Search Results (18,779)

Objective: The accurate visualization of root canal systems on periapical radiographs is critical for successful endodontic treatment. This study aimed to evaluate and compare the effectiveness of several image enhancement algorithms—including a novel Total Variation–Contrast-Limited Adaptive Histogram Equalization (TV-CLAHE) technique—in improving the detectability of root canal configurations in mandibular incisors, using cone-beam computed tomography (CBCT) as the gold standard. A null hypothesis was tested, assuming that enhancement methods would not significantly improve root canal detection compared to original radiographs. Method: A retrospective analysis was conducted on 60 periapical radiographs of mandibular incisors, resulting in 420 images after applying seven enhancement techniques: Histogram Equalization (HE), Contrast-Limited Adaptive Histogram Equalization (CLAHE), CLAHE optimized with Pelican Optimization Algorithm (CLAHE-POA), Global CLAHE (G-CLAHE), k-Caputo Fractional Differential Operator (KCFDO), and the proposed TV-CLAHE. Four experienced observers (two radiologists and two dentists) independently assessed root canal visibility. Subjective evaluation was performed using an own scale inspired by a 5-point Likert scale, and the detection accuracy was compared to the CBCT findings. Quantitative metrics including Peak Signal-to-Noise Ratio (PSNR), Signal-to-Noise Ratio (SNR), image entropy, and Structural Similarity Index Measure (SSIM) were calculated to objectively assess image quality. Results: Root canal detection accuracy improved across all enhancement methods, with the proposed TV-CLAHE algorithm achieving the highest performance (93–98% accuracy), closely approaching CBCT-level visualization. G-CLAHE also showed substantial improvement (up to 92%). Statistical analysis confirmed significant inter-method differences (p < 0.001). TV-CLAHE outperformed all other techniques in subjective quality ratings and yielded superior SNR and entropy values. Conclusions: Advanced image enhancement methods, particularly TV-CLAHE, significantly improve root canal visibility in 2D radiographs and offer a practical, low-cost alternative to CBCT in routine dental diagnostics. These findings support the integration of optimized contrast enhancement techniques into endodontic imaging workflows to reduce the risk of missed canals and improve treatment outcomes. Full article

Metacognitive monitoring plays a crucial role in self-regulated learning, as accurate monitoring enables effective control, which in turn impacts learning outcomes. Most studies on metacognitive monitoring have focused on learners’ monitoring abilities when they are explicitly prompted to monitor. However, in real-world educational settings, learners are more often prompted to control their learning, such as deciding whether to allocate additional time to a learning target. The primary goal of this study was to investigate whether retrieval is engaged when learners are explicitly prompted to control their learning processes by making study decisions. To address this, three experiments were conducted. In Experiment 1, participants (N = 39) studied 70 Swahili–English word pairs in a learning task. Each trial displayed a word pair for 8 s, followed by a distractor task (a two-digit mental addition) and a study decision intervention (choose “Study Again” or “Next”). After learning, participants provided a global judgment of learning (JOL), estimating their overall recall accuracy. Finally, they completed a cued recall test (Swahili cue). Responses were scored for accuracy and analyzed alongside study decisions, study decision reaction time (RT), and metacognitive judgments. Reaction times (RTs) for study decisions correlated positively with test accuracy, global judgments of learning (JOLs), and judgments of confidence (JOCs), suggesting retrieval likely underlies these decisions. Experiment 2 (N = 74, between-subjects) compared memory performance and intervention response time between single-study, restudy, retrieval (explicit recall prompt), and study decision (study decision prompt) groups to have better control over study time and cognitive processes. Although no significant group differences in test accuracy emerged, the retrieval group took longer to respond than the study decision group. Within-subject analyses revealed similar recall accuracy patterns: participants recalled successfully retrieved or “no restudy” items better than failed-retrieval or “restudy” items, implying shared cognitive processes underlying retrieval and study decision interventions. Experiment 3 (N = 74, within-subject, three learning conditions: single-study, retrieval, and study decision) replicated these findings, with no condition effects on test accuracy but longer RT for retrieval than study decisions. The similar recall accuracy patterns between retrieval and study decision interventions further supported shared cognitive processes underlying both tasks. Self-reports across experiments confirmed retrieval engagement in both retrieval and study decision interventions. Collectively, the results suggest that retrieval likely supports study decisions but may occur less frequently or less deeply than under explicit monitoring prompts. Additionally, this study explored objective, online measures to detect retrieval-based metacognitive monitoring. Full article

Background: Dietary advice for Paralympic athletes (PAs) with a spinal cord injury (PAs-SCI) requires particular attention and has been widely studied. However, currently, no particular attention has been addressed to nutritional guidelines for athletes with an amputation (PAs-AMP). This study aimed at filling up this gap, at least partially, and compared veteran PAs-SCI with PAs-AMP. Methods: A sample of 25 male PAs (12 with SCI and 13 with AMP), recruited during two training camps, was submitted to the following questionnaires: allergy questionnaire for athletes (AQUA), Nordic Musculoskeletal Questionnaire (NMQ), Starvation Symptom Inventory (SSI), neurogenic bowel dysfunction (NBD), orthorexia (ORTO-15/ORTO-7), alcohol use disorders identification test (AUDIT), and Mediterranean diet adherence (MDS). The PAs were also submitted to the following measurements: dietary Oxygen Radical Absorbance Capacity (ORAC) and intakes, body composition, handgrip strength (HGS), basal energy expenditure (BEE), peak oxygen uptake (VO_2peak), peak power, peak heart rate (HR), post-exercise ketosis, and antioxidant response after a cardiopulmonary exercise test (CPET) to voluntary fatigue. Results: Compared to PAs-AMP, PAs-SCI had higher NBD and lower VO_2peak (p < 0.05), peak power, peak HR, peak lactate, phase angle (PhA) of the dominant leg (p < 0.05), and ORTO15 (p < 0.05). The latter was related to NBD (r = −0.453), MDS (r = −0.638), and ORAC (r = −0.529), whereas ORTO7 correlated with PhA of the dominant leg (r = 0.485). Significant differences between PAs-AMP and PAs-SCI were not found in the antioxidant response, glucose, and ketone levels after CPET, nor in dietary intake, AUDIT, AQUA, NMQ, SSI, BEE, HGS, and FM%. Conclusions: The present study showed that PAs-SCI and PAs-AMP display similar characteristics in relation to lifestyle, energy intake, basal energy expenditure, and metabolic response to CPET. Based on both the similarities with PAs-SCI and the consequences of the limb deficiency impairment, PAs-AMP and PAs-SCI require personalized nutritional advice. Full article

Objectives: Diabetes Mellitus involves demanding challenges that interfere with family functioning and routines. In turn, family and social context impacts individual glycemic control. This study aims to identify this recursive interplay, the mutual influences of family systems and diabetes management. Design: Data was collected through a cross-sectional design comparing patients, aged 22–55, with and without metabolic control. Methods: Participants filled out a set of self-report measures of sociodemographic, clinical and family systems assessment. Patients (91) were also invited to describe their perception about disease management interference regarding family functioning. We first examined the extent to which family variables grouped dataset to determine if there were similarities and dissimilarities that fit with our initial diabetic groups’ classification. Results: Cluster analysis results identify a two-cluster solution validating initial classification of two groups of patients: 49 with metabolic control (MC) and 42 without metabolic control (NoMC). Independent sample tests suggested statistically significant differences between groups in family subscales- family difficulties and family communication (p < 0.05). Binary logistic regression shed light on predictors of explained variance to no metabolic control, in four models: Sociodemographic, Clinical data, SCORE-15/Congruence Scale and Eating Behavior. Furthermore, groups differ on family support, level and sources of family conflict caused by diabetes management issues. Considering only patients who co-habit with a partner for more than one year (N = 44), NoMC patients score lower on marital functioning in all categories (p < 0.05). Discussion: Family-Chronic illness interaction plays a significant role in a patient’s adherence to treatment. This study highlights the Standards of Medical Care for Diabetes, considering caregivers and family members on diabetes care. Full article

Cystic fibrosis (CF), the most common hereditary lung disease in Caucasians, is caused by dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR). We evaluated CFTR function using a newly developed Ussing chamber system, the Multi Trans Epithelial Current Clamp (MTECC), in an in vitro model of human airway epithelia. Air–liquid interface (ALI) cultures were established from nasal brushings of healthy controls (HC) and CF patients with biallelic CFTR variants. ALI layer thickness was similar between groups (HC: 62 ± 13 µm; CF: 55 ± 9 µm). Immunofluorescence showed apical CFTR expression in HC, but reduced or absent signal in CF cultures. MTECC enabled continuous measurement of transepithelial resistance (Rt), potential difference (PD), and conductance (G_t). G_t was significantly reduced in CF cultures compared to HC (0.825 ± 0.024 vs. −0.054 ± 0.016 mS/cm²), indicating impaired cAMP-inducible ion transport by CFTR. Treatment of CF cultures with elexacaftor, tezacaftor, and ivacaftor (Trikafta^®) increased G_t, reflecting partial restoration of CFTR function. These findings demonstrate the utility of MTECC in detecting functional differences in CFTR activity and support its use as a platform for evaluating CFTR-modulating therapies. Our model may contribute to the development of personalized treatment strategies for CF patients. Full article

Famatinite (Cu₃SbS₄) is an earth-abundant, nontoxic material with potential for thermoelectric energy generation applications. Herein, rapid, energy-efficient, and facile one-pot modified polyol synthesis was utilized to produce gram-scale quantities of phase-pure famatinite (Cu_2.7M_0.3SbS₄, M = Cu, Zn, Mn) nanoparticles (diameter 20–30 nm) with controllable and stoichiometric incorporation of transition metal dopants on the Cu-site. To produce pellets for thermoelectric characterization, the densification process by spark plasma sintering was optimized for individual samples based on thermal stability determined using differential scanning calorimetry and thermogravimetric analysis. Electronic transport properties of undoped and doped famatinite nanoparticles were studied from 225–575 K, and the thermoelectric power factor was calculated. This is the first time electronic transport properties of famatinite doped with Zn or Mn have been studied. All famatinite samples had similar resistivities (>0.8 mΩ·m) in the measured temperature range. However, the Mn-doped famatinite nanomaterials exhibited a thermoelectric power factor of 10.3 mW·m⁻¹·K⁻¹ at 575 K, which represented a significant increase relative to the undoped nanomaterials and Zn-doped nanomaterials engendered by an elevated Seebeck coefficient of ~220 µV·K⁻¹ at 575 K. Future investigations into optimizing the thermoelectric properties of Mn-doped famatinite nanomaterials are promising avenues of research for producing low-cost, environmentally friendly, high-performing thermoelectric materials. Full article

Multidimensional clustering of large-scale multi-view data is an important topic because it makes possible to combine a variety of manifestations of a complex information set. Nevertheless, comparing and selecting the most suitable deep clustering method is not an easy task, especially when several opposing criteria are applied. Multi-criteria decision-making (MCDM) techniques provide systematic approaches to making such judgments, although they are often limited in their ability to handle uncertainty, imprecise judgments, and interdependencies in practice. To solve these problems, this paper suggests a circular Fermatean fuzzy technique order preference by similarity to ideal solution (CFF-TOPSIS) method, which combines improved fuzzy modeling with MCDM to make the decision-making process accurate and sound. By exploiting the intrinsic symmetry of TOPSIS, where distances to positive and negative ideal solutions are treated symmetrically, the proposed model integrates five evaluation criteria for assessing clustering adequacy, including clustering accuracy, scalability, computational complexity, robustness, and interpretability, to critically evaluate five alternative clustering methods based on the input of three decision-makers. This measurement is performed efficiently by the CFF-TOPSIS method based on the uncertainty and subjective judgment contained within circular Fermatean fuzzy sets (CFFSs). The model is reliable and superior to existing models, as confirmed by sensitivity and comparative analyses. The suggested approach provides a systematic and flexible method for making decisions in complex big-data settings, while maintaining symmetry in the evaluation of alternatives and criteria. Full article

The K-means algorithm utilizes the Euclidean distance metric to quantify the similarity between data points and clusters, with the fundamental objective of assessing the relationship between points. It is important to note that, during the process of clustering, the relationships between the remaining points in the cluster and the points to be measured are ignored. In consideration of the aforementioned issues, this paper proposes the utilization of extension distance for the purpose of evaluating the relationship between the points to be measured and the cluster classes. Furthermore, it introduces a variant of the K-means algorithm based on the separator distance. Through a series of comparative experiments, the effectiveness of the proposed algorithm for clustering fan-shaped datasets is preliminarily verified. Full article

The small-spotted catshark and the smooth-hound are cartilaginous, carnivorous fish with similar depth ranges in their habitats. These two species are among the most abundant elasmobranchs in the Adriatic Sea and are frequently caught by local fishermen using longline fishing. Despite their ecological similarities, little is known about the physiological differences in their digestive processes. The study of enzymatic digestion in these ecologically relevant species helps to fill the knowledge gap in the understanding of nutrient processing in cartilaginous fish. Therefore, the aim of this study was to determine, measure and compare the enzymatic activity of alkaline phosphatase, acid phosphatase, non-specific esterase and aminopeptidase. Fish were caught in the central part of the Adriatic Sea between 2021 and 2023. A total of 60 adult individuals were analyzed, with samples taken from six parts of the digestive tract. Histochemical analysis of 1440 slides revealed clear differences in enzyme activity between the two species. In the small-spotted catshark, cellular protein degradation was most pronounced in esophagus, posterior stomach and rectum, whereas in the smooth-hound, it was concentrated in posterior stomach and spiral intestine. Cellular digestion of lipids in the small-spotted catshark appears to occur primarily in the stomach. The results of this study provide new insights into the distribution of cellular digestive enzymes in cartilaginous fish and emphasize the importance of studying the entire digestive tract as an integrated system rather than focusing on individual parts. This study fills an important knowledge gap and contributes to a deeper understanding of digestive physiology, which in turn has implications for species conservation and biological variability. Full article

Urban parking around the world faces similar challenges of inadequate space, pollution, and carbon emissions. Although various smart parking technologies have been tested and implemented, they primarily aim to reduce the time spent searching for parking, without considering the impact on air quality. In this study, the air quality in three urban garages was investigated with portable instruments at the entrance and exit gates and inside the garages. Garage emissions measured include CO₂, PM_2.5, PM₁₀, NO₂, and total VOCs. The results suggested that the PM_2.5 levels in these garages tend to be higher than the ambient levels. The emissions also exhibit seasonal variations, with the highest concentrations occurring in the summer, which are 20.32 µg/m³ in Campus Green, 14.25 µg/m³ in CCM, and 15.23 µg/m³ in Washington Park garages, respectively. PM_2.5 measured from these garages is strongly correlated (with an R² of 0.64) with ambient levels. CO₂ emissions are higher than ambient levels but within the indoor air quality limit. This suggests that urban garages in Cincinnati tend to enrich ambient air concentrations, which can affect garage users and garage attendants. Portable sensors are capable of long-term emission monitoring and are compatible with other technologies in smart garage development. With portable air sensors becoming increasingly accessible and affordable, there is an opportunity to integrate these devices with smart garage management systems to enhance the sustainability of parking garages. Full article

This study evaluates the relationship between preoperative cartilage quality, measured by T2 mapping, and patient-reported outcomes following labral tear treatment. We retrospectively reviewed patients aged 14–50 who underwent primary hip arthroscopy with either labral repair or reconstruction. Preoperative T2 values of femoral, acetabular, and labral tissue were assessed from MRI by blinded reviewers. International Hip Outcome Tool (iHOT-12) scores were collected preoperatively and up to two years postoperatively. Associations between T2 values and iHOT-12 scores were analyzed using univariate mixed linear models. Twenty-nine patients were included (mean age of 32.5 years, BMI 24 kg/m², 48.3% female, and 22 repairs). Across all patients, higher T2 values were associated with higher iHOT-12 scores at baseline and early postoperative timepoints (three months for cartilage and six months for labrum; p < 0.05). Lower T2 values were associated with higher 12- and 24-month iHOT-12 scores across all structures (p < 0.001). Similar trends were observed within the repair and reconstruction subgroups, with delayed negative associations correlating with worse tissue quality. T2 mapping showed time-dependent correlations with iHOT-12 scores, indicating that worse cartilage or labral quality predicts poorer long-term outcomes. These findings support the utility of T2 mapping as a preoperative tool for prognosis in hip preservation surgery. Full article

Background/Objectives: Breast cancer was the leading cause of malignant tumors among women in 2022. About two-thirds of breast cancer cases are hormone-receptor-positive. In these patients, aromatase inhibitors are a mainstay of treatment, but associated musculoskeletal symptoms can negatively affect patient compliance. Aromatase-inhibitor-induced carpal tunnel syndrome represents one of the main causes of aromatase inhibitor discontinuation, with a non-compliance rate of up to 67%, potentially leading to increased cancer mortality. This study investigates estrogen receptor expression in aromatase-inhibitor-induced carpal tunnel syndrome tissues, in order to better define its etiopathogenesis and derive preventive or therapeutic measures that can improve aromatase inhibitor patient compliance. To our knowledge, there is no study on this subject in the literature. Methods: Between 2023 and 2024, we recruited 14 patients at the Jewish Hospital of Rome, including seven patients with aromatase-inhibitor-induced carpal tunnel syndrome (study group) and seven with postmenopausal idiopathic carpal tunnel syndrome (control group). Each patient was evaluated based on a clinical visit, a questionnaire, instrumental exams, and serum hormone dosages and were treated with open carpal tunnel release surgery, during which transverse carpal ligament and flexor tenosynovium samples were collected. For immunohistochemical experiments, sections were treated with anti-estrogen receptor α and anti-estrogen receptor β antibodies. Results: The immunohistochemical features in the study and control groups were similar, demonstrating that tissues affected by aromatase-inhibitor-induced carpal tunnel syndrome are targets of direct estrogen action and that estrogen deprivation is correlated with disease etiogenesis. Surgery was effective in patient treatment. Conclusions: Aromatase-inhibitor-induced carpal tunnel syndrome represents a newly defined form of the disease. This syndrome represents one of the main causes of aromatase inhibitor discontinuation, due to its negative impact on the patient’s quality of life. The identification by clinicians of aromatase inhibitor use as a possible risk factor for carpal tunnel syndrome development is of essential importance, as early diagnosis and prompt management can improve patient compliance and overall breast cancer treatment outcomes. Full article

Background/Objectives: Feigning spectrum behavior (FSB) is the exaggeration, fabrication, or false imputation of symptoms. It occurs in compensable injury with great cost to society by way of loss of productivity and excessive costs. The aim of this study is to identify feigning by developing cut scores on the long and short forms (SF) of the Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ and OMPSQ-SF) and the Perceived Stress Scale (PSS and PSS-4). Methods: As part of pre-screening for a support program, 40 injured workers who had been certified unfit for work for more than 2 weeks were screened once with the OMPSQ and PSS by telephone by a mental health professional. A control sample comprised of 40 non-injured community members were screened by a mental health professional on four occasions under different aliases, twice responding genuinely and twice simulating an injury. Results: Differences between the workplace injured people and the community sample were compared using ANCOVA with age and gender as covariates, and then receiver operator characteristics (ROCs) were calculated. The OMPSQ and OMPSQ-SF discriminated (ρ < 0.001) between all conditions. All measures discriminated between the simulation condition and workplace injured people (ρ < 0.001). Intraclass correlation demonstrated the PSS, PSS-4, OMPSQ, and OMPSQ-SF were reliable (ρ < 0.001). Area Under the Curve (AUC) was 0.750 for OMPSQ and 0.835 for OMPSQ-SF for work-injured versus simulators. Conclusions: The measures discriminated between injured and non-injured people and non-injured people instructed to simulate injury. Non-injured simulators produced similar scores when they had multiple exposures to the test materials, showing the uniformity of feigning spectrum behavior on these measures. The OMPSQ-SF has adequate discriminant validity and sensitivity to feigning spectrum behavior, making it optimal for telephone screening in clinical practice. Full article

Background/Objectives: The social importance of health literacy (HL) is widely understood, and its measurement is the subject of various studies. Due to the recent pandemic, several instruments for measuring HL about COVID-19 have been proposed in different countries, including the HLS-COVID-Q22 questionnaire. The diversity of cultures and languages necessitates the cross-cultural adaptation of this instrument. Thus, the present study translates, adapts, and validates the psychometric properties of the HLS-COVID-Q22 questionnaire to provide its cross-cultural adaptation from English to Spanish (Peru). Methods: As part of ensuring that the final questionnaire accommodates the cultural nuances and idiosyncrasies of the target language, the following activities were carried out: (a) a survey of 40 respondents; and (b) a focus group with 10 participants, followed by expert approval. In addition, the validity and reliability of the health instrument have been ascertained through a further pilot test administered to 490 people in the city of Tacna in southern Peru. Results: The resulting questionnaire helps measure HL in Peru, aiding better-informed decision-making for individual health choices. Conclusions: The presence of such a tool is advantageous in case of similar global health emergencies, when the questionnaire can be made readily available to support a promotion of strategies towards better self-care. Moreover, it encourages other Latin American stakeholders to adjust the instrument to their own cultural, language, and socio-economic contexts, thus invigorating the regional and global expansion of the HL study network. Full article

The ability of earth-abundant metals to serve as catalysts for the oxygen reduction reaction is of increasing importance given the prominence of this reaction in several emerging technologies. It is now recognized that both the primary and secondary coordination environments of these catalysts can be modulated to optimize their performance. In this present work, we describe two Co^II complexes [Co^II(PaPy₂Q)](OTf) (1) and [Co^II(PaPy₂N)](OTf) (2) that catalyze chemical and electrochemical dioxygen reduction. Both 1 and 2 contain Co^II centers in a N₅⁻ coordination environment, but 2 has a naphthyridine group that places a nitrogen atom in the secondary coordination sphere. Solid-state X-ray crystallography and solution-state spectroscopic measurements reveal that, apart from this second-sphere nitrogen in 2, complexes 1 and 2 have essentially identical properties. Despite these similarities, 2 performs the chemical reduction of dioxygen ~10-fold more rapidly than 1. In addition, 2 has an enhanced performance in the electrochemical reduction of dioxygen compared to 1. Both complexes yield a significant amount of H₂O₂ in the chemical reduction of dioxygen (>25%). The enhanced catalytic performance of 2 is attributed to the presence of the second-sphere nitrogen atom, which might enable the efficient protonation of cobalt–oxygen intermediates formed during turnover. Full article