Search Results (128)

Background/Objectives: Photobiomodulation (PBM) therapy has shown potential in managing orofacial neuropathic pain (ONP); however, inconsistent PBM dosimetry and methodological variability limit its clinical application. This World Association for Photobiomodulation Therapy (WALT) Position Paper aims to critically appraise current evidence and provide recommendations for Clinical Practice Guidelines (CPG) and Expert Consensus Opinion (ECO) where appropriate. Methods: Evidence evaluation was guided by the HANNA (Holistic Analysis & Novel Normative Actions) Framework, a structured multi-step methodology integrating systematic review, quality appraisal, and expert consensus. A systematic review was conducted in accordance with PRISMA 2020 guidelines. Methodological quality was assessed using validated tools: AMSTAR 2 for systematic reviews, RoB2 for randomized controlled trials (RCTs), and ROBINS-I for non-randomized studies (NRCTs). The AGREE II Reporting Checklist was applied to ensure transparency and rigor in the development of WALT recommendations. The Somerfield Criteria were used to rate the level of evidence (LoE) for each included ONP condition, where deemed appropriate. Results: WALT CPG were established for primary burning mouth syndrome (BMS), supported by robust evidence (LoE I) from 204 patients across six “Low RoB” RCTs and NRCTs, and 557 patients included in a “High-Confidence” systematic review and meta-analysis of “low RoB” RCTs. WALT ECO were developed for idiopathic trigeminal neuralgia (TN) and post-herpetic neuralgia (PHN), both supported by LoE II. Insufficient evidence precluded formal recommendations for post-traumatic trigeminal neuralgia, glossopharyngeal neuralgia, and occipital neuralgia. Conclusions: This Position Paper introduces the HANNA Framework, for the first time, as a robust and transparent methodology for developing WALT recommendations by delivering evidence-based CPG for PBM in the management of neuropathic pain associated with primary BMS, along with ECO for both TN and PHN. These recommendations support PBM as a safe and effective therapeutic approach, and provide a structured roadmap for future research and periodic guidelines updates. Full article

Sosnovsky’s hogweed (Heracleum sosnowskyi Manden.) is an invasive plant species widely distributed across Eastern Europe and Russia that poses a serious threat to human health due to its pronounced phototoxic properties. Contact with the plant sap followed by exposure to solar ultraviolet (UV) radiation frequently results in phytophotodermatitis, which is characterized by erythema, blistering, ulceration, and persistent hyperpigmentation. The development of these photochemical injuries—most notably furanocoumarins—act as potent photosensitizers and induce cellular and DNA damage upon UV activation. This review provides an integrated overview of the geographical spread and invasiveness of H. sosnowskyi, the chemical composition of its biologically active metabolites, and the molecular mechanisms underlying hogweed-induced skin injury. Particular emphasis is placed on the photochemical transformations of furanocoumarins, including psoralens and their photooxidation products, such as 1,2-dioxetanes, which generate reactive oxygen species and DNA crosslinks. In addition, the review examines other compounds derived from hogweed biomass—including furan derivatives, aromatic compounds, fatty acids, sterols, and their oxidative products—that may contribute to phototoxic and cytotoxic effects. Clinical manifestations of hogweed-induced burns, their classification, symptomatology, and current therapeutic approaches are critically discussed, highlighting the absence of standardized treatment guidelines. Rather than serving as a purely clinical or botanical survey, this review frames Sosnovsky’s hogweed injury as a solar-light-activated photochemical hazard, tracing the sequence from environmental sunlight exposure through molecular photochemistry to biological tissue damage. By integrating chemical, biological, and dermatological perspectives, the review aims to clarify injury mechanisms and support the development of more effective preventive and mitigation strategies under real-world exposure conditions. Full article

During on-site welding operations, the sealant coated on anchor bolt surfaces can be ignited by hot particles or localized sparks, potentially triggering a fire hazard. This combustion process involves a complex multi-physics coupling among sealant combustion, convective and radiative heat transfer, and three-dimensional heat conduction in solids. To resolve this coupling, a simulation strategy is proposed that correspondingly integrates the Fire Dynamics Simulator (FDS, version 6.7.6) for modeling combustion and radiation with ABAQUS (2024) for simulating conductive heat transfer in solids. The proposed method is validated against experimental measurements, showing close agreement in temperature evolution. It also demonstrates robustness across varying geometric scales, thereby confirming its reliability for predicting thermal response. Using this validated method, simulations are performed to analyze the fire behavior of an anchor rod-sealant system. Results show that the burning sealant can raise anchor rod temperatures above 900 °C and lead to rapid flame spread between adjacent rods. Furthermore, a sensitivity analysis of thermophysical parameters identifies critical thresholds for fire safety optimization: sealants with an ignition temperature > 280 °C and thermal conductivity ≥ 0.26 W/(m·K) demonstrate effective self-extinguishing properties, while specific heat capacity can retard flame growth. These findings provide a robust numerical framework and quantitative guidelines for the fire-safe design of bridge anchorage systems. Full article

Background and Objectives: Sjögren’s syndrome (SS) causes destructive salivary gland dysfunction with substantial oral morbidity. To synthesize practical, evidence-based approaches for early recognition, initial oral management, and timely referral to dental care. Materials and Methods: Narrative review of English-language literature from the Web of Science Core Collection and PubMed, prioritizing systematic reviews, randomized trials, and consensus guidelines. Results: Early oral signs include rapid multifocal root and cervical caries, burning sensations, and rising dental treatment needs. Unstimulated whole saliva ≤ 0.1 mL/min supports significant hypofunction and complements the 2016 ACR/EULAR criteria. Preventive care should combine dietary counseling, salivary stimulation, and topical remineralization. Adjuncts include high-fluoride toothpaste, biomimetic hydroxyapatite dentifrices, and casein phosphopeptide–amorphous calcium phosphate (CPP-ACP). However, evidence for fluoride varnish in SS remains mixed. Pharmacologic sialogogues require screening for contraindications. Conclusions: Embedding oral screening, simple salivary metrics, and a structured referral pathway into rheumatology visits can reduce preventable tooth loss and improve comfort, function, and treatment adherence. Full article

The rehabilitation of burn patients is essential and is intrinsically linked to conventional rehabilitation; the motivational challenges faced by burn patients in maintaining engagement with these rehabilitation programs are well known. It is understood that the use of other resources, particularly technological ones, associated with conventional rehabilitation could overcome these constraints and thereby optimize the rehabilitation program and health outcomes. The objective of this study is to synthesize the available evidence on the use of exergames in rehabilitation programs for burn patients. This systematic review was developed following the guidelines of the Joanna Briggs Institute (JBI). The search was conducted in the following databases: Medline^®, CINAHL^®, Sports Discus^®, Cochrane^®, and Scopus^® during May 2025. The PRISMA Checklist Model was used to organize the information from the selected studies. Seven RCTs were included, involving a total of 236 participants. Outcomes related to the use of exergames in the rehabilitation of burn patients were identified, including increased range of motion, functionality, strength, speed of movement, improved balance, reduced fear and pain, and satisfaction with the technological resource used. It is believed that the results of this review, which confirmed the advantage of using exergames, such as Nintendo Wii, PlayStation, Xbox Kinect, or Wii Fit, to optimize the functionality of burn patients, can support clinical decision-making and encourage the integration of exergames to improve rehabilitation programs for burn patients. Full article

Background/Objectives: Surgical debridement and early excision of burned areas followed by skin autograft is the gold standard of treatment for partial and full-thickness pediatric burns. However, skin autografting might be unfeasible or unlikely to succeed due limited availability of skin donor areas or inadequate conditions. In these circumstances, alternative treatment is required, and Skin Substitutes (SS) cold play a role. Recently, Biological Skin Substitutes (BSS) and Tissue Engineered Skin Substitutes (TESS) are emerging as alternative treatment options, but strong evidence is missing. This review investigates the current literature focusing on BSS and TESS, aiming to improve the medical and surgical management of pediatric patients. Methods: A systematic review was performed in accordance with the PRISMA 2020 guidelines and registered in the PROSPERO database (CRD42024627569). A comprehensive search was conducted in PubMed (MEDLINE) from 2000 to 2024 using Boolean logic and PICO-based inclusion criteria. Study quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists according to study design. Results: Twenty-nine articles and 2676 pediatric patients undergoing surgical reconstruction by BSS or TESS for burns were included. The methodological quality was generally moderate, with most studies being observational or case series. Several strategies were critically analyzed and possibly discussed. Conclusions: While BSS and TESS are safe and effective reconstructive options, the overall level of evidence remains low to moderate. A schematic classification of SS for pediatric burns is presented. Further prospective trials are needed to define standardized algorithms for pediatric burn reconstruction. Full article

Anthropogenic methane (CH₄) emissions lead to global warming and air pollution. China has recently crafted a bottom-up approach to regulate its anthropogenic CH₄ emissions; however, emissions during and after the COVID-19 lockdown have not been fully investigated using this updated method. In this study, we calculate provincial-level anthropogenic CH₄ emissions in 2022 using this official bottom-up approach, explore feasible mitigation pathways, estimate reduction potentials, evaluate the economic cost of abatement, and assess the social benefits of reductions. The results show that China’s total anthropogenic CH₄ emissions in 2022 were estimated to be 52.6 (49.8–55.6) Tg, approximately 47.6%, 39.5%, and 12.9% of which were from agricultural activities, energy utilization, and waste management, respectively; forest burning contributed 0.35 Gg. Using currently available approaches, China’s total yearly anthropogenic CH₄ emissions can be reduced by around 33%, with an average reduction cost of USD 130.9 million per Tg of CH₄. The social cost of CH₄ was estimated to be USD 231.8 per metric ton, indicating that the negative impact of annual anthropogenic CH₄ emissions was equal to 0.07% of China’s GDP. Despite the consistency between top-down inversions and our bottom-up inventory, we argue that the official guideline may underestimate China’s soil CH₄ emissions due to changes in soil substrate availability, relative humidity, and the active layer of methanogens from global warming. Methods to improve current estimation accuracy are discussed. Owing to the slow international diffusion rate of methane-targeted abatement technologies, China needs to develop relevant technologies with independent intellectual property rights. Full article

Background: Critical care for patients with severe burn injuries is challenging, particularly in the first 24–48 h. Multiple guidelines exist but their recommendations vary in content and in the level of detail. Methods: This narrative review analyzed recent (last 10 years) adult burn guidelines in English, Dutch and German, sourced from PubMed, Medline and official burn society publications. The review focused on airway management, mechanical ventilation, fluid resuscitation, pain management and procedural sedation. Results: All guidelines emphasize early airway assessment and timely intubation in patients at risk for loss of airway patency; however, a strategy for analyzing patients at risk is lacking. Lung-protective ventilation strategy is generally recommended. Fluid resuscitation is the cornerstone during the first phase, though recommendations for thresholds, volume and adjuncts differ. (Chronic) pain management should be multimodal, combining pharmacologic and non-pharmacologic approaches, but specifics on choice of modality are limited, also, there is no uniform strategy for procedural sedation management. Conclusion: Current guidelines offer broadly consistent recommendations for initial burn care but differ in specifics, reflecting evidence gaps. Future guidelines should address advances in airway management, fluid resuscitation endpoints, volume and adjuncts, and give a more detailed (chronic) pain strategy to improve standardization and outcomes. Full article

Burn injury triggers a complex inflammatory cascade in which the interplay between pro- and anti-inflammatory mediators determines recovery or progression to sepsis, ventilator-associated pneumonia (VAP) or multi-organ dysfunction, and mortality. We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus for studies published between 2006 and 2024, identifying 1883 records. We conducted a comprehensive systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After screening and eligibility assessment, 24 studies covering both pediatric and adult populations met the inclusion criteria. Data on cytokines, acute-phase proteins, complement fragments, and systemic inflammatory indices were synthesized narratively. The evidence indicates that the inflammatory response to burn injury is not a linear sequence of events but a dynamic and unstable equilibrium, where outcomes are determined less by the initial magnitude of cytokine release and more by the persistence of dysregulated inflammation or failure of compensatory mechanisms. Full article

Background: Topical tranexamic acid (TXA), often combined with epinephrine, is used to reduce perioperative bleeding. This systematic review evaluates the safety and effectiveness of this combination across surgical procedures. Methods: A comprehensive search of eight databases was conducted from inception to 26 June 2025. Studies were eligible if they compared topically or locally applied TXA with epinephrine to epinephrine alone in surgical patients. Animal studies, case reports, non-English publications, and studies without comparators were excluded. Screening, data extraction, and risk of bias assessments followed PRISMA guidelines. Results: Ten studies met inclusion criteria (four randomized and six non-randomized), covering burn surgery, rhytidectomy, liposuction, septoplasty, endoscopic sinus surgery, dacryocystorhinostomy, and joint arthroplasty. TXA was applied topically or via tumescent infiltration. Most studies reported reduced intraoperative blood loss, improved surgical field visibility, lower drain output, shorter hemostasis time, and reduced transfusion rates. No increase in thromboembolic or major complications was observed. Conclusion: The combination of TXA and epinephrine appears safe and maybe effective for perioperative bleeding control. However, heterogeneity in dosing and outcomes limits generalizability. Further research is needed to standardize protocols and confirm long-term safety. Full article

Ecofriendly flame-retardant polystyrene (PS) composites were developed using the synergistic effects of phytic acid (PA), polyethyleneimine (PEI), and expandable graphite (EG). PA was chemically hybridized with PEI, and the hybrid (PAE) was incorporated into PS together with EG. The flame-retardant performances of the resulting composites were evaluated using the limiting oxygen index (LOI), UL-94 vertical burning test, and cone calorimetry test. The strong interaction between EG and PAE provided an effective barrier against heat and oxygen, thereby improving the flame retardancy. The best-performing composite (PA:PEI:EG = 1:1:1 (w/w/w), total flame-retardant loading = 10 parts per 100 parts of PS) exhibited an LOI of 27.7% and a UL-94 V-0 rating. The peak heat release rate (148.8 kW/m²) and total heat release (91.2 MJ/m²) of this composite were lower than those of pure PS by 79.2% and 34.0%, respectively. This study provides guidelines for the production of flame-retardant PS and other polymeric materials. Full article

Background/Objectives: The search for natural alternatives to enhance wound healing has driven the investigation of bioactive compounds, such as Spirulina. This microalga, rich in antioxidant, anti-inflammatory, and antimicrobial properties, contains compounds like phycocyanin (C-PC), which promote cell repair, reduce inflammatory markers, and combat bacteria. Although its effects are promising, its efficacy still requires validation through human clinical trials. This article aims to review scientific publications on the use of Spirulina in skin regeneration using animal wound models. Methods: A database search was conducted for studies published between 2017 and 2024 on the effects of Spirulina on tissue regeneration in rats, chosen for their genetic similarity to humans. In vitro studies, those using other animal models, or studies published in languages other than Spanish or English were excluded. The review followed the PRISMA 2020 guidelines. Results: Four studies were analyzed, all of which demonstrated promising results in wound healing in rats. Spirulina was administered through oral supplements, hydrogels, and nanophytosomal formulations. These treatments accelerated wound closure and improved granulation tissue formation, vascularization, and epithelialization. Additionally, they exhibited antihyperglycemic effects in diabetic rats. Conclusions: The reviewed studies highlight the potential of Spirulina platensis to enhance wound healing, particularly in cases of diabetes and burns. Its antioxidant and anti-inflammatory properties play a crucial role in accelerating cellular regeneration and reducing inflammation, contributing to faster and more effective recovery. However, further research in humans is necessary to confirm its safety and clinical efficacy. Full article

Burn wounds are complex injuries that require timely and accurate assessment to guide treatment decisions and improve healing outcomes. Traditional clinical evaluations are largely subjective, often leading to delays in intervention and increased risk of complications. Imaging technologies have emerged as valuable tools that enhance diagnostic accuracy and enable objective, real-time assessment of wound characteristics. This review aims to evaluate the range of imaging modalities currently applied in burn wound care and assess their clinical relevance, diagnostic accuracy, and cost-effectiveness. It explores how these technologies address key challenges in wound evaluation, particularly related to burn depth, perfusion status, bacterial burden, and healing potential. A comprehensive narrative review was conducted, drawing on peer-reviewed journal articles, NICE innovation briefings, and clinical trial data. The databases searched included PubMed, Ovid MEDLINE, and the Cochrane Library. Imaging modalities examined include Laser Doppler Imaging (LDI), Fluorescence Imaging (FI), Near-Infrared Spectroscopy (NIR), Hyperspectral Imaging, Spatial Frequency Domain Imaging (SFDI), and digital wound measurement systems. The clinical application and integration of these modalities in UK clinical practice were also explored. Each modality demonstrated unique clinical benefits. LDI was effective in assessing burn depth and perfusion, improving surgical planning, and reducing unnecessary procedures. FI, particularly the MolecuLight i:X device (MolecuLight Inc., Toronto, ON, Canada), accurately identified bacterial burden and guided targeted interventions. NIR and Hyperspectral Imaging provided insights into tissue oxygenation and viability, while SFDI enabled early detection of infection and vascular compromise. Digital measurement tools offered accurate, non-contact assessment and supported telemedicine use. NICE recognized both LDI and MolecuLight as valuable tools with the potential to improve outcomes and reduce healthcare costs. Imaging technologies significantly improve the precision and efficiency of burn wound care. Their ability to offer objective, non-invasive diagnostics enhances clinical decision-making. Future research should focus on broader validation and integration into clinical guidelines to ensure widespread adoption. Full article

Ship repair is hazardous, often presenting unsuitable working areas and risks due to the ship’s configuration. Welding tasks are particularly dangerous due to the high temperatures generated, high enough to melt the metal in structural elements, bulkheads, linings, and tanks. This study investigates the consequences of temperature distribution during the welding of naval plates and proposes some accident prevention measures. Industry working conditions were reproduced, including the materials, procedures, and tools used, as well as the certified personnel employed. DH 36-grade naval steel, with a composition of C max. 0.18%, Mn 0.90–1.60%, P 0.035%, S 0.04%, Si 0.10–0.50%, Ni max 0.4%, Cr max 0.25%, Mo 0.08%, Cu max 0.35%, Cb (Nb) 0.05%, and V 0.1%, was welded via FCAW-G (Gas-Shielded Flux-Cored Arc Welding), selected for this study because it is one of the most widely practiced in the naval industry. The main sensor used in the experiments was an FLIR model E50 thermographic camera, and thermal waxes were employed. The results for each thickness case are presented in both graphical and tabular form to provide accurate and actionable guidelines, prioritizing safety. After studying the butt jointing of naval plates of various thicknesses (8, 10, and 15 mm), safe distances to maintain were proposed to avoid risks in the most unfavorable cases: 350 mm from the welding seam to avoid burn injuries to unprotected areas of the body and 250 mm from the welding seam to avoid producing flammable gases. These numbers are less accurate but easier to remember, which prevents errors in the face of hazards throughout a long working day. Full article

Background: Orofacial pain (OFP) and headache are common and disabling conditions in people with head and neck cancer (HNC), although their clinical characteristics and underlying pain mechanisms remain poorly studied, leading to worse diagnosis and, thus, management. Therefore, this review aims to synthesize the literature regarding clinical features, pain descriptors, mechanisms, and assessment tools of OFP and/or headache in adults with HNC. Methods: A scoping review was conducted following the Arksey and O’Malley framework and reported using PRISMA-ScR guidelines. We searched PubMed, Embase, Scopus, and Web of Science. Quantitative and qualitative original studies were included. Data were charted and summarized using narrative synthesis. Results: Of 3647 records initially retrieved, 32 studies met the inclusion criteria. Most studies were observational and heterogeneous in design, population, and pain assessment methods. OFP was highly prevalent, with neuropathic descriptors (e.g., burning, electric shocks, tingling) reported in 13.1% to 64.5% of patients, although heterogeneity in study design and tools used to assess this potential pain mechanism was high. Pain was frequently localized at the tumor site, although pain in other regions beyond the head and neck was also reported. Pain intensity was generally moderate, although varied across studies. OFP and headache in HNC patients were often neuropathic in nature and contributed significantly to disability and reduced quality of life. Most articles lacked mechanistic classifications of pain, although some suggested that central sensitization may be involved in some patients. Conclusions: Orofacial pain and headache are prevalent, under-characterized symptoms in HNC patients. There is an urgent need for standardized assessments using validated tools to improve phenotyping and inform targeted treatment strategies. Full article