Applied Sciences-Basel最新文献

Introduction: Direct pulp capping (DPC) aims to preserve the vitality of the dental pulp by placing a protective biocompatible material over the exposed pulp tissue to facilitate healing. There are several calcium-silicate materials that have been designed to promote mineralization and the regulation of inflammation. These have strong potential for the repair and regeneration of dental pulp. Among them, Biodentine (BD) and EndoSequence RRM Putty (ES) have been found to promote in vitro and in vivo mineralization while minimizing some of the limitations of the first-generation calcium-silicate-based materials. Theracal-LC (TLC), a light-cured, resin-modified calcium-silicate material, is a newer product with potential to improve the clinical outcomes of DPC, but existing studies have reported conflicting findings regarding its biocompatibility and ability to support pulpal healing in direct contact with the pulp. A comprehensive assessment of the biocompatibility and pulpal protection provided by these three capping materials has not yet been performed.

Aim: We aimed to quantify the inflammatory response, dentin bridge formation, and material adaptation following DPC using three calcium-silicate materials: ES, BD, and TLC.

Materials and methods: DPC was performed on the maxillary first molar of C57BL/6 female mice. Maxilla were collected and processed at 1 and 21 days post-DPC. The early inflammatory response was measured 24 h post-procedure using confocal imaging of anti-Lys6G6C, which indicates the extent of neutrophil and monocyte infiltration. Reparative mineralized bridge formation was assessed at 21 days post-procedure using high-resolution micro-computed tomography (micro-CT) and histology. Lastly, the homogeneity of the capping materials was evaluated by quantifying voids in calcium-silicate restorations using micro-CT.

Results: DPC using TLC induced less infiltration of Lys6G6C⁺ cells at 24 h than BD or ES. BD promoted higher volumes of tertiary dentin than TLC, but TLC and ES showed no significant differences in volume. No differences were observed in material adaptation and void spaces among the three capping materials.

Conclusions: All three materials under investigation supported pulp healing and maintained marginal integrity. However, TLC induced a lower inflammatory response on day 1 and induced similar levels of tertiary dentin to ES. These observations challenge the common perception that resin-based capping materials are not suitable for direct pulp capping. Our findings underscore the need to balance biological responses with physical properties when selecting pulp capping materials to improve long-term clinical success.

Asymmetries are common during squats following anterior cruciate ligament reconstruction (ACLR). This study examined interlimb loading differences between squat phases at 6 months post-ACLR. Thirty-five participants performed bodyweight squats at self-selected speed and were analyzed using 3D motion capture. Vertical ground reaction force impulse (vGRFi), external knee flexion moment impulse (KFMi) and hip-to-knee flexion moment impulse ratio (HKRi) were calculated, along with interlimb ratios (ILR). Squat phase durations were also recorded. Paired t-tests and ANCOVA (controlling for time) were used to compare biomechanical variables across squat phases. Greater asymmetry was observed during ascent for vGRFi ILR (p = 0.045), KFMi ILR (p < 0.001) and HKRi ILR (p = 0.006). The ascent phase was faster than descent (p = 0.036). After adjusting for time, phase-related differences in ILRs were no longer significant. These findings suggest that greater limb and knee-specific loading asymmetries occur during the ascent phase of squats but may be influenced by movement speed. Importantly, significant knee-specific loading asymmetries persisted regardless of squat phase. At 6 months post-ACLR, addressing neuromuscular control and movement speed during rehabilitation may help reduce biomechanical imbalances during closed kinetic chain exercises.

Interdisciplinary research catalyzes innovation in mobile health (mHealth) by converging medical, technological, and social science expertise, driving critical advancements in this multifaceted field. Our longitudinal analysis evaluates how the NIH mHealth Training Institute (mHTI) program stimulates changes in research trajectories through a computational examination of 16,580 publications from 176 scholars (2015-2022 cohorts). We develop a hybrid analytical framework combining large language model (LLM) embeddings, Uniform Manifold Approximation and Projection (UMAP) dimensionality reduction, and Hierarchical Density-Based Spatial Clustering of Applications with Noise (HDBSCAN) clustering to construct a semantic research landscape containing 329 micro-topics aggregated into 14 domains. GPT-4o-assisted labeling identified mHealth-related publications occupying central positions in the semantic space, functioning as conceptual bridges between disciplinary clusters such as clinical medicine, public health, and technological innovation. Kernel density estimation of research migration patterns revealed 63.8% of scholars visibly shifted their publication focus toward mHealth-dense regions within three years post-training. The reorientation demonstrates mHTI's effectiveness in fostering interdisciplinary intellect with sustained engagement, evidenced by growth in mHealth-aligned publications from the mHTI scholars. Our methodology advances science of team science research by demonstrating how LLM-enhanced topic modeling coupled with spatial probability analysis can track knowledge evolution in interdisciplinary fields. The findings provide empirical validation for structured training programs' capacity to stimulate convergent research, while offering a scalable framework for evaluating inter/transdisciplinary initiatives. The dual contribution bridges methodological innovation in natural language processing with practical insights for cultivating next-generation mHealth scholarship.

Preserving dental pulp vitality is crucial in pediatric and adolescent dentistry to promote long-term oral health and reduce the need for invasive procedures. Vital pulp therapy (VPT) enhances pulp healing and dentin formation through advanced pulp capping materials. While calcium hydroxide-based materials laid the foundation for VPT, calcium silicate-based materials like mineral trioxide aggregate, Biodentine, and TheraCal offer superior biocompatibility and sealing properties. Recent advancements focus on regenerative strategies that enhance biocompatibility, antibacterial efficacy, and anti-inflammatory effects. Tissue engineering approaches, including stem cells, growth factors, and peptide-based scaffolds, are being explored to improve pulp regeneration and long-term treatment success. This review highlights recent developments in VPT for pediatric and adolescent patients, emphasizing minimally invasive techniques, clinical challenges, and the potential of emerging biomaterials. Continued research into biomaterial efficacy and regenerative capabilities holds promise for advancing VPT, ensuring more effective and biologically driven treatment strategies for young patients.

Although upper limb impairment is one of the most common deficits post-stroke and contributes substantially to diminished functional independence, many survivors receive low dosages of upper limb task training in the inpatient setting. This study evaluates the feasibility and user experience of a progressive-challenge cued activity program, delivered via wearable technology, to promote upper limb activity in an inpatient rehabilitation facility (IRF) post-stroke. Participants (N = 30) wore our wearable system Souvenir, which provided vibrotactile cues to prompt activity in the more-involved arm during idle time. Compliance with the program was high (94% in the IRF), and the system successfully prompted increased activity, as evidenced by significantly higher post-cue response rates compared to pre-cue activity rates (mean difference = 35.1%, t(28) = 9.398, p < 0.001). User experience was positive, with participants reporting high usability, satisfaction, and motivation. Follow-up data collected in unstructured home settings (n = 23) demonstrated continued high compliance (96%) and favorable user experience. These findings suggest that Souvenir and its cued activity program can effectively convert idle time into therapeutic activity while minimizing caregiver burden. Future research should focus on enhancing user engagement and evaluating the clinical efficacy of this approach in improving functional outcomes post-stroke.

This study investigates the impact of subglottic stenosis (SGS) on voice production using a subject-specific laryngeal and airway model. Direct numerical simulations of fluid-structure-acoustic interaction were employed to analyze glottal flow dynamics, vocal fold vibration, and acoustics under realistic conditions. The model accurately captured key physiological parameters, including the glottal flow rate, vocal fold vibration patterns, and the first four formant frequencies. Simulations of varying SGS severity revealed that up to 75% stenosis, vocal function remains largely unaffected. However, at 90% severity, significant changes in glottal flow and acoustics were observed, with vocal fold vibration remaining stable. At 96%, severe reductions in glottal flow and acoustics, along with marked changes in vocal fold dynamics, were detected. Flow resistance, the ratio of glottal to stenosis area, and pressure drop across the vocal folds were identified as critical factors influencing these changes. The use of anatomically realistic airway and vocal fold geometries revealed that while anatomical variations minimally affect voice production at lower stenosis grades, they become critical at severe stenosis levels (>90%), particularly in capturing distinct anterior-posterior opening patterns and focused jet effects that alter glottal dynamics. These findings suggest that while simplified models suffice for analyzing mild to moderate stenosis, patient-specific geometric details are essential for accurate prediction of vocal fold dynamics in severe cases.

Degenerative cervical myelopathy (DCM) is characterized by progressive neurological dysfunction, yet the contribution of intramedullary stress and strain during neck motion remains unclear. This study used patient-specific finite element models (FEMs) of the cervical spine and spinal cord to examine the relationship between spinal cord biomechanics and neurological dysfunction. Twenty DCM patients (mean age 62.7 ± 11.6 years; thirteen females) underwent pre-surgical MRI-based modeling to quantify von Mises stress and maximum principal strains at the level of maximum spinal cord compression during simulated neck flexion and extension. Pre-surgical functional assessments included hand sensation, dexterity, and balance. During flexion, the mean intramedullary stress and strain at the level of maximum compression were 7.6 ± 3.7 kPa and 4.3 ± 2.0%, respectively. Increased intramedullary strain during flexion correlated with decreased right-hand sensation (r = -0.58, p = 0.014), impaired right-hand dexterity (r = -0.50, p = 0.048), and prolonged dexterity time (r = 0.52, p = 0.039). Similar correlations were observed with intramedullary stress. Patients with severe DCM exhibited significantly greater stress during flexion than those with mild/moderate disease (p = 0.03). These findings underscore the impact of dynamic spinal cord biomechanics on neurological dysfunction and support their potential utility in improving DCM diagnosis and management.

Hematoma expansion (HE) is an independent predictor of poor outcomes and a modifiable treatment target in intracerebral hemorrhage (ICH). Evaluating HE in large datasets requires segmentation of hematomas on admission and follow-up CT scans, a process that is time-consuming and labor-intensive in large-scale studies. Automated segmentation of hematomas can expedite this process; however, cumulative errors from segmentation on admission and follow-up scans can hamper accurate HE classification. In this study, we combined a tandem deep-learning classification model with automated segmentation to generate probability measures for false HE classifications. With this strategy, we can limit expert review of automated hematoma segmentations to a subset of the dataset, tailored to the research team's preferred sensitivity or specificity thresholds and their tolerance for false-positive versus false-negative results. We utilized three separate multicentric cohorts for cross-validation/training, internal testing, and external validation (n = 2261) to develop and test a pipeline for automated hematoma segmentation and to generate ground truth binary HE annotations (≥3, ≥6, ≥9, and ≥12.5 mL). Applying a 95% sensitivity threshold for HE classification showed a practical and efficient strategy for HE annotation in large ICH datasets. This threshold excluded 47-88% of test-negative predictions from expert review of automated segmentations for different HE definitions, with less than 2% false-negative misclassification in both internal and external validation cohorts. Our pipeline offers a time-efficient and optimizable method for generating ground truth HE classifications in large ICH datasets, reducing the burden of expert review of automated hematoma segmentations while minimizing misclassification rate.

The simulation of gas flow in the bronchial tree using computational fluid dynamics (CFD) has become a useful tool for the analysis of gas flow mechanics, structural deformation, ventilation, and particle deposition for drug delivery during spontaneous and assisted breathing. CFD allows for new hypotheses to be tested in silico, and detailed results generated without performing expensive experimental procedures that could be potentially harmful to patients. Such computational techniques are also useful for analyzing structure-function relationships in healthy and diseased lungs, assessing regional ventilation at various time points over the course of clinical treatment, or elucidating the changes in airflow patterns over the life span. CFD has also allowed for the development and use of image-based (i.e., patient-specific) models of three-dimensional (3D) airway trees with realistic boundary conditions to achieve more meaningful and personalized data that may be useful for planning effective treatment protocols. This focused review will present a summary of the techniques used in generating realistic 3D airway tree models, the limitations of such models, and the methodologies used for CFD airflow simulation. We will discuss mathematical and image-based geometric models, as well as the various boundary conditions that may be imposed on these geometric models. The results from simulations utilizing mathematical and image-based geometric models of the airway tree will also be discussed in terms of similarities to actual gas flow in the human lung.

Postural imbalance is a leading cause of injury in older adults. Our study investigated the effectiveness of virtual reality (VR)-based interventions on balance ability in this population. Here, we examined 21 older, healthy adults (75.8 ± 5.2 years old). Participants performed 6 weeks of balance training, twice per week for 30 min; the experimental group donned an Oculus VR headset during the training while control participants did not. To assess balance ability, a force platform measured displacement of the center of pressure (COP) during quiet standing in double-leg, tandem, and single-leg stances with eyes closed pre- and post-assessment. COP measurements included mediolateral (ML) and anterior-posterior (AP) directions for root mean square (RMS), peak-to-peak displacement (MAXD), total excursion (TE), and 95% confidence area ellipse (AE) parameters. Post-training assessments showed improvements (significant decreases) in the COP parameters. Control group COP parameters improved in various stances ranging from a 3% to 40% decrease on average. The VR group improved MAXD, TE, and 95% AE ranging from a 5% to 47% decrease, on average, across various stances post-compared to pre-training. VR-based exercise training programs may encourage older adults to engage in mobility exercises, leading to a reduced risk of falls or injuries.