Search Results (4,223)

Chronic nonspecific low back pain (CNSLBP) might be associated with increased pain sensitivity and inflammation. High-intensity interval training (HIIT) has been suggested to reduce pain outcomes and inflammatory markers, but its effects compared to moderate-intensity continuous training (MICT) remain unclear. This study aimed to evaluate the acute effects of HIIT on pain sensitivity and inflammatory markers in persons with CNSLBP compared to healthy controls (HCs) and to determine how these effects differ from MICT. Twenty persons with CNSLBP and twenty HCs were assessed before (PRE) and after (POST) a single HIIT and MICT protocol for pain sensitivity (cuff pressure pain threshold (cPPT), temporal summation of pain (TS), conditioned pain modulation (CPM)), and inflammatory markers (IL-6, TNF-α). Data were analyzed using one-way ANOVAs, paired t-tests, and correlation analyses. At PRE, persons with CNSLBP exhibited lower cPPT (28.2 ± 7.1, Δ = −5.5, p = 0.040), higher TS (1.11 ± 0.89, Δ = 0.79, p = 0.042), and lower CPM (36.2 ± 11.6, Δ = −10.0, p = 0.023) compared to HCs. HIIT resulted in PRE–POST improvements in cPPT (38.9 ± 12.6, Δ = 5.2, p = 0.019) in HCs. No PRE–POST differences were observed in pain processing in those with CLBP. No PRE or PRE–POST differences were observed in the inflammatory markers in either group. The current exploratory study suggests that a single HIIT session might have a beneficial effect on pain sensitivity in HCs but does not alter acute pain sensitivity or inflammatory markers in persons with CNSLBP. Further research is needed to clarify the involved mechanisms and explore the (relation with the) long-term effects of HIIT. Full article

Background/Objectives: Spinal fusion surgery is an accepted form of management for select patients who suffer from degenerative lumbar disease. The need for cost-effective durable techniques is paramount as our population ages. This study compares the radiographic and clinical outcomes of PEEK and 3D-printed titanium interbody cages. Methods: This study compared two cohorts which underwent either PEEK or 3D-printed titanium (3DPT) interbody fusion at a single institution between 2013 and 2022. The PEEK cohort was a retrospective analysis of a prospectively collected registry. The 3DPT data were prospectively collected. The inclusion criteria were adults >18 years who underwent 1 or 2 level lumbar interbody fusion for degenerative spine disease with at least 6 months follow-up. Patient demographics, radiographs, and PROMs were collected. The cohorts were compared using ANOVA for continuous variables and Fisher’s exact test for categorical variables, with significance set to 0.05. Results: The final study included 91 patients, 49 PEEK and 42 3DPT. The 3DPT patients were older (p = 0.047) with increased incidence of hypertension (p < 0.001). The 3DPT patients had less bone morphogenetic protein (BMP) usage (80.9% vs. 54.8%; p = 0.012), but more cellular allograft (p < 0.001). Fusion rate was high for both cohorts, with PEEK at 95.9% and 3DPT at 97.6%. There was no significant difference in reoperation rate. Both the PEEK and 3DPT cohorts demonstrated an improvement in the Oswestry Disability Index (ODI) and EuroQol 5 Dimension (EQ-5D) at 1 and 2 years compared to preoperative baseline. More patients in the 3DPT group met the MCID for EQ-5D at 1 and 2 years compared to PEEK; however, this was not significant (p = 0.350; p = 1.000). Conclusions: The 3DPT interbody provided comparable if not superior fusion properties to the PEEK interbody given the decreased use of BMP. Both cohorts demonstrated similar improvements in ODI and EQ-5D compared to preoperative baseline. These results suggest that 3DPT cages may be a cost-effective alternative in spinal fusion. Further studies utilizing a larger population with higher follow-up rates are indicated to determine the economic and clinical benefits of 3DPT compared to PEEK cages in lumbar fusion surgery. Full article

(1) Background: Clear aligners are favored for their aesthetics in orthodontics, with newer 3D-printed technologies allowing the design of aligners with differential thicknesses and materials, offering advantages in terms of force distribution on the teeth, thereby optimizing treatment biomechanics. This study aimed to compare the initial and final forces of three types of 3D-printed aligners (with different thickness gradients and gingival margins) and traditional thermoformed aligners (with different gingival margins), evaluating stress relaxation and force consistency to determine which material and configuration may be optimal for better force distribution; (2) Methods: Twenty-seven 3D-printed aligners with three design variations and 18 thermoformed aligners were analyzed. Customized models were used to assess force at specific points on the upper incisor (1.1) and molar (2.6). A 3 h stress-relaxation test was conducted at 37 °C, and force data were recorded every second using a motorized compression stand. Statistical analysis was performed using ANOVA, post hoc tests, and Kruskal–Wallis tests for comparisons; (3) Results and Conclusions: Aligners with vertical and horizontal thickness gradients and a gingival margin trimmed 2 mm above the gingival contour exerted the highest forces, particularly at incisal/occlusal points. No significant differences in stress relaxation were observed. The force applied to the molars was consistently higher than the force applied to the incisors. These 3D-printed aligners with both horizontal and vertical gradients may offer a viable alternative to thermoformed aligners. Full article

Objectives: This study explored the impact of a 12-week walking and barre exercise program on depression levels (CES-D), stress hormones (dopamine, epinephrine, norepinephrine, cortisol, serotonin), high-sensitivity C-reactive protein (hs-CRP), and immunoglobulins (IgA, IgG, IgM) in women aged 65 and above. Methods: Twenty-seven participants were divided into a walking exercise group (WG), barre exercise group (BG) and control group (CG), each comprising nine individuals. Sessions lasted 50 min, thrice weekly, with intensity progressing every 4 weeks. Two-way repeated measures of ANOVA assessed time–group interactions and main effects, and paired t-tests and one-way ANOVA were used post hoc with significance set at 0.05. Results: The CES-D scores demonstrated significant interaction (p < 0.001), decreasing significantly in the BG and WG (p < 0.01) while rising in the CG (p < 0.05). Post hoc analysis revealed significantly lower depression levels in the BG compared to the CG (p < 0.01). Stress hormones epinephrine and cortisol showed a main effect of time (p < 0.05), with epinephrine increasing significantly in the BG (p < 0.05) and cortisol decreasing in the BG and WG (p < 0.05). An interaction effect emerged in hs-CRP levels (p < 0.05), while IgA and IgM displayed interaction effects (p < 0.05 and p < 0.01, respectively), both significantly increasing in the BG (p < 0.05). Conclusions: In summary, regular exercise positively impacted depression, stress hormones, and immune functions in older women. Full article

Background/Objectives: Fabrication of ceramic restorations with higher performance, biocompatibility, and mechanical durability, as well as excellent optical properties, is challenging. Therefore, this study was designed to investigate the mechanical properties and surface roughness of different glass ceramics manufactured with CAD/CAM and pressed techniques before and after exposure to simulated gastric acidic challenge. Methods: Lithium disilicate-based (LDS) ceramic, advanced lithium disilicate (ALDS), and zirconia-reinforced lithium silicate (ZLSC), were manufactured with two techniques. Disc-shaped (N = 336) specimens were used to test the biaxial flexural strength (BFS), while surface microhardness and surface roughness were evaluated before and after exposure to hydrochloric acid (34–37% concentration and 1.2 pH for 24 h). The results were statistically evaluated using two- and one-way ANOVA, Tukey’s post-hoc and Student’s t-test. Results: Both CAD and pressed types of LDS ceramic IPS e.max, showed significantly highest BFS and microhardness before and after acidic challenge (p = 0.01 and <0.01, respectively). ALDS and ZLSC showed significantly lower roughness before acidic aging, while all groups showed no significant difference after aging. Conclusion: Pressed groups showed better mechanical performance than CAD groups. LSD (IPS e.max types) continuously showed a better mechanical performance than modified LDS. ALDS and ZLSC showed the best performance in terms of surface smoothness, but after acidic exposure, no significant difference was observed compared to the other groups. Full article

This study determined the influence of surface treatment and protracted ageing on the shear bond strength (SBS) of orthodontic brackets bonded to CADCAM (milled) and 3D-printed polymethylmethacrylate (PMMA) provisional crowns (PCs). Eighty disc-shaped specimens [forty milled (CopraTemp WhitePeaks) [group (Gp) M] and forty printed (Asiga DentaTooth) (Gp P)] were divided into eight subgroups (Gp) based on surface treatment [no treatment (control) (Gp MC and Gp PC), coarse diamond (Gp MCD and Gp PCD), fine diamond (Gp MFD, and GP PFD) and sandblast (Gp MSB and Gp PSB)]. Orthodontic brackets were bonded (Assure Plus, Transbond XT), thermocycled (2200 cycles), and tested for SBS and failure (Adhesive Remnant Index) (ARI). Statistical tests included analysis of variance (ANOVA); Kruskal–Wallis (ARI ranks); and post hoc (Tukey, Dunn, and Bonferroni) for determining group differences at predetermined probability p-values less than 0.05. SBS was significantly increased in Gp MSB (15.51 Mpa) and Gp PSB (14.11 Mpa), while the coarse diamond subgroups yielded the lowest mean SBS values [Gp MCD (11.28 Mpa) and Gp PCD (11.62 Mpa)]. The SBS of subgroups MFD, MSB, PCD, and PSB showed significant differences from those of their respective controls (Gp MC and Gp PC). Low ARI scores were observed in Gp MC (0.40) and Gp MSB (0.80), while higher scores were observed in Gp PCD (2.10). Both milled and printed PCs fulfil the clinical criteria of the minimum SBS for orthodontic brackets for long-term use. However, milled PC has better SBS and low ARI scores, which make it more clinically feasible for orthodontic treatments. Full article

Infantry soldiers must cover long distances carrying heavy and bulky combat equipment. Since the beginning of their training, Spanish Marines have undergone this characteristic and demanding test. However, little is known about its effects on neuromuscular function and recovery in the days following the test. Twenty-six Spanish Marines completed the test, three of whom suffered injuries and had to withdraw from the study, resulting in a final sample of twenty-three Marines. These participants underwent evaluations before (pre), immediately after (post), and 24 and 48 h post-exercise, following a 30 km endurance march carrying their 34 kg combat equipment. A repeated-measures ANOVA, paired-samples t-test, and effect size (ES) analysis were conducted; the results are presented as mean ± SD. The significance level was set at p ≤ 0.05. The variables and p-values of changes over time are presented. Isometric mid-thigh pull (IMTP) (p = 0.004), countermovement jump (CMJ) (p ≤ 0.001), rating of fatigue scale (ROF) (p ≤ 0.001), maximum pull-ups in two minutes (PUmax) (p ≤ 0.001), body mass (BM) (p ≤ 0.001), hand grip strength (HGS): dominant (p = 0.180) and non-dominant (p = 0.616), and incident reports (IRPE) showed a significant increase over time and between the first 10 km and last 5 km in fatigue, muscle pain, joint pain, shortness of breath, excessive sweating (p ≤ 0.001), and muscle tremors (p = 0.028), except for palpitations (p = 0.189). In conclusion, the results indicate that the test had a significant impact on neuromuscular function, with no recovery observed in overall strength and lower limb power after 48 h, even though their perceived fatigue decreased substantially. The resilient spirit of operational military units and their philosophy of always being ready for combat could increase the injury rate. Full article

Background: University students often experience significant stress, which may contribute to disordered eating behaviors. Objectives: This study examines the relationship between perceived stress and eating attitudes among physical therapy students in Romania, exploring the impact on overall well-being and identifying predictors of maladaptive eating patterns. Methods: A cross-sectional survey was conducted with 192 students from the Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy. Two validated instruments were used: the Eating Attitudes Test (EAT-26) to assess eating behaviors and the Perceived Stress Scale (PSS-14) to measure stress levels. Statistical analyses included correlations, ANOVA, and regression models, with a significance threshold of p < 0.05. Results: Among respondents, 15.1% displayed disordered eating behaviors, with stress significantly correlating with EAT-26 subscales. Stress levels were predominantly moderate to high, with younger students reporting higher perceived stress. A significant positive correlation was found between perceived stress and disordered eating behaviors, particularly dieting and bulimia/food preoccupation. Female students reported higher stress levels than males; however, no significant gender differences were observed in disordered eating patterns. No significant associations were found between BMI, weight fluctuations, and EAT-26 scores, suggesting other factors may better explain disordered eating behaviors. Logistic regression identified perceived stress as a significant predictor of disordered eating risk, reinforcing its role in shaping maladaptive eating patterns. Conclusions: Stress significantly impacts eating attitudes, highlighting the need for targeted interventions to reduce stress and promote healthy coping mechanisms. Future research should investigate longitudinal patterns and the effectiveness of interventions aimed at improving student well-being. The limited sample size and the absence of sensitivity analyses are notable limitations that constrain the generalizability of the findings. Full article

Background: Respiratory infections pose a significant public health challenge, particularly among healthcare workers (HCWs). The COVID-19 pandemic exacerbated absenteeism due to respiratory illnesses, affecting healthcare workforce stability. Identifying factors influencing absenteeism is crucial for workforce resilience and effective care. Methods: This retrospective longitudinal study analyzed HCW absenteeism due to respiratory diseases from 2017 to 2023 at the “Sf. Maria” Children’s Emergency Hospital in Iași, Romania. Data from 3827 HCWs were examined, including demographic and occupational variables (age, gender, job role) and disease types. Statistical analyses (chi-square tests, ANOVA, and regression models) were conducted using SPSS to assess absenteeism trends and associated risk factors. Results: Sick leave peaked in 2020 (8322 days) and remained high in 2021 (8134 days), gradually decreasing in 2022–2023 but not returning to pre-pandemic levels (~5000 days/year). Nurses accounted for most leave days, while male staff and HCWs aged 41–50 were most affected. Seasonal variations showed higher absenteeism in transitional months and lower rates in summer. COVID-19 was the leading cause of absenteeism during the pandemic, with quarantine measures further increasing sick leave duration. Conclusions: Pediatric hospitals must strengthen infection control measures to protect HCWs and sustain care continuity. Preventive actions such as immunization, staff training, and health monitoring are critical in reducing absenteeism, maintaining a resilient workforce, and ensuring quality care during health crises. Full article

The use of water-efficient soil amendments has gained increasing importance in agriculture, particularly in regions facing water scarcity. So, this study evaluates the impact of silica and nano-silica hydrogels on soil water retention, crop yield, and crop water productivity under variable irrigation regimes. Using a randomized complete block design with furrow irrigation, the experiment tested different hydrogel application rates and irrigation levels in rice (Oryza sativa L.) and clover (Trifolium alexandrinum L.) across two growing seasons. Statistical tests, including ANOVA and t-tests, confirm that nano-silica hydrogel significantly improves soil properties, yield, and crop water productivity (CWP), especially at moderate irrigation levels (70–90% of water requirements). In the first season, nano-silica hydrogel enhanced rice yield, with a maximum yield of 10.76 tons ha⁻¹ with 90% irrigation and 119 kg ha⁻¹ of hydrogel compared with other treatments. In the second season, clover yields were also positively affected, with the highest fresh forage yield of 5.02 tons ha⁻¹ with 90% irrigation and 119 kg ha⁻¹ nano-silica hydrogel. Despite seasonal variation, nano-silica hydrogel consistently outperformed silica hydrogel in terms of improving soil water retention, reducing bulk density, and enhancing hydraulic conductivity across different irrigation levels. Principal Component Analysis (PCA) revealed that nano-silica hydrogel significantly improved soil water retention properties, including the water-holding capacity (WHC), field capacity (FC), and available water (AW), and reduced the wilting point (WP). These improvements, in turn, led to increased crop yield and water productivity, particularly at moderate irrigation levels (70–90% of the crop’s total water requirements. These findings highlight the potential of nano-silica hydrogel as an effective amendment for improving soil water retention, enhancing crop productivity, and increasing crop water productivity under reduced irrigation conditions. Full article

The objective of this study is to explore how various personality types correlate with enhanced work performance. The Enneagram type of the participants in the experiment was established by using the simplest version of the Riso–Hudson test. A two-way ANOVA was performed under the principles of the Design of Experiments, which allowed the identification of main effects and interactions in the response, i.e., the marks of the university teams. We found that the interactions between certain Enneagram types seem to increase the average performance marks as a primary effect. Conversely, when certain Enneagram types coincided within a team, the marks significantly decreased, posing a risk to project success. According to our results, the Enneagram framework may be used as a preliminary stage for identifying potential team members for future projects. Full article

Background: Mini-implants have transformed orthodontic treatment by providing reliable anchorage and addressing challenges in anchorage control. This in vitro study aimed to compare the insertion torque (IT) values of three types of orthodontic mini-implants. The null hypothesis stated that no significant difference would be found in IT based on mini-implant type. Methods: We analyzed the mechanical ITs of 12 mini-implants categorized into four groups based on lengths (6, 8, 10, and 12 mm) and diameters (1.4, 1.6, and 2.0 mm). Mini-implants were inserted at a 90° angle into artificial bone (Sawbones^®) without pre-drilling. The ANOVA and Tukey’s post hoc test assessed differences, and Spearman’s correlation evaluated relationships between IT, diameter, and length. Results: The Lomas Mondefit^® 2 × 8 mm mini-implant had the highest IT (35 N), while the Jeil 2 × 12 mm had the lowest. Torque correlated with diameter (ρ = 0.609, p = 0.047) and length (ρ = 0.890, p < 0.001). The ANOVA showed significant differences (p = 0.035), with Leone^® and Lomas Mondefit^® differing significantly (p = 0.029). Mini-implant dimensions strongly influence IT. Conclusions: Mini-implant diameter and length significantly influence IT, highlighting their importance in clinical applications for optimal stability and performance. Full article

The fabrication of AA5083/SiC composites by the friction stir processing (FSP) method is the main objective of this study. The study looks at how the mechanical properties of the composites are affected by three important process parameters: traversal speed, rotational speed, and tilt angle. The Taguchi L₉ design matrix was used to effectively investigate parameter effects, decreasing experimental trials and cutting expenses. Tensile testing measured tensile strength, whereas microhardness tests evaluated hardness. The findings showed that a maximum tensile strength of 243 MPa and a maximum microhardness of 94.80 HV were attained. The findings also showed that the optimal ultimate tensile strength (UTS) and percentage elongation (PE) were achieved at a tilt angle of 2°, a traverse speed of 30 mm per minute, and a rotating speed of 900 rev/min. On the other hand, a slightly greater traverse speed of 45 mm per minute was required to reach maximal microhardness (MH) with the same rotational speed and tilt angle. Analysis of variance (ANOVA) showed that rotational speed has a substantial impact on all mechanical properties, highlighting how important it is for particle dispersion and grain refining. This work is unique in that it systematically optimizes FSP parameters by using regression analysis and the Taguchi technique in addition to ANOVA. This allows for a better understanding of how these factors affect the mechanical properties of SiC-reinforced composites. The findings contribute to advancing the cost-effective fabrication of high-performance metal matrix composites for industrial applications requiring enhanced strength and durability. Full article

Background and Objectives: Hind limb ischemia–reperfusion (I/R) injury is a serious clinical condition that requires urgent treatment and develops as a result of a sudden decrease in blood flow in the extremity. Antioxidant combinations are frequently used in diseases today. This study aimed to investigate and compare the effectiveness of ellagic acid (EA) and berberine (BER), which are important antioxidants, and the combination on hind limb I/R injury to evaluate their therapeutic power. Materials and Methods: Thirty-five male Sprague Dawley rats were randomly divided into five groups: sham, I/R, EA+I/R, BER+I/R, and EA/BER+I/R. In the I/R procedure, the infrarenal abdominal aorta was clamped and reperfused for 2 h. EA (100 mg/kg, ip) and BER (200 mg/kg, ip) were administered in the 75th minute of ischemia. Oxidative stress markers (MDA, GSH, SOD, and CAT) and TNF-α were measured. Apoptosis (Bax, Bcl-2, and Cleaved caspase-3) and pyroptosis (Nrf2, NLRP3, and Gasdermin D) pathways were evaluated via Western blot. Muscle tissue was examined histopathologically by hematoxylin eosin staining. One-way ANOVA and post hoc LSD tests were applied for statistical analyses (p < 0.05). Results: Bax levels increased in the ischemia group and decreased with EA and BER (p < 0.05). Bcl-2 levels decreased in the ischemia group but increased with EA and BER (p < 0.05). The highest level of the Bax/Bcl-2 ratio was in the I/R group (p < 0.05). Cleaved caspase 3 was higher in the other groups compared to the sham group (p < 0.05). While Nrf2 decreased in the I/R group, NLRP3 and Gasdermin D increased; EA and BER normalized these levels (p < 0.05). In the histopathological analysis, a combination of EA and BER reduced damage (p < 0.05). TNF-α levels were similar between groups (p > 0.05). MDA levels were reduced by EA and BER, but GSH, SOD, and CAT levels were increased (p < 0.05). Conclusions: It was concluded that TNF-α levels depend on the degree and duration of inflammation and that no difference was found in relation to duration in this study. As a result, EA, BER, and their combination could be potential treatment agents on hind limb I/R injury with these positive effects. Full article

Background: the validity and reliability of the front plank test (FPT) have been studied in young adults but not in adults aged 34 to 60 years. The aim of this study was to analyze the criterion-related validity and reliability of the front plank test (FPT) for evaluating trunk musculature in adults according to sex and age groups. Methods: a repeated measures design was used to study the reliability of the FPT. A total of 84 adults aged 18–62 years performed trunk muscular force tests and the FPT. Criterion-related validity was assessed using repeated measures ANOVA. Reliability was examined by ICC, error measurements, and Bland–Altman analysis across sex and age groups. Results: significant differences in the activation of the rectus abdominis and external oblique muscles were found compared with the erector spinae and multifidus muscles (p < 0.001). No correlations were found between FPT time and physical activity or rate of perceived exertion at the end (p > 0.05). Low and moderate correlations were found with body fat percentage, trunk fat mass percentage, and external oblique, regardless of sex and age groups (p < 0.05). Extremely high reliability was found regardless of sex and age groups (ICC > 0.98), with low error measurements (RMSE = 11.93–18.73; %CV = 4.91–6.33; SEE = 11.45–16.84). MDC90 values indicated no real change between T1 and T2. Conclusion: FPT is a valid and reliable test for assessing trunk musculature in adults regardless of sex and age groups. Full article