Search Results (2,854)

Herpes Simplex Virus (HSV) infections, caused primarily by HSV-1 and HSV-2, are among the most prevalent viral diseases worldwide, with recurrent manifestations that significantly affect quality of life. Therapeutic strategies include both topical and systemic interventions, each with distinct goals. This systematic review was conducted according to PRISMA guidelines. A comprehensive search of PubMed, Scopus, and Web of Science (2005–2025) identified studies evaluating topical or systemic treatments for HSV. Eligible studies included randomized controlled trials and observational studies reporting validated clinical outcomes. Topical treatments, including acyclovir cream, docosanol, and newer formulations, primarily reduce lesion duration and alleviate local symptoms when applied early. These interventions have limited systemic absorption and generally do not influence recurrence frequency. Novel delivery methods and combination strategies, such as acyclovir–hydrocortisone formulations or photodynamic therapy, may enhance local efficacy and symptom control. Systemic Therapies: Systemic antivirals, such as acyclovir, valacyclovir, and famciclovir, target both lesion resolution and recurrence prevention. Evidence from randomized trials supports their use for episodic and suppressive therapy, including short-course, high-dose regimens that improve adherence while controlling symptoms. Systemic therapy is particularly indicated for recurrent, disseminated, or high-risk infections. Topical and systemic therapies serve complementary roles in HSV management. Topical agents are useful for localized or initial episodes, while systemic therapy addresses broader clinical objectives, including recurrence reduction. Future research should focus on mechanism-based therapies, novel delivery systems, and standardized outcome measures to guide personalized treatment strategies. Emerging therapies targeting viral latency, immune modulation, and gene-editing technologies hold promise for long-term suppression and personalized management of HSV infections. Full article

Heparin-based delivery platforms have gained increasing attention in regenerative medicine due to their exceptional affinity for growth factors and versatility in structural and functional design. This review first introduces the molecular biosynthesis and physicochemical diversity of heparin, which underpin its binding selectivity and degradability. It then categorizes the delivery platforms into microspheres, nanofibers, and hydrogels, with detailed discussions on their fabrication techniques, biofunctional integration of heparin, and release kinetics. Special focus is given to stimuli-responsive systems—including pH-, enzyme-, redox-, thermal-, and ultrasound-sensitive designs—which allow spatiotemporal control over growth factor release. The platform applications are organized by tissue types, encompassing soft tissue regeneration, bone and cartilage repair, neuroregeneration, cardiovascular regeneration, wound healing, anti-fibrotic therapies, and cancer microenvironment modulation. Each section provides recent case studies demonstrating how heparin enhances the bioactivity, localization, and therapeutic efficacy of pro-regenerative or anti-pathologic growth factors. Collectively, these insights highlight heparin’s dual role as both a carrier and modulator, positioning it as a pivotal component in next-generation, precision-targeted delivery systems. Full article

Surgical procedures trigger dynamic inflammatory responses that influence postoperative pain, wound healing, and long-term outcomes. Conventional therapies rely on the systemic delivery of anti-inflammatory and analgesic agents, which often lack spatiotemporal precision and carry significant side effects. Inflammation-responsive hydrogels offer a promising alternative by enabling localized, stimulus-adaptive drug release aligned with the evolving biochemical milieu of surgical wounds. These smart biomaterials respond to endogenous triggers, such as reactive oxygen species, acidic pH, and proteolytic enzymes, allowing precise modulation of inflammation and tissue repair. This narrative review outlines the pathophysiological features of perioperative inflammation and the design principles of responsive hydrogel systems, including pH-, reactive oxygen species-, enzyme-sensitive, and multi-stimuli platforms. We evaluated the integration of key payloads, NSAIDs, corticosteroids, α₂-adrenergic agonists, and biologics, highlighting their therapeutic synergy and translational relevance. Preclinical studies across soft tissue, orthopedic, thoracic, and abdominal models have demonstrated the efficacy of these systems in modulating immune responses, reducing pain, and enhancing regeneration. Despite these encouraging results, challenges remain, including trigger fidelity, surgical compatibility, and regulatory readiness. Future advances in biosensor integration, logic-based design, and artificial intelligence-guided formulation may accelerate clinical translation. Inflammation-responsive hydrogels represent a transformative strategy for precise perioperative care. Full article

Objective: The aim of this study is to develop and evaluate the antibacterial and anti-biofilm efficacy of ciprofloxacin-coated tympanostomy tubes (TTs) using a sustained-release varnish (SRV-CIPRO) and introduce a novel tympanic membrane model for preclinical evaluation. Study Design: This was an in vitro experimental study. Setting: This study was conducted in a biofilm research laboratory in an academic medical center. Methods: Sterile fluoroplastic TTs were coated with SRV-CIPRO or placebo varnish. A novel tympanic membrane (TM) model was developed using a layered agar–plastic system. Antibacterial activity, biofilm inhibition, and bacterial viability were assessed through agar diffusion, MTT, ATP quantification, HR-SEM, and SD-CLSM. Results: SRV-CIPRO-coated TTs exhibited sustained antibacterial activity for up to 10 days. Compared to the placebo, SRV-CIPRO significantly inhibited biofilm formation, reduced metabolic activity, and decreased bacterial viability (p < 0.05). Imaging confirmed fewer bacterial colonies on SRV-CIPRO TTs. The TM model allowed realistic testing of tube insertion and infection simulation. Conclusion: SRV-CIPRO-coated TTs offer sustained antibiotic delivery, potentially reducing postoperative otorrhea and biofilm-related complications. The TM model provides a platform for preclinical evaluation of middle ear devices. Full article

Due to increasing demand for the exploration of marine resources, underwater optical wireless sensor networks (UOWSNs) have emerged as a promising solution by offering higher bandwidth and lower latency compared to traditional underwater acoustic wireless sensor networks (UAWSNs), with their existing routing protocols facing challenges in energy consumption and packet forwarding. To address these challenges, this paper proposes an energy-partitioned routing protocol based on an advancement function (EPAR) for UOWSNs. By dynamically classifying the nodes into high-energy and low-energy ones, the proposed EPAR algorithm employs an adaptive weighting strategy to prioritize the high-energy nodes in relay selection, thereby balancing network load and extending overall lifetime. In addition, a tunable advancement function is adopted by the proposed EPAR algorithm by comprehensively considering the Euclidean distance and steering angle toward the sink node. By adjusting a tunable parameter α, the function guides forwarding decisions to ensure energy-efficient and directionally optimal routing. Additionally, by employing a hop-by-hop neighbor discovery mechanism, the proposed algorithm enables each node to dynamically update its local neighbor set, thereby improving relay selection and mitigating the impact of void regions on the packet delivery ratio (PDR). Simulation results demonstrate that EPAR can obtain up to about a 10% improvement in PDR and up to about a 30% reduction in energy depletion, with a prolonged network lifetime when compared to the typical algorithms adopted in the simulations. Full article

Background: Type 1 diabetes (T1D) is an autoimmune disorder characterized by destruction of insulin-producing β-cells. While conventional insulin therapy manages hyperglycemia, it fails to halt autoimmunity. Oral immunotherapy targeting autoantigens like GAD65 offers potential for antigen-specific tolerance; however, its efficacy is limited by gastrointestinal degradation and poor mucosal uptake. Lactococcus lactis (L. lactis), a food-grade delivery vector, enables sustained antigen release and intestinal tract immune modulation, yet the differential transcriptomic mechanisms underlying mucosal versus systemic immune responses remain uncharacterized. Methods: Non-obese diabetic (NOD) mice were randomized into control and GAD65 groups, receiving oral PBS or the GAD65 recombinant L. lactis vaccine, respectively. Fasting blood glucose was monitored weekly. GAD65-specific IgA and IgG, along with immune tolerance-related factors, were quantified using ELISA. Lymphocyte subsets were analyzed by flow cytometry, alongside RNA sequencing and transcriptional profiling. Results: The study demonstrated that the orally administered GAD65-L. lactis vaccine could significantly induce GAD65-specific IgA antibody and TGF-β cytokine and alleviate hyperglycemia and diabetes symptoms in NOD mice. Our study facilitated the induction of GAD65-specific regulatory T cells within both intestinal lamina propria lymphocytes (LPLs) and splenic lymphocytes. Notably, antigen-specific tolerance was mainly observed in intestinal LPLs. Crucially, the immune responses elicited by the vaccine demonstrated significant disparities between intestinal LPLs and splenic lymphocytes, with intestinal LPLs exhibiting unique local immune tolerance transcriptomic profiles. Conclusions: Our findings have enhanced the comprehension of the mechanisms by which oral vaccines influence the interplay between mucosal and systemic immune responses, thereby establishing a foundational framework for the design of oral vaccines. This understanding is instrumental in advancing antigen-specific immune tolerance strategies for autoimmune diseases such as Type 1 Diabetes (T1D). Full article

The growing demand for autonomous and energy-efficient telemetry systems in Industrial Internet of Things (IIoT) applications highlights the limitations of GSM-dependent infrastructure. This research proposes and validates a secure and infrastructure-independent telemetry transmission architecture based on Raspberry Pi and LoRa technology. The system integrates lightweight symmetric encryption (AES-128 with CRC-8) and local data processing, enabling long-range communication without reliance on cellular networks or cloud platforms. A fully functional prototype was developed and tested in real urban environments with high electromagnetic interference. The experimental evaluation was conducted over distances ranging from 10 to 1100 m, focusing on the Packet Delivery Ratio (PDR), Packet Error Rate (PER), and Packet Loss Rate (PLR). Results demonstrate reliable communication up to 200 m and high long-term stability, with a 24 h continuous transmission test achieving a PDR of 97.5%. These findings confirm the suitability of the proposed architecture for secure, autonomous IIoT deployments in infrastructure-limited and noisy environments. Full article

Autonomous driving represents a transformative advancement with the potential to significantly impact daily mobility, including enabling independent vehicle operation for individuals with visual disabilities. The commercialization of autonomous driving requires guaranteed safety and accuracy, underscoring the need for robust localization and environmental perception algorithms. In cost-sensitive platforms such as delivery robots and electric vehicles, cameras are increasingly favored for their ability to provide rich visual information at low cost. Despite recent progress, existing visual–inertial odometry systems still suffer from degraded accuracy in challenging conditions, which limits their reliability in real-world autonomous navigation scenarios. Estimating 3D positional changes using only 2D image sequences remains a fundamental challenge primarily due to inherent scale ambiguity and the presence of dynamic scene elements. In this paper, we present a visual–inertial odometry framework incorporating a depth estimation model trained without ground-truth depth supervision. Our approach leverages a self-supervised learning pipeline enhanced with knowledge distillation via foundation models, including both self-distillation and geometry-aware distillation. The proposed method improves depth estimation performance and consequently enhances odometry estimation without modifying the network architecture or increasing the number of parameters. The effectiveness of the proposed method is demonstrated through comparative evaluations on both the public KITTI dataset and a custom campus driving dataset, showing performance improvements over existing approaches. Full article

This paper explores the complexities of measuring impact from placemaking in the context of public and community housing (sometimes known as social or subsidised housing) in Aotearoa New Zealand. Placemaking refers to a range of practices and interventions—including the provision or facilitation of access to community infrastructure—that seek to cultivate a positive sense of place through everyday experiences, spaces, relationships, and rituals. Drawing on interviews with four community housing providers (CHPs), analysis of their documentation, and tenant survey and interview data from two of those CHPs, this research examines providers’ change theories about placemaking in relation to tenants’ experiences of safety, belonging and connectedness, including access to local amenities, ease of getting around, and a sense of neighbourhood and community affiliation. Based on the importance of these variables to wellbeing outcomes, the study highlights the potential of placemaking to support tenant wellbeing, while also recognising that providers must navigate trade-offs and co-benefits, limited resources, and varying levels of tenant engagement. While placemaking can help to foster feelings of connection, belonging and safety, its impact depends on providers’ capacity to initiate and sustain such efforts amidst competing demands and constraints. The study offers indicative findings and recommendations for future research. Although the impacts of placemaking and community infrastructure provision are difficult to quantify, research findings are synthesised into a prototype framework to support housing providers in their decision-making and housing development processes. The framework, which should be adapted and evaluated in situ, potentially also informs other actors in the built environment—including architects, landscape architects, urban designers, planners, developers and government agencies. In Aotearoa New Zealand, where housing provision occurs within a colonial context, government agencies have obligations under Te Tiriti o Waitangi to actively protect Māori rights and to work in partnership with Māori in housing policy and delivery. This underscores the importance of placemaking practices and interventions that are culturally and contextually responsive. Full article

In dense urban environments and large-scale events, Internet infrastructure often becomes overloaded due to high communication demand. Many of these communications are local and short-lived, exchanged between users in close proximity but still relying on global infrastructure, leading to unnecessary network stress. In this context, delay-tolerant networks (DTNs) offer an alternative by enabling device-to-device (D2D) communication without requiring constant connectivity. However, DTNs face significant challenges in routing due to unpredictable node mobility and intermittent contacts, making reliable delivery difficult. Considering these challenges, this paper presents a hybrid Beyond 5G (B5G) DTN architecture to provide private context-aware routing in dense scenarios. In this proposal, dynamic contextual notifications are shared among relevant local nodes, combining federated learning (FL) and edge artificial intelligence (AI) to estimate the optimal relay paths based on variables such as mobility patterns and contact history. To keep the local FL models updated with the evolving context, edge nodes, integrated as part of the B5G architecture, act as coordinating entities for model aggregation and redistribution. The proposed architecture has been implemented and evaluated in simulation testbeds, studying its performance and sensibility to the node density in a realistic scenario. In high-density scenarios, the architecture outperforms state-of-the-art routing schemes, achieving an average delivery probability of 77%, with limited latency and overhead, demonstrating relevant technical viability. Full article

Background: Evidence of the real-world management of dedifferentiated liposarcoma (DDLPS) is limited by the patient size and coding. The objective of this study is to generate consensus expert opinion on locally advanced or metastatic DDLPS diagnosis, treatment, and unmet needs. Methods: A three-round Delphi consensus panel was conducted with 9 DDLPS clinical experts from November to December 2023. Expert panelists were recruited across academic specialty and traditional settings and US regions. The Delphi panel included two rounds of surveys followed by a consensus building workshop. Surveys contained multiple-choice and free response questions, and statements for level of agreement rating. Panelists rated each statement for level of agreement on a 9-point Likert scale. Statements with ≥75% of scores ≥ 7 achieved consensus, and those that did not achieve consensus agreement were modified or removed from subsequent testing. A virtual workshop was held to discuss areas which did not achieve consensus and refine previously agreed upon statements. Results: In total 25 consensus statements were developed by the Delphi panel. Survey 1 achieved 7 consensus statements across the areas of burden, treatment, and unmet needs of DDLPS. Survey 2 generated an additional 10 consensus statements. During the workshop, eight more statements achieved consensus, and four statements were refined for enhanced clarity and precision. The study findings are limited by the number of Delphi panel participants and consensus statements may not be fully representative of clinician perspectives across the US. Conclusions: Consensus areas identified by the Delphi panel help better understand the decision factors for surgical and non-surgical treatments and anticipated utilization. These results could be used to inform both drug development programs as well as care delivery challenges for liposarcoma patients. Full article

Collagen-based biomaterials are increasingly explored in dentistry for their ability to deliver drugs locally and support healing. In this study, we developed chlortetracycline-loaded collagen sponges aimed at preventing postoperative infections. Five formulations were prepared by lyophilization, each with the same collagen-to-drug ratio but different glutaraldehyde (GA) concentrations: 0%, 0.25%, 0.5%, 0.75%, and 1% (w/w) relative to dry collagen. The sponges were characterized using FT-IR and UV–VIS–NIR spectroscopy, and their swelling capacity, enzymatic stability, and drug release kinetics were evaluated. Antibacterial activity was tested against Escherichia coli, Staphylococcus aureus, and Enterococcus faecalis. Statistical differences between formulations were assessed using one-way ANOVA followed by Tukey’s post hoc test (p < 0.05). All sponges released the antibiotic rapidly within the first 60 min, followed by a sustained release for up to 10 h. The non-crosslinked sponge showed the highest antimicrobial effect, while the 0.25% GA formulation offered a good balance between stability and bioactivity. While higher cross-linking enhanced structural stability, it progressively reduced antimicrobial efficacy, highlighting a crucial design trade-off. These findings underline the need to fine-tune cross-linking conditions to achieve both durability and strong antimicrobial action in collagen-based drug delivery systems for dental applications. Full article

Background/Objectives: Parents report unmet information needs relating to childhood brain tumors. Existing research shows that providing information to families supports self-efficacy and well-being. The project therefore aimed to co-design resources tailored to the informational needs of families navigating childhood brain tumors in Australia. Methods: Mixed methods were used across multiple phases. A landscape analysis in Phase 1 confirmed the gap in Australian resources as well as the identification of international resources suitable to inform local solutions. Following the Double Diamond Design Framework, subsequent phases of the project aimed to discover and define the problems faced by families before developing and delivering the solution. Parents of children with brain tumors participated in a journey mapping workshop, content adaptation through feedback, and an online survey to determine the preferred delivery mode of information. Clinicians provided iterative feedback as the resource was developed and refined. Results: Nine mothers participated in journey mapping and iterative adaptation of the resource along with twelve clinicians. There were 46 respondents to the survey, which identified a preference for multi-modal delivery of information, and 23 clinical and consumer reviewers in the final revision phase. The process of adaptation is presented, providing transparency on the development of this national resource. Conclusions: The use of self-efficacy theory and co-design was pivotal in this project. Integration of concepts from self-efficacy moves beyond simply presenting information to empowering the audience to feel capable of the task ahead of them. Co-design ensured the content and tone of the resulting resource are fit-for-purpose from the perspective of both clinicians and consumers. The resource is available as a physical book, digital resource, and audiobook and disseminated through children’s hospitals, professional networks, and brain tumor support groups. Full article

Azelaic acid (AzA), a saturated dicarboxylic acid, is indicated for the treatment of acne vulgaris, rosacea, melasma, and post-inflammatory hyperpigmentation. Its antimicrobial, anti-inflammatory, and antimelanogenic properties support its use; however, its poor aqueous solubility and limited skin permeability constrain its optimal topical delivery. This review summarizes clinical evidence and advances in formulations—including conventional vehicles, polymeric/lipid nanocarriers, and deep eutectic solvent (DES) systems—to promote more effective and well-tolerated use. Across indications, 15–20% azelaic acid (AzA) formulations produced clinically meaningful improvements with mild, transient local irritation. For acne vulgaris, reductions in inflammatory and noninflammatory lesions were comparable to those of topical retinoids/adapalene, and tolerability was superior in some studies. For rosacea, the 15% gel formulation was comparable to metronidazole in reducing papules, pustules, and erythema while maintaining negligible systemic exposure. In melasma and other dyschromias, 20% cream demonstrated efficacy similar to hydroquinone, exhibiting a favorable safety profile. Advanced delivery systems, including liposomes, niosomes/ethosomes, nanostructured lipid carriers, microemulsions, nanosponges, and DES platforms, increased AzA solubilization, cutaneous deposition, and stability. This enabled dose-sparing strategies and improved adherence. Data on AzA cocrystals and ionic salts suggest additional control over release and irritation. AzA remains a versatile and well-tolerated dermatologic agent whose performance is strongly vehicle-dependent. Rational selection and engineering of carriers, particularly DES-integrated polymeric and lipid systems, can mitigate solubility and permeability limitations, enhance skin targeting, and reduce irritation in the treatment of acne and rosacea. Full article

Background/Objectives: Penile urethral stricture is a therapeutically challenging condition that significantly impacts quality of life and is often managed initially with urethral dilation or internal urethrotomy. However, both techniques are associated with high recurrence rates, limited long-term efficacy, and potential adverse effects, particularly in the penile urethra. Urethroplasty remains the gold standard but is invasive and not suitable for all patients. Optilume, a paclitaxel-coated balloon, combines mechanical dilation with localized drug delivery to reduce recurrence rates and the need for re-intervention. This study evaluated its effectiveness in patients with penile urethral strictures. Methods: A retrospective, multicenter study was conducted at two German clinics. Eight male patients (mean age 59) with symptomatic penile urethral strictures underwent Optilume treatment. Symptom severity was assessed using the International Prostate Symptom Score (IPSS) and quality of life (QoL) scores before and after treatment. The primary endpoint was symptom improvement, while the secondary endpoint was the need for reintervention. Patients were followed for a median of 16.5 months. Statistical analyses included Wilcoxon signed-rank and Mann–Whitney U tests. Results: The median IPSS improved from 25.5 to 5.0 and QoL scores from 4.5 to 1.0 after treatment (p < 0.01 for both). No patients required reintervention during follow-up. The subgroup analysis showed slightly better outcomes in patients without prior interventions, although differences were not statistically significant. The stricture length did not correlate with treatment response. Conclusions: Optilume significantly reduces urinary symptoms and improves QoL in penile urethral strictures, and the absence of re-interventions during follow-up underscores its durable mid-term success. It offers a minimally invasive alternative to urethroplasty, particularly for patients seeking symptom relief with a shorter recovery time and no hospital stay or general anesthesia. These preliminary findings suggest that Optilume may be a promising minimally invasive option for selected patients. Larger, controlled studies are warranted to validate these results and refine patient selection criteria. Full article