Search Results (1,751)

Objectives: The present scoping review aims to provide a panoramic view of the current state of knowledge, highlighting the strengths, limitations, and future directions, on the use of CBCT in orthodontic practice. Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines to identify eligible studies from the following databases: PubMed, Scopus, and Web of Science. The research question was formulated as follows: “What is the scientific evidence concerning the preferential use of 3D CBCT over 2D radiography in orthodontics”? Results: Through database searching, 521 records were identified, and ultimately, 37 studies that compared 3D CBCT with 2D conventional radiography were included. Of these, 16 articles regarded the use of CBCT for cephalometric analysis, 5 papers analyzed the evaluation of root resorption, 10 studies evaluated the diagnostic accuracy of root angulation and determining tooth position, and the remaining 6 articles were conducted for miscellaneous applications: determining the size of the nasopharyngeal airway (n = 2), miniscrew positioning (n = 1), estimating cervical vertebrae maturity (n = 1), and evaluating the correctness of the root location when placing digital indirect brackets (n = 1). Conclusions: The choice between 3D CBCT or CBCT-generated radiography and conventional 2D radiography in orthodontics involves careful consideration of the specific clinical context, the complexity of the case, and the balance between the diagnostic advantages and the associated limitations. Future Directions: Future studies with a prospective design and standardized imaging protocols are encouraged to facilitate the development of a consensus on the best practices. Full article

Background: An external ventricular drain (EVD) is used to release elevated intracranial pressure by draining cerebrospinal fluid (CSF) from the brain’s ventricles. The establishment of an EVD is one of the most commonly performed neurosurgical procedures to treat intracranial pressure in patients. Nevertheless, infections are very frequent complications. Identifying the risk factors for EVD-related infections is a key to improving patient safety and outcomes. Methods: We conducted a retrospective, single-center study of patients who underwent EVD implantation between January 2022 and March 2024. Patients were classified into infected and non-infected groups based on their clinical symptoms, as well as laboratory and microbiological results. Patient characteristics and possible risk factors for infection were compared between the two groups. Results: In total, 123 patients treated with 156 EVDs were included in this study, with a mean age of 55.8 (range: 25–84) years. EVD-associated infections were observed in 37 patients (30%). We found no significant association between infection risk and patient characteristics, including gender, primary diagnosis, craniotomy, or immunosuppression. There was no significant difference in terms of EVD insertion, i.e., whether the insertion took place in the operating room (OR) with antibiotic prophylaxis or outside the OR with no periprocedural antibiotic treatment. However, within the intensive care unit (ICU), EVD infection was much lower (13%) if EVD insertion took place in a single-bed room compared to multiple-bed room insertions (34%). Furthermore, there were significant differences in terms of the duration of first EVD (both single and multiple catheterizations) (p < 0.0001) and the total catheterization time (p = 0.0001). Additionally, there was a significant association with patient days in the ICU and EVD catheterization. Conclusions: Revisiting infection control measures is necessary, with special attention to the replacement of EVDs in single-bed ICU rooms, to introduce antibiotic prophylaxis in the ICU. Minimizing unnecessary EVD manipulation during catheterization is crucial in order to decrease the risk of EVD infection. Full article

The article’s primary purpose is to highlight the importance of cybersecurity for Internet of Things (IoT) devices. Due to the widespread use of such devices in everyone’s daily and professional lives, taking care of their security is essential. This security can be strengthened by raising awareness about the vulnerabilities and risks of these devices among their manufacturers and users. Therefore, this paper shows the results of several years of work regarding building vulnerabilities and exploiting databases, with a particular focus on IoT devices. We highlight multiple unique features of our solution, such as aggregation, correlation, and enrichment of known vulnerabilities and exploits collected from 12 different sources, presentation of a timeline of threats, and combining vulnerability information with exploits. Our databases have more than 300,000 entries, which are the result of aggregating and correlating more than 1,300,000 entries from 12 different databases simultaneously, enriched with information from unstructured sources. We cover the innovative utilization of Artificial Intelligence (AI) to support data enrichment, examining the usage of the Light Gradient-Boosting Machine (LGBM) model to automatically predict vulnerability severity and Mistral7B to categorize vulnerable products, which, especially in the case of IoT devices, is critical due to the diversity of nomenclature. Social media and various unstructured sources are prominent places for gathering information. Retrieving data from them is much more complex than from structured databases, but the information there is normally supplied at a faster rate. Thus, we added Mastodon monitoring to enhance our threat timelines. Full article

The minimal instrumentation of portable medical diagnostic devices for point-of-care applications is facilitated by using chemical heating in place of temperature-regulated electrical heaters. The main applications are for isothermal nucleic acid amplification tests (NAATs) and other enzymatic assays that require elevated, controlled temperatures. In the most common implementation, heat is generated by the exothermic reaction of a metal (e.g., magnesium, calcium, or lithium) with water or air, buffered by a phase-change material that maintains a near-constant temperature to heat the assay reactions. The ability to incubate NAATs electricity-free and to further to detect amplification with minimal instrumentation opens the door for fully disposable, inexpensive molecular diagnostic devices that can be used for pathogen detection as needed in resource-limited areas and during natural disasters, wars, and civil disturbances when access to electricity may be interrupted. Several design approaches are reviewed, including more elaborate schemes for multiple stages of incubation at different temperatures. Full article

Iron oxide nanoparticles (IONPs) have garnered significant attention in biomedical applications due to their unique magnetic properties, biocompatibility, and versatility. This review comprehensively examines the synthesis methods, surface functionalization techniques, and diverse biomedical applications of IONPs. Various chemical and physical synthesis techniques, including coprecipitation, sol–gel processes, thermal decomposition, hydrothermal synthesis, and sonochemical routes, are discussed in detail, highlighting their advantages and limitations. Surface functionalization strategies, such as ligand exchange, encapsulation, and silanization, are explored to enhance the biocompatibility and functionality of IONPs. Special emphasis is placed on the role of IONPs in biosensing technologies, where their magnetic and optical properties enable significant advancements, including in surface-enhanced Raman scattering (SERS)-based biosensors, fluorescence biosensors, and field-effect transistor (FET) biosensors. The review explores how IONPs enhance sensitivity and selectivity in detecting biomolecules, demonstrating their potential for point-of-care diagnostics. Additionally, biomedical applications such as magnetic resonance imaging (MRI), targeted drug delivery, tissue engineering, and stem cell tracking are discussed. The challenges and future perspectives in the clinical translation of IONPs are also addressed, emphasizing the need for further research to optimize their properties and ensure safety and efficacy in medical applications. This review aims to provide a comprehensive understanding of the current state and future potential of IONPs in both biosensing and broader biomedical fields. Full article

Research facilities have established animal adoption programs for laboratory animals. However, adoption to private owners is not an option for non-human primates (NHPs), so their post-research life presents a unique challenge. Here, we describe a collaborative effort between laboratory animal veterinarians and behavioral management staff in retiring NHPs in place to ensure their quality of life after the completion of research projects. The success of our retirement program hinges on our collaborative efforts to manage clinical diseases such as arthritis, amyloidosis, and diarrhea; to surgically ex-plant previous research hardware; and to evaluate the animals’ behavior and temperament to ensure each individual is placed in a new group or living situation in which they are likely to be successful and to have good welfare. Implementation of a quality-of-life assessment tool for all retired animals allows all staff involved in the animals’ care to proactively and periodically assess the quality of life of these animals. The successful retirement of NHPs living in social groups is rewarding for all personnel and promotes a culture of caring. Research animal retirement is an important way for us to give back and honor the contributions these animals have made to advancing medicine. Full article

Background: Bortezomib (B), known as Velcade, is a reversible proteasome inhibitor approved for relapsed/refractory multiple myeloma (RRMM) patients (pts). The standard of care protocol includes eight cycles of intravenous push (IVP) injections of B and oral dexamethasone (D), which increases the toxicity. Here, we describe the results of an open-label, phase II clinical trial employing only four cycles of B/D. Methods: RRMM pts treated with at least one previous therapy qualified for the trial. Pts were treated with B 1.3 mg/m² IVP or subcutaneous (SC) on day 1, 4, 8, and 11, followed by a 10-day rest, Q21 days for four cycles; followed by maintenance therapy with once weekly B 1.6 mg/m² IVP or SC on day 1, 8, 15, and 22, followed by 13 days’ rest, repeated Q36 day. Pts received D 20 mg on the days of and days after B. Pts with a complete response (CR) were removed. Those with a partial response (PR) or stable disease (SD) were placed on maintenance therapy until progressive disease (PD), unacceptable toxicity, or pts’ decision to stop. Results: A total of 24 pts were enrolled. CR was observed in six pts (25%), PR in eight pts (33%), and SD in nine pts (37.5%). Moreover, 14 of the 24 pts (58.3%) had PR or better. Four pts had PD during induction. The grade 3 toxicities included fatigue (58%), sensory neuropathy (54%), and thrombocytopenia (50%); the grade 4 toxicities were thrombocytopenia (12.5%), fatigue (12.5%), and sensory neuropathy (12.5%). Conclusions: A short course of B/D, plus maintenance with B, is well tolerated in RRMM pts. Long-term maintenance with B/D could become an alternative to new agents. Full article

Many injuries and deaths occur yearly in the United States due to preventable errors; however, documented harm is lower in hospitals with Magnet^® designation from the American Nurses Credentialing Center (Silver Spring, MD, USA). This manuscript illustrates insights from Magnet^® and non-Magnet^® nurses and nursing leaders regarding what impacts hospital system health, how those factors are communicated, and how hospital system health impacts patient safety. A qualitative descriptive approach was used with semi-structured interview questions. Within-methods data triangulation was applied to transcribed interviews using thematic analysis, application of the Goodwin statistic, and natural language processing (NLP). Thematic analysis revealed the four main themes of Healthy Systems, Unhealthy Systems, Patient Safety, and Nurse Well-Being. NLP revealed non-Magnet^® leaders and nurses scored highest for anxiety, anger, and sadness, in contrast to Magnet^® participants who had the highest levels of positive emotion. Key findings from the Magnet^® participants revealed that poaching employees and placing people in the wrong positions harm hospital system health and patient safety. The use of within-methods data triangulation illuminated the contextual depth of the participants’ speech, revealing the alarming emotional state that non-Magnet^® nurses and leaders are facing. Healthcare staff’s wellness must be prioritized to cultivate environments that provide safe care. Full article

The United Nations 2030 Agenda defines the priorities and aspirations for global development based on seventeen ambitious sustainable development goals encompassing economic, environmental, and social dimensions. Tourism plays a vital role in the list of actions for the people and the planet. While the tourism industry drives economic growth, its environmental and social impact is equally high. Sustainable tourism aims to reduce the damage caused by the tourism industry, protect communities, and guarantee the industry’s long-term future. These changes require tourists’ collective and concerted effort. The question arises whether tourists are willing to be more demanding about sustainability when looking for a destination. This study uses artificial intelligence to classify a new trend in European citizens’ search for sustainable destinations and to generate intelligent recommendations. Using data from the Flash Eurobarometer 499, we use a tree-based algorithm, random forest, to obtain intelligent citizens classification systems supported by machine learning. The classification system explores the predisposition of citizens to contribute to the three pillars of sustainability when choosing a destination to visit based on gender, age, and the region of living. We found that European citizens place little emphasis on the social sustainability pillar. While they care about preserving the environment, this competes with the cultural offerings and availability of activities at the destination. Additionally, we found that the willingness to contribute to the three pillars of sustainability varies by gender, age, and European region. Full article

Breast implant surgery has evolved significantly, yet challenges such as capsular contracture remain a persistent concern. This review presents an in-depth analysis of recent advancements in understanding the immune mechanisms and clinical implications associated with silicone mammary implants (SMIs). The article systematically examines the complex interplay between immune responses and capsular fibrosis, emphasizing the pathophysiological mechanisms of inflammation in the etiology of this fibrotic response. It discusses innovations in biomaterial science, including the development of novel anti-biofilm coatings and immunomodulatory surfaces designed to enhance implant integration and minimize complications. Emphasis is placed on personalized risk assessment strategies, leveraging molecular insights to tailor interventions and improve patient outcomes. Emerging therapeutic targets, advancements in surgical techniques, and the refinement of post-operative care are also explored. Despite notable progress, challenges such as the variability in immune responses, the long-term efficacy of new interventions, and ethical considerations remain. Future research directions are identified, focusing on personalized medicine, advanced biomaterials, and bridging preclinical findings with clinical applications. As we advance from bench to bedside, this review illuminates the path forward, where interdisciplinary collaboration and continued inquiry weave together to enhance the art and science of breast implant surgery, transforming patient care into a realm of precision and excellence. Full article

Background/Objective: Deepening knowledge about the meaning of acceptance in the context of the nurse–patient relationship will help us to understand the importance and value that people with mental health challenges attach to this attribute in the process of the therapeutic relationship. The objective of this study was to understand the process of acceptance as part of the therapeutic relationship between nurses and patients in the field of mental health. Methods: This study employed a qualitative research design using Strauss and Corbin’s grounded theory approach. Using theoretical sampling, data were collected through unstructured interviews with mental health nurses and with people with mental health challenges. Results: Acceptance is a complex and dynamic process that takes place when both patients and nurses feel and make the other feel like an individual human being. Acceptance is not an automatic process; rather, it requires awareness on behalf of both parties involved in the therapeutic relationship. The creation of a non-hierarchical caring environment is fundamental for fostering mutual acceptance and engagement in the therapeutic process. Conclusions: Nurses must develop self-awareness and reflect on their attitudes and biases to provide person-centered care. Nurse training and personal development are essential requirements for achieving an effective therapeutic relationship and empowering patients in their recovery process. Full article

Introduction: In recent years, the integration of robotic systems into various aspects of daily life has become increasingly common. As these technologies continue to advance, ensuring user-friendly interfaces and seamless interactions becomes more essential. For social robots to genuinely provide lasting value to humans, a favourable user experience (UX) emerges as an essential prerequisite. This article aimed to evaluate the usability of the MINI robot, highlighting its strengths and areas for improvement based on user feedback and performance. Materials and Methods: In a controlled lab setting, a mixed-method qualitative study was conducted with ten individuals aged 65 and above diagnosed with mild dementia (MD) and mild cognitive impairment (MCI). Participants engaged in individual MINI robot interaction sessions, completing cognitive tasks as per written instructions. Video and audio recordings documented interactions, while post-session System Usability Scale (SUS) questionnaires quantified usability perception. Ethical guidelines were followed, ensuring informed consent, and the data underwent qualitative and quantitative analyses, contributing insights into the MINI robot’s usability for this demographic. Results: The study addresses the ongoing challenges that tasks present, especially for MD individuals, emphasizing the importance of user support. Most tasks require both verbal and physical interactions, indicating that MD individuals face challenges when switching response methods within subtasks. These complexities originate from the selection and use of response methods, including difficulties with voice recognition, tablet touch, and tactile sensors. These challenges persist across tasks, with individuals with MD struggling to comprehend task instructions and provide correct answers and individuals with MCI struggling to use response devices, often due to the limitations of the robot’s speech recognition. Technical shortcomings have been identified. The results of the SUS indicate positive perceptions, although there are lower ratings for instructor assistance and pre-use learning. The average SUS score of 68.3 places device usability in the “good” category. Conclusions: Our study examines the usability of the MINI robot, revealing strengths in quick learning, simple system and operation, and integration of features, while also highlighting areas for improvement. Careful design and modifications are essential for meaningful engagement with people with dementia. The robot could better benefit people with MD and MCI if clear, detailed instructions and instructor assistance were available. Full article

Brain aneurysms, characterized by abnormal bulging in blood vessels, pose significant risks if ruptured, necessitating precise neuroanatomical knowledge and advanced neurosurgical techniques for effective management. This article delves into the intricate neuroanatomy relevant to brain aneurysms, including the vascular structures and critical regions involved. It provides a comprehensive overview of the pathophysiology of aneurysm formation and progression. The discussion extends to modern neurosurgical approaches for treating brain aneurysms, such as microsurgical clipping, endovascular coiling, and flow diversion techniques. Emphasis is placed on preoperative planning, intraoperative navigation, and postoperative care, highlighting the importance of a multidisciplinary approach. By integrating neuroanatomical insights with cutting-edge surgical practices, this article aims to enhance the understanding and treatment outcomes of brain aneurysms. Full article

Background: Globally, many women express the desire to avoid immediate pregnancy for 24 months postdelivery, and only forty percent use contraceptives during this period. There is an enormous demand for postpartum family planning, particularly in developing countries with low- or middle-income grades. Postpartum intrauterine devices such as long-acting reversible contraceptives (LARCs) are among the most effective methods of family planning in the immediate postpartum period, yet their effectiveness is hindered because of a lack of availability and training. Strategies to increase access to LARCs are essential. Hence, the purpose of the current study is to determine the barriers among healthcare providers in providing immediate postpartum family planning services. Methods: A cross-sectional study was conducted in the Department of Obstetrics and Gynaecology at SIMS, a tertiary care teaching hospital, from January to March 2024. Approximately 293 healthcare providers who fulfilled the inclusion criteria were provided an online questionnaire in the form of a Google Forms link, which included a structured questionnaire focusing on various aspects, including demographics, knowledge, practices, and barriers in their practice. The data collected were analysed through SPSS version 26, which employs chi-square tests and Pearson’s correlation to determine any significant associations among them. Based on the key statistical outcomes and the significant correlations observed related to the data, a thematic analysis through SWOT (strengths, weaknesses, opportunities, threats) was conducted. The study adhered to the method outlined by Braun and Clarke (2006) and compiled with the COREQ (consolidated criteria for reporting qualitative research) checklist to uphold methodological integrity. Results: Among the participants, 92.4% provided family planning counselling after childbirth, predominantly during the antenatal period (75.1%), and the provision of immediate postnatal family planning was reported in 76.1% of the participants, with PPIUDs identified as the most utilized method by 52.6%. Various barriers were identified, including insufficient training on Implanon (33.4%) and the PPIUCD (12.6%), the unavailability of implants (59.0%), and a lack of interest among patients (46.1%). Statistically significant associations were observed between the practice setting and knowledge of postpartum family planning (p = 0.002), as well as deficiencies in training for the PPIUCD (p < 0.001). The study highlights the place of practice and the practitioners’ experience as significant strengths in offering immediate postpartum contraception and referring patients for family planning. However, qualification was identified as a limiting factor for practicing immediate postpartum family planning. Conclusions: This study revealed significant difficulty in delivering prompt postpartum long-acting reversible contraceptives (LARCs), underscoring the necessity of improved education and training for professionals. Focusing on these challenges is important in enhancing postpartum family planning acceptance and decreasing unfulfilled requirements in resource-limited settings. Full article

The completion rates of higher education are low among young adults with a history of foster care. Understanding how students from foster care alumni fare is imperative for facilitating attainment and preventing drop-out. The aim of this study was to compare students from foster care alumni and the general student population by examining (1) sociodemographic characteristics, academic functioning and need for special assistance; (2) contextual factors important for student life; and (3) mental and somatic health, loneliness, life satisfaction and use of cannabis and alcohol. Data comprised self-reports from the Norwegian national survey Students’ Health and Well-being Study 2022. Reports from foster care alumni students (n = 508) were compared to those of the general student sample (n = 59,036). Compared to the general sample, twice as many foster care alumni students reported receiving or needing special assistance in their studies. Moreover, they reported substantially higher economic burden than their student peers, by higher frequency of work income, more financial worries, and less parental financial support. Foster care alumni students also reported a higher load of informal care responsibilities, poorer mental and somatic health, more loneliness and lower life satisfaction. Foster care alumni students fare comparably well in terms of grades and study progression despite the reported economic burden and impaired health and well-being. As these are factors shown to impact study completion, policies need to be put in place to ensure that care-experienced students receive adequate support through their young adulthood and specifically in higher education. Full article