Search Results (169)

Background: Dyspeptic symptoms are very common in the general population, with an estimated prevalence of 14% to 41%, and the majority of patients experience symptoms without an organic cause for them (so-called functional dyspepsia). While the pathophysiology of functional dyspepsia remains elusive, the impact of functional dyspepsia on quality of life is detrimental. The treatment involves a change in lifestyle—a healthy diet and physical activity—in combination with pharmacological treatments. However, currently, there is no standard therapy for this condition, although a nutritional approach appears to be feasible and well accepted by patients. In this context, the intake of some mineral water types might be able to play an important role. Objective: The aim of the present study was to evaluate whether the regular intake of bicarbonate natural mineral water (Aqua Carpatica from source “F2 Păltiniș”) is able to positively influence the symptomatic process of dyspepsia, promoting digestion and improving the quality of life of patients. Methods: The patients enrolled in this open-label study had diagnosis of functional dyspepsia formulated in accordance with the Rome III criteria. During the 4-week study, patients had to ingest tap water at 1.5 L/day (wash-out period: 2 weeks), and in the 2-week subsequent period, they had to ingest alkaline natural mineral water at 1.5 L/day. The primary efficacy endpoint of this study includes a statistically significant improvement (p < 0.05) in the “heartburn”, “regurgitation”, and “dyspepsia” subscales and the total Reflux Disease Questionnaire’s (RDQ) score with respect to the effects of alkaline natural mineral water. As secondary endpoints, we considered statistically significant improvements (p < 0.05) in quality-of-life scores (Psychological General Well-Being Index—Short form; PGWB-S), the patient’s self-assessment of the state of efficiency of their digestion, and their sense of post-prandial fullness, as well as the use of antacids. Results: Forty-five patients were enrolled: all were Caucasian and mostly women (25, 55.6% vs. 20 men, 44.4%), and they were aged between 25 and 75 years (50.6 ± 13.5 years; mean ± SD). The results of this preliminary study show a significant improvement in functional dyspepsia symptoms—as assessed via the RDQ—and an improvement in quality of life—as assessed using the PGWB-S score—after the intake of alkaline natural mineral water. Conclusions: This preliminary study provides clinical evidence for a recommendation of alkaline natural mineral water as a symptomatic treatment of dyspepsia. Full article

Background: Periodontitis is linked to sleep-disordered breathing (SDB), including snoring, with 50–75% of cases involving mouth breathing (MB). Standard treatment includes scaling and root planing (SRP). Oral appliance therapy (OAT) is used to treat snoring and SDB. OAT plus a mouth shield (OAT+) worn during sleep may reduce MB to enhance periodontal health. This study evaluated whether OAT+, as an adjunct to SRP, improves periodontal health by reducing periodontal pathogens and facilitating upper airway patency. Methods: Fourteen participants with mild–moderate periodontitis were randomized to receive SRP on one side of the mouth at baseline (T0). Pocket depth (PD), bleeding on probing (BOP), and plaque index (PI) were recorded, and bacterial DNA from periodontal pockets were analyzed via PCR at baseline (T0) and 12 weeks (T3). At 4 weeks (T1), all participants received a self-titrated myTAP^® OA, followed by a mouth shield at 8 weeks (T2). Sleep metrics, including respiratory disturbance index (RDI), were recorded using the NOX T3 at T0–T3. Results: BOP and deep PD levels exhibited slight improvements from the baseline for both SRP and non-SRP (OAT+ only) treated sites but did not achieve significance. BOP decreased significantly more from the baseline in the SRP than in the non-SRP group at T3 (p = 0.028); P. gingivalis’ presence declined on both sides (p = 0.0135). Other periodontal and bacterial parameters showed no significant differences between or within groups. Snoring (p = 0.011), MB (p = 0.025), and RDI (p = 0.019) significantly decreased with OAT+ at T3. Conclusions: In mild–moderate periodontitis patients who snore, OAT+ reduces snoring, MB, and obstructive events, serving as an adjunct to SRP with no negative clinical effects over the short term. The combined therapy yielded similar results to OAT+ alone, likely due to minimization of MB. Its capacity to improve the oral environment is worthy of further investigation. Full article

We designed detachable steel sleeves to reinforce wooden joints and improve their integrity under earthquake action and investigated their mechanical properties. Monotonic bending tests were performed on a half-tenon pure wooden joint and a joint strengthened by a detachable steel sleeve. More obvious tenon pulling-out failure was observed in the pure wood joint; in comparison, only slight extrusion fracture of wooden beams and extrusion deformation of steel sleeves occurred in the wood joint reinforced by a detachable steel sleeve. Our test results showed that the initial rotational stiffness of the strengthened joint, JG1, was increased by 495.4% compared with that of the unstrengthened joint, JG0. The yield bending moment increased by 425.9%, and the ultimate bending moment increased by 627.5%, which indicated that the mechanical performance was significantly improved when the joint was reinforced by a detachable steel sleeve. Numerical simulations of different components were performed with finite element analysis software to analyze the mechanical performance of the reinforced joint. It was found that the stiffness and ultimate flexural performance of the joint could be increased by setting stiffeners on the steel sleeve and connecting the wooden column with self-tapping screws. The results of the tests were compared with those obtained through finite element analysis, and a high degree of accuracy was achieved, which could provide a theoretical basis for the reinforcement of timber structural buildings. Full article

Background/Objectives: Technological approaches for the objective, quantitative assessment of motor functions have the potential to improve the medical management of people with Parkinson’s disease (PwPD), offering more precise, data-driven insights to enhance diagnosis, monitoring, and treatment. Markerless motion capture (MMC) is a promising approach for the integration of biomechanical analysis into clinical practice. The aims of this project were to evaluate a commercially available MMC system, develop and validate a custom MMC data processing algorithm, and evaluate the effectiveness of the algorithm in discriminating fine motor performance between PwPD and healthy controls (HCs). Methods: A total of 58 PwPD and 25 HCs completed finger-tapping assessments, administered and recorded by a self-worn augmented reality headset. Fine motor performance was evaluated using the headset’s built-in hand tracking software (Native-MMC) and a custom algorithm (CART-MMC). Outcomes from each were compared against a gold-standard motion capture system (Traditional-MC) to determine the equivalence. Known-group validity was evaluated using CART-MMC. Results: A total of 82 trials were analyzed for equivalence against the Traditional-MC, and 152 trials were analyzed for known-group validity. The CART-MMC outcomes were statistically equivalent to Traditional-MC (within 5%) for tap count, frequency, amplitude, and opening velocity metrics. The Native-MMC did not meet equivalence with the Traditional-MC, deviating by an average of 24% across all outcomes. The CART-MMC captured significant differences between PwPD and HCs for tapping amplitude, amplitude variability, frequency variability, finger opening and closing velocities, and their respective variabilities, and normalized path length. Conclusions: The biomechanical data gathered using a commercially available augmented reality device and analyzed via a custom algorithm accurately characterize fine motor performance in PwPD. Full article

Given the suboptimal responses to medication and cognitive behavioral therapies in the treatment of post-traumatic stress disorder (PTSD), new approaches are needed. Background/Objectives: Therapies that include a somatic component such as Emotional Freedom Techniques (EFT) and Eye Movement Desensitization and Reprocessing (EMDR) have demonstrated efficacy in the treatment of PTSD in numerous clinical trials. This case series introduces the Trauma Reintegration Process (TRP), a psychotherapeutic process developed by the author that can be combined with somatic therapies to enhance their effectiveness, especially in patients with dissociation. Methods: This case series describes the use of TRP in combination with EFT, an energy-based somatic treatment that engages the meridian system of the body through gentle tapping on acupressure points. TRP uses EFT in combination with a focused guided imagery sequence. This case series describes the treatment of two patients: a 20-year-old woman who experienced PTSD and somatic symptoms following a serious motor vehicle accident (MVA) and a 45-year-old woman with a history of severe abuse as a child as well as adult trauma who had also been in a serious MVA. The cases contrast the way TRP can be applied in patients with single versus multiple traumas and who experience dissociation. Results: In both cases, EFT treatment stalled when the patient dissociated. After TRP was introduced, however, the EFT treatment regained momentum, leading to significant improvement in PTSD symptoms including a reduction of nightmares and flashbacks and resolution of other somatic symptoms. Conclusions: The trauma reintegration process (TRP) in combination with EFT has the potential to assist in the memory processing of patients with dissociation and complicated trauma presentation without retraumatizing the client and causing further distress or dissociation. In addition, it provides the patient with a self-empowering method to alleviate any additional traumatic sequelae. Full article

(1) Background: Neurofeedback (NFB) and biofeedback (BFB) have been shown to reduce stress, enhance physiological self-regulation, improve cognitive performance, and accelerate response times. Stimulating the sensorimotor rhythm (12–15 Hz) is particularly effective in improving working memory and selective attention. However, most studies on air force pilots focus on addressing post-traumatic stress disorder rather than investigating how these interventions might enhance performance and safety during flights, as explored in the present study. (2) Methods: Twelve Spanish Air Force fighter pilot trainees (mean age = 22.83 (0.94) years) participated in the study. Six pilots underwent 24 sessions of combined NFB and BFB training (experimental group), while six served as controls. (3) Results: The experimental group demonstrated improved heart rate variability during baseline, alarm sounds, math tasks, and real flights, which is indicative of greater parasympathetic modulation. A significant decrease in the Theta/SMR ratio was observed in the experimental group during the same conditions, suggesting improved focus, with lower values than the control group. Cognitive performance improved in the experimental group, with higher accuracy and a greater number of completed operations during math tasks. Regarding dual-task performance, the experimental group showed lower reaction time and a better ratio taps/reaction post-intervention. Psychological benefits included reduced cognitive, somatic, and state anxiety levels, along with increased self-confidence. (4) Conclusions: Neurofeedback and biofeedback training, integrated with real flights, simulators, and virtual reality, can enhance physiological regulation, cognitive performance, and emotional resilience, contributing to improved performance and safety in air force pilots. Full article

Objectives: The aim of the present study was to provide insight into potential predictors of HPV vaccination uptake and the willingness to get vaccinated. Methods: This cross-sectional study was conducted among university students using an online, anonymous, self-administered questionnaire. Vaccine hesitancy was measured according to the adult Vaccine Hesitancy Scale (aVHS). Sociodemographic characteristics, beliefs about vaccination decision-making, vaccination behavior, and willingness to receive the HPV vaccine among unvaccinated students, and sources of information about vaccinations were investigated. Results: Among the 542 sampled students, 11.1% were classified as vaccine-hesitant. About one third (31.7%) had not received the HPV vaccination. Males, older students, those who had not received the dTap-IPV booster dose, and those being discouraged from getting vaccinated by a healthcare worker were more likely not to be vaccinated. Students having one parent holding a university degree or higher were more likely to be vaccinated compared to those having parents with a high school diploma or less. Among unvaccinated students, 65.7% were willing to get vaccinated against HPV, and it was positively associated with a low aVHS score and female gender, as well as being enrolled in medical and life sciences majors. Conclusions: Suboptimal HPV vaccination uptake was observed, especially among male and older university students. Insights from the present study highlight the need to address misconceptions about HPV infection and vaccines by providing facts that can be used in conversations with individuals who may feel insecure after having heard various myths about HPV vaccination. Full article

Self-tapping screws are becoming increasingly popular for use in modern timber structures. The axial stress distribution of self-tapping screws due to a mechanical load has been previously studied. However, the stress distribution of self-tapping screws due to moisture swelling-induced load from wood has not been explored so far. This research presents an analytical model to predict the axial stress distribution in self-tapping screws embedded in mass timber products under the combined effects of axial mechanical loading and wood moisture-induced swelling. The analytical model has been validated with numerical simulation. The input properties of the analytical model can be determined from withdrawal tests of self-tapping screws and the manufacturer’s guide of screw and mass timber products. A simple program has been developed to predict the stress distribution and maximum axial stress in self-tapping screws for a range of effective penetration lengths under a pre-load and moisture content change. Correctly predicting the maximum axial stress in self-tapping screws under the simultaneous action of a pre-load and wood moisture swelling-induced load can help design safer timber structures. This research provides a practical method for practicing engineers to predict the maximum axial stress in self-tapping screws due to pre-load and wood moisture swelling. Full article

Laparoscopic surgery reduces tissue trauma and accelerates recovery, but postoperative pain remains a concern. Opioids are effective but have adverse effects, highlighting the need for multimodal analgesia. Nefopam, a non-opioid analgesic, provides pain relief without respiratory depression or dependence. This study aims to investigate the efficacy of intravenous nefopam combined with a transversus abdominis plane (TAP) block in living liver donors undergoing laparoscopic hepatectomy. This retrospective cohort analysis was conducted on 452 adult living donors who underwent laparoscopic hepatectomy with a TAP block between August 2013 and August 2018 at a single tertiary medical center. After propensity score matching, 296 patients were included, with 148 in the nefopam group and 148 in the non-nefopam group. The primary outcomes assessed were pain scores using the Numeric Rating Scale (NRS) at 1, 4, 8, 12, and 24 h postoperatively, opioid consumption, postoperative nausea and vomiting, and nefopam-related adverse effects. Nefopam significantly reduced NRS at 1, 4, and 8 h postoperatively (p < 0.001) and decreased fentanyl use in the post-anesthesia care unit (26.0 ± 32.2 μg vs. 60.5 ± 37.9 μg, p < 0.001) and total intravenous patient-controlled analgesia volume (p < 0.001). The incidence of postoperative nausea and vomiting and severe opioid-related complications did not differ between groups. Nefopam-related side effects were mild and self-limiting. Nefopam combined with a TAP block effectively reduces postoperative pain and opioid consumption in living liver donors, supporting its role in multimodal analgesia. Further research is needed to explore its broader applications. Full article

Abstract: Background: Transcatheter aortic valve implantation (TAVI) is the treatment of choice for symptomatic aortic stenosis in patients with moderate to high surgical risk. When transfemoral access is unsuitable, alternative routes such as transapical (TAP) or transaxillary (TAX) routes must be considered. This study compares the in-hospital mortality and clinical outcomes of TAP vs. TAX TAVI. Methods: We conducted a retrospective analysis of 76 patients who underwent TAP or TAX TAVI between 2018 and 2021 at our department. Inverse probability of treatment weighting (IPTW) was used to account for baseline differences. Results: Among 1901 TAVI procedures, a total of 76 was selected of which TAP was performed in 34.2% (n = 26), and TAX in 65.8% (n = 50) of cases. Self-expanding CoreValve Evolut R valve prostheses were used in 96% of TAX cases, while balloon-expandable Edwards SAPIEN 3 valve prostheses were exclusively implanted in TAP cases. After IPTW adjustment, baseline characteristics, including EuroSCORE II, LVEF, and NYHA class, were comparable. TAX was associated with a higher pacemaker implantation rate (22.6% vs. 0%; p = 0.032), while TAP had a higher incidence of late bacteremia (13.4% vs. 1.6%; p = 0.027) and longer hospitalization (19 [13, 28] vs. 10 [8, 21] days; p = 0.016). In-hospital (0% vs. 2.1%; p = 0.388), 30-day (3.4% vs. 3.5%; p = 0.957), and 3-year mortality (6.7% vs. 4.8%; p = 0.709) were similar. Device implantation success was 100% in both groups. Major bleeding and vascular complications were rare. Balloon predilatation was more frequent in TAX (57.6% vs. 13.3%; p = 0.002). Rates of mild and moderate aortic regurgitation did not differ. Conclusions: In patients unsuitable for transfemoral TAVI, TAP was associated with lower pacemaker rates but longer hospitalization and increased late bacteremia compared to TAX. Both approaches showed comparable safety and efficacy, emphasizing the need for individualized access selection. Full article

Straw–concrete combined floor slabs consist of straw boards, shear-resistant connectors, and concrete slabs. These slabs offer various advantages over traditional reinforced concrete slabs due to the straw boards’ properties of excellent insulation and sound absorption. Research using ABAQUS software created 15 composite floor models to study the impact of connection methods, bond strength, connector spacing, and thickness of straw and concrete on the flexural performance. Results indicated that the composite floor slab with adhesive bonding had a 7.34% and 17.34% higher load-carrying capacity than the bolt-connected and self-tapping screw-connected composite floor slabs, respectively. Increasing bond strength from 40 MPa to 60 MPa improved the load-carrying capacity of self-tapping nail-connected slabs by 80.84%. Connector spacing negatively correlated with slab capacity, while increasing the thickness of straw boards or concrete slabs enhanced the ultimate load-carrying capacity, with the latter having a more significant effect. Midspan deflection and flexural capacity were calculated using the converted cross-section method and static calculation formulas, with theoretical and simulated values showing good agreement, offering guidance for engineering applications. Full article

Wound healing is a complicated biological process that is important for restoring tissue integrity and function after injury. Infection, usually due to bacterial colonization, significantly complicates this process by hindering the course of healing and enhancing the chances of systemic complications. Recent advances in wearable biosensors have transformed wound care by making real-time monitoring of biomarkers such as pH, temperature, moisture, and infection-related metabolites like trimethylamine and uric acid. This review focuses on recent advances in biosensor technologies designed for wound management. Novel sensor architectures, such as flexible and stretchable electronics, colorimetric patches, and electrochemical platforms, enable the non-invasive detection of changes associated with wounds with high specificity and sensitivity. These are increasingly combined with AI and analytics based on smartphones that can enable timely and personalized interventions. Examples are the PETAL patch sensor that applies multiple sensing mechanisms for wide-ranging views on wound status and closed-loop systems that connect biosensors to therapeutic devices to automate infection control. Additionally, self-powered biosensors that tap into body heat or energy from the biofluids themselves avoid any external batteries and are thus more effective in field use or with limited resources. Internet of Things connectivity allows further support for remote sharing and monitoring of data, thus supporting telemedicine applications. Although wearable biosensors have developed relatively rapidly and their prospects continue to expand, regular clinical application is stalled by significant challenges such as regulatory, cost, patient compliance, and technical problems related to sensor accuracy, biofouling, and power, among others, that need to be addressed by innovative solutions. The goal of this review is to synthesize current trends, challenges, and future directions in wound healing and infection monitoring, with emphasis on the potential for wearable biosensors to improve patient outcomes and reduce healthcare burdens. These innovations are leading the way toward next-generation wound care by bridging advanced materials science, biotechnology, and digital health. Full article

Miniscrews are used in orthodontic treatment and can be applied immediately after implantation, making their initial stability crucial. However, clinical reports show that the success rate is not 100%, and many researchers have tried to identify the factors influencing success and optimize designs. A review of the literature reveals that studies on the same geometric parameter of miniscrews using different indicators and different brand samples have led to conflicting results. This study will use consistent miniscrew conditions to verify whether the design differences in the literature are reasonable. This study employs the Taguchi method and ANOVA for optimization analysis. The four control factors comprise thread pitch, thread depth, tip taper angle, and self-tapping notch. Using an L9(3⁴) orthogonal array, the experimental models are reduced to nine. The primary stability indicators for the miniscrew include bending strength, pull-out strength, insertion torque, and self-tapping performance. The results of the single-objective experiments in this study align with the findings from the other literature. However, when analyzed collectively, they do not yield the same optimal solution. Under equal weighting, the combined multi-objective optimal solution is A2B2C1D1. This study exhibits minimal experimental error, ensuring high analytical reliability. The findings confirm that the optimal design does not converge across four single-objective analyses, as different stability indicators yield contradictory trends in design parameters. Given that these four indicators already demonstrate notable discrepancies, the influence of additional stability factors would be even more pronounced. Therefore, a multi-objective optimization approach is essential for the rational design of miniscrews. Full article

Background: Immediate post-extraction dental implants are increasingly popular, but ensuring primary stability and managing peri-implant tissues remain challenging. Implant macro-design significantly impacts stability and osseointegration. This study used Cone-beam Computed Tomography (CBCT) to evaluate changes in alveolar bone following immediate placement of two implant designs, System 2P and Dura-Vit 3P, which feature semi-conical microgeometry and apical self-tapping portions for improved stability and bone regeneration. Methods: With a 1:1 allocation ratio, the current investigation was a two-arm parallel group randomized clinical trial. Patients qualified if they required immediate dental replacements with adequate buccal bone support. Two types of implants were placed: System 2P (cylindrical shape) and Dura-Vit 3P (more conical shape, with a particular architecture of threads). Following the intervention, CBCT was performed both immediately (T1) and six months later (T2). Measurements of CBCT horizontal bone level at apical, medial, and bevel height on the palatal/lingual and vestibular sides as well as the buccal vertical gap were the primary results. Complications, implant stability quotient (ISQ), and torque insertion were evaluated. The Mann–Whitney test was used to determine time-based differences within each group, while the Wilcoxon test was used to estimate differences between groups. The impact of baseline marginal gap dimension and gingival biotype was estimated using multiple regressions. Results: Thirty patients were recruited and randomized to treatments, with two lost to follow-up. One System 2P implant failed and two patients of the Dura-Vit 3P group dropped out. At T1, the Dura-Vit 3P group exhibited a lower mean insertion torque and a higher ISQ than the System 2P group. Furthermore, the Dura-Vit 3P group showed lower bone reduction compared to System 2P at horizontal and vertical measurements with significant differences for the vestibular and palatal base and medial level (p-values < 0.05). Regression models indicated a positive effect of thick biotypes on gap filling and dimensional bone reduction. No complications were observed in both groups. Conclusions: The Dura-Vit 3P implant exhibits high primary stability when inserted in post-extraction sites. Furthermore, this kind of implant stimulates higher bone stability on both the palatal and buccal side when compared to the System 2P implant. The present findings support the evidence that the macro-design of the Dura-Vit 3P implant promotes increased primary stability and reduces bone loss. Full article

This study’s goal was to evaluate associations of human exposure to unfiltered tap water during the Flint water crisis (FWC) with perceived harm to pets from exposure to contaminated water. We also explored the associations of perceived pet harm with participants’ self-reported general, physical, and mental health, as well as quality of life. Adult (n = 3264) pet owners from a public health registry reported unfiltered tap water exposure, perceived pet health, and general health/quality of life at baseline, as well as health/quality of life 1 year later (n = 1172). Using frequencies, percentages, and odds ratios, we evaluated associations of unfiltered tap water consumption with perceived pet health (cross-sectional) and perceived pet health with general health and quality of life (cross-sectional and longitudinal). Daily unfiltered tap water drinkers were 3.12 (95% CI: 2.33–4.23) times more likely to report the FWC had made their pet ill compared to participants who never drank unfiltered water. Participants who reported Flint water made their pet ill had approximately a two-fold increase in odds of reporting poor/fair across all four health/quality-of-life measures compared to those who did not. Both animals and humans were exposed and impacted by the FWC. This study supports the interconnectedness between human and animal health, especially regarding environmental disaster exposure and outcomes. Full article