Search Results (113)

Gastrointestinal cancers account for roughly a quarter of global cancer incidence, and early detection through endoscopy has proven effective in reducing mortality. Multi-class endoscopic disease detection, however, faces three persistent challenges: feature redundancy from non-pathological content, severe illumination inconsistency across imaging modalities, and extreme scale variability with blurry boundaries. This paper introduces Endo-DET, a domain-specific detection framework addressing these challenges through three synergistic components. The Adaptive Lesion-Discriminative Filtering (ALDF) module achieves lesion-focused attention via sparse simplex projection, reducing complexity from $O\left(N^2\right)$ to $O\left(\alpha N^2\right)$. The Global–Local Illumination Modulation Neck (GLIM-Neck) enables illumination-aware multi-scale fusion through four cooperative mechanisms, maintaining stable performance across white-light endoscopy, narrow-band imaging, and chromoendoscopy. The Lesion-aware Unified Calibration and Illumination-robust Discrimination (LUCID) module uses dual-stream reciprocal modulation to integrate boundary-sensitive textures with global semantics while suppressing instrument artifacts. Experiments on EDD2020, Kvasir-SEG, PolypGen2021, and CVC-ClinicDB show that Endo-DET improves mAP50-95 over the DEIM baseline by 5.8, 10.8, 4.1, and 10.1 percentage points respectively, with mAP75 gains of 6.1, 10.3, 6.8, and 9.3 points, and Recall50-95 improvements of 10.9, 12.1, 11.1, and 11.5 points. Running at 330 FPS with TensorRT FP16 optimization, Endo-DET achieves consistent cross-dataset improvements while maintaining real-time capability, providing a methodological foundation for clinical computer-aided diagnosis. Full article

Background: Facial asymmetry affecting the mandibular contour may significantly impact facial harmony even in patients with stable occlusion. Although orthognathic surgery remains the standard for skeletal correction, it carries substantial morbidity. In selected cases, contour-focused approaches can achieve meaningful esthetic improvement with reduced surgical burden. Objective: To describe the virtual surgical planning (VSP) workflow and clinical outcome of a unilateral Wing osteotomy for mandibular contour asymmetry. Case presentation: A 24-year-old woman presented with left-sided mandibular contour deficiency and facial asymmetry, despite stable Class I occlusion and preserved function. VSP with contralateral mirroring guided the design of the osteotomy and fabrication of a stereolithographic model and patient-specific cutting guide. Surgery was performed through a tunnelized mandibular approach using a 702 bur and reciprocating saw. Fixation was achieved with pre-bent 2.0 plates adapted to the 3D model, and Bio-Oss Collagen was interposed within the osteotomy gap. Occlusion and mental nerve function were preserved. Results: Postoperatively, the patient demonstrated improved facial symmetry, uneventful healing, preserved long-term neurosensory function, and high esthetic satisfaction. Conclusions: Unilateral Wing osteotomy guided by VSP and patient-specific instrumentation is a predictable, minimally invasive alternative to bimaxillary orthognathic surgery with genioplasty in selected patients presenting contour-focused asymmetry and stable occlusion. This case highlights a rare, underreported application of the technique. Full article

Workplace productivity fundamentally involves group processes where vertical authorities interact with lateral peer relationships, involving various types of resources. Leveraging theoretical arguments from self-determination, social exchange, and justice perspectives, we argue that different types of support matter for cultivating workers’ job motivation and their engagement in extra-role behaviors in the workplace. We investigate how workers’ perceptions of managers and coworkers, regarding their instrumental support (aid for job tasks) and relational support (fairness in decision-making and treatment) contribute to increased motivation, which in turn leads to more reciprocal behaviors like making suggestions, helping coworkers, and volunteering for extra work. Our distinctive approach, involving both types of support from both sources, extends work that concentrates on just one type or source. We draw on survey data from 2062 workers across various occupations. Path analytic results largely confirm the hypothesized positive effects of support from authorities and coworkers on job motivation and extra-role behaviors, and show the extent to which job motivation mediates the effects of the types and sources of support. Nuanced results regard which type and source of support influence which type of extra-role behavior. We conclude by noting that our dual-process approach to workplace group processes may be useful for fostering overall productivity. Full article

Background: Nickel–titanium (NiTi) endodontic instruments have undergone significant improvements in heat treatment processing and geometric design, aimed at enhancing flexibility, cutting efficiency, and fatigue strength. Reciprocating motion was introduced to increase cyclic fatigue resistance, which remains the predominant mode of failure in NiTi endodontic file systems. Although these instruments are widely used in both clinical practice and research, few comparative studies have integrated geometric, metallurgical and mechanical evaluations of the most commonly used reciprocating systems. Methods: In the present study, four single-file reciprocating NiTi systems (Reciproc Blue, WaveOne Gold, EdgeOne Fire, and Easy-File Flex) were evaluated for their geometric design, metallurgical composition, and cyclic fatigue strength. Stereomicroscopy and scanning electron microscopy were employed to assess active blade length, spiral configuration, and surface finish, while elemental composition and phase transformation temperatures were analyzed using energy-dispersive X-ray spectroscopy and differential scanning calorimetry. Ten instruments from each group were tested for cyclic fatigue using a standardized curved stainless-steel canal at room temperature, and the time to fracture was recorded. Fatigue data were statistically analyzed using Mood’s median test, with significance set at p < 0.05. Results: Reciproc Blue exhibited the longest active blade length, highest spiral density, and superior surface finish. R-phase start and finish temperatures were highest in WaveOne Gold and lowest in Easy-File Flex. Reciproc Blue demonstrated the higher cyclic fatigue strength, whereas Easy-File Flex showed the lowest. Conclusions: These findings suggest that the metallurgical and geometric characteristics of the Reciproc Blue file significantly enhance its strength to cyclic fatigue compared with the other instruments evaluated. Full article

This study evaluated the effect of clockwise reciprocation motion used in the original Optimum Torque Reverse kinematics, compared with clockwise continuous rotation, on the cyclic fatigue strength of nickel–titanium rotary instruments (NiTi) with different metallurgical characteristics. A total of 120 instruments, ProFile and EndoSequence in sizes 25/.04, 30/.04, and 35/.04, were tested under continuous rotation or reciprocation motions (n = 10 per subgroup). Instruments were examined by optical and scanning electron microscopy to exclude manufacturing defects. Phase transformation temperatures were determined by differential scanning calorimetry, and cyclic fatigue testing was conducted using a custom device simulating a curved canal with a 6 mm radius and an 86° curvature. The time to fracture was recorded, and the number of cycles to fracture was calculated. Statistical comparisons were performed using the Mann–Whitney U test with a significance level of p < 0.05. Differential scanning calorimetry showed that ProFile instruments were fully austenitic at the test temperature, while EndoSequence instruments exhibited a mixed R-phase and austenitic structure. Clockwise reciprocation motion significantly increased cyclic fatigue resistance in all groups compared with clockwise continuous rotation. Time to fracture increased by 241.3% to 337.5%, and EndoSequence instruments consistently demonstrated higher fatigue resistance. The greatest relative improvement was observed in ProFile 35/.04, with a 422.4% increase in the number of cycles to fracture. Overall, the reciprocation motion markedly enhanced cyclic fatigue strength irrespective of metallurgical phase composition, indicating a practical mechanical benefit that may reduce the risk of instrument separation during endodontic procedures. Full article

Background and Objectives: The anatomically demanding structure of curved root canals increases the technical difficulty of retreatment procedures. This study aimed to evaluate the retreatment efficacy of various rotary and reciprocating instruments in curved root canals obturated with cold and warm techniques regarding root canal filling material removal, apical transportation, and retreatment time. Materials and Methods: Sixty-four curved mesial root canals of mandibular molars with Vertucci type IV morphology were prepared using the ProTaper Gold system and obturated with AH Plus sealer using either the single-cone (SC) (n = 32) or continuous wave vertical compaction (CWC) (n = 32) technique. Each group was divided into four subgroups (n = 8) and retreated using MicroMega Remover (MM Remover), ProTaper Universal Retreatment (PTUR), Reciproc (Rec), and Hedstrom file systems. Micro-computed tomography was used to assess residual filling material volume and apical transportation. The time required for retreatment was recorded. The level of statistical significance was set at p < 0.05. Results: Across both obturation techniques, the MM Remover and PTUR groups demonstrated shorter retreatment times compared with the CWC–Hedstrom group (p < 0.05). No statistically significant differences were observed among the file systems in terms of filling material removal and apical transportation (p > 0.05). Conclusions: All tested instruments effectively preserved root canal anatomy within clinically acceptable apical transportation limits. The MM Remover and PTUR systems achieved significantly shorter retreatment times, indicating clinical advantages in efficiency. None of the evaluated systems achieved complete removal of the filling materials in either obturation technique. This study provides one of the first comparative evaluations of the MM Remover system, supporting its applicability in complex canal configurations. Full article

This study analyzed how different downward loads and rotational kinematics influence NiTi rotary instrumentation outcomes. Heat-treated NiTi instruments were used to prepare extracted human single-rooted premolars with a moderate canal curvature. Instrumentation was performed using an automated endodontic instrumentation device with controlled downward loading and torque/force sensing, under different downward load settings (1, 2, and 3 N), employing either continuous rotation (CR) or optimum torque reverse (OTR) motion, which is a torque-sensitive reciprocation. Instrumentation was completed without instrument fracture or ledge formation in all six groups. OTR-3N specimens displayed a significantly lower upward force (i.e., screw-in force) than OTR-2N specimens (p < 0.05). OTR-1N specimens required a significantly longer instrumentation time than CR-1N specimens and the other OTR specimens (p < 0.05). At 1 mm from the apex, CR-2N specimens showed a significantly larger canal-centering ratio (i.e., larger deviation) than OTR-2N specimens (p < 0.05). Overall, applying a downward load of 2–3 N in OTR mode provided shaping efficiency similar to CR, but with a reduced screw-in force and enhanced canal-centering in the apical region, supporting the use of OTR as a promising alternative to CR for curved canal preparation using heat-treated NiTi instruments. Full article

This article examines how students experience and build relational ties in online higher education. Using a hermeneutic phenomenological approach, it analyses students’ lived and desired relationships across four domains: the online campus, the degree programme, teachers, and peers. One hundred and forty-four students completed an open-ended questionnaire. Their narratives informed the Relational Proximity Matrix (RPM), a framework used to map connections and distinguish transformative, functional, and residual modes of proximity. Findings indicate strong affective and supportive ties among peers, whereas interactions with teachers and the online campus are often formal or instrumental. The study concludes that relational proximity, rather than access alone, depends critically on recognition, reciprocity, and pedagogical care. The RPM offers a heuristic orientation that may inform educational design and support educators and institutions in cultivating practices that enhance relational quality. Full article

A constantly increasing incidence of chronic diseases is a challenge for healthcare worldwide, being directly associated with physical inactivity, which is considered an important cause of most chronic diseases. In contrast, physical exercise has been proven as a powerful instrument of healthcare to protect individuals against health-to-disease transition and against disease progression. Nonetheless, a number of studies warn against inappropriate high-intensity and/or unaccustomed exercise that exceeds an individual’s physical capacity. Indeed, extensive cardiac activity during prolonged exercise leads to significantly increased cardiac dimensions, triggering cardiac complications that may result in arrhythmogenic sudden cardiac death. The remarkable plasticity of mitochondria allows these organelles to sense and adapt to a variety of stressors and respond to stimuli by molecular signalling, regulating bioenergetics and cellular homeostasis, decisive for repair processes, proliferation, apoptosis, and tissue regeneration to combat degeneration, with whole body outcomes. Mitochondria act as biosensors in the human body; they are reactive to stimuli and protective against health-to-disease transition. To perform this life-important function throughout life, mitochondria need supportive measures, including physical activity, considered an essential pillar of mitochondrial medicine. This article highlights reciprocity between the quality of mitochondrial health and homeostasis on one hand and physical fitness and exercise intervention on the other hand. The proposed novelty relates to the monitoring of mitochondrial homeostasis, which is strongly recommended for creating individualised training programmes, and monitoring exercise efficacy during and after the programme is completed. To this end, a patient-friendly non-invasive approach is already established, utilising tear fluid multi-omics, mitochondria as the vital biosensors, and AI-based multi-professional data interpretation. Full article

The development of endodontics leads to increasingly innovative techniques, which improve mechanical root canal preparation. Endostar E3 Azure (Poldent Co., Warsaw, Poland) is a nickel–titanium file, which can be used in rotary, reciprocal, and optimum torque reverse (OTR) movements. The aim of this study was to assess canal transportation (CT), canal-centering ability (CCA), and wall thickness reduction (WTR) after the use of Endostar E3 Azure files in these three movements. In total, 24 two-canal artificial teeth were used, which were divided into three groups, depending on the applied movement (n = 16 canals). Each canal was initially prepared manually and then instrumented with Endostar E3 Azure files using rotary, reciprocal, or OTR movements. Cone-beam computed tomography was performed before and after canal preparation. The root wall thickness was measured at 3 mm, 6 mm, and 9 mm from the radiological apex and CT, CCA, and WTR were calculated. Reciprocal movement resulted in significantly better outcomes in canal-centering ability (CCA = 0.57) compared with rotary movement (CCA = 0.27) in the middle part of the canal. The wall thickness was significantly reduced in the rotary group: 0.21, 0.19, and 0.13; in the reciprocal group: 0.09, 0.08, and 0.1; and in the OTR group: 0.11, 0.15, and 0.17 at 3, 6, and 9 mm from the apex, respectively. Moreover, rotary movement caused a statistically greater reduction in wall thickness in the apical and middle area compared to other groups. Endostar E3 Azure files significantly reduce the thickness of the root wall along its entire length, which may indicate the effective removal of infected tissue. The use of OTR movement did not affect the analyzed parameters negatively, and it is a safe option which combines the advantageous features of rotary and reciprocal movements. Full article

The sustainability of coastal ecosystem resources hinges on collective action; however, conservation programs often fail when the underlying values that shape human behavior are overlooked. Anchored in behavioral change theory and common-pool resource governance, this study explores artisanal fishers’ subconscious value orientations as drivers of conservation. Relational value, as defined by IPBES, was used to assess the strength of the relationship between artisanal fishers and coastal resources. Principal Component Analysis of survey data revealed three value components, Natural Legacy Value (NLV), Non-Economic Value (NEV), and Economic Value (EV), and two conservation orientations, tangible and intangible. Relational valuation, blending intrinsic and instrumental motives, strongly influences conservation attitudes. NEV correlates with religion and intangible measures (knowledge, cultural practices) (R = 0.153, p < 0.05), while EV supports both tangible and intangible strategies but none of the demographic factors, indicating strategic leverage points for inclusive engagement. Conversely, NLV’s negative association with tangible measures reflects cultural sensitivities that can hinder compliance. The results suggest that embedding value-sensitive approaches into co-management frameworks can foster trust, reciprocity, and behavioral change, key elements in Ostrom’s design principles. This study contributes to sustainability science by linking socio-psychological drivers to governance strategies for promoting coastal socio-ecological systems resilience. Full article

Objectives: The aim of this study is to investigate how Adaptive Torque Control motion influences the shaping efficiency of Neolix EDMax (Neolix SAS, Évron, France) and its ability to reach working length with or without a pre-existing glide path. Methods: A total of 90 endo training blocks with an S-shape curvature were divided into three groups based on the kinematics and preparation phase: the control group, where the Neolix EDMax (Neolix SAS, Évron, France) was used for shaping after a glide path was established; the no glide path group, where the Neolix EDMax (Neolix SAS, Évron, France) was used for shaping without a glide path; and the Adaptive Torque Control group, where the Neolix EDMax (Neolix SAS, Évron, France) was used for shaping without a glide path but in an Adaptive Torque Control motion. The time for shaping, the instrument passes, and the ability to reach working length were recorded and analyzed using a one-way Anova and Tukey’s HSD post hoc test. Results: Establishing a glide path helped the shaping file to reach working length faster and in fewer passes when compared with the no glide path group, but the Adaptive Torque Control group was able to perform even better than the control group despite not having a pre-established glide path. Conclusions: The Adaptive Torque Control motion on continuous rotation instruments does impact their performance. Combining the efficiency of continuous rotation and the safety of reciprocation, this type of motion had a significant effect on the ability to shape the simulated root canal even in the presence of a double curvature and without a pre-established glide path. Full article

AlCoCrFeNi coatings were electrospark-deposited (ESD) on H13 steel substrates, and their nano-mechanical and tribological properties under a load of 2 N, 4 N, 6 N, 8 N, and 10 N were investigated by utilizing a nanoindentation instrument and a reciprocating friction and wear tester, respectively. The morphologies, composition, and phase structure of the as-deposited and worn AlCoCrFeNi coating were characterized using SEM (Scanning electron Microscope), EDS (Energy dispersive spectrometer), and XRD (X-Ray Diffraction). The results showed that the as-deposited AlCoCrFeNi coating with a nanocrystalline microstructure mainly consists of a BCC and B2 phase structure, and a gradient transition of elements between the coating and the substrate ensures an excellent bond between the coating and the substrate. The hardness of the AlCoCrFeNi coating exhibits an 8% increase, while its elastic modulus is reduced by 16% compared to the H13 steel. The AlCoCrFeNi coating remarkably increased the tribological property of the H13 steel under various loads, and its wear mechanism belongs to micro-cutting abrasive wear whilst that of the H13 steel can be characterized as severe adhesive wear. The friction coefficient and weight loss of the AlCoCrFeNi coating decrease with increasing load, both following a linear relationship with respect to the applied load. As the load intensifies, the work hardening sensitivity and oxidation degree on the worn surface of the coating are significantly enhanced, which collectively contributes to the improved tribological performance of the AlCoCrFeNi coating. Full article

Orthognathic surgery is a successful surgical method for correcting facial deformities, and the piezoelectric system can be used in place of or in addition to traditional tools like the reciprocating saw to perform osteotomies. This study assesses how using a reciprocating saw or a piezoelectric device exclusively affects neurosensory impairment. A review was performed following the PRISMA-ScR recommendations. A search was conducted until December 2024 in PubMed, Embase, and Web of Science. Clinical trials and quasi-experimental studies in English and Spanish were included. A total of nine articles were obtained for full-text review using inclusion and exclusion criteria. The selected articles included a total of 731 subjects. The age range of the studies included was between 18 and 49 years. Three of the six analyzed state that piezoelectric surgery positively correlates with neurosensory recovery, showing less surgical time and a less painful and faster postoperative recovery than the use of a saw. However, only two reported no significant statistical difference in sensitivity recovery between the saw and piezoelectric instruments. Despite the methodological heterogeneity among the studies included, the sample size, and the variability of factors, using a piezoelectric system typically shows a better postoperative recovery of sensitivity compared to using a saw. Full article

Objective: This study investigated the shaping efficiency of four reciprocating systems—WaveOne Gold, Reciproc Blue, Excalibur, and One Reci—in three dimensional (3D) resin models of natural mandibular premolar teeth with two canals. Methods: Forty 3D-printed mandibular premolars (Vertucci configuration type V) were divided into four groups, each of which was assigned one of the reciprocating systems. According to the manufacturer’s protocols, each canal was prepared, with pre- and post-instrumentation micro computed tomography (micro-CT) scans evaluating canal volume, surface area, percentage of unprepared canal walls, and resin reduction in the pericervical area. Instrumentation time and screw-in sensation were recorded as qualitative performance indicators. Statistical analysis was performed using one-way ANOVA and chi-square tests with a significance of (p < 0.05). Results: All systems increased canal volume and surface area, primarily in the apical third, with Reciproc Blue and One Reci achieving the largest volume. WaveOne Gold had the highest percentage of unprepared walls (27.03%) and Reciproc Blue the lowest (19.65%), though these differences were not statistically significant (p > 0.05). Reciproc Blue caused the highest pericervical resin loss (22.24%), significantly higher than Excalibur (15.09%) and One Reci (15.17%) (p = 0.035). Reciproc Blue exhibited the highest incidence of screw-in sensation (70%), while WaveOne Gold achieved the shortest instrumentation time (86.7 s), although neither variable showed statistical significance. Conclusions: All systems effectively shaped complex canal anatomies, with Reciproc Blue demonstrating the highest dentin removal and WaveOne Gold proving the most time efficient. Clinically, these findings suggest that instrument selection should balance shaping efficiency with dentin preservation. Minimizing unprepared areas and preserving pericervical dentin are essential for enhancing disinfection and reducing the risk of root fractures, ultimately contributing to the long-term success of endodontic treatment. Full article