Search Results (12,721)

Background: Dentinal hypersensitivity (DH) significantly impacts oral health-related quality of life. While global prevalence estimates range from 10–15%, region-specific data from Saudi Arabia remain limited. This study also aligns with Saudi Vision 2030’s mental health initiatives, as DH-associated anxiety impacts overall well-being. This study assessed DH prevalence and quality of life impact among Saudi adults. Methods: A cross-sectional online survey was conducted among 748 Saudi adults aged ≥ 18 years between April and May. Data were collected using a validated Arabic Dentinal Hypersensitivity Experience Questionnaire (DHEQ) alongside socio-demographic variables. Participants reporting DH symptoms within 12 months were included in impact analyses. Descriptive statistics and one-way ANOVA examined associations between DHEQ scores and participant characteristics. Results: Self-reported DH prevalence was 54.3% (n = 406), substantially exceeding global estimates. Among affected individuals, mean DHEQ score was 0.56 ± 0.19, indicating moderate-to-substantial quality-of-life impact. Functional limitations were most affected, particularly enjoyment of eating and drinking (0.72 ± 0.21). Significant associations were identified between higher DHEQ scores and age extremes (<18 and >35 years; p < 0.001), higher income levels (p = 0.032), fewer teeth (p = 0.040), and dental pain presence (p = 0.009). Sex, residence, education, and employment showed no significant associations. Conclusions: More than half of Saudi adults reported DH symptoms, representing a significant public health concern with substantial quality of life implications. Prevalence substantially exceeds global estimates, highlighting the need for targeted interventions. Age, income, tooth count, and pain presence emerged as key factors. These findings support developing population-specific prevention strategies, particularly targeting younger and older adults with tooth loss. Full article

Filled pauses are thought to be reflections of linguistic processes (e.g., lexical retrieval, speech planning and execution). Uh may be a self-directed cue for when a speaker needs more time to retrieve lexical–semantic representations, whereas um serves as a listener-directed, pragmatic cue. The use of filled pauses has not been examined in children who are hard of hearing (CHH). Participants included 68 CHH and 33 children with typical hearing (CTH). Participants engaged in conversations, expository discourse, and fable retells. We analyzed filled pauses as a function of hearing status and discourse contexts and evaluated the relationship between filled pauses and language ability. CHH produced uh across discourse contexts more often than their hearing peers. CHH did not differ in their use of um relative to CTH. Both um and uh were used more often in conversational samples compared to other types of discourse. Spearman’s correlations did not show any significant associations between the rate of filled pauses and standardized language scores. These results indicate that CHH produces uh more often than CTH, suggesting that they may have difficulty retrieving lexical–semantic items during ongoing speech. This information may be useful for interventionists who are collecting language samples during assessment. Full article

During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the physical condition of adolescent athletes before and after activity restrictions due to the pandemic; and second, to innovatively develop and validate a non-contact medical checkup application. Medical checks were conducted on 563 athletes designated for sports enhancement. Participants were junior high school students aged 13 to 15, and the sample consisted of 315 boys and 248 girls. Furthermore, we developed a smartphone application and compared self-checks using the application with in-person checks by orthopedic surgeons to determine the challenges associated with self-checks. Statistical tests were conducted to determine whether there were statistically significant differences in range of motion and flexibility parameters before and after the pandemic. Additionally, items with discrepancies between values self-entered by athletes using the smartphone application and values measured by specialists were detected, and application updates were performed. Student’s t-test was used for continuous variables, whereas the chi-square test was used for other variables. Following the coronavirus 2019 pandemic, athletes were stiffer than during the pre-pandemic period in terms of hip and shoulder joint rotation range of motion and heel–buttock distance. The dominant hip external rotation decreased from 53.8° to 46.8° (p = 0.0062); the non-dominant hip external rotation decreased from 53.5° to 48.0° (p = 0.0252); the dominant shoulder internal rotation decreased from 62.5° to 54.7° (p = 0.0042); external rotation decreased from 97.6° to 93.5° (p = 0.0282), and the heel–buttock distance increased from 4.0 cm to 10.4 cm (p < 0.0001). The heel–buttock distance and straight leg raising angle measurements differed between the self-check and face-to-face check. Although there are items that cannot be accurately evaluated by self-check, physical condition can be improved with less contact by first conducting a face-to-face evaluation under appropriate guidance and then conducting a self-check. These findings successfully address our primary objectives. Specifically, we demonstrated a significant decline in the physical condition of adolescent athletes following pandemic-related activity restrictions, thereby quantifying their impact. Furthermore, our developed non-contact medical checkup application proved to be a viable tool for monitoring physical condition with reduced contact, although careful consideration of measurable parameters is crucial. This study provides critical insights into the long-term effects of activity restrictions on young athletes and offers a practical solution for health monitoring during infectious disease outbreaks, highlighting the potential for hybrid checkup approaches. Full article

Status epilepticus occurs when a seizure lasts more than five minutes or when multiple seizures occur with incomplete return to baseline. SE induces a myriad of pathological changes involving synaptic and extra-synaptic factors. The transition from a self-limiting seizure to a self-sustaining one is established by maladaptive receptor trafficking, whereby GABA_A receptors are progressively endocytosed while glutamatergic receptors (NMDA and AMPA) are transported to the synaptic membrane, causing excitotoxicity and alteration in glutamate-dependent downstream signaling. The subsequent influx of Ca²⁺ exposes neurons to increased levels of [Ca²⁺]i, which overwhelms mitochondrial buffering, resulting in irreversible mitochondrial membrane depolarization and mitochondrial injury. Oxidative stress resulting from mitochondrial leakage and increased production of reactive oxygen species activates the inflammasome and induces a damage-associated molecular pattern. Neuroinflammation perpetuates oxidative stress and exacerbates mitochondrial injury, thereby jeopardizing mitochondrial energy supply in a state of accelerated ATP consumption. Additionally, Ca²⁺ overload can directly damage neurons by activating enzymes involved in the breakdown of proteins, phospholipids, and nucleic acids. The cumulative effect of these effector pathways is neuronal injury and neuronal death. Surviving neurons undergo long-term alterations that serve as a substrate for epileptogenesis. This review highlights the multifaceted mechanisms underlying SE self-sustainability, pharmacoresistance, and subsequent epileptogenesis. Full article

Background/Objectives: This study investigated the association between cochlear implant (CI) users’ assessed perception of musical sound quality and their subjective music perception and music-related quality of life (QoL). The aim was to provide a comprehensive evaluation by integrating a relatively objective Turkish Multiple Stimulus with Hidden Reference and Anchor (TR-MUSHRA) test and a subjective music questionnaire. Methods: Thirty CI users and thirty normal-hearing (NH) adults were assessed. Perception of sound quality was measured using the TR-MUSHRA test. Subjective assessments were conducted with the Music-Related Quality of Life Questionnaire (MuRQoL). Results: TR-MUSHRA results showed that while NH participants rated all filtered stimuli as perceptually different from the original, CI users provided similar ratings for stimuli with adjacent high-pass filter settings, indicating less differentiation in perceived sound quality. On the MuRQoL, groups differed on the Frequency subscale but not the Importance subscale. Critically, no significant correlation was found between the TR-MUSHRA scores and the MuRQoL subscale scores in either group. Conclusions: The findings demonstrate that TR-MUSHRA is an effective tool for assessing perceived sound quality relatively objectively, but there is no relationship between perceiving sound quality differences and measures of self-reported musical engagement and its importance. Subjective music experience may represent different domains beyond the perception of sound quality. Therefore, successful auditory rehabilitation requires personalized strategies that consider the multifaceted nature of music perception beyond simple perceptual judgments. Full article

Poly(organo)phosphazenes (PPZs) are increasingly recognized as versatile biomaterials for drug delivery applications in nanomedicine. Their unique hybrid structure—featuring an inorganic backbone and highly tunable organic side chains—confers exceptional biocompatibility and adaptability. Through precise synthetic methodologies, PPZs can be engineered to exhibit a wide spectrum of functional properties, including the formation of multifunctional nanostructures tailored for specific therapeutic needs. These attributes enable PPZs to address several critical challenges associated with conventional drug delivery systems, such as poor pharmacokinetics and pharmacodynamics. By modulating solubility profiles, enhancing drug stability, enabling targeted delivery, and supporting controlled release, PPZs offer a robust platform for improving therapeutic efficacy and patient outcomes. This review explores the fundamental chemistry, biopharmaceutical characteristics, and biomedical applications of PPZs, particularly emphasizing their role in zero-dimensional nanotherapeutic systems, including various nanoparticle formulations. PPZ-based nanotherapeutics are further examined based on their drug-loading mechanisms, which include electrostatic complexation in polyelectrolytic systems, self-assembly in amphiphilic constructs, and covalent conjugation with active pharmaceutical agents. Together, these strategies underscore the potential of PPZs as a next-generation material for advanced drug delivery platforms. Full article

Background: Mothers’ health significantly affects their well-being and that of their families. The early years of motherhood can be tough and impact mental health. This study examined the associations between mothers’ self-compassion, social support, and self-care behaviors and their physical and mental well-being. Methods: In August 2023, an online cross-sectional survey was conducted among 514 Israeli mothers with children under three. Mothers’ physical and mental health was assessed using SF12. Self-compassion was measured by the Self-Compassion Scale (SCS). Social support was evaluated through the Multidimensional Scale of Perceived Social Support (MSPSS), and self-care was assessed via the Pittsburgh Enjoyable Activities Test (PEAT). Results: Respondents’ average age was 31.5 years. Their self-reported physical health was relatively high, with a mean of 78.36 (SD = 21) on a 0–100 scale (n = 442). Mental health scores were lower, with a mean of 65.88 (SD = 20.28, n = 401). Perceived physical health was higher among Jewish mothers, younger mothers, and those with higher income levels. Additionally, greater social support and self-compassion correlated with better perceived physical health (Adj R² = 0.11, p < 0.001). For mental health, higher scores were observed among Jewish mothers, younger mothers, and full-time employed mothers. Furthermore, higher social support, self-compassion, and self-care practices were associated with improved perceptions of mental health (Adj R² = 0.39, p < 0.001). Conclusions: Promoting the well-being of mothers is crucial for their health, their children’s well-being, and the family unit. Health professionals working with mothers of young children should emphasize and help promote social support, self-compassion, and self-care activities. Full article

Background: Seiza, a traditional sitting posture requiring deep ankle plantarflexion and knee flexion, often becomes difficult after ankle fracture surgery because of restricted mobility. Increased stiffness of the tibialis anterior (TA) muscle, particularly in its deep and superficial fibres, may limit plantarflexion and affect functional recovery. This study aimed to investigate the relationship between TA muscle stiffness, assessed using shear wave elastography (SWE), and the ability to assume the seiza posture after ankle fracture surgery. We also sought to determine whether the stiffness in the deep or superficial TA fibres was more strongly correlated with seiza ability. Methods: In this cross-sectional study, 38 patients who underwent open reduction and internal fixation for ankle fractures were evaluated 3 months postoperatively. Seiza ability was assessed using the ankle plantarflexion angle and heel–buttock distance. The shear moduli of the superficial and deep TA fibres were measured using SWE. Ankle range of motion, muscle strength, and self-reported seiza pain were also measured. Multiple linear regression was used to identify the predictors of seiza performance. Results: The shear moduli of both deep (β = −0.454, p < 0.001) and superficial (β = −0.339, p = 0.017) TA fibres independently predicted ankle plantarflexion angle during seiza (adjusted R², 0.624). Pain during seiza was significantly associated with reduced plantarflexion, whereas muscle strength was not a significant predictor. Conclusions: TA muscle stiffness, especially in the deep fibres, was significantly associated with limited postoperative seiza performance. Targeted interventions that reduce deep TA stiffness may enhance functional outcomes. Full article

Background/Objectives: Physical activity is a cornerstone of diabetes mellitus (DM) management and is strongly recommended in the American Diabetes Association (ADA)’s guidelines. This study aims to investigate the self-reported physical activity levels of individuals with DM in Germany, as well as the barriers and facilitators they encounter. Methods: Individuals with type 1 DM (T1DM) and type 2 DM (T2DM) were asked to fill out an online questionnaire that was partly based on the International Physical Activity Questionnaire (IPAQ). Results: The questionnaire was completed by 338 persons with either T1DM (57.1%) or T2DM (42.9%) (females: 56.2%, males: 42.0%, gender diverse persons: 1.8%) of all age groups (at least 18 years). In total, 80.5% of respondents were aware of the current physical activity recommendations. Among the respondents, 58% reported meeting the recommendations for endurance-type physical activity, while only 30.5% reported meeting those for strength training. The three most frequently cited barriers to physical activity were lack of time, lack of motivation and current state of health. Supporting factors included coverage of costs, availability of exercise programs in close proximity to the patient’s home and target group specific exercise programs. Conclusions: The results imply that many individuals with DM in Germany do not meet ADA’s physical activity recommendations, especially considering that self-reports often overestimate actual behavior. In particular, the actual number of individuals who regularly engage in strength training may be too low. There is a clear need to better communicate the benefits of different forms of physical training and to provide physical activity programs aligned with patients’ individual needs. Full article

Background/Objectives: Bronchiolitis is the leading cause of hospitalization in infants under 12 months. While often self-limiting, a subset of cases evolves into severe disease requiring intensive care. This study aimed to identify risk factors for severe bronchiolitis in two consecutive respiratory syncytial virus (RSV) seasons (before and after the introduction of nirsevimab) in Southern Italy. Methods: A retrospective, multicenter cohort study was conducted on all infants ≤12 months hospitalized with bronchiolitis from October 2023 to March 2025. Patients were categorized by disease severity: those requiring Sub-Intensive or Intensive Care (IC group) and others (n-IC group). Demographic and clinical data, virological testing, and therapeutic interventions were analyzed. Multivariable logistic regression was used to identify independent risk factors for severe disease. Results: Among 1056 hospitalized infants, 10.5% required intensive care. RSV was detected in 73.5% of tested patients and was significantly associated with severe outcomes. Independent risk factors for IC admission included younger age (<3 months), comorbidities, and RSV infection. A 33% reduction in bronchiolitis admissions was observed in the second season (post-nirsevimab), although the rate of severe cases remained stable (about 10% in both seasons). Conclusions: Younger age, comorbidities, and RSV infection are significant predictors of severe bronchiolitis. Although overall admissions decreased post-nirsevimab, severe cases persisted. These findings underscore the need for targeted preventive strategies and highlight the potential role of intermediate care approaches in managing bronchiolitis severity. Full article

Direct electrification and hydrogen utilization represent two key pathways for decarbonizing the glass industry, with their effectiveness subject to adequate furnace design and renewable energy availability. This study presents a techno-economic assessment for optimal solar energy integration in a representative 300 t/d oxyfuel container glass furnace with a specific energy consumption of 4.35 GJ/t. A mixed-integer linear programming formulation is developed to evaluate specific melting costs, carbon emissions, and renewable energy self-consumption and self-production rates across three scenarios: direct solar coupling, battery storage, and a hydrogen-based infrastructure. Battery storage achieves the greatest reductions in specific melting costs and emissions, whereas hydrogen integration minimizes electricity export to the grid. By incorporating capital investment considerations, the study quantifies the cost premiums and capacity requirements under varying decarbonization targets. A combination of 30 MW of solar plant and 9 MW of electric boosting enables the realization of around 30% carbon reduction while increasing total costs by 25%. Deeper decarbonization targets require more advanced systems, with batteries emerging as a cost-effective solution. These findings offer critical insights into the economic and environmental trade-offs, as well as the technical constraints associated with renewable energy adoption in the glass industry, providing a foundation for strategic energy and decarbonization planning. Full article

The main objective of this study was to compare the long-term outcomes of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis, focusing on differences between self-expanding valve (SEV) versus balloon-expandable valve (BEV) prostheses and the influence of balloon pre- and post-dilatation on clinical results. The secondary objective was to report the long-term outcomes after TAVI in Romania. All patients who underwent a TAVI procedure for severe AS between November 2016 and May 2025 at a tertiary center in Romania were included in the present study. A total of 702 patients were included, of which 455 (64.8%) and 247 (35.1%) patients received a BEV (Sapien3 platform) and a SEV (Accurate, Boston, Portico, Evolut, or Navitor platforms), respectively. Pre-dilatation was performed in 514 (73.2%) cases, and post-dilatation was performed in 189 (26.9%) cases. There were 10.5 and 7.8 all-cause and cardiovascular-cause mortality event rates per 100 patient years, respectively. In regard to the univariable Cox regression, a BEV has significantly lower mortality than an SEV (HR = 0.67[0.46–0.96], p = 0.03), pre-dilatation did not influence mortality (HR = 0.71[0.48–1.04], p = 0.08), and post-dilatation significantly increased mortality (HR = 1.51[1.05–2.19], p = 0.03). In regard to the multivariable Cox regression, survival was not influenced by pre-dilatation or the valve platform, while post-dilatation had a trend towards higher mortality (p = 0.06). The BEV and SEV have similar survival rates, with no heterogeneity among a large number of TAVI platforms. While pre-dilatation had no impact on mortality, post-dilatation was associated with a trend towards increased mortality (p = 0.06), which was independent of the transprosthetic gradient. Survival after TAVI in Romania is comparable to that reported in Western registries. Full article

Cutaneous malignant melanoma is an extraordinarily aggressive and heterogeneous cancer that contains a small subpopulation of tumor stem cells (CSCs) responsible for tumor initiation, metastasis, and recurrence. Identification and characterization of CSCs in melanoma is challenging due to tumor heterogeneity and the lack of specific markers (CD271, ABCB5, ALDH, Nanog) and the ability of cells to dynamically change their phenotype. Phenotype-maintaining signaling pathways (Wnt/β-catenin, Notch, Hedgehog, HIF-1) promote self-renewal, treatment resistance, and epithelial–mesenchymal transitions. Tumor plasticity reflects the ability of differentiated cells to acquire stem-like traits and phenotypic flexibility under stress conditions. The interaction of CSCs with the tumor microenvironment accelerates disease progression: they induce the formation of cancer-associated fibroblasts (CAFs) and neo-angiogenesis, extracellular matrix remodeling, and recruitment of immunosuppressive cells, facilitating immune evasion. Emerging therapeutic strategies include immunotherapy (immune checkpoint inhibitors), epigenetic inhibitors, and nanotechnologies (targeted nanoparticles) for delivery of chemotherapeutic agents. Understanding the role of CSCs and tumor plasticity paves the way for more effective innovative therapies against melanoma. Full article

Adolescence is marked by identity formation and moral development, often accompanied by increased transgressive behaviors. While existing research highlights the interplay between moral constructs and transgression in adolescence, the role of kindness remains underexamined. This study conceptualizes kindness as a multidimensional moral construct and investigates the relationship between different stages of kindness (i.e., egocentric, social/normative, extrinsically motivated, authentic) and transgressive behaviors among adolescents, also considering the moderating role of self-importance of moral identity. The participants were 215 Italian adolescents (aged 15–19) who completed a self-report questionnaire. The results showed that egocentric and authentic kindness were positively and negatively associated with transgression, respectively. Moreover, moral identity significantly enhanced the protective role of authentic kindness. These findings suggest that the relationship between kindness and transgression varies based on the stage of kindness and the importance adolescents attribute to their moral identity. They contribute to extending the understanding of kindness during adolescence, offering implications for reducing transgressive behaviors through targeted and innovative interventions. Full article

Background/Objectives: Conventional blood collection can be challenging in a non-clinical or home-based setting. In response, vacuum-assisted lancing devices for capillary blood collection (typically from the upper arm) have gained popularity to broaden access to diagnostic testing. However, these devices are often costly relative to the reimbursement rate for common laboratory testing panels. This study describes the design and evaluation of Comfort Draw™, a simplified and economical vacuum-assisted capillary blood collection device. Methods: Comfort Draw™ was evaluated by 12 participants in a preliminary study and by 42 participants in a follow-up study. Metrics assessed included the following: vacuum pressure of the device, skin temperature generated by the Comfort Draw prep warmer, blood collection volume, and analytical accuracy (for 19 common serum-based analytes). Results: Acceptable blood volume (>400 µL) and serum volume (>100 µL) were collected by Comfort Draw in 85.5% and 95.1% of cases, respectively. Seventeen of the nineteen analytes examined were within CLIA acceptance limits compared to matched venous samples. Self-reported pain scores associated with Comfort Draw collection averaged 0.39 on a scale from 0 to 10. Conclusions: In this preliminary clinical study, Comfort Draw was found to be a valid and relatively painless method for collecting capillary blood specimens. The device’s simple design and lower cost could enable broader applications compared to more complex alternative capillary blood collection devices. Full article