As electric vehicles (EVs) gain widespread adoption, interactions between EVs and charging infrastructure are increasing, driving the need for secure and efficient authentication methods. However, existing authentication approaches are inadequate to address the unique challenges of dynamic EV charging scenarios. Moreover, they often suffer from static credentials, high computational overhead, and limited adaptability to dynamic user behavior and environmental variability. To address these challenges, this paper proposed PufCB-Auth, a lightweight multi-factor authentication scheme that integrates hardware-level Physical Unclonable Functions (PUFs) with charging behavior features to generate a multi-modal digital fingerprint. To alleviate the negative effects rooting from EV user's charging behavior drift and PUF response fluctuations, the paper also proposed Enhanced PufCB-Auth by incorporating a fingerprint update mechanism. The proposed scheme achieves lightweight design, strong robustness, and continuous authentication capability, making it well-suited for dynamic and resource-constrained EV charging environments. Simulation results validate its effectiveness in improving authentication accuracy and robustness, with minimal system overhead, enabling practical deployment in real-world ChaoJi charging pile-EV interaction environments.
Traumatic dental injuries in immature permanent teeth present significant diagnostic and therapeutic challenges, particularly when associated with root fractures. A 7-year-old boy presented with trauma to the anterior maxilla after a fall on the pavement. Right central incisor (#11), previously unerupted due to premature extraction of the primary predecessor, erupted rapidly within 2 weeks post-trauma, likely facilitated by dental trauma. Initial radiographic examination revealed an immature root with an open apex (Cvek Stage 1) and an oblique root fracture extending from the cervical region toward the middle-apical third. No other clinical signs were present. The patient remained asymptomatic throughout the observation period, reporting no pain or discomfort at any time. Cone beam computed tomography (CBCT) obtained 3 months later confirmed the root fracture and demonstrated dentin bridge formation, isolating the coronal pulp associated with the root fracture from the unaffected pulp. A sinus tract developed 6 months post-trauma, but definitive treatment was delayed because of insufficient clinical crown for access. A month later, sufficient eruption allowed access cavity preparation. Under high magnification, a thick, continuous tertiary dentin bridge was observed overlying the pulp, with a localized pulpal exposure at the junction with the distal dentinal wall; bleeding confirmed pulpal vitality. The coronal pulp space above the bridge was gently irrigated with 1% NaOCl and 17% EDTA without mechanical instrumentation and subsequently sealed with a calcium silicate-based cement up to 2 mm below the cementoenamel junction. Clinical and radiographic follow-up for up to 2 years showed continued root development, dentin bridge formation, canal narrowing, and absence of symptoms. Conservative vital pulp therapy may be a viable treatment option in selected cases of root fractures in immature permanent teeth when pulp vitality is preserved.
Acute respiratory infections (ARIs) are the most common infectious diseases during childhood, responsible for significant morbidity and mortality in the pediatric population worldwide. Metabolomics, the global analysis of small metabolites, is a novel tool that offers insights into diagnostics and prognostics of viral respiratory infections. This review summarizes the existing literature on metabolomic studies in viral acute respiratory infections (ARIs) within the pediatric population. Metabolomic research on patients with bronchiolitis has addressed several clinical questions, such as discrimination by causative agent, i.e. respiratory syncytial virus or rhinovirus, and most importantly prognosis, predicting disease severity and long-term outcomes. In pneumonia, studies have focused on discriminating viral from bacterial etiology and from healthy controls but also predicting disease severity. There is a growing number of studies on metabolomics in ARIs providing a strong foundation for addressing remaining challenges and allowing for more comparable results and greater impact on clinical practice.
Greece holds a critical geographic position in the introduction of domestic sheep into Europe during Neolithic and post-Neolithic migrations, acting as a bridge with Asia. The genomic profile of Greek sheep remains underexplored compared to global breeds, despite their importance for sustainable livestock production. In this study, we constructed an extensive 50 K SNP data collection from 1,625 Greek indigenous sheep reared in 23 flocks compared to southwest Asian, Asian, south, central and north European populations. We detected a diverse genomic profile for Greek breeds linked to both European and Asian ancestry using PCA, admixture and NeighborNet analyses. The Greek breeds were clearly differentiated at the breed level with close genetic relationships between Greek mainland populations and the Italian Zackel-type sheep. PCA clustering and network topology showed an east-to-west genetic axis extending from Asia to the Iberian Peninsula across the Mediterranean, consistent with the Mediterranean dispersal of domestic sheep, with Greece serving as an interlink between the two continents. The Greek cluster showed the highest reticulation level in the regional phylogenetic analysis, implying recent admixture events compared to other geographic clusters. The average observed heterozygosity in Greek sheep (Ho = 0.358), ranging from 0.326 to 0.376, was comparable to that of Mediterranean breeds (Ho = 0.366). At local scale, the analysis of multiple farms revealed heterogeneous management practices, enabling genetic identification in particular cases as evidenced by the admixture profiles by both between- and within-breed comparisons. Semi-fat-tailed Chios (FIS= 0.17) and Pelagonia (FIS= 0.10) sheep displayed higher inbreeding across farms compared to the other Greek sheep attributed to long-lasting selection pressure, conservation efforts and sampling scheme, respectively. Collectively, our findings can be integrated into national conservation actions, especially for endangered populations, to prevent genetic erosion and support sustainable management of local livestock genetic resources.
Primary healthcare (PHC) physicians play a pivotal role in the diagnosis and management of hypertension. While guidelines suggest that blood pressure (BP) should be measured in every patient visit at PHC units, the few studies conducted among PHC physicians report a low ratio of BP measurements in PHC settings. Data on PHC physicians' practices concerning BP measurement in Greece are lacking. This study aimed to investigate the practices of PHC physicians regarding BP measurement in Greece. A cross-sectional web-based survey was conducted among PHC physicians across Greece. A total of 284 PHC physicians completed the questionnaire and 282 responses were included in the analysis, 42.9% male, 92.9% General Practitioners, 89.4% working in the public sector, with a median of 25 (17 - 30) daily patient visits. PHC physicians reported measuring BP in 33.3% (20-50%) of their patients and recommending home BP measurements in 31.1% (SD: 24.3%) of them. Among those who measured BP, 22.3% measured it once, 44.7% measured it twice, and only 21.3% measured it three times, while 54.6% used an electronic upper arm BP monitor. The main barriers reported were high daily patient volume (60.5%), together with limited time available with patients (69.5%), while only 1.3% declared insufficient training. This is the first study in Greece investigating the practices of PHC physicians regarding BP measurements. Our findings underscore the need for targeted interventions to improve BP monitoring practices. Education and motivation of physicians and other primary care team members would be fundamental in addressing the challenge of implementing BP measurement recommendations in clinical practice.
Morphological and geochemical characterization of the particulate depositions collected from the surfaces of urban monuments located in two Mediterranean cities characterized by high levels of atmospheric particulate matter (PM), namely Thessaloniki in Greece and Nicosia in Cyprus, was carried out using multiple analytical techniques. The geochemical composition of bulk samples was found to be dominated by CaO and SiO2 with lower proportions of Al2O3, Fe2O3, and MgO suggesting influence from local and/or transported dust (road dust, Saharan dust). The effect of traffic was evident on the sides of monuments oriented towards busy roads with higher concentrations of anthropogenic elements such as Zn, Ba, Cu, V, and Ni. Gypsum was detected in a few samples only and is possibly attributed to sulfation process and/or windblown Saharan dust. Notably, a wide spectrum of low- and high-molecular-weight organic compounds was also detected (aliphatic hydrocarbons and organic compounds containing carbonyl- and carboxyl-groups, urea and nitrogen-containing biomass, amino acids, fatty acids and lipids, plant residues, synthetic polymer residues, and combustion products) suggesting the presence of various natural and anthropogenic sources. The results obtained in the study may serve as a guide for the development of appropriate strategies for protection and conservation of the urban architectural heritage in the two countries.
The objective of this study was to evaluate the effect of xylanase supplementation in high- and low-fiber diets on the performance of lactating sows and their offspring. At d108 of gestation, 48 sows were assigned to four treatments in a 2 × 2 factorial design: a low-fiber control diet (LF; LF-Con; 12.43% NDF), LF supplemented with 45,000 U/kg xylanase (LF + XYL), a high-fiber control diet (HF; HF-Con; 13.93% NDF), and HF supplemented with xylanase (HF + XYL). Sow body weight (BW) and P2 backfat thickness were recorded at d108 of gestation and weaning. Average daily feed intake (ADFI) was recorded throughout lactation, and piglet BW was measured 24 h post-farrowing and at weaning. Results indicated that sows fed HF diets consumed more feed compared to LF sows (P = 0.003). Furthermore, xylanase supplementation significantly increased ADFI (P = 0.002), reduced lactation weight loss (P = 0.001), and attenuated backfat mobilization (P = 0.003) compared to unsupplemented controls. Regarding the fecal microbiota, HF diets increased the relative abundance of Prevotellaceae and Rikenellaceae. Notably, an increase in the butyrate-producing genus Roseburia (family Lachnospiraceae) was observed, likely driven by cross-feeding mechanisms. Xylanase supplementation reduced the relative abundance of Prevotellaceae, potentially by altering the availability of their preferred carbohydrate substrates. In conclusion, supplementing lactating sows with an endo-1,4-β-xylanase in both LF + XYL and HF + XYL diets, influenced sow energy balance, by elevating feed intake and reducing tissue mobilization, while simultaneously altering the fecal microbiome to a more beneficial, butyrate-producing composition, particularly when using fibrous feedstuffs.
This in vitro study aimed to assess the fracture resistance of simulated stages of root maturation following regenerative endodontic treatment using a cyclic loading method. Ninety extracted maxillary central incisors were randomly allocated into three experimental groups representing different stages of root development, following revitalization: Group A for completely immature teeth immediately after treatment; Group B for teeth with apical closure, and Group C for teeth with apical closure and wall thickening. Two control groups were also included: Group D for intact teeth and Group E for simulated immature teeth without the bioceramic material. Following simulation of immature apices and treatment with a bioceramic material, all specimens were subjected to cyclic loading using a step-stress fatigue protocol until failure. The number of cycles to fracture and the peak load were recorded and statistically analyzed. Statistically significant differences in loading forces were observed between the negative control group (Group D) and Groups A, B, and E (p < 0.05). However, no statistically significant differences were detected among the experimental groups. These results indicate that apical closure and dentinal wall thickening alone did not substantially improve mechanical reinforcement under cyclic loading conditions. Although intact teeth exhibited superior mechanical performance, apical closure and wall thickening alone were insufficient to enhance reinforcement under cyclic loading.
Since 2018, important advancements in the medical care of people with cystic fibrosis, particularly the introduction and widespread use of highly effective cystic fibrosis transmembrane conductance regulator modulators, have contributed to the adult cystic fibrosis population growing substantially and has led to an increased need for tailored health-care approaches. Our study aimed to analyse the extent to which the clinical characteristics and treatment outcomes of adults with cystic fibrosis have evolved from 2014 to 2024. The European Cystic Fibrosis Society Patient Registry (ECFSPR), collects annual data for more than 55 000 people with cystic fibrosis. Longitudinal data from 20 countries in Europe with high patient coverage (>85%) from 2014 to 2024 were analysed, representing 80% of the whole ECFSPR cohort. Differences in annual cross-sectional estimates were assessed using regression models. Between 2014 and 2024, the number of adults with cystic fibrosis increased by 45·0%, from 50·9% to 60·5% of the total cystic fibrosis population. The number of adults older than 30 years nearly doubled. Among adults with cystic fibrosis who had not received a transplant, mean percent predicted FEV1 improved from 66·1% to 78·8% (p<0·0001), with most of the gain occurring after 2020. Chronic Pseudomonas aeruginosa infection declined significantly (p<0·0001), whereas mean BMI increased significantly (p<0·0001), halving the proportion of individuals who are underweight. Age-related complications, such as malignancy, increased, whereas cystic fibrosis-specific complications and insulin-treated diabetes declined. The largest improvements were observed in individuals with at least one variant responsive to elexacaftor-tezacaftor-ivacaftor (ETI). The uptake of ETI increased from 2% in 2019 to 71% in 2024, associated with improvements in health indicators. From 2014 to 2024, the adult cystic fibrosis population in Europe expanded substantially due to marked improvements in treatment, particularly following the availability of ETI triple therapy from 2018-19 onwards. The growing number of people with CF surviving to adulthood is consistent with substantial effects from improved care and cystic fibrosis transmembrane conductance regulator modulators, such as ETI, and highlight evolving care needs of people with cystic fibrosis. None.
Considerable practice variation persists regarding Tübingen splint discontinuation strategies in developmental dysplasia of the hip (DDH). This study compared ultrasonographic and radiographic outcomes between immediate discontinuation and gradual weaning protocols. This retrospective comparative study included 44 hips (38 patients) with Graf type IIc, D, or III DDH treated with the Tübingen splint. Twenty hips underwent immediate discontinuation upon achieving α-angle ≥60 degrees (no weaning group), while 24 hips followed a 3-month gradual weaning protocol with nighttime-only use (weaning group). Primary outcomes included final α-angle at treatment completion and acetabular index (AI) at 6 and 12 months. Statistical analysis used Wilcoxon rank-sum tests with propensity score sensitivity analysis. Groups were comparable at baseline regarding demographics and initial ultrasound findings. The weaning group achieved significantly higher final α-angles [68 degrees (IQR: 65, 70) vs. 66 degrees (IQR: 64, 68), P =0.037] and lower 12-month AI values [24 degrees (IQR: 23, 24) vs. 24 degrees (IQR: 24, 25), P =0.023]. Propensity score analysis confirmed the robustness of these findings. No surgical interventions were required in either group. A structured 3-month weaning protocol following Tübingen splint treatment was associated with small but statistically significant improvements in final α-angle and 12-month acetabular index compared with immediate discontinuation. As all hips normalized radiographically and none required intervention in either group, these absolute differences were modest and of uncertain clinical importance; weaning, therefore, appears to be a safe and reasonable option rather than a definitively superior strategy. Level III-therapeutic study.
In this work, a novel and green capsule phase microextraction method followed by high-pressure liquid chromatography coupled to diode array detector (CPME-HPLC-DAD) was developed for the selective determination of four tetracyclines, namely oxytetracycline (OTC), tetracycline (TC), chlortetracycline (CTC) and doxycycline (DC), in human urine. Among five tested CPME devices, the sol-gel C18 capsules exhibited the highest extraction efficiency. The main factors affecting the sample preparation procedure were optimized using the one-factor-at-a-time (OFAT) strategy, leading to the selection of 4 mL as the optimal sample volume. Following the optimization of CPME parameters, the method was validated in terms of linearity, selectivity, accuracy, sensitivity and precision. For all analytes, linearity was confirmed over the concentration range of 0.03-0.50 μg/mL (R2 > 0.998), while method limits of detection (LODs) and quantification (LOQs) were equal to 9 ng/mL and 30 ng/mL, respectively. The relative standard deviation (%RSD) expressing intra-day and inter-day repeatability of the reported method were found to be lower than 6.7% and 8.7%, respectively. The accuracy of the optimized method was evaluated using spiked samples with analytical recoveries ranging from 93.9% to 110.8% (intra-day) and 90.8% to 112.4% (inter-day). The green character and practicality of the proposed method, as well as the level of innovation and analytical performance were assessed using advanced metric tools, including ComplexMoGAPI (Complex Modified Green Analytical Procedure Index), BAGI (Blue Applicability Grade Index), VIGI (Violet Innovative Grade Index) and RAPI (Red Analytical Performance Index). Overall, the developed CPME-HPLC-DAD protocol provides a simple, eco-friendly and highly reliable approach for the selective quantification of these four tetracyclines in human urine.
The journal retracts and removes the article, "Normative Data for the D-KEFS Tower Test in Greek Adult Population Between 20 and 85 Years Old" [...].
Finding indicators of early response to antidepressant treatment in EEG signals recorded from patients suffering from major depressive disorder. Functional brain connectivity networks based on weighted imaginary coherence and weighted imaginary mean phase coherence were computed for 176 patients for 6 different EEG frequency bands. Cross-hemispheric connectivity (CH) and lateral asymmetry (LA) were estimated from these networks based on EEG signals recorded before the beginning of treatment (Vis1) and one week after the start of the treatment (Vis2). Repeated measures ANOVA was used to check for statistically significant changes in connectivity based on these measures at Vis2 w.r.t. Vis1. Post-hoc analysis was performed with multiple pairwise comparison tests to determine which group means were significantly different. It was found that CHVis2 was significantly reduced w.r.t. CHVis1 in the β1 [12.5 - 17.5 Hz] frequency band for the responders to treatment. Also, LAVis2 was significantly increased w.r.t. LAVis1 in the β1 frequency band for the responders. No such significant changes were observed for the non-responders. Brain networks constructed using both weighted imaginary coherence and weighted imaginary mean phase coherence were found to exhibit these results. For the CH connectivity changes, binarized networks and for the LA connectivity changes, weighted networks were found to be more reliable. Responders were found to show a reduction in cross-hemispheric connectivity and an increase in lateral asymmetry, both in the β1 band while no such change was observed for the non-responders. Decrease in cross-hemispheric connectivity and increase in lateral asymmetry in the β1 band may represent candidate neurophysiological indicators of early treatment response, but they require independent replication before any clinical application can be considered.
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Background: Coenzyme Q10 and Alpha-lipoic acid are two essential antioxidants involved in numerous physiological processes, including cellular energy production and the mitigation of oxidative stress. Their accurate quantification is critical for understanding their biological roles and therapeutic potential. Herein, an RPLC-MS/MS method for the rapid and simultaneous determination of ubiquinone-10 (CoQ10), the reduced form ubiquinol-10 (CoQ10H2), and Alpha-lipoic acid (ALA) in human serum was developed and validated. Methods: Chromatographic separation was performed on a Waters ACQUITY UPLC HSS T3 column (2.1 mm × 150 mm, i.d. 1.7 μm). Detection was performed on a SCIEX Triple Quad 6500+ system, applying multiple reaction monitoring (MRM). Single-phase protein precipitation was selected as the sample preparation protocol, providing satisfactory recovery for the analytes. Results: The method was linear over the concentration of 53.8-613 ng/mL for CoQ10H2, 23.1-263 ng/mL for CoQ10 and 7.7-87.6 ng/mL for ALA. Intra- and inter-day accuracy was found to be between 81.8 and 109% and 84.4 to 106%, respectively, for all analytes, while intra- and inter-day precision was found to vary from 0.8% to 9.9% %RSD and 2.0% to 7.7% %RSD, respectively. A limit of quantitation (LOQ) of 4.2 ng/mL was found for CoQ10H2, 1.7 ng/mL for CoQ10 and 0.7 ng/mL for ALA. Conclusions: The developed LC-MS/MS method enables rapid, sensitive and simultaneous quantification of CoQ10H2, CoQ10, and ALA in human serum with satisfactory accuracy, precision and sensitivity. The method is suitable for bioanalytical applications and was successfully applied to the analysis of 10 real samples obtained from healthy volunteers.
Biventricular pacing (BVP) remains the standard method for delivering cardiac resynchronization therapy (CRT) in patients with heart failure and left bundle branch block (LBBB). Despite its established role, BVP is a non-physiological pacing approach and is limited by factors such as anatomical constraints of the coronary sinus and a substantial proportion of non-responders. Conduction system pacing (CSP), including His bundle pacing and left bundle branch area pacing, has emerged as a more physiological alternative aimed at optimizing CRT outcomes. Early studies suggest that CSP may achieve superior electro-mechanical ventricular synchrony compared with BVP. Nevertheless, evidence from large-scale randomized controlled trials remains scarce, and challenges related to procedural complexity and insufficient long-term outcome data currently prevent CSP from replacing BVP as the first-line CRT strategy. This systematic review synthesizes the existing literature on CSP in CRT, explores its potential applications across different clinical contexts, and discusses the ongoing controversies and future prospects of this evolving technique.
Hypertrophic cardiomyopathy (HCM) is the most common inherited myocardial disorder and a major cause of sudden cardiac death in young adults and competitive athletes. Distinguishing HCM from exercise-induced physiological hypertrophy is clinically critical, particularly, within the diagnostic "gray zone," where morphological and functional parameters overlap. Artificial intelligence (AI), including machine learning (ML) and deep learning, has emerged as a methodological framework for extracting latent diagnostic information from complex cardiovascular data sets. However, the extent of its validated application in differentiating HCM from athlete's heart remains unclear. A scoping review was conducted according to the Arksey and O'Malley methodology and PRISMA-ScR guidelines. Four electronic databases (PubMed, Scopus, Web of Science, IEEE Xplore) were searched (up to October 2025) for primary studies using AI/ML to discriminate HCM from physiological or other etiologies of left ventricular hypertrophy. Inclusion criteria required confirmed HCM populations, use of AI analytical methods, and reporting of diagnostic performance metrics. Data extraction focused on population source, data modality, model architecture, performance indexes, and presence of athlete-specific cohorts. Eight studies met the inclusion criteria. Only one directly compared HCM with athlete's heart, using deformation-derived echocardiographic parameters and support vector machine classification (AUC 0.93). The remaining studies examined HCM versus hypertensive or non-pathological hypertrophy using ECG-, echocardiography-, radiomics-, or video-based AI analysis, demonstrating AUC values between 0.89 and 0.96. No recent athlete-specific data sets were identified. AI shows strong potential to enhance the differential diagnosis of HCM through advanced imaging and ECG pattern analysis. However, the paucity of athlete-derived data sets and limited external validation significantly constrain clinical applicability in sports cardiology. Future research should prioritize explainable, multimodal models and dedicated athlete cohorts.
Hydrogels made from natural polymers are widely used in biomedical engineering as they resemble the extracellular matrix. Alginate dialdehyde-gelatin (ADA-GEL) hydrogels are notable for their biocompatibility, biodegradability, and adjustable crosslinking. However, their limited mechanical strength and bioactivity present significant challenges for use in tissue regeneration and wound healing. To overcome these issues, this study explores the addition of 0.1 and 1 wt.% mesoporous bioactive glass nanoparticles (MBGNs) or silver-doped bioactive glass nanoparticles (Ag-BGNs) into ADA-GEL hydrogels to create composite hydrogel films. These nanocomposites were tested in terms of printability, swelling, degradation, antibacterial effects, and in vitro compatibility using MG-63 cells (osteosarcoma cells). MBGNs improved the hydrogels' osteogenic ability and structural stability. At the same time, Ag-BGNs provided vigorous antibacterial activity, especially against Staphylococcus aureus and Escherichia coli, without significantly affecting cell viability and morphology. The use of bioactive and antimicrobial nanoparticles in the ADA-GEL matrix offers a promising approach for developing new soft biomaterials for applications such as bone regeneration, wound healing, and implant coatings.
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Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease (NAFLD), is the most prevalent chronic liver disorder globally and is strongly associated with obesity, type 2 diabetes mellitus, and the metabolic syndrome. Accurate and timely assessment of hepatic steatosis and fibrosis is critical for risk stratification and therapeutic monitoring. However, liver biopsy, the current reference standard, is invasive, subject to sampling variability, and unsuitable for repeated assessments of a large population. Non-invasive imaging modalities have emerged as potential alternatives, offering reproducibility and possibility for quantitative evaluation. Ultrasound-based techniques are focused on qualitative and sometimes quantitative assessment of liver fat, while elastography techniques are focused on liver stiffness, which is associated with fibrosis stage. Magnetic resonance techniques offer highly reproducible evaluation of steatosis, metabolic alterations, and fibrosis, with magnetic resonance imaging-proton density fat fraction regarded as the reference standard for fat quantification and magnetic resonance elastography providing the highest accuracy for fibrosis staging. Computed tomography also enables liver fat quantification; however, its use is limited mainly because of exposure to ionizing radiation. Recent artificial intelligence (AI) applications are oriented towards enhancing diagnostic accuracy and automate quantitative assessment while supporting longitudinal monitoring. Despite these advancements, further research is required to validate emerging techniques, standardize acquisition protocols, and ensure widespread clinical implementation. This review summarizes and synthesizes current evidence on non-invasive imaging diagnostic techniques for MASLD, highlighting their strengths, limitations, and potential integration into routine clinical practice in order to reduce dependence on invasive liver biopsy.