Search Results (132)

Objectives: Strictures are a major complication of Crohn’s disease (CD) affecting up to 20% of patients at diagnosis. Endoscopic balloon dilation (EBD) is the first-line endoscopic approach; however, it entails complications and a need for reintervention. Endoscopic stricturotomy (ESt) and stricturoplasty (ESTx) are promising alternatives. This review aims to provide an up-to-date and comprehensive assessment of their efficacy and safety in CD-associated strictures. Methods: A literature search was performed until August 2025. Primary outcomes were clinical and technical success. Secondary outcomes included adverse events, additional endoscopic or surgical treatments, medication escalation, emergency department visits and hospitalization following intervention. A minimum of four studies were required for meta-analysis, and pooled estimates were calculated using random-effects meta-analysis. Study quality was assessed using CASP checklist. Results: Fifteen studies including 1050 IBD patients (470 CD) were included. Strictures were short (0.9–2.4 cm) and some had prior EBD (7.8–57.1%) or surgery (3.6–91%). Technical success of ESt ranged from 88% to 100% and clinical success from 50% to 96%. The bleeding rate was up to 11.8%, but perforation rate was mostly <2%. The need for additional intervention, endoscopic (18.2–66.6%) or surgical (0–18.2%), varied considerably. Additionally, ESTx’s technical success ranged from 91.7% to 100% whereas clinical success ranged from 71.4% to 91%, with bleeding ranging from 5.2% to 8.8% and perforation from 0% to 3.4%. Similarly, the need for additional endoscopic procedures (7.1–57.1%) and surgery (9.5–25%) varied considerably. Conclusions: ESt and ESTx are safe and effective for managing CD-related strictures, particularly when short, straight, accessible, fibrotic, anastomotic, or refractory to EBD. Full article

Zoonotic diseases account for approximately one billion cases of illness and millions of deaths globally each year. Increasing contact between humans and competent wildlife hosts elevates the risk of zoonotic spillover. Synanthropic bird species are key players in the transmission of zoonotic pathogens, including flaviviruses such as West Nile virus (WNV) and influenza A viruses like Avian Influenza Virus (AIV). Active surveillance of sentinel birds inhabiting urban areas allows for early detection of emerging pathogens before they cause zoonotic outbreaks. Despite nesting in close proximity to humans, the role of the house martin (Delichon urbicum) in the circulation of flaviviruses and AIV remains poorly understood. Here, we analyzed the presence of antibodies against flaviviruses and AIV in a colony of house martins from southwestern Spain. In addition, we aimed to detect amplicons of the matrix and nucleoprotein genes of AIV using RT-qPCR. While none of the samples tested positive for AIV by RT-qPCR, we observed an AIV seroprevalence of 2.13% based on non-subtyped ELISA. Notably, this is the first report of AIV-seropositive D. urbicum individuals captured in Spain. Moreover, we detected a flavivirus-group seroprevalence of 24.34%, similar to rates reported in the same house martin population between 2018 and 2020, suggesting widespread circulation of flaviviruses within this synanthropic species. These results support the hypothesis that house martins may participate in the transmission of these viruses between wild bird populations and humans in urban environments. Full article

Background/Objectives: Genitourinary syndrome of menopause (GSM) is a chronic, progressive condition that deeply affects sexual wellbeing and vaginal health. As many women—especially cancer survivors—seek non-hormonal alternatives, energy-based devices have gained increasing interest. However, comparative data between different technologies remain limited. This retrospective, non-randomized study aimed to directly compare the effectiveness and tolerability of fractional diode laser and monopolar radiofrequency (RF) in women with GSM. Methods: The study included 91 women treated with diode laser (n = 43) or RF (n = 48). Baseline evaluation comprised the Female Sexual Function Index (FSFI-19), Vaginal Health Index (VHI), and symptom severity. Post-treatment assessment included FSFI-19, VHI, Patient Global Impression of Improvement (PGI-I), and procedural discomfort (VAS 0–100). Results: Both modalities resulted in clear clinical benefits. Among women treated with the diode laser, FSFI total scores rose from 11.0 ± 8.4 to 15.3 ± 9.8 (p < 0.001), while VHI improved from 12.6 ± 3.0 to 15.9 ± 3.6 (p < 0.001). Similarly, RF treatment increased FSFI scores from 8.9 ± 7.4 to 14.3 ± 9.5 (p < 0.001) and VHI from 13.5 ± 3.0 to 16.5 ± 3.3 (p < 0.001). The overall degree of improvement was comparable between groups (ΔFSFI: 4.3 ± 6.5 vs. 5.4 ± 7.1; ΔVHI: 3.3 ± 2.9 vs. 3.0 ± 3.0). Despite this, a higher proportion of patients in the RF group reported PGI-I scores < 4 (95.5% vs. 74.3%; p = 0.010), in parallel with significantly lower procedural discomfort compared to laser treatment (VAS 14.1 vs. 53.6; p = 0.001). No adverse events were observed. Conclusions: Vaginal diode laser and monopolar RF proved to be effective, non-hormonal interventions capable of improving sexual function and restoring vaginal health in women with GSM. However, RF demonstrated superior tolerability, suggesting it may provide a more comfortable therapeutic experience without sacrificing clinical effectiveness. Full article

Global urbanization redirects attention toward the sensory quality of the built environment as a decisive factor in public health and psychological resilience. In automated retail, façades function as sensory interfaces to mitigate the psychological alienation and sensory deprivation inherent in automated nodes. This preliminary study proposes and empirically validates a multimodal evaluation framework for assessing WELL-informed, AI-generated biophilic façade designs in automated retail contexts. Grounded in Environment-Based Design (EBD) theory, the framework systematically integrates health-oriented design logic with generative AI–based façade synthesis and multimodal human-response evaluation. To evaluate the effectiveness of the proposed methodology, this study pursued three specific objectives: (1) to utilize a curated series of architectural façade variations with calibrated biophilic complexity derived from an environment-based AI generative framework, as experimental stimuli, (2) to quantify subconscious responses represented by gaze patterns and behavioral indicators elicited by these configurations, and (3) to analyze the correlation and potential divergence between implicit physiological responses and explicit conscious aesthetic appraisals. The multimodal experiment involving 30 participants integrated eye-tracking, facial expression analysis, and Semantic Differential (SD) scales. Area of Interest (AOI)-based visual attention analysis indicated that biophilic complexity, particularly the integration of organic patterns and natural materials, significantly enhanced subconscious visual interest and sustained engagement within specific design zones. The findings unveiled a complexity–aesthetic paradox where subconscious physiological and behavioral indicators exhibited peak engagement with high-complexity patterns while conscious aesthetic preference favored material-driven structural clarity. Statistical verification via repeated measures correlation analysis revealed a lack of significant linear association between instinctive physiological engagement and explicit aesthetic appraisal, highlighting a notable divergence between implicit and explicit responses. In conclusion, grounded in an EBD–driven evaluation framework, this research establishes a systematic evaluation methodology for health-conscious design, recommending a material-first strategy with pattern as an enhancement to align subconscious fascination with psychological comfort. Full article

We report new fossil larval specimens that have characters of the group Megaloptera, i.e., are either megalopteran or megalopteran-like larvae from the Triassic, Cretaceous, or Eocene. Fossils from the latter two times are preserved in amber. One of the new fossils reveals that some earlier reported presumed megalopteran-like fossils, that have been already suspected to be beetles, are indeed more likely beetles of the group Myxophaga. A quantitative morphological comparison supports that most fossil megalopteran (and megalopteran-like) larvae did not differ significantly from extant megalopteran larvae, indicating no major losses of morphology over time. However, two newly reported fossil specimens from Kachin amber indeed separate from the other larvae, representing an extinct morphotype. The morphotype is characterised by a prominent terminal filament, indicating that the specimen is a representative of Sialidae. However, unlike most of the known larvae of this group, it possesses a rather elongate prothorax and strongly curved mandibles. These two characters are more commonly known in larvae of Corydalidae. It seems most likely that the presence of these characters in the new morphotype does not represent a plesisomorphy, but is more likely the product of convergent evolution. Full article

Madagascar is a global biodiversity hotspot, with approximately 90% of all its plant and animal species being endemic, most of them associated with forest ecosystems. This rich biodiversity is threatened by relentless deforestation; in 2014 only about 15% of the national territory retained highly fragmented native forests, and deforestation continues with worrying forecasts for the coming decades. This rapid loss of habitat is not only causing species losses, but also the loss of important ecological functions that may disappear well before the extinction of the species involved. Here we want to draw attention to the three species of parrots endemic to Madagascar, for which there is a lack of systematically collected data on their distribution and population trends. We compiled available evidence, including data derived from citizen science, suggesting that the distribution and abundance of at least two of the three parrot species have declined in recent decades. These declines are likely driven not only by forest loss but also by persecution for the pet trade, crop protection, and hunting for food. There is also evidence, although still scarce, showing that these parrot species not only act as plant antagonists, but also fulfill mutualistic functions such as seed dispersal by different mechanisms, pollination, and maintenance of plant health. We urge researchers to study the current distribution and population size of the Malagasy parrots, as well as the full antagonism–mutualism spectrum of relationships with their food plants. This is needed for assessing their current conservation status, which may be significantly worse than that reflected by the IUCN Red List, and for identifying important ecological functions that may be lost before the disappearance of the species involved, which can be key to the maintenance and regeneration of the forests they inhabit. Full article

Facial aging is not a singular phenomenon but a cascade of anatomical and biological transformations unfolding across the skeleton, fat, ligaments, muscles, dermis, and epidermis. Its clinical expression-volume loss, sagging, wrinkling, and surface irregularities-cannot be adequately explained by simplistic metaphors of “filling” or “lifting.” This article is a narrative review synthesizing current anatomical, physiological, and clinical evidence relevant to multimodal facial rejuvenation. Traditional monotherapies, while sometimes effective in isolation, are increasingly inadequate for contemporary patients who demand outcomes that are natural, harmonious, and durable. Modern esthetic practice has therefore shifted toward multimodal approaches that address aging across multiple planes. Hyaluronic acid (HA) fillers provide volumetric scaffolding and hydration; collagen stimulators such as poly-L-lactic acid (PLLA) and calcium hydroxylapatite (CaHA) induce neocollagenesis and long-term dermal remodeling; botulinum toxin restores balance to muscular vectors and improves expression dynamics; while energy-based devices (EBDs), including fractional lasers, radiofrequency microneedling, and high-intensity focused ultrasound (HIFU), enhance skin texture, tone, and elasticity. When applied in a sequenced and evidence-based manner, these modalities act synergistically to deliver results unattainable by any single intervention. In addition to established modalities, the field has recently witnessed aggressive promotion of “regenerative” therapies-growth factors, exosomes, platelet-rich plasma (PRP), and platelet-rich fibrin (PRF). While biologically plausible, their efficacy and safety remain uncertain due to the absence of robust, randomized clinical trials and the heterogeneity of current data. This raises a critical question: is aesthetic medicine advancing through science, or being driven by novelty and marketing? This review synthesizes current anatomical and physiological knowledge of aging, evaluates the mechanisms, clinical applications, and safety considerations of major treatment modalities, and proposes practical sequencing strategies. It also emphasizes the ethical imperative that aesthetic medicine, while innovative and fast-evolving, must remain anchored in scientific evidence and patient safety—because aesthetic medicine is, fundamentally, still medicine. Full article

The growing demand for portable and wireless electronic devices, along with the necessity to reduce reliance on non-renewable energy sources, has driven the need for energy harvesting materials. Nanocomposites, combining a polymeric matrix and a high-performance dielectric ceramic phase, are a promising solution. In such systems, the design of a hybrid matrix–filler interface is critical for achieving desired properties. Here, nanocomposites (NCs) were prepared by adding various amounts of hydrothermally synthesized BaTiO₃ (BT) nanoparticles (NPs) to polydimethysiloxane (PDMS). To investigate hybrid interfaces, NPs were used either bare or surface-functionalized with two silanes, 3-glycidyloxypropyltrimethoxysilane (GPTMS) or 2-[acetoxy(polyethyleneoxy)propyl]triethoxysilane (APEOPTES). NC films (80–100 μm thick) were characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDXS), and thermogravimetric analysis (TGA). Dielectric properties and breakdown strength (E_BD) were measured, and the theoretical volumetric energy density was calculated as a function of the filler loading and functionalization. The results demonstrate that hybrid interface design is pivotal for enhancing dielectric performance in NCs. APEOPTES-functionalized NPs significantly improved the dielectric response at a low filler loading (3.5%vol.), increasing permittivity from 2.8 to 7.5, E_BD from 33.8 to 42.1 kV/mm and energy density from 30 to >100 mJ/cm³. These findings underscore that designing hybrid interfaces through NP functionalization provides an effective strategy to achieve superior dielectric performance in PDMS-based NCs, retaining the advantages of the elastomeric matrix by reducing the amount of ceramic fillers. Full article

Population size estimates are essential for investigating numerous aspects of the ecology, evolution, and conservation of wildlife. However, the life cycles of many species include cryptic life stages that are difficult to detect or sample, such as the non-breeding fractions typical of many bird populations. Quantifying the proportions of breeders and non-breeders is crucial to better assess their conservation status and population trends. We propose a simple method applicable to species that show phenotypic differences between adults and juveniles. By quantifying the proportion of ages, the size of the whole population, and its productivity, the size of the non-breeding and breeding fractions can be inferred. We applied this approach to the red-spectacled amazon, Amazona pretrei, a threatened parrot endemic to the Brazilian Atlantic Forest. The entire global population aggregates in winter in a few localities to feed on the seeds of the Parana pine Araucaria angustifolia, a critically endangered tree whose range has declined >97% due to massive exploitation. From a global population of ~16,000 individuals in 2015 and ~20,000 individuals in 2017, our methodology allowed us to estimate a low proportion of juveniles (14%) and a large proportion of non-breeders (80%) within the adult population, with narrow confidence intervals. These proportions did not change between years, but the estimated number of breeding pairs increased, from ca. 1300 to 1700 pairs, in parallel with the global population increase. Our methodology, with its possible improvements to reduce uncertainty in estimates, can be applied to the long-term monitoring of this and many other species, to better understand their conservation challenges and inform effective management strategies. Full article

In the context of industrial heritage conservation and adaptive reuse, the transformation of industrial buildings into patriotic education bases has emerged as a significant approach, where enhancing emotional education efficacy becomes crucial. This study adopts an evidence-based design (EBD) methodology, focusing on the Siwangzhang patriotic education base in Guangdong Province, to address the scientific evaluation and optimization of emotional arousal efficacy. The research rigorously follows the standardized EBD workflow: (1) during problem definition, the literature review establishes the dual objectives of quantitative assessment and spatial optimization; (2) evidence collection employs questionnaire surveys to capture emotional data from both static environmental nodes and dynamic activity nodes; (3) evidence analysis integrates descriptive analysis, factor analysis, emotional mapping visualization, and paired-sample t-tests. Key findings reveal the following: (1) spatial emotional distribution exhibits three distinct patterns—high-arousal clusters, single-node prominence areas, and emotional depressions; (2) dynamic training activities significantly enhance 66.7% of observed emotional variables. A seven-stage progressive training protocol was developed to achieve phased emotional cultivation. This study validates the applicability of EBD methodology in educational space optimization through a complete workflow, establishing an operational evaluation framework integrating spatial-behavioral-emotional metrics. It provides empirical evidence for targeted optimization of patriotic education bases while pioneering a data-driven transition from conventional experiential design. The results hold theoretical and practical significance for revitalizing industrial heritage through socially valuable functional transformations. Full article

Obtaining reliable estimates of population sizes and their temporal trends is essential for assessing the conservation status and guiding the management of threatened species. Parrots (order Psittaciformes) are among the most diverse yet most threatened groups of birds worldwide, but information on their population sizes remains scarce. Their ecological traits and low densities complicate the application of widely used distance sampling methods for estimating population densities, which correct for declining detectability with increasing distance. Researchers have proposed simple encounter rates—the number of birds or groups detected per hour of observation during casual walks—as an alternative approach to address these limitations when estimating the abundance of rare species. Previous studies of the globally endangered African grey parrot (Psittacus erithacus) demonstrated that encounter rates derived from walk transects serve as reliable surrogates for densities estimated using distance sampling models. In this study, we evaluated whether car surveys and point counts, two other commonly used methods for estimating bird abundance, produce encounter rates comparable to those obtained from walk transects, thereby allowing greater methodological flexibility. To this end, we conducted a nationwide survey of African grey parrots in Equatorial Guinea using walk transects, car transects, and point counts (199 surveys, 1973 km, 192 h), which yielded 1166 encounters and 2972 recorded individuals. Three aspects of parrot detectability (the frequency of aural and visual detections, whether birds were perched or in flight, and detection distances) did not differ among the three survey methods. Encounter rates and the number of individuals observed per hour varied among sampled regions but did not differ among survey methods. These findings support the use of the three methods, either individually or in combination, to estimate the abundance of this globally endangered species and provide a basis for testing and applying this approach to other parrot species and geographic regions. Full article

Background/Objectives: Eating behavior disorders (EBDs) are a public health concern among undergraduate students. Evidence suggests that certain health-related academic environments may be associated with heightened psychological vulnerability. Hence, we aimed to evaluate the association between nursing education and the risk of EBDs and to assess whether self-esteem and anxiety mediate this relationship. Methods: A cross-sectional analytical study was conducted between July and August 2023 among 433 undergraduate students from two public universities in Hidalgo, Mexico. The sample included 209 nursing students and 224 peers from non-health-related programs. Self-esteem, anxiety, and EBD risk were assessed using the Rosenberg Self-Esteem Scale, Hamilton Anxiety Rating Scale, and Eating Attitudes Test-26, respectively. Logistic regression and counterfactual mediation analyses were performed, adjusting for age, sex, family income, and year of study. Results: Nursing students showed higher odds of low self-esteem (aOR = 1.64; 95% CI: 1.06–2.53), anxiety (aOR = 2.06; 95% CI: 1.25–3.37), and EBDs risk (aOR = 2.37; 95% CI: 1.37–4.09) compared with non-health peers. Mediation analyses revealed significant indirect effects through self-esteem (aOR = 1.20; 95% CI: 1.03–1.38) and anxiety (aOR = 1.14; 95% CI: 1.01–1.29). Conclusions: Nursing education was independently associated with a higher risk of EBDs, with statistical mediation analyses indicating that differences in self-esteem and anxiety may help characterize this association. Self-esteem exerted a slightly stronger indirect effect, suggesting that negative self-evaluation may represent a more proximal psychological process rather than a causal determinant. Full article

This paper presents a braking force coordination control strategy for electric vehicles based on a hierarchical control architecture. The proposed strategy integrates electronic brakeforce distribution (EBD), direct yaw control (DYC), anti-lock braking system (ABS), and braking force reconstruction functions to effectively enhance braking stability under brake actuator failure conditions. First, a full-vehicle model is established to investigate the braking force coordination process during braking. Then, by analyzing the coupling relationship between the yaw moment and DYC control, a dynamic ABS/DYC coordination strategy is developed. A dynamic computation model of the braking force limited weight coefficient is established, and a three-level braking force coordination mechanism is constructed according to the braking force limited state of each wheel. This mechanism achieves integrated coordination and reconstruction of longitudinal and lateral braking forces. Considering road adhesion, failure sequence, and failure location, eleven typical verification scenarios are designed. Simulation results show that, compared with uncoordinated control methods, the proposed method not only can effectively handle with muti-wheel failure scenarios, but also can reduce the braking distance by up to 7.05% and the lateral deviation by 26.74%, effectively improving the braking safety of electric vehicles. Full article

The current study evaluates how effective the integration of evidence-based design (EBD) and biophilic design (BD) principles are in cancer healthcare environments. This study takes a step further from current biophilic applications in architecture and sheds light on the crucial role of material selection in improving patient well-being through improved indoor air quality (IAQ), natural light exposure, greenery, and material selection. To this end, a case study observation and semi-structured interviews with healthcare professionals and architects at King Hussein Cancer Center are conducted to develop a comprehensive design guide to help healthcare architects and designers implement environmental solutions tailored to patient needs. This study contributes to the growing body of research in healthcare environmental design and highlights the need for cancer-specific environmental design in therapeutic settings. Full article

This study explores how outdoor environments in cold-region university campuses influence students’ physical and mental health, addressing the lack of research on health-oriented campus design under cold climatic conditions. Drawing on Evidence-Based Design (EBD) theory and the Socio-Ecological Model (SEM), a Multi-Factor Analysis (MFA) framework integrating theoretical analysis, data mining, and empirical validation was developed to reveal the mechanisms linking campus environmental factors and student health. Through a systematic literature review and Latent Dirichlet Allocation (LDA) topic modeling, six key factors—climate adaptability, architectural layout, infrastructure, natural landscape, safety, and transportation accessibility—were identified and further verified through questionnaire data (N = 480) for reliability and validity. The Delphi method was then used to refine the indicator system and determine factor weights, while case studies of representative cold-region universities proposed optimization strategies from the dimensions of built environment, climatic adaptation, and perceived environment. The findings enrich the application of socio-ecological theory in health-oriented campus research and provide scientific and practical guidance for planning and promoting healthy university environments in cold regions. Full article