Search Results (52,548)

The use of fish skin grafts as xenografts is a promising alternative for wound healing. Several studies have shown fish skin grafts to be a safer and more effective option compared to other alternatives, due to the large amount of fatty acids, including omega-3, which have been proven to promote wound healing. The purpose of this study was to evaluate the efficacy of fish skin grafts as wound dressing. A literature search up to March 2024 was conducted using the electronic databases of PubMed, Cochrane, and ScienceDirect. A total of 158 patients from six studies were included in this systematic review. All studies showed early wound healing using fish skin grafts; one study showed that wound healing was halved compared to paraffin gauze. Complete wound healing using fish skin grafts was noted as early as 30 days. Out of 114 patients treated with fish skin grafts, 1 patient showed signs of infection, and no patients showed allergic reactions. One study also found that fish skin grafts provide satisfactory wound scar quality. This study concludes that fish skin grafts are a great alternative and should be considered in wound treatment. The high omega-3 component that is preserved in fish skin grafts promotes faster wound healing and contains antibacterial agents that prevent infection. However, randomized control trials with a larger sample size are recommended to further assess the efficacy of fish skin grafts. Full article

This study investigates the permeability performance and engineering performance of porous asphalt concrete (PAC) mixtures. PAC-10 and PAC-13 mixture specimens with various porosities were prepared. The relationships among porosity, effective porosity, and effective porosity proportion were analyzed, and the pavement engineering performance was evaluated. Moreover, the effects of nominal maximum aggregate size (NMAS) and porosity characteristics on the permeability coefficient were also examined. The results indicate that both the effective porosity and the effective porosity proportion increase with total porosity for both the PAC-10 and PAC-13 mixtures. PAC-13 consistently exhibits a higher effective porosity than PAC-10, suggesting enhanced drainage performance. The designed PAC mixtures satisfy the requirements of high-temperature stability and moisture resistance for asphalt pavements, while the large porosity is contradictory with high-temperature stability and moisture resistance. Additionally, the permeability coefficient significantly increases with larger NMAS, and a strong linear correlation is observed between permeability and both total and effective porosity, where the coefficient of determination (R²) is larger than 0.9. These findings demonstrate that porosity parameters can serve as reliable indicators for assessing the permeability performance of PAC mixtures with different gradations. Full article

This study investigates the mechanical performance of two prosthetic forelimb designs for dogs—one with a solid structure and the other with a perforated structure—using Finite Element Analysis (FEA). Both models were analyzed under static loading conditions representing approximately 60% of a dog’s body weight, the typical load borne by the forelimbs. The prosthetics were modeled with ABS plastic, a widely used 3D printing material, and evaluated for Von Mises stress, total deformation, elastic strain, and factor of safety. The analysis showed that both models remained within the elastic limit of the material, indicating that no permanent deformation would occur under the applied loads. The Solid Model demonstrated a significantly higher factor of safety (14) and lower deformation, confirming its structural strength but also highlighting excessive rigidity, increased material use, and higher cost. In contrast, the Perforated Model exhibited slightly higher localized stresses and a lower factor of safety (3.01), yet it still met essential safety requirements while providing greater compliance, flexibility, and material efficiency. These attributes are desirable for comfort, adaptability, and practicality in veterinary applications. Although its long-term durability requires further evaluation, the Perforated Model strikes a more effective balance between safety, comfort, and sustainability. Based on these findings, the perforated design is considered the more suitable option for canine prosthetic development. Future work will extend the analysis to dynamic loading scenarios, such as walking and running, to better simulate real-world performance. Full article

The combined effects of soil properties, zinc (Zn), and chloride ion (Cl⁻) concentrations on Zn distribution across soil fractions are poorly understood, even though zinc chloride (ZnCl₂) contamination in industrial soils is a major source of mobile Zn and poses significant environmental risks. This study aimed to (1) assess how the soil type, physicochemical properties, and Zn concentration affect Zn distribution in Community Bureau of Reference (BCR)-extracted fractions; (2) evaluate the impact of Cl⁻ on Zn mobility; and (3) develop predictive models for mobile and stable Zn fractions based on soil characteristics. Zn mobility was analyzed in 18 soils differing in Zn and Cl⁻, pH, specific surface area (SSA), organic matter (OM), and texture (sand, silt, clay (CLY)), using a modified BCR method. Zn fractions were measured by atomic absorption spectroscopy (AAS). Analysis of Covariance was used to assess Zn distribution across soil types, while Zn fractions were modeled using non-linear regression (NLR). The results showed that mobile Zn increased with the total Zn, and that the soil type and Zn levels influenced Zn distribution in soils contaminated with ZnCl₂ (Zn 304–2136 mg·kg⁻¹ d.m.; Cl⁻ 567–2552 mg·kg⁻¹; pH 3.5–7.5; CLY 11–22%; SSA 96–196 m²·g⁻¹; OM 0–4.8%). Although Cl⁻ enhanced Zn mobility, its effect was weaker than that of Zn. Predictive models based on the total Zn, SSA, and CLY accurately estimated Zn in mobile and stable fractions (R > 0.92), whereas the effects of the pH and OM, although noticeable, were not statistically significant. Full article

A low-carbon ferrite/martensite-laminated 0.1C5Mn3Al dual-phase steel was hot-rolled to an engineering strain of 98%, and a tensile strength of 1277 ± 44 MPa and a total elongation of 11.8 ± 0.4% was obtained in the steel. Hot-rolling induces a laminated/layered structure characterized by alternating ferrite phases and martensite phases distributed perpendicular to the rolling direction. A deformation mechanism was evaluated using nano-indentation and in situ compression of micropillars in a scanning electron microscope. The excellent mechanical properties of the steel are attributed to the refinement of ferrite/martensite layers and ultra-fine martensite laths. The synergistic deformation of the ferrite and martensite laminates provides the steel with a good combination of high strength and tensile elongation. Full article

Objectives: The purpose of this retrospective cohort study was to ascertain the risk of abortion, ectopic pregnancy and hydatidiform mole development in women with polycystic ovary syndrome (PCOS) using data from Korea’s National Health Insurance Service. Method: The women aged 20–49 years who were diagnosed with PCOS between 1 January 2012 and 31 December 2020 were enrolled. The control group (non-PCOS group) was composed of women aged 20–49 years who visited medical institutions for health examinations during the same period. Women diagnosed with any cancer were excluded from both groups. Logistic regression analysis was used to evaluate the risks of abortion, ectopic pregnancy and hydatidiform mole in PCOS in the presence of certain pregnancy-related confounding factors. Results: A total of 724,307 women were extracted, 169,998 women without PCOS and 44,714 women with PCOS were enrolled in the study. The PCOS group had a higher incidence of GDM and endometriosis. Abortions, ectopic pregnancies and hydatidiform moles were higher in the PCOS group than in the control group (abortion: 14.7% vs. 7.3%, p < 0.001; ectopic pregnancy: 3.3% vs. 1.1%, p < 0.001; hydatidiform mole: 0.2% vs. 0.1%, p < 0.001). After adjusted logistic regression, PCOS was found to be a risk factor for abortion (RR = 1.473, 95% CI = 1.424–1.524; p < 0.001) and ectopic pregnancy (RR = 1.845, 95% CI = 1.716–1.984, p < 0.001) but not hydatidiform mole (RR = 1.225, 95% CI = 0.927–1.62, p = 0.154). Conclusions: A history of PCOS itself might increase the risk of abortion and ectopic pregnancy. These findings could be useful in prenatal counseling and the management of patients with PCOS-associated pregnancies. Full article

Background: Class II is considered one of the most common malocclusions, influencing 37% of schoolchildren in Europe and 33% of orthodontic patients in the United States. When this type of malocclusion is combined with increased overjet with proclined teeth and maxillary excess, then moving maxillary molars distally is suggested. According to the recent literature, modern appliances that lack patient cooperation can be combined with temporary anchorage devices to provide absolute and skeletal anchorage while supporting the non-compliance appliances to eliminate their side effects, such as anterior and posterior anchorage loss along with maxillary molar inclination and rotation. To counteract these limitations, the Advanced Molar Distalization Appliance (amda^®), a non-compliance appliance for maxillary molar distalization supported by two mini-implants (MIs) with anterior abutments, was recently developed. Methods: In this preliminary prospective clinical trial, eight consecutive patients treated with the amda^® are evaluated through lateral cephalometric radiographs, while its application, construction, and anchorage is presented and discussed. The evaluation of dentoalveolar and skeletal changes has been made with 14 variables measured on the pre- and post-cephalometric radiographs before and immediately after maxillary molar distalization (T₀ and T₁, respectively), along with cephalometric superimpositions by the structural method. Results: In total, the mean distal molar movement was 4.2 ± 1.37 mm, the mean distal tipping was 1.7 ± 1.9 degrees, and the vertical movement was 1.6 ± 2.6 mm. Conclusions: The amda^® seems to provide an ideal option for treating patients with Class II malocclusion, achieving bodily movement of the maxillary molars with only minimal distal tipping and no anchorage loss. Full article

Background/Objectives: Previous research has demonstrated that the lactate/albumin ratio (L/A) may predict mortality among critically ill patients. Based on pathophysiological rationale, L/A may also correlate with volume status, however such an association has not been investigated extensively. This retrospective cohort study aimed to confirm the prognostic value of L/A and to assess the prognostic value of L/A and its relationship with hypovolemia severity in intensive care unit (ICU) patients. Methods: We analyzed data from consecutive adult patients admitted to the ICU. Admission L/A was evaluated in relation to 30-day mortality and indirect markers of volume status (mean arterial pressure on admission, median dose of norepinephrine and fluid intake within the first 24 h of ICU stay). Results: A total of 1421 patients were included. L/A ≥ 0.06 (estimated on the basis of ROC curve using the Youden index) was an independent predictor of 30-day mortality (HR = 1.423; 95%CI 1.183–1.712; p < 0.001). L/A moderately correlated with markers of absolute or relative hypovolemia, i.e., lower mean arterial pressure (r = −0.353, p < 0.001) on admission, higher norepinephrine dose (r = 0.506, p < 0.001) and greater fluid intake (r = 0.233, p < 0.001) within the first 24 h of ICU stay. Furthermore, L/A ≥ 0.06 on admission was an independent risk factor for the implementation of continuous renal replacement therapy (OR = 2.134; 95%CI 1.652–2.757; p = 0.001). Conclusions: L/A is not only a predictor of poor prognosis but also may be a valuable indirect marker of the extent of hypovolemia in critically ill patients. Further prospective studies are necessary to assess if this parameter should incline a decision for more aggressive fluid management in hypovolemic patients. Full article

Background/Objectives: Grey zone serologic results in blood donor screening pose challenges for transfusion safety, donor management, and blood supply sustainability. In Saudi Arabia, standardized national protocols for managing grey zone outcomes remain lacking. This study aimed to evaluate the prevalence and follow-up outcomes of grey zone serologic results among blood donors at a Saudi hospital over a five-year period. Methods: Serological screening results of six transfusion-transmissible infections (TTIs) markers were extracted alongside nucleic acid testing (NAT) results for HBV, HCV, and HIV. The grey zone was defined as a signal-to-cutoff (S/CO) of 0.90–0.99. Repeat and follow-up results, including subsequent donations, were assessed for seroconversion. Results: A total of 48,241 donations from 38,524 donors were analyzed. Anti-HBc showed the highest reactivity (n = 2312; 4.8%), followed by HbsAg (n = 2292; 0.31%) and syphilis (n = 218; 0.5%). Grey zone results were rare, and most frequent in anti-HBc (n = 76; 0.16%), HCV (n = 39; 0.08%), and HBsAg (n = 28; 0.06%). Grey zone-to-reactive conversion upon subsequent donation was rare. Three donors who initially tested in the grey zone for anti-HBc later tested reactive in subsequent donations, but their HBV NAT remained negative. Conclusions: While grey zone outcomes were infrequent, a subset involving HBV markers showed low-level reactivity on repeat testing. For other TTIs markers, grey zone results likely reflected assay variability rather than true infection. We propose a six-month temporary deferral with follow-up serologic and NAT testing, allowing conditional re-entry for donors with consistently non-reactive results, supporting both transfusion safety and a more sustainable donor pool. Full article

In the context of the rising demand for total knee arthroplasty (TKA) in older adults and persistent uncertainty about the quality of long-term functional recovery, this study evaluated elderly patients’ mobility after unilateral TKA via a transquadriceps approach using instrumented Timed Up and Go (TUG) tests. A total of 20 patients treated between 2022 and 2024 at a tertiary hospital were invited to participate in this observational, retrospective, descriptive study, and 19 met the inclusion criteria (age 50–80 and Kellgren–Lawrence ≥ 4). The participants performed two TUG trials at two postoperative time points (18 and 53 months), with an inertial measurement unit (G-sensor) capturing 15 kinematic variables. When comparing the postoperative time points, it was found that the total TUG duration remained stable (14.97 ± 3.48 vs. 15.47 ± 2.93 s; p = 0.58), while the mid-turning peak velocity increased significantly (106.44 ± 30.96 vs. 132.77 ± 30.82°/s; p = 0.0039; r = 0.88). The end-turning velocity and sit-to-stand parameters showed small-to-moderate effect size gains without statistical significance. These findings suggest that, in the first year following surgery, patients continue to experience difficulties with movement fluidity and motor control—especially during turning—underscoring the value of segmented, sensor-based assessments and the need for extended rehabilitation protocols that emphasize rotational control and balance. These findings provide clinically relevant parameters that can support future interventional studies and help guide rehabilitation planning after TKA. Full article

CTX-M beta-lactamases have become the predominant extended-spectrum beta-lactamases (ESBLs) globally, contributing to increased patient morbidity, mortality, and healthcare costs. This study investigated the prevalence of biofilm formation and CTX-M genes in Klebsiella pneumoniae strains isolated from Baghdad hospitals, aiming to better understand antimicrobial resistance mechanisms and support the development of targeted interventions. A total of 300 samples were collected from various clinical and hospital sources, and antibiotic susceptibility testing was performed using the Kirby–Bauer disc diffusion method. ESBL production was also confirmed using specifically designed primers. Platanus orientalis Linn extract was evaluated for its antimicrobial and antibiofilm activity against K. pneumoniae isolates. The results showed significant resistance to the majority of antibiotics, including cefotaxime, gentamicin, levofloxacin, ceftazidime, and ceftriaxone. A high prevalence of the CTX-M gene (100%) was detected in the isolates, with the most frequent alleles being blaCTX-M-15 (65.2%) and blaCTX-M-1 (30%). Furthermore, 95.6% of the isolates were capable of forming biofilms. However, when treated with P. orientalis Linn extract, most isolates exhibited reduced biofilm production, becoming weak biofilm producers. Phytochemical analysis of P. orientalis Linn revealed significant amounts of phenolic compounds, tannins, and glycosides, as well as the presence of alkaloids and carbohydrates. Overall, this study demonstrates a correlation between CTX-M production and biofilm-forming ability in K. pneumoniae and highlights the potential role of P. orientalis Linn extract in combating antibiotic-resistant infections. Full article

This study investigates the bidirectional relationship between biodiversity conservation, an increasingly important dimension of corporate social responsibility (CSR), and corporate financial performance (CFP). Specifically, it compares the manufacturing sector, which has substantial environmental impact and close ties to ecosystems, and the nonmanufacturing sector. The analysis draws on 1079 firm-year observations of Japanese companies from 2017 to 2022, employing the ratio of biodiversity-related expenditures to total environmental costs as the independent variable. CFP is measured by return on assets (ROA) and the price-to-book ratio (PBR). The results show that the effects on ROA significantly differ between manufacturing and nonmanufacturing sectors, with more positive impacts in manufacturing. In contrast, no clear sectoral differences are identified for the PBR. The reverse analysis suggests that, in the nonmanufacturing sector, firms with a higher PBR tend to allocate less to biodiversity conservation, whereas in manufacturing firms, both ROA and the PBR indicate positive effects, although statistical significance was not established. These findings indicate that biodiversity conservation in the manufacturing sector can be regarded as a strategic investment that contributes to profitability, and that its effects differ across industries. The study further suggests that investors and policymakers should consider industry-specific characteristics when evaluating corporate initiatives and designing institutional frameworks. Full article

Background: Pelvic organ prolapse (POP) significantly impairs patients’ quality of life, especially in urinary, bowel, and sexual domains. While laparoscopic sacrocolpopexy (LS) is the current gold standard for apical prolapse repair, it is associated with certain complications. Laparoscopic pectopexy (LP), a newer technique utilizing the iliopectineal ligament for apical suspension, may offer improved outcomes with fewer adverse effects. This scoping review aimed to evaluate patient-reported outcomes (PROs) and quality of life (QoL) following LP and compare its effectiveness to other established surgical approaches. Methods: A scoping review was conducted in accordance with PRISMA-ScR guidelines. Searches of PubMed, Scopus, and Web of Science databases were performed through June 2025. Eligible studies included randomized controlled trials, prospective and retrospective cohorts, and case series that reported PROs following LP. Data on validated QoL tools (e.g., P-QOL, PFDI-20, PFIQ-7, FSFI, PISQ-12), surgical technique, and follow-up duration were extracted. Due to heterogeneity in the study design and outcomes, findings were synthesized qualitatively. Results: Thirteen studies including a total of 742 patients met the inclusion criteria. Across all included studies, LP was associated with significant improvements in QoL metrics, including urinary and sexual function, and overall patient satisfaction. Tools such as PFDI-20, FSFI, PISQ-12, and PGI-I consistently showed postoperative improvement (p < 0.05). Comparative studies demonstrated that the outcomes for LP were similar or superior to those of sacrocolpopexy, sacrospinous fixation, or sacrohysteropexy, particularly regarding sexual function. Conclusions: LP is an effective surgical alternative for apical POP repair, offering significant improvements in patient-reported quality of life and functional outcomes. Its favorable safety profile and comparable efficacy to traditional methods make it a compelling option, particularly for patients with contraindications to sacral dissection. Findings are limited by small and heterogeneous studies, short follow-up, and potential publication and language biases. Further prospective studies with long-term follow-up periods are necessary to confirm these findings and refine patient selection criteria. Full article

Background: Concerns exist regarding the lowest effective dose of opioids in opioid-naïve pregnancies. This study aimed to compare the effectiveness of 25 µg vs. 50 µg fentanyl in relieving labor pain. Methods: In total, 122 term-singleton pregnant females, who planned vaginal delivery, were randomized to receive 25 µg or 50 µg intravenous fentanyl, followed by hourly doses—as needed—for labor pain relief. The primary outcome was the comparison of pain score reduction 30 min after treatment between these regimens. Secondary outcomes included maternal and neonatal safety, total fentanyl dose administered, maternal satisfaction with the fentanyl dosing regimen, and breastfeeding, which were analyzed using appropriate statistical tests. Results: Within-group analysis revealed significant pain score reduction 30 min after fentanyl injection: −1.57 (95% confidence interval, CI −2.1 to −1.1, p < 0.001) and −1.69 (95% CI −2.2 to −1.2, p < 0.001) for 25 µg and 50 µg fentanyl groups, respectively. No significant differences in the pain reduction were observed in between-group comparisons (0.3, 95% CI −0.6 to 1.2, p > 0.999), including secondary maternal and neonatal outcomes. Total fentanyl dose was significantly lower in the 25 µg group compared with the 50 µg group (32.8 ± 13.3 vs. 60.2 ± 22.1, p < 0.001). Conclusions: A 25 µg intravenous fentanyl dose can reduce VAS score, used for evaluating labor pain 30 min after treatment, and is comparable to a 50 µg intravenous fentanyl dose. Given the efficacy of the reduced dosage of fentanyl, this study suggests using 25 µg intravenous fentanyl as an alternative initial dosing for labor pain relief. Full article

Background: Ibrutinib has been associated with an increased risk of cardiovascular adverse events (CVAEs), including atrial fibrillation (AF), hypertension (HTN), heart failure (HF), and ventricular arrhythmias (VAs). However, baseline predictors of CVAEs remain poorly characterized. In this study, we sought to identify baseline patient characteristics associated with the occurrence of ibrutinib-related CVAEs, with particular emphasis on parameters linked to the renin–angiotensin system. Methods: We conducted a prospective, single-center cohort study of consecutive patients treated with ibrutinib for B-cell malignancy, with systematic assessment of a predefined panel of potential predictors of CVAEs at baseline (NCT03678337). These predictors included demographic and clinical variables, 16 circulating biomarkers related to inflammation, fibrosis, and neurohormonal activation, as well as nine echocardiographic parameters. The primary objective was to evaluate the association between baseline patient characteristics and the occurrence of CVAEs from ibrutinib initiation through the end of follow-up. The CVAE endpoint was defined as a composite of atrial fibrillation, new or worsening hypertension, new or worsening heart failure, and ventricular arrhythmias. Statistical analyses were performed using the Wilcoxon–Mann–Whitney test or Fisher’s exact test, with a p-value < 0.05 considered statistically significant. Results: Among the 25 patients included, 7 experienced a total of 9 CVAEs over a median follow-up of 672 days. Elevated baseline plasma renin levels (>1336.10 pg/mL) were significantly associated with CVAEs occurrence (57% vs. 11%, p = 0.032). Higher baseline plasma aldosterone levels (>488.95 pg/mL) were also observed in patients who developed CVAEs, although this association did not reach statistical significance (p = 0.058). Conclusions: Baseline plasma renin level was univariably associated with CVAEs occurrence, while plasma aldosterone levels were higher among patients with CVAEs but did not reach statistical significance. These findings provide preliminary insights into the mechanisms underlying ibrutinib-related cardiovascular toxicity, suggesting a potential role for the renin–angiotensin–aldosterone system. Confirmation of this hypothesis, however, will require larger, dedicated studies. Full article