Search Results (395)

Background/Objectives: Although children’s playgrounds foster physical, cognitive and emotional health, sandpits can harbour antibiotic-resistant bacteria, representing a health concern for kids. Therefore, this point prevalence study investigated the presence and antimicrobial resistance of Escherichia coli in sandpits at four schools in Durban to ascertain the potential risk to schoolchildren and inform school authorities of the need to prevent such occurrences. Methods: Twenty samples were collected from schools on a single day. E. coli was isolated using colilert-18^® and confirmed using PCR. Antibiotic susceptibility testing was performed against 19 antibiotics using the disc diffusion method and Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: E. coli was detected in 2/4 schools (50%), yielding 100 pure isolates. Of these, 71% (31 Site B and 40 Site C isolates) were resistant to at least one of the antibiotics tested, displaying 36 antibiograms. The highest resistance was to CFX (n = 40), and the lowest was to AMK and MEM (n = 1). All isolates were susceptible to CIP, CHL, GEN and TZP. At Site B, the highest resistance was against CFX (n = 16) and the lowest against AMK, CTX and NAL (n = 1). The highest resistance at Site C was against TET (n = 26), and the lowest against ATH and AUG (n = 1). Twenty isolates (20%) were multidrug-resistant, displaying resistance to at least one antibiotic from 3 classes. Conclusions: These results show that children with poor hygiene practices could get sick from playing in sandpits. Schools must change their sand regularly and ensure that sandpits are constantly exposed to the sun. Full article

Background/Objectives: We aim to develop an image linearization process and a program capable of quantifying vertical and left–right asymmetries observed in macular scans. We then sought to verify its applicability in clinical settings. Methods: In this single-center cross-sectional study, we examined 37 consecutive patients with unilateral open-angle glaucoma and analyzed paired data (glaucomatous eye vs. fellow normal eye). Spectral-domain OCT images were automatically processed by a custom program to align the disc–fovea axis and temporal raphe, and the following parameters were evaluated: (1) mean inner retinal thickness difference (superior–inferior), (2) Vertical Asymmetry Score, and (3) Quadrantal Asymmetry Score. Results: We analyzed 37 healthy eyes and 37 POAG eyes. After linearization, the mean inner retinal thicknesses for the normal and POAG groups were 93.4 µm (interquartile range [IQR]: 90.1–98.5) and 80.3 µm (IQR: 77.3–85.0), respectively. The Vertical Asymmetry Score was 6.80 (IQR: 6.15–7.25) for healthy eyes and 9.69 (IQR: 9.16–11.58) for POAG eyes. The Quadrantal Asymmetry Score was 6.35 (IQR: 5.94–7.19) for healthy eyes and 8.47 (IQR: 8.11–9.63) for POAG eyes. Significant differences were found between groups for all parameters (p < 0.001). The Vertical Asymmetry Score (AUC = 0.967, p < 0.001) and Quadrantal Asymmetry Score (AUC = 0.946, p < 0.001) demonstrated significantly greater accuracy in detecting glaucoma compared to the mean inner retinal thickness (AUC = 0.743). Conclusions: The developed linearization program and asymmetry scores have shown promise as parameters for objectively quantifying macular asymmetry using spectral-domain OCT. External validation in independent cohorts, including bilateral disease, is warranted. Full article

Background/Objectives: Transforaminal epidural steroid injection (TFESI) is widely used to treat lumbosacral radicular pain caused by a herniated lumbar disc (HLD). However, therapeutic response varies substantially, and reliable outcome prediction remains challenging because of the multifactorial interplay of clinical and morphological factors. Machine learning (ML) approaches may address this limitation by modeling nonlinear interactions among patient-specific variables. Methods: This retrospective cohort study analyzed 242 patients with HLD-related radiculopathy who underwent single-level lumbar TFESI. Eight variables—age, sex, injection side, injection level, pain duration, pretreatment numeric rating scale (NRS) score, HLD location, and HLD subtype—were used as input features. Therapeutic outcome was defined as a ≥50% reduction in NRS score at 1 month after TFESI. Three predictive models, namely deep neural network (DNN), random forest (RF), and XGBoost, were developed and evaluated using a validation cohort of 49 patients. Results: The DNN model demonstrated the best validation performance, achieving an area under the curve (AUC) of 0.821 (95% confidence interval [CI], 0.690–0.929). The performance of the RF (AUC, 0.711; 95% CI, 0.535–0.865) and XGBoost (AUC, 0.674; 95% CI, 0.498–0.831) models was inferior to that of the DNN. In addition, the DNN produced fewer false-positive predictions and showed more robust discrimination between favorable and poor outcomes than the other ML models. Conclusions: A deep learning–based predictive model demonstrated superior performance in predicting therapeutic outcomes after lumbar TFESI in patients with HLD-related radiculopathy. Integration of routine clinical and magnetic resonance imaging (MRI)-derived features into ML algorithms may enhance individualized prognostication and assist clinicians in optimizing patient selection for interventional procedures. To the best of our knowledge, this is the first study to develop an ML-based model integrating routine clinical variables with MRI findings for the prediction of TFESI outcomes in HLD-related radiculopathy. Nevertheless, the study is limited by its single-center retrospective design, lack of external validation, and reliance on MRI assessments performed by a single rater. Future multicenter studies are warranted to improve generalizability and confirm clinical utility. Full article

Background/Objectives: Occlusal splints are widely used for managing sleep bruxism (SB), providing uniform contact across the entire dentition in the centric relation. Nonetheless, different guidance schemes, such as bilateral balanced occlusion (BBO) and canine guidance (CG), are used during eccentric movements, and the optimal design remains unclear. This study compared the effects of BBO and CG on masticatory muscle activity, sleep architecture, and subjective outcomes during sleep. Methods: This non-blinded randomized crossover trial enrolled 24 healthy adults diagnosed with SB (16 men and 8 women; mean age, 26.1 years) who were randomly assigned to either a BBO-first or CG-first sequence. Individual splints of both types were milled from the polymethyl methacrylate discs. After a 5-night baseline period, each splint was worn for 33 nights in a home environment, and data from nights 29 to 33 were analyzed. Masseter muscle activity was assessed using single-channel electromyography (EMG), yielding EMG parameters, including integrated EMG per hour, number of episodes and bursts per hour, mean episode duration, and total episode duration per hour. Sleep architecture was assessed using portable polysomnography with automatic scoring, and subjective outcomes were assessed for sleep disturbance, morning symptoms, and splint comfort. Differences between splints were analyzed using Wilcoxon signed-rank tests (α = 0.05). Results: Twenty-three participants completed the study. No statistically significant differences were found between the BBO and CG splints for any EMG parameters, sleep variables, or subjective measures. Conclusions: Splint guidance design differences showed no significant effects; however, smaller, potentially clinically relevant effects cannot be excluded. Full article

Objective: This study aimed to investigate the effects of dual-task stroboscopic visual training (DTSVT) on balance, functional mobility, and gait in children who are hard-of-hearing. Methods: This randomized controlled study included 31 children (17 girls, 14 boys) with congenital sensorineural hearing loss. Participants were assigned to one of three groups: control group, conventional balance training (CBT) group, and DTSVT group. The CBT and DTSVT groups participated in an exercise program for 16 weeks, twice weekly, for 40 min (a total of 24 sessions). Static balance was assessed using the Tandem Romberg test and Single-Leg Stance (SLS) test, while dynamic balance was evaluated using the Functional Reach Test (FRT), balance disc test, and the Four Square Step Test (FSST). The Pediatric Balance Scale (PBS) was used as a subjective balance assessment. Functional mobility was assessed using the Timed Up and Go (TUG) Test, Step Test, 10 m Walk Test (10 MWT), and Functional Gait Assessment (FGA). Postural sway parameters were recorded using the GyKo device, including Sway Area (EA, cm²), Distance Length (DL, cm), Length (anterior–posterior (AP)) (cm), Length (medial–lateral (ML)) (cm), Mean Distance (D) (cm), Mean Distance (AP) (cm), and Mean Distance (ML) (cm). Results: Significant between-group differences were primarily observed in favor of the DTSVT group post-treatment, particularly in PBS scores, GyKoDL values during the eyes-open SLS test, and TUG test completion times (p < 0.05). Some baseline differences were noted among groups in functional reach distance, FSST completion time, and eyes-closed duration on the Balance Disc test (p < 0.05). Within-group comparisons revealed significant improvements in FSST times in both intervention groups, reduced postural sway parameters during the FRT in the DTSVT and control groups, and increased eyes-closed Tandem Romberg duration in the CBT group (p < 0.05). Most other outcome measures did not demonstrate statistically significant changes either within or between groups (p > 0.05). Conclusions: Dual-task stroboscopic visual training was more effective than conventional balance training in improving specific aspects of balance and functional mobility in children who are hard-of-hearing. These findings highlight the potential of adding cognitively demanding and visually engaging balance tasks to rehabilitation programs for this population. Larger and more diverse samples in future studies are needed to enhance the generalizability of these results. Studies that assess balance and gait using standardized clinical or laboratory tests may be particularly valuable. Given the small sample size and multiple comparisons, the results should be considered preliminary and exploratory. Full article

The rock is the direct object of disc cutter rock-breaking engineering. It contains natural joint surface. To investigate the influence of joint-surface roughness on the rock-breaking process. The hob model is created using AutoCAD software. The single- and twin-hob rock-breaking processes in intact rocks are simulated with PFC (Particle Flow Code) software. Furthermore, a rough joint network model is established based on MATLAB platform. The influence of joint-surface roughness on failure mode, crack propagation, and rock-breaking load is examined. The results reveal that cutter spacing in intact rock markedly governs the trends of rock-breaking load and crack count. The damage zone extends from the disc cutter–rock contact surface into the specimen interior. The rock-breaking process is mainly dominated by shear cracks. Fracturing of the rock mass occurs along the structural plane, and the force chain and crack propagation mainly distribute through tensile cracks. The initial structural plane of failure gradually penetrates the rock mass surface, resulting in the failure zone development. While considering joint roughness, the RDFN (Rough Discrete Fractures Network) model exhibits higher disc cutter contact force than the DFN (Discrete Fracture Network) model. Throughout the rock-breaking period, both RDFN and DFN models intersect in the number of cracks, but the difference between the two models remains significant. The contact force of the cutter in the RDFN and DFN models differs from that in whole rock. These findings offer a useful reference for elucidating the hob-breaking mechanism in jointed rock masses. Full article

Background and Objectives: Preoperative cefazolin is the standard of care for intervertebral disc surgery as it reduces the incidence of iatrogenic spondylodiscitis. The aim of this study was to determine the impact of intervertebral disc degeneration and endplate changes on the penetration of prophylactic cefazolin into the intervertebral disc during spinal surgery. Materials and Methods: Adult patients undergoing single-level microdiscectomy for lumbar disc herniation received prophylaxis with 2 g of cefazolin. Venous blood and intervertebral disc samples were collected and analyzed using high-performance liquid chromatography to determine cefazolin concentrations. The severity of intervertebral disc and endplate changes was assessed on magnetic resonance images using the Pfirrmann and Modic grading systems. Results: Cefazolin concentrations were significantly higher in cases with Modic type II changes compared to type 0/I (14.6 ± 9.2 µg g⁻¹ vs. 10.2 ± 4.5 µg g⁻¹ and 9.2 ± 4.1 µg g⁻¹; p = 0.01). 35.4% of patients with Modic type II changes had concentrations > 16 µg g⁻¹, compared to 10% and 25% for patients with Modic type 0/I (p = 0.008). For Pfirrmann grading, 34.6% of grade V discs reached >16 µg g⁻¹ versus 16.7% and 20.3% for grades III and IV (p = 0.26). Patient age, weight, and timing showed no significant correlations with intradisc concentrations. Conclusions: Ninety-four percent of disc samples exceeded the minimum inhibitory concentration for Staphylococcus aureus (>4 µg/g), but considerable variability in cefazolin levels was observed, with higher concentrations in discs showing Modic type II changes. Full article

Objective: Bilateral facetectomy (BF) within minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) remains debated regarding its advantages over unilateral facetectomy (UF) in restoring segmental lordosis, addressing spondylolisthesis and decompressing both neural foramina. The evidence is limited. We sought to determine the benefits of contralateral facetectomy on radiographic and clinical outcomes. Methods: We conducted a single-center retrospective analysis on patients with lumbar degenerative disease who underwent single-level percutaneous instrumentation and MI-TLIF with either UF or BF. Plain radiographs, CT and MRI were utilized for comparative radiographic analysis. Various intraoperative and clinical parameters were evaluated to assess surgical effort and clinical outcomes. Results: We included 81 UF and 23 BF cases; complete radiological data were available for 27 and 13 patients, respectively. Both techniques demonstrated a comparable increase in segmental lordosis (UF 2.1° ± 5.3° vs. BF 4.3° ± 5.4°, p > 0.1), which is below the study’s minimum detectable effect (MDE ≈ 5.1° at 80% power). Spondylolisthesis reduction was similar, with UF achieving a mean of 2.8 ± 2.2 mm and BF 2.4 ± 1.9 mm (p > 0.1). Mean posterior disc height did not differ significantly between groups (p > 0.1). The mean intraoperative blood loss was significantly higher with BF (803 ± 347 mL) compared to UF (437 ± 207 mL, p < 0.001). The mean duration of surgery was significantly longer for BF (240 ± 48 min) compared to UF (197 ± 37 min, p = 0.001). Conclusions: This study found no evidence of a large advantage of BF over UF in restoring segmental lordosis, spondylolisthesis and posterior disc height in monosegmental MI-TLIF surgery. Given the higher blood loss and longer operative time observed with BF, its use should be selective for specific indications. Full article

Objective: This study aims to assess the prevalence of clinically significant incidental findings as well as incidental findings of minor clinical significance in multiparametric MRI (mpMRI) of the prostate. Materials and Methods: A retrospective analysis was conducted on 607 male patients (mean age: 72 years) who underwent prostate MRI between 2018 and 2023 at a single center. Two radiologists reviewed in consensus the scans for incidental findings during multiparametric MRI of the prostate. The findings were classified according to their clinical relevance, organ group and patient age. Results: Among 607 male patients (mean age: 72 years), 665 incidental findings were identified in 410 patients (67.5%; 95% CI 63.7–71.1). This corresponds to an average of 1.10 incidental findings per patient across the entire cohort. Of the 665 findings, 12 (1.8%; 95% CI 0.9–3.1) were classified as clinically significant. These included cases of sarcoma, rectal carcinoma, hydronephrosis, aortic aneurysm, avascular necrosis of the femoral head and high-grade disc protrusion with spinal canal stenosis and diverticulitis. Conclusions: Our data indicate that incidental findings are common in prostate mpMRI examinations; however, only a small proportion are clinically significant. This underscores the need for awareness of such findings, while avoiding unnecessary follow-up for those without clinical relevance. Full article

The diameter of the sunflower flower head and the thickness of its margins are important crop phenotypic parameters. Traditional, single-dimensional two-dimensional imaging methods often struggle to balance precision with computational efficiency. This paper addresses the limitations of the YOLOv11n-seg model in the instance segmentation of floral disk fine structures by proposing the MBLA-YOLO instance segmentation model, achieving both lightweight efficiency and high accuracy. Building upon this foundation, a non-contact measurement method is proposed that combines an improved model with three-dimensional point cloud analysis to precisely extract key structural parameters of the flower head. First, image annotation is employed to eliminate interference from petals and sepals, whilst instance segmentation models are used to delineate the target region; The segmentation results for the disc surface (front) and edges (sides) are then mapped onto the three-dimensional point cloud space. Target regions are extracted, and following processing, separate models are constructed for the disc surface and edges. Finally, with regard to the differences between the surface and edge structures, targeted methods are employed for their respective calculations. Whilst maintaining lightweight characteristics, the proposed MBLA-YOLO model achieves simultaneous improvements in accuracy and efficiency compared to the baseline YOLOv11n-seg. The introduced CKMB backbone module enhances feature modelling capabilities for complex structural details, whilst the LADH detection head improves small object recognition and boundary segmentation accuracy. Specifically, the CKMB module integrates MBConv and channel attention to strengthen multi-scale feature extraction and representation, while the LADH module adopts a tri-branch design for classification, regression, and IoU prediction, structurally improving detection precision and boundary recognition. This research not only demonstrates superior accuracy and robustness but also significantly reduces computational overhead, thereby achieving an excellent balance between model efficiency and measurement precision. This method avoids the need for three-dimensional reconstruction of the entire plant and multi-view point cloud registration, thereby reducing data redundancy and computational resource expenditure. Full article

Background/Objectives: When transitioning from an older surgical technique to a newer one, we expect improved treatment outcomes and fewer complications. However, direct comparative studies to confirm these advantages are often lacking. Tubular minimally invasive transforaminal lumbar interbody fusion (MISTLIF) has been widely used, but limitations in visualization and endplate preparation may compromise fusion quality. Biportal endoscopic TLIF (BETLIF), a more recent alternative, offers enhanced magnification and superior hemostasis. Still, CT-based comparative data on fusion integrity remain limited. To evaluate the clinical and radiological outcomes following a chronological transition from MISTLIF to BETLIF, using thin-slice CT to assess fusion integrity. Methods: This retrospective study analyzed 179 patients treated by a single surgeon between January 2018 and May 2021. The first 90 cases underwent MISTLIF, followed by 89 BETLIF procedures. Clinical outcomes included Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and Japanese Orthopedic Association (JOA) scores. Radiological assessments at one year postoperatively (X-ray and thin-slice CT) included disc height, segmental lordosis, Bridwell fusion grade, cage subsidence, and subchondral osteolysis. Results: BETLIF was associated with significantly shorter hospital stays (5.7 vs. 7.4 days) and fewer transfusions (0% vs. 14.7%). BETLIF showed significantly better ODI (12.7 vs. 23.5), JOA scores (26.4 vs. 20.6), and comparable VAS improvement. Radiologically, BETLIF had significantly higher fusion rates (93.3% vs. 82.4%), greater disc height restoration, and lower rates of cage subsidence (5.0% vs. 13.7%) and osteolysis (13.3% vs. 52.9%). Conclusions: BETLIF demonstrated superior clinical and radiological outcomes, likely due to enhanced endoscopic visualization and precise endplate preparation. Full article

Background: Polyacrylamide gel electrophoresis (PAGE) has long been used for lipoprotein analysis, enabling the separation and profiling of lipoprotein fractions such as LDL and HDL. However, conventional disc PAGE systems are limited by low throughput and inability to directly compare multiple samples under identical conditions. Alternative methods, including high-performance liquid chromatography and agarose gel electrophoresis, require specialized equipment and expertise, limiting their clinical utility. Methods: We present a colorimetric and fluorescence-based histidine-imidazole PAGE (HI-PAGE) system that provides rapid, cost-effective, and reproducible separation and profiling of lipoproteins in human serum. By combining electrophoretic separation with lipid-specific fluorescent staining using Nile Red, the fluorescence-based HI-PAGE (fHI-PAGE) not only visualizes distinct migration patterns of lipoprotein fractions, but also enables the quantification of LDL-cholesterol (LDL-C). Clear resolution of LDL and other lipoprotein fractions was achieved within 1 h without band distortion, allowing for direct comparison of multiple samples on a single gel. Results: We validated fHI-PAGE using serum from healthy individuals and patients, demonstrating that its fluorescence-based detection was more sensitive than conventional Sudan Black B staining while providing LDL-C estimates concordant with values calculated by the Friedewald formula. Moreover, fHI-PAGE proved advantageous in cases of hypertriglyceridemia, where Friedewald calculations are unreliable. Conclusions: These findings establish fHI-PAGE as a practical and clinically applicable platform for simultaneous lipoprotein profiling and LDL-C quantification. Full article

In conventional mechanized garlic seeding process, seed remains a persistent challenge that is difficult to avoid. This study proposes a solution by designing and testing a garlic seeding device based on a rigid–flexible coupling mechanism, aimed at minimizing seed damage during sowing. The seeding pocket was constructed from a flexible metal sheet, which served as its structural foundation. A slider moving along a fixed track enabled the retraction and release of the pocket, thereby facilitating seed collection and discharge. The effects of pocket radius, rotational speed of seed discharge disc, and thickness of metal sheet on the stress of garlic seeds were investigated through the finite element method. Subsequently, an experimental bench was set up to analyze the effects of influence of these parameters on seed damage rate, single-seed rate, and leakage rate. Results demonstrated that under optimal parameters—a pocket radius of 12 mm, a seed discharge disc rotational speed of 0.21 rad/s, and a metal sheet thickness of 0.15 mm—the mechanism achieved a single-seed rate of 78.4%, a leakage rate of 11.4%, and a maximum stress on garlic seeds of only 0.535 MPa. Notably, this stress level was well below the damage threshold of garlic seeds, resulting in zero damage that outperformed conventional rigid seeding devices. These findings demonstrate the mechanism’s strong potential to preserve seed integrity, although the overall seeding performance remains modest and warrants further optimization in future designs. Full article

Oral diseases such as dental caries, stomatitis, and periodontitis are closely associated with biofilms that are resistant to conventional therapeutic approaches. Streptococcus sanguinis and Streptococcus mutans play a key role as primary and secondary colonizers of oral surfaces, respectively, and interact synergistically with other species, including Candida albicans, to promote the establishment and progression of infection. Objective: To evaluate the antimicrobial activity of ethanolic extracts of propolis from Tame (Arauca) on biofilms formed in co-cultures from reference strains and co-cultures with clinical isolates of oral pathogens. Methodology: Propolis was collected from Apis mellifera hives placed in rural Tame (Arauca), located in the foothills of the Eastern Andes (Colombia). Ethanolic extracts of propolis (EEP) were prepared in a 0.07 g/mL concentration and biological characterization was performed on single and complex co-cultures of S. mutans (serotype c), S. sanguinis, and C. albicans using disc diffusion test, determination of MIC and BMC, growth curves and biofilm formation. The cell viability and metabolic activity of primary cell cultures derived from a dental pulp explant were evaluated using the MTT assay. Results: EEP exhibited higher inhibition zones than chlorhexidine against S. mutans and C. albicans and lower efficacy against S. sanguinis. Among the microorganisms evaluated, S. mutans showed the lowest MIC and BCM values, followed by C. albicans and S. sanguinis. Growth curves and biofilm formation assays revealed higher inhibition in co-cultures of reference strains (S. mutans + C. albicans), while multi-species cultures (S. mutans + S. sanguinis + C. albicans), or clinical strains (S. mutans clinical isolated + S. sanguinis + C. albicans), showed higher resistance. Cell viability assays revealed low cytotoxicity (<30%) in primary cell cultures. Conclusions: EEPs exhibited antimicrobial activity against relevant oral pathogens, especially in simple co-cultures, supporting their potential as natural therapeutic alternatives. However, their efficacy decreases in the presence of clinical strains and complex co-cultures, highlighting the importance of considering these variables in the development of oral treatments. Full article

Background/Objectives: Low back pain (LBP) remains one of the leading causes of disability globally and contributes significantly to healthcare expenditures. Discogenic LBP, a subtype stemming from intervertebral disc degeneration, often provesrefractory to conventional treatment modalities. Regenerative orthobiologic therapies, including platelet-rich plasma (PRP), platelet lysate (PL), and mesenchymal stem cells (MSCs), have emerged as promising alternatives, though long-term outcomes and safety profiles are not yet well understood. Methods: This case series reports 13 patients treated between 2015 and 2016 at an outpatient interventional pain center who received intradiscal culture-expanded MSC injections with or without additional injections to other surrounding vertebral structures. There was no control group. Inclusion required patients to have discogenic LBP with or without radiculopathy and at least six years of completed follow-up data. Outcomes were assessed using Numeric Rating Scale (NRS), Functional Rating Index (FRI), and modified Single Assessment Numeric Evaluation (SANE) scores at multiple time points up to 10 years post treatment. Results: Thirteen patients met the inclusion criteria. Significant reductions in NRS and FRI scores were observed at 6 months, 3 years, and 6 years (p < 0.01). At 6 years, the average NRS score decreased by 2.50 points, FRI by 24.14 points, and SANE showed a 60% improvement. At 10 years, among the seven patients who responded, average SANE improvement was 78.1%. No adverse events were reported. Conclusions: This study presents the longest known follow-up data for intradiscal MSC therapy for discogenic LBP, demonstrating sustained improvements in pain and function. These findings support further investigation into combination orthobiologic therapies as a viable long-term treatment option for chronic LBP. Full article