Search Results (114)

Background: Sarcomas are a rare and biologically diverse group of malignant tumors that originate from mesenchymal tissues. They are characterized by a broad range of histopathological subtypes, varying clinical courses, and differing responses to treatment. This study seeks to clarify the clinicopathological and molecular predictors of recurrence in leiomyosarcomas, carcinosarcomas, and endometrial stromal sarcomas to enhance our understanding, thereby improving clinical knowledge, consultation practices, and the overall benefit for patients. Methods: A literature search was conducted utilizing PubMed/MEDLINE, Embase, Cochrane Library, and Scopus to execute a comprehensive structured narrative review of articles published up to 31 March 2025. Results: We summarize existing evidence on the clinical, histological, and molecular predictors of recurrence and poor prognosis for leiomyosarcomas, carcinosarcomas, and endometrial stromal sarcomas. While the stage, grade, tumor size, and novel molecular biomarkers are crucial high-risk parameters that have been associated with recurrence, existing data demonstrate contradictory results, indicating the need for further research. Conclusions: Recent advancements in next-generation sequencing have facilitated the identification of women at increased risk of recurrence, poor disease-free survival, and overall adverse prognosis. Stratifying this risk requires a comprehensive understanding of the clinical, histological, and molecular risk factors involved. Understanding these underlying factors is essential for effectively addressing the initial consultation, guiding management, and—considering the novel treatment modalities—individualizing the care provided to the affected women. Full article

Background: Deficiency of IL-36 Receptor Antagonist (DITRA) is a rare monogenic autoinflammatory disease, characterized by dysregulation of IL-36 signaling and phenotypically classified as a subtype of generalized pustular psoriasis. Objectives: This study aimed to explore the role of potentially coding and non-coding RNAs (ncRNAs) in the IL36RN interactome to identify putative pathogenic mechanisms, biomarkers, and therapeutic targets for DITRA. Methods: A systems biology approach was applied using the STRING database to construct the IL36RN protein–protein interaction network. Key ncRNA interactions were identified using RNAInter. The networks were visualized and analyzed with Cytoscape v3 and the CytoHubba plugin to identify central nodes and interaction hubs. Pathway enrichment analysis was then performed to determine the biological relevance of candidate ncRNAs and genes. Results: Analysis identified thirty-eight ncRNAs interacting with the IL36RN network, including six lncRNAs and thirty-two miRNAs. Of these, thirty-three were associated with key DITRA-related signaling pathways, while five remain to be validated. Additionally, seven protein-coding genes were highlighted, with three (TINCR, PLEKHA1, and HNF4A) directly implicated in biological pathways related to DITRA. Many of the identified ncRNAs have prior associations with immune-mediated diseases, including psoriasis, supporting their potential relevance in DITRA pathogenesis. Conclusions: This study provides novel insights into the ncRNA-mediated regulation of IL36RN and its network in the context of DITRA. The findings support the potential utility of specific ncRNAs and genes, such as TINCR, PLEKHA1, and HNF4A, as key genomic elements warrant further functional characterization to confirm their mechanistic roles and may inform biomarker discovery and targeted therapeutic development in DITRA. Full article

Respiratory tract infections are frequently encountered in clinical practice. The growing incidence of antimicrobial resistance among the causative pathogens exerts sustained pressure on the existing therapeutic options. The emergence of antimicrobial resistance limits the treatment options and often leads to unfavorable patient outcomes. However, in the past few years, newly developed antibiotics have become available, providing viable choices for antibiotic-resistant infections. New β-lactam/β-lactamase combinations, such as ceftazidime/avibactam, meropenem/vaborbactam, and imipenem/relebactam, are effective against carbapenem-resistant Enterobacterales. Several new drugs including ceftolozane/tazobactam are active against multi-drug-resistant Pseudomonas aeruginosa, while sulbactam/durlobactam and cefiderocol have potent activity against Acinetobacter baumannii. A number of new options, such as lefamulin, omadacycline, and delafloxacin, have also emerged for pathogens commonly associated with community acquired pneumonia. This article aims to review the characteristics of newly approved antibiotics for the treatment of respiratory tract infections, as well as to discuss some investigational agents that are currently under development. Full article

Ovarian cancer is the most lethal gynecologic malignancy, which causes 313,959 new cases and 207,252 deaths worldwide annually. The lack of specific symptoms, together with no effective screening tools, results in 75% of patients receiving their diagnosis at an advanced stage. The combination of cytoreductive surgery with platinum-based chemotherapy plays a pivotal role in the treatment of advanced epithelial ovarian cancer, but patients still experience poor long-term survival because of frequent relapses and chemotherapy resistance. The treatment landscape has evolved because bevacizumab and Poly-ADP Ribose Polymerase inhibitors now serve as frontline and maintenance therapies for homologous recombination-deficient tumors. Treatment decisions for recurrent disease depend on platinum sensitivity assessment, which determines the appropriate therapeutic approach, while targeted agents deliver significant benefits to specific patient groups. The development of antibody-drug conjugates such as mirvetuximab soravtansine and immunotherapy, including checkpoint inhibitors and cancer vaccines, demonstrates promising investigative potential. The precision of therapy improves through the use of emerging biomarkers and molecular profiling techniques. The future management of this disease may change because of innovative approaches that include adoptive cell therapy, cytokine therapy, and oncolytic viruses. The progress made in ovarian cancer treatment still faces challenges when it comes to drug resistance, survival improvement, and life quality preservation. The development of translational research alongside clinical trials remains essential to bridge treatment gaps while creating personalized therapies based on molecular and clinical tumor characteristics. Full article

Infective endocarditis (IE) during pregnancy, while uncommon, is associated with substantial maternal and fetal morbidity and mortality due to the complex physiological adaptations of pregnancy. Hemodynamic alterations, including increased cardiac output and changes in vascular resistance, combined with immunological modulation, predispose pregnant individuals to increased risk of infection and associated complications. Predominant pathogens implicated in pregnancy-associated IE are Staphylococcus aureus, Streptococcus viridans, and Enterococcus faecalis, with S. aureus infections frequently leading to poorer clinical outcomes. Diagnosis remains challenging due to commonly atypical presentation and relies on microbiological identification via blood cultures in conjunction with imaging modalities such as transthoracic echocardiography. IE in pregnancy is associated with increased maternal mortality rates (5–17%) and adverse fetal outcomes, including preterm birth, intrauterine growth restriction (IUGR), and fetal loss. Management necessitates careful selection of antimicrobial therapy to ensure efficacy while minimizing fetal toxicity, especially in settings of increased antimicrobial resistance. Anticoagulation and surgical interventions must be judiciously considered, with surgical timing individualized based on the severity of heart failure and coordinated multidisciplinary care. In conclusion, IE during pregnancy constitutes a significant clinical challenge, underscoring the need for enhanced diagnostic strategies, optimized therapeutic protocols, and the development of pregnancy-specific management guidelines to improve maternal and fetal outcomes. Full article

The most frequent form of ectopic pregnancy, known as tubal pregnancy, leads to a dangerous situation where the fertilized ovum implants inside a fallopian tube, which can result in tubal rupture and severe bleeding. The purpose of this narrative review is to evaluate all existing data regarding epidemiology, risk factors, pathophysiology, clinical presentation, diagnosis, and management of tubal ectopic pregnancy in order to provide a comprehensive understanding of this common yet difficult clinical condition. Prior ectopic pregnancy, together with tubal pathology and assisted reproduction, represent the main risk factors for this condition. The diagnosis relies on serial β-hCG tests combined with transvaginal ultrasonography, but laparoscopy serves as the diagnostic tool for cases with uncertain results. The treatment plan depends on the fallopian tube integrity, along with the patient’s hemodynamic condition. Patients with unruptured pregnancies who are hemodynamically stable receive methotrexate treatment as the preferred option, but surgical intervention with salpingectomy or salpingostomy becomes necessary in case of tubal rupture or when medical treatment fails. The development of laparoscopic procedures has led to better results and improved possibilities for fertility preservation. The psychological effects on patients require both counseling and follow-up care. Early detection, along with personalized management, helps decrease maternal complications and optimize reproductive outcomes. Full article

Background/Objectives: Although ectopic pregnancy has been extensively studied in terms of epidemiology, associated risk factors, diagnostic approaches, and treatment modalities, the data regarding its impact on the development of adverse outcomes in subsequent pregnancy remain scarce and conflicting. We aim to evaluate the adverse perinatal outcomes of women with a history of ectopic pregnancy Methods: We used the Medline (1966–2024), Scopus (2004–2024), Clinicaltrials.gov (2008–2024), EMBASE (1980–2024), Cochrane Central Register of Controlled Trials CENTRAL (1999–2024), and Google Scholar (2004–2024) databases in our primary search. All studies that evaluated the impact of prior of ectopic pregnancy on the perinatal outcomes of the subsequent pregnancy and reported rates of adverse perinatal outcomes were considered eligible for inclusion. Twelve peer-reviewed papers were considered for inclusion in our study. We enrolled a total of 2,162,731 women. Of those, 23,823 (1.1%) had a history of prior ectopic pregnancy. A total of 4 out of 12 studies provided the necessary data to be included in the metanalysis. Results: Women with a history of treated ectopic pregnancy, either medically or surgically, demonstrated increased risk of developing placental abruption, hypertensive disorders of pregnancy, and preterm birth. History of ectopic pregnancy was also positively associated with low birth weight, subsequent ectopic pregnancy, and increased risk of a subsequent emergency cesarean section. Conclusions: The meta-analysis reveals evidence that ectopic pregnancy is positively associated with adverse perinatal outcomes in subsequent pregnancy. Our findings should be considered preliminary and serve as a basis for future research as the retrieved data are scarce and cannot be deemed sufficient. Full article

The female genital microbiota plays a critical role in reproductive health and has recently emerged as a key factor influencing the outcomes of Assisted Reproductive Techniques (ARTs). Beyond traditional concerns about vaginal dysbiosis and infections such as bacterial vaginosis or mycoses, recent evidence highlights the broader impact of genital microbial communities, including the vaginal, cervical, and endometrial niches, on ART success rates. New findings suggest that specific bacterial profiles, as well as shifts in the virome and mycobiome, can significantly affect implantation and pregnancy outcomes. Non-invasive biomarkers such as menstrual blood have also been proposed for assessing endometrial receptivity. Furthermore, growing attention has been directed towards methodological challenges such as contamination risks during microbiota sampling which may influence study reliability. This review synthesizes the latest data on the relationship between the female genital microbiota and ART outcomes, with a focus on standardized microbiological analysis techniques and specific patient populations such as those experiencing recurrent implantation to optimize ART success based on microbiota profiling. Full article

Meeting the rising need for secure authentication in IoT and Industry 4.0, this work presents chemically synthesized ZnO nanostructured homojunctions as powerful and scalable physical unclonable functions (PUFs). By leveraging intrinsic variability from Li doping and the stochastic hydrothermal growth process, we systematically identified electrical parameters offering outstanding variability, stability, and reproducibility. ZnO devices outperform commercial diodes by delivering richer parameter diversity, lower costs, and superior environmental sustainability. Pushing beyond traditional approaches, we introduce multi-level quantization for boosted accuracy and entropy, demonstrate the normal distribution of challenge candidate parameters to support a novel method under development, and extract multiple parameters (8–10) per device instead of relying on a single-bit output. Parameter optimization and selection are performed upfront through a rigorous assessment of variability and inter-correlation, maximizing uniqueness and reliability. Thanks to their strong scalability and eco-friendliness, ZnO-based homojunctions emerge as a dynamic, future-proof platform for building low-cost, high-security, and sustainable digital identity systems. Full article

Background: Ankylosing Spondylitis (AS) is a rare autoinflammatory disorder affecting 0.1–1.4% of the population, with increasing recognition over the past 20 years. Although the specific causes of AS remain unclear, the presence of the HLA-B27 gene is associated with increased risk, though only 1–5% of carriers develop the disease. Despite extensive research, no definitive lab tests exist, and many patients are diagnosed years after symptom onset. Methods: In the present study, in order to investigate the disease’s genetic background in correlation with autoimmune diseases, a metanalysis has been performed following PRISMA guidelines using Scopus and PubMed publications towards extracting single-nucleotide polymorphisms (SNPs) of high importance for the disease. Moreover, the polymorphisms have been annotated and analyzed using information from several databases, including PubMed, LitVar2, ClinVar, and Gene Ontology. Results: From 1940 screened titles and abstracts, 57,909 studies were selected, with 539 meeting the inclusion criteria. The genetic background of AS is described through 794 genetic variants, of which 76 SNPs are directly associated with AS (Classes A and B), predominantly located in intronic regions. ERAP1 and IL23R emerged as key genes implicated in AS, while chromosomes 1, 2, and 5 accumulated the most associated SNPs. Functional enrichment revealed strong associations with immune regulation and interleukin signaling pathways, particularly IL6 and IL10 signaling. IL-6 promotes inflammation in AS, while IL-10 tries to suppress it, acting as an anti-inflammatory cytokine. Of the 78 AS-related SNPs, 16 were unique to AS, while 66 were common to autoimmune diseases, especially rheumatoid arthritis (RA) and psoriasis (PsO), suggesting genetic overlap between these diseases. Conclusions: This study creates a comprehensive genetic map of AS-associated SNPs, highlighting key pathways and genetic overlap with autoimmune diseases. These findings contribute to understanding disease mechanisms and could guide therapeutic interventions, advancing precision medicine in AS management. Full article

The relationship between tearing energy and crack growth rates in elastomers is typically divided into three regions—slow crack growth, fast crack growth, and a transitional region—each described by separate power law relationships, requiring six variables to fully characterize the behavior. This study introduces a novel, unified equation that simplifies this relationship by combining two coexisting energy dissipation mechanisms into a single model with only four variables. The model consists of two terms, one for each energy dissipation mechanism: one term is dominant at slow crack growth rates and limited by a threshold energy, and the other is dominant at fast speeds. The transition region emerges naturally as the dominant mechanism shifts. The model’s simplicity enables new advances, such as predicting fast crack growth tearing and transition energies using only slow crack growth data. This capability is demonstrated across a wide range of non-strain crystallizing rubbers, including filled and unfilled compounds, tested at room temperature and elevated temperatures and in both swollen and unswollen states. This model offers a practical tool for material design, failure prediction, and reducing experimental effort in characterizing elastomer performance. Notably, this is the first model to unify slow, transition, and fast crack growth regimes into a single continuous equation requiring only four variables, enabling the prediction of high-speed behavior using only low-speed experimental data—a major advantage over existing six-parameter models. Full article

Effective nurse leadership increases nurses’ job satisfaction, performance, motivation, and empowerment. Ensuring nurses’ organizational and professional commitment is vital for addressing quality, sustainability, and cost-effectiveness challenges in a high-demanding healthcare environment. The aim of this study was to explore the impact of transformational leadership on nurses’ organizational and professional commitment. A systematic review was conducted using the Scopus, ScienceDirect, PubMed/Medline, Scilit.net, and Wiley Online Library databases. Original research studies published between 2016 and 2024 focusing exclusively on nurses’ professional and organizational commitment and transformational leadership were included. The indexing terms “nursing leadership”, “transformational leadership”, “professional/organizational commitment”, and “nursing” were used along with the Boolean operators AND, OR, and NOT. According to the findings, transformational leadership practices increase nurses’ organizational and professional commitment through vision sharing, motivation, career development, interpersonal communication, a positive working environment, and productive resources management. The healthcare policy makers should invest in organizing, supporting, and promoting relational leadership practices to retain their nursing workforce and obtain their organizational and professional commitment to ensure high care quality. Full article

Additive Manufacturing, or 3D Printing, is based on manufacturing physical objects by sequential deposition of layers of material. Although the usage of AM is growing, no straightforward methodology exists to produce parts with specific, or optimized, mechanical properties. In this work, an approach for optimizing the mechanical properties of AM specimens under bending stress is presented, using DOE. For the experimental procedure, Fused Deposition Modeling (FDM) technology was used along with Polylactic acid (PLA) as the in-process material. Nozzle temperature, printing speed, infill pattern and printing orientation were selected as manufacturing factors to be optimized to achieve so maximum load and deflection to be acquired. Both optimized sets of values were increased by 53% and 28%, respectively, and were experimentally checked to validate the accuracy of the approach. Full article

Natural toothpastes were introduced to limit the use of chemical ingredients commonly found in conventional toothpastes. The purpose of this in vitro study was to evaluate the antimicrobial properties of three developed natural toothpastes containing different antimicrobial agents: (a) Biosecur Organic Oral Care (BOOC), (b) Microsilver BG, and (c) Cranberry LG. These toothpastes were compared with a natural toothpaste of the same composition but without any added natural antimicrobial agent (negative control), as well as with a commercial synthetic toothpaste (positive control). The antimicrobial properties of the toothpastes were assessed using the disc diffusion test against three oral pathogens: Candida albicans, Streptococcus mutans, and Prevotella intermedia. Each tested toothpaste sample was placed in Petri dishes, where specific microorganisms selected for the study were cultivated. After incubation, the circular area formed around the discs (diameter), known as the inhibition zone, was measured demonstrating the inhibitory effect of the product on the microorganisms used in the efficacy test. All the experimental toothpastes exhibited higher antimicrobial properties compared to the negative control group, except for Streptococcus mutans, where only BOOC-containing toothpaste presented significant higher inhibition zones (p < 0.001). Considering the outcomes of the antimicrobial property test, the most effective natural experimental toothpaste was the BOOC-containing one, which showed better antimicrobial behavior even from the commercially available synthetic toothpaste (positive control). The tested natural antimicrobial agents were effective for enhancing the antimicrobial properties of the experimental toothpastes that were included, especially Biosecur Organic Oral Care agent. Full article

Background/Objectives: Greek cancer patients deal with high out-of-pocket medical expenses in comparison with the European Union average. All these high costs affect the quality of life of cancer patients, leading to financial toxicity. The purpose of this study is to investigate the association between financial toxicity and quality of life in patients undergoing cancer treatment. Methods: A cross-sectional study was conducted in four hospitals in Greece. The Comprehensive Score for Financial Toxicity (COST) Scale was used for the evaluation of financial toxicity, and the EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) was used for the assessment of quality of life. Quantitative variables were first tested for normality using the Kolmogorov–Smirnov criterion. Spearman correlation coefficients (rho) were used to explore the association of two continuous variables. Multiple linear regression analysis was used with dependent the QoL subscales. Logarithmic transformations of the QoL scales were used for the regression analyses. Internal consistency reliability was determined by the calculation of Cronbach’s α coefficient. All reported p values are two-tailed. Statistical significance was set at p < 0.05 and analyses were conducted using SPSS statistical software (version 27.0). Results: Greater financial toxicity score, i.e., lower toxicity, was significantly associated with greater global health status (rho = 0.34; p < 0.001) and greater physical (rho = 0.37; p < 0.001), role (rho = 0.17; p = 0.001), emotional (rho = 0.34; p < 0.001), cognitive (rho = 0.22; p < 0.001), and social (rho = 0.27; p < 0.001) functioning. Conclusions: There is a strong correlation between a greater financial toxicity score and the quality of life of Greek cancer patients, meaning the lower their financial toxicity, the better their quality of life. Full article