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Search Results (153)

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Keywords = avoided burden approach

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24 pages, 4297 KiB  
Article
Finite-Time RBFNN-Based Observer for Cooperative Multi-Missile Tracking Control Under Dynamic Event-Triggered Mechanism
by Jiong Li, Yadong Tang, Lei Shao, Xiangwei Bu and Jikun Ye
Aerospace 2025, 12(8), 693; https://doi.org/10.3390/aerospace12080693 - 31 Jul 2025
Viewed by 176
Abstract
This paper proposes a hierarchical cooperative tracking control method for multi-missile formations under dynamic event-triggered mechanisms, addressing parameter uncertainties and saturated overload constraints. The proposed hierarchical structure consists of a reference-trajectory generator and a trajectory-tracking controller. The reference-trajectory generator considers communication and collaboration [...] Read more.
This paper proposes a hierarchical cooperative tracking control method for multi-missile formations under dynamic event-triggered mechanisms, addressing parameter uncertainties and saturated overload constraints. The proposed hierarchical structure consists of a reference-trajectory generator and a trajectory-tracking controller. The reference-trajectory generator considers communication and collaboration among multiple interceptors, imposes saturation constraints on virtual control inputs, and generates reference trajectories for each receptor, effectively suppressing aggressive motions caused by overload saturation. On this basis, a radial basis function neural network (RBFNN) combined with a sliding-mode disturbance observer is adopted to estimate unknown external disturbances and unmodeled dynamics, and the finite-time convergence of the disturbance observer is proved. A tracking controller is then designed to ensure precise tracking of the reference trajectory by missile. This approach not only reduces communication and computational burdens but also effectively avoids Zeno behavior, enhancing the practical feasibility and robustness of the proposed method in engineering applications. The simulation results verify the effectiveness and superiority of the proposed method. Full article
(This article belongs to the Section Aeronautics)
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12 pages, 1078 KiB  
Article
Aerostability of Sin Nombre Virus Aerosol Related to Near-Field Transmission
by Elizabeth A. Klug, Danielle N. Rivera, Vicki L. Herrera, Ashley R. Ravnholdt, Daniel N. Ackerman, Yangsheng Yu, Chunyan Ye, Steven B. Bradfute, St. Patrick Reid and Joshua L. Santarpia
Pathogens 2025, 14(8), 750; https://doi.org/10.3390/pathogens14080750 (registering DOI) - 30 Jul 2025
Viewed by 242
Abstract
Sin Nombre virus (SNV) is the main causative agent of hantavirus cardiopulmonary syndrome (HCPS) in North America. SNV is transmitted via environmental biological aerosols (bioaerosols) produced by infected deer mice (Peromyscus maniculatus). It is similar to other viruses that have environmental [...] Read more.
Sin Nombre virus (SNV) is the main causative agent of hantavirus cardiopulmonary syndrome (HCPS) in North America. SNV is transmitted via environmental biological aerosols (bioaerosols) produced by infected deer mice (Peromyscus maniculatus). It is similar to other viruses that have environmental transmission routes rather than a person-to-person transmission route, such as avian influenza (e.g., H5N1) and Lassa fever. Despite the lack of person-to-person transmission, these viruses cause a significant public health and economic burden. However, due to the lack of targeted pharmaceutical preventatives and therapeutics, the recommended approach to prevent SNV infections is to avoid locations that have a combination of low foot traffic, receive minimal natural sunlight, and where P. maniculatus may be found nesting. Consequently, gaining insight into the SNV bioaerosol decay profile is fundamental to the prevention of SNV infections. The Biological Aerosol Reaction Chamber (Bio-ARC) is a flow-through system designed to rapidly expose bioaerosols to environmental conditions (ozone, simulated solar radiation (SSR), humidity, and other gas phase species at stable temperatures) and determine the sensitivity of those particles to simulated ambient conditions. Using this system, we examined the bioaerosol stability of SNV. The virus was found to be susceptible to both simulated solar radiation and ozone under the tested conditions. Comparisons of decay between the virus aerosolized in residual media and in a mouse bedding matrix showed similar results. This study indicates that SNV aerosol particles are susceptible to inactivation by solar radiation and ozone, both of which could be implemented as effective control measures to prevent disease in locations where SNV is endemic. Full article
(This article belongs to the Special Issue Airborne Transmission of Pathogens)
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16 pages, 1435 KiB  
Case Report
Multidimensional Effects of Manual Therapy Combined with Pain Neuroscience-Based Sensorimotor Retraining in a Patient with Chronic Neck Pain: A Case Study Using fNIRS
by Song-ui Bae, Ju-hyeon Jung and Dong-chul Moon
Healthcare 2025, 13(14), 1734; https://doi.org/10.3390/healthcare13141734 - 18 Jul 2025
Viewed by 395
Abstract
Chronic neck pain is a multifactorial condition involving physical, psychological, and neurological dimensions. This case report describes the clinical course of a 25-year-old female with chronic neck pain and recurrent headaches who underwent a 6-week integrative intervention consisting of manual therapy and pain [...] Read more.
Chronic neck pain is a multifactorial condition involving physical, psychological, and neurological dimensions. This case report describes the clinical course of a 25-year-old female with chronic neck pain and recurrent headaches who underwent a 6-week integrative intervention consisting of manual therapy and pain neuroscience-based sensorimotor retraining, administered three times per week. Outcome measures included the Headache Impact Test-6 (HIT-6), Neck Pain and Disability Scale (NPDS), Pain Catastrophizing Scale (PCS), Fear-Avoidance Beliefs Questionnaire (FABQ), pressure pain threshold (PPT), cervical range of motion (CROM), and functional near-infrared spectroscopy (fNIRS) to assess brain activity. Following the intervention, the patient demonstrated marked reductions in pain and psychological distress: HIT-6 decreased from 63 to 24 (61.9%), NPDS from 31 to 4 (87.1%), FABQ from 24 to 0 (100%), and PCS from 19 to 2 (89.5%). Improvements in PPT and CROM were also observed. fNIRS revealed decreased dorsolateral prefrontal cortex (DLPFC) activation during pain stimulation and movement tasks, suggesting a possible reduction in central sensitization burden. These findings illustrate that an integrative approach targeting biopsychosocial pain mechanisms may be beneficial in managing chronic neck pain, improving function, and modulating cortical responses. This report provides preliminary evidence in support of the clinical relevance of combining manual therapy with neurocognitive retraining in similar patients. Full article
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25 pages, 1824 KiB  
Article
Orofacial Myofunctional Therapy for Patients with Obstructive Sleep Apnea—A Mixed Methods Study of Facilitators and Barriers to Treatment Adherence
by Diana Dobran Hansen, Unn Tinbod, Xin Feng, Toril Dammen, Harald Hrubos-Strøm and Helge Skirbekk
Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 6; https://doi.org/10.3390/ijom51020006 - 30 Jun 2025
Viewed by 946
Abstract
Orofacial myofunctional therapy (OMT) for obstructive sleep apnea (OSA) is a promising, new treatment. We aimed to study patients’ experiences and adherence to OMT. Twelve patients with OSA were included in the study, and they engaged in OMT exercises three times daily for [...] Read more.
Orofacial myofunctional therapy (OMT) for obstructive sleep apnea (OSA) is a promising, new treatment. We aimed to study patients’ experiences and adherence to OMT. Twelve patients with OSA were included in the study, and they engaged in OMT exercises three times daily for 12 weeks. Participants tracked their sleep and OMT exercise activities in an electronic diary. Exercise techniques were guided by a certified therapist. Patients’ experiences with OMT were assessed through semi-structured individual interviews conducted after a 12-week intervention, and the transcripts were analyzed using thematic analysis. The findings revealed an overarching theme that captured both facilitators of and barriers to OMT, organized into three subthemes: (1) motivation, (2) perceived support, and (3) perceived effects. Motivation was driven by a desire to improve general health and avoid continuous positive airway pressure treatment, and was supported by a sense of mastery and perceived effectiveness. Key facilitators included a trusting patient–therapist relationship, as well as developing routines and a sense of control. Barriers involved managing the comprehensive treatment protocol, insecurities around exercise execution and the potential impact of OMT, sickness burden, and previous negative healthcare experiences. These themes were supported by quantitative findings, which demonstrated high treatment adherence, while sleep data indicated modest individual improvements in subjective sleep quality and efficiency. By recognizing facilitators and barriers and addressing the individual differences among OSA patients, healthcare providers can better tailor their approach to meet diverse patient needs. This personalized approach, supported by emerging sleep improvements, may enhance patient engagement and improve adherence to OMT. Full article
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17 pages, 2087 KiB  
Article
Intertemporal Allocation of Recycling for Long-Lived Materials from Energy Infrastructure
by Mario Schmidt and Pia Heidak
Energies 2025, 18(13), 3393; https://doi.org/10.3390/en18133393 - 27 Jun 2025
Viewed by 334
Abstract
Energy conversion and infrastructure facilities consist of large amounts of metal and have lifetimes of several decades. When recycling metals, the methods of allocation play a decisive role in evaluating how primary and secondary materials, as well as the products that are produced [...] Read more.
Energy conversion and infrastructure facilities consist of large amounts of metal and have lifetimes of several decades. When recycling metals, the methods of allocation play a decisive role in evaluating how primary and secondary materials, as well as the products that are produced with them, are to be evaluated ecologically. So-called credits for recycling are the subject of a particularly controversial discussion. This article shows that the current practice of giving credits for long-lasting products leads to a significant distortion of the actual emissions. Using the examples of steel, aluminum, and copper, prospective LCA data is used to show how the carbon footprint actually behaves. When credits are applied, the time dependency of emissions must be taken into account; otherwise, burden shifting into the future occurs, which can hardly be considered sustainable. The increase compared to the conventional time-independent practice lies, depending on the metal, at 70 to 300%. It is recommended that the cutoff approach be used conservatively when allocating recycling cascades in order to optimize environmental impact and avoid greenwashing. Full article
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23 pages, 3344 KiB  
Article
Trajectory Optimization with Dynamic Drivable Corridor-Based Collision Avoidance
by Weijie Wang, Tantan Zhang, Zihan Song and Haipeng Liu
Appl. Sci. 2025, 15(13), 7051; https://doi.org/10.3390/app15137051 - 23 Jun 2025
Viewed by 321
Abstract
Trajectory planning for autonomous vehicles is essential for ensuring driving safety, passenger comfort, and operational efficiency. Collision avoidance constraints introduce significant computational complexity due to their inherent non-convex and nonlinear characteristics. Previous research has proposed the drivable corridor (DC) method, which transforms complex [...] Read more.
Trajectory planning for autonomous vehicles is essential for ensuring driving safety, passenger comfort, and operational efficiency. Collision avoidance constraints introduce significant computational complexity due to their inherent non-convex and nonlinear characteristics. Previous research has proposed the drivable corridor (DC) method, which transforms complex collision avoidance constraints into linear inequalities by constructing time-varying rectangular corridors within the spatiotemporal domains, thereby enhancing optimization efficiency. However, the DC construction process involves repetitive collision detection, leading to an increased computational burden. To address this limitation, this study proposes a novel approach that integrates grid-based obstacle representation with dynamic grid merging to accelerate collision detection and dynamically constructs the DC by adaptively adjusting the expansion strategies according to available spatial dimensions. The feasibility and effectiveness of the proposed method are validated through simulation-based evaluations conducted over 100 representative scenarios characterized by diverse and unstructured environmental configurations. The simulation results indicate that, with appropriately selected grid resolutions, the proposed approach achieves up to a 60% reduction in trajectory planning time compared to conventional DC-based planners while maintaining robust performance in complex environments. Full article
(This article belongs to the Special Issue Advancements in Motion Planning and Control for Autonomous Vehicles)
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20 pages, 1278 KiB  
Review
Global Diseases Deserve Global Solutions: Alzheimer’s Disease
by Emma Twiss, Carley McPherson and Donald F. Weaver
Neurol. Int. 2025, 17(6), 92; https://doi.org/10.3390/neurolint17060092 - 14 Jun 2025
Cited by 1 | Viewed by 729
Abstract
Alzheimer’s Disease (AD) is a global issue, with increasing incidence and prevalence as the world’s population ages and life expectancy increases. Projections indicate that by 2050, over 150 million individuals worldwide will be personally living with AD, an impending crisis made worse by [...] Read more.
Alzheimer’s Disease (AD) is a global issue, with increasing incidence and prevalence as the world’s population ages and life expectancy increases. Projections indicate that by 2050, over 150 million individuals worldwide will be personally living with AD, an impending crisis made worse by the absence of cure therapies. Moreover, the risk factor relationship of dementia with rising global temperatures and air pollution further necessitates the urgency of a coordinated international response. With an extensive economic and emotional burden, AD is no longer just a disease; it is a worldwide societal crisis. This review presents five calls to action to address the AD global health emergency. First, AD research must be approached as an internationally performed activity, involving standardized data sharing, collaborative innovation, and improved access to pharmaceutical studies in low- and middle-income countries (LMICs), alongside increased diversity, inclusion, and equity in research. Second, there must be a commitment to develop universally accessible, affordable, and non-invasive diagnostic tools for AD. Third, advancements in AD therapeutics should prioritize the development of affordable agents, allowing for widespread geographic distribution. Fourth, we identify focus areas for global dementia risk reduction: sleep, head injury prevention, exercise, learning, and diet (SHIELD risk reduction strategy). Fifth, improving care for individuals with AD requires eliminating stigma through educational programs for both the public and caregivers. The escalating AD crisis demands an unprecedented global coalition in research, diagnostics, therapeutics, prevention, and education to avoid a future where the disease becomes the defining crisis of our era. Full article
(This article belongs to the Collection Brain Health Initiative: Advocacy in Global Neurology)
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12 pages, 427 KiB  
Article
The Safety and Feasibility of Single-Stage Versus Staged Laparoscopic Approach for Acute Appendicitis with Inguinal Hernia in Pediatric Patients: A Comparative Study
by Zenon Pogorelić, Anders Ødeverp and Miro Jukić
J. Clin. Med. 2025, 14(12), 4243; https://doi.org/10.3390/jcm14124243 - 14 Jun 2025
Viewed by 576
Abstract
Background: The simultaneous surgical treatment of acute appendicitis and inguinal hernia in children is still controversial. However, there are no established guidelines for the simultaneous surgical treatment of pediatric patients with acute appendicitis and inguinal hernia. The aim of this study is to [...] Read more.
Background: The simultaneous surgical treatment of acute appendicitis and inguinal hernia in children is still controversial. However, there are no established guidelines for the simultaneous surgical treatment of pediatric patients with acute appendicitis and inguinal hernia. The aim of this study is to evaluate the safety and efficacy of a simultaneous laparoscopic approach for acute appendicitis and inguinal hernia in a pediatric population. Methods: The case records of 2254 pediatric patients who underwent appendectomy at our institution between 1 January 2012 and 1 January 2025 were reviewed. Finally, 44 patients who met the inclusion criteria and had an inguinal hernia at the time of laparoscopic appendectomy were selected for further analysis. The patients who underwent single-stage surgery (simultaneous laparoscopic appendectomy and hernia repair) were assigned to group I (n = 25), while the patients who underwent delayed laparoscopic hernia repair were assigned to group II (n = 19). The groups were compared for final outcome, complications, rate of readmissions within 30 days of index surgery, duration of surgery, and length of hospital stay. Results: The mean age of all the included patients was 11.5 ± 4.0 years, with males slightly outnumbering females (n = 25, 56.8%). The study population consisted of two comparable groups in terms of age, anthropometric measures, gender distribution, and baseline clinical characteristics. A major difference between the two methods was the operation time, which was significantly longer in the single-stage group (53.5 ± 11.2 min vs. 41.5 ± 10.9 min; p = 0.001). Despite the difference in operative time, the length of hospital stay (3.5 ± 2.0 days vs. 3.5 ± 2.2 days; p = 0.899) was almost identical between the two groups, suggesting that the additional intraoperative time was not reflected in a prolonged recovery time. In addition, postoperative complications were rare and evenly distributed between both surgical strategies (n = 2 (8%) vs. n = 2 (10.5%); p = 0.772). All the complications were minor and were treated conservatively. Importantly, there was no recurrence of hernia in either group during the follow-up period. Conclusions: From a clinical perspective, these results suggest that the single-stage approach is feasible and safe, even in complicated appendicitis, particularly in cases where the postponement of hernia repair is not desirable. The longer operative time associated with the single-stage approach must be weighed against the potential benefits of avoiding a second surgical procedure and unnecessary anesthesia, reducing overall healthcare utilization, and minimizing patient burden. Full article
(This article belongs to the Section General Surgery)
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12 pages, 604 KiB  
Perspective
Overcoming Implementation Barriers of Concurrent Treatment for Eating Disorders and Posttraumatic Stress Disorder: Two Novel and Feasible Approaches
by Kathryn Trottier, Sara Bartel and Aaron Keshen
Behav. Sci. 2025, 15(6), 749; https://doi.org/10.3390/bs15060749 - 30 May 2025
Viewed by 534
Abstract
Eating disorders (EDs) and posttraumatic stress disorder (PTSD) frequently co-occur and share a functional relationship. Evidence suggests benefits of integrated and/or concurrent treatment; however, implementation is hindered by clinician training burden and the challenges of delivering two treatments simultaneously. This paper explores two [...] Read more.
Eating disorders (EDs) and posttraumatic stress disorder (PTSD) frequently co-occur and share a functional relationship. Evidence suggests benefits of integrated and/or concurrent treatment; however, implementation is hindered by clinician training burden and the challenges of delivering two treatments simultaneously. This paper explores two novel and feasible approaches to addressing ED-PTSD. The first is a clinician-guided cognitive behavioural workbook intervention delivered concurrently with ED treatment. It involves psychoeducation, addresses dissociation, and encourages approach (versus avoidance) practices. The second involves combining Written Exposure Therapy (WET) with ED treatment at both outpatient and day hospital levels of care. Both interventions have a low training burden and are feasible in routine clinical practice, making concurrent approaches available to those who need them. Full article
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26 pages, 708 KiB  
Review
Manifestation and Markings of HIV Stigma in Indonesia: A Scoping Review
by Ni Kadek Sudastri, Luh Putu Lila Wulandari and Pande Putu Januraga
Int. J. Environ. Res. Public Health 2025, 22(6), 840; https://doi.org/10.3390/ijerph22060840 - 27 May 2025
Viewed by 952
Abstract
Stigma related to HIV hinders access to healthcare services and worsens the quality of life for people living with HIV (PLHIV). A comprehensive understanding of HIV stigma is crucial for designing effective stigma interventions. This scoping review offers an overview of the manifestations [...] Read more.
Stigma related to HIV hinders access to healthcare services and worsens the quality of life for people living with HIV (PLHIV). A comprehensive understanding of HIV stigma is crucial for designing effective stigma interventions. This scoping review offers an overview of the manifestations and markings of HIV stigma in Indonesia. Articles published in PubMed, Scopus, Google Scholar, and other sources were searched. Studies selected were published between 2019 and 2023, written in English, and focused on the manifestations or markings of HIV stigma in Indonesia. A thematic approach was applied to analyze the findings. From an initial pool of 4776 articles, 745 advanced to the title and abstract screening process, with 40 ultimately included in the review. The findings indicate that HIV stigma in Indonesia manifested as avoidance of contact with PLHIV, differential treatment of PLHIV, negative reactions toward PLHIV, and self-stigma. These stigmatizing behaviors were observed across various societal levels, including family members, the general public, colleagues in the workplaces, healthcare providers, and even PLHIV themselves. The findings further reveal the dual burden of stigma experienced by vulnerable populations such as children, adolescents, pregnant women, and key populations. Additionally, this review notes the presence of stigma marking directed at PLHIV, portraying them as dangerous, unclean, immoral, bad and irresponsible, and even sinners. In conclusion, in Indonesia, HIV stigma may take many different forms and occur in many different societal levels. This underscores the need for comprehensive, collective action and cross-sectoral interventions to effectively address these issues. Full article
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17 pages, 1443 KiB  
Review
Phenotypes of Exacerbations in Chronic Obstructive Pulmonary Disease
by Lucia-Cristina Nisip Avram, Tamara Mirela Poroșnicu, Patricia Hogea, Emanuela Tudorache, Elena Hogea and Cristian Oancea
J. Clin. Med. 2025, 14(9), 3132; https://doi.org/10.3390/jcm14093132 - 30 Apr 2025
Viewed by 1091
Abstract
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with an important public health challenge and a major burden on health-care resources, having a progressive character with constant deterioration of lung function. During the course of the disease, patients experience acute episodes [...] Read more.
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease with an important public health challenge and a major burden on health-care resources, having a progressive character with constant deterioration of lung function. During the course of the disease, patients experience acute episodes of exacerbation, which are characterized by worsening symptoms, and require additional treatment during these exacerbating episodes. Given the heterogeneity of exacerbations, their phenotyping is of great interest in order to administer the most effective treatment with the aim of reducing mortality and preventing future exacerbation episodes. The lack of specific biomarkers for the diagnosis of acute exacerbations of COPD maintains researchers’ interest in trying to identify such a biomarker. In this review, we explore the different phenotypes of COPD exacerbation, and we also evaluated the ability of various biomarkers to establish the etiology of exacerbations in association with clinical manifestations. Furthermore, we addressed the main therapeutic measures necessary according to each phenotype. Overall, phenotyping exacerbations allows for an individualized approach to these patients, thus avoiding the side effects of some treatments. Full article
(This article belongs to the Section Respiratory Medicine)
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16 pages, 1150 KiB  
Article
A Decentralized Signcryption Scheme Based on CFL
by Leyi Shi and Mengting Liu
Sensors 2025, 25(6), 1773; https://doi.org/10.3390/s25061773 - 12 Mar 2025
Viewed by 793
Abstract
The rapid advancement of quantum computing technology poses a significant threat to conventional public key cryptographic infrastructure. The SM2 (state key cryptography algorithm no. 2) elliptic curve public key cryptographic algorithm, which adopts elliptic curve cryptography, has demonstrated strong resistance to quantum attacks. [...] Read more.
The rapid advancement of quantum computing technology poses a significant threat to conventional public key cryptographic infrastructure. The SM2 (state key cryptography algorithm no. 2) elliptic curve public key cryptographic algorithm, which adopts elliptic curve cryptography, has demonstrated strong resistance to quantum attacks. However, existing signcryption schemes remain vulnerable due to their reliance on a single certification authority (CA) managing all keys. The cryptography fundamental logics (CFL) authentication process eliminates the need for third-party involvement, achieving decentralized authentication and reducing the burden on certificate generation centers. Therefore, a decentralized signcryption scheme based on CFL was proposed using the SM2 national cryptographic algorithm. Unlike traditional signcryption schemes, this approach does not depend on the certification authority’s private key during the public–private key generation process. This innovation helps avoid risks associated with certification authority private key leakage and ensures decentralized characteristics. The proposed scheme was rigorously verified under the random oracle model (ROM) and based on the complexity assumption of the elliptic curve Diffie–Hellman (ECDH) problem. The theoretical analysis and experimental results demonstrate that compared to traditional methods, the proposed scheme exhibits higher efficiency in communication and computation. Specifically, the proposed scheme reduces computational overheads by approximately 30% and communication overheads by approximately 20% in practical working environments. These quantitative improvements highlight the scheme’s promising application prospects and practical value. Full article
(This article belongs to the Section Internet of Things)
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7 pages, 211 KiB  
Perspective
Non-Communicable Diseases, Longevity, and Health Span: A Hong Kong Perspective
by Jean Woo and Michael Marmot
Int. J. Environ. Res. Public Health 2025, 22(3), 359; https://doi.org/10.3390/ijerph22030359 - 28 Feb 2025
Viewed by 1076
Abstract
The health of different countries evolves in parallel with their economic development. Communicable diseases play a more prominent role in low-income countries compared with high-income countries, while non-communicable diseases (NCDs) have become dominant in developing and developed economies. This transition has been accompanied [...] Read more.
The health of different countries evolves in parallel with their economic development. Communicable diseases play a more prominent role in low-income countries compared with high-income countries, while non-communicable diseases (NCDs) have become dominant in developing and developed economies. This transition has been accompanied by public health efforts to prevent NCDs, resulting in improvements in total life expectancy at birth (TLE). It is recognized that health determinants are not confined to healthcare systems, but that social determinants play a key role in health inequalities. The rapid increase in life expectancy at birth has led to increasing numbers of older adults, where health inequalities are accentuated. The current UN Decade of Healthy Aging calls for a life-course approach to building intrinsic capacity, maintaining function, and avoiding dependency with age instead of avoiding mortality and morbidity. TLE in Hong Kong is one of the highest in the world as a result of public health preventive efforts and an essentially free hospital system. However, the increase in TLE has not been accompanied by the same magnitude of increase in health span, resulting in an increasing dependency burden. Geography, culture, dietary and smoking habits, physical activity, urban planning, and neighbourhood cohesion are some of the social determinants affecting TLE and also health inequalities. With population ageing, it would be appropriate to focus on the social determinants affecting health span to maintain functional independence rather than prolonging life. A whole-of-society response instead of relying solely on the adaptation of health and social care systems would be needed, together with more nuanced metrics to measure health span. Full article
7 pages, 190 KiB  
Perspective
Treat to Target in Gout Management: A Critical Reappraisal of Current Strategies
by Anusha Moses, Martijn Oude Voshaar, Mart van de Laar and Tim L. Th. Jansen
Gout Urate Cryst. Depos. Dis. 2025, 3(1), 3; https://doi.org/10.3390/gucdd3010003 - 28 Feb 2025
Viewed by 1562
Abstract
Gout management strategies remain a topic of debate, particularly regarding the efficacy of treat-to-target (T2T) and treat-to-avoid-symptoms (T2S) approaches. T2T, endorsed by major rheumatology societies, involves systematic serum urate (sUA) monitoring and urate-lowering therapy (ULT) dose escalation to maintain sUA below a predefined [...] Read more.
Gout management strategies remain a topic of debate, particularly regarding the efficacy of treat-to-target (T2T) and treat-to-avoid-symptoms (T2S) approaches. T2T, endorsed by major rheumatology societies, involves systematic serum urate (sUA) monitoring and urate-lowering therapy (ULT) dose escalation to maintain sUA below a predefined threshold. In contrast, T2S, which focuses on symptom relief rather than routine sUA monitoring, is supported by alternative guidelines. Despite the widespread adoption of T2T in other chronic diseases, its clinical benefits beyond biochemical parameters, such as serum urate reduction, remain uncertain in gout. This study evaluates current evidence on T2T and T2S, analyzing data from a pragmatic multicenter trial comparing both strategies. Findings suggest that while T2T is effective in reducing sUA levels, its superiority in preventing flares and improving patient-reported outcomes remains inconclusive. Some studies report reduced tophus burden and better adherence with T2T, whereas others find negligible differences in pain relief and functional improvement between the two strategies. The lack of high-quality comparative trials underscores the need for further investigation. Future research should prioritize long-term, patient-centered outcomes and pragmatic implementation strategies. Full article
13 pages, 1544 KiB  
Review
Emerging Treatment Options for Peanut Allergy
by Travis Satnarine, Alana Xavier de Almeida, Malaika Woody, Krisia Banegas Carballo, Diana Chan, Pytregay Thompson, Gary Kleiner and Melissa Gans
Allergies 2025, 5(1), 5; https://doi.org/10.3390/allergies5010005 - 19 Feb 2025
Viewed by 2431
Abstract
Peanut allergy, a significant public health issue, poses challenges due to its potential for life-threatening anaphylaxis and profound impact on quality of life. Traditional management approaches, including allergen avoidance and epinephrine administration, are effective in mitigating acute symptoms but do not address the [...] Read more.
Peanut allergy, a significant public health issue, poses challenges due to its potential for life-threatening anaphylaxis and profound impact on quality of life. Traditional management approaches, including allergen avoidance and epinephrine administration, are effective in mitigating acute symptoms but do not address the underlying allergy or long-term disease burden. Recent advances in immunotherapy and biologics, as well as innovative technologies such as gene editing and microbiome modulation, have introduced promising pathways for desensitization and sustained unresponsiveness. This review provides a comprehensive exploration of emerging therapies for peanut allergy, including oral, sublingual, and epicutaneous immunotherapy, biologic agents, gene-editing techniques, and novel drug therapies. We discuss their mechanisms, clinical efficacy, and associated challenges, emphasizing the potential for these innovations to revolutionize peanut allergy treatment. Despite significant progress, barriers such as adverse reactions, cost, and limited access remain. Addressing these challenges through further research and standardization could transform the future of peanut allergy management. Full article
(This article belongs to the Section Food Allergy)
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