Search Results (879)

The OHI demonstrated moderate internal consistency and consistent associations with oral health-related quality of life and cardiovascular risk indicators. Objective: The primary objective was to propose and internally assess an Oral Health Index (OHI) which integrates multiple clinically assessed oral health variables. The secondary objective was to investigate its association with oral health-related quality of life (OHRQoL) and common clinical cardiovascular risk (CVR) factors. Material and Methods: This observational study included 191 participants. Seven parameters (tooth loss, periodontal disease, endodontic involvement, residual roots, extractions due to periodontitis, inflammatory oral mucosal diseases, and dental maintenance and rehabilitation status) were combined using Z-scores to compute the OHI, with higher scores indicating poorer oral health. CVR factors included age/sex thresholds, education level, BMI, smoking status, diabetes, hypertension, pulse pressure, and lung function. OHRQoL was assessed using the Oral Health Impact Profile. Results: Higher OHI scores were associated with poor oral health-related quality of life. Participants with cardiovascular risk factors had significantly higher OHI scores. The analysis demonstrated that the OHI was directly associated with worse oral health-related quality of life and a greater cardiovascular risk burden, independent of age, sex, and comorbidities. Conclusions: This study proposed and internally assessed the Oral Health Index, designed to integrate multiple clinical parameters into a single standardized measure of oral health. The OHI demonstrated moderate internal consistency and showed consistent associations with poorer oral health conditions, reduced oral health-related quality of life, and a greater cardiovascular risk burden. Full article

Background/Objectives: Posterior cage migration is a clinically relevant complication after lumbar interbody fusion. Most reported risk factors are derived from open techniques, whereas evidence specific to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is limited. We evaluated factors associated with cage migration and symptomatic retropulsion in a large MIS-TLIF cohort. Methods: We retrospectively reviewed 650 consecutive patients undergoing MIS-TLIF, comprising 1126 fused motion segments. Cage migration was defined as posterior displacement > 3 mm compared with early postoperative radiographs. Demographic, clinical, surgical, and radiographic variables were compared between segments with and without migration. Cases with migration were further stratified by revision requirement. Results: Cage migration occurred in 27 of 1126 levels (2.4%). Seven cases required revision surgery for symptomatic cage retropulsion, corresponding to a level-based incidence of 0.6%. More posterior initial cage placement was significantly associated with subsequent migration. Age, body habitus, smoking, diabetes, endplate violation, and multilevel fusion were not associated with migration. Among migration cases, male sex was associated with higher odds of revision, and no radiographic or mechanical parameter predicted progression from radiographic migration to symptomatic retropulsion. In revision cases, the migrated cage was removed via the original approach, followed by contralateral placement of a new interbody cage using a minimally invasive technique. Conclusions: In this MIS-TLIF cohort, posterior initial cage placement was the primary factor associated with cage migration, consistent with prior open-series findings. Progression from migration to symptomatic retropulsion was not explained by mechanical parameters alone, suggesting a multifactorial process. These findings underscore the importance of meticulous cage positioning during MIS-TLIF and provide practical insights for postoperative surveillance and revision decision-making. Full article

Background/Objectives: Cigarette smoking is a well-established risk factor for periodontal tissue damage caused by oxidative stress and increased proteolytic activity. Electronic cigarettes (e-cigarettes), marketed as less harmful alternatives, deliver nicotine and reactive compounds that may similarly disrupt periodontal health. However, their molecular effects on clinically healthy periodontal tissues remain unclear. This study aimed to compare oxidative stress-related and matrix-degradative biomarkers in the gingival crevicular fluid (GCF) of cigarette smokers (CS), e-cigarette (EC) users, and non-smokers (NS), and to examine the relationships among these markers. Methods: Sixty individuals, who were systemically and periodontally healthy (20 CS, 20 EC, and 20 NS), were examined. Clinical parameters, including probing depth (PD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP), were recorded. GCF samples were analyzed for reactive oxygen species (ROS), matrix metalloproteinase-9 (MMP-9), and forkhead box protein O-1 (FOXO-1) using ELISA. Initial group comparisons were descriptive, followed by analysis of covariance (ANCOVA) to adjust for age; PI and PD were included as covariates in separate models. Correlations were assessed using Spearman’s analysis. Results: PD was significantly higher in both EC users and CS compared with NS (p = 0.022). MMP-9 levels were significantly higher in CS than in EC users and NS (p < 0.05), while FOXO-1 concentrations were significantly lower in CS compared with NS (p = 0.0227). ROS levels did not differ significantly among groups (p > 0.05). After adjustment for age, PI, or PD, group differences in MMP-9 and FOXO-1 remained statistically significant, whereas ROS levels remained comparable. FOXO-1 demonstrated positive correlations with ROS and MMP-9 within exposure groups; these associations were considered exploratory. Conclusions: In this cross-sectional study, CS and EC use were associated with altered matrix-regulatory biomarker profiles in clinically healthy periodontal tissues, independent of age and periodontal indices. Causal or temporal inferences cannot be drawn, and longitudinal studies are needed to clarify the long-term periodontal implications of these findings. Full article

Conventional cigarette smoke and electronic cigarette vapor contain toxic compounds that may impair immune function, particularly in the spleen. This study evaluated histopathological changes in the spleen in male white rats (Rattus norvegicus, n = 32) divided into four groups: control, conventional-cigarette smoke (CCS), electronic cigarette vapor (ECS), and transitional cigarette smoke (TCS). The TCS group was sequentially exposed to CCS for 15 days followed by ECS for 15 days, with twice-daily exposure. Spleen tissues were analyzed semi-quantitatively using ImageJ and statistically using the Kruskal–Wallis test after Shapiro–Wilk normality testing. Comparisons among the four groups showed significant differences in necrosis (p = 0.025) and vascular degeneration (p = 0.027). In contrast, hemosiderin, congestion, stretching, and vacuolization parameters did not show statistically significant differences among groups (p > 0.05). These findings suggest that switching from conventional cigarettes to e-cigarettes does not protect against splenic damage and may exacerbate immune dysfunction due to cumulative toxic exposure. Full article

Background/Objectives: Volatile organic compounds (VOCs) have emerged as promising non-invasive biomarkers for assessing metabolic and reproductive health. In the context of assisted reproductive techniques (ARTs), the volatilomic composition of follicular fluid (FF) may reflect the biochemical environment surrounding the oocyte, influencing fertilization success and embryo development. This study aimed to characterize the volatilomic profile of FF in women undergoing ARTs and to explore associations between specific VOCs and female fertilization-related parameters (FFRPs). Methods: A total of 54 Caucasian women aged 19–39 years, enrolled between October 2015 and July 2019, were recruited at the Assisted Reproduction Laboratory of the Local Health Unit of Cova da Beira, Covilhã. FF samples were analyzed via gas chromatography–mass spectrometry (GC–MS) in scan mode, identifying 136 VOCs, of which 72 were selected based on prevalence. Sixteen FFRPs were evaluated, including age, body mass index (BMI), smoking habits, infertility factor, oocyte yield, embryo quality, β-hCG levels, country of birth, and reproductive history. Associations between VOCs and FFRPs were assessed using the Chi-square (χ²) test. Results: Significant correlations (p ≤ 0.05) were identified between 45 VOCs and 11 FFRPs. The detected compounds comprised alkanes, siloxanes, aromatics, alcohols, ketones, aldehydes, carboxylic acids and esters, fatty acid derivatives, epoxides, acrylates, nitriles, and sterols. Several VOCs were associated with more than one FFRP, indicating overlapping metabolic pathways that may influence reproductive performance. Conclusions: The volatilomic profile of FF demonstrates significant variability linked to individual reproductive and metabolic factors. VOC analysis may provide novel insights into follicular physiology, representing a promising approach for identifying potential biomarkers of infertility and ART outcomes. Full article

Psychological stress is increasingly investigated as a potentially modifiable factor in male infertility, in part through oxidative stress. This narrative review synthesizes mechanistic and translational evidence linking stress-related neuroendocrine activation and coping behaviors with redox imbalance in the male reproductive tract. Chronic activation of the hypothalamic–pituitary–adrenal axis and sympathetic outflow elevates glucocorticoids and catecholamines. In controlled animal stress paradigms, this is accompanied by suppression of the hypothalamic–pituitary–gonadal axis and by immune and metabolic changes that favor reactive oxygen species generation. The resulting oxidative stress may reduce Leydig cell steroidogenesis, impair testicular and epididymal function, and induce lipid peroxidation, mitochondrial dysfunction, and sperm DNA fragmentation. In such models, these lesions, together with apoptosis of germ and supporting cells, are associated with lower sperm concentration, reduced motility, compromised viability, and diminished fertilizing potential. Overall, preclinical animal studies using defined stress paradigms provide experimental evidence consistent with causal effects of stress on oxidative injury and reproductive impairment in preclinical settings. Human studies linking perceived stress, anxiety/depression, and disturbed sleep to adverse semen parameters and oxidative biomarkers are summarized. However, the human evidence is predominantly associative, and the available studies are cross sectional and remain vulnerable to residual confounding and reverse causality. Potential effect modifiers, including smoking, alcohol use, and circadian disruption, are also discussed as contributors to heterogeneity across clinical studies. Standardized assessment of stress biology and redox status, longitudinal designs aligned with spermatogenic timing, and well-powered intervention trials are needed to define dose–response relationships and support individualized prevention and care. Full article

Non-communicable diseases, particularly cardiovascular diseases (CVD) and metabolic syndrome (MS), remain a major challenge for primary health care (PHC). This study aimed to assess cardiometabolic risk and health behaviours in adult PHC patients using routine preventive screening. This prospective observational study included 506 adults attending routine consultations in an urban PHC centre in Poland. Preventive assessment included anthropometric measurements (body weight, height, BMI, and waist circumference), blood pressure, lipid profile, and fasting glucose levels. Health behaviours were recorded using the standardised NFZ CHUK questionnaire. The 10-year CVD risk was estimated using the SCORE2 algorithm. Multivariable logistic regression was used to identify independent factors associated with high cardiovascular risk (SCORE2 ≥ 5%) and of a composite endpoint defined as the presence of any non-optimal biochemical parameter. Nearly half of the participants had excess body weight (overweight or obesity), and more than half met criteria for central obesity. Borderline or elevated total cholesterol was found in 47% of patients, abnormal LDL in 27%, low HDL-C (<40 mg/dL) in 80% (84% when applying sex-specific cut-offs), and impaired fasting glucose or diabetes in about 12%. High SCORE2 risk (≥5%) was observed in approximately 9% of the cohort. In multivariable models, SCORE2 components (age, sex, and smoking) were, as expected, associated with high SCORE2 risk, and obesity (BMI ≥ 30 kg/m²)—a factor not included in SCORE2—was additionally associated with higher risk. Additionally, age, male sex, and obesity also predicted the presence of at least one non-optimal biochemical marker. The prevalence of high SCORE2 risk increased from 1.2% in patients with 0–1 modifiable risk factor to 25.7% in those with 4–5 factors. Lower educational attainment was associated with a higher proportion of high-risk individuals in univariate analysis. Routine preventive activities in PHC enable the identification of important lipid and glucose abnormalities and the clustering of modifiable risk factors, even in a relatively young, highly educated population. Systematic cardiovascular screening and a focus on patients with accumulated risk factors should remain a priority in PHC to enable early identification of high-risk patients and timely implementation of lifestyle and therapeutic interventions. Full article

Cannabis is one of the most common intoxicants used worldwide. Cannabis is widely consumed worldwide and can lead to visual alterations. However, most of the available information on its effects comes from studies conducted in developed countries, while data remain limited in developing regions such as Morocco, despite its significant role in cannabis cultivation. The aim of this study was to explore multiple visual parameters and self-perceived eyesight in cannabis users in Morocco. A cross-sectional study was conducted between March 2022 and April 2023 in Marrakesh, Morocco, in cannabis consumers. Data collection was performed in two phases. First a hetero-administrated questionnaire was used to collect socio-demographics, intoxicant consumption habit information, and eye health information. Then, several visual acuity tests were performed, including a preliminary examination, a visual function assessment, and an eye health assessment. Ninety-five cannabis users participated in this study. The majority were single (62.1%) males (87.4%). All lived in the Marrakesh-Safi region (100%), and most had daily activities such as having a job or being a student (77.9%). Most had vision conditions like astigmatism or myopia (83.4%). The majority had multiple addictions (66.5%), mainly to tobacco (43.7%). Hashish was the main cannabis type used (57.9%), and smoked cannabis was the principal mode of consumption (94.7%). Many had a family history of cannabis addiction (58.9%). Day light sensitivity (66.3%) and appearance of eye symptoms after cannabis use (90.5%) were declared by the majority. In most cases, no impact on far or near vision or vision impairment due to cannabis use were declared. Our results showed that using cannabis could have significant adverse effects on visual functions. Full article

American tegumentary leishmaniasis (ATL) and other infectious granulomatous diseases (IGDs) may present with oral/oropharyngeal mucosal lesions (OOPML). IGD-OOPML can result from fungal, parasitic, or bacterial infections, and squamous cell carcinoma (SCC) represents the main differential diagnosis. ATL, other IGD, and SCC share overlapping clinical and epidemiological features, making diagnostic suspicion challenging. This study compared sociodemographic and clinical characteristics among ATL, other IGD, and SCC. Descriptive, comparative, and multivariable logistic regression analyses were performed. Among 7551 patients, 213 met inclusion criteria (83-SCC and 130-IGD). Except for smoking, which differed only between ATL and SCC, most IGD parameters were similar. Male patients predominated in all groups. SCC patients were significantly older (p < 0.001) and had a shorter median disease duration (p = 0.007). The presence of pain increased the odds of SCC-OOPML by 3.96 times (95% CI 1.97–12.51). SCC patients were more likely to present lesions in a single subsite, either the oral cavity or oropharynx. Painful, ulcerated, or exophytic lesions favored SCC diagnosis, whereas infiltrative, granular, or mulberry-like lesions, involvement of multiple subsites, or associated nasal and laryngeal lesions suggested IGDs. Although clinical differentiation remains difficult, these findings may support early diagnostic suspicion, prompt treatment, and reduced sequelae. Full article

Background/Objectives: Type 2 diabetes (T2D) is a chronic metabolic disorder closely linked to cardiovascular disease and obesity and notably influenced by lifestyle and dietary patterns. The Mediterranean diet has well-established benefits across multiple cardiometabolic risk factors, including those relevant to diabetes. This study aimed to investigate the degree to which adults with T2D adhere to a Mediterranean dietary pattern and to examine how such adherence relates to glycemic and lipidemic regulation. Methods: This cross-sectional study included 100 adults with T2D (54 men and 46 women). Adherence to the Mediterranean diet was assessed using the Mediterranean Diet Score (MDS). Demographic, anthropometric, lifestyle, and clinical data were collected, and glycemic and lipid parameters were analyzed. Associations between Mediterranean diet adherence and metabolic outcomes were examined using correlation analyses and multivariable regression models adjusted for relevant confounders. Results: Most participants showed low adherence to the Mediterranean diet. A significant inverse association was observed between Mediterranean diet adherence and hemoglobin A1c (HbA1c) levels, with individuals scoring ≤35 on the MDS demonstrating higher HbA1c levels. Similar trends were observed in the lowest tertile of adherence. Notably, each one-point increase in MDS predicted a 0.13% reduction in HbA1c. In multivariable regression analyses, Mediterranean diet adherence remained the strongest predictor of glycemic control, independent of age, body mass index (BMI), sex, smoking status, physical activity and the number of antidiabetic treatments. Higher adherence was also significantly associated with lower low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels, as well as higher high-density lipoprotein cholesterol (HDL) concentrations. Conclusions: Greater adherence to the Mediterranean diet is independently associated with improved glycemic regulation and a more favorable lipid profile in adults with T2D. These findings support the Mediterranean diet as a valuable non-pharmacologic strategy for optimizing metabolic outcomes in people with T2D. Full article

Objectives: This study aimed to evaluate the radiographic characteristics of medication-related osteonecrosis of the jaw (MRONJ) by digital panoramic radiographs and to investigate the associations between radiographic findings and clinical, demographic, and treatment-related variables in patients receiving antiresorptive therapy. Methods: A retrospective analysis was performed on 55 patients receiving antiresorptive therapy, categorized into a tooth-extraction group (n = 20) and an MRONJ group (n = 35). Standardized panoramic radiographs obtained at baseline (T0) and during the 6-month follow-up (T1) were evaluated for lamina dura thickness, trabecular bone alteration, osteosclerosis, cancellous bone loss, sequestration, and periosteal response. Statistical analyses were conducted on associations involving drug type, administration route, therapy duration, smoking, diabetes, hypertension, gender, and serum C-terminal telopeptide (CTX) levels. Results: The incidence of sequestrum development and cancellous bone loss was considerably higher in the MRONJ group. Sequestration demonstrated significant associations with both the duration of antiresorptive therapy (>3 years) and intermediate-risk CTX levels. No significant correlations were found between CTX and other radiographic parameters. Lamina dura thickening, trabecular alterations, osteosclerosis, and periosteal reaction exhibited no differences across groups or in relation to smoking, diabetes, age, or gender; periosteal reaction was an uncommon and variable finding. Conclusions: Panoramic radiography provides clinically useful information in the evaluation of MRONJ, particularly for identifying sequestration and cancellous bone degradation. The formation of sequestrum appears to be the most indicative radiographic indicator, representing both the duration of treatment and biochemical risk. Full article

Background: Cigarette smoking remains one of the most important preventable causes of respiratory morbidity, exerting detrimental effects even in young adults. Medical students represent a particularly relevant population, as the lifestyle habits they adopt during their training years may influence both their personal health and professional credibility. Methods: We conducted a cross-sectional analysis of 264 medical students from the University of Medicine, Pharmacology, Science and Technology of Târgu-Mures, aged 18–30 years, stratified according to smoking status, type of tobacco product used, and lifestyle characteristics (athletic vs. sedentary). Standardized spirometry was performed to assess FVC, FEV₁, FEV₁/FVC ratio, PEF, and small airway flow parameters (MEF₂₅, MEF₅₀, MEF₇₅). Statistical comparisons between groups were performed using t-tests, Mann–Whitney U tests, chi-square tests, and correlation analyses, with p < 0.05 considered statistically significant. Results: Smokers demonstrated significantly lower values for FEV₁, PEF, and MEF parameters compared with non-smokers, confirming early functional impairment of both large and small airways. Within the smoking group, users of e-cigarettes or heated tobacco products exhibited more favorable FEV₁ and small airway flow values than conventional cigarette smokers. However, differences in FVC were less pronounced. Significantly, athletes consistently outperformed their sedentary peers across all respiratory parameters, regardless of smoking status, with markedly higher FEV₁, FVC, and MEF values and a lower prevalence of obstructive patterns. Cumulative smoking exposure (pack-years) was inversely associated with small airway function, whereas higher levels of physical activity were independently linked to a pronounced protective effect. Conclusions: Even in early adulthood, smoking is related to measurable declines in lung function, particularly affecting small airway dynamics. Although alternative products may appear less harmful than conventional cigarettes, they cannot be considered risk-free. Conversely, regular physical activity demonstrated a protective association in the case–control analysis, attenuating functional decline and supporting the preservation of long-term respiratory health. These findings underscore the importance of integrated prevention strategies in medical universities, combining smoking cessation initiatives with the systematic promotion of physical activity to safeguard the health of future physicians and reinforce their role as credible health advocates. Full article

Early detection of small-scale fires is crucial for minimizing damage and enabling rapid emergency response. While recent deep learning-based fire detection systems have achieved high accuracy, they still face three key challenges: (1) limited deployability in resource-constrained edge environments due to high computational costs, (2) performance degradation caused by feature interference when jointly learning flame and smoke features in a single backbone, and (3) low sensitivity to small flames and thin smoke in the initial stages. To address these issues, we propose a lightweight dual-stream fire detection architecture based on YOLOv5n, which learns flame and smoke features separately to improve both accuracy and efficiency under strict edge constraints. The proposed method integrates two specialized attention modules: ESCFM++, which enhances spatial and channel discrimination for sharp boundaries and local flame structures (flame), and ESCFM-RS, which captures low-contrast, diffuse smoke patterns through depthwise convolutions and residual scaling (smoke). On the D-Fire dataset, the flame detector achieved 74.5% mAP@50 with only 1.89 M parameters, while the smoke detector achieved 89.2% mAP@50. When deployed on an NVIDIA Jetson Xavier NX (NVIDIA Corporation, Santa Clara, CA, USA)., the system achieved 59.7 FPS (single-stream) and 28.3 FPS (dual-tream) with GPU utilization below 90% and power consumption under 17 W. Under identical on-device conditions, it outperforms YOLOv9t and YOLOv12n by 36–62% in FPS and 0.7–2.0% in detection accuracy. We further validate deployment via outdoor day/night long-range live-stream tests on Jetson using our flame detector, showing reliable capture of small, distant flames that appear as tiny cues on the screen, particularly in challenging daytime scenes. These results demonstrate overall that modality-specific stream specialization and ESCFM attention reduce feature interference while improving detection accuracy and computational efficiency for real-time edge-device fire monitoring. Full article

Objectives: Post-extraction remodelling of hard and soft tissues results in volume reduction, leading to aesthetic challenges in planning prosthetic restorations, particularly in the anterior maxilla. This study assessed whether atraumatic vertical extraction, versus conventional extraction, could reduce postoperative volume loss and aesthetic compromises at the extraction site and adjacent teeth. Methods: Following randomized tooth extraction with unassisted healing in the test (Benex^® extraction, n = 10) and control group (conventional extraction, n = 10), postoperative scans were conducted at 30 days (t₁), 60 days (t₂), 90 days (t₃) and 12 months (t₄). Each scan was aligned with the baseline scan (t₀), and surface comparison was performed with five regions of interest (ROIs: central, mesial, distal, papilla mesial and papilla distal). Aesthetic parameters, including recession and Pink Esthetic Score (PES) of adjacent teeth, were clinically evaluated at each follow-up appointment. Statistical analysis used a mixed linear model accounting for confounding factors such as smoking, buccal bone integrity, gingival phenotype, and provisional use. Results: Both groups showed significant volume reduction from baseline to t₃ and t₄. The largest volume loss occurred in the central ROI in both test (t₄: −65.34 ± 36.89 mm³) and control group (t₄: −70.85 ± 30.96 mm³), with no significant difference between groups. A decline in PES and recession at the adjacent teeth was noted in both groups at 12 months. Conclusions: Both groups showed significant volume reduction with aesthetic impairment at the adjacent teeth’s soft tissue. Full article

Forest ecosystems, as vital natural resources, are increasingly endangered by wildfires. Effective forest fire management relies on the accurate and early detection of small–scale flames and smoke. However, the complex and dynamic forest environment, along with the small size and irregular shape of early fire indicators, poses significant challenges to reliable early warning systems. To address these issues, this paper introduces SER–YOLOv8, an enhanced detection model based on the YOLOv8 architecture. The model incorporates the RepNCSPELAN4 module and an SPPELAN structure to strengthen multi-scale feature representation. Furthermore, to improve small target localization, the Normalized Wasserstein Distance (NWD) loss is adopted, providing a more robust similarity measure than traditional IoU–based losses. The newly designed SERDet module deeply integrates a multi–scale feature extraction mechanism with a multi-path fused attention mechanism, significantly enhancing the recognition capability for flame targets under complex backgrounds. Depthwise separable convolution (DWConv) is utilized to reduce parameters and boost inference efficiency. Experiments on the M4SFWD dataset show that the proposed method improves mAP50 by 1.2% for flames and 2.4% for smoke, with a 1.5% overall gain in mAP50–95 over the baseline YOLOv8, outperforming existing mainstream models and offering a reliable solution for forest fire prevention. Full article