Search Results (317)

Background/Objectives: For kidney transplantation, it is very important to provide effective post-transplantation interventions to help patients achieve continuous and efficient self-management. Therefore, we review the self-management interventions applied to kidney transplant recipients and suggest the optimal approach to increase the effectiveness of future self-management interventions. Design: Systematic review. Methods: Search terms and strategies included kidney transplantation; self-management; intervention; systematic review. We searched MEDLINE via PubMed, Excerpta Media dataBASE, Cochrane Register Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and one domestic Korean database to identify studies of self-management interventions for kidney transplant recipients aged ≥ 18 years published in English or Korean until 14 May 2025. Two reviewers independently selected related studies and extracted relevant data. Identified studies were assessed for quality and bias. Results: Of 1340 studies identified, 27 with 1912 participants met the inclusion criteria. Educational interventions were the most common self-management interventions and were provided 3 months to 1 year after kidney transplantation; most interventions were administered by nurses. Outcome variables were divided into cognitive, behavioral, affective, and health outcomes. Educational interventions were effective in improving cognitive, behavioral, and affective aspects. Some differences were observed, depending on the study. Conclusions: We recommend that nurse-involved educational interventions be included when developing self-management interventions and guidelines for kidney transplant recipients in clinical and community nursing settings. Full article

Background: Immunization is a highly effective intervention for controlling over 20 life-threatening infectious diseases, significantly reducing both morbidity and mortality rates. One notable achievement in vaccination efforts was the global eradication of smallpox, which the World Health Assembly declared on 8 May 1980. Additionally, there has been a remarkable 99.9% reduction in wild poliovirus cases since 1988, decreasing from more than 350,000 cases that year to just 30 cases in 2022. Objectives: The objective of this review was to assess the effects of various interventions designed to increase vaccination uptake among adults. Search Methods: A thorough search was conducted in the CENTRAL, Embase Ovid, Medline Ovid, PubMed, Web of Science, and Global Index Medicus databases for primary studies. This search was conducted in August 2021 and updated in November 2024. Selection Criteria: Randomized trials were eligible for inclusion in this review, regardless of publication status or language. Data Analysis: Two authors independently screened the search outputs to select potentially eligible studies. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for each randomized controlled trial (RCT). A meta-analysis was conducted using a random-effects model, and the quality of the evidence was assessed using the GRADE approach. Main Results: A total of 35 randomized controlled trials met the inclusion criteria and were included in this review, with the majority conducted in the United States. The interventions targeted adults aged 18 and older who were eligible for vaccination, involving a total of 403,709 participants. The overall pooled results for interventions aimed at increasing influenza vaccination showed a risk ratio of 1.41 (95% CI: 1.15, 1.73). Most studies focused on influenza vaccination (18 studies), while the remaining studies examined various other vaccines, including those for hepatitis A, COVID-19, hepatitis B, pneumococcal disease, tetanus, diphtheria, pertussis (Tdap), herpes zoster, and human papillomavirus (HPV). The results indicate that letter reminders were slightly effective in increasing influenza vaccination uptake compared to the control group (RR: 1.75, 95% CI: 0.97, 1.16; 6 studies; 161,495 participants; low-certainty evidence). Additionally, participants who received education interventions showed increased levels of influenza vaccination uptake compared to those in the control group (RR: 1.88, 95% CI: 0.61, 5.76; 3 studies; 1318 participants; low-certainty evidence). Furthermore, tracking and outreach interventions also led to an increase in influenza vaccination uptake (RR: 1.87, 95% CI: 0.78, 4.46; 2 studies; 33,752 participants; low-certainty evidence). Conclusions: Letter reminders and educational interventions targeted at recipients are effective in increasing vaccination uptake compared to control groups. Full article

This paper presents the development, implementation, and outcomes of the ELEVATE-US-UP (Engaging Learners through Exploration of Visionary Academic Thought and Empowerment in UnderServed and UnderPrivileged communities) teaching methodology, an equity-centered, culturally responsive pedagogical framework designed to enhance student engagement, academic performance, and science identity among underrepresented learners. This framework was piloted at Northern New Mexico College (NNMC), a Hispanic- and minority-serving rural institution. ELEVATE-US-UP reimagines science education as a dynamic, inquiry-driven, and contextually grounded process that embeds visionary scientific themes, community relevance, trauma-informed mentoring, and authentic assessment into everyday instruction. Drawing from culturally sustaining pedagogy, experiential learning, and action teaching, the methodology positions students not as passive recipients of content but as knowledge-holders and civic actors. Implemented across upper-level environmental science courses, the method produced measurable gains: class attendance rose from 67% to 93%, average final grades improved significantly, and over two-thirds of students reported a stronger science identity and a newfound confidence in their academic potential. Qualitative feedback highlighted increased perceptions of classroom inclusivity, community relevance, and instructor support. By centering on cultural context, student voice, and place-based application, the ELEVATE-US-UP framework offers a replicable and scalable model for educational transformation in underserved regions. Full article

Kidney transplant recipients face a substantial burden of premature mortality and morbidity, primarily due to persistent inflammation, cardiovascular risk, and nutritional deficiencies. Traditional nutritional interventions in this population have either focused on supplementing individual nutrients—often with limited efficacy—or required comprehensive dietary overhauls that compromise patient adherence. In this narrative review, we explore the rationale for dietary nut enrichment as a feasible, multi-nutrient strategy tailored to the needs of kidney transplant recipients. Nuts, including peanuts and tree nuts with no added salt, sugar, or oil, are rich in beneficial fats, proteins, vitamins, minerals, and bioactive compounds. We summarize the multiple post-transplant challenges—including obesity, sarcopenia, dyslipidemia, hypertension, immunological dysfunction, and chronic inflammation—and discuss how nut consumption may mitigate these issues through mechanisms involving improved micro-nutrient intake (e.g., magnesium, potassium, selenium), lipid profile modulation, endothelial function, immune support, and gut microbiota health. Additionally, we highlight the scarcity of randomized controlled trials in high-risk populations such as kidney transplant recipients and make the case for studying this group as a model for investigating the clinical efficacy of nuts as a nutritional intervention. We also consider practical aspects for future clinical trials, including the choice of study population, intervention design, duration, nut type, dosage, and primary outcome measures such as systemic inflammation. Finally, potential risks such as nut allergies and oxalate or mycotoxin exposure are addressed. Altogether, this review proposes dietary nut enrichment as a promising, simple, and sustainable multi-nutrient approach to support cardiometabolic and immune health in kidney transplant recipients, warranting formal investigation in clinical trials. Full article

The “That Girl” self-optimization trend on TikTok, promoting beauty and productivity, had over 17.4 billion views by August 2024. “That Girl” video clips showcase perfectly organized daily routines, fitness activities, and healthy eating—allegedly to inspire other users to aspire to similar flawlessness. Based on social comparison theory, the “That Girl” archetype serves as an upward comparison target. We expected detrimental effects of viewing “That Girl” content on young women in terms of positive and negative affect and body satisfaction. Expanding other research in this area, possible effects on self-discipline and dieting intentions were explored. Focusing on immediate intraindividual changes, a preregistered two-group online experiment using a pre–post measurement design was conducted. Female participants (N = 76) watched four minutes of either 16 video clips showing “That Girl” content or nature videos (control condition). Mixed ANOVAs provided evidence of a significant adverse influence of watching “That Girl” videos on female recipients regarding all dependent variables with medium or large effect sizes. Post-hoc analyses revealed that these effects were driven by participants who reported upward comparisons to “That Girls”. Based on these results, the positive impact on self-improvement—as proclaimed by contributors of the “That Girl” trend—is critically questioned. Full article

This research study focuses on the social preference parameters and financial decisions among welfare populations receiving social benefits in Miami, Florida. Understanding the attitudes and primary motivations that shape financial decision-making is of great interest to economists, marketers, and other social scientists. The implications of developing a solid understanding of these attitudes and motivations are vast in terms of erecting tangible and sensitive workforce development policies to assist the specific population studied. This study is designed to determine whether significant differences exist in the strength of preference parameters between welfare participants and other populations. The preference parameters assessed in this paper were self-interest, altruism, trust, and reciprocity, both positive and negative. The control group in this study is college students. The results from the experiments show that welfare recipients exhibit similar behavioral patterns and make financial decisions in a manner similar to the general population. In other words, the control group and the experimental group did not differ significantly in their financial decision processes. This finding has several implications for how economists and policymakers assess and approach policymaking; nevertheless, the question remains whether or not there are other preference parameters that differ between the two groups. Full article

Automated parcel lockers (APLs) are transforming urban last-mile delivery by reducing failed distributions, decoupling delivery from recipient availability, optimizing carrier routes, reducing carbon foot-print and mitigating traffic congestion. The paper investigates the optimal design of APLs systems under stochastic demand and operational constraints, formulating the problem as a resource allocation optimization with service-level guarantees. We proposed a data-driven discrete-event simulation (DES) model implemented in ARENA to (i) determine optimal locker configurations that ensure customer satisfaction under stochastic parcel arrivals and dwell times, (ii) examine utilization patterns and spatial allocation to enhance system operational efficiency, and (iii) characterize inventory dynamics of undelivered parcels and evaluate system resilience. The results show that the configuration of locker types significantly influences the system’s ability to maintain high customers service levels. While flexibility in locker allocation helps manage excess demand in some configurations, it may also create resource competition among parcel types. The heterogeneity of locker utilization gradients underscores that optimal APLs configurations must balance locker units with their size-dependent functional interdependencies. The Dickey–Fuller GLS test further validates that postponed parcels exhibit stationary inventory dynamics, ensuring scalability for logistics operators. As a theoretical contribution, the paper demonstrates how DES combined with time-series econometrics can address APLs capacity planning in city logistics. For practitioners, the study provides a decision-support framework for locker sizing, emphasizing cost–service trade-offs. Full article

A cochlear implant (CI) system holds two spiral coils, one external and one implanted. These coils are used to transmit both data and power. A magnet at the center of the coils ensures proper alignment to assure the highest coupling. However, when the recipient needs a magnetic resonance imaging (MRI) scan, this magnet can cause problems due to the high magnetic field of such a scan. Therefore, a new type of implant without magnets would be beneficial and even supersede the current state of the art of hearing implants. To examine the feasibility of magnet-free cochlear implants, this research studies the impact of coil misalignment on the inductive coupling between the coils and thus the power and data transfer. Rather than using time-consuming finite element analysis (FEA), MATLAB is used to examine the impact of lateral, vertical and angular misalignment on the coupling coefficient using derivations of Neumann’s equation. The MATLAB model is verified with FEA software with a median 8% relative error on the coupling coefficient for various misalignments, ensuring that it can be used to study the feasibility of various magnet-free implants and wireless power and data transmission systems in general. In the case of cochlear implants, the results show that by taking patient and technology constraints like skinflap thickness and mechanical design dimensions into account, the mean error can even be reduced to below 5% and magnet-free cochlear implants can be feasible. Full article

Background: The opioid epidemic has highlighted the need for alternative pain management modalities in postoperative patients. Peripheral nerve blocks (PNBs) have been shown to reduce opioid consumption in the immediate postoperative period, but limited data exists on their impact on chronic opioid use. Objective: The present investigation focused on the use of preoperative PNB utilization in orthopedic surgeries and its association with chronic opioid use. Methods: A retrospective cohort study was conducted on 533 patients that had a total shoulder arthroplasty, reverse total shoulder arthroplasty, or knee arthroscopy between July 2021 and July 2024. Patients were grouped based on whether they received a preoperative PNB. Opioid prescription data were collected at 1-, 3-, and 6-month postoperative periods. In addition, a subset of patients completed a questionnaire to assess self-reported opioid consumption and other analgesic usage. Results: Patients who received a PNB were significantly less likely to report continued opioid use at one month postoperatively compared to those who did not (32.8% vs. 61.9%). Additionally, PNB recipients more often declined additional opioids due to a lack of need (p = 0.025), while those without a PNB cited other reasons, including fear of addiction or poor pain control (p = 0.033). Conclusions: The results of the present investigation suggest that preoperative PNBs may be associated with reduced chronic opioid use and have an important role in prescribing practices and pain management strategies following orthopedic surgery. Limitations: The limitations are as follows: retrospective design; potential recall and selection bias from questionnaire use; lack of data confirming actual opioid prescription fills; inclusion of patients with chronic pain comorbidities requiring long-term opioid use. Full article

Allogeneic adipose stem cells (AASCs) are increasingly recognized for their potential in regenerative medicine. They offer a promising alternative to autologous cells, with potential advantages such as availability and reduced morbidity in the recipient. Therefore, the aim of the present systematic review was to explore AASCs applications in various diseases and conditions, including skin lesions, Crohn’s disease, glandular dysfunction, kidney disease, spinal muscular atrophy and osteoarthritis. This review was conducted according to PRISMA guidelines; PubMed, Embase and Web of Science databases were used to search for studies published between 2011 and 2024, without language restrictions. Our review was strictly limited to the inclusion of controlled clinical trials to ensure the relevance and quality of the data. After screening, 22 articles were retained, with a total of 953 patients that met the established inclusion criteria. The data obtained from these studies showed that AASCs have promising efficacy in improving scars and ulcers, managing Crohn’s disease, and treating glandular dysfunction and kidney disease. In spinal muscular atrophy and osteoarthritis, preliminary results also suggested potential benefits. AASCs-based treatments were well tolerated with no major adverse effects, thus emphasizing their favorable safety profile. AASCs show a significant potential for a variety of clinical applications, but the results must be interpreted with caution due to the methodological limitations of the included studies. Well-designed Phase III clinical trials are needed to confirm these promising results and ensure the safe and effective use of AASCs in clinical practice. This review highlights the importance of the standardization of procedures and raises relevant ethical issues related to the use of donor cells. Full article

Background: The Human Papillomavirus (HPV) vaccine generates high antibody titers against targeted HPV types. This study investigated vaccine-induced anti-HPV18 immunoglobulin (IgG) antibody titers and subsequent HPV18/45 infections. Methods: We performed a nested matched case-control study leveraging a prospective longitudinal cohort of adolescent and young adult women (AYW) vaccinated with the quadrivalent HPV vaccine (4vHPV) attending the Mount Sinai Adolescent Health Center (MSAHC) in Manhattan, NY. The case individuals included AYW who had an incident detection of cervical HPV18 (n = 3) or HPV45 (n = 34) DNA after vaccination and were compared to two vaccinated control individuals (HPV18/45-negative); one random control (RC, n = 37) and one high-risk control (HRC, n = 37) selected from the upper quartile of a sexual risk behavior score. Serological titers against HPV18 were measured by end-point dilution and enzyme-linked immunosorbent assay (ELISA) in serum collected before the incident detection of HPV. Matching was performed based on age at first dose, follow-up time, and sexual risk behavior score. Conditional logistic regression was used to assess the association between case-control status and anti-HPV antibody titers, consistent with the matched-pair design. Results: Antibody titers for HPV18 were most different between AYW who developed an HPV18/45 infection compared to high-risk controls OR = 1.66, 95% CI: 0.96–2.85 (p = 0.1629). Analyses of pooled data from vaccinated recipients including who developed HPV16/31 or HPV18/45 infections demonstrated that the odds of a one-log unit increase in anti-HPV16 or 18 antibody titers, respectively, were 40% higher in the combined control groups (RC + HRC, n = 160) (OR = 1.40, 95% CI: 1.09–1.79, p = 0.0135) and 73% higher in the HRC (n = 80) (OR 1.73, 95% CI: 1.34, 2.52, p = 0.0117) compared to HPV16/18/31/45 cases (n = 80). Conclusions: Overall, these findings suggest that higher IgG antibodies to HPV16/18 after vaccination represent an increased likelihood of protection from homologous and cross-reactive HPV types (HPV16/18/31/45). These results show that differences in antibody titers are associated with breakthrough infection after vaccination, suggesting that further study of long-term antibody titers and infection should be pursued. Full article

We aimed to determine the influence of donors’ vascular function on renal function in recipients and to evaluate the role of Orai1 calcium channels as a potential marker. A prospective collaborative multicenter study was designed. Blood, aorta (HA), mesenteric arteries (HMAs) and corpus cavernosum (HCC) specimens were obtained from organ donors at the kidney procurement procedure (n = 60). Evolution (up to 2 years) of renal function measured as serum creatinine (SCr) and glomerular filtration rate (GFR) was evaluated in respective recipients (n = 64). Vascular responses were determined in HA, HMA and HCC from donors. Tumor necrosis factor-α, asymmetric dimethyl arginine and Orai1 were measured in plasma. Orai1 protein expression was also evaluated in each donor’s aorta. Endothelium-dependent vasodilation (HMA, HCC) and adrenergic contraction (HA) in donors determined renal function in recipients, 12 months post-transplantation. Donors in the best quartile of vascular function predicted lower SCr and higher GFR in kidney recipients for 12/24 months. Plasma Orai1 in donors was negatively correlated with vascular function and predicted renal function at 3–6 months post-transplantation. Donor Orai1 vascular content was associated with reduced vascular function and with poorer recipient renal function for 1-year post-transplantation. Systemic vascular function of kidney donors determines recipients’ renal function at short/mid-term. Donors’ vascular function and recipients’ renal function are negatively associated with donors’ Orai1 vascular expression, being a potential biomarker of renal outcomes. Full article

Background: Autogenous tooth transplantation is a valuable option for dental rehabilitation, particularly in young patients. Template-guided approaches, using 3D-printed replicas of donor teeth, have recently emerged as a method to increase precision and reduce extraoral time—two critical factors in maintaining periodontal ligament (PDL) vitality, which is essential to improve long-term outcomes. Methods: This report presents the case of a 12-year-old patient who underwent autotransplantation of tooth 18 to the site of tooth 75, which exhibited ankylosis. Patients exhibiting unfavorable root anatomy and morphology, systemic conditions, or completed root development were not considered for this technique. A patient-specific donor tooth replica was digitally designed and 3D-printed via CAD/CAM manufacturing to preoperatively shape the recipient site. The transplanted tooth 18 was then inserted with an extraoral time of less than one minute and subsequently stabilized using a flexible titanium trauma splint (TTS). Results: Longitudinal clinical and radiographic follow-up over 12 months confirmed favorable healing without signs of complications. Conclusions: This case illustrates the practical advantages of a fully digital, template-guided workflow in managing anatomically complex cases. Full article

The last-mile delivery crisis, exacerbated by the surge in e-commerce demands, continues to face persistent challenges. Logistics companies often overlook the possibility that recipients may not be at the designated delivery location during courier distribution, leading to interruptions in the delivery process and spatiotemporal mismatches between couriers and users. Parcel lockers (PLCs), as a contactless self-pickup solution, mitigate these mismatches but suffer from low utilization rates and user dissatisfaction caused by detour-heavy pickup paths. Existing PLC strategies prioritize operational costs over behavioral preferences, limiting their real-world applicability. To address this gap, we propose a user-centric path planning model that integrates spatiotemporal trajectory mining with kernel density estimation (KDE) to optimize PLC selection and conducted a small-scale experimental study. Our framework integrated user behavior and package characteristics elements: (1) Behavioral filtering: This extracted walking trajectories (speed of 4–5 km/h) from 1856 GPS tracks of four campus users, capturing daily mobility patterns. (2) Hotspot clustering: This identified 82% accuracy-aligned activity hotspots (50 m radius; ≥1 h stay) via spatiotemporal aggregation. (3) KDE-driven decision-making: This dynamically weighed parcel attributes (weight–volume–urgency ratio) and route regularity to minimize detour distances. Key results demonstrate the model’s effectiveness: a 68% reduction in detour distance for User A was achieved, with similar improvements across all test subjects. This study enhances last-mile logistics by integrating user behavior analytics with operational optimization, providing a scalable tool for smart cities. The KDE-based framework has proven effective in campus environments. Its future potential for expansion to various urban settings, ranging from campuses to metropolitan hubs, supports carbon-neutral goals by reducing unnecessary travel, demonstrating its potential for application. Full article

Objectives: Upper urinary tract urothelial cell carcinoma (UTUC) in kidney transplant recipients (KTRs) presents distinct clinical challenges due to the complexities of managing both cancer and the long-term immunosuppressive therapy required to preserve graft function. UTUC in this population often presents at advanced stages, contributing to poorer outcomes compared to immunocompetent individuals. Methods: This systematic review (SR) evaluates the incidence, clinical presentation, treatment approaches, and survival outcomes of UTUC in KTRs, based on 16 retrospective studies including 526 patients. Results: The present study highlights a predominance of female patients (ranging from 50% to 91.6%) and significant variability in time to diagnosis (from 7 to 181 months post-transplant). Tumor characteristics also showed considerable heterogeneity, with high-grade and advanced-stage (T3–T4) tumors being more common. The standard treatment for UTUC in KTRs remains radical nephroureterectomy (RNU), with additional resection of the bladder (TURB) when bladder cancer (BC) coexists. Survival outcomes vary significantly, with 5-year overall survival (OS) rates ranging from 16.7% to 90.9%, strongly influenced by tumor stage at diagnosis. This SR further reports high rates of bladder recurrence (18.8% to 61.2%) and challenges in balancing effective cancer treatment with graft preservation. The variability in immunosuppressive regimens across studies complicates the assessment of their role in UTUC progression. The limitations of the current evidence include small sample sizes, retrospective designs, and inconsistent follow-up durations. Conclusions: This SR underscores the need for tailored treatment strategies and improved long-term surveillance. Future research should focus on prospective studies with larger cohorts, exploring the impact of immunosuppression and novel therapies on UTUC outcomes in KTRs. Full article