Search Results (610)

The study presents a comprehensive assessment of the combustion efficiency of low-grade coal from the Karazhyra deposit in small- and medium-capacity boiler units of the energy workshops operated by Vostokenergo LLP (East Kazakhstan Region, Kazakhstan). It was found that the average annual thermal energy output amounts to 2,387,348.85 GJ with a coal consumption of 164,328.5 tons. Based on operational data from 2016 to 2017, the average thermal efficiency (boiler efficiency) was 66.03%, with a maximum value of 75% recorded at the Zhezkent energy workshop. The average lower heating value (LHV) of the coal was 19.41 MJ/kg, which is below the design value of 20.52 MJ/kg, indicating the use of coal with reduced energy characteristics and elevated ash content (21.4%). The unburned carbon content in the ash and slag waste (ASW) was determined to be between 14 and 35%, indicating incomplete combustion. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) analyses revealed the presence of microspheres, porous granules, and coal residues, with silicon and aluminum oxides dominating the composition (up to 70.49%). Differences in the pollutant potential of ash from different boiler units were identified. Recommendations were substantiated regarding the adjustment of the air–fuel regime, modernization of combustion control systems, and utilization of ASW. The results may be used to develop measures aimed at improving the energy efficiency and environmental safety of coal-fired boiler plants. Full article

Background/Objectives: Accurate and accessible perioperative health information empowers patients and enhances recovery outcomes. Artificial intelligence tools, such as ChatGPT, have garnered attention for their potential in health communication. This study evaluates the accuracy and readability of responses generated by ChatGPT to questions commonly asked about breast cancer. Methods: Fifteen simulated patient queries about breast cancer surgery preparation and recovery were prepared. Responses generated by ChatGPT (4o version) were evaluated for accuracy by a pool of breast surgeons using a 4-point Likert scale. Readability was assessed with the Flesch–Kincaid Grade Level (FKGL). Descriptive statistics were used to summarize the findings. Results: Of the 15 responses evaluated, 11 were rated as “accurate and comprehensive”, while 4 out of 15 were deemed “correct but incomplete”. No responses were classified as “partially incorrect” or “completely incorrect”. The median FKGL score was 11.2, indicating a high school reading level. While most responses were technically accurate, the complexity of language exceeded the recommended readability levels for patient-directed materials. Conclusions: The model shows potential as a complementary resource for patient education in breast cancer surgery, but should not replace direct interaction with healthcare providers. Future research should focus on enhancing language models’ ability to generate accessible and patient-friendly content. Full article

Systematic reviews are a cornerstone of evidence-based research, providing comprehensive summaries of existing studies to answer specific research questions. This article offers a detailed guide to conducting high-quality systematic reviews in biology, health and social sciences. It outlines key steps, including developing and registering a protocol, designing comprehensive search strategies, and selecting studies through a screening process. The article emphasizes the importance of accurate data extraction and the use of validated tools to assess the risk of bias across different study designs. Both meta-analysis (quantitative approach) and narrative synthesis (qualitative approach) are discussed in detail. The guide also highlights the use of frameworks, such as GRADE, to assess the certainty of evidence and provides recommendations for clear and transparent reporting in line with the PRISMA 2020 guidelines. This paper aims to adapt and translate evidence-based review principles, commonly applied in clinical research, into the context of biological sciences. By highlighting domain-specific methodologies, challenges, and resources, we provide tailored guidance for researchers in ecology, molecular biology, evolutionary biology, and related fields in order to conduct transparent and reproducible evidence syntheses. Full article

With climate change, the spatial and temporal patterns of precipitation are altered to a certain degree, which potentially affects the grey water footprint (GWF) of total nitrogen (TN) in agriculture, thereby threatening water security in the Yangtze River Basin (YRB), the largest river in China. The current study constructs an assessment framework for climate change impacts on the GWF of agricultural TN by coupling Shared Socioeconomic Pathways (SSPs) with the InVEST model. The framework consists of four components: (i) data collection and processing, (ii) simulating the two critical indicators (L_TN and W) in the GWF model based on the InVEST model, (iii) calculating the GWF and GWF index (GI) of TN, and (iv) calculating climate change impact index on GWF of agricultural TN (CI) under two SSPs. It is applied to the YRB, and the results show the following: (i) GWFs are 959.7 and 961.4 billion m³ under the SSP1-2.6 and SSP5-8.5 climate scenarios in 2030, respectively, which are both lower than that in 2020 (1067.1 billion m³). (ii) The GI values for TN in 2030 under SSP1-2.6 and SSP5-8.5 remain at “High” grade, with the values of 0.95 and 1.03, respectively. Regionally, the water pollution level of Taihu Lake is the highest, while that of Wujiang River is the lowest. (iii) The CI values of the YRB in 2030 under SSP1-2.6 and SSP5-8.5 scenarios are 0.507 and 0.527, respectively. And the CI values of the five regions in the YRB are greater than 0, indicating that the negative effects of climate change on GWFs increase. (iv) Compared with 2020, L_TN and W in YRB in 2030 under the two SSPs decrease, while the GI of TN in YRB rises from SSP1-2.6 to SSP5-8.5. The assessment framework can provide strategic recommendations for sustainable water resource management in the YRB and other regions globally under climate change. Full article

Background and Objectives: Accurate noninvasive differentiation between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) remains a clinical challenge. This study aimed to assess the dignostic performance of apparent diffusion coefficient (ADC) values from diffusion-weighted MRI in distinguishing between HCC and ICC, with histological confirmation as the gold standard. Materials and Methods: A retrospective analysis was performed on 61 patients (41 HCC, 20 ICC) who underwent liver MRI and percutaneous biopsy between 2019 and 2024. ADC values were measured from diffusion-weighted sequences (b-values of 0, 500, and 1000 s/mm²), and regions of interest were placed over solid tumor areas. Statistical analyses included t-tests, one-way ANOVA, and ROC curve analysis. Results: Mean ADC values did not differ significantly between HCC (1.09 ± 0.19 × 10⁻³ mm²/s) and ICC (1.08 ± 0.11 × 10⁻³ mm²/s). ROC analysis showed poor discriminative ability (AUC = 0.520; p = 0.806). In HCC, ADC values decreased with lower differentiation grades (p = 0.008, η² = 0.224). No significant trend was observed in ICC (p = 0.410, η² = 0.100). Immunohistochemical markers such as CK-7, Glypican 3, and TTF-1 showed significant diagnostic value between tumor subtypes. Conclusions: ADC values have limited utility for distinguishing HCC from ICC but may aid in HCC grading. Immunohistochemistry remains essential for accurate diagnosis, especially in poorly differentiated tumors. Further studies with larger cohorts are recommended to improve noninvasive diagnostic protocols. Full article

Background: Endometrial cancer (EC) is the most common gynecological malignancy, increasingly affecting premenopausal women. While hysterectomy is the standard treatment, it eliminates reproductive potential, highlighting the need for effective fertility-sparing alternatives. Current ESHRE/ESGO/ESGE guidelines recommend progestin-based therapies, often with hysteroscopic resection. However, these are based on limited pharmacological options and moderate to low-quality evidence. Novel and combination therapies have shown promise but remain absent from current clinical guidelines. This review aims to evaluate the efficacy and safety of fertility-preserving treatments for early-stage EC, emphasizing the need to update current strategies based on emerging data. Methods: A systematic review and meta-analysis will follow PRISMA guidelines and the Cochrane Handbook. Eligible studies, including randomized and non-randomized designs, will assess fertility-preserving treatments for early-stage EC. Data will be extracted on complete response, recurrence, and long-term fertility outcomes. The GRADE system will assess evidence certainty. Risk of bias will be evaluated using RoB 2 for RCTs and ROBINS-I for non-randomized studies. Meta-analysis will be performed if sufficient data are available. Conclusions: This review will provide a comprehensive analysis of fertility-sparing treatments for early-stage EC, support personalized strategies, identify evidence gaps, and guide future research. Trial registration—Prospero: CRD420251032161. Full article

This study presents a social life cycle assessment (S-LCA) of the F-CUBED Production System (FPS), an innovative process that converts wet biogenic residues—specifically paper biosludge, virgin olive pomace, and fruit and vegetable residues—into intermediate bioenergy carriers via hydrothermal treatment (TORWASH^®), pelletization, and anaerobic digestion. The hydrothermal carbonization of these low-grade, moisture-rich biogenic residues enhances the flexibility and reliability of renewable energy systems while also offering the potential to reduce environmental burdens compared to conventional disposal methods. Through this S-LCA, the study aims to evaluate the cradle-to-gate socioeconomic impacts of the FPS in three European contexts—Sweden, Italy, and Spain—using the 2020 UNEP Guidelines and the Social Hotspots Database (SHDB) and applying quantitative modeling via SimaPro. The functional unit is defined as 1 kWh of electricity produced. The assessment combines SHDB-based modeling with primary data from stakeholder surveys conducted in the three countries. Impact categories are harmonized between SHDB and UNEP typologies, and the results are reported in medium-risk-hour equivalents (mrheq). The results show a heterogeneous social impact profile across case studies. In Sweden, the treatment of paper biosludge delivers substantial benefits with minimal risk. In Spain (orange peel), the introduction of the FPS demonstrated a strong social benefit, particularly in health and safety and labor rights, indicating high institutional performance and good integration with local industry. Conversely, in Italy (olive pomace), the FPS revealed significant social risks, especially in the biopellet production and electricity generation sectors, reflecting regional vulnerabilities in labor conditions and governance. This suggests that targeted mitigation strategies are recommended in contexts like Southern Italy. These findings highlight that the social sustainability of emerging bioenergy technologies is context-dependent and sensitive to sectoral and regional socioeconomic conditions. This S-LCA complements prior environmental assessments and emphasizes the importance of integrating social performance considerations in the deployment and scaling of innovative bioenergy systems. Full article

Background/Objectives: Tumor-infiltrating lymphocytes (TILs) and inflammation status are emerging prognostic markers in various cancers, but their significance in high-grade serous ovarian carcinoma (HGSC) remains unclear. Our objective was to evaluate different TIL subtypes and inflammation status in relation to progression-free survival (PFS) in primary HGSC. Methods: CD3⁺/CD4⁺/CD8⁺/PD-1+ stromal TILs (sTILs) and intraepithelial TILs (iTILs) were evaluated by manual assessment and digital image analysis (DIA), following TIL Working Group recommendations. Inflammation status was evaluated through the following scores: systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), CA125, and lactate dehydrogenase (LDH). Results: CD8⁺ TILs were the most prevalent subtype in both iTILs and sTILs. However, sTILs were significantly more abundant than iTILs (p < 0.001) among all subsets, except for PD-1+ cells. DIA results of TIL assessments were in agreement with manual assessments. High stromal CD3⁺ and CD8⁺ TILs, PIV, CA125, and LDH, were associated with improved PFS. Potential independent prognostic factors for PFS in manual assessment were PIV (HR = 0.32, CI 95% = 0.12–0.82) and CD8⁺ sTILs (HR = 0.30, CI 95% = 0.12–0.79), whereas in DIA assessment they were CD3⁺ sTILs (HR = 0.31, CI 95% = 0.15–0.67), PIV (HR = 0.35, 95% CI 0.13–0.96), and residual disease (HR = 0.21 95% CI 0.08–0.53). Conclusions: CD3⁺/CD8⁺ sTILs and PIV are promising prognostic indicators in HGSC; however, further research is needed to confirm their clinical utility. Full article

Aortic stenosis (AS), the most common valvular heart disease, is traditionally graded based on several echocardiographic quantitative parameters, such as aortic valve area (AVA), mean pressure gradient (MPG), and peak jet velocity (Vmax). This systematic review evaluates the clinical significance and prognostic implications of discordant high-gradient AS (DHG-AS), a distinct hemodynamic phenotype characterized by elevated MPG despite a preserved AVA (>1.0 cm²). Although often overlooked, DHG-AS presents unique diagnostic and therapeutic challenges, as high gradients remain a strong predictor of adverse outcomes despite moderately reduced AVA. Sixty-three studies were included following rigorous selection and quality assessment of the key studies. Prognostic outcomes across five key studies were discrepant: some showed better survival in DHG-AS compared to concordant high-gradient AS (CHG-AS), while others reported similar or worse outcomes. For instance, a retrospective observational study including 3209 patients with AS found higher mortality in CHG-AS (unadjusted HR: 1.4; 95% CI: 1.1 to 1.7), whereas another retrospective multicenter study including 2724 patients with AS observed worse outcomes in DHG-AS (adjusted HR: 1.59; 95% CI: 1.04 to 2.56). These discrepancies may stem from delays in intervention or heterogeneity in study populations. Despite the diagnostic ambiguity, the presence of high gradients warrants careful evaluation, aggressive risk stratification, and timely management. Current guidelines recommend a multimodal approach combining echocardiography, computed tomography (CT) calcium scoring, transesophageal echocardiography (TEE) planimetry, and, when needed, catheterization. Anatomic AVA assessment by TEE, CT, and cardiac magnetic resonance imaging (CMR) can improve diagnostic accuracy by directly visualizing valve morphology and planimetry-based AVA, helping to clarify the true severity in discordant cases. However, these modalities are limited by factors such as image quality (especially with TEE), radiation exposure and contrast use (in CT), and availability or contraindications (in CMR). Management remains largely based on CHG-AS protocols, with intervention primarily guided by transvalvular gradient and symptom burden. The variability among the different guidelines in defining severity and therapeutic thresholds highlights the need for tailored approaches in DHG-AS. DHG-AS is clinically relevant and associated with substantial prognostic uncertainty. Timely recognition and individualized treatment could improve outcomes in this complex subgroup. Full article

Background: Incomplete eyelid closure and lagophthalmos due to facial nerve palsy are significant functional and aesthetic concerns often requiring surgical correction. The aim of this systematic review is to quantitatively assess the efficacy, safety, and patient satisfaction associated with gold or platinum weight implantation, autologous fat grafting (lipofilling), and müllerectomy. Methods: A systematic review was performed following PRISMA guidelines, searching PubMed, Embase, Cochrane Library, Web of Science, and Scopus up to March 2025. Studies included clinical data on surgical correction for incomplete eyelid closure in facial palsy, reporting functional, anatomical, and satisfaction outcomes. Quality was assessed using the Newcastle–Ottawa Scale (NOS) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: Twenty-six studies including a total of 1205 patients were included. Gold/platinum weight implantation achieved complete or near-complete eyelid closure in 83–92% of cases, with a reduction in lagophthalmos to <1 mm. Complication rates ranged from 5–15% (mainly extrusion/migration), and patient satisfaction averaged 7.9/10. Lipofilling showed persistent benefit in 77% of cases, with 9–20% requiring repeat procedures and 10–12% experiencing minor complications. Müllerectomy yielded symptomatic improvement or resolution in 92% of cases, with a mean lagophthalmos reduction of 1.18 mm. Conclusions: Gold or platinum weight implantation provides the most reliable improvement for severe upper eyelid dysfunction in facial palsy. Lipofilling is a viable autologous alternative, while müllerectomy is effective in selected cases. Further prospective comparative trials are needed to refine surgical selection and optimize outcomes. Full article

Kiwifruit has attracted much attention in fruit and vegetable processing due to its high nutritional and economic value. However, there is a lack of systematic research on the effects of long-term frozen storage on the pulp quality of kiwifruit. Using kiwifruit pulp stored at −20 °C for 0, 3, 6, 9, and 12 months as the research materials, the dynamic changes in the phenotype, color, antioxidant activity, and flavor compounds were comprehensively evaluated. The results showed that frozen storage caused a significant decline in the quality of the fruit pulp. Specifically, the contents of chlorophyll and carotenoids decreased and the color deteriorated (color difference increased); the turbidity and centrifugal sedimentation rates increased, and pH and viscosity changed in different stages. Additionally, antioxidant compounds, such as vitamin C and total phenols, were significantly reduced with the extension of storage duration, and the 2,2-diphenyl-1-picrylhydrazyl (DPPH)/2,2-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) free radical scavenging ability was decreased. The content of volatile aroma compounds diminished, leading to a notable shift in the flavor profile. Correlation analysis revealed that changes in volatile substances were significantly correlated with physical, chemical, and antioxidant indicators (p < 0.05). These correlations can serve as a key basis for assessing quality deterioration. This study systematically elucidated, for the first time, the mechanism of quality deterioration in kiwifruit pulp during frozen storage, thereby providing theoretical support for enterprises to optimize pulp grading strategies and the timing of by-product development. Hence, it is recommended that the duration of freezing should be limited to less than 9 months for kiwifruit pulp. Moreover, it is essential to consider varietal differences and new pretreatment technologies to further enhance the industrial utilization and economic value of frozen pulp. Full article

Background: Oral mucositis (OM) is a painful and debilitating stomatitis that often arises following head and neck radiotherapy, chemotherapy, or stem cell transplant, leading to treatment delays and potential patient intervention interruption. The aim of this narrative review was to explore the modalities in the management of OM. When supported by evidence, treatment is customized according to its severity. Method: A literature search was performed using the PubMed database. The search strategy consists of keywords such as “pain management”, “pain control”, and “oral mucositis”. Literature references from 1997 to 2024 were selected by the authors based on relevance to the current practice of oral mucositis pain management. Results: Fourteen studies were included in this review. Interventions were classified into pharmacological and non-pharmacological modalities. In relation to pain measurement, for grade 1 OM, topical treatments are the primary recommendation. For grades 2 to 4, where pain is moderate to severe, systemic analgesia should be administered. Honey and oral care are beneficial for OM with grades 2 to 4. Conclusions: Effective management of OM should be tailored to the severity of the condition, incorporating both pharmacological and non-pharmacological strategies. While various modalities have shown promise in relieving symptoms and enhancing the quality of life, a multifaceted, patient-centered approach remains essential. Advancing high-quality clinical trials, particularly those evaluating non-pharmacological interventions will be crucial to expanding treatment options. Future efforts should focus on personalized therapies, integration of combination treatments, adoption of standardized pain assessment tools, and long-term outcome studies to improve clinical effectiveness and optimize patient care. Full article

Background/Objectives: Fibroproliferative disorders (FPDs), such as Dupuytren’s contracture, scleroderma, capsular contracture, rhinophyma, and keloid scars, are characterised by excessive fibroblast activity and collagen deposition. These conditions are frequently encountered in plastic and reconstructive surgery and remain therapeutically challenging. Cyclooxygenase (COX) inhibitors have emerged as a potential adjunct therapy to modulate fibrotic pathways and improve clinical outcomes. This systematic review aims to evaluate the efficacy and safety profile of COX inhibitors in the management of plastic-surgery-related FPDs. In doing so, it explores how phenotype-guided and route-specific COX-inhibitor use may contribute to precision, patient-centred care. Methods: To identify eligible studies, a comprehensive search was conducted in MEDLINE, Embase, and the Cochrane Library. Data were synthesised using both tabular summaries and narrative analysis. The certainty of evidence was appraised according to the GRADE guidelines. Results: Thirteen studies from 1984 to 2024 met inclusion criteria, addressing FPDs such as hypertrophic scarring, Dupuytren’s contracture, and desmoid tumours, representing 491 patients. Of those, five studies were related to Dupuytren contracture, three studies were related to hypertrophic scar, and one study each was on topics related to scleroderma, keloid scar, osteogenesis imperfecta, actinic keloidalis nuchae/dissecting cellulitis of the scalp, and desmoid tumours. Nine studies reported clinical improvements (four demonstrating statistically significant outcomes), three showed no difference, and one did not assess outcomes. The thirteen studies show minor side effects from oral and topical COX inhibitors. The overall certainty of evidence was graded as “low.” Conclusions: COX inhibitors demonstrate promising efficacy with minimal adverse effects in the management of plastic-surgery-related FPDs. Their accessibility, safety, and potential to reduce fibrosis underscore the need for future high-quality, large-scale studies to establish definitive clinical recommendations. Full article

Objective: Central neurocytomas (CNs), classified as CNS (central nervous system) grade 2 tumors, are exceptionally rare tumors, accounting for approximately 0.1–0.5% of all intracranial neoplasms, and are typically characterized by a benign clinical course and frequent association with hydrocephalus. This study aims to present a comprehensive analysis of surgical and adjuvant therapies for CN. Methods: The study comprised all patients who underwent microsurgical tumor removal in our center over the past decade (2013–2023). Clinical manifestations, surgical and adjuvant therapy approaches, MRI and histological findings, clinical outcomes, and recurrence-free survival were evaluated. Results: A total of eleven patients (six men, mean age of 28.0 years; five women, mean age of 53.6 years) underwent surgical treatment. Intraventricular tumors were the most common (72.7%, n = 8). The predominant presenting symptoms were headache and visual disturbances. All tumors exhibited contrast enhancement on MRI. Hydrocephalus was present in five patients. The Ki67 proliferation index ranged from 2% to 10%, with nine patients exhibiting Ki67 > 3%. The median recurrence-free survival was 38.0 months (IQR: 25.0–53.0). The most severe postoperative complications included aphasia, hemiparesis, and memory impairment, resulting in a postoperative Karnofsky Performance Status (KPS) below 70% in five patients. Follow-up assessments showed significant symptomatic improvement in all affected patients. Conclusions: Gross total resection is the recommended first-line therapy with favorable neurological outcomes and for atypical CN as well. Adjuvant radiotherapy should be reserved for tumor progression and recurrence. The role of adjuvant chemotherapy remains unclear, but it may be an option for CN with a high proliferation index. Full article

Background/Objectives: Personalized dietary recommendations are essential for managing chronic conditions such as diabetes and irritable bowel syndrome (IBS). However, traditional approaches often fall short in accounting for individual metabolic variability. This systematic review evaluates the effectiveness of artificial intelligence (AI)-generated dietary interventions in improving clinical outcomes among adults. Methods: Following PRISMA guidelines, we searched six electronic databases for peer-reviewed studies published between 19 November 2015 to 6 September 2024. Eligible studies included adults aged 18 to 91 who received AI-generated dietary recommendations based on biomarkers such as blood glucose, gut microbiome composition, and self-reported data. Study designs included randomized controlled trials (RCTs), pre-post studies, and cross-sectional analyses. The GRADE system was used to assess the quality of evidence. Results: Eleven studies met inclusion criteria (five RCTs, five pre-post designs, one cross-sectional). Most AI methods used in the included studies were based on machine learning (ML), including conventional ML algorithms, deep learning (DL), and hybrid approaches integrating ML with IoT-based systems. Interventions led to improved glycemic control, metabolic health, and psychological well-being. Notable outcomes included a 39% reduction in IBS symptom severity and a 72.7% diabetes remission rate. Among nine studies with comparison groups, six reported statistically significant improvements in AI groups, two found comparable or better outcomes, and one found no difference. Mild side effects such as fatigue and constipation were observed. Conclusions: AI-generated dietary interventions show promise in surpassing traditional approaches by providing personalized, data-driven recommendations. Further research is needed to validate long-term effects, refine intervention protocols, and enhance user adherence in both clinical and public health settings. Full article