the need for a rigorous approach in restoring endodontically treated teeth. Absence of gaps between the root canal filling and post and homogeneous filling density are key protective factors for maintaining periapical health. Regular radiographic follow-up and future longitudinal studies (3D imaging and clinical parameters) remain essential to refine protocols and improve outcomes. Full article

Background/Objectives: The world’s interest in the applications of artificial intelligence (AI) is rapidly increasing. In medicine, machine learning-based devices have proliferated, especially for image analysis, heralding significant new challenges for the use of AI in healthcare. Based on this context, this research addresses the following question: What are the major bioethical issues related to the use of AI in radiological patient reports? Methods: This study examined the main bioethical concerns surrounding AI in radiological reports, based on a narrative literature review grounded in the works of prominent authors in the field of bioethics. Results: We highlight the legal frameworks regulating medical devices and data protection in the European Union and the United States of America, evaluating recent developments in the contemporary medical landscape. Conclusions: Despite progress, many issues remain unresolved and must be addressed in order to advance the regulation of AI applications in medicine. Full article

This study investigates the spatial distribution of ambient dose equivalent rates (ADER) on Avala and Kosmaj mountains, two protected landscapes located within the territory of the City of Belgrade, Serbia. Both sites, characterized by rich biodiversity and cultural heritage, were analyzed to assess their radiological safety and suitability for outdoor recreation. In mid-October 2025, in situ measurements were conducted at 42 sampling points using the Radex RD1503+ GM counter. The recorded values ranged from 0.085 to 0.2 µSv/h, remaining below the recommended safety threshold of 0.2 µSv/h. To visualize the gamma dose spatial variability, all field data were georeferenced and processed in QGIS 3.28.10 using the Inverse Distance Weighting (IDW) interpolation method. Integration of GIS and Remote Sensing techniques enabled the correlation between gamma radiation patterns, land cover, and elevation gradients derived from digital elevation models (DEMs). The comprehensive GIS-based approach confirms that Avala and Kosmaj maintain low natural background radiation levels comparable to global averages for similar geomorphological settings, and therefore are safe and suitable for sports, tourism and recreation. The applied combination of field dosimetry, Remote Sensing, and geostatistical modeling provides a valuable framework for continuous environmental monitoring and sustainable landscape management in protected mountainous landscapes in Central Serbia. Full article

Background/Objectives: Cardiovascular interventions require prolonged fluoroscopy, which increases the risk of radiation. Diagnostic Reference Levels (DRLs), set at the 75th percentile of the dose distribution, are vital benchmarks for dose optimization. Following the release of national DRLs by the Korea Disease Control and Prevention Agency in March 2025, this study established institutional DRLs at a tertiary center to evaluate local optimization against national and international standards. Methods: This study analyzed radiation doses from 2022 to 2024 using DICOM Radiation Dose Structured Reports data from a single center’s angiography system. The total kerma-area product values and fluoroscopy times were evaluated across the categorized procedures. Following the International Commission on Radiological Protection guidelines, institutional DRLs were established at the 75th percentile of the dose distribution to benchmark against national and international DRLs. Results: Analysis of 1663 radiation dose structured reports established institutional DRLs, with the total kerma-area product ranging from 23.43 Gy·cm² for coronary angiography to 329.45 Gy·cm² for chronic total occlusion interventions. Complexity significantly increased the radiation burden; multivessel percutaneous coronary intervention and acute myocardial infarction nearly doubled the doses and fluoroscopy times in single-vessel interventions. Although the diagnostic procedures were cine image-driven, for moderate-complexity interventions, the contribution of fluoroscopy was greater. Conclusions: These findings support institutional optimization and development of safety guidelines to enhance patient protection during high-complexity cardiovascular procedures. Full article

Radon is a significant indoor air pollutant and a leading cause of lung cancer in non-smokers. While geogenic radon potential is well-documented, the specific contribution of building materials—particularly historic stones and those containing industrial by-products—requires precise in situ characterization to ensure public safety. This study investigates radon activity concentrations and surface exhalation rates across three distinct case studies in Slovakia: a mid-20th-century structure with cinder blocks, a UNESCO-protected Gothic building featuring volcanic andesite, and a historic stone plinth. Continuous radon monitoring and accumulation chamber measurements were employed, integrated with the tracking of meteorological parameters. The results revealed the highest surface exhalation rate in cinder block masonry (8.98 Bq m⁻² h⁻¹), followed by andesite ashlars (7.9 Bq m⁻² h⁻¹) and stone (1.87 Bq m⁻² h⁻¹). A clear correlation was observed between indoor radon levels and barometric pressure, whereas the influence of outdoor temperature appeared negligible. An estimated Activity Concentration Index of 0.30 suggests that the volcanic rock is likely radiologically safe for use as a bulk building material. The study concludes that while specific materials contribute to exhalation, indoor radon stability is primarily governed by barometric variations and the effectiveness of floor barriers against geogenic ingress rather than the masonry itself. Full article

Wood ash from biomass power plants and coarse, low-grade sheep wool from farming are underutilized biowastes that are often landfilled. Their valorization could reduce waste and emissions, decrease reliance on virgin materials, and support the circular economy and European Green Deal targets. However, both materials may contain naturally occurring radionuclides, primarily ⁴⁰K, as well as trace uranium and thorium isotopes, with higher concentrations typically found in wood ash due to combustion processes. Assessing their activity concentrations and bioavailability is therefore essential to ensure regulatory compliance and protect public health. This study quantified radionuclide levels in wood ash and sheep wool samples collected in Croatia and evaluated their suitability for agricultural applications. Natural radionuclides (⁴⁰K, ²³²Th, ²³⁸U, ²¹⁴Pb, ²¹⁴Bi, ²²⁶Ra, ²¹⁰Pb, ²¹⁰Po) and ¹³⁷Cs were determined using high-resolution gamma-ray and alpha spectrometry. The influence of different factors on radionuclide content was discussed, and transfer factors within the soil–hay–wool pathway were calculated to assess bioavailability. Measured activity concentrations were consistently low, and transfer factors indicated minimal radionuclide mobility. The results support the safe agricultural reuse of these materials and provide baseline data for radiological safety assessments in sustainable waste management practices. Full article

Background/Objectives: In Puerto Rico (PR), lung cancer mortality remains high because diagnoses frequently occur at advanced stages. Although low-dose computed tomography (LDCT) lowers lung cancer–specific mortality, this screening is difficult to operationalize locally due to high false-positive rates, radiology capacity constraints, payer limitations, and geographic barriers affecting rural populations. Methods: We performed a narrative review on the literature from 2001–2026 of established and emerging detection strategies—LDCT; serum biomarkers (CEA, CYFRA-21-1, NSE, ProGRP, SCC-Ag, HE4, Hp, TAAb); breath analysis (FeNO and VOCs); and liquid biopsy (ctDNAs/CTCs/miRNAs). We assessed technical performance, feasibility, and health-system fit in PR and then synthesized these findings into an implementable biomarker-first triage workflow for are. Results: Multiplex serum panels analyzed with machine learning outperform single markers and TAAb provide high specificity with biological lead time, supporting their use as a triage gateway before LDCT. Breathomics is also feasible at the point of care. Liquid biopsy has modest sensitivity in very-early disease yet provides molecular adjudication for indeterminate nodules. A stepwise pathway—expanded risk assessment, integrated multi-panel testing in primary care, LDCT reserved for biomarker-positive individuals, and liquid biopsy when imaging is inconclusive—can enrich pre-test probability, reduce unnecessary scans, align with capitation, and protect limited radiology capacity. Conclusions: An integrated, non-invasive, biomarker-first triage model offers a pragmatic, equitable route to earlier lung cancer detection in PR and resource stewardship, while reducing disparities. Full article

Artificial intelligence (AI) is at the vanguard of transforming radiology in several ways, including augmenting diagnoses, improving workflows, and increasing operational efficiency. Several integration challenges, including concerns over privacy, clinical usability, and workflow compatibility, still remain. This review discusses the foundations and current trends of clinical AI in radiology to provide essential context for ongoing developments. To illustrate translational potential, we describe representative applications, including: (1) local deployment of large language models (LLMs) for restructuring and streamlining radiology reports, improving clarity and consistency without relying on external resources; (2) multimodal AI frameworks combining CT images, clinical data, laboratory biomarkers, and LLM-extracted features from clinical notes for early detection of cachexia in pancreatic cancer; (3) privacy-preserving federated learning (FL) infrastructure enabling collaborative AI model development across institutions without sharing raw patient data; and (4) an uncertainty-aware de-identification pipeline for removing Protected Health Information (PHI) from radiology images and clinical reports to support secure data analysis and sharing. We further discuss emerging opportunities for tumor board decision support, clinical trial matching, radiology report quality assurance, and the development of an imaging complexity index. Collectively, these applications highlight the importance of local deployment, multimodal reasoning, privacy preservation, and human-in-the-loop oversight in translating AI models from research to oncology radiology practice. Full article

Building materials have become a predominant source of indoor radon in mid- to high-rise buildings, making in situ measurement of radon exhalation rates from building surfaces essential for identifying radon sources and assessing associated risks. Based on practical survey requirements—addressing sealing leakage at chamber edges and ensuring device portability—this study developed an improved in situ measurement method integrated with leakage compensation through theoretical analysis and experimental validation. The method employs an acrylic accumulation chamber and a portable passive radon detector, adopts a 24 h continuous measurement duration, and processes radon concentration data using an exponential fitting approach. Comparative experiments with the activated carbon method demonstrated good consistency between the two methods. Furthermore, small-scale in situ measurements were conducted in the Beijing area, covering diverse building materials (concrete, brick), surface treatments (cement plaster, coating, wallpaper), and structural components (walls, floors). The results, which varied widely from 0.13 ± 0.11 to 28.00 ± 4.87 Bq/m²·h, confirm the reliability and applicability of the method for in situ determination of radon exhalation rates from interior building surfaces. Full article