Search Results (499)

Background: Cervical intraepithelial neoplasia (CIN) represents a precancerous condition whose effective management is crucial for preventing invasive cervical cancer, a disease that remains a leading cause of cancer-related mortality among women worldwide. The long pre-invasive phase of cervical carcinogenesis and the availability of effective screening and treatment procedures make CIN a largely preventable and curable entity. Objectives: This review aimed to analyze therapeutic options applied in CIN, correlating interventions with lesion grade and guideline recommendations, in order to outline a management model adapted to the Romanian clinical setting. Materials and Methods: A structured narrative review of 20 published articles addressing cervical intraepithelial neoplasia (CIN 1–3) published between 2021 and 2023 was performed. Relevant studies were identified through a targeted literature search and analyzed descriptively. This study synthesized data from the recent literature and international clinical guidelines to identify management trends and context-specific adaptations. Results: Extracted variables included lesion grade, reported therapeutic approach (surveillance, excisional, or ablative treatment), reproductive considerations, and patient compliance, with international guidelines used as reference standards. Across the reviewed studies, excisional procedures (conization and LEEP) were predominantly reported for high-grade neoplasia (CIN 2–3), while low-grade lesions (CIN 1) were managed either conservatively or through close surveillance. Treatment decisions described in the literature were strongly influenced by patient age, fertility preservation needs, and obstetric history. Overall, management approaches reported in Romanian and international studies were broadly aligned with current guideline recommendations, although variations were observed in the expectant management of younger patients. Conclusions: The findings emphasize the importance of individualized management in cervical dysplasia, integrating lesion characteristics with patient-specific factors. While international guidelines provide a robust framework, their adaptation to the Romanian healthcare context should prioritize patient education, compliance, and structured post-treatment follow-up strategies. Full article

The lack of interest in the reuse of phosphorus in agriculture is mainly due to the high abundance of pathogens, organic pollutants, microplastics, and possibly toxic metals. Therefore, different forms of treatment are necessary to take advantage of phosphorus recovery potential, one of which is the use of ash from incinerated/calcined biological sludge. A high rate of conversion of the non-apatite inorganic phosphorus fraction into apatite phosphorus was obtained in this study because of the use of commercially pure CaO additive in the dry sludge calcination tests, which is more bioavailable to plants. The obtained phosphorus pentoxide content ranged from 12 to 17%, surpassing several phosphorus-based raw materials and fertilizers. In addition, the ashes have been shown to contain toxic metals far below those recommended by Brazilian and international environmental legislation, so they can be applied directly to the soil for crop fertilization, or be used in P extraction and separation technologies for fertilizer production. Full article

Objective: In this study, we aimed to develop and internally validate a clinically applicable nomogram for predicting live birth following in vitro fertilization (IVF) using routinely available clinical and embryological parameters. Methods: This retrospective study was conducted at a single tertiary IVF center. Women undergoing IVF/ICSI were included if their baseline demographic and clinical data were available, they had undergone at least one fresh or frozen–thawed embryo transfer, and they had a known live birth outcome. Women with cycles without embryo transfer and those missing key outcome data were excluded from the analysis. As a result, a total of 2119 IVF/ICSI treatment cycles resulting in embryo transfer were included in the analysis. To identify independent predictors of live birth, multivariable logistic regression analysis was performed. Results: Among the 2119 treatment cycles analyzed, 541 resulted in live birth (25.5%). Multivariable logistic regression with backward stepwise selection identified female age (OR: 0.959, p < 0.001), high embryo quality (OR: 2.752, p < 0.001), day of embryo transfer (day 5 vs. day 3, OR: 1.427, p = 0.001), and endometrial thickness on the day of transfer as independent predictors of live birth (OR: 1.086, p < 0.001). These variables were incorporated into a nomogram (the Zübeyde Hanim IVF Nomogram) to estimate individualized live birth probability. The model demonstrated acceptable discrimination, with a bootstrap-corrected area under the receiver operating characteristic curve (AUC) of 0.64 (95%CI: 0.61–0.66), and it showed satisfactory calibration across deciles of predicted risk. Conclusions: The Zubeyde Hanim IVF Nomogram provides an individualized and clinically practical tool for predicting live birth following IVF treatment. Based on routinely available parameters, this model may assist clinicians in patient counseling and treatment planning. Full article

Infertility affects 10–30% of couples globally, with significant psychological and social impacts in sub-Saharan Africa, where fertility is closely tied to identity and social status. To explore how couples’ understanding of infertility causes influences their treatment-seeking behaviours and healthcare decision-making processes in Ghana, this cross-sectional qualitative study used in-depth interviews with 24 married participants (nine dyads and six individuals) experiencing current or past infertility in Greater Accra, Ghana, from August to October 2023. Data were analysed using thematic analysis with NVivo version 15. Couples demonstrated comprehensive knowledge of infertility causes spanning medical, spiritual, cultural, and lifestyle factors, although they lacked knowledge of clinical diagnostic criteria. Three main treatment pathways emerged: medical/orthodox, herbal, and spiritual interventions, pursued either sequentially or concurrently. Decision-making was influenced by internal factors (treatment effectiveness, financial constraints, and safety concerns) and external factors (family influence and peer testimonials). Four distinct navigation strategies were identified: informed notification, trial periods and evaluation, parallel relationship management, and strategic sequencing. Couples experiencing infertility are sophisticated healthcare consumers who skilfully navigate pluralistic healthcare systems through strategic decision-making. Rather than representing non-compliance, their multimodal approaches reflect rational responses to structural constraints and cultural values. Healthcare systems should recognise and accommodate these navigation strategies to improve therapeutic relationships and outcomes. Full article

Soil total carbon (TC) and total nitrogen (TN) are key indicators of soil fertility and ecosystem stability, particularly in dryland agroecosystems. However, how rotational tillage combined with straw return affects aggregate formation and aggregate-associated TC and TN stabilization remains insufficiently understood. In this study, we aimed to clarify how rotational tillage affects aggregate structure, stability, and the spatial distribution of TC and TN, thereby revealing internal processes driving nutrient stabilization in dryland farming systems. A long-term field experiment was conducted at the Shenfeng site of Shanxi Agricultural University, China, including three rotational tillage systems with straw return: T1 (two years of no tillage (NT) + one year of deep tillage (DT)), T2 (two years of conventional tillage (CT) + one year of DT), and T3 (two years of DT + one year of CT). Soil aggregates were separated into total mechanical aggregate (TMA), 0.25–2 mm MA, and 2–10 mm MA, and they were further fractionated into water-stable aggregates (WM, Wm, and Wf) for TC and TN analysis. The results showed that aggregate stability, TC, and TN were positively correlated and decreased with soil depth, indicating strong surface enrichment. TC was mainly enriched in 0.25–2 mm MA, whereas TN was concentrated in 2–10 mm MA, and water-stable macroaggregates (WM) acted as the dominant reservoirs for R_C and R_N. Relative to the 2016 baseline (CK), TC in 2022 tended to be higher under rotational tillage with straw return, while NT-containing systems better maintained TN across the 0–60 cm profile. Among the treatments, T1 provided the most balanced performance, with a higher MWD and GMD, lower D, and improved aggregate-associated TC and TN retention. These findings suggest that rotational tillage with straw return, particularly the NT–NT–DT sequence, can support aggregate stability and is associated with improved aggregate-mediated TC and TN retention in the Loess Plateau dryland winter wheat system. Full article

Irrigation practices and nitrogen (N) addition play pivotal roles in wheat production, and their rational coordination can significantly enhance N, phosphorus (P), and potassium (K) use efficiency and yield of wheat. However, the comprehensive effects of irrigation practices and N addition rates on N, P, and K accumulation and utilization and yield of wheat in dryland remain unclear. A field experiment with two irrigation practices (W0, zero-irrigation and W1, one-off irrigation), and four N addition rates (0, 120, 180, and 240 kg N ha⁻¹, represented by N0, N120, N180, and N240, respectively) was conducted in 2021–2022 and 2023–2024. Compared to W0N0, W1N180 significantly increased wheat grain yield, spike number, and grains per spike by 46.4%, 35.9%, and 18.9%, respectively. Wheat yield and N, P, and K accumulation reached the maximum value at N180 or N240. One-off irrigation significantly improved the uptake efficiency and fertilizer partial factor productivity for N, P, and K, whereas increased N addition enhanced these parameters specifically for P and K. However, N180 treatment increased N uptake efficiency, N fertilizer partial factor productivity, P internal efficiency, and K internal efficiency by 22.2%, 31.1%, 9.4%, and 5.9%, respectively, compared to N240 under one-off irrigation. In addition, W1N180 significantly increased above-ground N, P, and K accumulation by 45.8%, 52.8%, and 51.8%, as well as pre-anthesis N and P translocation by 48.5% and 47.0%, respectively, compared to W0N120. Consequently, the W1N180 strategy not only improved wheat yield but also optimized N, P, and K accumulation, pre-anthesis N and P translocation, and nutrient use efficiency. Therefore, one-off irrigation combined with N180 can be recommended for enhancing wheat yield and nutrient use efficiency in dryland. Full article

Background/Objectives: Infertility is a multifactorial condition with an etiopathology that remains largely unclear. Although substantial evidence implicates oxidative stress (OS) as a key contributor to both male and female infertility, targeted strategies for OS-mediated reproductive dysfunction are still not well defined and require further investigation. Ubiquinol is the reduced form of Coenzyme Q10 involved in mitochondrial bioenergetics. It can be synthesized by humans endogenously or provided by dietary sources—typically egg yolks, oily fish, organ meats, and in smaller amounts in nuts and seeds and leafy green vegetables. The present article reviews possible mechanisms through which Ubiquinol plays a role in the regulation of fertility and reproduction, discussing why it could be positioned as a conditionally essential nutrient. Several questions and areas for further inquiry are also proposed. Methods: The present position paper narratively summarizes evidence related to Ubiquinol fertility and reproduction, focusing on the literature from PubMed, Science Direct, and Semantic Scholar. Results: Research advancements suggest that when physiological demands rise during certain life stages, e.g., the reproductive years, the amount of Ubiquinol produced internally may not be enough to meet heightened needs, particularly with advanced maternal/paternal age. This places a heavier reliance on obtaining Ubiquinol from the diet, thus presenting itself as a conditionally essential nutrient during certain life stages. Conclusions: Overall, Ubiquinol appears to enhance mitochondrial energy production and antioxidant defense in gametes, a process that appears to aid sperm function, oocyte quality, and early embryo development. Collectively, these data indicate a key physiological role for Ubiquinol in male and female fertility, especially given its age-related decline. Full article

Understanding how supplemental nitrogen (N) interacts with biological N₂ fixation (BNF) in modern soybean cultivars is essential for designing fertilization strategies that avoid unnecessary N inputs. We investigated N partitioning among soil, fertilizer and symbiotic sources in soybean grown in a greenhouse pot experiment on a tropical Oxisol. Plants were inoculated with Bradyrhizobium and subjected to four N managements: no external N, soil-applied ¹⁵N-urea (20 kg N ha⁻¹), foliar ¹⁵N-urea (2 kg N ha⁻¹, 0.7% w/v), and the combination of soil + foliar N. Using ¹⁵N isotope dilution, we quantified N derived from the atmosphere (NDFA), fertilizer (NDFF) and soil (NDFS) at organ and whole-plant scales, and related these fractions to nodulation, nitrogenase activity and yield. In the absence of external N, NDFA exceeded 97% in all organs, indicating a strong reliance on BNF and efficient internal N remobilization during grain filling, accompanied by higher leaf nitrate reductase activity. Soil and soil + foliar N markedly increased NDFF and NDFS while suppressing nodulation (particularly at V4) and reducing nitrogenase activity, yet they did not improve grain yield or vegetative biomass. Foliar N alone had only modest effects on N partitioning and did not enhance yield. Under these tropical soil conditions, symbiotic fixation and internal N remobilization were sufficient to meet grain N demand, highlighting the limited agronomic benefit and potential ecological cost of supplemental N during reproductive growth. Full article

The current rise in global energy demand and environmental degradation has highlighted the need to use renewable energy as an alternative to fossil fuels. Ricinus communis L. (castor bean oil) has emerged as a promising source for biofuels production due to high oil content (45–55%), ability to grow on marginal soils, and resistance to adverse conditions. This review analyzes 93 relevant studies from 2019 to 2025, selected by the PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses) from databases such as Google Scholar and Web of Science. There were identified that agronomic techniques such as optimized plant spacing, balanced fertilization, and elicitation can significantly increase productivity. Among the production methods used, heterogeneous catalysis (96.8%) and enzymatic processes (90%) stand up for their sustainability and efficiency. However, the main limitation remains the high viscosity of castor biodiesel (14–18 mm²/s at 40 °C), which exceeds international quality standards. Even so, castor biodiesel offers excellent lubricity (reduces injection wear by 20%), has standard oxidative stability, and has a relatively low cetane number (38–42), which poses challenges for ignition quality. Improvement strategies such as blending, enzymatic modification, and additive incorporation have shown potential to mitigate these limitations. The review also addresses environmental benefits, regulatory challenges, and market opportunities where the castor biodiesel offers competitive advantages. Enhancing research and innovation, supported by targeted public policies and technical standards, is essential to overcome current barriers and enable the commercial adoption of castor biodiesel as part of a more sustainable and diversified energy future. Full article

Background: Conservative management of grade 2 cervical intraepithelial neoplasia (CIN2) is now supported by international guidelines, especially in young women or those seeking fertility. However, identifying subgroups at increased risk of progression remains a clinical priority, especially in settings with prolonged surveillance. Objectives: To evaluate the clinical evolution of CIN2 in an HPV-positive cohort followed under active surveillance for a maximum follow-up of 48 months, with particular attention to the risk of progression, persistence and regression, and associated predictors. Methods: Retrospective observational study conducted on a cohort of 237 HPV-positive women with a histological diagnosis of CIN2. Three possible clinical outcomes (progression, persistence, and regression) were analyzed. Patients underwent structured follow-up including cytology and colposcopy every 6 months, and HPV testing annually. Excisional treatment was performed only in case of progression or poor compliance. Logistic regression (univariate and multivariate) was applied to identify independent predictors of progression and regression. Results: After a maximum follow-up of 48 months. 61.3% of lesions regressed spontaneously, 13.1% persisted, and 25.5% progressed to CIN3. In multivariate analysis, high-grade cytology (ASC-H/HSIL) and HPV 16/18 infection were independently associated with a reduced likelihood of regression (OR ≈ 0.5, p < 0.01) and an increased risk of progression (OR ≈ 2.0, p < 0.05). Lesion size and age were not significant predictors. Importantly, no invasive carcinoma occurred during follow-up. Conclusions: Active surveillance for CIN2 remains a valid strategy in low-risk subgroups, but it is not universally safe. Data suggest that the combination of high-grade cytology and HPV 16/18 represents a high oncological risk profile, for which prompt treatment is indicated. Persistence beyond 36 months should be considered a cumulative risk marker, with implications for personalized follow-up and risk management. Further prospective, registry-linked studies are required to validate long-term safety and refine risk-based management strategies for CIN2. Full article

Assisted Reproductive Technology (ART), particularly In Vitro Fertilization (IVF), generates highly sensitive medical data classified as Protected Health Information (PHI) under international privacy and data protection laws. Ensuring the secure, transparent, and ethically governed management of this data is both essential and legally mandated. However, conventional Electronic Medical Record (EMR) systems often present significant challenges, including data-integrity risks, unauthorized access, and limited patient control—issues that become especially critical in contexts such as fertility preservation for cancer patients. EmbryoTrust introduces a blockchain-based framework designed to ensure the confidentiality, integrity, and availability of IVF-related information through a private, permissioned network integrated with role-based access control (RBAC). Smart contracts, implemented in Solidity on the Ethereum platform, verify spousal identities and enforce data immutability in compliance with religious legislation and ethical regulations. Off-chain data are stored in MongoDB for scalable, privacy-preserving management, while on-chain summaries provide tamper-evident traceability and verifiable auditability. The system was deployed and validated on the Ethereum Holešky testnet using Solidity 0.8.21 and Node.js 18.17, achieving an average transaction-confirmation time of 2.8 s, 99.9% uptime and a 95% user-satisfaction rate. Functional, integration, and usability testing confirmed secure and efficient data handling with minimal computational overhead. Comparative analysis demonstrated that the hybrid on-/off-chain architecture reduces latency and gas costs while maintaining automated compliance enforcement. The modular design enables adaptation to other jurisdictions by reconfiguring ethical and regulatory parameters within the smart-contract layer, ensuring flexibility for global deployment. Overall, the EmbryoTrust framework illustrates how blockchain logic can technically enforce medical and ethical rules in real time, providing a reproducible model for secure, culturally compliant, and privacy-preserving digital-health information management. Its alignment with Saudi Vision 2030 and the Wold Health Organization (WHO) Global Strategy on Digital Health 2020–2025 highlights its potential as a scalable solution for next-generation ART information systems. Full article

Phosphate rock is a vital natural resource classified by the European Commission as a critical raw material (CRM), extensively mined for its agricultural, industrial, and technological applications. While primarily used in fertilizer production, phosphate deposits also contain significant concentrations of trace metals, notably rare earth elements (REE), which are essential for renewable energy, electronics, and defense technologies. In response to growing demand, the recovery of REE from phosphate ores and processing by-products, particularly phosphogypsum (PG), has gained international attention. This review provides a comprehensive analysis of the global phosphate industry, examining production trends, market dynamics, and the environmental implications of phosphate processing. Special focus is placed on the geochemical behavior and mineralogical associations of REE within phosphate ores and industrial residues, namely PG and purification sludge. Although often treated as waste, these by-products represent underexplored secondary resources for REE recovery. Technological advancements in hydrometallurgical, solvometallurgical, and bioleaching methods have demonstrated promising recovery efficiencies, with some pilot-scale studies exceeding 70%–80%. However, large-scale implementation remains limited due to economic, technical, and regulatory constraints. The circular economy framework offers a pathway to enhance resource efficiency and reduce environmental impact. By integrating innovative extraction technologies, strengthening regulatory oversight, and adopting sustainable waste management practices, phosphate-rich countries can transform environmental liabilities into strategic assets. This review concludes by identifying key knowledge gaps and suggesting future research directions to optimize REE recovery from phosphate deposits and associated by-products, contributing to global supply security, economic diversification, and environmental sustainability. Full article

The incorporation of cattle slurry in soil in short-rotation-cycle poplar cultivations can be a win–win strategy, insofar as a main feedstock derived from local intensive dairy cattle breeding can be used as a natural fertilizer and in bioenergy produced in the same region. The circularity of this process can contribute to boosting local socio-economic value. In this context, this work involved the installation of a poplar SRC plantation with a density of 5330 trees ha⁻¹ in a 4000 m² moderately fertile flat site, which was formerly used as a vineyard. Mechanical dosages of slurry of 0, 26.6, 53.2, and 106.5 Mg ha⁻¹, designated as treatments T0, T1, T2, and T3, were applied three times per year during 2019, 2020, and 2021. The variables quantified were related to plant growth, biomass productivity and mass balances of K, P, Cu, Zn, Mg, and N, and organic matter in the whole soil, plant, and slurry system during the first rotation cycle. For treatments T0 and T1, all these seven chemical components showed positive balances in the system, with cumulative demand by soil and biomass being higher than cumulative supply by slurry. Negative balances occurred for P with T2 and T3 and for Zn with T3, so that an overall condition of nutrient saturation of the whole system was not achieved. A no-slurry application, or at most a moderate application equivalent to T1, in the second rotation cycle should therefore be prescribed to allow a nutrient equilibrium status to be achieved through internal seasonal recycling mechanisms. The biomass average productivities ranged from 6.1 to 11.8 Mg ha⁻¹ y⁻¹, peaking under treatment T2, and are within the typical values for a first rotation cycle for poplar SRCs. The biomass fuel quality was not affected by the slurry treatments. A good performance of plant total height and growth in diameter at breast height suggested that poplar trees were not stressed by the applied slurry. Only treatment T1 could assure that cattle CO₂-eq methane emissions were overall equilibrated by the carbon sequestration from poplar cultivation, with an absence of climatic-warming impacts. Treatments T2 and T3 could only partially minimize that impact, which would always exist. Globally, this site-specific analysis showed that, under moderately fertile conditions, controlled cattle slurry fertilization of poplar SRC cultivations, which would assure a long-term steady-state equilibrium, can be a viable option to contribute to decentralized production of bioenergy in rural communities. Full article

Urea production plays a crucial part in the worldwide agricultural economy, providing a primary supply of nitrogen for fertilizers. For storage and transport, urea is synthesized in granular form, and the prilling technology is frequently employed. In this technique, the hot liquid feed passes through an atomizer to produce small droplets, which then fall along the high tower. During the falling process, the liquid droplets gradually become solid because the internal energy is removed by the cooling air, which flows upward from the bottom. Typically, three consecutive thermal phases are analyzed for the solidification process: the liquid droplet cooling, solidification when the surface reaches freezing point, and the solid particle cooling. In this paper, the temperature distribution across the radius of the urea particles was analyzed using a heat transfer equation, which is considered a two-phase Stefan problem. The system of partial differential equations is solved numerically using the finite difference method and the enthalpy method. The temperature of the cooling air at various heights of the tower and the degree of solidification of different particle sizes were estimated and compared with data obtained from the urea factory to assess their reliability. The validation demonstrated a strong correlation between the model estimates and the real plant observations. Full article

Objectives: We aimed to develop and validate a per-cycle prediction model for in vitro fertilization (IVF) success using only preprocedural clinical variables available at the first consultation. Methods: We retrospectively analysed 1243 IVF/ICSI cycles (University of Szeged, 21 January 2022–12 December 2023). An Extreme Gradient Boosting (XGBoost version 1.7.7.1) classifier was trained on 14 baseline predictors (e.g., female age, AMH, BMI, FSH, LH, sperm concentration/motility, and infertility duration). A parsimonious 9-variable model was derived by feature importance. Model performance was assessed on the untouched test set and, as a final step, on an independent same-centre external validation cohort (n = 92) without re-fitting or recalibration. Results: The 9-variable model achieved an AUC of 0.876 on the internal test set, with an accuracy of 81.70% (95% CI 76.30–86.30%), sensitivity of 75.60%, specificity of 84.40%, PPV of 68.60%, and NPV of 88.50%. In external validation, the model maintained strong performance with an accuracy of 78.30%, confirming consistent discrimination on an independent same-centre cohort. Female age was the dominant high-impact feature, while AMH and BMI acted as “workhorse” predictors, and male factors added incremental value. Conclusions: IVF outcome can be predicted at the first visit using routinely collected preprocedural data. The model showed consistent discrimination internally and in external validation, supporting its potential utility for early, individualized counselling and treatment planning. Full article