Search Results (28,917)

Background: We proposed a comprehensive clinicopathological study involving the characterization of the study cohort and a comparative analysis of biopsies and surgical specimens from patients with Hirschsprung’s disease. The study was complemented by the diagnostic value of calretinin, CD56, and S-100 immunohistochemistry. Methods: Descriptive statistical analysis of diagnostic variables in the group of biopsy specimens (n = 32) and bowel resection specimens (n = 16) was performed. The pattern of calretinin and CD56 expression in Meissner’s plexus elements was analyzed and the maximum thicknesses of the nerve fibers were measured using morphometry with S100-immunostained sections. Conclusions: Coupled calretinin–CD56 immunohistochemistry is useful in diagnosing ganglion cell paucity biopsies or specimens with incomplete submucosa. In cases where there are no ganglion cells but there are calretinin-positive nerve fibrils in the lamina propria without nerve trunk (NT) hypertrophy, re-biopsy is the best solution. The significant differences in NT size between biopsies and surgical specimens highlight the importance of assessing NT diameter in all tissue samples examined. Full article

Background. GLASS (Global Limb Anatomic Staging System) classification is a classification proposed in 2019 by The Lower Extremity Guidelines Committee of the Society for Vascular Surgery, which aims to identify the anatomic substrate that defines the severity of a lower extremity arterial injury and predict the success rate of possible revascularization. The aim of the study is to demonstrate the usefulness of this classification and if it is a reliable tool in predicting the success of the revascularization procedures for patients with chronic limb-threatening ischemia (CLTI). Methods. A retrospective study was conducted on patients undergoing revascularization for CLTI. Glass staging was applied to angiographic data, categorizing them into GLASS 1, 2, or 3 based on the complexity of the femoropopliteal and infrapopliteal lesions. We investigated the clinical characteristics and types of endovascular treatment in correlation with GLASS classification. We also evaluated the technical success of revascularization procedures and the specificity and accuracy of the GLASS classification. Results. After the first testing, we found out that GLASS classification has a sensitivity of 63% and a specificity of 77%. After the second testing, the sensitivity was 82%. of 77% also. The follow-up of this sample was made after 1 year, with no patients lost to follow-up and with an amputation-free survival of 81.3%. Conclusions. GLASS 1 and 2 patients had significantly higher rates of success compared to GLASS 3. GLASS serves as a valuable tool in predicting revascularization success and provides a standardized approach to anatomical complexity, but further studies should integrate more data in order to enhance its predictive capability. Full article

(1) Background: Microcracks and structural fragility in teeth, often undetected by traditional methods until severe complications like fractures or pulp exposure occur, are evaluated in this study using electrical impedance analysis (EIA) as a non-invasive tool for early detection and assessment. (2) Methods: A total of 57 patients were recruited, including individuals with bruxism (n = 20), dental restorations (n = 18), and no significant dental history (control group, n = 19). Electrical impedance measurements were performed on all teeth using a portable device, with data collected from occlusal and proximal surfaces. Patients with abnormal values underwent additional imaging (standard radiographs) to confirm the presence of microcracks. Statistical analyses included ANOVA to compare impedance values between groups and logistic regression to assess the predictors of structural fragility. (3) Results: Teeth with microcracks confirmed by standard radiographs exhibited significantly lower impedance values (mean 50 kΩ) compared to healthy teeth (mean 120 kΩ, p < 0.01). Patients with bruxism showed the highest proportion of teeth with abnormal impedance (45%). Logistic regression identified bruxism as a significant predictor of reduced impedance values (p < 0.05). (4) Conclusions: Electrical impedance analysis demonstrates promise as a non-invasive method for detecting microcracks and assessing structural fragility in teeth. Its application in routine dental check-ups could enable early interventions, particularly for high-risk patients with bruxism or restorations. Full article

Background/Objectives: Atopic dermatitis (AD) and alopecia areata (AA) frequently coexist due to shared immune-mediated mechanisms. Treatments targeting AD, including Janus kinase (JAK) inhibitors and dupilumab, may impact AA outcomes in unpredictable ways. This study aims to evaluate the effects of advanced therapies on patients with concurrent AD and AA to inform treatment strategies. Methods: A retrospective cohort study was conducted on six patients diagnosed with both AD and AA. Treatments included systemic corticosteroids, dupilumab, and JAK inhibitors (baricitinib and upadacitinib). Outcomes were assessed at six months using the Severity of Alopecia Tool (SALT), Dermatology Life Quality Index (DLQI), and Scoring Atopic Dermatitis (SCORAD) scores. Results: Patients receiving JAK inhibitors showed significant improvements in AD and AA outcomes, with mean reductions of 95.65% in SALT scores, 91.03% in DLQI scores, and 89.57% in SCORAD scores. Dupilumab was associated with the onset or worsening of AA in two patients. Systemic corticosteroids provided short-term benefits but are unsuitable for long-term management due to safety concerns. Conclusions: JAK inhibitors are effective for managing concurrent AD and AA, offering substantial improvements in disease control and quality of life. However, dupilumab requires cautious use in patients with these comorbid conditions. Personalized treatment strategies, informed by patient-specific factors, are essential for optimizing outcomes and minimizing risks. Further research is needed to identify predictive markers and refine therapeutic approaches for this challenging population. Full article

The study presents the ethanol vapor sensing performance of a resistive sensor that utilizes a quaternary nanohybrid sensing layer composed of holey carbon nanohorns (CNHox), graphene oxide (GO), SnO₂, and polyvinylpyrrolidone (PVP) in an equal mass ratio of 1:1:1:1 (w/w/w/w). The sensing device includes a flexible polyimide substrate and interdigital transducer (IDT)-like electrodes. The sensing film is deposited by drop-casting on the sensing structure. The morphology and composition of the sensitive film are analyzed using scanning electron microscopy (SEM), Energy Dispersive X-ray (EDX) Spectroscopy, and Raman spectroscopy. The manufactured resistive device presents good sensitivity to concentrations of alcohol vapors varying in the range of 0.008–0.16 mg/cm³. The resistance of the proposed sensing structure increases over the entire range of measured ethanol concentration. Different types of sensing mechanisms are recognized. The decrease in the hole concentration in CNHox, GO, and CNHox due to the interaction with ethanol vapors, which act as electron donors, and the swelling of the PVP are plausible and seem to be the prevalent sensing pathway. The hard–soft acid-base (HSAB) principle strengthens our analysis. Full article

Background: Periodontitis is characterized as a change in the total periodontal tissues that includes tissue loss, as evidenced by clinical loss of attachment, and radiographically determined alveolar bone loss, periodontal pockets, and gingival bleeding. Objectives: The aim of this study was to observe and analyze recent information from the literature on the effect of enamel matrix derivative proteins on the bony defects caused by periodontitis. Methods: Through using two major online databases and search engines, the literature was manually searched for papers published until May 2024. To find relevant studies, this research utilized a combination of target keywords, and the reference lists of manuscripts that were chosen for inclusion in this study were checked and analyzed in tabular form, enabling the collection and comparison of data. Results: According to the results, the average value of the probing depth gained was 4 mm for the EMD™ alone and 4.25 mm for the EMD combined with surgical techniques such as open-flap techniques, platelet derivatives, and growth factors. In regard to clinical attachment level (CAL) gaining, average values of 3.6 mm in EMD™ alone and 3.86 mm with EMD™ combined with other techniques were observed. Conclusions: It can be concluded that the healing propensity depends on the morphological structure of the bone defect represented by the wall stage, and there is a certain coherence and correlation between the values of probing depth (PD) and clinical attachment level (CAL), whether for the use of EMD alone or its use in combination with other materials. Full article

Background/Objectives: Otitis media (OM) is a common pediatric condition that significantly impacts hearing, language development, and quality of life. Emerging evidence suggests that vitamin D plays a crucial role in immune regulation and that deficiency may predispose children to recurrent OM. This study aimed to evaluate whether low serum vitamin D levels are associated with increased incidence and severity of OM in children aged 2–7 years. Methods: A cross-sectional study was conducted at a pediatric otolaryngology clinic in northwest Romania between November 2023 and April 2024. A total of 118 children were enrolled, including 87 children with documented episodes of OM within the preceding six months and 31 quasi-controls without recent OM episodes. Participants were stratified into three age groups (2–3, 4–5, and 6–7 years) and classified into clinical subtypes of OM (Acute Suppurative Otitis Media, Serous Otitis Media, and Acute Congestive Otitis Media). Serum 25-hydroxyvitamin D levels were measured using a chemiluminescence immunoassay and categorized as deficient (≤20 ng/mL), insufficient (21–29 ng/mL), or sufficient (≥30 ng/mL). Statistical analyses included one-way ANOVA with post-hoc tests, chi-square tests, linear regression, logistic regression, and Poisson regression. Results: Children with OM exhibited significantly lower vitamin D levels compared to controls, with the most pronounced deficiency observed in the Acute Suppurative OM group. One-way ANOVA revealed significant differences among the groups (F(3,114) = 82.30, p < 0.001), and linear regression demonstrated a strong inverse correlation between vitamin D levels and the frequency of OM episodes (r = −0.793, adjusted R² = 0.63, p < 0.001). Logistic regression indicated that vitamin D insufficiency significantly increased the odds of OM (OR ≈ 120.74, p < 0.001), while Poisson regression showed incidence rate ratios of 13.62 for deficient and 10.47 for insufficient vitamin D status (p < 0.001). Conclusions: The findings indicate that low serum vitamin D levels are significantly associated with an increased risk and frequency of otitis media in preschool-aged children. These results support the role of vitamin D deficiency as an independent, modifiable risk factor for recurrent OM, suggesting that vitamin D screening and supplementation could be beneficial in reducing the clinical and economic burden of this condition. Full article

The objective of this study is to present and validate a pedagogical method based on practice testing and student-generated questions, delivered in a blended learning environment. The research is founded on assessment-based approaches for two consecutive management accounting disciplines (management accounting and performance measurement and control) at the most prestigious economics university in Romania. Our study is motivated by the desire to improve the student learning process, as students, in general, find management accounting difficult. The moment is especially significant given the large-scale adoption of blended learning after the COVID-19 pandemic. Data were collected for a period of two semesters, starting with the moment that marked the return to traditional learning after lockdown. A new variable labeled “consistent learning” was developed to account for student participation in these learning strategies throughout the semester. The sample comprised 107 students. Hypotheses were formulated to identify and test learning patterns within and between these disciplines using the self-determination theory. The results show that the learning outcomes are positively correlated with consistent learning, for both disciplines. Two clusters were identified: involved learners versus a voluntary non-involvement group. For all learning outcomes, the group that adopted the learning strategy had significantly better results at the end of the semester than the rest of the sample. This study provides an opportunity for professors, showing that the implementation of assessment-based learning strategies in a blended environment leads to significant improvements in student learning outcomes in related disciplines. Full article

Objectives/Background: This study investigated the influence of acid–base and electrolyte balance on the performance of female athletes in a 45 km ultramarathon. The aim was to analyze the impact of these variables on performance, particularly in athletes with varying completion times. Methods: Nineteen female athletes (mean age: 35.9 ± 6.5 years) were divided into three groups based on their race completion times: faster, intermediate, and slower. Blood samples were collected before and after the race to assess biochemical variables and arterial blood gases. Results: Significant differences in potassium (K⁺) levels were found in the intermediate (p = 0.003, adjusted p = 0.01) and slower (p = 0.006, adjusted p = 0.03) groups. Hematocrit (Hct) showed a significant reduction in the intermediate group (p = 0.007, adjusted p = 0.04). In arterial blood gas variables, significant reductions in HCO₃⁻ and pCO₂ were observed in the faster (HCO₃⁻: p = 0.002, adjusted p = 0.008; pCO₂: p = 0.007, adjusted p = 0.02) and intermediate (HCO₃⁻: p = 0.005, adjusted p = 0.02) groups. In the slower group, significant reductions in pH (p = 0.001, adjusted p = 0.004) and HCO₃⁻ (p = 0.001, adjusted p = 0.004) were found. The correlation between post-race Na⁺ levels and performance was significant in the intermediate group (p = 0.01, adjusted p = 0.02). Conclusions: Acid–base and electrolyte imbalances significantly affect ultramarathon performance, with a greater impact observed in athletes with slower times. These findings highlight the importance of strategies to optimize electrolyte and acid–base balance in endurance events. Full article

The authors have designed a structure for a gyro system (used for the guidance of self-guided missiles) with two gimbals and a rotor in magnetic suspension (AMBs—active magnetic bearings). The system (double-gimbal magnetic suspension gyro system for guidance—DGMSGG) orients the common axis rotor AMB (the sight line) in the direction of the target line (the guide line) by means of some control system of the gyro rotor’s rotations and translations, as well as by means of some servo systems for the gimbals’ rotation angle control. The DGMSGG provides specific signals for the missile’s autopilot, to guide it toward the target, so that the guidance line translates parallel to itself to the point of interception of the target (according to the self-guidance method by parallel approach). Based on the DGMSGG’s established mathematical model, the authors propose and design adaptive control systems for the decoupled dynamics of the gyro rotor’s translations and rotations and of the gimbals’ rotations; the concept of dynamic inversion is used, as well as linear dynamic compensators (P.D.- and P.I.D.-type), state observers, reference models, and neural networks. The theoretical results are validated through numerical simulations, using Simulink/Matlab models’ stabilization and orientation operating regimes. Full article

The present paper investigates new connections and characterization results on interval-valued minimization models. Specifically, we describe the solution set of the considered control problem with mixed constraints by employing the solution set associated with a class of controlled split variational inequalities. These equivalence results are also accompanied by suitable numerical experiments. Full article

The isothermal motion of incompressible second-grade fluids induced by an infinite circular cylinder that rotates around its symmetry axis is analytically and numerically investigated when the magnetic and porous effects are taken into consideration. General closed-form expressions are established for the dimensionless velocity field and the corresponding motion problem is completely solved. For illustration, some special cases are considered, and the results’ correctness is graphically proved. Based on a simple but important observation, the obtained results have been used to provide a general expression for the shear stress corresponding to MHD motions of the same fluids through a porous medium induced by a longitudinal shear stress on the boundary. Finally, graphical representations are used to bring to light the influence of the magnetic field and porous medium on the fluid behavior. It was found that the fluid flows slower and the steady state is reached earlier in the presence of a magnetic field or porous medium. Full article

Background: The first trimester of pregnancy is known for its proinflammatory state, so it is considered a challenging period due to increased maternal vulnerability to viral infections. The main purpose of the current study was to evaluate the incidence trend of early miscarriages and whether there was any possible influence of the COVID-19 pandemic on pregnancy outcomes. Materials and Methods: We conducted a retrospective cohort study in which we included all pregnant women who had been admitted to our hospital between January 2018 and December 2022. Our aim was to compare the percentage of early miscarriages occurring in the pre-pandemic period (January 2018–February 2020) and during the pandemic (March 2020–December 2022). We decided to measure the total number and percentage of early pregnancy outcomes, including all viable pregnancies, ectopic pregnancies, and both medical and spontaneous abortions. Results: The annual incidence of registry-identified early miscarriages declined from 5.4% of 12–46-year-old women in 2018 to 3.6% in 2022 (p = 0.008). An overall incidence rate of 3.66% [95% C.I. 3.26–4.05] was calculated, with 4.25% [95% C.I. 3.35–4.41] in the pre-pandemic period and 3.24% [95% C.I. 2.82–3.57] during the pandemic. The highest incidence rate (p < 0.0001) was identified among nulliparous women (36.9%). Conclusions: To conclude, this study proved that the increase in the early miscarriage incidence rate could be assigned to an advanced maternal age, irrespective of one’s reproductive history. This study proved that no significant increase in the incidence rate of early miscarriage during the COVID-19 pandemic was noted, suggesting that this viral infection does not alter the risk of miscarriages. We hope that these findings help women deal with emotional stress and offer them reassurance about bearing children during pandemic periods. Full article

This article addresses the complex behavior of composite laminates under varied layer orientations during tensile tests, focusing on carbon fiber and epoxy matrix composites. Data characterizing the mechanical load behavior are obtained using twelve composite laminates with different layer orientations and the DIGIMAT-VA software (version 2023.3). First, these data were used to elaborate a complex comparative analysis of composite laminates from the perspective of materials science. Composite laminates belong to three classes: unidirectional, off-axis oriented, and symmetrically balanced laminates, each having a specific behavior. From the perspective of designing a new material, a prediction model that is faster than the finite element analysis is needed to apply this comparative analysis’s conclusions. As a novelty, this paper introduces several machine learning prediction models for composite laminates with 16 layers arranged in different orientations. The Regression Neural Network model performs best, effectively replacing expensive tensile test simulations and ensuring good statistics (RMSE = 34.385, R² = 1, MAE = 19.829). The simulation time decreases from 34.5 s (in the case of finite element) to 0.6 s. The prediction model returns the stress–strain characteristic of the elastic zone given the new layer orientations. These models were implemented in the MATLAB system 2024, and their running proved good models’ generalization power and accuracy. Even specimens with randomly oriented layers were successfully tested. Full article

Microplastics (<5 mm) are an emerging threat to marine ecosystems and organisms, including fish. Recent studies have ranked the Black Sea as one of the most plastic-polluted European seas. Although there is evidence of microplastic ingestion in various fish species in the Black Sea, data for the Romanian sector are still lacking. This study presents the first assessment of microplastic abundance, color, shape, and size in the gastrointestinal tract and gills of Engraulis encrasicolus (European anchovy) collected from different locations along the Romanian coast (NW Black Sea). Ingested plastics were identified using 10% potassium hydroxide (KOH) chemical digestion and analyzed under a stereomicroscope. We observed a high frequency of plastic ingestion, with up to 88% of anchovies containing microplastics (98.5%) and mesoplastics (1.5%), with a mean of 3.03 plastic items/individual, marking the highest reported abundance in the Black Sea. The most common types found were transparent fibers, within the size range of 330 µm–1 mm. Our assessment is the first to demonstrate microplastic contamination in commercial European anchovies from the Romanian coast. Further studies are required to completely understand the extent of microplastic pollution in Black Sea anchovies and its potential impact on both human health and the ecosystem. Full article