Search Results (282)

Background: Zambia, like many low- and middle-income countries, faces a growing burden of antimicrobial resistance (AMR), driven by the misuse of antimicrobials in both human and animal health, a limited diagnostic capacity, and weak regulatory enforcement. To address this challenge, Standard Treatment Guidelines (STGs) were developed for the veterinary sector, which represents a major milestone in the country’s AMR containment strategy. STGs are evidence-based protocols that guide veterinary professionals in consistently and appropriately diagnosing and treating animal diseases. They promote the rational use of veterinary medicines, and can mitigate AMR and improve animal health outcomes. By translating the best evidence into best practices, STGs also provide a practical foundation for antimicrobial stewardship (AMS) programs. Until 2023, Zambia lacked nationally adopted STGs for the veterinary sector. The introduction and standardization of these guidelines are expected to promote prudent antimicrobial use and raise the standard of care delivered to animal patients across the country. Objective: The aim of this paper is to provide a practical reference for future revisions of STGs and outline the successful methodology used to create STGs in the Zambian animal sector. Methods: A situational analysis was conducted to identify priority animal health conditions and existing treatment gaps within the veterinary sector. A multidisciplinary expert committee was then formed, comprising veterinarians, veterinary paraprofessionals, academics, regulatory authorities, and private sector stakeholders, to lead the development of the STGs. The process was guided by the WHO methodology for developing treatment guidelines, including a comprehensive review of the clinical evidence, local disease patterns, antimicrobial resistance data, and existing treatment practices. Draft STGs were developed with clearly defined, species-specific treatment protocols tailored to the Zambian context. For the validation process, the AGREE II instrument was used to assess the quality, clarity, and applicability of the guidelines. Structured stakeholder consultations with practitioners, policy-makers, and technical experts were held to ensure that the guidelines were practical, evidence-based, and aligned with national priorities. The validated drafts were then disseminated and piloted in selected districts. Conclusions: The development of the species-specific STGs represents an essential turning point in the country’s efforts to promote responsible veterinary care and contain AMR. STGs have become a prominent key support in the delivery of quality animal care. Further, the guidelines will assist in the optimization of antimicrobial use in animal health in Zambia. Full article

The Co(II) complex [CoCl₂(AImd)₂] (AImd = 1-allylimidazole) was reinvestigated using a combination of experimental and theoretical methods. The previously reported crystal structure was redetermined and Hirshfeld surface analysis and enrichment ratios were added showing that intermolecular H⋯Cl and π⋯π interactions are the primary forces in the crystal structure, while H⋯H interactions dominate the surface of the molecule, making it rather hydrophobic in keeping with a low solubility in water. A Quantum Theory of Atoms in Molecules (QTAIM)/Non-Covalent Interactions (NCI)-Reduced Density Gradient (RDG) analysis on a dimeric model showed that the energies V(r) of the classical H⋯Cl hydrogen bonds range from −3.64 kcal/mol to −0.75 kcal/mol and were augmented by hydrophobic H⋯C interactions of >1 kcal/mol. T-dependent magnetization measurements reveal paramagnetic behavior with an effective magnetic moment of µ_eff = 4.66(2) µ_B. UV-vis absorption spectra in solution showed intense absorptions peaking at 240 nm, corresponding to intraligand π→π* transitions within the 1-allylimidazole moiety and a structured absorption around 600 nm, which is attributed to the spin-allowed d→d transitions of the high-spin Co(II) d⁷ ion in a distorted tetrahedral geometry. Both assignments were confirmed through TD-DFT calculations on the electronic transitions and agree with the DFT-calculated compositions of the frontier molecular orbitals. Molecular docking to hypoxia-inducible factor-1 alpha (HIF-1α) gave a docking score of −5.48 kcal/mol and showed hydrophobic⋯hydrophobic π-stacking interactions with the Ile233, Leu243, Val338, and Leu262 residues. A higher docking score of −6.11 kcal/mol and predominant hydrophobic⋯hydrophobic interactions with Trp296, His279, and Ile281 were found for HIF-1 inhibiting factor (FIH-1). Full article

Flow past bluff bodies (e.g., circular cylinders) forms a canonical context for teaching external flow separation, vortex shedding, and the coupling between surface pressure and hydrodynamic forces in offshore engineering. Conventional laboratory implementations, however, often fragment local and global measurements, delay data feedback, and omit intelligent modeling components, thereby limiting the development of higher-order cognitive skills and data literacy. We present a low-cost, modular, data-enabled instructional hydrodynamics platform that integrates a transparent recirculating water channel, multi-point synchronous circumferential pressure measurements, global force acquisition, and an artificial neural network (ANN) surrogate. Using feature vectors composed of Reynolds number, angle of attack, and submergence depth, we train a lightweight AI model for rapid prediction of drag and lift coefficients, closing a loop of measurement, prediction, deviation diagnosis, and feature refinement. In the subcritical Reynolds regime, the measured circumferential pressure distribution for a circular cylinder and the drag and lift coefficients for a rectangular cylinder agree with empirical correlations and published benchmarks. The ANN surrogate attains a mean absolute percentage error of approximately 4% for both drag and lift coefficients, indicating stable, physically interpretable performance under limited feature inputs. This platform will facilitate students’ cross-domain transfer spanning flow physics mechanisms, signal processing, feature engineering, and model evaluation, thereby enhancing inquiry-driven and critical analytical competencies. Key contributions include the following: (i) a synchronized local pressure and global force dataset architecture; (ii) embedding a physics-interpretable lightweight ANN surrogate in a foundational hydrodynamics experiment; and (iii) an error-tracking, iteration-oriented instructional workflow. The platform provides a replicable pathway for transitioning offshore hydrodynamics laboratories toward an integrated intelligence-plus-data literacy paradigm and establishes a foundation for future extensions to higher Reynolds numbers, multiple body geometries, and physics-constrained neural networks. Full article

The metabolism of antibiotics, antidepressants, and cardiovascular drugs has been investigated widely over the last few decades. The aim of this study was to develop an efficient analytical protocol based on the combination of electrochemistry (EC) and mass spectrometry for the identification of electrochemical products (potential pharmacologically active metabolites) of selected drugs (enalapril, metronidazole, midazolam, propranolol, venlafaxine). The electrochemical mimicry of the oxidative phase I and II metabolism was achieved in a thin-layer cell equipped with different working electrodes (magic diamond (MD), glassy carbon (GC), gold (Au), platinum (Pt)). The structures of the electrochemically generated metabolites were elucidated based on accurate mass ion data and tandem mass spectrometry (MS/MS) experiments. The in silico prediction of the main sites of selected drugs’ metabolism was performed using Biotransformer 3.0, GLORYx, and Xenosite software. Moreover, incubation with liver microsomes (LMs) was performed to examine the proposed metabolic pathways of target compounds. The data from in vitro experiments agreed with the data from electrochemical oxidation, which predicted some potential metabolites found in the real samples from patients. For enzymatic incubation, N-dealkylation, O-demethylation, and hydroxylation were the metabolic pathways involved mainly in their metabolism. Their in vitro phase II metabolites were identified as glucuronic acid conjugates. Finally, different in vivo phase I and II metabolites were identified for the studied drugs, including metabolic pathways for in vivo phase I N-demethylation, N-dealkylation, O-demethylation, and hydroxylation, while the metabolic pathways for in vivo phase II metabolites were identified as glucuronic acid conjugates. Full article

Background/Objectives: Developmental dysplasia of the hip (DDH) is one of the most common pediatric orthopedic disorders and warrants timely diagnosis and treatment to prevent long-term disability. This review identified, summarized, and assessed the quality of current European national guidelines for DDH screening and treatment. Methods: Guidelines were identified by contacting the national orthopedic societies from 46 European countries and retrieving the guidelines from a recent systematic review. Two researchers independently extracted data and assessed guideline quality using the AGREE II checklist. Interrater agreement was assessed using Cohen’s $\kappa$. Results: Nine European national DDH guidelines were identified, of which four were published in peer-reviewed scientific journals. All guidelines advised clinical examination and imaging as part of the DDH screening program, though screening approach and timing varied considerably. Four guidelines included treatment recommendations. The type of treatment (abduction treatment vs. active monitoring) and duration of long-term follow-up showed great variation. Guideline quality ranged from 16 to 92% (Cohen’s $\kappa$ = 0.62), with two out of nine guidelines rated “good quality” (>70%). Conclusions: European national DDH guidelines appear scarce and of varying quality and content. A coordinated European initiative is warranted to urge countries to develop evidence-based DDH guidelines using validated tools and to publish these guidelines in peer-reviewed journals, thereby advancing equal diagnosis and treatment for children with DDH. Full article

Electromagnetic implosions of hollow lithium cylinders can be utilized to compress magnetized plasma targets in the context of Magnetized Target Fusion (MTF). Two small-scale experiments were conducted at General Fusion as a stepping stone toward compressing magnetized plasmas on a larger scale. The first experiment is an electromagnetic implosion of a lithium ring, and the second is a compression of toroidal magnetic flux by imploding a hollow lithium cylinder onto an hourglass-shaped central structure. Here we present the methodology and results of modelling these experiments with OpenFOAM. Our in-house axisymmetric compressible MHD multi-phase solver was further extended to incorporate: (i) external RLC circuit model for electromagnetic compression coils and (ii) diffusion of the magnetic field into multiple solid materials. The implementation of the external RLC circuit model for electromagnetic coils was verified by comparison with results obtained with FEMM software and with the analytical solution. The solver was then applied to model both experiments and the main conclusions are as follows: (i) modelling solid lithium as a high-viscosity liquid is an adequate approach for the problems considered; (ii) the magnetic diffusivity of lithium is an important parameter for the accurate prediction of implosion trajectories (for the implosion of the lithium ring, higher values of magnetic diffusivity in the range $0.2 \le {\eta }_{\mathrm{ring}}[{\mathrm{m}}^2/\mathrm{s}] \le 0.5$ resulted in a better fit to the experimental data with a relative deviation in the trajectory of $\lesssim 20\%$); (iii) simulation results agree well with experimental data, and in particular, the toroidal field amplification of 2.25 observed in the experiment is reproduced in simulations within a relative error margin of 20%. The solver is proven to be robust and has the potential to be employed in a variety of applications. Full article

Background: The quality of decision-making processes is increasingly recognized as critical to public trust and policy sustainability. Objectives: This narrative review aims to identify and describe process-focused decision support models (DSMs) applied in pharmaceutical policy, and to examine their potential contributions to improving procedural quality in decisions related to pricing, reimbursement, and access to medicines. Methods: Relevant peer-reviewed and gray literature published between 2000 and 2025 was considered, drawing from key databases (e.g., PubMed and Scopus) and international policy reports (e.g., WHO, ISPOR, and HTA agencies). Studies were included if they provided insights into DSMs addressing at least one dimension of decision process quality. Results: Findings are synthesized narratively and organized by tool type, application context, and key quality dimensions. Frequently referenced tools included the Quality of Decision-Making Orientation Scheme (QoDoS), WHO-INTEGRATE, and AGREE II. QoDoS emerged as the only tool applied across regulatory, HTA, and industry settings, evaluating both individual- and organizational-level practices. WHO-INTEGRATE highlighted equity and legitimacy considerations but lacked a structured format. Overall, most tools demonstrated benefits in promoting internal consistency, transparency, and stakeholder engagement; however, their adoption remains limited, especially in low- and middle-income countries. Conclusions: Process-focused DSMs offer promising avenues for enhancing transparency, consistency, and legitimacy in pharmaceutical policy. Further exploration is needed to standardize evaluation approaches and expand the use of DSMs in diverse health systems. Full article

Background: Physical activity (PA) is associated with lower mortality and cancer recurrence risks. Although evidence shows health benefits for cancer patients before, during, and immediately after treatment, PA recommendations are not regularly included in the standard care. Objective: The study aimed to identify perceived knowledge, barriers, and facilitators of oncology providers’ PA promotion for cancer patients using the 5A (Assess, Advise, Agree, Assist, and Arrange) framework. Methods: A qualitative research design with a phenomenological approach was adopted. A purposive sample of 16 oncology care providers in Nebraska participated in semi-structured interviews via Zoom/phone. Interviews were audio-recorded, transcribed, and imported into MAXQDA 2024 for thematic analysis. Results: Analysis of the qualitative data identified five themes: (i) Broad and inclusive conceptualizations of PA among oncology care providers suggested that they were able to define PA; (ii) Current Practices in PA Counseling included advising on PA and assessment; (iii) Barriers to PA counseling included lack of guideline awareness, insufficient training, low prioritization, uncertainty about responsibility, time constraints, limited resources, lack of referral systems, patient health conditions, and environmental factors; (iv) Facilitators were identified as acknowledged health benefits for cancer survivors, awareness of PA recommendations, access to community resources, and support from interdisciplinary teams; and (v) Expressed desire among oncology care providers for training on incorporating PA into oncology care. Conclusions: Oncology providers recognized PA’s health benefits for cancer survivors but did not promote it due to inadequate knowledge of guidelines and lack of resources. These barriers require improved PA counselling education to help providers incorporate PA into clinical care. Full article

Background: The UK Department for Digital, Culture, Media, and Sport (DCMS) grassroots concussion guidance, May 2023, advised that all community-based sport-related concussions (SRCs) be diagnosed by a healthcare practitioner. This may require that general practitioners (GPs) diagnose and manage SRCs. Diagnosing SRCs in primary care settings in the United Kingdom (UK) presents significant challenges, primarily due to the lack of validated tools specifically designed for general practitioners (GPs). This scoping review aims to identify diagnostic and management tools for SRCs in grassroots sports and primary care settings. Aims: To identify tools that can be used by GPs to diagnose and manage concussions in primary care, both adult and paediatric populations. Design and Methods: A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScRs). Five databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, Google Scholar) were searched from 1946 to April 2025. Search terms included “concussion”, “primary care”, and “diagnosis”. Studies that discussed SRCs in community or primary care settings were included. Those that exclusively discussed secondary care and elite sports were excluded, as well as non-English studies. Two reviewers independently screened titles, abstracts, and full texts, with a third resolving any disagreements. Data were extracted into Microsoft Excel. Studies were assessed for quality using the Joanna Briggs critical appraisal tools and AGREE II checklist. Results: Of 727 studies, 12 met the inclusion criteria. Identified tools included Sport Concussion Assessment Tool 6 (SCAT6, 10–15 min, adolescent/adults), Sport Concussion Office Assessment Tool 6 (SCOAT6, 45–60 min, multidisciplinary), the Buffalo Concussion Physical Examination (BCPE, 5–6 min, adolescent-focused), and the Brain Injury Screening Tool (BIST, 6 min, ages 8+). As part of BCPE, a separate Telehealth version was developed for remote consultations. SCAT6 and SCOAT6 are designed for healthcare professionals, including GPs, but require additional training and time beyond typical UK consultation lengths (9.2 min). BIST and BCPE show promise but require UK validation. Conclusions: SCAT6, SCOAT6, BIST, and BCPE could enhance SRC care, but their feasibility in UK primary care requires adaptation (e.g., integration with GP IT systems and alignment with NICE guidelines). Further research is required to validate these tools and assess additional training needs. Full article

Co(II) complexes have shown promising applications as single-molecule magnets (SMMs) in quantum computing and structural biology. Deciphering the Co(II) complexes may facilitate the development of SMM materials. Structural optimizations and calculations of chemical and magnetic properties were performed for Co(II) complexes with a tripodal tetradentate phenolate-amine ligand using MP2/aug-cc-pvdz, MP2/Def2svp, and CASSCF/Def2svp methods. The Second Order Perturbation Theory Analysis of Fock Matrix in NBO Basis unravels that Co(II) ions form unusual coordinate quasi-double bonds with ligand oxygen donor atoms, and the bond strengths range from 142.01 kcal/mol to 167.36 kcal/mol but lack further spectrometric evidence. The average 151.70 kcal/mol of the Co(II-O coordinates quasi-double bonds are formed mainly by two lone pairs of electrons from the ligand phenolate donor oxygen atoms. Dispersion forces contribute 24%, 28%, 27%, and 31% to the Co(II)-ligand interaction. Theoretical results of ZFS D, transversal ZFS E, and g-factor agree well with the experimental values. Magnetic susceptibility parameters calculated based on 5 doublet roots account for 85% of results computed 40 doublet roots are specified. These insights may aid in the rational design of SMM materials and Co(II) porphyrin fullerene conjugate for CO₂ electroreduction with superior magnetic properties. Full article

In 2023, the Polish Society of Gynecologic Oncology (PSGO) published clinical recommendations for the diagnosis, treatment, and care of women with endometrial cancer (EC), developed using the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. A 2025 update was initiated in response to new evidence, particularly regarding systemic therapies for metastatic, advanced, or recurrent EC, and the introduction of an updated FIGO classification. A targeted literature review identified relevant phase III clinical trials and systematic reviews, including RUBY, GY-018, AtTend, and DUO-E. These trials were critically assessed by an Expert Panel in accordance with the AGREE II methodology. Updated recommendations were formulated based on this evidence, with a comparative analysis of the old and new FIGO staging systems and visual updates to treatment pathways. Key changes include the addition of immunotherapy (I/O) plus chemotherapy (CHTH) as first-line treatment for all molecular subtypes of high-grade endometrioid and non-endometrioid carcinomas, replacing chemotherapy alone. For MMRp-positive cases, the 2025 version introduces the use of Olaparib alongside Durvalumab and CHTH. HER2-positive MMRp serous carcinoma remains eligible for trastuzumab in combination with CHTH. Second-line treatment guidance remains unchanged for patients who did not receive I/O plus CHTH initially. However, options for those previously treated with this combination are still under evaluation. This update ensures alignment with the latest international standards and reinforces evidence-based, personalized care for EC patients. Full article

Background: Aortic dissection is a life-threatening condition where emergent surgical repair is the standard of care. However, despite operative intervention, mortality is 10–15% in all patients. Objective markers to distinguish when surgical repair is more beneficial versus being futile are warranted. Currently, no such known measures are widely agreed upon. Since most complications from aortic dissection stem from malperfusion, serum lactate is thought to be a surrogate marker for malperfusion. This scoping review aims to examine the preoperative predictive value of lactate or lactate dehydrogenase (LDH) in assessing postoperative mortality in patients undergoing surgical repair for acute Stanford Type A aortic dissection (ATAAD). Methods: PubMed was searched for the following search terms: “Dissection, Ascending Aorta”, “Dissection, Thoracic Aorta”, or “Aortic Dissection”. Prospective and retrospective randomized controlled trials, case reports, and cohort studies were included in the initial search. Studies were first screened for inclusion of preoperative lactate or LDH level with a search of “lac” or “LDH”. Included studies consisted of patients aged 18 or older diagnosed with Stanford Type A/Debakey Type I and II aortic dissection with reported preoperative lactate or LDH levels and postoperative mortality treated within 14 days of symptom onset. Preoperative laboratory values were measured from samples collected prior to patient transfer to the operating room or before utilization of ECMO intraoperatively. Results: A comprehensive database search identified a total of 4722 articles. After a rigid screening process, 46 studies fit the inclusion criteria. These papers reported a combined 4696 participants with either preoperative lactate or LDH levels and postoperative mortality. The mean preoperative lactate level was 2.4 mmol/L, whereas the LDH level was 424.9 U/L. Postoperative mortality was 16.51%. Average creatinine, BUN, platelets, INR, PT, PTT, and hemoglobin were all within normal lab analysis limits. Conclusions: Neither lactate nor LDH should be used as a solo predictor of postoperative mortality after ATAAD due to lack of consensus on the cut-off values. Accompanying clinical signs, lab abnormalities, and radiographic findings taken together may be better predictors of prognosis. Full article

The rechargeable zinc-iodine (Zn-I₂) battery is a promising energy storage system due to its high theoretical capacity, low cost, and safety. So far, most researchers agree that the poor electrical conductivity of iodine and the shuttling of polyiodide lead to a rapid decrease in capacity and low coulombic efficiency (CE) during cycling, which seriously hinders their further development and application. Herein, to understand the polyidide shuttling effects in Zn-I₂ battery, we utilize I₃⁻/I⁻ electrolytes as the active capacity source coupled with carbon cloth, devoid-of-iodine (I₂) loading cathode, to simulate the behavior of the shuttling of polyidide in the Zn-I₂ battery, based on the concept of a dual-ion battery system. Experiments show that these batteries exhibit a specific capacity of 0.24 mAh·cm⁻² at 1.0 A·cm⁻² and 0.2 mAh·cm⁻² at 20 A·cm⁻², corresponding to 1.0~1.3 mg active mass of I₂, based on the 2I⁻/I₂ redox couple (221 mAh·g⁻¹). It is noteworthy that the inclusion of polyiodide enhances the electrochemical and redox activity, which is advantageous for electrochemical performance; however, it is limited to the polyiodine reduction on the Zn surface (Zn + I₃⁻ → 3I⁻ + Zn²⁺). Full article

The living gymnosperms include about 1200 species in five major groups: cycads, ginkgo, gnetophytes, Pinaceae (conifers I), and cupressophytes (conifers II). Molecular phylogenetic studies have yet to reach a unanimously agreed-upon relationship among them. Moreover, cytonuclear phylogenetic incongruence has been repeatedly observed in gymnosperms. We collated a comprehensive dataset from available genomes of 17 gymnosperms across the five major groups and added our own high-quality assembly of a species from Podocarpaceae (the second largest conifer family) to increase sampling width. We used these data to infer reconciled nuclear species phylogenies using two separate methods to ensure the robustness of our conclusions. We also reconstructed organelle phylogenomic trees from 42 mitochondrial and 82 plastid genes from 38 and 289 gymnosperm species across the five major groups, respectively. Our nuclear phylogeny consistently recovers the Ginkgo–cycads clade as the first lineage split from other gymnosperm clades and the Pinaceae as sister to gnetophytes (the Gnepines hypothesis). In contrast, the mitochondrial tree places cycads as the earliest lineage in gymnosperms and gnetophytes as sister to cupressophytes (the Gnecup hypothesis) while the plastomic tree supports the Ginkgo–cycads clade and gnetophytes as the sister to cupressophytes. We also examined the effect of mitochondrial RNA editing sites on the gymnosperm phylogeny by manipulating the nucleotide and amino acid sequences at these sites. Only complete removal of editing sites has an effect on phylogenetic inference, leading to a closer congruence between mitogenomic and nuclear phylogenies. This suggests that RNA editing sites carry a phylogenetic signal with distinct evolutionary traits. Full article

This paper shows the fabrication of a new environmentally friendly sensor, an activated glassy carbon electrode with an in situ deposited bismuth film (aGCE/BiF), to determine Cd(II) and Pb(II) at the nanotrace level. The electrochemical activation of the GCE surface was achieved in a solution of 0.1 M phosphate-buffered saline (PBS) of pH = 7 by performing five cyclic voltammetric scans in the range of −1.5–2.5 V at ν of 100 mV/s. The newly developed electrode provides several advantages, such as an increased electron active surface (compared to the glassy carbon electrode) and improved electron transfer kinetics. As a result, the new voltammetric procedure (square-wave anodic stripping voltammetry, SWASV) was established and optimized. With the SWASV method, the following calibration curves and low detection limits (LODs) were obtained for Cd(II) and Pb(II), respectively: 5–100 nM, 0.62 nM, 2–200 nM, and 0.18 nM. The newly prepared method was used to determine the amounts of Pb(II) and Cd(II) in the certified reference material, and the results agreed with the certified values. Moreover, the procedure was successfully applied to determine the Cd(II) and Pb(II) in river samples. The official and standard addition methods validated the measurement results. Full article