Search Results (12,027)

Background/Objectives: Electronic medical record systems play a crucial role in the operation of modern healthcare institutions, enabling the foundational data necessary for advancements in personalized medicine. Despite their importance, the software supporting these systems frequently experiences data availability and integrity issues, particularly concerning patients’ personal information. This study aims to present a decentralized architecture that integrates both clinical and personal patient data, with a provenance mechanism to enable data tracing and auditing, ultimately supporting more precise and personalized healthcare decisions. Methods: A system implementation based on the solution was developed, and a feasibility study was conducted with synthetic medical records data. Results: The system was able to correctly receive data of 190 instances of the entities designed, which included different types of medical records, and generate 573 provenance entries that captured in detail the context of the associated medical information. Conclusions: For the first cycle of the research, the system developed served to validate the main features of the solution, and through that, it was possible to infer the feasibility of a decentralized EHR and PHR health system with formal provenance data tracking. Such a system lays a robust foundation for secure and reliable data management, which is essential for the effective implementation and future development of personalized medicine initiatives. Full article

T1D and CD commonly occur together. This association has received increasing attention from researchers and is considered in detail in this review. Since CD is over-represented in T1D, it may cause ill health with attendant complications, but because there is an effective dietary treatment, screening has been recommended in children and adults. However, there are many unknowns regarding this association, and understanding the why, when, and how with regard to screening and managing those with dual diagnoses requires thorough consideration when introducing the concept of screening to patients. It is important that patients and, where appropriate, carers are put at the heart of the decision-making process with careful discussion of the issues involved before undertaking screening that might uncover a second life-changing diagnosis, for which, without preparatory preparation and support, individuals may be ill-prepared, causing mental health issues. For some patients, an initial policy of monitoring rather than moving to immediate small bowel biopsy and exposure to a gluten-free diet (GFD) will be appropriate. The correct management of patients will ultimately improve their quality of life medically and socially. Full article

Grafting involves complex hormonal interactions at graft interfaces that are not yet fully understood. In this study, we analyzed hormone fluctuations and gene expression during callus proliferation and vascular tissue differentiation in hickory (Carya cathayensis Sarg.) grafts. Cytokinin and ethylene precursor ACC levels steadily increased after grafting. The biosynthetic genes for these hormones (IPT3, ACS1, ACO1, and ACO5) exhibited heightened expression. Genes related to cytokinin signaling (RR3, ARR4, and ZFP5) and ethylene signaling (MKK9, ESE1, and ESE3) were similarly upregulated. Conversely, genes associated with jasmonic acid, abscisic acid, and strigolactone pathways were downregulated, including synthesis genes (AOC4 and AOS) and those involved in signal transduction (NAC3, WRKY51, and SMAX1). Correspondingly, JA-Ile and 5-deoxystrigol levels significantly decreased. Indole-3-acetic acid (IAA) levels also dropped during the early stages of graft union formation. These results suggest that low auxin concentrations may be essential in the initial stages after grafting to encourage callus proliferation, followed by an increase at later stages to facilitate vascular bundle differentiation. These findings imply that maintaining a balance between low auxin levels and elevated cytokinin and ethylene levels may be critical to support cell division and callus formation during the initial proliferation phase. Later, during the vascular differentiation phase, a gradual rise in auxin levels, accompanied by elevated ethylene, may facilitate the differentiation of vascular bundles in hickory grafts. Full article

Brain cancer is a heterogeneous collection of malignant neoplasms, such as glioblastoma multiforme (GBM), astrocytomas and medulloblastomas, with high morbidity and mortality. Its treatment is complicated by the tumor’s site, infiltrative growth mode and selective permeability of the blood–brain barrier (BBB). During tumor formation, the BBB dynamically remodels into the blood–brain tumor barrier (BBTB), disrupting homeostasis and preventing drug delivery. Furthermore, the TME (Tumor Micro Environment) supports drug resistance, immune evasion and treatment failure. This review points out the ways in which nanomedicine overcomes these obstacles with custom-designed delivery systems, sophisticated diagnostics and personalized therapies. Traditional treatments fail through a lack of BBB penetration, non-specific cytotoxicity and swift tumor adaptation. Nanomedicine provides greater drug solubility, protection against enzymatic degradation, target drug delivery and control over the release. Nanotheranostics’ confluence of therapeutic and diagnostic modalities allows for dynamic adjustment and real-time monitoring. Nanotechnology has paved the way for the initiation of a new era in precision neuro-oncology. Transcending the limitations of conventional therapy protocols, nanomedicine promises to deliver better outcomes by way of enhanced targeting, BBB penetration and real-time monitoring. Multidisciplinary collaboration, regulatory advancements and patient-centered therapy protocols customized to the individual patient’s tumor biology will be necessary to facilitate translation success in the future. Full article

Inclusive Education aims to ensure equitable learning opportunities for all students, including those with special educational needs (SEN) and disabilities, by promoting accessible teaching practices and supportive learning environments. Although its importance for fostering the academic and social development of diverse learners has been widely recognized in international policy and research, its practical implementation is still under investigation, particularly within the Greek primary education system. This study investigates (a) Greek primary school teachers’ perspectives, focusing on their attitudes, knowledge, challenges, and perceived needs in Inclusive Education for SEN students and (b) research trends relating to these perspectives, focusing on publication trends and methodological characteristics, through a systematic literature review using the PRISMA methodology. The analysis revealed a shift in Greek primary teachers’ attitudes towards Inclusive Education for SEN students, trending towards neutral or negative responses, alongside limited knowledge, various challenges, and an absence of targeted support mechanisms. The analysis also highlighted chronological gaps between the identified studies in international journals and a variability in methodological approaches and sample characteristics. These insights point to a pressing need for further targeted and ongoing research on Greek primary teachers’ perspectives and professional development initiatives to enable effective and inclusive practices for SEN students in Greek primary education. Full article

Accurate detection of fractures in X-ray images is important to initiate appropriate medical treatment in time—in this study, an advanced combined attention CNN model with multiple attention mechanisms was developed to improve fracture detection by deeply representing features. Specifically, our model incorporates squeeze blocks and convolutional block attention module (CBAM) blocks to improve the model’s ability to focus on relevant features in X-ray images. Using computed tomography X-ray images, this study assesses the diagnostic efficacy of the artificial intelligence (AI) model before and after optimization and compares its performance in detecting fractures or not. The training and evaluation dataset consists of fractured and non-fractured X-rays from various anatomical locations, including the hips, knees, lumbar region, lower limb, and upper limb. This gives an extremely high training accuracy of 99.98 and a validation accuracy 96.72. The attention-based CNN thus showcases its role in medical image analysis. This aspect further complements a point we highlighted through our research to establish the role of attention in CNN architecture-based models to achieve the desired score for fracture in a medical image, allowing the model to generalize. This study represents the first steps to improve fracture detection automatically. It also brings solid support to doctors addressing the continued time to examination, which also increases accuracy in diagnosing fractures, improving patients’ outcomes significantly. Full article

The EU power market system has successfully maintained a centralized governance structure ensuring stable electricity supply and affordable prices for over two decades. However, the ongoing energy transition towards carbon neutrality has exposed critical governance limitations, leading to challenges in community projects implementation. Given that Heating and Cooling (H&C) accounts for more than 50% of the EU’s energy consumption, community H&C initiatives can drive local energy transitions and support renewable integration. This study analyzes the best practices from European community energy initiatives, supplemented by insights from the Energy Leap project. By employing a comparative analysis approach, the study proposes a technically sound and regulatory feasible governance model, alongside a robust ecosystem support framework. The proposed framework introduces new roles and new forms of partnerships between communities—private entities and consumers—taking advantage of the benefits offered by the operation of Energy Communities (ECs), enhancing community engagement and regulatory adaptability. These insights offer practical guidance and contribute to effective policymaking in support of the EU’s energy transition objectives. Full article

This study examines the integration and sustainability of solar energy technologies as a tool for rural electrification in Ghana, using the Lofetsume community as a case study. Persistent electricity access deficits in rural areas, coupled with unreliable grid systems and high energy costs, underscore the need for alternative energy solutions. Through semi-structured interviews and surveys, the study explores community perspectives and expert views on the viability of solar energy in rural Ghana. Findings reveal strong grassroots support for solar energy due to its reliability and environmental benefits, despite barriers such as high upfront installation costs and maintenance challenges. The study recommends multi-stakeholder partnerships, innovative financing models, and capacity-building initiatives to enhance solar energy adoption. By prioritizing solar energy technologies, the government, private sector, and local communities can collaborate to develop sustainable and affordable electrification solutions, ultimately improving living standards in remote areas and contributing to Ghana’s broader energy sustainability goals. Full article

This study analyzes the evolution of Pakistan’s energy policies from 1990 to 2024, documenting their transition from a singular focus on generation capacity to an integrated approach prioritizing renewable energy and efficiency. Through a systematic literature review of 110 initially screened studies, with 50 meeting the inclusion criteria and 22 selected for in-depth analysis, we evaluated policy effectiveness and identified implementation barriers. Our methodology employed predefined criteria focusing on energy efficiency, environmental sustainability, and climate impact, utilizing the Web of Science and Scopus databases. Early policies like the National Energy Conservation Policy (1992) and the Energy Policy (1994) emphasized energy security through generation capacity expansion while largely neglecting renewable sources and efficiency improvements. The policy landscape evolved in the 2000s with the introduction of renewable energy incentives and efficiency initiatives. However, persistent challenges include short-term planning, inconsistent implementation, and fossil fuels dependence. Recent framework like the Alternative and Renewable Energy Policy (2019) and the National Energy Efficiency and Conservation Plan (2020–2025) demonstrate progress toward sustainable energy practices. However, institutional, financial, and regulatory barriers continue to constrain effectiveness. We recommend that Pakistan’s energy strategy prioritize the following: (1) long-term planning horizon; (2) enhanced fiscal incentives; and (3) strengthened institutional support to meet global energy security and climate resilience standards. These measures would advance Pakistan’s sustainable energy transition while supporting both energy security and environmental objectives. Full article

Emergency preparedness training in organizations frequently involves simple evacuation drills triggered by fire alarms, limiting the opportunities for broader skill development. Digital technologies, particularly virtual reality (VR), offer promising methods to enhance learning for handling incidents and evacuations. However, implementing VR-based training remains challenging due to unclear integration strategies within organizational practices and a lack of empirical evidence of VR’s effectiveness. This paper explores how VR-based training tools can be implemented in schools to enhance emergency preparedness among students, teachers, and staff. Following a design science research process, data were collected from a questionnaire-based study involving 12 participants and an exploratory study with 13 participants. The questionnaire-based study investigates initial attitudes and willingness to adopt VR training, while the exploratory study assesses the VR prototype’s usability, realism, and perceived effectiveness for emergency preparedness training. Despite a limited sample size and technical constraints of the early prototype, findings indicate strong student enthusiasm for gamified and immersive learning experiences. Teachers emphasized the need for technical and instructional support to regularly utilize VR training modules, while firefighters acknowledged the potential of VR tools, but also highlighted the critical importance of regular drills and professional validation. The relevance of the results of utilizing VR in this context is further discussed in terms of how it can be integrated into university curricula and aligned with other accessible digital preparedness tools. Full article

Advanced renal cell carcinoma (RCC) has a poor prognosis; this drives the exploration of alternative systemic therapies to identify more effective treatment options. Recent research has revealed that crebanine, an alkaloid derivative of the Stephania genus, induces apoptotic effects in various cancers; however, a thorough investigation of the role of crebanine in RCC has not been conducted thus far. For this study, we evaluated tumor cell viability, clonogenicity, cell-cycle distributions, morphological changes, and cell mortality with the aim of exploring the antitumor effects of crebanine in RCC. Furthermore, we compared gene and protein expressions using RNA sequencing analysis and Western blotting. The findings indicated that crebanine significantly inhibited RCC colonies and caused G1-phase cell-cycle arrest with sub-G1-phase accumulation, thus leading to suppressed cell proliferation and cell death. In addition, Hoechst 33342 staining was used to observe apoptotic cells, which revealed chromatin condensation and a reduction in the nuclear volume associated with apoptosis. Further, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis indicated that differentially expressed genes are involved in the initiation of DNA replication, centrosome duplication, chromosome congression, and mitotic processes in the cell cycle along with signaling pathways, such as I-kappaB kinase/NF-kappaB signaling, Hippo signaling, and intrinsic apoptotic pathways. Consistent with GO and KEGG analyses, increased levels of cleaved caspase-3, cleaved caspase-7, and cleaved PARP, and decreased levels of cIAP1, BCL2, survivin, and claspin were observed. Finally, the expressions of G1/S phase transition cyclin D1, cyclin E/CDK2, and cyclin A2/CDK2 complexes were downregulated. Overall, these findings supported the potential of crebanine as an adjuvant therapy in RCC. Full article

This study contributes to the broader sustainability discourse by evaluating public knowledge, awareness, and practices regarding air pollution among residents of Hanoi, Vietnam, focusing on its causes, health impacts, and mitigation strategies. A cross-sectional survey was conducted with 521 individuals in suburbs around Hanoi. A multistage sampling technique, combining cluster and simple random sampling, was used for participant recruitment. Three central and three suburban districts of Hanoi were randomly selected as clusters. One individual from each household was invited to participate and answer a structured survey, which assessed perceptions of air pollution, its human-induced causes, recognised health impacts, and individual and community-level mitigation behaviours. Nearly all participants (98.3%) were aware of air pollution, with 65.3% attributing it to human activities and 61.2% recognising specific air pollutants as primary contributors. The majority (93.9%) acknowledged health impacts, citing respiratory infections (55.1%) and sinus issues (51.2%) as prevalent concerns. Vulnerable groups, such as children under 5 (82.3%) and adults over 65 years old (77.4%), were identified as disproportionately affected. Social media (68.9%) and television (58.3%) were the dominant sources of information. Despite a recognition of air pollution’s importance (98.5%), there was limited engagement in systemic sustainability actions, such as supporting renewable energy initiatives. Most participants (84.3%) reported personal mitigation efforts, including energy-saving practices (35.5%) and walking instead of driving a car or bike (35.3%). While awareness of air pollution and its health impacts is high among Hanoi residents, proactive engagement in systemic solutions remains limited. Policymakers should prioritise community-based programs, public–private partnerships, sustainability education, and culturally tailored policy interventions to bridge gaps between awareness and action. Tailored interventions addressing demographic and cultural factors are essential to fostering socio-environmental sustainability in rapidly urbanising contexts. Full article

Miami, Florida, renowned for its cultural richness and coastal beauty, also faces the concerning challenges created by urban heat islands (UHIs). As one of the hottest cities of the United States, Miami is facing escalating temperatures and threatening heat-related vulnerabilities due to urbanization and climate change. Our study addresses the critical issue of mapping and investigating UHIs in complex urban settings. This study leveraged Planet satellite data and Landsat data to conceptualize and develop appropriate mitigation strategies for UHIs in Miami. Utilizing the Planet satellite imagery and Landsat data, we conducted a combined study of land cover and land surface temperature variations within the city. This approach fuses remotely sensed data to identify the UHI hotspots. This study aims for dynamic approaches for UHI mitigation. This includes studying the status of green spaces present in the city, possible expansion of urban green spaces, the propagation of cool roof initiatives, and exploring the recent climatic trend of the city. The research revealed that built-up areas consistently showed higher land surface temperatures while zones with dense vegetation have lower surface temperatures, supporting the role of urban green spaces in surface temperature reduction. This research can also set a robust model for addressing UHIs in other cities facing rapid urbanization and experiencing mounting temperatures each passing year by helping in assessing LST, land cover, and related spectral indices as well. Full article

An investigation into the biological mechanisms initiated in wounded skin following the application of mesenchymal stem cells (MSCs) and nanoparticles (NPs) (Ag, ZnO), either alone or combined, was performed in mice, with the aim of determining the optimal approach to accelerate the healing process. This combined treatment was hypothesized to be beneficial, as it is associated with the production of molecules supporting the healing process and antimicrobial activity. The samples were collected seven days after injury. When compared with untreated wounded animals (controls), the combined (MSCs+NPs) treatment induced the expression of Sprr2b, encoding small proline-rich protein 2B, which is involved in keratinocyte differentiation, the response to tissue injury, and inflammation. Pathways associated with keratinocyte differentiation were also affected. Ag NP treatment (alone or combined) modulated DNA methylation changes in genes involved in desmosome organization. The percentage of activated regulatory macrophages at the wound site was increased by MSC-alone and Ag-alone treatments, while the production of nitric oxide, an inflammatory marker, by stimulated macrophages was decreased by both MSC/Ag-alone and MSCs+Ag treatments. Ag induced the expression of Col1, encoding collagen-1, at the injury site. The results of the MSC and NP treatment of skin wounds (alone or combined) suggest an induction of processes accelerating the proliferative phase of healing. Thus, MSC-NP interactions are a key factor affecting global mRNA expression changes in the wound. Full article

Regional ecological environmental quality (EEQ) is a vital indicator for environmental management and supporting sustainable development. However, the absence of robust and accurate EEQ prediction models has hindered effective environmental strategies. This study proposes a novel approach to address this gap by integrating the ecological index (EI) model with several predictive models, including autoregressive integrated moving average (ARIMA), convolutional neural network (CNN), long short-term memory (LSTM), and cellular automata (CA), to forecast regional EEQ. Initially, the spatiotemporal evolution of the input data used to calculate the EI score was analyzed. Subsequently, tailored prediction models were developed for each dataset. These models were sequentially trained and validated, and their outputs were integrated into the EI model to enhance the accuracy and coherence of the final EEQ predictions. The novelty of this methodology lies not only in integrating existing predictive models but also in employing an innovative fusion technique that significantly improves prediction accuracy. Despite data quality issues in the case study dataset led to higher prediction errors in certain regions, the overall results exhibit a high degree of accuracy. A comparison of long-term EI predictions with EI assessment results reveals that the R² value for the EI score exceeds 0.96, and the kappa value surpasses 0.76 for the EI level, underscoring the robust performance of the integrated model in forecasting regional EEQ. This approach offers valuable insights into exploring regional EEQ trends and future challenges. Full article