Search Results (17,330)

Objectives: The present cross-sectional analysis aimed to investigate whether Large Language Model-based chatbots can be used as reliable sources of information in orthodontics by evaluating chatbot responses and comparing them to those of dental practitioners with different levels of knowledge. Methods: Eight true and false frequently asked orthodontic questions were submitted to five leading chatbots (ChatGPT-4, Claude-3-Opus, Gemini 2.0 Flash Experimental, Microsoft Copilot, and DeepSeek). The consistency of the answers given by chatbots at four different times was assessed using Cronbach’s α. Chi-squared test was used to compare chatbot responses with those given by two groups of clinicians, i.e., general dental practitioners (GDPs) and orthodontic specialists (Os) recruited in an online survey via social media, and differences were considered significant when p < 0.05. Additionally, chatbots were asked to provide a justification for their dichotomous responses using a chain-of-through prompting approach and rating the educational value according to the Global Quality Scale (GQS). Results: A high degree of consistency in answering was found for all analyzed chatbots (α > 0.80). When comparing chatbot answers with GDP and O ones, statistically significant differences were found for almost all the questions (p < 0.05). When evaluating the educational value of chatbot responses, DeepSeek achieved the highest GQS score (median 4.00; interquartile range 0.00), whereas CoPilot had the lowest one (median 2.00; interquartile range 2.00). Conclusions: Although chatbots yield somewhat useful information about orthodontics, they can provide misleading information when dealing with controversial topics. Full article

Ensuring the structural integrity of reinforced concrete (RC) components in nuclear facilities exposed to extreme conditions is essential for safe decommissioning. This study investigates the impact of high-temperature exposure on RC pedestal structures supported by steel ring-shaped shear connectors—critical elements for maintaining vertical and lateral load paths in containment systems. Scaled-down cyclic loading tests were performed on pedestal specimens with and without prior thermal exposure, simulating post-accident conditions observed at a damaged nuclear power plant. Experimental results show that thermal degradation significantly reduces lateral stiffness, with failure mechanisms concentrating at the interface between the concrete and the embedded steel skirt. Complementary finite element analyses, incorporating temperature-dependent material degradation, highlight the crucial role of load redistribution to steel components when concrete strength is compromised. Parametric studies reveal that while geometric variations in the inner skirt have limited influence, thermal history is the dominant factor affecting vertical capacity. Notably, even with substantial section loss in the concrete, the steel inner skirt maintained considerable load-bearing capacity. This study establishes a validated analytical framework for assessing structural performance under extreme conditions, offering critical insights for risk evaluation and retrofit strategies in the context of nuclear facility decommissioning. Full article

This work investigates on how Fe incorporation influences the surface, microstructural, and optical properties of solution precursor plasma-sprayed TiO₂ coatings. The Fe-TiO₂ coatings were prepared using titanium isopropoxide and iron acetylacetonate as precursors, with ethanol as the solvent. X-ray diffraction analysis revealed the existence of both anatase and rutile TiO₂ phases, with a predominant rutile phase, also confirmed by Raman spectroscopy. There was an increase in the anatase crystals upon the addition of Fe ions. A longer spray distance further enhanced the anatase content and reduced the average TiO₂ crystallite sizes present in the Fe-added coatings. SEM cross-sectional images displayed finely grained, densely packed deposits in the Fe-added coatings. UV-Vis spectroscopy showed visible-light absorption by the Fe-TiO₂ coatings, with reduced band gap energies ranging from 2.846 ± 0.002 eV to 2.936 ± 0.003 eV. Photoluminescence analysis showed reduced emission intensity at 356 nm (3.48 eV) for the Fe-TiO₂ coatings. These findings confirm solution precursor plasma spray to be an effective method for developing Fe-TiO₂ coatings with potential application as visible-light-active photocatalysts. Full article

Background/Objectives: Prostate cancer (PCa) remains a major global health issue, associated with significant mortality and morbidity. Despite advances in diagnosis and treatment, predicting biochemical recurrence (BCR) after radical prostatectomy remains challenging, highlighting the need for reliable biomarkers to guide prognosis and therapy. The study aimed to evaluate the prognostic significance of the PTEN and ERG biomarkers in predicting BCR and tumor progression in PCa patients who underwent radical prostatectomy. Methods: This study consisted of a cohort of 91 patients with localized PCa who underwent radical prostatectomy between 2016 and 2022. From this cohort, 77 patients were selected for final analysis. Tissue microarrays (TMAs) were constructed from paraffin blocks, and immunohistochemical (IHC) staining for PTEN and ERG was performed using specific antibodies on the Ventana BenchMark ULTRA system (Roche Diagnostics, Indianapolis, IN, USA). Stained sections were evaluated and correlated with clinical and pathological data. Results: PTEN expression showed a significant negative correlation with BCR (r = −0.301, p = 0.014), indicating that reduced PTEN expression is associated with increased recurrence risk. PTEN was not significantly linked to PSA levels, tumor stage, or lymph node involvement. ERG expression correlated positively with advanced pathological tumor stage (r = 0.315, p = 0.005) but was not associated with BCR or other clinical parameters. Conclusions: PTEN appears to be a valuable prognostic marker for recurrence in PCa, while ERG may indicate tumor progression. These findings support the potential integration of PTEN and ERG into clinical practice to enhance risk stratification and personalized treatment, warranting further validation in larger patient cohorts. Full article

Mental health difficulties in university students are an increasing concern, especially after the COVID-19 global crisis. This study used a cross-sectional design to analyze the effect of psychological factors on students’ psychological well-being. Participants were 190 university students enrolled in undergraduate or graduate programs at a public university. Based on previous research and grounded theoretical models, a conceptual model was proposed to analyze the influence of affect states/experiences (emotion regulation difficulties, anxiety and depression, perceived stress, self-compassion, gratitude, and satisfaction with life) on psychological well-being, including the indirect effect of emotions (negative emotions, positive activation emotions, self-efficacy emotions, prosocial emotions, and serenity emotions), using a path analysis. Multigroup analyses were also performed to test the moderating effect of gender and education level. Findings indicated that self-efficacy emotions had an indirect effect on the relationship between anxiety and depression, self-compassion, and psychological well-being. Both prosocial and self-efficacy emotions indirectly impacted the relationship between gratitude, satisfaction with life, and psychological well-being. Being a female and a bachelor student played a moderating role in the final model. The findings suggest that psychological interventions focused on self-efficacy and prosocial emotions are needed to increase psychological well-being in university students. Full article

Botulinum neurotoxin-A (BoNT-A) injections are effective in reducing focal limb spasticity; however, their impact on strength and active function needs to be established. This review was a secondary analysis aimed at evaluating changes to active function in the context of muscle strength changes following BoNT-A intramuscular injection for adult upper and lower limb spasticity. The original review searched eight databases (CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Google Scholar, MEDLINE, PEDro, PubMed, Web of Science) and was conducted with methodology that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines as described in section 6.2 of Gill et al. For this secondary analysis, no databases were searched; only further data were extracted. The current and preceding review were registered in the Prospective Register of Systematic Reviews (PROSPERO: CRD42022315241). Twenty studies were screened for inclusion, and three studies were excluded because active function was not assessed in all participants. Seventeen studies (677 participants) met the inclusion criteria for analysis. Quality was examined using the PEDro scale and modified Downs and Black checklist and rated as fair to good. Pre- and post-BoNT-A injection strength (agonist, antagonist, and global), active function (activity), participation, and quality-of-life outcomes at short-, mid-, and long-term time points were extracted and analysed. Significant heterogeneity and limited responsiveness in strength and active function outcome measures limited the ability to determine whether changes in strength mediate an effect on active function. Further, variability in BoNT-A type and dose, adjunctive therapies provided, and variability in reporting limited analyses. Overall, no clear relationship existed between the change in muscle strength and active function following BoNT-A injections to the upper and lower limbs for focal spasticity in adult-onset neurological conditions. Full article

Background/Objectives: Tumor budding (TB)—clusters of one to five tumor cells at the invasive front—has emerged as a prognostic marker in various cancers. Its prognostic value in head and neck squamous cell carcinoma (HNSCC) is unclear. Methods: We retrospectively analyzed 98 HNSCC patients. The tumor buds were counted on hematoxylin–eosin-stained sections as per the 2016 International Tumor Budding Consensus Conference (ITBCC) guidelines. An optimal cutoff was determined by ROC analysis using excisional lymph nodes and five-year overall survival (OS) as the endpoint, stratifying patients into low- (≤4 buds) and high-risk (>4 buds) groups. The associations with clinicopathological features, OS, and disease-free survival (DFS) were assessed using Kaplan–Meier curves and Cox regression. Results: Among the 98 patients (median follow-up 58 months, range 18–108), 32 (32.7%) died. The optimal TB cutoff was 4.5 (AUC 0.85, 95% CI 0.76–0.93). High TB was associated with poorer five-year OS (26.4% vs. 85.3%). Multivariate Cox regression identified TB and extranodal extension as independent predictors of OS (TB HR: 3.4, 95% CI 1.3–9.2, p = 0.013). In the laryngeal cancer subgroup, TB was associated with worse survival in the univariate analysis (HR 7.5, 95% CI 1.6–35.6, p = 0.011), though this was not significant in the multivariate modeling. High TB independently predicted neck lymph node metastasis (multivariate OR 4.9, 95% CI 1.2–20.5, p = 0.029), which was present in 65.8% of the high-TB vs. 31.7% of the low-TB patients. High TB correlated with advanced AJCC stage and lymphovascular invasion. No clinicopathological factors, including TB, independently predicted DFS, in either the full cohort or the laryngeal subgroup. Conclusions: High tumor budding denotes an aggressive HNSCC phenotype and may guide decisions on elective neck dissection. Its assessment is simple, cost-effective, and potentially valuable for routine pathology, pending external validation. Full article

In recent decades, European countries have seen a substantial increase in home cultivation of cannabis. In France, the prevalence of cannabis use continues to increase despite its possession, sale, and cultivation being strictly illegal. The present study aimed to describe the profile and motivations of people in France who cultivate cannabis at home. We separately analyzed data from two convenience samples of people who use cannabis daily in France, based on two online cross-sectional surveys. In the first analysis (N = 3840), we used a multivariable logistic regression model to assess factors associated with home cultivation as the main source of cannabis supply. In the second analysis (N = 574), we described participants’ motivations for home cultivation and their cultivation patterns. In the two samples, 11% and 16% reported home cultivation as their main source of supply, respectively. Age, male gender, stable housing, living with a partner, consuming cannabis in herbal form, smoking joints with little or no tobacco, smoking cannabis from a bong or pipe, non-smoking modes of cannabis administration, and using cannabis exclusively for therapeutic reasons were all positively associated with home cultivation, while urban area of residence and at-risk alcohol use were negatively associated. The main reason reported for home cultivation was to manage quality. Few reported selling some of their crop, and most were self-sufficient. Finally, we interpret this practice as a personal response to cannabis prohibition and the unregulated market. Accordingly, possible harm reduction strategies are discussed. Full article

This study introduces a new method for modeling the nonlinear behavior of adhesively bonded composite steel–concrete T-beam systems. The model characterizes the interfacial behavior between the steel beam and the concrete slab using a strain compatibility approach within the framework of linear elasticity. It captures the nonlinear distribution of shear stresses over the entire depth of the composite section, making it applicable to various material combinations. The approach accounts for both continuous and discontinuous bonding conditions at the bonded steel–concrete interface. The analysis focuses on the top flange of the steel section, using a T-beam configuration commonly employed in bridge construction. This configuration stabilizes slab sliding, making the composite beam rigid, strong, and resistant to deformation. The numerical results demonstrate the advantages of the proposed solution over existing steel beam models and highlight key characteristics at the steel–concrete interface. The theoretical predictions are validated through comparison with existing analytical and experimental results, as well as finite element models, confirming the model’s accuracy and offering a deeper understanding of critical design parameters. The comparison shows excellent agreement between analytical predictions and finite element simulations, with discrepancies ranging from 1.7% to 4%. This research contributes to a better understanding of the mechanical behavior at the interface and supports the design of hybrid steel–concrete structures. Full article

This study investigates the downstream wake characteristics of a helical hydrokinetic turbine through combined experimental and numerical analyses. A four-bladed helical turbine with a 20 cm rotor diameter and blockage ratio of 53.57% was tested in an open water channel under a flow rate of 180 m³/h, corresponding to a Reynolds number of approximately 90 × 10³. Velocity measurements were collected at 13 downstream cross-sections using an Acoustic Doppler Velocimeter, with each point sampled repeatedly. Standard error analysis was applied to quantify measurement uncertainty. Complementary numerical simulations were conducted in ANSYS Fluent using a steady-state k-ω Shear Stress Transport (SST) turbulence model, with a mesh of 4.7 million elements and mesh independence confirmed. Velocity deficit and turbulence intensity were employed as primary parameters to characterize the wake structure, while the analysis also focused on the recovery of cross-sectional velocity profiles to validate the extent of wake influence. Experimental results revealed a maximum velocity deficit of over 40% in the near-wake region, which gradually decreased with downstream distance, while turbulence intensity exceeded 50% near the rotor and dropped below 10% beyond 4 m. In comparison, numerical findings showed a similar trend but with lower peak velocity deficits of 16.6%. The root mean square error (RMSE) and mean absolute error (MAE) between experimental and numerical mean velocity profiles were calculated as 0.04486 and 0.03241, respectively, demonstrating reasonable agreement between the datasets. Extended simulations up to 30 m indicated that flow profiles began to resemble ambient conditions around 18–20 m. The findings highlight the importance of accurately identifying the downstream distance at which the wake effect fully dissipates, as this is crucial for determining appropriate inter-turbine spacing. The study also discusses potential sources of discrepancies between experimental and numerical results, as well as the limitations of the modeling approach. Full article

Syphilis, which is caused by Treponema pallidum, remains one of the most common congenital infection worldwide and has tremendous consequences for the mother and her developing foetus if left untreated. The complexity of the exposure to this pathogen extends beyond the well-established clinical manifestations, as it can profoundly affect placental histomorphology. This study aimed to compare T. pallidum-exposed placental villi structures with healthy placentae at term to evaluate the histomorphological differences using stereology. In this case-control study conducted at term (38 weeks ± 2 weeks), 78 placentae were collected from the hospital delivery suites, comprising 39 cases (T. pallidum-exposed) and 39 controls (non-exposed), who were gestational age-matched with other potential confounders excluded. Blood samples from the umbilical vein and placental basal plate were tested for syphilis, using rapid diagnostic test (RDT) kits for T. pallidum (TP) antibodies (IgG and IgM) to classify placentae as exposed to T. pallidum (cases) and non-exposed (controls). Tissue sections were prepared and stained with haematoxylin and eosin, and the mean volume densities of syncytial knots, foetal capillaries, syncytial denuded areas, and intervillous spaces were estimated using stereological methods. Statistical analysis was performed to compare the mean values between the case and control groups. Stereological assessment revealed significant differences between the T. pallidum-exposed and non-exposed groups with regard to syncytial knots (p < 0.0001), syncytial denudation (p < 0.0001), and foetal capillaries (p < 0.0001), but no significant difference in the intervillous space was found (p = 0.1592). Therefore, our study shows, for the first time, that the histomorphology of human placental villi appears to be altered by exposure to T. pallidum. It will, therefore, be interesting to determine whether these changes in the placental villi translate into long-term effects on the baby. Full article

Cyanotypes, known as photographs and architectural plans made by photo-reproduction from the 19th and 20th centuries, are subjects for conservation. Wet cleaning for conservation treatment has been reported to be unsuitable for cyanotypes because Prussian blue on cyanotypes is thought to move physically with the application of water. The manner in which Prussian blue is fixed onto the paper substrate is important for determining the treatment method. This study is the first step toward clarifying this mechanism. The presence of Prussian blue in cyanotypes was first confirmed using X-ray diffraction analysis (XRD). Then, the location of Prussian blue in the fibre was confirmed using optical microscopy and micro-Raman spectroscopy analysis, by observing the blue colour and by detecting its cyanide bond. With field-emission scanning electron microscopy (FE-SEM), particles approximately 20–100 nm in size were observed on the surface of cyanotype paper fibres, and particles approximately 20–50 nm in size were observed from the cross-section of the paper fibres. The location where the particles were observed agreed with the location where the blue colour was observed and cyanide bond was detected. The fact that the sensitiser solution soaked into the paper fibres and formed Prussian blue within the paper fibres when exposed to light is thought to be important for the blue fixation of cyanotypes. Full article

Background: Urinary incontinence (UI) and depression are prevalent conditions affecting millions globally and are significantly associated with various demographic, health, and socio-economic factors. This study examines the associations between UI and depression over a 14-year period using nationwide data. Methods: We analyzed cross-sectional data from the Turkish Health Studies Surveys conducted in seven different years between 2008 and 2022, including 125,276 participants aged 15 and older and excluding those with incomplete key health data. Variables included chronic conditions, BMI, depression severity (assessed by PHQ-8), socio-economic status, and lifestyle factors. Univariable and multivariable logistic regression models were used to investigate associations between UI and various risk factors over time. Results: The prevalence of UI and depression fluctuated over the 14 years, with a significant increase observed in 2014. Multivariate analysis confirmed a strong and consistent association between UI and depression across genders and age groups, even after adjusting for confounders. Higher depression severity increased the odds of experiencing UI. Age, multiple comorbidities, higher BMI, and lower socio-economic status were associated with an increased likelihood of UI. Obesity was a significant risk factor for UI in females but not in males. Urban living and higher education levels were inversely associated with UI. The simultaneous rise in UI and depression in 2014 may be linked to socio-economic changes during that period. Conclusions: The findings suggest a robust link between UI and depression, influenced by a complex interplay of health, demographic, and socio-economic factors, needing prospective studies to further investigate the causal pathway of these associations. Full article

Background: Mass casualty events in conflict-affected regions can lead to the displacement of civilians and are often accompanied by substantial psychological and emotional impact on those affected. While physical activity is known to support mental health, the ways in which it relates to anxiety, resilience, and well-being in conflict-affected populations are still being explored. Objective: This study examined the associations among physical activity, anxiety, resilience, and well-being in evacuees from a conflict-affected zone. We hypothesized that higher levels of intense physical activity would be associated with higher levels of resilience and well-being and lower levels of anxiety. Methods: In this cross-sectional study, 107 evacuees completed an online survey in December 2023. The questionnaire assessed the frequency and intensity of physical activity, generalized anxiety, resilience, and well-being. Participants were categorized by weekly total physical activity levels. Data was analyzed using ANOVA, Pearson correlations, and multiple linear regression. Results: Evacuees engaging in more than three hours of vigorous-intensity physical activity exhibited significantly higher resilience and better well-being compared to those with lower activity levels. Although not statistically significant, the data suggested a possible pattern of lower anxiety among evacuees engaging in higher levels of physical activity. Regression analysis identified higher resilience and lower anxiety as significant predictors of greater mental well-being. Additionally, residing in a community exposed to a higher number of traumatic events was associated with reduced well-being. The overall model explained a substantial portion of the variance in mental well-being. Conclusions: Physical activity, especially intense exercise, is associated with improved mental health and resilience among evacuees, supporting its inclusion in interventions for trauma-affected populations. Full article

The research is grounded in the perspective of urban historical landscape (HUL), exploring the connections between cultural heritage and a broader urban context, as well as the general public and communities. It also focuses on small cultural heritage sites (SCHSs) in urban areas that have been overlooked in previous studies. By integrating various types of data, an assessment framework and methodology comprising six dimensions and 24 indicators were established and applied to the empirical research of 30 SCHSs in the Beijing section of the Grand Canal. The empirical research demonstrated the operability, effectiveness, and flexibility of the HUL assessment for SCHSs. The research findings are as follows. (1) The method provides differentiated recommendations for the formulation of tailored policies and planning management schemes based on heritage types, conservation levels, and the urban districts in which they are located. (2) The comprehensive quality of the open spaces where SCHSs are situated is critical for the cognition of the general public and community residents. (3) The overall conservation of the community areas containing SCHSs is highly significant, and the linkage between social development levels and cultural resources enhances public cognition of the SCHSs. (4) Cluster analysis offers guidance for the refined improvement of different SCHSs. The research aims to establish an action-oriented assessment framework, with a dimensional framework responding to the requirements of HULs and allowing for indicator flexibility. This study is significant for supporting the conservation and utilization of SCHSs in urban areas and for promoting their sustainable development. Full article