Search Results (2,667)

(1) Background: Gestational diabetes mellitus (GDM) is a glucose metabolism disorder that typically develops in the second half of pregnancy, transforming a normal pregnancy into a high-risk condition, with both short- and long-term complications for the mother and the fetus. Achieving optimal glycaemic control during pregnancy is essential for preventing these outcomes and could be realized using continuous glucose monitoring systems (CGMSs). This systematic review aims to evaluate the role of the CGMS as a potential diagnostic aid and predictor of maternal and fetal outcomes in GDM. (2) Methods: Following the PRISMA guidelines (protocol ID: CRD42024559169), we performed a literature search using the terms “(continuous glucose monitoring system OR CGMS) AND (gestational diabetes mellitus OR GDM)” in the PubMed, Web of Science, and Scopus databases. (3) Results: Twelve studies were included, all reporting data on CGMS use in pregnancies complicated by GDM. The data included in our analysis are heterogeneous, the results suggesting that the CGMS may offer several advantages such as improved glycaemic control (by avoiding hyper- and hypoglycaemia), better gestational weight management, timely initiation of pharmacologic treatment, lower rates of preeclampsia, and improved neonatal outcomes. (4) Conclusions: the CGMS offers a more detailed assessment of both maternal and fetal exposure to high glucose levels, which could lead to earlier detection of those at risk for GDM complications and better guide treatment regimens, especially timely pharmacological intervention. While the current data are heterogeneous, reporting both limited or no benefits and superior benefits compared to the classic monitoring, larger longitudinal studies are mandatory to validate these findings and to better refine the role of CGMS in the monitoring and management of GDM. Full article

Background/Objectives: Advanced lung cancer is a highly distressing disease that negatively impacts older adults. Supportive care interventions designed for this population are scarce and often inaccessible due to competing demands and transportation access. We adapted and refined an evidence-based treatment, Self-System Therapy (SST), to address the unmet needs of older adults with advanced cancer. Methods: Guided by principles of implementation science, we conducted patient interviews, focus groups, and user testing to refine our new SST for the lung cancer (SST-LC) protocol. We then conducted a single-arm pilot trial (clinicaltrials.gov NCT04057196) for patients aged 65+ and above with Stage III or IV lung cancer (N = 30). Benchmarks for acceptability, feasibility, and preliminary changes in outcome measures were assessed. Results: Our study met the desired recruitment goals and demonstrated high treatment adherence rates (89%) and satisfaction rates (85%), indicating that SST-LC was feasible and well-received. Participants also showed reductions in distress and depression, and improvements in emotional and functional well-being from baseline to post-intervention, with effects mostly maintained at follow-up. Physical well-being, social well-being, and quality of life showed smaller, non-significant changes. Feedback from participants also suggested that SST enhanced their resilience and ability to cope with cancer-related challenges, but also indicated a preference for fewer sessions. Conclusions: SST for older adults living with advanced lung cancer is feasible and acceptable. Moreover, this supportive care intervention shows promise in addressing psychological distress, emotional well-being, and functional well-being in older adults. Future research will include testing the efficacy of SST in a larger randomized controlled trial. Full article

Livestock-intensive regions in Europe face dual challenges: nutrient surpluses and a high dependency on import of high-protein feedstocks. This study proposes duckweed (Lemnaceae) as a potential solution by recovering nutrients from manure-derived waste streams while producing protein-rich biomass. This study evaluated the performance of duckweed treatment systems at a pig manure processing facility in Belgium. Three outdoor systems were monitored over a full growing season under temperate climate conditions. Duckweed cultivated on constructed wetland effluent showed die-off and low protein content, while systems supplied with diluted liquid fraction and nitrification–denitrification effluent achieved consistent growth, yielding 8 tonnes of dry biomass/ha/year and 2.8 tonnes of protein/ha/year. Average removal rates were 1.2 g N/m²/day and 0.13 g P/m²/day. Growth ceased after approximately 100–120 days, likely due to rising pH and electrical conductivity, suggesting ammonia toxicity and salt stress. Harvested duckweed had a high protein content and a total amino acid profile suitable for broilers, though potentially limiting in histidine and methionine for pigs or cattle. Additionally, promising energy and protein values for ruminants were measured. Although high ash and fibre contents may limit use in monogastric animals, duckweed remains suitable as part of a balanced feed. Its broad mineral profile further supports its use as a circular, locally sourced feed supplement. Full article

The purpose of this study was to design a Pt/TiO₂–ZrO₂ catalytic-based treatment system to remove ethanol and oxygen (O₂) from a gaseous feed stream. The ultimate target application was the conversion of ethanol and O₂ to carbon dioxide (CO₂) and water (H₂O) from a feed stream of CO₂ in a commercial beer brewing operation. Bench-scale reactions were performed at 250 °C and 300 °C, representing two temperatures under practical consideration for a full-scale catalytic reactor. The target gaseous feed stream would be expected to have a relatively low (near-stoichiometric) concentration of O₂, so the effect of O₂ concentration was also studied. On the bench scale, ethanol was completely converted to CO₂ under low flow rate conditions, and the reactions proceeded through volatile and non-volatile reaction intermediates. Results from the bench-scale tests were used to make predictions for designing a pilot-scale catalytic reactor under conditions of high and low O₂ concentration. A pilot-scale reactor was constructed and installed in a commercial brewing facility, and results from testing the pilot-scale reactor are also presented. The pilot-scale system reduced the feed stream ethanol concentrations by 99.9% while concomitantly reducing the O₂ concentrations over the course of a six-day demonstration period without generating unacceptable levels of byproducts. Full article

Acinetobacter baumannii is a Gram-negative, non-motile pathogen commonly associated with healthcare settings. It is capable of causing severe infections, particularly in immunocompromised and critically ill individuals, and is linked to poor clinical outcomes. Infections caused by carbapenem-resistant A. baumannii (CRAB) represent a major public health concern due to limited treatment options and high resistance rates. Several virulence determinants contribute to CRAB’s pathogenicity, including capsular exopolysaccharide (CPS), lipopolysaccharide (LPS), lipooligosaccharide (LOS), efflux pumps, outer membrane proteins (OMPs), pili, metal acquisition systems, two-component regulatory systems (TCSs), and secretion systems (SSs). The dominant resistance mechanism in CRAB involves the production of carbapenemases, most notably oxacillinase-23 (OXA-23) and metallo-β-lactamases (MBLs) such as Verona integron-encoded MBL (VIM) and New Delhi MBL (NDM). Accurate identification of these resistance mechanisms is crucial for guiding effective antimicrobial therapy. Potential treatment options include older agents like polymyxins, ampicillin–sulbactam, high-dose carbapenems, tigecycline, and minocycline, along with newer antimicrobials such as eravacycline, cefiderocol, and aztreonam–avibactam. This review aims to explore the virulence mechanisms and molecular pathogenesis of CRAB, while also presenting recent developments in its epidemiology and available antimicrobial therapies. Full article

Background: Sirolimus is an effective treatment for kaposiform hemangioendothelioma (KHE), a rare vascular tumor in children. However, its immunosuppressive properties raise concerns regarding the safety and efficacy of vaccinations during treatment. This study aims to evaluate the safety and immunogenicity of inactivated and live-attenuated vaccines administered to pediatric KHE patients undergoing sirolimus therapy. Methods: We conducted a prospective study involving 56 KHE children receiving sirolimus who were vaccinated during treatment. Data on vaccine-related adverse events were collected to assess safety. Immunogenicity was evaluated by measuring seroconversion or protective antibody titers against vaccines, including Hepatitis B, DTaP, and MMR. Results: Among 56 catch-up vaccinated children, no serious adverse events related to vaccination were observed. Mild local or systemic reactions occurred in a minority of patients. Serological analysis demonstrated that children with kaposiform hemangioendothelioma (KHE) receiving sirolimus therapy were able to generate and sustain robust protective antibody responses following vaccination. High seroconversion rates and antibody titers were observed for both inactivated vaccines (e.g., hepatitis B and DTaP) and live-attenuated vaccines (e.g., MMR). Protective antibody levels were maintained both within 3 months and beyond 6 months post-vaccination, indicating durable immunogenicity under sirolimus treatment. Conclusions: Vaccination during sirolimus therapy appears to be safe and immunogenic in children with KHE. These findings support the administration of both inactivated and live-attenuated vaccines under appropriate clinical monitoring in this rare patient population. Full article

Background/Objectives: Commonly known as clubfoot, congenital talipes equinovarus (CTEV) is a structural deformity characterized by cavus, adductus, varus, and equinus (CAVE) positioning of the foot. Idiopathic clubfoot requires prompt treatment to achieve functional, pain-free, and aesthetically normal feet. The Ponseti method is a conservative treatment involving serial manipulation, casting, and Achilles tenotomy, which has demonstrated high success rates. The purpose of this study is to report 10 years of experience using the Ponseti method. Methods: A retrospective and follow-up analysis were conducted with 72 patients (118 feet) with idiopathic clubfoot were treated between 2011 and 2023 who met the minimum follow-up requirement of 12 months (mean follow-up: 54.15 months). The severity of deformities was assessed using the Pirani score. Data collection included demographic details, number of casts, tenotomy procedures, adherence to the Denis Browne brace protocol, and complications. Results: Initial correction of deformities was achieved in all 91 patients (100%). Outcomes were measured using the Ponseti functional scoring system. The average number of casts applied was 9.51 per patient. Percutaneous Achilles tenotomy was performed in 91.21% of cases. Relapse occurred in 22.2% of patients, which required additional treatments. The outcomes were excellent in 77.7% of cases, good in 13.88%, fair in 6.94%, and poor in 1.38%. Discussion: The Ponseti method is effective for idiopathic clubfoot treatment and achieves high rates of initial correction, favorable mid-term outcomes, and minimal complications. These results confirm its reliability and align with previously reported success rates. Full article

Background/Objectives: Leishmania spp. are protozoan parasites transmitted by female sandflies (Phlebotomus or Lutzomyia). Clinical manifestations depend on species and host immunity. While cutaneous and visceral forms prevail, mucocutaneous involvement—particularly isolated nasal septum leishmaniasis—is rare and frequently misdiagnosed as an inflammatory, infectious, or neoplastic condition. Risk factors associated with mucocutaneous leishmaniasis include systemic or local immunodeficiency, prior renal transplantation, treatment with chronic inhaled steroids, residence in endemic areas or travel to such regions, and previous Leishmania infections. Immunosuppressed patients are at higher risk for atypical presentations and delayed diagnosis, which can result in extensive tissue destruction. Early clinical suspicion, histopathological confirmation, and prompt therapy are essential to prevent permanent mucosal damage. Therefore, a multidisciplinary approach is needed for adequate evaluation and effective treatment. Methods: A 67-year-old man with rheumatoid arthritis on methotrexate reported a two-year history of right-sided nasal obstruction and ulceration that failed to respond to antibiotics. He did not present systemic symptoms. Results: Facial CT revealed a septal deviation; the patient underwent septoplasty, and biopsy confirmed Leishmania amastigotes. Serology (rK39 immunochromatographic test) was positive. He was treated with liposomal amphotericin B at 4 mg/kg/day for five days, followed by miltefosine at 100 mg/day orally for 14 days. At an eight-week follow-up, the nasal mucosa was fully healed, obstruction was resolved, and there was no evidence of recurrence. Conclusions: Although nasal septum leishmaniasis is uncommon, it should be considered in the differential diagnosis of chronic nasal lesions, especially in immunocompromised patients or those from endemic regions. Definitive diagnosis requires biopsy with histological or molecular confirmation. Combined liposomal amphotericin B and miltefosine therapy yields high cure rates and prevents mucosal destruction. Early recognition is critical to avoid diagnostic delays and long-term sequelae. Full article

Introduction and Aims: Androgen deprivation therapy (ADT) with systemic anti-cancer treatment (SACT) ± palliative radiotherapy (pRT) is the current standard of care for Oligo-metastatic hormone-sensitive prostate cancer (o-mHSPC). Cytoreductive radical prostatectomy (cRP) has gained interest in this group of patients, with potential benefits including reduced tumour burden and a lower risk of local events from disease progression. In this review, we compare both survival outcomes and local event rates between cRP and upfront ADT ± SACT. Methods: All randomised trials and observational studies comparing cRP with standard treatment (ST), which we defined as ADT ± SACT for o-mHSPC, were included in the review. The study protocol was registered in PROSPERO (CRD42024516586), and the review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The databases searched included Embase, Medline, Cochrane Library, PubMed, and Web of Science. A risk of bias assessment was performed for the included studies as recommended by the Cochrane Handbook of Systematic Reviews and Interventions. The primary outcome measures were Overall Survival (OS), Cancer-Specific Survival (CSS), Progression-free Survival (PFS), Castrate-resistant Prostate Cancer-free Survival (CRPC-FS), and local complication rates. The secondary outcome measures were complication rates and functional outcomes post-cRP. Results: A total of 5130 studies were identified for this review (5119 by database searching and 11 through manual searching). Eight studies were included in the review, comprising 611 patients. cRP was identified to have superior OS (HR: 0.56 (95% CI: 0.34–0.92), I² = 0%, p = 0.02 (very low certainty)) and CSS (HR: 0.27 (95% CI: 0.15–0.47), I² = 0%, p < 0.0001 (very low certainty)). The PFS (HR: 0.67 (95% CI: 0.34–1.33), I² = 58%, p = 0.25 (very low certainty)) and CRPC-FS (HR: 0.67 (95% CI: 0.32–1.43), I² = 57%, p = 0.30 (very low certainty)) were similar between the two groups. The rates of local events were significantly lower in patients undergoing cRP (RR 0.27 (95% CI: 0.13–0.59), I² = 17%, p = 0.001 (low certainty)). The rates of Clavien–Dindo (CD) grade 3 or higher complications ranged from 0% to 13.1%. Additionally, the reported continence rates ranged from 81.5% to 91.3%. The review is limited by the lack of a uniform definition for o-mHSPC and the predominance of low-quality, heterogeneous studies. Despite mitigation strategies, the overall certainty of evidence remains very low per GRADE assessment. Conclusion: cRP significantly reduces local event rates compared with ST and offers comparable PFS and CFPC-FS, with superior OS and CSS in the cRP arm compared to the ST arm in patients with o-mHSPC. However, there is a paucity of high-quality literature on this subject. Ongoing randomised controlled trials may soon clarify the role of cRP in the context of o-mHSPC concerning survival benefits. Full article

Mastitis, an inflammatory disease caused by the invasion of various pathogenic microorganisms into mammary gland tissue, is a core health issue plaguing the global dairy industry. The consequences of this disease are manifold. In addition to directly compromising the health and welfare of dairy cows, it also precipitates a substantial decline in lactation function, a precipitous drop in raw milk production, and alterations in milk composition (e.g., increased somatic cell counts and imbalanced ratios of milk protein to fat). These changes result in a marked degradation of milk quality and safety, and in turn, engender significant economic losses for the livestock industry. Therefore, the establishment and implementation of a comprehensive prevention and control system is a key strategy to effectively curb the occurrence of mastitis, reduce its incidence rate, and minimise economic losses. This review systematically explores the complex etiological factors and pathogenic mechanisms of mastitis in dairy cows, and summarises various diagnostic methods, including milk apparent indicators monitoring, pathogen detection, physiological parameter monitoring, omics technologies, and emerging technologies. Furthermore, it undertakes an analysis of treatment protocols for mastitis in dairy cows, with a particular emphasis on the significance of rational antibiotic use and alternative therapies. Moreover, it delineates preventive measures encompassing both environmental and hygiene management, and dairy cow health management. The objective of this paper is to provide a comprehensive and scientific theoretical basis and practical guidance for dairy farming practices. This will help to improve the health of dairy cows, ensure a stable supply of high-quality dairy products, and promote the sustainable and healthy development of the dairy farming industry. Full article

Background/Objectives: Recurrent meningiomas remain difficult to manage due to the absence of effective systemic therapies and comparatively high treatment failure rates, particularly in high-grade tumors. Stereotactic radiosurgery (SRS) offers a minimally-invasive and precise option, particularly for tumors in surgically complex locations. However, the risks associated with re-irradiation, and recent changes in the WHO classification of CNS tumors highlight the need for more personalized and strategic treatment approaches. This systematic review evaluates the safety, efficacy, and clinical considerations for use of SRS for recurrent meningiomas. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature search was conducted using the PubMed, Scopus, and Web of Science databases for studies reporting outcomes of SRS in recurrent, pathologically confirmed intracranial meningiomas. Studies were excluded if they were commentaries, reviews, case reports with fewer than three cases, or had inaccessible full text. The quality and risk of bias of the included studies were assessed using the modified Newcastle-Ottawa Scale. Data on patient and tumor characteristics, SRS treatment parameters, clinical outcomes, adverse effects, and statistical analysis results were extracted. Results: Sixteen studies were included. For WHO Grade I tumors, 3- to 5-year progression-free survival (PFS) ranged from 85% to 100%. Grade II meningiomas demonstrated more variable outcomes, with 3-year PFS ranging from 23% to 100%. Grade III tumors had consistently poorer outcomes, with reported 1-year and 2-year PFS rates as low as 0% and 46%, respectively. SRS performed after surgery alone was associated with superior outcomes, with local control rates of 79% to 100% and 5-year PFS ranging from 40.4% to 91%. In contrast, tumors previously treated with radiotherapy, with or without surgery, showed substantially poorer outcomes, with 3- to 5-year PFS ranging from 26% to 41% and local control rates as low as 31%. Among patients with prior radiotherapy, outcomes were particularly poor in Grade II and III recurrent tumors. Toxicity rates ranged from 3.7% to 37%, and were generally higher for patients with prior radiation. Predictors of worse PFS included prior radiation, older age, and Grade III histology. Conclusions: SRS may represent a reasonable salvage option for carefully selected patients with recurrent meningioma, particularly following surgery alone. Outcomes were notably worse in high-grade recurrent meningiomas following prior radiotherapy, emphasizing the prognostic significance of both histological grade and treatment history. Notably, the lack of molecular and genetic data in most existing studies represents a key limitation in the current literature. Future prospective studies incorporating molecular profiling may improve risk stratification and support more personalized treatment strategies. Full article

Desalination plays a critical role in addressing global water scarcity, yet brine disposal remains a significant environmental challenge. This study evaluates a minimal liquid discharge (MLD) membrane-based system integrating high-pressure reverse osmosis (HPRO) and membrane distillation (MD) for brine treatment, with a focus on the Eastern Mediterranean. A techno-economic assessment (TEA) was conducted to analyze the system’s feasibility, water recovery performance, energy consumption, and cost-effectiveness. The results indicate that the hybrid HPRO-MD system achieves a high water recovery rate of 78.65%, with 39.65 m³/day recovered from MD and 39 m³/day from HPRO. The specific energy consumption is 23.2 kWh/m³, with MD accounting for 89% of the demand. The system’s cost is USD 0.99/m³, generating daily revenues of USD 228 in Cyprus and USD 157 in Greece. Compared to conventional brine disposal methods, MLD proves more cost-effective, particularly when considering evaporation ponds. While MLD offers a sustainable alternative for brine management, challenges remain regarding energy consumption and the disposal of concentrated waste streams. Future research should focus on renewable energy integration, advanced membrane technologies, and resource recovery through brine mining. The findings highlight the HPRO-MD MLD system as a promising approach for sustainable desalination and circular water resource management. Full article

This work investigated the effect of high-nitrogen/low-hydrogen mixed atmosphere heat treatment on the electrochemical corrosion and wear resistance of plasma-sprayed FeCoNiCrAl high-entropy alloy (HEA) coatings. The HEA coatings were sequentially prepared through annealing at 400, 600, and 800 °C for 6 h. The heat treatment method was conducted in a vacuum tube furnace under 0.1 MPa total pressure, with gas flow rates set to 300 sccm N₂ and 100 sccm H₂. The XRD results indicated that the as-deposited coating exhibited α-Fe (BBC) and Al_0.9Ni_4.22 (FCC) phases, with an Fe_0.64N_0.36 nitride phase generated after 800 °C annealing. The electrochemical measurements suggested that an exceptional corrosion performance with higher thicknesses of passive film and double-layer capacitance can be detected based on the point defect model (PDM) and effective capacitance model. Wear tests revealed that the friction coefficient at 800 °C decreased by 3.84% compared to that in the as-sprayed state due to the formation of a dense nitride layer. Molecular orbital theory pointed out that the formation of bonding molecular orbitals, resulting from the overlap of valence electron orbitals of different atomic species in the HEA coating system, stabilized the structure by promoting atomic interactions. The wear mechanism associated with stress redistribution and energy balance from compositional synergy is proposed in this work. Full article

Polymer flooding is an enhanced oil recovery (EOR) technique that improves oil extraction by injecting polymer solutions into reservoirs. However, the disposal and treatment of polymer flooding waste liquids (PFWL) present significant challenges due to their high viscosity, complex molecular structure, and environmental impact. This study investigates the shear-induced degradation of polymer solutions, focusing on rheological properties, particle size distribution, and morphological changes under controlled shear conditions. Experimental results show that shear forces significantly reduce the viscosity of polymer solutions, with shear rates of 4285.36 s⁻¹ in the rotating domain and 3505.21 s⁻¹ in the fixed domain. The particle size analysis reveals a significant reduction in average particle size, indicating polymer aggregate breakup. SEM images confirm these morphological changes. Additionally, numerical simulations using a power-law model highlight the correlation between shear rate, wall shear stress, and polymer degradation efficiency. This study suggests that optimizing rotor–stator configurations with high shear forces is essential for efficient polymer degradation, offering insights for designing more effective polymer waste liquid treatment systems in oilfields. Full article

The tension in the relationship between water and energy seriously restricts the harmonious coexistence between man and the ecological environment. The solar-powered interface evaporation technology emerging in recent years has shown good application prospects in high-salt wastewater treatment for achieving the zero-discharge treatment of wastewater. In this review, advanced solar-driven interfacial evaporation is primarily focused on its mechanisms, photothermal materials optimization, and the structure of solar evaporators for salt removal. The high wide-spectrum solar absorption rate of photothermal materials determines the total energy that can be utilized in the evaporation system. The light-to-heat conversion capacity of photothermal materials directly affects the efficiency and performance of solar interface evaporators. We highlight the microstructures enabled by the nanophotonic designs of photothermal material-based solar absorbers, which can achieve highly efficient light harvesting across the entire solar irradiance spectral range with weighted solar absorptivity. Finally, based on current research, existing problems, and future development directions for high-salt wastewater evaporation research are proposed. The review provides insights into the effective treatment of high-salt wastewater. Full article