Search Results (53,405)

Background/Objectives: Crohn’s disease (CD) is a chronic inflammatory disorder that significantly affects patients’ quality of life; conventional treatments often provide limited relief. Methods: This systematic review and meta-analysis explored the potential of regenerative therapies, particularly platelet-rich plasma (PRP), as an adjunctive treatment for CD. The study protocol was registered with PROSPERO (CRD42024576683), and a comprehensive search was conducted across major databases, such as PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. The search included terms related to CD and PRP. Studies assessing the efficacy of PRP in CD treatment were selected. Statistical analysis was conducted using the PICO framework with R software (version 4.3.2) and meta-package. Results: Of the 29 studies identified, 10 met the inclusion criteria, comprising pilot studies and controlled trials. Nine studies focused on Crohn’s disease perianal fistulas (CDPF), and one focused on colonic CD. Among 138 patients with CDPF, 82.44% showed some fistula healing after PRP treatment, with 48.05% achieving complete resolution. In a sub-analysis, combining PRP with a stromal vascular fraction (SVF) resulted in a 58.62% complete healing rate, whereas combining PRP with adipose-derived stem cells (ASCs) showed even higher efficacy at 85.89%. PRP treatment alone resulted in a lower complete healing rate of 38.51%. PRP was well tolerated, with minor side effects such as localized pain. Conclusions: These findings suggest that PRP, especially when combined with stem cells, offers a promising new approach for treating CD. However, larger trials are needed to confirm its long-term benefits and refine its clinical applications. Full article

The sodium chloride cotransporter (NCC) is essential for electrolyte balance, blood pressure regulation, and pathophysiology of hypertension as it mediates the reabsorption of ultrafiltered sodium in the renal distal convoluted tubule. Given its pivotal role in the maintenance of extracellular fluid volume, the NCC is regulated by a complex network of cellular pathways, which eventually results in either its phosphorylation, enhancing sodium and chloride ion absorption from urines, or dephosphorylation and ubiquitination, which conversely decrease NCC activity. Several factors could influence NCC function, including genetic alterations, hormonal stimuli, and pharmacological treatments. The NCC’s central role is also highlighted by several abnormalities resulting from genetic mutations in its gene and consequently in its structure, leading to dysregulation of blood pressure control. In the last decade, among other improvements, the acquisition of knowledge on the NCC and other renal ion channels has been favored by studies on extracellular vesicles (EVs). Dietary sodium and potassium intake are also implicated in the tuning of NCC activity. In this narrative review, we present the main cornerstones and recent evidence related to NCC control, focusing on the context of blood pressure pathophysiology, and promising new therapeutical approaches. Full article

The clinical success of laminate veneers depends upon their marginal discrepancy (MD) and internal gap (IG). This study aims to compare and evaluate the MD, overall discrepancy (OD), absolute marginal discrepancy (AMD), and IG of 3D-printed (Varseosmile TrinQ and Varseosmile Crown Plus) and computer-aided design and manufacturing (CAD/CAM)-milled (Brilliant Crios) laminate veneers using cone-beam computed tomography (CBCT). Thirty maxillary central incisors were prepared and divided randomly into three groups (n = 10). All teeth were scanned for veneer fabrication: Group PVT teeth with 3D-printed Varseosmile TrinQ, Group PVC teeth with 3D-printed Varseosmile Crown Plus, and Group BCM teeth with Brilliant Crios milled veneers. The specimens with respective veneers were scanned using CBCT, and the sectional images were measured for IG, MD, OD, and AMD. The mean values for MD recorded were 0.27, 0.31, and 0.40 for PVT, PVC, and BCM respectively). The mean values for IG recorded were as follows: PVT group—0.24, PVC group—0.28, and BCM group—0.39, and those for OD were as follows: PVT—0.22, PVC—0.32, and BCM—0.41. Intragroup significance was observed for IG and OD (p = 0.001). Findings revealed that milled veneers have a higher IG and MD than 3D-printed veneers, making them less clinically acceptable. Full article

As the socio-economic landscape expands and tourism flourishes, the traditional earthen dwellings of Tuyugou Village, Turpan, Xinjiang, face significant challenges, including low energy efficiency and suboptimal living comfort, necessitating data-driven and scientifically robust renovation strategies. Existing renovation methods, however, often lack empirical support and rely heavily on the subjective judgments of architects, thus hindering the effective preservation and transmission of cultural heritage. This research addresses the renovation of these traditional dwellings by employing the AHP method to systematically evaluate user requirements, with input from diverse stakeholders, including homeowners, tourists, experts, and government authorities. The study then applies the QFD method to construct the House of Quality, translating user needs into specific design attributes; this is followed by a comprehensive quantitative analysis for optimization. A novel multi-objective optimization model (MOP) is introduced, with materials as the central focus, addressing key aspects of engineering, culture, and energy conservation. The NSGA-II algorithm is utilized to generate optimal Pareto solutions, which are then further refined using the entropy-weighted VIKOR method. Among the ten pre-selected renovation solutions, the sixth design plan was identified as the optimal choice, excelling in cost control, cultural integration, and energy performance. Specifically, it achieved a unit construction cost of RMB 340.566/m², a cultural adaptability score of 1.5364, and an energy cost of RMB 352.793/kWh, thereby demonstrating an effective balance between traditional architectural elements and modern requirements. The objective decision making enabled by the VIKOR method successfully balances cultural preservation with contemporary needs, enhancing both living standards and tourism appeal. This study offers innovative and empirically grounded renovation strategies for traditional dwellings in arid and semi-arid climates, providing a framework that effectively balances cultural preservation and modernization. Full article

Campanula fragilis Cirillo is a species distributed in central and southern Italy and includes two subspecies with uncertain taxonomic position and distribution. By means of nuclear and chloroplast markers, we attempted at testing the genetic distinctness of the two subspecies, as well as their possible correspondence with geographical or ecological patterns. After a revision of geographic occurrences based on herbarium data, we carried out species distribution modeling to assess the present and future distribution of this species under different ecological variables, also for conservation purposes. Our findings support the recognition of two weakly differentiated taxa, here accepted at subspecific rank, in agreement with the current taxonomic treatment. We found that C. fragilis subsp. cavolinii is monophyletic and limited to mountains and hills of central Italy. On the contrary, C. fragilis subsp. fragilis shows a higher genetic variability and a broader distribution in central and southern Italy, with a wider altitudinal range from coasts to mountain cliffs. We confirmed that both subspecies are narrowly calcicolous and have similar ecological requirements, but C. fragilis subsp. cavolinii occurs in colder habitats. Our results forecast a significant distribution contraction in the long term. Full article

This study focuses on two significant factors shaping university students’ perception of environmental sustainability. Those are (a) personal values, measured by the Portrait Values Questionnaire (PVQ) and (b) the usage of and proficiency in information technology. Personal values have been widely used to analyze individual perspectives toward various issues, including environmental ones. As contemporary social arrangements include significant influences from social networks and mobile phone usage, overall engagement with technology becomes an essential factor affecting university student attitudes and behaviors. While the individual impact of those factors can be found in the extant literature, we look into their interaction concerning university student pro-environmental attitudes, measured by the Revised NEP (New Ecological Paradigm) Scale, and their environmental self-efficacy. Our sample comes from the population of undergraduate business and economics students from Central and Southeast Europe, specifically Slovenia, Croatia, Bosnia and Herzegovina, Serbia, and Montenegro. We discuss our findings in the context of previous studies from the same regions and consider the unique socio-economic factors. The research results address Sustainable Development Goals 4 (quality education), 12 (responsible consumption and production), and 13 (climate action) by analyzing the factors contributing to university student pro-environmental attitudes and their self-efficacy in the context of their information technology usage and proficiency. Full article

Stomata regulate CO₂ and water vapor exchange between leaves and the atmosphere, serving as a vital indicator of climate change resilience. Therefore, understanding the difference in stomatal numbers and patterns among different soybean cultivars across growth stages is essential to comprehending the complex mechanisms underlying soybean adaptation to climate change. The accurate measurements of stomatal density in soybean leaves are essential to understanding the complexity of stomatal density by environmental conditions. We demonstrated that the five epidermal sections and five microscopic images taken from both sides of each epidermal section at each leaf position (tip, middle, and bottom) were sufficient for stomatal measurements. Furthermore, we investigated variations in stomatal density among leaflet locations (left, right, and central) and leaf position across different growth stages. Notably, while there was no significant variation between the two leaves of the vegetative cotyledon (VC) stage and among the three leaflets of the V1 (first trifoliate) to V4 (fourth trifoliate) growth stages, leaves of the VC stage exhibited the lowest stomatal density, whereas those of the V4 stage exhibited the highest stomatal density. These findings could serve as a valuable tool for evaluating stomatal density, analyzing physiological differences under adverse climatic conditions, and phenotyping a large-scale population to identify the genetic factors responsible for stomatal density variations in soybean genotypes. Full article

Hyperspectral image (HSI) classification is a crucial technique that assigns each pixel in an image to a specific land cover category by leveraging both spectral and spatial information. In recent years, HSI classification methods based on convolutional neural networks (CNNs) and Transformers have significantly improved performance due to their strong feature extraction capabilities. However, these improvements often come with increased model complexity, leading to higher computational costs. To address this, we propose a compact and efficient spectral-spatial feature extraction and attention-based neural network (SSFAN) for HSI classification. The SSFAN model consists of three core modules: the Parallel Spectral-Spatial Feature Extraction Block (PSSB), the Scan Block, and the Squeeze-and-Excitation MLP Block (SEMB). After preprocessing the HSI data, it is fed into the PSSB module, which contains two parallel streams, each comprising a 3D convolutional layer and a 2D convolutional layer. The 3D convolutional layer extracts spectral and spatial features from the input hyperspectral data, while the 2D convolutional layer further enhances the spatial feature representation. Next, the Scan Block module employs a layered scanning strategy to extract spatial information at different scales from the central pixel outward, enabling the model to capture both local and global spatial relationships. The SEMB module combines the Spectral-Spatial Recurrent Block (SSRB) and the MLP Block. The SSRB, with its adaptive weight assignment mechanism in the SToken Module, flexibly handles time steps and feature dimensions, performing deep spectral and spatial feature extraction through multiple state updates. Finally, the MLP Block processes the input features through a series of linear transformations, GELU activation functions, and Dropout layers, capturing complex patterns and relationships within the data, and concludes with an argmax layer for classification. Experimental results show that the proposed SSFAN model delivers superior classification performance, outperforming the second-best method by $1.72\%$, $5.19\%$, and $1.94\%$ in OA, AA, and Kappa coefficient, respectively, on the Indian Pines dataset. Additionally, it requires less training and testing time compared to other state-of-the-art deep learning methods. Full article

Clarifying the driving mechanisms of ecosystem service (ES) supply and demand under urbanization is of significant importance for urban ecological planning and management. However, how the balance of ES supply and demand and its driving mechanisms vary with the degree of urbanization has been little studied. In this study, we analyzed the spatiotemporal changes and the correlations between ES supply and demand and the degree of urbanization in the Zhengzhou Metropolitan Area (ZZMA) from 2000 to 2020 and further explored the driving mechanisms behind these changes. The results showed that, (1) between 2000 and 2020, the ZZMA experienced a deficit in comprehensive ES supply and demand, and regions with rapid urbanization development were more likely to trigger imbalances in ES supply and demand; (2) the spatial mismatch between low–high ES supply and demand was primarily distributed in the built-up areas of various cities, while the high–low spatial mismatch was mostly found in forest and grassland areas; (3) the comprehensive urbanization level of the ZZMA was spatially negatively correlated with the ratio of ES supply and demand. Regions with lower ES balance were more susceptible to disturbances caused by urbanization; (4) population density was the key factor influencing the supply and demand of carbon sequestration, oxygen release, water conservation, and food provision services, while the proportions of forest land and construction areas had the greatest influence on the supply and demand of air purification and leisure services. It is important to ensure the ecological status of the northwestern, southwestern, and central mountainous and forested areas; maintain the agricultural status of the main grain-producing areas in the eastern plains; strengthen ecological restoration and green infrastructure in built-up areas; and formulate differentiated management policies to promote the sustainable supply of ES and safeguard the ecological security of the region. Full article

Background: Nurses in emergency rooms face high levels of psychological stress during their work, which is why they have an increased risk of burnout. The aim of this pilot study was to determine the extent to which effort–reward imbalance (ERI) at work is connected to the risk of burnout among emergency nurses. Methodology: Thirty-five nurses from the central emergency department of a maximum care provider, aged 35.1 ± 0.6 years, voluntarily participated in this pilot study. ERI was recorded using the Effort–Reward Imbalance questionnaire. The nurses were then divided into two groups: the nonrisk group (ERI ratio < 1, n = 19) and the risk group (ERI ratio ≥ 1, n = 16). The burnout dimensions were determined via the Maslach Burnout Inventory (MBI) and the burnout risk was then determined. Results: Nurses in the nonrisk group were significantly less emotionally exhausted (1.6 ± 1.1 points) and had a lower overall risk of burnout (MBI total score 1.2 ± 0.67 points) than the nurses of the risk group. (3.3 ± 1.5 and 2.2 ± 1.2 points, respectively). Eighteen nurses from the total sample had a medium or high risk of burnout. There is a correlation between the risk of burnout and the ERI ratio (r = 0.392, p < 0.05) and the ERI scale “job promotion” (r = −0.462, p < 0.05). Conclusions: The pilot study provides indications of a relationship between effort–reward imbalance at work and burnout risk in emergency nurses. These findings may improve rewards for nurses in the form of increased salary and/or recognition to reduce the risk of burnout among employees and avoid turnover. Further research is needed to investigate the influence of preventive measures on the risk of burnout and gratification crises, particularly with regard to the influence of status and recognition on the risk of burnout. Full article

Purpose: To investigate intraretinal changes and central millimeter thickness (CMMT) after successful uncomplicated cataract surgery in patients with asymptomatic epiretinal membrane (ERM). Design: prospective, single-center, interventional case series. Methods: Thirty eyes from 26 patients with cataract and ERM (ERM group) and fifteen consecutive eyes with senile cataract with a healthy macula (control group) were included. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) as well as biomicroscopy were performed at baseline, one week, one month and three months after cataract surgery. OCT raster scans were further analyzed regarding CMMT and structural changes in the retinal morphology. Results: The baseline mean visual acuity improved significantly three months after cataract surgery in both groups (p < 0.05). CMMT in the ERM group was 342 (±53 μm) at baseline and increased significantly to 356 (±57) μm after three months (p < 0.05). One patient in the ERM group developed temporary cystoid macular edema one week after cataract surgery that resolved under topical treatment within three months. CMMT in the control group increased significantly three months after cataract surgery as well but no structural changes in the retinal morphology were observed in this group. Conclusions: This study provides evidence that cataract surgery in eyes with asymptomatic pre-existing ERM can be considered as safe and effective, resulting in good visual acuity outcomes. However, an increase in CMMT and temporary mild changes in retinal morphology may occur. Full article

Food security is the primary condition for the development of human society. The Great River Basin is very important to ensure the accessibility and availability of agricultural irrigation, which is vital for food security. The Yellow River Basin plays a significant role in China’s food security, with counties serving as key administrative units for guaranteeing this security. This study uses the Yellow River Basin in China as a case study to construct an evaluation index system for county-level food security. It assesses the food security of 22 counties (districts) in Ningxia from 2013 to 2022, applying spatial correlation theories and driving factor analysis methods to explore the factors influencing county-level food security. The results reveal the following: (1) Overall, the food security index in Ningxia has been on the rise, but there is significant internal variation among counties. (2) Spatially, the food security index is relatively low in administrative centers, while the irrigation areas along the Yellow River play a crucial role in maintaining food security, and the overall food security index in the central arid areas is improving. (3) Food security is driven by multiple factors including economic, social, and climatic influences. To enhance food security in the Yellow River Basin, it is necessary to manage land resources systematically, improve grain production technology, and balance ecological protection with food security. Full article

Background: Progressive atelectasis regularly occurs during general anaesthesia; hence, positive end-expiratory pressure (PEEP) is often applied. Individualised PEEP titration may reduce the incidence of postoperative pulmonary complications (PPCs) and improve oxygenation as compared to fixed PEEP settings; however, evidence is lacking. Methods: This systematic review and meta-analysis was registered on PROSPERO (CRD42021282228). A systematic search in four databases (MEDLINE Via PubMed, EMBASE, CENTRAL, and Web of Science) was performed on 14 October 2021 and updated on 26 April 2024. We searched for randomised controlled trials comparing the effects of individually titrated versus fixed PEEP strategies during abdominal surgeries. The primary endpoint was the incidence of PPCs. The secondary endpoints included the PaO₂/FiO₂ at the end of surgery, individually set PEEP value, vasopressor requirements, and respiratory mechanics. Results: We identified 30 trials (2602 patients). The incidence of PPCs was significantly lower among patients in the individualised group (RR = 0.70, CI: 0.58–0.84). A significantly higher PaO₂/FiO₂ ratio was found in the individualised group as compared to controls at the end of the surgery (MD = 55.99 mmHg, 95% CI: 31.78–80.21). Individual PEEP was significantly higher as compared to conventional settings (MD = 6.27 cm H₂O, CI: 4.30–8.23). Fewer patients in the control group needed vasopressor support; however, this result was non-significant. Lung-function-related outcomes showed better respiratory mechanics in the individualised group (Cstat: MD = 11.92 cm H₂O 95% CI: 6.40–17.45). Conclusions: Our results show that individually titrated PEEP results in fewer PPCs and better oxygenation in patients undergoing abdominal surgery. Full article

Financial technologies metamorphose economies with customer-focused innovation. In this way, financial inclusion is fostered and economic growth is increased. However, risks, trust issues, and ethical concerns stem from the faster advancement of digital technologies and expanding financial innovation. Thus, this paper aims to understand the risks and barriers associated with FinTech and consumer adoption, focussing on the impact of digitalization on financial products/services’ acceptance. The research investigates the impact of digitalization on financial services and the recognition of the role played in the global economy by FinTech. For this reason, the regression analysis was used to explore the influence and correlation of various variables on FinTech in Central and Eastern European (CEE) countries, such as Internet usage, online shopping, paying bills via the Internet, and making and receiving digital payments. The results show differences between three clusters of CEEs in terms of FinTech adoption. While several past studies have explored the advantages of FinTech, few studies have investigated the risks associated with its adoption, trust, and barriers to its usage in different country contexts. The present paper fills the gap by analysing the data on Internet usage, online shopping, paying bills via Internet, and sending or receiving digital payments in CEE countries. The study recommends that FinTech companies share information online not only to present their offerings to users, but also to promote financial education through clear and straightforward communication about the features of their services. This approach can indirectly benefit society by contributing to financial development, inclusion, social stability, and, consequently, sustainable development. Full article

Landfills pollute air, soil, and surface and groundwater worldwide. The present work aims to assess the environmental risks of three landfills in southern Riyadh using GIS, soil quality guidelines, and contamination indices. GIS tools indicated an increase in the area of the landfill sites with time. The concentration of heavy metals (HMs) in the investigated landfills had the following descending order: Fe (11,532 mg/kg) ˃ Al (5405 mg/kg) ˃ Pb (561.7 mg/kg) ˃ Zn (356.8 mg/kg) ˃ Mn (165 mg/kg) ˃ Cr (74.8 mg/kg) ˃ Cu (42.7 mg/kg) ˃ Ni (22.4 mg/kg) ˃ V (21.8 mg/kg) ˃ As (5.16 mg/kg) ˃ Co (4.08 mg/kg). The highest values of Al, As, Co, Ni, Pb, V, and Zn were recorded from Al Kharj road landfill (RL3). However, the average values of all HMs were lower than those from most worldwide soils and backgrounds, except for Zn, Cu, Cr, and Pb. Results of enrichment factor and statistical analysis indicated deficiency to minimal enrichment and geogenic sources for Al, Co, Mn, and V, while those of As, Cr, Pb, Zn, and Cu showed EF ˃ 2, which might be indicative of anthropogenic activities, especially in RL3. Additionally, very high contamination and a high effects range—median were reported in individual samples, especially for Pb, As, and Zn, indicating frequent adverse effects for these HMs. The difference in contamination for the HMs in the studied landfill sites might be attributed to the difference in the magnitude of input for each metal into the landfill site and/or the difference in the removal rate of each metal from it. Full article