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29 pages, 1789 KB  
Article
Pathloss Estimation of Digital Terrestrial Television Communication Link Within the UHF Band
by Abolaji Okikiade Ilori, Kamoli Akinwale Amusa, Tolulope Christiana Erinosho, Agbotiname Lucky Imoize and Olumayowa Ayodeji Idowu
Telecom 2025, 6(4), 97; https://doi.org/10.3390/telecom6040097 - 12 Dec 2025
Abstract
The global shift to digital terrestrial television broadcasting (DTTB) from the conventional analogue has significantly transformed television culture, necessitating comprehensive technical and infrastructural evaluations. This study addresses the limitations of existing path-loss models for accurately predicting path loss in digital terrestrial television broadcasting [...] Read more.
The global shift to digital terrestrial television broadcasting (DTTB) from the conventional analogue has significantly transformed television culture, necessitating comprehensive technical and infrastructural evaluations. This study addresses the limitations of existing path-loss models for accurately predicting path loss in digital terrestrial television broadcasting in the UHF bands, motivated by the need for reliable, location-specific models that account for seasonal, meteorological, and topographical variations in Abeokuta, Nigeria. The study focuses on path-loss prediction in the UHF band using Ogun State Television (OGTV), Abeokuta, Nigeria, as the transmission source. Eight receiving sites, spaced 2 kilometers apart, were selected along a 16.7 km transmission contour. Daily measurements of received signal strength (RSS) and weather conditions were collected over one year. Seasonal path-loss models PLwet for the wet season and PLdry. For the dry season, models were developed using multiple regression analysis and further optimized using least squares (LS) and gradient descent (GD) techniques, resulting in six refined models: PLwet, PLdry, PLwetLS, PLdryLS, PLwetGD, and PLdryGD. Model performance was evaluated using Mean Absolute Error, Root Mean Square Error, Coefficient of Correlation, and Coefficient of Multiple Determination. Results indicate that the Okumura model provided the closest approximation to measured RSS for all the receiving sites, while the Hata and COST-231 models were unsuitable. Among the developed models, PLwet (RMSE 1.2633, MAE  0.9968, MSE  1.5959, R  0.9935, R2  0.9871) and PLdryLS(RMSE 1.1884, MAE  0.7692, MSE  1.4124, R  0.9942, R2  0.9883) were found to be the most suitable models for the wet and dry seasons, respectively. The major influence of location-based elevation and meteorological data on path-loss prediction over digital terrestrial television broadcasting communication lines in Ultra-High-Frequency bands was evident. Full article
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52 pages, 1966 KB  
Review
Emerging Novel Psychoactive Substances (2020–2025): GC-MS Approaches for Separation, Detection, and Characterization
by Dušan Dimić
Chemosensors 2025, 13(12), 426; https://doi.org/10.3390/chemosensors13120426 - 9 Dec 2025
Viewed by 403
Abstract
The rapid emergence of novel psychoactive substances (NPSs) after 2020 has created one of the most dynamic analytical challenges in modern forensic science. Hundreds of new synthetic cannabinoids, synthetic cathinones, synthetic opioids, hallucinogens, and dissociatives, appearing as hybrid or structurally modified analogues of [...] Read more.
The rapid emergence of novel psychoactive substances (NPSs) after 2020 has created one of the most dynamic analytical challenges in modern forensic science. Hundreds of new synthetic cannabinoids, synthetic cathinones, synthetic opioids, hallucinogens, and dissociatives, appearing as hybrid or structurally modified analogues of conventional drugs, have entered the illicit market, frequently found in complex polydrug mixtures. This review summarizes recent advances in gas chromatography-mass spectrometry (GC-MS) for their detection, structural elucidation, and differentiation between 2020 and 2025 based on the ScienceDirect and Google Scholar databases. Due to its reproducible electron-ionization spectra, established reference libraries, and robustness toward complex matrices, GC-MS remains the primary tool for the separation and identification of emerging NPS. The current literature highlights significant improvements in extraction and pre-concentration procedures, derivatization strategies for thermally unstable analogues, and chromatographic optimization that enable discrimination between positional and stereoisomers. This review covers a wide range of matrices, including powders, herbal materials, vaping liquids, and infused papers, as well as biological specimens such as blood, urine, and hair. Chemometric interpretation of GC-MS data now supports automated classification and prediction of fragmentation pathways, while coupling with complementary spectroscopic techniques strengthens compound confirmation. The review emphasizes how continuous innovation in GC-MS methodology has paralleled the rapid evolution of the NPS landscape, ensuring its enduring role as a reliable, adaptable, and cost-effective platform for monitoring emerging psychoactive substances in seized materials. Full article
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10 pages, 1168 KB  
Article
More Fixation, Better Outcome? Evaluating the Role of Additional Acromioclavicular Ligament Reconstruction in AC Joint Injuries: A Multicenter Analysis
by Gregor Wollner, Samuel Luisi, Florian Hruska, Florian Pengg, Felix R. M. Koenig, Gustav Timmel, Michael Osti, Christian Bach and Thomas Haider
J. Clin. Med. 2025, 14(24), 8679; https://doi.org/10.3390/jcm14248679 - 8 Dec 2025
Viewed by 139
Abstract
Background/Objectives: Acromioclavicular (AC) joint injuries account for 9–12% of shoulder injuries, predominantly affecting young male athletes. While conservative treatment is established for Rockwood type I–II injuries and surgery is widely regarded as indicated for type V–VI, management of type III–IV injuries remains controversial. [...] Read more.
Background/Objectives: Acromioclavicular (AC) joint injuries account for 9–12% of shoulder injuries, predominantly affecting young male athletes. While conservative treatment is established for Rockwood type I–II injuries and surgery is widely regarded as indicated for type V–VI, management of type III–IV injuries remains controversial. Biomechanical studies have shown superior results in combined reconstruction of the coracoclavicular and AC ligament complex, however clinical data is scarce. Therefore, the present study aimed to assess whether the addition of an acromioclavicular ligament reconstruction to an isolated coracoclavicular repair offers superior clinical and radiographic outcomes in the treatment of acute AC joint dislocations. Methods: A retrospective multicenter study was conducted on patients with Rockwood type III–VI AC joint injuries who underwent surgical treatment between 2019 and 2024. Patients were divided into two groups: isolated CC reconstruction (group I) and combined CC and AC ligament reconstruction (group II). Clinical outcome was assessed using patient-reported outcome measures (American Shoulder and Elbow Surgeons Score, Simple Shoulder Test, Single Assessment Numeric Evaluation, Visual Analogue Scale) and radiographic evaluations were performed regularly up to 6 months postoperatively. Results: Fifty-five patients (94.5% male, mean age 33.5 ± 10.9 years) were included in the present study. High patient satisfaction (group I: ASES 96.3 ± 7.9, SST 99.2 ± 3.3, SANE 95.3 ± 7.0; group II: ASES 95.8 ± 8.8, SST 96.8 ± 8.2, SANE 93.6 ± 12.8) was documented in both groups, but no significant differences were observed. The median coracoclavicular loosening ratio was 24.7% in the CC group and 32.6% in the CC and AC ligament reconstruction group (p = 0.830). Five complications occurred: two infections and three revision surgeries due to excessive secondary dislocations. Conclusions: Both surgical techniques demonstrated excellent clinical outcomes. In this study combined CC and AC ligament reconstruction did not yield superior clinical or radiological results compared to isolated coracoclavicular reconstruction. Our findings suggest that a routine AC ligament augmentation may not be necessary in all patients. Further randomized controlled trials are needed to validate these results. Full article
(This article belongs to the Special Issue Trends and Prospects in Shoulder and Elbow Surgery)
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13 pages, 936 KB  
Article
Diroximel Fumarate-Loaded Solid Lipid Nanoparticles (DRF-SLNs) as Potential Carriers for the Treatment of Multiple Sclerosis: Preformulation Study
by Debora Santonocito, Giuliana Greco, Maria Grazia Sarpietro, Aurélie Schoubben, Claudia Sciacca, Giuseppe Romeo, Katia Mangano and Carmelo Puglia
Int. J. Mol. Sci. 2025, 26(24), 11827; https://doi.org/10.3390/ijms262411827 - 7 Dec 2025
Viewed by 121
Abstract
Diroximel fumarate (DRF) is an orally administered prodrug used in multiple sclerosis (MS) treatment. Although it exhibits better gastrointestinal (GI) tolerability than its analogues, many patients still discontinue therapy due to frequent GI adverse events. To overcome these limitations, alternative drug delivery systems [...] Read more.
Diroximel fumarate (DRF) is an orally administered prodrug used in multiple sclerosis (MS) treatment. Although it exhibits better gastrointestinal (GI) tolerability than its analogues, many patients still discontinue therapy due to frequent GI adverse events. To overcome these limitations, alternative drug delivery systems that bypass the GI tract are needed. Direct nose-to-brain delivery represents a promising approach to circumvent the blood–brain barrier and target the central nervous system; however, limited nasal mucosal absorption and the small volume of the nasal cavity pose significant challenges. Solid lipid nanoparticles (SLNs) can potentially overcome these obstacles by enhancing drug bioavailability and protecting against enzymatic degradation. This research aimed to develop an innovative intranasal nanoformulation of DRF to improve brain targeting and patient compliance. DRF-loaded SLNs were prepared using a solvent-diffusion technique with stearic acid as the lipid phase and Poloxamer 188 as the surfactant. The obtained nanoparticles displayed favorable technological characteristics, with a mean diameter of 210 nm, a polydispersity index of 0.17, and a zeta potential of −36 mV, suggesting good long-term stability. Interactions between SLNs and biomembrane models (MLV) were also studied to elucidate their cellular uptake mechanism. Future work will focus on evaluating the in vivo efficacy of this novel nanoformulation. Full article
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11 pages, 2242 KB  
Case Report
Surgical Management of Bilateral Trapeziometacarpal Arthritis: Suspension Arthroplasty and Dual Mobility Prosthesis in the Same Patient, Treated at the Same Time
by Matteo Guzzini, Alice Patrignani, Claudio Bagni, Rocco De Vitis, Simone Cerciello and Stefano Palermi
Surgeries 2025, 6(4), 109; https://doi.org/10.3390/surgeries6040109 - 6 Dec 2025
Viewed by 101
Abstract
Background: Trapeziometacarpal osteoarthritis (TMC OA) is a prevalent degenerative disorder that causes considerable pain and functional limitations, especially in older individuals, whose ideal treatment is still debated in the literature. Various treatments are described to restore a good functional outcome of the thumb; [...] Read more.
Background: Trapeziometacarpal osteoarthritis (TMC OA) is a prevalent degenerative disorder that causes considerable pain and functional limitations, especially in older individuals, whose ideal treatment is still debated in the literature. Various treatments are described to restore a good functional outcome of the thumb; over the past 50 years, biological arthroplasties have been considered the gold standard for treating advanced stages of TMC OA. However, in the last decade, the use of dual mobility cup prostheses has significantly increased, with numerous studies reporting excellent clinical outcomes. In this case report, we show the results of a patient treated on the left hand with suspension arthroplasty and on his right hand with dual mobility arthroplasty in one-stage surgery. The aim of this case report is to directly compare outcomes between trapeziometacarpal prosthesis and suspension arthroplasty performed simultaneously in the same patient. Case Presentation: The present case reports a 71-year-old male patient with bilateral TMC osteoarthritis, referred to our clinic in May 2024. His medical history included hypertension, hypertriglyceridemia, paroxysmal atrial fibrillation, and benign prostatic hyperplasia. On examination, the right hand showed grade 3 osteoarthritis according to the Eaton–Littler classification, with the trapezium maintaining adequate bone stock, making the patient eligible for trapeziometacarpal prosthesis implantation. Conversely, the left hand demonstrated scaphotrapezoid arthritis with a slight reduction in trapezial bone stock, indicating the need for trapeziectomy followed by suspension arthroplasty. Both procedures were performed during the same surgical session by the same experienced hand surgeon using a lateral approach. On the right side, the trapeziometacarpal joint surfaces were resected and replaced with a dual mobility prosthesis, while on the left side, the trapezium was excised, and suspension arthroplasty was performed using a slip of the flexor carpi radialis (FCR) tendon. Methods: The patient underwent simultaneous treatment with a dual mobility trapeziometacarpal prosthesis on the right hand and trapeziectomy with suspension arthroplasty on the left hand. Clinical outcomes (grip and pinch strength, pain, QuickDASH, satisfaction, and range of motion) were evaluated at 1, 3, 6, and 12 months. Paired comparative statistics were applied with significance set at p < 0.05. Results: At all follow-up intervals (1, 3, 6, and 12 months), the hand treated with a trapeziometacarpal prosthesis demonstrated superior grip and pinch strength compared to the hand treated with trapeziectomy and suspension arthroplasty, with the greatest difference observed at 3 months. At 12 months, grip strength increased from 28 kg to 40 kg in the prosthesis-treated hand and from 25 kg to 33 kg in the suspension arthroplasty hand. Paired comparisons were performed at each follow-up interval up to 12 months, confirming a significant difference for grip strength. Pain levels (VAS, Visual Analogue Scale) decreased progressively in both hands, with a more rapid reduction in the hand treated with a trapeziometacarpal prosthesis, reaching statistical significance. QuickDASH scores indicated an earlier return to daily activities in the hand treated with the prosthesis, although this difference was not statistically significant. Patient satisfaction was consistently higher for the hand treated with a trapeziometacarpal prosthesis, with the patient reporting a ‘very satisfied’ rating at all timepoints. Range of motion recovery, assessed through the Kapandji score and measurements of thumb abduction and extension, also favored the hand treated with the prosthesis, with statistically significant differences for abduction and extension, whereas the hand treated with trapeziectomy and suspension arthroplasty demonstrated more gradual improvement over time. Conclusions: This case highlights the functional efficacy of both surgical approaches—biological arthroplasty and trapeziometacarpal prosthesis—in the treatment of TMC osteoarthritis. Both procedures resulted in a good clinical outcome and high patient satisfaction. However, recovery was noticeably faster in the hand treated with a trapeziometacarpal prosthesis, which is consistent with findings previously reported in the literature. These observations suggest that, while both techniques are valid and effective, trapeziometacarpal prosthetic replacement may offer a quicker return to function in appropriately selected patients. Full article
(This article belongs to the Section Hand Surgery and Research)
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10 pages, 2104 KB  
Article
Comparison Between Eleven-Bar Cushion and Pillow for Contrast Media Spread in Caudal Block
by Jaeho Cho, Sang Jun Park, Jae Chul Koh, Na Eun Kim, Won Sok Chang, Jae Hyung Kim, Keuntak Yuk, Mazen Zein, Jong Bum Choi and Yi Hwa Choi
J. Clin. Med. 2025, 14(23), 8524; https://doi.org/10.3390/jcm14238524 - 1 Dec 2025
Viewed by 184
Abstract
Background/Objectives: A caudal epidural steroid injection (CESI) is a widely used technique for managing low back and lower extremity pain due to its relative ease and safety. However, cephalic spread of the injectate may be limited by the long distance from the sacral [...] Read more.
Background/Objectives: A caudal epidural steroid injection (CESI) is a widely used technique for managing low back and lower extremity pain due to its relative ease and safety. However, cephalic spread of the injectate may be limited by the long distance from the sacral hiatus and by increased intra-abdominal pressure caused using conventional abdominal pillows during prone positioning. This study aimed to investigate whether an eleven-bar cushion could facilitate higher cephalic spread of contrast medium during CESI compared to a conventional pillow. Methods: This retrospective study was approved by the Institutional Review Board (IRB number: AJOUIRB-DB-2025-103). Data from 76 patients, who underwent CESI between January 2023 and March 2024, were analyzed. Patients were divided into two groups the eleven-bar group (n = 38) using a pelvic eleven-bar cushion and the pillow group (n = 38) using a conventional pillow. Fluoroscopic images were reviewed to identify the highest vertebral level reached by the injectate and the number of nerve roots visualized. Visual analogue scale (VAS) scores before and one month after the procedure were also assessed. Statistical analyses included Mann–Whitney U tests, linear regression, and Poisson regression. Results: Baseline demographic characteristics were similar between groups. The cephalic spread of contrast medium was significantly higher in the eleven-bar group compared with the pillow group (median level L3/4 vs. L4/5, p = 0.0002). No significant differences were observed in the number of nerve roots reached or in the VAS score improvement between groups. Conclusions: The eleven-bar cushion facilitated greater cephalic spread of contrast medium during CESI compared with a conventional pillow. Although this technique did not affect nerve root distribution or pain reduction outcomes, it may represent a useful positioning strategy to enhance drug delivery to higher lumbar levels during caudal epidural injections. Full article
(This article belongs to the Section Anesthesiology)
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12 pages, 2242 KB  
Article
Augmented Reality-Assisted Micro-Invasive Apicectomy with Markerless Visual–Inertial Odometry: An In Vivo Pilot Study
by Marco Farronato, Davide Farronato, Federico Michelini and Giulio Rasperini
Appl. Sci. 2025, 15(23), 12588; https://doi.org/10.3390/app152312588 - 27 Nov 2025
Viewed by 224
Abstract
Introduction: Apicectomy is an endodontic surgical procedure prescribed for persistent periapical pathologies when conventional root canal therapy or retreatment have failed. Accurate intraoperative visualization of the root apex and surrounding structures remains challenging and subject to possible errors. Augmented reality (AR) allows for [...] Read more.
Introduction: Apicectomy is an endodontic surgical procedure prescribed for persistent periapical pathologies when conventional root canal therapy or retreatment have failed. Accurate intraoperative visualization of the root apex and surrounding structures remains challenging and subject to possible errors. Augmented reality (AR) allows for the addition of real-time digital overlays of the anatomical region, thus potentially improving surgical precision and reducing invasiveness. The purpose of this pilot study is to describe the application of an AR method in cases requiring apicectomy. Materials and Methods: Patients presenting with chronic persistent apical radio-translucency associated with pain underwent AR-assisted apicectomy. Cone-beam computed tomography (CBCT) scans were obtained preoperatively for segmentation of the target root apex and adjacent anatomical structures. A custom visual–inertial odometry (VIO) algorithm was used to map and stabilize the segmented digital 3D models on a portable device in real time, enabling an overlay of digital guides onto the operative field. The duration of preoperative procedures, was recorded. Postoperative pain measured by a Visual Analogue Scale (VAS), and periapical healing assessed with radiographic evaluations, were recorded at baseline (T0) and at 6 weeks and 6 months (T1–T2) after surgery. Results: AR-assisted apicectomies were successfully performed in all three patients without intraoperative complications. The digital overlap procedure required an average of [1.49 ± 0.34] minutes. VAS scores decreased significantly from T0 to T2, and patients showed radiographic evidence of progressive periapical healing. No patient reported persistent discomfort at follow-up. Conclusion: This preliminary pilot study indicates that AR-assisted apicectomy is feasible and may improve intraoperative visualization with low additional surgical time. Future larger-scale studies with control groups are needed to validate the method proposed and to quantify the outcomes. Clinical Significance: By integrating real-time digital images of bony structures and root morphology, AR guidance during apicectomy may offer enhanced precision for apical resection and may decrease the risk of iatrogenic damage. The use of a visual–inertial odometry-based AR method is a novel technique that demonstrated promising results in terms of VAS and final outcomes, especially in anatomically challenging cases in this preliminary pilot study. Full article
(This article belongs to the Special Issue Advanced Dental Imaging Technology)
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14 pages, 1992 KB  
Article
A Novel and Validated GC-MS/MS Method for the Detection of Four Opioids and Seven Fentanoids in Oral Fluid for Forensic Applications
by Roberta Tittarelli, Davide Filardi, Federico Mineo and Giulio Mannocchi
Molecules 2025, 30(22), 4478; https://doi.org/10.3390/molecules30224478 - 20 Nov 2025
Viewed by 524
Abstract
In recent years, the marked increase in the abuse of fentanyl and its analogues has emphasized the importance of developing highly sensitive and selective analytical methods for their detection in biological matrices. Oral fluid (OF) has emerged as a useful alternative to blood [...] Read more.
In recent years, the marked increase in the abuse of fentanyl and its analogues has emphasized the importance of developing highly sensitive and selective analytical methods for their detection in biological matrices. Oral fluid (OF) has emerged as a useful alternative to blood in forensic toxicology, offering a non-invasive and easily accessible matrix for the identification of a recent drug intake. However, its composition requires rigorous sample preparation and robust analytical techniques. A gas chromatography–tandem mass spectrometry (GC-MS/MS) method was developed and validated for the quantification of four opioids and seven fentanyl analogues. A fast and simple solid-phase extraction (SPE) procedure was optimized, enabling the identification and quantification of all analytes in 11 min. The method was validated according to international guidelines, showing a satisfactory degree of linearity (R2 ≥ 0.993), precision, accuracy, and sensitivity, with limit of detections (LODs) ranging from 0.10 to 0.20 ng/mL. The method was then successfully applied to n = 10 real OF samples collected during traffic stops set up by police forces which tested negative at the screening tests. Two samples tested positive for codeine and morphine, and one was positive for fentanyl and norfentanyl. The small number of samples currently limits the interpretation of the results. However, our study represents a good starting point for further application of this method to a wider population of real samples. Full article
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11 pages, 883 KB  
Article
The Use of Polymethylmethacrylate Cement in Percutaneous Vertebroplasty Versus Conservative Management: How to Treat Osteoporotic Vertebral Compression Fractures
by Corrado Ciatti, Chiara Asti, Pietro Maniscalco, Michelangelo Rinaldi, Gianfranco Pirellas, Gianfilippo Caggiari, Francesco Pisanu, Angelino Sanna and Carlo Doria
Medicina 2025, 61(11), 2004; https://doi.org/10.3390/medicina61112004 - 9 Nov 2025
Viewed by 324
Abstract
Background and Objectives: Osteoporotic vertebral compression fractures (OVCFs) are a major cause of morbidity, disability, and loss of independence in the elderly population. The optimal management of these fractures remains debated, especially regarding the balance between conservative treatment and minimally invasive surgical [...] Read more.
Background and Objectives: Osteoporotic vertebral compression fractures (OVCFs) are a major cause of morbidity, disability, and loss of independence in the elderly population. The optimal management of these fractures remains debated, especially regarding the balance between conservative treatment and minimally invasive surgical techniques such as percutaneous vertebroplasty (VP). This study aimed to compare clinical and radiological outcomes of VP and conservative management in patients with acute OVCFs. Materials and methods: A retrospective observational cohort study was conducted on 120 patients with acute OVCFs treated either conservatively or through percutaneous VP using polymethylmethacrylate (PMMA) cement. Clinical outcomes were assessed using the Visual Analogue Scale (VAS) for pain, Roland–Morris Disability Questionnaire (RMDQ), and Oswestry Disability Index (ODI). Evaluations were performed at baseline and at 1, 3, 6, and 12 months post-treatment. Radiological follow-up assessed fracture healing and new vertebral fractures. Results: Patients treated with VP experienced significantly faster pain relief and functional improvement than those managed conservatively, with marked differences in VAS, RMDQ, and ODI scores within the first month (p < 0.01). By 12 months, outcomes converged between groups, with comparable pain and functional levels. No major complications were reported; cement leakage was asymptomatic, and no neurological or systemic adverse events occurred. Radiological healing was satisfactory in both groups, without increased risk of adjacent fractures in the VP group. Conclusions: Percutaneous vertebroplasty resulted in faster short-term improvement compared with conservative treatment, while functional outcomes converged over time. The retrospective, non-randomized design limits causal inference. Full article
(This article belongs to the Section Orthopedics)
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30 pages, 2650 KB  
Article
Advanced Spectroscopic Studies of the AIE-Enhanced ESIPT Effect in a Selected 1,3,4-Thiadiazole Derivative in Liposomal Systems with DPPC
by Alicja Skrzypek, Iwona Budziak-Wieczorek, Lidia Ślusarczyk, Andrzej Górecki, Daniel Kamiński, Anita Kwaśniewska, Sylwia Okoń, Igor Różyło and Arkadiusz Matwijczuk
Int. J. Mol. Sci. 2025, 26(21), 10643; https://doi.org/10.3390/ijms262110643 - 31 Oct 2025
Viewed by 468
Abstract
Liposomal systems are advanced carriers of active substances which, thanks to their ability to encapsulate these substances, significantly improve their pharmacokinetics, bioavailability, and selectivity. This article presents the results of spectroscopic studies for a selected compound from the 1,3,4-thiadiazole group, namely 4-[5-(naphthalen-1-ylmethyl)-1,3,4-thiadiazol-2-yl]benzene-1,3-diol (NTBD, [...] Read more.
Liposomal systems are advanced carriers of active substances which, thanks to their ability to encapsulate these substances, significantly improve their pharmacokinetics, bioavailability, and selectivity. This article presents the results of spectroscopic studies for a selected compound from the 1,3,4-thiadiazole group, namely 4-[5-(naphthalen-1-ylmethyl)-1,3,4-thiadiazol-2-yl]benzene-1,3-diol (NTBD, see below in the text), in selected liposomal systems formed from the phospholipid 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC). Detailed spectroscopic analyses were carried out using electronic absorption and fluorescence spectroscopy; resonance light scattering (RLS) spectra measurements; dynamic light scattering (DLS); as well as time-resolved methods—fluorescence lifetime measurements using the TCSPC technique. Subsequently, based on the interpretation of spectra obtained by FTIR infrared spectroscopy, the preliminary molecular organization of the above-mentioned compounds within lipid multilayers was determined. It was found that NTBD preferentially occupies the region of polar lipid headgroups in the lipid multilayer, although it also noticeably interacts with the hydrocarbon chains of the lipids. Furthermore, X-ray diffraction (XRD) techniques were used to study the effect of NTBD on the molecular organization of DPPC lipid multilayers. Monomeric structures and aggregated forms of the above-mentioned 1,3,4-thiadiazole analogue were characterized using X-ray crystallography. Interesting dual fluorescence effects observed in steady-state fluorescence measurements were linked to the excited-state intramolecular proton transfer (ESIPT) effect (based on our earlier studies), which, in the obtained biophysical systems—liposomal systems with strong hydrophobicity—is greatly enhanced by aggregation-induced emission (AIE) effects. In summary, the research presented in this study, concerning the novel 1,3,4-thiadiazole derivative NTBD, is highly relevant to drug delivery systems, such as various model liposomal systems, as it demonstrates that depending on the concentration of the selected fluorophore, different forms may be present, allowing for appropriate modulation of its biological activity. Full article
(This article belongs to the Special Issue AIEgens in Action: Design, Mechanisms, and Emerging Applications)
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12 pages, 370 KB  
Article
Ultrasound-Guided Versus Traditional Refill of Intrathecal Infusion Pumps: A Prospective Quasi-Experimental Clinical Study
by Beatriz Lechuga Carrasco, Jose Manuel Martínez-Linares, José Alejandro Ávila-Cabreja, Jonathan Cortés-Martín, Beatriz Piqueras-Sola, Nicolás Cordero Tous and Rafael Gálvez Mateos
Biomedicines 2025, 13(11), 2671; https://doi.org/10.3390/biomedicines13112671 - 30 Oct 2025
Viewed by 406
Abstract
Background: There are multiple treatments and approaches available to manage pain. However, when these interventions fail to achieve adequate relief, pain management may involve the implantation of intrathecal infusion pumps. The use of ultrasound guidance may enhance nursing practice by improving procedural efficiency [...] Read more.
Background: There are multiple treatments and approaches available to manage pain. However, when these interventions fail to achieve adequate relief, pain management may involve the implantation of intrathecal infusion pumps. The use of ultrasound guidance may enhance nursing practice by improving procedural efficiency and patient comfort. This technique offers a more precise, safer, and less painful approach, potentially increasing patient satisfaction and reducing procedural complications. Aim: To evaluate patient pain levels during intrathecal infusion pump refills under ultrasound guidance compared to the traditional approach, also aiming to determine the time taken per technique and to assess related intra-procedural complications. Design: A prospective quasi-experimental pre-post study. Methods: The study population included individuals with intrathecal infusion pumps. Each participant underwent two refill visits: one using the traditional method and the subsequent refill using ultrasound guidance. The time required to complete the procedure, any complications, and pain related to the procedure were measured for both techniques. Time was measured using a stopwatch, and pain was assessed at the end of each procedure using a Visual Analogue Scale (VAS). Results: A total of 45 patients (25 men and 20 women), with a median age of 56.0 years were included. The estimated mean refill duration was 13.67 min for the traditional method versus 7.26 min for ultrasound-guided refills, representing a 53.2% reduction. The adjusted mean VAS was 2.76 (2.27–3.24) with ultrasound versus 5.91 (5.20–6.62) with the traditional method, yielding an adjusted mean difference of −3.16 (−4.02 to −2.30; p < 0.001). Reductions were consistent across subgroups defined by sex, refill duration, inter-procedural interval, intrathecal medication, and medical history. Complications occurred in 20.0% of traditional refills but in none of the ultrasound-guided procedures. Conclusions: Ultrasound guidance significantly reduces pain, complications, and procedure time, positioning it as the new standard of care for intrathecal pump refills. This mandates its immediate integration into nursing protocols and health management policies. Full article
(This article belongs to the Special Issue New Trends in Regional Anesthesia and Pain Management)
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10 pages, 1871 KB  
Article
Modified Hofmann Articulated Spacer in the Treatment of Peri-Prosthetic Joint Infection of the Knee—Surgical Technique and Early Clinical Evaluation
by Salvatore Risitano, Simone Sanfilippo, Beatrice Limone, Stefano Artiaco, Marianna Faggiani, Marcello Capella and Alessandro Massè
J. Clin. Med. 2025, 14(21), 7605; https://doi.org/10.3390/jcm14217605 - 27 Oct 2025
Viewed by 421
Abstract
Background/Objectives: The rate of periprosthetic joint infection (PJI) is expected to increase in the next years worldwide, mainly due to increasing volume of total joint replacement, longer prosthesis lifespans, and patients with multiple comorbidities. The aim of this study is to describe [...] Read more.
Background/Objectives: The rate of periprosthetic joint infection (PJI) is expected to increase in the next years worldwide, mainly due to increasing volume of total joint replacement, longer prosthesis lifespans, and patients with multiple comorbidities. The aim of this study is to describe our personal technique, the modified Hofmann Articulated Spacer (mHAS), in which a CR femoral shield and a partially threaded cannulated screw are inserted into the liner replicating a tibial stem, and to evaluate the efficacy of the spacer as a definitive treatment option in selected patients with knee infections. Methods: A consecutive series of 132 patients were treated for orthopedic infection at the Orthopedic and Trauma Center, University of Turin, between November 2023 and May 2025. All patients included in the study had undergone knee prosthesis removal followed by the implantation of a modified Hofmann Articulated Spacer (mHAS). Functional recovery was evaluated through clinical examination, particularly knee range of motion, and patient-reported outcome measures (PROMs), including the Knee Society Score (KSS), Oxford Knee Score (OKS), and the EQ-5D-5L Visual Analogue Scale (VAS). Results: Nine patients were enrolled in the study, at a mean follow-up of 8.12 months (range: 3–13). The mean range of motion of the knee was 95 degrees (range: 80–120°, SD: 15°). The Knee Society Score (KSS) presented a mean value of 71.9 (SD: 18.11). The Oxford Knee Score (OKS) showed a mean value of 30.8 (SD: 8.5). The EuroQol-5 Dimension-5 Level Visual Analogue Scale (EQ-5D-5L VAS) scores demonstrated an excellent quality of life among the participants. Conclusions: The Modified Hofmann Articulated Spacer demonstrated good functional, qualitative outcomes and eradication rates in patients who underwent the first-stage revision TKA for PKI. This has led us to propose it as a definitive treatment option for more critical and low-demand patients and to postpone the second-stage surgery in the remaining cohort due to satisfactory spacer joint function without pain. Full article
(This article belongs to the Section Orthopedics)
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18 pages, 1453 KB  
Article
Comparative Clinical and Volumetric Outcomes of Contemporary Surgical Techniques for Lumbar Foraminal Stenosis: A Retrospective Cohort Study
by Renat M. Nurmukhametov, Vladimir Klimov, Abakirov Medetbek, Stepan Anatolevich Kudryakov, Medet Dosanov, Anastasiia Alekseevna Guseva, Petr Ruslanovich Baigushev, Timur Arturovich Kerimov and Nicola Montemurro
Surgeries 2025, 6(4), 91; https://doi.org/10.3390/surgeries6040091 - 20 Oct 2025
Viewed by 757
Abstract
Background: Lumbar foraminal stenosis (LFS) is a prevalent degenerative condition associated with significant radicular pain and impaired quality of life. Advances in minimally invasive and fusion-based surgical techniques have introduced new strategies for decompressing the neural elements. However, comparative data correlating volumetric foraminal [...] Read more.
Background: Lumbar foraminal stenosis (LFS) is a prevalent degenerative condition associated with significant radicular pain and impaired quality of life. Advances in minimally invasive and fusion-based surgical techniques have introduced new strategies for decompressing the neural elements. However, comparative data correlating volumetric foraminal expansion with functional outcomes remain limited. Methods: This retrospective cohort study analyzed 256 patients treated surgically for symptomatic LFS between December 2017 and December 2023. Patients were categorized into four surgical subgroups: endoscopic decompression, anterior lumbar interbody fusion (ALIF), microsurgical decompression, and transforaminal lumbar interbody fusion (TLIF). Preoperative and postoperative assessments included magnetic resonance imaging (MRI) to calculate foraminal volume and standardized clinical scales: the Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for back and leg pain, and SF-36 health-related quality-of-life scores. Statistical significance was determined using p-values, and inter-observer agreement was evaluated via κ-statistics. Results: Postoperative imaging demonstrated a significant increase in foraminal canal volume across all surgical groups: endoscopy (29.9%), ALIF (71.8%), microsurgery (48.06%), and TLIF (67.0%). ODI scores improved from a preoperative mean of 55.25 to 18.27 at 24 months post-surgery (p < 0.001). VAS scores for back pain decreased from 6.37 to 2.1 (p < 0.001), while leg pain scores declined from 6.85 to 2.05 (p < 0.001). Functional improvement reached or exceeded the minimal clinically important difference (MCID) threshold in over 66% of patients. Conclusions: Modern surgical strategies for LFS, particularly fusion-based techniques, yield significant volumetric decompression and durable clinical improvement. Volumetric gain in the foraminal canal is closely associated with pain reduction and enhanced functional outcomes. These findings support a tailored surgical approach based on anatomical pathology and segmental stability. Full article
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23 pages, 4464 KB  
Article
Synthesis of First Copper Metal Complex of C=C Extended Curcuminoid Analogue: Structure, β-Cyclodextrin Association, and Biological Properties
by Rosario Tavera-Hernández, Rubén Sánchez-Obregón, Marco A. Obregón-Mendoza, Antonio Nieto-Camacho, María Teresa Ramírez-Apan, Leidys L. Pérez-González and Raúl G. Enríquez
Molecules 2025, 30(19), 3943; https://doi.org/10.3390/molecules30193943 - 1 Oct 2025
Viewed by 478
Abstract
The search for bioactive compounds against chronic diseases such as cancer and diabetes includes curcuminoids as promising scaffolds. Here, we report the synthesis of a family of curcuminoid analogue compounds with an extended unsaturated central chain, as follows: difluoroboron complex 1, the [...] Read more.
The search for bioactive compounds against chronic diseases such as cancer and diabetes includes curcuminoids as promising scaffolds. Here, we report the synthesis of a family of curcuminoid analogue compounds with an extended unsaturated central chain, as follows: difluoroboron complex 1, the enolised curcuminoid 2, and its homoleptic copper complex 3, in moderate to good yields (68–90%). Additionally, their β-cyclodextrin (BCD) association complexes, 4 and 5, were prepared through a mechanochemical method and characterised by spectroscopic techniques. Complete 1H and 13C NMR assignments and NOESY correlations revealed unique solvent effects on the conformational disposition of compound 2, while the copper complex 3 displayed the highest extinction coefficient (1.20 × 105 M−1·cm−1). Furthermore, the authentication of the polymorph of 1 and the new crystal structures of 2 and 3, determined by single-crystal X-ray analysis, were highlighted. Although the copper complex 3 initially exhibited the lowest a-glucosidase inhibitory activity (IC50 > 100 µM), it showed a significant increase (IC50 = 36.27 µM) upon association with BCD, reaching values comparable to the free ligand (IC50 = 45.63 µM). Compounds 15 were non-toxic to healthy cells (COS-7), but compound 5 stands out as a promising candidate against this metabolic condition. Full article
(This article belongs to the Special Issue Advances in Phenolic Based Complexes)
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13 pages, 1118 KB  
Perspective
Nitazenes: The Emergence of a Potent Synthetic Opioid Threat
by Joana R. P. Pereira, Alexandre Quintas and Nuno R. Neng
Molecules 2025, 30(19), 3890; https://doi.org/10.3390/molecules30193890 - 26 Sep 2025
Viewed by 4902
Abstract
The global unregulated drug supply faces a critical challenge with the emergence of nitazenes, a class of novel synthetic opioids (NSOs) structurally distinct from fentanyl and associated with extreme potency and high risk of fatal overdose. First synthesised in the late 1950s, etonitazene [...] Read more.
The global unregulated drug supply faces a critical challenge with the emergence of nitazenes, a class of novel synthetic opioids (NSOs) structurally distinct from fentanyl and associated with extreme potency and high risk of fatal overdose. First synthesised in the late 1950s, etonitazene was a target of preclinical research in rats and rhesus monkeys, but it never reached clinical trials due to an unfavourable balance between therapeutic and toxic effects. Nitazenes’ consistent reappearance began in 2019 with isotonitazene, followed by a rapid proliferation of analogues worldwide, many reported to be hundreds to thousands of times more potent than morphine and, in some cases, stronger than fentanyl. This rise is fuelled by their ease of synthesis, low production costs, and evasion of regulatory controls. Nitazenes are frequently mis-sold as counterfeit medications or adulterated into other drugs, resulting in unintentional exposure and overdose, particularly among opioid-naïve users. The primary cause of death is severe and prolonged respiratory depression. Analytical challenges are significant, as traditional screening methods are ineffective, and the low concentration in biological samples requires expensive and highly sensitive liquid chromatography mass spectrometry techniques. This perspective paper highlights critical gaps in detection, clinical management, and regulatory readiness for nitazenes. Urgent efforts are needed to improve surveillance, develop robust analytical methodologies, provide clinical guidance to nitazene intoxications, and strengthen international policy to curb their proliferation. Full article
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