Search Results (3,359)

Hedgehogs are small omnivorous mammals prevalent across Europe, Asia, and Africa. The expanding intrusion of humans into hedgehog habitats and rising popularity of keeping exotic animals like hedgehogs as pets have disrupted the delicate balance of the human–animal–environment interface. Despite their ecological importance, hedgehog-borne flea species have received limited research attention, with most studies focusing on their vectorial role, and except one report, nothing on the species composition and genetic diversity of hedgehog flea specimens. An inventory and phylogenetic investigation, conducted for the first time in Algeria as well as in North Africa, allowed for collecting 45 hedgehogs (15 males and 30 females) and 303 fleas, and analyzing them through morphological and molecular approaches. The hedgehog specimens were subjected to macro- and microscopic examinations based on diagnostic morphological criteria and morphometric measurements, resulting in their identification as Atelerix algirus. This study represents the first report of this species’ prevalence in Djelfa. The ecological and geographical diversity of the studied areas, from arid deserts to humid regions, highlights the adaptability and resilience of A. algirus to diverse habitats. Additionally, 271 and 32 flea specimens were morphologically identified as Archaeopsylla erinacei and Ctenocephalides felis, respectively. Molecular examination targeting ITS1-rDNA further confirmed the morphological identification of fleas species. Phylogenetic analysis of fleas’ ITS1-rDNA sequences revealed heterogeneity, with the specimens clustering into two distinct clades. The first clade comprised two populations of A. erinacei, while the second clade included C. felis specimens of this study, grouped with homologous sequences from various regions worldwide. No correlation between flea species and geographical locations was observed demonstrating the sympatric distribution of flea specimens in the studied regions. In addition, no hybrid or genetic combination notion was observed among the flea specimens processed in this study compared with those coming from other countries. These findings contribute to our understanding of the species composition and distribution of hedgehogs and their flea ectoparasites in Algeria and provide a baseline for future epidemiological and entomological research in the country. Full article

Despite the plethora of digital and technological advances made in the construction industry over the past three decades, at its core, the sector remains human-centric. Consequently, this research investigates the core soft skills employed on public linear infrastructure (PLI) projects (during the construction phase) that are digitally enabled and concludes with the development of a decision support tool for PLI project team management. A mixed philosophical stance is implemented using interpretivism, postpositivism and grounded theory together with abductive reasoning to examine subject matter experts’ perceptions of the phenomena under investigation. Textual analysis is then utilised to formulate a decision support tool as a theoretical construct. The research findings demonstrate that communication, leadership and creativity/curiosity are the three main soft skills required of PLI projects. Furthermore, the key elements of a decision support tool—namely, trackable and measurable data, clear objectives and success criteria, and an easy-to-understand visual format—were identified. Such knowledge provides a strong base for building an emotionally intelligent project team. This research constitutes the first attempt to understand the essential soft skills required on PLI projects and, premised upon this, generate a decision support tool for project management in teams that helps to augment project performance through workforce investment via a learning organisation. Full article

With the intensification of aging populations and economic development, installing elevators in existing residential buildings has become crucial for achieving SDG 11 (Sustainable Cities and Communities). While elevator retrofits improve accessibility, they may also compromise living quality through obstructed ventilation, reduced daylighting, visual interference, and noise pollution. Despite provincial guidelines in China specifying elevator types for retrofitting, the lack of clear selection criteria complicates implementation. This study addresses the challenge of scientifically selecting elevator types that balance accessibility improvements with minimal impact on residential environments. Focusing on 50 operational elevator retrofits in eight Beijing communities employing eight half-landing elevator models from the Beijing Multi-story Residential Elevator Retrofit Guidelines, we establish a comprehensive evaluation framework integrating objective measurements (indoor ventilation, noise, daylighting, and external visibility) and subjective resident assessments. Taking Xicheng District’s Yutaoyuan Community as a case study, this research identifies the optimal elevator configuration through a multi-criteria analysis. The proposed methodology offers two key contributions: (1) a practical elevator selection system providing technical and theoretical support for nationwide retrofitting projects, and (2) a quantifiable assessment tool aligning with the 2030 Sustainable Development Agenda for urban renewal objectives. Full article

Background and Objectives: Realistic surgical simulation models are essential for neurosurgical training, particularly in glioma resection. We developed a patient-specific simulation model designed for fluorescence-guided glioma resection, providing an anatomically accurate and reusable platform for surgical education. While insular gliomas were used as an example, the model can be adapted to simulate gliomas in other brain regions, making it a versatile training tool. Methods: Using open-source 3D software, we created a digitally reconstructed skull, brain, and cerebral vessels, including a fluorescent insular glioma. The model was produced through additive manufacturing and designed with input from neurosurgeons to ensure a realistic and reusable representation of the Sylvian fissure and bone structures. The simulator’s educational effectiveness and usability were evaluated by two senior physicians, four assistant physicians, and six medical students using actual microsurgical instruments. Assessments were based on subjective and objective criteria. Results: Subjective evaluations, using a 5-point Likert scale, showed high face and content validity. Objective measures demonstrated strong construct validity, accurately reflecting the participant’s skills. Medical students and resident neurosurgeons showed marked improvement in their learning curve over three attempts, with progressive improvement in performance. Conclusions: This simulation model addresses advanced neurosurgical training needs by providing a highly realistic, cost- effective, and adaptable platform for fluorescence-guided glioma resection. Its effectiveness in enhancing surgical skills suggests significant potential for broader integration into neurosurgical training programs. Further studies are warranted to explore its applications in different glioma localizations and training settings. Full article

Facial nerve injury (FNI) induces complex molecular and cellular responses, with reactive oxygen species (ROS) and free radicals (FRs) playing pivotal roles in nerve degeneration and regeneration. However, to date, no systematic review has specifically investigated the involvement of ROS and FRs in FNI. To address this unmet need, we reviewed the literature on the subject, comprehensively searching SCOPUS, PubMed, Cochrane Library, EMBASE, and Google Scholar to identify studies that assessed the roles of FRs and ROS in FNI and summarize their findings. A total of 15 studies that satisfied search criteria were identified. Key findings showed that excessive ROS and FR lead to mitochondrial dysfunction, lipid peroxidation, and ferroptosis, exacerbating nerve degeneration after facial nerve injury. These effects are modulated by antioxidants, including alpha-lipoic acid, edaravone, N(ω)-nitro-L-arginine methyl ester (L-NAME), glutathione peroxidase 4, glutathione, methylprednisolone sodium succinate, Si-based agents, superoxide dismutase, and tirilazad mesylate. The insights gained from this review suggest that levels of FRs and ROS are strongly associated with the pathophysiology of facial nerve injury and underscore the therapeutic potential of targeting ROS and FR pathways in facial nerve injuries. Full article

Background/Objectives: Periodontitis is an inflammatory disease associated with many systemic disorders such as diabetes and cardiovascular disease. The aim was to evaluate the usefulness of the CDC/AAP and the EFP/AAP criteria to detect subclinical atherosclerosis in subjects with diabetes and severe periodontal disease. Methods: This was a cross-sectional study. Atheroma plaque was evaluated by high-resolution carotid and femoral ultrasonography. A dental examination protocol was implemented by a trained periodontist. A full-mouth periodontal clinical examination was carried out at six sites by automated computerized Florida Probe Periodontal Probing. Periodontal disease was defined by CDC/AAP and EFP/AAP criteria. Results: In total, 98 patients were included (60.2% women), of which 50% had diabetes. Subjects with diabetes showed a high prevalence of severe cases of periodontal disease. Both criteria were useful to detect the presence of atheroma plaque only in the presence of diabetes. However, the CDC/AAP criteria had higher correlation with atheroma plaques than EFP/AAP criteria (r = 0.522 vs. r = 0.369, p < 0.001). Conclusions: The CDC/AAP and the EFP/AAP criteria are a useful tool to identify subclinical atherosclerosis in subjects with severe periodontal disease and diabetes. These results show the potential role of the oral healthcare team in the dental office for the identification of subjects with diabetes at risk of developing cardiovascular disease. Full article

Background and Objectives. Our recent systematic review and meta-analysis of all studies on meditation as treatment for PTSD (61 studies) found a moderate effect size of Hedges’s g = −0.67 for post-minus-pre change in symptom scores. Separate tests of the four meditation categories found a large effect size of g = −1.13 for the Transcendental Meditation (TM) technique that is significantly greater than for each other category. The present follow-up used a different method, calculating effects relative to internal controls, to better characterize the effects of this meditation technique. Materials and Methods. Our study followed Prisma guidelines. Major databases, research anthologies, and bibliographies were searched for studies that used TM for treating PTSD, all military and civilian populations, and all age groups. Results. The searches located 15 controlled trials on TM that met the inclusion criteria (longitudinal and reporting sufficient statistics to calculate effect sizes), 1248 subjects total, mean age 40.5 years (range 20.6 to 54.4 years), and 46.9% males (range 0% to 100%). Using the random effects model, the pooled effect across all studies of TM compared to other treatments was g = −1.01, 95% CI = −1.29 to −0.74, p < 0.000000001. One-study removed analysis found that no study reduced the pooled effect to less than −1.0. Funnel plots indicated no risk of bias. TM was non-inferior to prolonged exposure therapy, p = 0.0001, and it worked significantly faster (p = 0.04 at week six). Conclusions. TM produced clinically meaningful reductions in PTSD for civilian and military personnel, young and older adults, and for both men and women. We recommend phase-III multisite studies comparing TM with known first-line treatments for PTSD. Full article

Pruning waste (PW) and agricultural timber residue are rarely treated, creating environmental pollution issues. The lack of regulations and environmental control criteria has led to poor ecosystems. In this study, it is proposed to transform PW and turn it from a nuisance into a valuable energy source and other alternative resources under environmental constraints. Current reuse and recycling options include turning the waste into a food source or using it to generate energy, compost, soil fertilizer, and other products. A linear programming model with Boolean variables and a management model are defined and run for the reuse of PW. The management model defines the diverse options for PW reuse in terms of resource recovery. These options depend, to a considerable extent, on the country’s production capacity and the preferred applied alternatives. The country of Israel is split into separate regions, which are classified according to the preferred alternatives for PW treatment and reuse. These alternatives include factors such as the annual amounts of trash generated, transportation expenses, energy demands, and requirements based on annual and daily needs. An optimization model (based on operations research methods) is defined, solved, and subjected to a series of constraints. The goal of the study is to find out the best location for PW treatment facilities and optimal recycling product technology using linear programming software with Boolean variables. The results show that a net profit of approximately 3.5 million USD/year for a total community of close to 10 × 10⁶ residents could be derived from the amounts of waste, including improved environmental control, in addition to the additional energy source. This work raises an urgent need to control and regulate recycling policies for PW in various environmental regions worldwide. Full article

The etiology of acute myeloid leukemia (AML) is complex, including genetic and environmental abnormalities. The immune system anomalies play an essential role in the process of leukemogenesis. However, the immunopathological factors, including abnormal T helper (Th) subsets, contributing to the initiation and progression of this neoplasm, require further investigation. Considering the previously mentioned data, we decided to study the expression pattern of transcription factors T-bet, Foxp3, and RORγt that regulate Th1, Treg, and Th17, respectively, in acute myeloid leukemia with correlation to clinical and other investigation data and treatment outcomes. This study was conducted on 80 newly diagnosed patients with AML recruited from the National Cancer Institute, Cairo University, and 25 healthy control subjects. The AML patient cohort consisted of 30 females (37.5%) and 50 males (62.5%), ranging from 18 to 74 years old. The control group was 8 females (32%) and 17 males (68%), with ages ranging from 23 to 40 years old. Samples were provided from the bone marrow of donor cases for allogeneic bone marrow transplantation. The diagnosis of acute myeloid leukemia was based on morphologic and cytochemical evaluation, immunophenotyping, and complementary cytogenetics according to WHO criteria. Upshift from the normal T-bet intensity of power (MFI), RORγt⁺ CD4⁺ T lymphocyte frequency (%) with downshift from the normal FOXP3 intensity of power (MFI), may suggest a state of inflammation. In contrast, an upshift from the normal FOXP3⁺ CD4⁺ T lymphocyte frequency (%) may reflect a state of immunosuppression in the bone marrow microenvironment of AML. Combined, they constitute a sophisticated scenario of immunological disorder in AML. Co-expression of T-bet and RORγt transcription factors in CD4⁺ T lymphocytes in both normal and AML groups may suggest CD4⁺ T lymphocyte plasticity. Full article

Background/Objectives: This double-blinded study aimed to evaluate the clinical performance of a giomer restorative material in comparison to a nanotechnology-based restorative system for the restoration of non-carious cervical lesions over a period of 48 months. Methods: A 48-month randomized, controlled, split-mouth trial was conducted with 49 subjects at its baseline, which was reduced to 34 subjects at follow-up, yielding a statistical power of 69.55%. Cervical lesions were restored using either BEAUTIFIL II LS (BL) or 3M/ESPE Filtek Supreme Universal Restorative (FS). Clinical assessments were performed by blinded examiners, excluding the one who placed the restorations. Evaluations were based on the Hickel criteria, covering esthetic, functional, and biological properties, with comparisons made using the Wilcoxon signed-rank test. Results: Hickel scores were analyzed with the Mann–Whitney U test to compare BL and FS groups within subjects. Changes in median Hickel scores, sensitivity, and the gingival index were assessed via Friedman’s test, followed by Wilcoxon signed-rank tests with a Bonferroni correction for post-hoc comparisons. The p-values under 0.05 were considered significant, except with the Bonferroni correction. Statistical analysis showed no significant differences between materials across most Hickel parameters (p > 0.05), though BL exhibited a trend of better surface staining (76.5% excellent with BL vs. 76.5% excellent with FS) and adjacent mucosa, while FS showed slight advantages in surface luster and color match. Conclusions: The clinical evaluation of restorations for non-carious cervical lesions using giomer and nanotechnology-based restorative systems revealed no statistically significant differences according to the Hickel criteria, indicating a similar clinical performance for both restorative materials. Full article

Objectives: The term ‘prosthesis’ in reference to breast implants is used to clarify its distinction from the general term ‘breast implant’, which is widely adopted by plastic surgeons. This terminology highlights the role of the implant as a functional tissue substitute, particularly in post-mastectomy reconstruction, rather than solely as a cosmetic enhancement. This distinction is relevant for understanding the long-term implications of implant-based reconstruction and the associated complications. The aim of this systematic review was to compile and analyze the current evidence on the long-term complications associated with breast implants. We explored how these complications vary depending on implant type, surgical techniques, patient-specific factors, and the indication for implantation (cosmetic vs. reconstructive). These indications were analyzed separately to avoid assumptions regarding their correlation with surgical techniques. Methods: A systematic search was conducted across PubMed, Web of Science, and Scopus for studies published up to December 2024, following PRISMA 2020 guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. An initial search identified 1480 studies. After screening and applying inclusion criteria, 11 studies were selected for the final analysis. Studies included in this review reported long-term complications in human subjects, were published in English, and evaluated breast implants. The quality of the included studies was assessed using the ROBINS-E tool. Additionally, subgroup analyses examined differences based on implant type (silicone vs. saline), surgical techniques, and patient characteristics, such as age, comorbidities, and the duration of follow-up. Results: This review study was performed between September 2024 and December 2024. A total of 11 studies were included in the review. The included studies were published between 1997 and 2021, providing a long-term perspective on breast implant complications. The most frequently reported complications were capsular contracture, implant rupture, seroma, and infection, with capsular contracture being the most prevalent. Silicone implants were associated with a higher risk of rupture compared to saline implants. Techniques using textured implants and dual-plane placements were found to reduce the incidence of capsular contracture. Patient-related factors, such as age and smoking status, were identified as significant risk factors for complications, while longer follow-up periods revealed more late-onset complications. Conclusions: This review underscores the importance of understanding the long-term risks of breast implants and highlights the need for personalized surgical planning and thorough follow-up care. Future studies should focus on standardizing outcomes reporting and further evaluating the safety and effectiveness of new implant materials and surgical approaches. Full article

Background: Ultrasonography is essential for diagnosing endometrial pathologies, such as hyperplasia, polyps, and endometrial cancer. The International Endometrial Tumor Analysis (IETA) group provides guidelines for using ultrasound to assess endometrial thickness, texture, and irregularities, aiding in the diagnosis of these conditions. The aim of this study was to evaluate the utility of various endometrial morphological features, as assessed by gray-scale ultrasound, and endometrial vascular features, as assessed by power Doppler ultrasound, in differentiating benign and malignant endometrial pathologies. A secondary objective was to compare the effectiveness of these ultrasound techniques in assessing myometrial invasion. Methods: A total of 162 women, both pre- and postmenopausal, with or without abnormal vaginal bleeding were enrolled in a prospective study. All participants underwent transvaginal gray-scale and color Doppler ultrasound examinations, conducted by examiners with over 15 years of experience in gynecological ultrasonography. Endometrial morphology and vascularity characteristics were evaluated based on the IETA group criteria, which include parameters such as endometrial uniformity, echogenicity, the three-layer pattern, regularity of the endometrial–myometrial border, Doppler color score, and vascular pattern (single dominant vessel with or without branching, multiple vessels with focal or multifocal origin, scattered vessels, color splashes, and circular flow). Sonographic findings were compared with histopathological results for comprehensive assessment. Results: The mean age of the study population was 56.46 ± 10.84 years, with a range from 36 to 88 years. Approximately 53.08% of the subjects were postmenopausal. The mean endometrial thickness, as measured by transvaginal ultrasonography, was 18.02 ± 10.94 mm with a range of 5 to 64 mm (p = 0.028), and it was found to be a significant predictor of endometrial malignancy. The AUC for the ROC analysis was 0.682 (95% CI: 0.452–0.912), with a cut-off threshold of 26 mm, yielding a sensitivity of 62.5% and a specificity of 89%. Vascularization was absent in 68.4% of patients with polyps. Among the cases with submucosal myomas, 80% exhibited a circular flow pattern. Malignant lesions were identified in 22.84% of the cases. Subjective ultrasound assessment of myometrial invasion, categorized as <50% or ≥50%, corresponded in all cases with the histopathological evaluation, demonstrating the effectiveness of ultrasound in evaluating myometrial invasion in endometrial cancer. Conclusions: In this study, cystic atrophic endometrium was identified as the most prevalent cause of postmenopausal bleeding. The most significant ultrasound parameters for predicting malignancy included heterogeneous endometrial echogenicity, increased endometrial thickness, and the presence of multiple vessels with multifocal origins or scattered vascular patterns. Additionally, color Doppler blood flow mapping was demonstrated to be an effective diagnostic tool for the differential diagnosis of benign intrauterine focal lesions. Full article

Although the relationship between ESG performance and firm performance has been the subject of several studies, the nonlinear relationship between ESG performance and the corporate performance of insurance companies remains less explored, specifically in the Middle East, North Africa, and Turkey (MENAT) region. Moreover, the moderating effect of institutional quality on this relationship has not been examined. To fill this gap, this paper investigates the nonlinear impact of ESG performance on the financial performance of insurance companies in the MENAT region, as well as the moderating effect of institutional quality. To achieve this, a sample of 31 insurance companies located in the seven MENAT countries was constructed over the period 2017–2022. The sample was selected based on the completeness and availability of ESG-related data. This ensured a standardized dataset to enhance the reliability of the results. To estimate this relationship, the System Generalized Method of Moments (SGMM) was used. This technique was used to address endogeneity issues. The empirical results indicate that the performance of the insurance companies is better for those with better ESG performance. Moreover, the quality of institutions is an even more important factor in enhancing the ESG practices–corporate performance nexus. More in-depth analysis is needed to show how these various relationships might be altered with ESG criteria. The findings of this research would, therefore, be beneficial to insurers in terms of an increased understanding of how effective integration of ESG practices, both at the institutional and company level, could be streamlined to enhance their long-term competitiveness and profitability. Full article

Background/Objectives: Septic arthritis of the temporomandibular joint is an infectious disease with a rapid course and possible long-term complications. It is crucial to diagnose and implement treatment quickly and to know the potential causes of the occurrence of SATMJ. The planned systematic review aims to summarize current knowledge on this subject. Methods: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. The following scientific databases will be searched: ACM, BASE, ClinicalTrials.gov, Cochrane Library, Google Scholar, PubMed, and Scopus. Studies on SATMJ that are consistent with the pre-established PICOTS criteria will be included in the systematic review. Two authors will independently conduct the record screening, data extraction, and quality appraisal phases. The quality of the studies will be evaluated using the JBI critical appraisal tools. Certainty assessment will be conducted using the GRADE tool. The obtained research results and data will be used to define and establish the current scientific position on the diagnosis and treatment of SATMJ. Conclusions on the lack of association of gender, age, and race with the occurrence of this disease entity will be verified, among others. The planned systematic review will be based on extensive searches for studies with no high risk of bias. The aim is to assist clinicians in managing SATMJ, and to inspire future research. Full article

This study explores the use of artificial intelligence and geospatial tools to analyze historical explorers’ narratives. Explorers’ accounts provide valuable insights into the cultural, environmental, and logistical dynamics of exploration journeys. However, traditional methods of analyzing these narratives are often subjective and difficult to reproduce on a large scale. The main objective is to overcome the limitations of traditional methods by using AI techniques to systematically extract and structure information from explorers’ narratives. This study employs Python scripts to extract factual data from narratives available on Project Gutenberg, followed by structuring the data in JSON format. Geographic data are enriched through geocoding using libraries such as Geopy and OpenCage. An interactive web interface based on Leaflet allows for the visualization and validation of explorers’ routes. The results show a concentration of visits in North and West Africa, with traditional modes of transport like caravans and traveling on foot being dominant. The main challenges faced were related to transportation, climatic conditions, and natural obstacles. Principal component analysis (PCA) and correspondence analysis reveal latent structures in the data, while clustering analysis segments the journeys based on similarity criteria. This research demonstrates the value of AI and geospatial tools for a more objective and detailed analysis of explorers’ narratives, opening new perspectives for historical and geographical studies. Full article