Search Results (26,080)

The use of blood plasma, fibrinogen or fibrin, a natural biomaterial, has been widely studied for the development of different skin tissue-engineered products and other dermatological treatments. This systematic review reports the preclinical and clinical studies which use it alone or combined with other biomaterials and/or cells for the treatment of several dermatological conditions. Following the PRISMA 2020 Guidelines, 147 preclinical studies have revealed that the use of this biomaterial as a wound dressing or as a monolayer (one cell type) skin substitute are the preferred strategies, mainly for the treatment of excisional or surgical wounds. Moreover, blood plasma is mainly used alone although its combination with other biomaterials such as agarose, polyethylene glycol or collagen has also been reported to increase its wound healing potential. However, most of the 17 clinical reviewed evaluated its use for the treatment of severely burned patients as a wound dressing or bilayer (two cell types) skin substitute. Although the number of preclinical studies evaluating the use of blood plasma as a dermatological treatment has increased during the last fifteen years, this has not been correlated with a wide variety of clinical studies. Its safety and wound healing potential have been proved; however, the lack of a standard model and the presence of several approaches have meant that its translation to a clinical environment is still limited. A higher number of clinical studies should be carried out in the coming years to set a standard wound healing strategy for each dermatological disease. Full article

This study investigates the impact of wall roughness on the performance of the Non-Line-of-Sight (NLOS) component in Visible Light Communication (VLC) systems designed for underground mining environments, adhering to safety and communication standards such as IEC 60079-28(intrinsic safety in explosive atmospheres) and IEEE 802.15.7 (VLC parameters). Using probabilistic models aligned with the ITU-R P.1238 propagation guidelines, the research evaluates how wall materials (e.g., coal, shale, limestone) and their irregular geometries, characterized by surface roughness profiles compliant with ISO 8503-2,influence reflection coefficients (0.05–0.85 range), incidence angles (0°–90°), and irradiance angles (5°–180°), which are critical for signal propagation. Simulation scenarios, parameterized with material reflectivity data from ASTM E423, explore the effects of statistical distributions (uniform, normal with $\mu$ = 0.3, $\sigma$ = 0.2; exponential $\lambda$ = 2; gamma $\alpha$ = 0.5, $\beta$ = 0.2) on power distribution, channel impulse response, and reflection coefficients. The results indicate variations in maximum received power: a decrease of 80% for uniform distribution, an increase of 150% for exponential distribution, and a 100% increase for gamma distribution in reflection conditions. Under incidence and irradiance conditions, uniform distribution exhibited a 158.62% increase, whereas exponential distribution and gamma distribution experienced reductions of 72.22% and 7.04%, respectively. These variations align with IEC 62973-1 EMI limits and emphasize the role of roughness (Ra = 0.8–12.5 μm per ASME B46.1). Full article

This study explores the adoption of AI in the UAE’s creative industries through interviews with nine professionals, primarily Emiratis, from journalism, filmmaking, content creation, and heritage sectors. Their insights shed light on the intricate relationship between technological progress, job stability, and the preservation of cultural integrity. One of the key observations was the dual nature of AI’s impact: while it undeniably enhances operational efficiency and reduces expenses, there are valid concerns regarding the authenticity and quality of AI-generated content and its potential impact on the development and utilization of professional skills within these industries. Despite the UAE government’s strategic initiatives to promote AI adoption, the findings revealed a notable absence of clear guidelines, placing the onus on individuals to proactively navigate the landscape of AI integration. This research challenges the prevailing narratives that often depict the Global South as passive consumers of technology as it highlights the participants’ acute awareness of the inherent biases present in AI technologies, particularly in the representation of their local culture. Full article

This review aimed to critically assess the effectiveness of LEED certification in enhancing the energy performance of buildings. This study discusses the background to the creation of LEED, the LEED energy performance assessment, the consumption of certified buildings compared to non-certified buildings, the consumption predicted by simulations versus actual consumption, and the influence of considering thermal insulation in the envelope on the effectiveness of the certification. The review highlights that LEED was developed in the United States and bases its energy performance assessment on ASHRAE 90.1. Findings highlight significant energy performance variability among LEED-certified buildings due to factors like geographic location, building type, and discrepancies between predicted and actual energy consumption, often influenced by occupancy patterns and user behaviour. While higher certification levels generally correlate with better energy performance, lower levels frequently underperform. Additionally, in hot climates, thermal insulation strategies following ASHRAE guidelines may inadvertently increase cooling demands in buildings with high internal loads, hindering heat dissipation. In conclusion, although LEED represents a significant milestone in advancing sustainable construction practices, its energy performance framework requires refinement to better account for diverse climatic and cultural contexts, thereby optimising its contribution to energy efficiency. Full article

Background/Objectives: Neoadjuvant therapy (NAT) improves surgical outcomes in pancreatic cancer, but its role in elderly patients remains unclear. Due to comorbidities and lower chemotherapy tolerance, assessing NAT’s benefits and risks in this population is essential. This systematic review assesses the impact of NAT on overall survival (OS), surgical resection rates, and treatment-related toxicities(G3-4) in elderly patients with resectable, borderline, or locally advanced pancreatic cancer. Methods: A systematic search was conducted in PubMed, MEDLINE, EMBASE, Scopus, and Cochrane databases according to PRISMA guidelines. Studies reporting that NAT outcomes in elderly patients (≥70 years) were included. The Newcastle–Ottawa scale was used to assess study quality. Subgroup analyses compared NAT versus upfront surgery and outcomes in elderly versus younger patients. Results: Twelve studies (four prospective and eight retrospective) including 11,385 patients met the inclusion criteria. Among 9580 elderly patients, only 24% underwent NAT. NAT significantly improved R0 resection rates compared to upfront surgery (p < 0.001), and elderly patients receiving NAT had a median OS of 26.5 (range 15.7–39.1) months versus 20.3 months (range 11.5–23.8) of upfront surgery and versus 36.2 months (range 23.6–43.0) of NAT in young patients. Elderly patients experienced higher rates of major toxicities (17–57.5%). Personalized regimens, such as gemcitabine/nab-paclitaxel, were better tolerated than FOLFIRINOX. Conclusions: NAT is associated with improved survival and surgical outcomes in elderly pancreatic cancer patients, despite a higher risk of adverse events. Patient selection based on performance status rather than age alone is essential to optimize treatment benefits. Further prospective trials are needed to refine treatment approaches in this population. Full article

Chronic obstructive pulmonary disease (COPD) is often exacerbated by various viruses and bacteria, leading to acute episodes of worsening respiratory symptoms, which contribute significantly to the morbidity and mortality associated with COPD. Consequently, vaccination against these pathogens is recommended by numerous guidelines to safeguard COPD patients from adverse health outcomes. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendation advocates for vaccination against influenza, Streptococcus pneumoniae, respiratory syncytial virus (RSV), severe acute respiratory syndrome coronavirus (SARS-CoV2), pertussis, and varicella zoster. This review article will examine the current vaccination strategies recommended for adult COPD patients and will discuss the clinical benefits associated with these vaccines. Full article

Background/Objectives: High fiber (34–36 g/day) diets are recommended during pregnancy due to inverse associations with constipation and adverse pregnancy health outcomes, including pre-eclampsia and gestational diabetes. However, the mechanism for this protective effect is poorly defined. Fiber may be protective due to its impact on the composition and function of specific bacteria within the pregnancy gut microbiome. The purpose of this analysis was to investigate whether a sub-sample of cohort study participants in their third trimester met daily dietary fiber and vegetable intake recommendations and, in turn, how this impacted bacterial composition and butyrate-producing genes within the gut microbiome. Methods: Pregnant participants (n = 52) provided stool samples and survey data, which were used to calculate fiber and vegetable intake. Genomic DNA was extracted from the stool samples, followed by PCR to amplify the V4 region of the 16S rRNA gene. Amplicons were sequenced and mapped to the RDP reference. Quantitative real-time PCR was used to measure the abundance of bacterial genes for butyrate production. Results: Of the pregnant participants in this sample, 84.7% and 92.3% failed to meet recommendations in the Dietary Guidelines for Americans for dietary fiber and vegetable intake, respectively. All four participants who met the vegetable recommendation were a subset of those who met the fiber recommendation. The participants who met the pregnancy fiber recommendation had gut microbiotas with greater alpha diversity (Shannon and Inverse Simpson) than those who did not. However, there was no association between dietary fiber intake and the abundance of bacterial genes for butyrate production. Conclusions: This research suggests that general fiber intake during pregnancy has a modest association with the gut bacterial community. These preliminary results demonstrate a need to improve fiber intake during pregnancy. Further, studies that measure the relationship between dietary intake of specific types of fiber and associations with specific gut bacterial community members and their functions are needed. Full article

Epidemiological data show racial and ethnic differences exist in breast cancer morbidity and mortality amongst Black, Indigenous, Asian, and Hispanic populations, with non-white females experiencing earlier age at diagnosis, more aggressive breast cancer subtypes and advanced cancer stages, and earlier mortality than white females. However, the current Canadian breast cancer screening guidelines recommend biannual screening for all females starting from age 50 to age 74 and suggest not to screen individuals aged 40–49. In May 2024, the Canadian Task Force for Preventative Health released updated draft breast cancer screening guidelines, maintaining such recommendations for screening. Both the existing and the proposed guidelines fail to account for the unique cancer burden amongst racialized populations in Canada and risk further perpetuation of existing racial and ethnic disparities by underscreening racialized females. This commentary will present data regarding racial disparities in cancer burden, highlighting the role social and biological factors play in impacting cancer risk and age of disease and presenting perspectives from stakeholder groups reflecting the impacts of current screening guidelines. Ultimately, we critique the current “one-size-fits-all” approach to breast cancer screening in Canada, emphasizing the need for adapted screening practices with the understanding that the current approaches overlook the needs of racialized Canadian populations. Full article

Background/Objectives: The Lymph Node Ratio (LNR) index is the proportion of lymph nodes with present metastases to lymph nodes removed and examined. This is an additionally established parameter for predicting the prognosis of gastric cancer patients. The most popular cancer classification, TNM, describes only the number of affected lymph nodes. It can result in a negative overestimation of the prognosis of patients with gastric cancer if the number of nodes examined is relatively limited. Methods: In this study, we retrospectively analyzed 194 patients diagnosed with gastric cancer operated on between 2017 and 2021 at the Clinical Department of Oncological Surgery, University Centre of General and Oncological Surgery of the University Clinical Hospital in Wroclaw. In total, 133 patients underwent gastrectomy with D2 lymphadenectomy and 61 remaining patients had the resection procedure abandoned due to an unresectable lesion. The LNR index was calculated based on histopathological examination, and postoperative complications were assessed using the Clavien–Dindo (C-D) scale. Statistical analysis was performed regarding the dependence of LNR on the following patient characteristics: sex, age, TNM features, tumor stage, tumor location, performed procedure, chemotherapy application, C-D complication rate, and survival rate. Results: The value of the LNR index significantly depends on TNM features (p < 0.05), clinical tumor stage (p < 0.05), and patient survival (p < 0.05), while no statistically significant relationship with C-D complication rate was demonstrated. Conclusions: The LNR index is a relevant parameter in predicting prognosis and survival time in gastric cancer patients, but future studies on larger and differentiated groups of patients could further confirm its usefulness in the development of guidelines. Full article

One of the most significant breakthroughs in cancer research has been the identification of persistent infection with certain human papillomaviruses (HPV) genotypes as the cause of cervical cancer. Since then, a range of diagnostic and therapeutic methods has been developed based on this discovery. This article aims to describe the latest updates in the biology, prevention, and treatment of HPV-related cervical cancer. The current state of knowledge regarding vaccinations, diagnostic tests, and cervical cancer therapies is presented. The latest WHO guidelines on vaccinations are presented, as well as announcements of upcoming changes. The final part of the article summarizes promising new diagnostic and treatment methods, as well as perspectives and the latest research findings on self-administered diagnostic tests, the use of therapeutic vaccines, and circulating cell-free DNA in diagnosis. Despite the significant progress made in recent years, the strategy based on vaccination and testing remains the cornerstone in the fight against HPV-related cervical cancer. Full article

Background/Objectives: Patients suffering from rare diseases are particularly vulnerable to vitamin D deficiency. The role of vitamin D status in rare disease management remains insufficiently investigated and employed in routine clinical practice. Methods: This review analyses current data on vitamin D status in selected rare diseases of organs involved in vitamin D metabolism: skin (epidermolysis bullosa, morphea), liver (autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis), kidney (Alport syndrome, Fabry disease), and cystic fibrosis as a model of a systemic rare disease. Additionally, this review critically examines potential drug–vitamin D interactions in the context of rare disease patient polypharmacy. Results: Evidence suggests that vitamin D deficiency is prevalent in rare disease patient populations, often at once exacerbating and being simultaneously exacerbated by the underlying condition. Vitamin D deficiency correlates with worse clinical outcomes and lower quality of life across the examined diseases. Immunoregulatory properties of vitamin D appear relevant for rare diseases with autoimmune components. Conclusions: An urgent need for developing disease-specific clinical practice guidelines, implementing routine vitamin D monitoring in rare disease patient care, and introducing tailored supplementation under the principles of precision medicine is emphasized. Full article

In this study, for the first time, a systematic review and meta-analysis were conducted to understand the prevalence and genetic diversity of haemosporidian parasites—namely, Plasmodium, Haemoproteus and Leucocytozoon—in avian species in Southeast Asia. Following the PRISMA guidelines, 14,211 studies were retrieved from PubMed, ScienceDirect and Scopus, which contain data relevant to ‘Plasmodium’ or ‘Haemoproteus’ or ‘Leucocytozoon’ and ‘birds’ or ‘chickens’. Of these, 15 articles reporting the prevalence of Plasmodium, Haemoproteus or Leucocytozoon in Southeast Asia were selected for meta-analysis. The pooled prevalence estimates with 95% confidence intervals (CIs) of Plasmodium, Haemoproteus and Leucocytozoon were analyzed using a meta-analysis of their proportions, implemented in R programming. The publication bias was checked using a funnel plot and Egger’s test. Consequently, the pooled prevalences of Plasmodium, Haemoproteus and Leucocytozoon in Southeast Asia were found to be 21% (95% CI: 18–25%), 18% (95% CI: 15–22%) and 34% (95% CI: 30–37%), respectively. The prevalence of Plasmodium in domestic poultry (37.94%) was found significantly higher than in wild birds (6.46%). There was substantial heterogeneity among studies related to Plasmodium (χ² = 171.50, p < 0.0001, I² = 94.84%), Haemoproteus (χ² = 52.20, p < 0.0001, I² = 90.4%) and Leucocytozoon (χ² = 433.90, p < 0.0001, I² = 98.80%). Additionally, this review revealed 23 lineages of Plasmodium, 35 lineages of Haemoproteus and 21 lineages of Leucocytozoon reported from both domestic poultry and wild birds in Southeast Asia. In conclusion, this systematic review suggested that the prevalence of avian haemosporidian parasites in Southeast Asia is high. Particularly, domestic poultry has a high prevalence of Plasmodium, suggesting that monitoring of this parasite should be implemented in the poultry production system. Furthermore, several parasites found in wild birds are undescribed species. Further experimental studies using combined microscopic and molecular techniques might reveal the characteristics of overlooked parasites. Full article

Background/Objectives: Although the benefits of low-germ diets for patients are increasingly being questioned, their application in practice is widespread. The aim of this review is to summarise the current data and evaluate the effectiveness of the neutropenic diet (ND) in adult haemato-oncological patients to provide a basis for practical guidelines. Methods: A systematic search was conducted in four electronic databases (Medline (Ovid), CINAHL (EBSCO), EMBASE (Ovid) and Cochrane CENTRAL) to identify English and German randomised controlled trials (RCTs) concerning the effectiveness of an ND in adult haematological patients. The main endpoints were fever and systemic infections, gastrointestinal (GI) infections, mortality, nutritional status and hospitalisation length. Results: A total of five RCTs with 510 adult patients were included in this systematic review. All patients received high-dose chemotherapy in order to treat haemato-oncological malignancies. None of the analysed endpoints showed a significant advantage of the ND compared to the control group. Conclusions: An ND does not have a beneficial effect on infection rates, GI health, mortality or hospitalisation length for haemato-oncological patients. On the contrary, an ND tends to negatively affect the patient’s nutritional status; therefore, an adaption in clinical routine should take place. Full article

This study investigates how mine backfill interacts with pillars to enhance load-bearing mechanisms in underground mining using the bonded-block modeling method. Through systematic numerical simulations of single- and three-pillar systems, we evaluate critical design parameters—backfill ratio, backfill’s cohesion, lateral confinement pressure, and pillar height-to-width ratio—to quantify their effects on cooperative load-bearing behavior. Key findings reveal that backfill provides essential horizontal passive support to pillars, with this stabilizing effect amplifying as the pillars fragment or undergo lateral expansion. Increasing the backfill-to-roof contact ratio due to the lateral expansion and squeezing effect of the pillar to the adjacent backfill strengthens the lateral constraints, reducing the tensile failures and axial crack propagation in the pillars at peak stress. In multi-pillar configurations, higher backfill cohesion improves system stability by redistributing loads across adjacent structures. Practical guidelines are proposed. Low-cohesion backfill with high filling ratios is recommended for single pillars to absorb energy during sudden failures, while high-cohesion backfill optimizes stability in multi-pillar systems. These insights advance the design of safer and more efficient backfill–pillar support systems in mining engineering. Full article

Background: Acute colonic pseudo-obstruction (ACP) is a life-threatening, rare condition of non-mechanical colon dilatation that can result in bowel ischaemia and perforation. The aetiology is relatively unknown but includes older age coupled with high comorbidity, decreased parasympathetic activity, certain medications, chemoradiotherapy and recent surgery. There are limited research data on ACP following reversal of ileostomy after ultra-low anterior resections (ULAR), thus this systematic review included cases from various types of bowel surgeries. Methods: A comprehensive literature search of relevant articles was conducted using the EMBASE, Medline, PubMed, Cochrane, and Scopus databases. Two cases of ACP following ileostomy reversal after ULAR for rectal cancer were also reported from the authors’ rural institution. This systematic review was conducted according to PRISMA 2020 guidelines. Results: A total of 522 studies were screened of which five case reports were included. Two case series (six patients) and the two patients from the authors’ rural institution developed ACP following reversal of ileostomy post-ULAR with potential causes being the > 6 months’ time from initial surgery to reversal causing prolonged colonic mucosal inflammation and reduced wall contractile strength. Anastomotic leak and chemoradiotherapy were other considerations. One of the rural patients developed right colon ischaemia and perforation needing urgent laparotomy, right hemicolectomy and formation of end ileostomy and mucous fistula. Conservative treatment included aperients, enemas, flatus tube, bedside or endoscopic decompression, and neostigmine. Conclusions: Early recognition is vital to treat ACP with medical therapy and decompression to prevent bowel ischaemia and perforation. Further research is needed to better characterise the aetiology, incidence and management strategies for this rare condition. Full article