Search Results (21,305)

Healing large bone defects remains challenging. Gelatin scaffolds are biocompatible and biodegradable, but lack osteoinductive activity. Plant-derived exosomes carry miRNAs, growth factors, and proteins that modulate osteogenesis, but free exosomes suffer from poor stability, limited targeting, and low bioavailability in vivo. We developed a 3D GelMA hydrogel loaded with Epimedium-derived exosomes (“GelMA@Exo”) to improve exosome retention, stability, and sustained release. Its effects on MC3T3-E1 preosteoblasts—including proliferation, osteogenic differentiation, migration, and senescence—were evaluated via in vitro assays. Angiogenic potential was assessed using HUVECs. Underlying mechanisms were examined at transcriptomic and protein levels to elucidate GelMA@Exo’s therapeutic osteogenesis actions. GelMA@Exo exhibited sustained exosome release, enhancing exosome retention and cellular uptake. In vitro, GelMA@Exo markedly boosted MC3T3-E1 proliferation, migration, and mineralized nodule formation, while reducing senescence markers and promoting angiogenesis in HUVECs. Mechanistically, GelMA@Exo upregulated key osteogenic markers (RUNX2, TGF-β1, Osterix, COL1A1, ALPL) and activated the PI3K/Akt pathway. Transcriptomic data confirmed global upregulation of osteogenesis-related genes and bone-regeneration pathways. This study presents a GelMA hydrogel functionalized with plant-derived exosomes, which synergistically provides osteoinductive stimuli and structural support. The GelMA@Exo platform offers a versatile strategy for localized delivery of natural bioactive molecules and a promising approach for bone tissue engineering. Our findings provide strong experimental evidence for the translational potential of plant-derived exosomes in regenerative medicine. Full article

Background: Behçet’s Disease (BD) was traditionally classified according to the International Study Group (ISG), where oral ulcers were mandatory. The International Team for the Revision of the International Criteria for BD (ICBD) introduced a scoring system instead. Our aim was to assess (a) sensitivity, (b) concordance between ISG and ICDB criteria in global and severe BD cases (ocular, vascular, and neurological), and (c) evaluate their clinical implications. Methods: Retrospective cohort study including 142 BD patients diagnosed in a well-defined population in Northern Spain, between January 1980 and November 2023. Both ISG and ICBD criteria were compared, sensitivity and concordance were assessed using Prevalence-Adjusted and Bias-Adjusted Kappa (PABAK) and the unadjusted Kappa. Results: A total of 142 BD patients diagnosed by expert rheumatologists (73 men; mean age of 36.4) were studied. Among them, 84 met ISG criteria, while 116 fulfilled ICBD criteria. Sensitivity of ISG and ICBD criteria in the overall cohort was (59.1% and 81.6%), respectively. Among patients with severe manifestations (ocular, vascular, or neurological), sensitivity increased to 71.2% for ISG and 92.5% for ICBD. Overall concordance was moderate (Kappa = 0.490), with 70.4% of patients classified identically. When adjusting prevalence and bias, concordance improved slightly (PABAK = 0.549). Of the 32 patients classified as BD exclusively by ICBD, 7 were receiving anti-TNF therapy, and 2 were receiving apremilast. Conclusions: The ICBD criteria demonstrated higher sensitivity than the traditional ISG criteria in classifying BD, particularly in severe cases. Classifying these additional patients under ICBD facilitated the initiation of on-label biologic treatments, potentially enhancing BD management, especially for severe cases. Full article

Design Thinking (DT) has emerged as a relevant methodology for addressing global challenges aligned with the United Nations Sustainable Development Goals (SDGs). This study presents a systematic literature review, conducted following PRISMA 2020 guidelines, which analyzes 42 peer-reviewed publications from 2013 to 2023. Through inductive content analysis, 10 core DT principles—such as empathy, iteration, user-centeredness, and systems thinking—I identified and thematically mapped to specific SDGs, including goals related to health, education, innovation, and climate action. The study also presents five real-world cases from diverse sectors such as technology, healthcare, and urban planning, illustrating how DT has been applied to address practical challenges aligned with the SDGs. However, the review identifies persistent gaps in the field: the lack of standardized evaluation frameworks, limited integration across SDG domains, and weak adaptation of ethical and contextual considerations, particularly in vulnerable communities. As a response, this paper recommends the adoption of structured impact assessment tools (e.g., Cities2030, Responsible Design Thinking), integration of design justice principles, and the development of participatory, iterative ecosystems for innovation. By offering both conceptual synthesis and applied insights, this article positions Design Thinking as a strategic and systemic approach for driving sustainable transformation aligned with the 2030 Agenda. Full article

Background: Concerns over women’s mental health have intensified globally, especially among mothers managing dual careers and family responsibilities. Positive Psychology Interventions (PPIs), such as gratitude journaling and well-being workshops, have demonstrated promise in enhancing mental health; however, their applicability in Arab contexts remains underexplored. This study aims to investigate the effectiveness of PPIs on mothers’ well-being, gratitude, depression, anxiety, and stress in Saudi Arabia. Methods: This quasi-experimental, one-group pretest–posttest study assessed the effects of a four-week PPI on 37 Saudi working mothers (aged 21–50 years) employed at a private school in Riyadh. The intervention included guided gratitude journaling thrice weekly and two workshops on positive psychology and gratitude. Pre- and post-intervention assessments used validated Arabic versions of the Depression Anxiety Stress Scale (DASS-21), WHO-5 Well-being Index, and Gratitude Questionnaire (GQ-6). Results: Significant improvements were found post-intervention: depression, anxiety, and stress scores decreased (p < 0.001), while well-being and gratitude increased (p = 0.001). However, participants with lower household income (<50,000 SAR) showed less improvement, indicating a potential moderating effect of socioeconomic status. Conclusions: The intervention demonstrated promising short-term improvements in mental health and well-being among Saudi mothers. The findings underscore the importance of culturally appropriate PPIs and highlight the need for further research using controlled, long-term designs. Limitations include the small, non-random sample, absence of a control group, and restriction to a single geographic region. Full article

Objective: The accurate visualization of root canal systems on periapical radiographs is critical for successful endodontic treatment. This study aimed to evaluate and compare the effectiveness of several image enhancement algorithms—including a novel Total Variation–Contrast-Limited Adaptive Histogram Equalization (TV-CLAHE) technique—in improving the detectability of root canal configurations in mandibular incisors, using cone-beam computed tomography (CBCT) as the gold standard. A null hypothesis was tested, assuming that enhancement methods would not significantly improve root canal detection compared to original radiographs. Method: A retrospective analysis was conducted on 60 periapical radiographs of mandibular incisors, resulting in 420 images after applying seven enhancement techniques: Histogram Equalization (HE), Contrast-Limited Adaptive Histogram Equalization (CLAHE), CLAHE optimized with Pelican Optimization Algorithm (CLAHE-POA), Global CLAHE (G-CLAHE), k-Caputo Fractional Differential Operator (KCFDO), and the proposed TV-CLAHE. Four experienced observers (two radiologists and two dentists) independently assessed root canal visibility. Subjective evaluation was performed using an own scale inspired by a 5-point Likert scale, and the detection accuracy was compared to the CBCT findings. Quantitative metrics including Peak Signal-to-Noise Ratio (PSNR), Signal-to-Noise Ratio (SNR), image entropy, and Structural Similarity Index Measure (SSIM) were calculated to objectively assess image quality. Results: Root canal detection accuracy improved across all enhancement methods, with the proposed TV-CLAHE algorithm achieving the highest performance (93–98% accuracy), closely approaching CBCT-level visualization. G-CLAHE also showed substantial improvement (up to 92%). Statistical analysis confirmed significant inter-method differences (p < 0.001). TV-CLAHE outperformed all other techniques in subjective quality ratings and yielded superior SNR and entropy values. Conclusions: Advanced image enhancement methods, particularly TV-CLAHE, significantly improve root canal visibility in 2D radiographs and offer a practical, low-cost alternative to CBCT in routine dental diagnostics. These findings support the integration of optimized contrast enhancement techniques into endodontic imaging workflows to reduce the risk of missed canals and improve treatment outcomes. Full article

Rabies remains a significant global public health concern, causing an estimated 59,000–69,000 human fatalities annually. Despite being entirely preventable through vaccination, rabies continues to impose substantial economic burdens worldwide. This study presents a scoping review of the economic research on rabies to determine overlaps and gaps in knowledge and inform future research strategies. We selected 150 studies (1973–2024) to analyze. The review categorizes the literature based on geographic distribution, species focus, and type of study. Findings indicate that economic studies are disproportionately concentrated in developed countries, such as the United States and parts of Europe, where rabies risk is low, while high-risk regions, particularly in Africa and Asia, remain underrepresented. Most studies focus on dog-mediated rabies, reflecting its dominant role in human transmission, while fewer studies assess the economic impacts of wildlife and livestock-mediated rabies. Case studies and modeling approaches dominate the literature, whereas cost–benefit and cost–effectiveness analyses—critical for informing resource allocation—are limited. The review highlights the need for more economic evaluations in rabies-endemic regions, expanded research on non-dog reservoirs, and broader use of economic methods. Addressing these gaps will be crucial for optimizing rabies control and supporting global initiatives to eliminate dog-mediated rabies by 2030. Full article

This study evaluates the effectiveness of the B Impact Assessment (BIA) as a catalyst for integrating sustainability into industrial firms through a qualitative case study of LC Paper, the first B Corp-certified tissue manufacturer globally and a pioneer in applying BIA in the pulp and paper sector. Based on semi-structured interviews, organizational documents, and direct observation, this study examines how BIA influences corporate governance, environmental practices, and stakeholder engagement. The findings show that BIA fosters structured goal setting and the implementation of measurable actions aligned with environmental stewardship, social responsibility, and economic resilience. Tangible outcomes include improved stakeholder trust, internal transparency, and employee development, while implementation challenges such as resource allocation and procedural complexity are also reported. Although the single-case design limits generalizability, this study identifies mechanisms transferable to other firms, particularly those in environmentally intensive sectors. The case studied also illustrates how leadership commitment, participatory governance, and data-driven tools facilitate the operationalization of sustainability. By integrating stakeholder and institutional theory, this study contributes conceptually to understanding certification frameworks as tools for embedding sustainability. This research offers both theoretical and practical insights into how firms can align strategy and impact, expanding the application of BIA beyond early adopters and into traditional industrial contexts. Full article

Addressing global challenges such as climate change and inequality requires convergence competencies that enable learners to devise sustainable solutions. Such competencies have been emphasized in Science, Technology, Engineering, Mathematics (STEM) fields, but empirical research and assessment tools tailored to Humanities, Arts, and Social Sciences (HASS) remain scarce. This study aimed to develop and validate a self-assessment tool to measure convergence competencies among HASS learners. A three-round Delphi survey with domain experts was conducted to evaluate and refine an initial pool of items. Items with insufficient content validity were revised or deleted, and all retained items achieved a Content Validity Ratio (CVR) of ≥0.800, with most scoring 1.000. The validated instrument was administered to 455 undergraduates participating in a convergence education program. Exploratory factor analysis identified five key dimensions: Convergent Commitment, Future Problem Awareness, Future Efficacy, Convergent Learning, and Multidisciplinary Inclusiveness, explaining 69.72% of the variance. Confirmatory factor analysis supported the model’s goodness-of-fit (χ² (160) = 378.786, RMSEA = 0.054, CFI = 0.952), and the instrument demonstrated high internal consistency (Cronbach’s α = 0.919). The results confirm that the tool is both reliable and valid for diagnosing convergence competencies in HASS contexts, providing a practical framework for interdisciplinary learning and reflective engagement toward sustainable futures. Full article

Background/Objectives: Mumps remains a relevant vaccine-preventable disease globally, especially in settings where immunization coverage fluctuates or vaccine-induced immunity wanes. This study aimed to assess long-term trends in mumps incidence, vaccination coverage, clinical outcomes, and demographic characteristics in the Autonomous Province of Vojvodina (AP Vojvodina), Serbia, over a 47-year period. Methods: We conducted a retrospective observational study using surveillance data from the Institute of Public Health of Vojvodina. Analyses included annual mumps incidence rates (1978–2024), coverage with mumps-containing vaccines (MuCVs; 1986–2024), monthly case counts, and individual-level case data for the 1997–2024 period. Variables analyzed included age, month of notification, gender, vaccination status, presence of clinical complications, and the method used for case confirmation. Results: Following the introduction of MuCV in 1986, the mumps incidence markedly declined, with limited resurgences in 2000, 2009, and 2012. Between 1997 and 2024, a total of 1358 cases were reported, with 62.7% occurring in males. Over time, the age distribution shifted, with adolescents and young adults being increasingly affected during the later (2011–2024) observed period. In 2012, the highest age-specific incidence was observed among individuals aged 10–19 and 20–39 years (49.1 and 45.5 per 100,000, respectively). Vaccination coverage for both MuCV doses was suboptimal in several years. The proportion of unvaccinated cases decreased over time, while the proportion with unknown vaccination status increased. Mumps-related complications—such as orchitis, pancreatitis, and meningitis—were rare and predominantly affected unvaccinated individuals: 84.2% of orchitis, 40.0% of pancreatitis, and all meningitis cases. Only two pancreatitis cases (40.0%) were reported after one MMR dose, while fully vaccinated individuals (two doses) had one orchitis case (5.3%) and no other complications. Laboratory confirmation was applied more consistently from 2009 onward, with 49.6% of cases confirmed that year (58 out of 117), and, in several years after 2020, only laboratory-confirmed cases were reported, indicating improved diagnostic capacity. Conclusions: Despite substantial progress in controlling mumps, gaps in vaccine coverage, waning immunity, and incomplete vaccination records continue to pose a risk for mumps transmission. Strengthening routine immunization, ensuring high two-dose MuCV coverage, improving vaccination record keeping, and enhancing laboratory-based case confirmation are critical. Consideration should be given to booster doses in high-risk populations and to conducting a seroepidemiological study to estimate the susceptible population for mumps in AP Vojvodina. Full article

Amidst global climate change, carbon emissions across the edible vegetable oil supply chain are critical for sustainable development. This paper systematically reviews the existing literature, employing life cycle assessment (LCA) to analyze key factors influencing carbon footprints at stages including cultivation, processing, and transportation. It reveals the differential impacts of fertilizer application, energy structures, and regional policies. Unlike previous reviews that focus on single crops or regions, this study uniquely integrates global data across major edible oils, identifying three critical gaps: methodological inconsistency (60% of studies deviate from the requirements and guidelines for LCA); data imbalance (80% concentrated on soybean/rapeseed); weak policy-technical linkage. Key findings: fertilizer emissions dominate cultivation (40–60% of total footprint), while renewable energy substitution in processing reduces emissions by 35%. Future efforts should prioritize multidisciplinary integration, enhanced data infrastructure, and policy scenario analysis to provide scientific insights for the low-carbon transformation of the global edible oil industry. Full article

The cement industry is a significant contributor to global carbon dioxide emissions, primarily due to the energy demands of its production process and its reliance on clinker, a material formed through the high-temperature calcination of limestone. Strategies to reduce emissions include the adoption of low-carbon fuels, the use of carbon capture and storage (CCS) technologies, and the integration of supplementary cementitious materials (SCMs) to reduce the clinker content. The effectiveness of these measures depends on a complex set of interactions involving technological feasibility, market dynamics, and regulatory frameworks. This study presents a system dynamics model designed to assess how various decarbonization approaches influence long-term emission trends within the cement industry. The model accounts for supply chains, production technologies, market adoption rates, and changes in cement production costs. This study then analyzes a number of scenarios where there is large-scale sustained investment in each of three carbon mitigation strategies. The results show that CCS by itself allows the cement industry to achieve carbon neutrality, but the high capital investment results in a large cost increase for cement. A combined approach using alternative fuels and SCMs was found to achieve a large carbon reduction without a sustained increase in cement prices, highlighting the trade-offs between cost, effectiveness, and system-wide interactions. Full article

The classification of cancer based on gene expression profiles is a central challenge in precision oncology due to the high dimensionality and low sample size inherent in microarray datasets. Effective gene selection is crucial for improving classification accuracy while minimizing computational overhead and model complexity. This study introduces Genetic-Embedded Nuclear Reaction Optimization (GNR), a novel hybrid metaheuristic that enhances the conventional Nuclear Reaction Optimization (NRO) algorithm by embedding a genetic uniform crossover mechanism into its fusion phase. The proposed algorithm leverages a two-stage process: an initial F-score filtering step to reduce dimensionality, followed by GNR-driven optimization to identify compact, informative gene subsets. Evaluations were conducted on six widely used microarray cancer datasets, with Support Vector Machines (SVM) employed as classifiers and performance assessed via Leave-One-Out Cross-Validation (LOOCV). Results show that GNR consistently outperforms the original NRO and several benchmark hybrid algorithms, achieving 100% classification accuracy with significantly smaller gene subsets across all datasets. These findings confirm the efficacy of the genetic-embedded fusion strategy in enhancing local exploitation while preserving the global search capabilities of NRO, thereby offering a robust and interpretable approach for gene selection in cancer classification. Full article

Plastic pollution in marine environments poses a new global threat. Microplastics (MPs) can bioaccumulate in marine organisms, leading to oxidative stress (OS). This study investigates MP accumulation and associated OS responses in six invertebrate species (Bivalvia, Gastropoda, and Malacostraca) and three key fish species of the Bulgarian Black Sea ecosystems. The target hydrobionts were collected from nine representative coastal habitats of the northern and southern aquatory. MPs were quantified microscopically, and OS biomarkers (lipid peroxidation, glutathione, and antioxidant enzymes) were analyzed spectrometrically in fish liver and gills and invertebrate soft tissues (STs). The specific OS (SOS) index was calculated as a composite indicator of the ecological impact, incl. MP effects. The results revealed species-specific MP bioaccumulation, with the highest concentrations in Palaemon adspersus, Rathke (1837) (0.99 ± 1.09 particles/g ST) and the least abundance in Bittium reticulatum (da Costa, 1778) (0.0033 ± 0.0025 particles/g ST). In Sprattus sprattus (Linnaeus, 1758), the highest accumulation of MPs was present (2.01 ± 2.56 particles/g muscle). The correlation analyses demonstrated a significant association between MP counts and catalase activity in all examined species. The SOS index varied among species, reflecting different stress responses, and this indicated that OS levels were linked to ecological conditions of the habitat and the species-specific antioxidant defense potential to overcome multiple stressors. These findings confirmed the importance of environmental conditions, including MP pollution and the evolutionarily developed capacity of marine organisms to tolerate and adapt to environmental stress. This study emphasizes the need for novel approaches in monitoring MPs and OS to better assess potential ecological risks. Full article

Given the urgent need to decarbonize the global energy system, green hydrogen has emerged as a key alternative in the transition to renewables. However, its production via electrolysis demands high water quality and raises environmental concerns, particularly regarding reject water discharge. This study employs an experimental and analytical approach to define optimal water characteristics for electrolysis, focusing on conductivity as a key parameter. A pilot water treatment plant with reverse osmosis and electrodeionization (EDI) was designed to simulate industrial-scale pretreatment. Twenty water samples from diverse natural sources (surface and groundwater) were tested, selected for geographical and geological variability. A predictive algorithm was developed and validated to estimate useful versus reject water based on input quality. Three conductivity-based categories were defined: optimal (0–410 µS/cm), moderate (411–900 µS/cm), and restricted (>900 µS/cm). Results show that water quality significantly affects process efficiency, energy use, waste generation, and operating costs. This work offers a technical and regulatory framework for assessing potential sites for green hydrogen plants, recommending avoidance of high-conductivity sources. It also underscores the current regulatory gap regarding reject water treatment, stressing the need for clear environmental guidelines to ensure project sustainability. Full article

Stroke is a significant global health concern characterized by the abrupt disruption of cerebral blood flow, leading to neurological impairment. Accurate and timely diagnosis—enabled by imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI)—is essential for differentiating stroke types and initiating interventions like thrombolysis, thrombectomy, or surgical management. In parallel, recent advancements in wearable technology, particularly smart clothing, offer new opportunities for stroke prevention, real-time monitoring, and rehabilitation. These garments integrate various sensors, including electrocardiogram (ECG) electrodes, electroencephalography (EEG) caps, electromyography (EMG) sensors, and motion or pressure sensors, to continuously track physiological and functional parameters. For example, ECG shirts monitor cardiac rhythm to detect atrial fibrillation, smart socks assess gait asymmetry for early mobility decline, and EEG caps provide data on neurocognitive recovery during rehabilitation. These technologies support personalized care across the stroke continuum, from early risk detection and acute event monitoring to long-term recovery. Integration with AI-driven analytics further enhances diagnostic accuracy and therapy optimization. This narrative review explores the application of smart clothing in conjunction with traditional imaging to improve stroke management and patient outcomes through a more proactive, connected, and patient-centered approach. Full article