Search Results (29,135)

Background: Pain is a prominent and disabling manifestation of inflammatory bowel disease (IBD), including abdominal, pelvic, musculoskeletal, axial, and neuropathic pain phenotypes. Patients referred to pain clinics represent a selected subgroup with clinically meaningful, persistent, refractory, or diagnostically complex pain. Objective: To characterize pain phenotypes, treatment patterns, interventional pain-care exposure, and utilization burden among patients with IBD evaluated in tertiary pain-clinic settings and to explore differences between Crohn’s disease and ulcerative colitis patients. Methods: We performed a retrospective electronic medical-record cohort study of patients with documented IBD who were evaluated in pain-clinic settings between 24 October 2010 and 14 May 2026. Repeated clinical entries were aggregated into unique visit dates and patient-level variables. IBD diagnosis, pain phenotypes, treatment documentation, interventional procedures, and pain-clinic utilization were summarized descriptively using counts, percentages, means, medians, interquartile ranges, and ranges as appropriate. Crohn’s disease and ulcerative colitis subgroups were compared using univariable odds ratios with 95% confidence intervals and two-sided p-values. Because repeated clinical entries could belong to the same patient, the primary analytic unit was the patient rather than the individual note. Results: The source dataset included 19,615 clinical entries representing 7053 unique pain-clinic visits among 596 unique patients with IBD. The cohort included 314 patients with Crohn’s disease (52.7%), 247 with ulcerative colitis (41.4%), and 35 with IBD-unclassified (5.9%). The mean number of pain-clinic visits per patient was 11.8, with a median of four visits (interquartile range, 1–11). The dominant patient-level pain phenotypes were limb or peripheral joint pain (395/596, 66.3%), back or axial spine pain (358/596, 60.1%), and abdominal or pelvic pain (246/596, 41.3%). Overall, 437 patients (73.3%) had documentation of at least one interventional pain procedure. Compared with ulcerative colitis, Crohn’s disease was associated with higher documentation of abdominal or pelvic pain (148/314, 47.1% vs. 82/247, 33.2%; odds ratio, 1.79; 95% confidence interval, 1.27–2.53; p = 0.001) and fibromyalgia-like or widespread pain (83/314, 26.4% vs. 39/247, 15.8%; odds ratio, 1.92; 95% confidence interval, 1.25–2.93; p = 0.0027). In contrast, radiofrequency procedures (59/314, 18.8% vs. 78/247, 31.6%; odds ratio, 0.50; 95% confidence interval, 0.34–0.74; p = 0.0005) and facet or medial branch procedures (79/314, 25.2% vs. 87/247, 35.2%; odds ratio, 0.62; 95% confidence interval, 0.43–0.89; p = 0.012) were less frequently documented in Crohn’s disease than in ulcerative colitis. Conclusions: Among patients with IBD referred to tertiary pain-clinic evaluation, pain was heterogeneous and predominantly musculoskeletal, axial, neuropathic, and procedurally targetable rather than exclusively visceral. These findings support structured, mechanism-based pain assessment integrated with gastroenterology, rheumatology, and pain-medicine care. Full article

Background/Objectives: Labor pain is a multidimensional experience associated with physiological, cultural, psychological, and contextual factors. This study aimed to examine the association of personality-related characteristics, cultural beliefs, obstetric characteristics, and proxy indicators of post-disaster context with labor pain perception among women giving birth in Hatay after the 2023 Türkiye earthquakes. Methods: This prospective observational study was conducted with 314 women admitted to Hatay Training and Research Hospital between February and June 2025. Participants were between 38 and 42 gestational weeks, had a singleton healthy fetus, were admitted in active labor, and were expected to give birth vaginally. Data were collected using a researcher-developed questionnaire, the Ten-Item Personality Inventory, and the Visual Analog Scale. Labor pain was assessed at 6 cm, 8 cm, and full cervical dilatation (10 cm). Results: VAS scores increased significantly across cervical dilatation points, from 5.04 ± 0.81 at 6 cm to 7.01 ± 0.82 at 8 cm and 8.06 ± 0.93 at full cervical dilatation (10 cm). Repeated-measures ANOVA showed a significant within-person increase in pain intensity across the three assessment points, F(2, 626) = 996.444, p < 0.001, partial η² = 0.761. Age was not significantly correlated with VAS pain score at full cervical dilatation. In exploratory unadjusted comparisons, VAS scores at full cervical dilatation differed according to education level, official marriage status, previous birth history and mode, attendance at antenatal education, and praying to relieve labor pain. In the multivariable regression model, higher Extraversion and higher education level were associated with lower VAS scores, whereas attendance at antenatal education, greater importance given to traditional rules, previous assisted vaginal/cesarean birth, and current place of residence were independently associated with VAS scores. Conscientiousness was not significantly associated with VAS scores in the adjusted model. Earthquake experience was not significantly associated with VAS scores. Conclusions: Labor pain perception was associated with selected sociodemographic, obstetric, and cultural characteristics. The findings support the importance of individualized, culturally sensitive, and trauma-informed midwifery care in disaster-affected regions. Personality-related findings should be interpreted cautiously because the corrected reliability analysis showed low internal consistency for Agreeableness, Emotional Stability, and Openness to Experience, although Extraversion showed high internal consistency and Conscientiousness showed relatively better but still limited internal consistency. Disaster-related findings should also be interpreted cautiously because post-disaster context was assessed using only limited proxy indicators; current place of residence was independently associated with VAS scores in the adjusted model, whereas earthquake experience was not. Because of the observational design, causal interpretations cannot be made. Full article

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are characterized by marked heterogeneity, challenging disease monitoring and individualized treatment. Despite advances in treat-to-target strategies, unmet needs persist, particularly in assessing transmural healing and optimizing therapeutic decisions. This narrative review evaluates the role of intestinal ultrasound (IUS) as a key tool for precision medicine in IBD. IUS is a non-invasive, repeatable, and cost-effective imaging modality with diagnostic accuracy comparable to endoscopy and magnetic resonance enterography, with reported sensitivities and specificities frequently exceeding 80–90% for detecting active disease. It enables real-time assessment of transmural inflammation and complications, while parameters such as bowel wall thickness and Doppler vascularity support prognostic stratification. Early reductions in bowel wall thickness (≥25–30%) have been associated with improved treatment response, allowing identification of responders within weeks of therapy initiation. IUS informs therapeutic decision-making, including initiation, optimization, and de-escalation of advanced therapies, and may reduce reliance on invasive procedures. Integration into routine care has been associated with improved disease control and cost-effectiveness. Standardization of protocols, operator training, and prospective validation are required to establish IUS as a cornerstone of precision medicine in IBD. Full article

Three-dimensional UAV operations require path planning methods that can jointly maintain route efficiency, threat avoidance, and trajectory smoothness under spatially distributed and time-varying constraints. To address this problem, this paper develops an integrated Dual-Layer Adaptive T-perturbation and Opposition-based Multi-Objective Particle Swarm Optimization framework, termed DATO-MOPSO, for 3D UAV path planning in complex threat environments. The method integrates a dual-layer adaptive inertia-weight and velocity-regulation mechanism with symmetric T-perturbation, an elite quasi-opposition-based learning strategy for diversity recovery and feasible local exploitation, and an archive-driven simulated annealing rule for stagnation-aware personal-best updating. A three-objective model minimizing path length, threat exposure, and path smoothness is established, and comparative experiments against MOPSO, ZAMOPSO, NSGA-II, and SPEA2 are conducted in both static and dynamic environments, together with statistical and ablation analyses. In the static scenario, DATO-MOPSO achieved the highest mean HV and stable repeated-run performance, but its IGD was comparable to ZAMOPSO with higher computational cost. In the dynamic scenario, DATO-MOPSO showed its main advantage, achieving the highest mean HV and the lowest mean IGD with statistically significant HV and IGD improvements over all baselines. Overall, DATO-MOPSO is most advantageous in time-varying complex threat environments, whereas its static-scenario advantages are accompanied by higher computational cost. Full article

Objectives: To compare an endoscopically guided, modified in-office internal superior laryngeal nerve (iSLN) percutaneous steroid injection technique with a traditional landmark-guided percutaneous approach for refractory chronic cough. Methods: Single-centre retrospective comparative cohort study of those with chronic cough >8 weeks adjudicated as neurogenic/hypersensitivity-related after structured evaluation and management of common aetiologies. Consecutive patients treated at a tertiary laryngology service from January 2021 to January 2025 were identified. Patients underwent either landmark-guided percutaneous iSLN block (unmodified) or iSLN percutaneous block under flexible nasolaryngoscopic visualisation (modified), enabling real-time confirmation of needle position and routine bilateral treatment with partial superficial laryngeal mucosal instillation. Primary outcome was patient-reported improvement (Y/N; 1–10 severity scale). Secondary outcomes included Leicester Cough Questionnaire, Cough Severity Index, Newcastle Laryngeal Hypersensitivity Questionnaire, Reflux Severity Index, Voice Handicap Index-10, repeat procedures, and adverse events. Results: Of 142 patients (median age 62.8 years; 75% female), 65 underwent landmark-guided injection and 77 underwent the modified endoscopically guided technique. At most recent follow-up, global improvement was reported by 84.4% (65/77) in the modified cohort versus 47.7% (31/65) in the unmodified cohort. Median symptom reduction was greater with the modified approach (77.8% (IQR 61.3–86.6)) than among unmodified responders (50.3% (IQR 25.0–75.0)). Across all validated patient-reported outcome measures, the modified technique demonstrated more pronounced improvement than the landmark-guided approach. Minor adverse events were uncommon (modified = 6.5%, unmodified = 4.6%). Conclusions: Endoscopically guided modified iSLN steroid injection with routine bilateral targeting is associated with greater patient-reported improvement and superior validated cough outcomes than landmark-guided injection, without added significant risk. Full article

The oral pathogen Filifactor alocis encodes a repeats-in-toxin (RTX) protein, FtxA, that is encoded by the ftxA gene; it is present in approximately 50% of known isolated strains from various infected oral sites, including periodontitis, peri-implantitis, and root canal infections. It has been determined from PCR assessment of periodontally diseased cohorts in Ghana and Australia. Based on current knowledge, ftxA appears to be associated with both the progress and severity of periodontitis. This finding could potentially be linked to enhanced levels of ftxA-positive F. alocis, relative to ftxA-negative strain, and/or, in addition, a synergy between ftxA-positive strains and other periodontal pathogens. The exact mechanism remains unclear but may depend on an FtxA-mediated shifting of the host cell response toward immunosuppression. The main objective of the present work was to evaluate the prevalence and loads of F. alocis and the presence of ftxA in subgingival plaque in patients recruited for periodontal treatment in Sweden. This observational study included all samples that were received from external clinics over one full year (n = 71 patients). Our findings revealed that F. alocis was carried by 49 (69%) of the individuals, with the prevalence of ftxA amounting to 42.9% (n = 21). In 32 of the 71 samples, F. alocis could be quantitatively assessed. In this sub-population of F. alocis-positive patients, high loads of the bacterium were not related to age, and high loads were more frequently observed upon carriage of ftxA. The presence of, and co-colonization with, F. alocis with four additional periodontal pathogens was also evaluated. F. alocis was notable in that it co-colonized with all of the other species. Moreover, it was detected alongside two and even three of the other species within the same sample. Full article

Scent marking has been discussed as an important component of communication in brown bears (Ursus arctos Linnaeus, 1758). However, the environmental factors influencing the occurrence of rub trees and their value for non-invasive genetic sampling remain poorly understood. This study examined the patterns of rub tree occurrence in the eastern High Tatra Mountains (Slovakia) at two spatial scales. At the tree scale, paired-design generalized linear mixed models showed that rub trees were more frequently recorded on large-diameter coniferous trees, indicating an association with visually prominent and chemically suitable substrates. At the landscape scale, logistic regression models revealed that the probability of rub tree occurrence increased with elevation and distance from human settlements, identifying high-elevation forests as areas of higher predicted rub tree occurrence. The best-supported model was used to produce a predictive map of rub tree occurrence across the study area. We also evaluated whether rub trees are reliable sources of biological material for non-invasive sampling. Hair collected during repeated field visits provided DNA suitable for genotyping and individual identification. Overall, the results show that rub trees exhibit non-random spatial patterns and represent effective focal points for systematic genetic sampling, linking patterns of rub tree occurrence to the spatial targeting of non-invasive genetic sampling in mountain landscapes. Full article

Aflatoxin contamination is the main risk factor in grain and oil crops, which brings serious threats to food and feed safety. Exploring a green and safe way to reduce aflatoxin is meaningful. In this study, six strains with aflatoxin removal ability are screened from traditional Chinese fermented vegetables. It was found that Lactiplantibacillus plantarum YS-718, as fermentation probiotics, showed the best performance on the aflatoxin B₁ mitigation with the removal rate of 78.15% in liquid fermentation. To investigate the mechanism of removal, the aflatoxin B₁ reduction tests by different components of Lactiplantibacillus plantarum YS-718 demonstrated that the bacterial suspension of Lactiplantibacillus plantarum YS-718 fermentation exhibited stronger adsorption ability compared to the removal ability of the supernatant of YS-718 fermentation. In addition, the Lactiplantibacillus plantarum YS-718 and aflatoxin B₁ complex retained 43.74% of adsorption ability after four times repeated elution with PBS and 37.22% of adsorption after digestion with simulated gastric fluid for four hours. Moreover, Lactiplantibacillus plantarum YS-718 could be used to reduce aflatoxin B₁ in peanut meal. By evaluating the contents of protein, amino acids, total sugars, and fatty acids after the fermentation treatment, it was found that Lactiplantibacillus plantarum YS-718 fermentation could increase the contents of protein, fatty acids, and amino acids in peanut meal. This study might provide useful information for constructing a green, safe, and efficient method for removing aflatoxin from peanut meal. Full article

Fatigue health monitoring of engineering structures requires continuous degradation assessment, yet ground-truth health labels are unavailable during run-to-failure tests. Existing self-supervised approaches rely on monotonic degradation assumptions that are violated by the structured non-monotonic behaviour of acoustic emission signals during fatigue. A self-supervised framework called Cross-Modal Degradation Rivalry (CMDR) is proposed, which introduces the Modal Rivalry Index (MRI) as a directional measure of cross-modal predictability between heterogeneous sensor modalities. CMDR comprises a label-free representation-learning stage trained via the Cross-Modal Prediction Asymmetry (CMPA) pretext task, followed by a lightweight supervised stage that maps MRI features to scalar health indicators (HIs) using normalised lifecycle labels. The MRI is conceptually related, under the stated assumptions only loosely met in practice, to the Transfer Entropy difference between sensor latent channels. Experiments on a structural fatigue dataset with seven specimens under two loading conditions demonstrate that CMDR achieves competitive trendability and prognosability, as well as the lowest remaining useful life (RUL) error in three of four scenarios. RUL evaluations are additionally repeated under a fully online estimator that uses only training specimens. A strictly inductive ablation that re-pre-trains the self-supervised stage within each leave-one-specimen-out fold confirms a bounded transductive-vs-inductive gap, and CMDR remains the best against three further self-supervised baselines on the within-condition and mixed-condition scenarios. Ablation studies confirm the necessity of directional asymmetry, bottleneck architecture, and momentum-updated target encoders. Full article

Virtual reality can support the preparation and rehearsal of assembly tasks by providing a safe and repeatable digital representation of workstations. This study presents the development and laboratory feasibility validation of a geometry- and procedure-oriented VR simulation model for the assembly and disassembly of end-effectors on an industrial robot. The workflow was implemented using the Almega AX-V6 robotic workstation as a case study and included geometric acquisition of the real robot, CAD modelling in SolidWorks, redesign of the original end-effector connection using a quick-change flange concept, creation of two alternative end-effector models, modelling of the laboratory workspace in SketchUp, and scene enhancement in Twinmotion. The resulting robot and environment models were integrated in Pixyz Review and deployed through an Oculus Rift-based VR setup. Compared with the original flange concept, which required twelve screws, the redesigned training concept used two screws and two nuts, reducing the number of fastening elements by 66.7% and the number of screw positions by 83.3%. The VR implementation supported visual inspection, controller-based placement and alignment, and symbolic confirmation of fastening steps; it did not include force feedback, threaded fastening physics, automatic error scoring, or quantified transfer-of-training evaluation. Laboratory feasibility validation confirmed correct asset integration, spatial correspondence with the physical workplace, and functional executability of the target exchange sequence. The results show that the workflow is useful as a case-study pipeline for CAD-to-VR modelling and assembly rehearsal, while controlled user studies are still required before claims about training effectiveness can be made. Full article

Acoustic propagation in stratified shallow seas is governed by finite-depth waveguiding, impedance contrasts at the seawater–seabed interface, and coupled space–time wave dynamics. Conventional numerical solvers are accurate but often require detailed environmental priors, mesh generation, and explicit time marching, increasing the cost of simulations involving complex boundaries or repeated evaluations. This study proposes a physics-informed residual network (ResNet-PINN) for continuous simulation of two-dimensional acoustic fields in shallow-sea stratified media. The framework embeds a variable-density, variable-sound-speed acoustic pressure wave equation, initial and boundary constraints, and interface-focused collocation into network training. A Gaussian initial wave packet and temporal gating are incorporated through the output transformation to improve early-time physical consistency. The model is validated against SPECFEM2D simulations and a stratified semi-analytical modal benchmark. The results show that it captures source-region spreading, main wavefront evolution, and transmission–reflection structures near the seawater–seabed interface at an equivalent frequency of approximately 477 Hz. Supplementary tests with sloping and arched interfaces and modified boundary conditions indicate adaptability to smooth interface variations. Overall, the framework provides a physically consistent neural network strategy for continuous shallow-sea acoustic field simulation and a complementary basis for future extensions to higher-frequency propagation, more complex environments, and dynamically varying ocean conditions. Full article

Wesselsbron disease remains an underrecognized mosquito-borne flaviviral disease despite long-standing evidence of ruminant reproductive loss, neonatal disease, hepatic pathology, zoonotic infection, and mosquito-associated circulation. This narrative review critically synthesizes verified evidence on Wesselsbron virus (WSLV) at the animal–human–vector–environment interface, with the specific aim of clarifying why the virus should be considered a surveillance-sensitive One Health pathogen rather than a rare veterinary curiosity. The review integrates classical veterinary pathology, experimental infection studies, human case reports, serological and molecular evidence, mosquito surveillance, ecological suitability modelling, diagnostic-development studies, and recent evidence from molecular epidemiology, camel investigations, and digital histopathology. The review uses an evidence-weighted synthesis to distinguish experimentally and pathologically supported animal disease, confirmed but poorly quantified human infection, mosquito-associated detection, ecological suitability, diagnostic under-recognition, and unresolved reservoir or transmission questions before integrating these domains into a qualitative One Health risk-assessment framework. The evidence supports WSLV as a cause of ruminant abortion, neonatal disease, and hepatic lesions, confirms zoonotic potential, and indicates repeated detection in ecologically relevant mosquito and multi-host contexts. However, current data remain insufficient for robust estimates of animal burden, human incidence, reservoir competence, natural route frequency, or climate-driven expansion. WSLV should therefore be incorporated into targeted differential diagnosis, laboratory readiness, and One Health surveillance where ruminant abortion events, unexplained neonatal disease, compatible mosquito ecology, undiagnosed febrile illness, diagnostic ambiguity, or ecological suitability indicate plausible risk. Full article

Ultraviolet (UV) light exposure is a recognised risk factor for dermal haemangiosarcoma (HSA) in dogs and dermal squamous cell carcinoma (SCC) in dogs and cats. These tumours cause substantial local disease and often require repeated surgery due to recurrence or de novo lesions, creating a notable welfare and financial burden. Research on preventing harmful UV exposure in pets is still in its infancy, particularly in relation to the safety of UV filters used in sunscreens. This review summarises the current evidence on UV-induced carcinogenesis, strategies to reduce UV exposure, and the safety of sunscreen ingredients in dogs and cats. UV light is strongly implicated in a range of dermatoses, from actinic keratosis to dermal HSA and SCC in dogs and cats, and the risk is likely higher in Australian pets. Indoor confinement during peak UV periods, shade, and sun-protective clothing can reduce exposure, with sunscreen an additional strategy. Sunscreen is relevant because UV-associated cancers typically develop in sparsely haired or hairless regions such as the nose and ventrum, making these areas suitable for targeted sunscreen application. Sunscreens containing non-nanoparticle zinc oxide appear safe for dogs and cats when ingestion is prevented or minimised, whereas the safety of organic UV filters remains unclear due to limited safety data in both humans and animals. Non-nanoparticle titanium dioxide is a possible alternative to zinc oxide and organic filters, but there is currently little information on its safety when ingested by dogs and cats. Overall, the available evidence supports sunscreen as a necessary component of UV-reduction strategies in pets, but substantial research is needed to determine the safety profiles of different UV filters and to establish evidence-based guidelines for their safe use. Full article

Background/Objectives: Chest X-ray (CXR) images are a widely used first-line screening tool for pulmonary tuberculosis (TB) detection but are difficult to interpret, which has increased demand for an automated screening tool. Deep-learning-based computer-aided diagnosis systems have demonstrated a classification performance comparable to that of trained radiologists, but they rely on dense annotations such as lesion-level or pixel-level labels, which are costly and difficult to obtain in routine clinical workflows. We developed CPM-XNet, an annotation-efficient framework for lesion-annotation-free downstream TB classification in CXR images. Methods: CPM-XNet incorporates a compressing–projecting mask (CPM) to provide soft lung-aware modulation while preserving global contextual information. The CPM-modulated images are then used for downstream classification with multiple convolutional neural network backbones and a vision transformer baseline. Results: Experiments were conducted using an internal hospital dataset and public TB datasets, and CPM-XNet showed improved performance compared with baseline models trained on unmodulated images. In a repeated-seed evaluation of the main ResNet-101 configuration on the Tung cohort, CPM-ResNet101 showed higher and more stable performance than the non-CPM counterpart and demonstrated significant paired improvement using McNemar’s exact test. An ablation analysis indicated that CPM modulation was the main contributor to performance improvement while data augmentation and the classifier architecture further influenced the overall robustness. Conclusions: CPM-XNet provides an annotation-efficient strategy for lesion-annotation-free downstream TB classification in CXR images. The findings support preliminary technical feasibility, although larger, naturally imbalanced, cross-institutional validation is required before clinical deployment can be inferred. Full article

Background/Objectives: The right inferior frontal gyrus (rIFG) is a key node of the neural network underlying inhibitory control and a promising target for non-invasive brain stimulation. Here, we investigated whether an accelerated anodal transcranial direct current stimulation (tDCS) protocol over the rIFG could produce cumulative improvements in response inhibition. This issue is particularly relevant because cumulative effects of accelerated stimulation cannot be taken for granted, and repeated administrations may lead to progressive improvement, saturation, or no measurable offline persistence. In addition, sham-controlled accelerated studies remain limited. Methods: Twenty-two healthy participants underwent three stimulation sessions within the same day. Inhibitory control was assessed using the Stop-Signal task, while Stop-Signal Reaction Time (SSRT) and mean error rate were analyzed by means of linear mixed-effects models. Results: Results showed a significant effect of time and a significant stimulation-by-time interaction across the three sessions, indicating a progressive reduction in SSRT during the accelerated protocol. Thus, inhibitory control performance improved as stimulation sessions increased. Conclusions: These findings suggest that accelerated anodal tDCS over the rIFG can induce cumulative short-term improvements in inhibitory control. The results support the relevance of the rIFG as a neuromodulation target, while highlighting the importance of interindividual variability and the need for more translationally oriented protocols. Full article