Search Results (647)

The use of opioids for cancer-related pain is essential but poses significant challenges due to the risk of misuse and the development of opioid use disorder (OUD). This review takes a multidisciplinary perspective based on the current scientific literature to analyze the pharmacological mechanisms, classification, and therapeutic roles of opioids in oncology. Key risk factors for opioid misuse—including psychiatric comorbidities, prior substance use, and insufficient clinical monitoring—are discussed in conjunction with validated tools for pain assessment and international guidelines. The review emphasizes the importance of integrating toxicological, pharmacological, physiological, and public health perspectives to promote rational opioid use. Pharmacogenetic variability is explored as a determinant of treatment response and addiction risk, underscoring the value of personalized medicine. Evidence-based strategies such as early screening, psychosocial interventions, and the use of buprenorphine-naloxone are presented as effective measures for managing OUD in cancer patients. Ultimately, this work advocates for safe, patient-centered opioid prescribing practices that ensure effective pain relief without compromising safety or quality of life. Full article

Creating a comfortable microclimate in the premises of buildings is currently becoming one of the priorities in the field of architecture, construction and engineering systems. The increased attention from the scientific community to this topic is due not only to the desire to ensure healthy and favorable conditions for human life but also to the need for the rational use of energy resources. This area is becoming particularly relevant in the context of global challenges related to climate change, rising energy costs and increased environmental requirements. Practice shows that any technical solutions to ensure comfortable temperature, humidity and air exchange in rooms should be closely linked to the concept of energy efficiency. This allows one not only to reduce operating costs but also to significantly reduce greenhouse gas emissions, thereby contributing to sustainable development and environmental safety. In this connection, this study presents a parametric assessment of the influence of climatic and geometric factors on the aerodynamic characteristics of the air cavity, which affect the heat exchange process in the ventilated layer of curtain wall systems. The assessment was carried out using a combined analytical calculation method that provides averaged thermophysical parameters, such as mean air velocity ($V_s$), average internal surface temperature ($t_{in.s}^{av}$), and convective heat transfer coefficient (${\alpha }_s$) within the air cavity. This study resulted in empirical average values, demonstrating that the air velocity within the cavity significantly depends on atmospheric pressure and façade height difference. For instance, a 10-fold increase in façade height leads to a 4.4-fold increase in air velocity. Furthermore, a three-fold variation in local resistance coefficients results in up to a two-fold change in airflow velocity. The cavity thickness, depending on atmospheric pressure, was also found to affect airflow velocity by up to 25%. Similar patterns were observed under ambient temperatures of +20 °C, +30 °C, and +40 °C. The analysis confirmed that airflow velocity is directly affected by cavity height, while the impact of solar radiation is negligible. However, based on the outcomes of the analytical model, it was concluded that the method does not adequately account for the effects of solar radiation and vertical temperature gradients on airflow within ventilated façades. This highlights the need for further full-scale experimental investigations under hot climate conditions in South Kazakhstan. The findings are expected to be applicable internationally to regions with comparable climatic characteristics. Ultimately, a correct understanding of thermophysical processes in such structures will support the advancement of trends such as Lightweight Design, Functionally Graded Design, and Value Engineering in the development of curtain wall systems, through the optimized selection of façade configurations, accounting for temperature loads under specific climatic and design conditions. Full article

Background/Objectives: Knee osteoarthritis is one of the most significant diseases globally and in Portugal. Despite the availability of international guidelines, there is a lack of tailored, evidence-based recommendations specifically for Portuguese physiotherapists to manage their knee osteoarthritis patients with non-pharmacological and non-surgical interventions. This study aimed to develop a clinical practice guideline that integrates the latest international evidence with local clinical practice data to enhance patient outcomes. Methods: To achieve the objective, a comprehensive search was conducted in November 2024 across major health-related databases, to identify robust and recent evidence regarding the efficacy of non-pharmacological and non-surgical interventions, as well as their usage in the national context. Two key sources were identified: An umbrella and a mixed-methods study. Data from both sources were independently reviewed and integrated through a comparative analysis to identify interventions with robust scientific support and high local acceptability. Recommendations were then formulated and categorized into gold (strong), silver (moderate), and bronze (weak) levels based on evidence quality and clinical relevance. A decision-making flowchart was developed to support guideline implementation and clinical usage. Results: The integrated analysis identified three gold-level interventions, namely Nutrition/Weight Loss, Resistance Exercise, and Self-care/Education. Five silver-level recommendations were Aerobic Exercise, Balneology/Spa, Extracorporeal Shockwave Therapy, Electrical Stimulation, and Manual Therapy. Similarly, five bronze-level recommendations comprised Kinesio Taping, Stretching, Ultrasound Therapy, Thermal Agents, and Walking Aids. Conclusions: This clinical practice guideline provides a context-specific, evidence-based framework for Portuguese physiotherapists managing knee osteoarthritis. By bridging international evidence with local clinical practice, the guideline aims to facilitate optimal patient care and inform future research and guideline updates. Full article

This study conducts a comparative evaluation of Turkiye’s carbon emission profile from both sectoral and global perspectives. Utilizing 2022 data from 76 countries, it applies two widely recognized multi-criteria decision-making (MCDM) methods: MEREC, for determining objective weights of criteria, and PROMETHEE II, for ranking countries based on these criteria. All data used in the analysis were obtained from the World Bank, a globally recognized and credible statistical source. The study evaluates seven criteria, including carbon emissions from the energy, transport, industry, and residential sectors, along with GDP-related indicators. The results indicate that Turkiye’s carbon emissions, particularly from industry, transport, and energy, are substantially higher than the global average. Moreover, countries with higher levels of industrialization generally rank lower in environmental performance, highlighting a direct relationship between industrial activity and increased carbon emissions. According to PROMETHEE II rankings, Turkiye falls into the lower-middle tier among the assessed countries. In light of these findings, the study suggests that Turkiye should implement targeted, sector-specific policy measures to reduce emissions. The research aims to provide policymakers with a structured, data-driven framework that aligns with the country’s broader sustainable development goals. MEREC was selected for its ability to produce unbiased criterion weights, while PROMETHEE II was chosen for its capacity to deliver clear and meaningful comparative rankings, making both methods highly suitable for evaluating environmental performance. This study also offers a broader analysis of how selected countries compare in terms of their carbon emissions. As carbon emissions remain one of the most pressing environmental challenges in the context of global warming and climate change, ranking countries based on emission levels serves both to support scientific inquiry and to increase international awareness. By relying on recent 2022 data, the study offers a timely snapshot of the global carbon emission landscape. Alongside its contribution to public awareness, the findings are expected to support policymakers in developing effective environmental strategies. Ultimately, this research contributes to the academic literature and lays a foundation for more sustainable environmental policy development. Full article

The global pursuit of sustainable development has intensified the need to integrate Circular Economy (CE), Sustainable Development Goals (SDGs), and Industry 4.0 (I4.0) as mutually reinforcing frameworks. This study explores the scientific evolution and interconnections among these pillars through a dual approach: (i) a scientometric analysis using CiteSpace, VOSviewer, and Bibliometrix in RStudio (2024.12.1+563), and (ii) a targeted mini-review of high-impact literature. A dataset of 478 Scopus-indexed articles (2016–2024) was analyzed, revealing CE and I4.0 as key technological and strategic enablers of the SDGs—particularly SDG 12 (Responsible Consumption and Production), SDG 9 (Industry, Innovation and Infrastructure), and SDG 13 (Climate Action). Moreover, the results underscore an increasing role of enabling digital technologies—such as IoT, blockchain, and big data—in shaping sustainable production systems. An important insight from this work is the growing relevance of policy frameworks as catalysts for implementing CE and I4.0 strategies, especially within national and international sustainability agendas. However, the low citation frequency of “policy” as a keyword indicates a gap in the literature that merits further exploration. Future research is encouraged to conduct in-depth bibliometric studies focused on sustainability-related policies, including regulations that operationalize CE and I4.0 to support SDG achievement. This study contributes a comprehensive overview of emerging research trends, identifies strategic knowledge gaps, and highlights the need for cohesive governance mechanisms to accelerate the digital–ecological transition. Full article

This paper presents the results of laboratory tests on the intensity of mass and heat exchange in a polytunnel, with a focus on the synergy between the polytunnel and a stone accumulator. The subject of study was a standard polytunnel made of double polythene sheathing. In the process of selecting the appropriate working conditions for such a polytunnel, the characteristic operating parameters were modeled and verified. They were related to the process of mass and energy exchange, which takes place in regular controlled-environment agriculture (CEA). Then, experimental tests of a heat accumulator on a fixed stone bed were carried out. The experiments were carried out for various accumulator surfaces ranging from 18.7 m² to 74.8 m², which was measured perpendicularly to the heat medium. To standardize the results obtained, the analysis included the unit area of the accumulator and the unit time of the experiment. In this way, 835 heat and mass exchange events were analyzed, including 437 accumulator charging processes and 398 discharging processes from April to October, which is a standard period of polytunnel use in the Polish climate. During the tests, internal and external parameters of the process were recorded, such as temperature, relative humidity, solar radiation, wind speed and air flow speed in the accumulator system. Based on the parameters, a set of empirical relationships was developed using mathematical modeling. This provided the foundation for calculating heat gains as a result of its storage in a stone accumulator and its discharging process. The research results, including the developed dependencies, not only fill the scientific gap in the field of heat storage, but can also be used in engineering design of polytunnels supported by a heat storage system on a stone bed. In addition, the proposed methodology can be used in the study of other heat accumulators, not only in plant production facilities. Full article

Scientific knowledge and international collaboration are critical to achieving the Sustainable Development Goals (SDGs). This study conducts a large-scale bibliometric analysis of 49.4 million publications indexed in the Web of Science (1945–2023) related to the SDGs, with a specific focus on SDG 3 (Good Health and Well-Being). Since 1992, SDG 3 has accounted for 58% of SDG-related scientific output. Using K-means clustering and network analysis, we classified countries/regions by research productivity and mapped core–periphery collaboration structures. Results reveal a sharp concentration: the United States, China, England, and Germany account for 51.65% of publications. In contrast, the group composed of the 195 least productive countries and territories accounts for approximately 5% of the total scientific output on the SDGs, based on the same clustering method. Collaboration patterns mirror this inequality, with 84.97% of partnerships confined to the core group and only 2.81% involving core–periphery cooperation. These asymmetries limit the capacity of developing regions to generate health research aligned with local needs, constraining equitable progress toward SDG 3. Expanding scientific cooperation, fostering North–South and South–South collaborations, and ensuring equitable research funding are essential to promote inclusive knowledge production and support sustainable global health. Full article

Self-realization, a multifaceted concept, has long been a subject of interest in the scientific literature. Given its profound impact on overall well-being and work-related satisfaction, the development of instruments capturing its complexity assumes significant relevance. Therefore, this study presents the development and validation of the META—Measurement for Evolution, Transformation, and Autorealization, a self-report measure designed to assess the propensity for self-realization. The study involved a sample of 634 participants, who completed a survey comprising the META, Satisfaction with Life Scale, Career Adapt-Abilities Scale, General Self-Efficacy Scale, Insight Orientation Scale, and 10-item Connor–Davidson Resilience Scale. The analyses confirmed the statistical solidity of the three hypothesized sections; Part A (Evolutionary Thrust), including Sense of life, Spirit of service, Self-Authorizing, Self-Centering, and Internal Drive for Realization; Part B (Transformative Adaptation), including Propensity for transformation, Distress to change, Adaptability, and Fullness of the Experience; Part C (Work Attitude), including Social Service and Care, Administrative and Office Works, Entrepreneurship, Customer Service and Hospitality, and Manual activities. Factor analyses supported the structural validity of the three hypothesized sections of the META, and all subscales showed good to excellent internal consistency. Significant correlations between the META dimensions/subdimensions and self-realization or well-being outcomes also emerged. The META showed excellent psychometric properties and may be used in various fields, promoting advancements in research and practices supporting well-being and personal fulfilment. Full article

The integration of lithium-ion (Li-ion) battery energy storage systems (LiBESSs) with photovoltaic (PV) generation offers a promising solution for powering auxiliary services (ASs) in high-voltage power stations. This study conducts a systematic literature review (SLR) to evaluate the feasibility, benefits, and challenges of this integration. The proposed SLR complies with the PRISMA 2020 statement, and it is also registered on the international PROSPERO platform (ID 1073599). The selected methodology includes the following key steps: definition of the research questions; search strategy development; selection criteria of the studies; quality assessment; data extraction and synthesis; and discussion of the results. Through a comprehensive analysis of scientific publications from 2013 to 2024, trends, advancements, and research gaps are identified. The methodology follows a structured review framework, including data collection, selection criteria, and evaluation of technical feasibility. From 803 identified studies, 107 were eligible in accordance with the assessed inclusion criteria. Then, a custom study impact factor (SIF) framework selected 5 out of 107 studies as the most representative and assertive ones on the topics of this SLR. The findings indicate that Li-ion BESSs combined with PV systems enhance reliability, reduce reliance on conventional sources, and improve grid resilience, particularly in remote or constrained environments. The group of reviewed studies discuss optimization models and multi-objective strategies for system sizing and operation, along with practical case studies validating their effectiveness. Despite these advantages, challenges related to cost, regulatory frameworks, and performance variability remain. The study concludes that further experimental validations, pilot-scale implementations, and assessment of long-term economic impacts are necessary to accelerate the adoption of BESS-PV systems in high-voltage power substations. This study was funded by the R&D program of the Brazilian National Electric Energy Agency (ANEEL) via project number PD-07351-0001/2022. Full article

Triangular shapes have been studied from different perspectives over a wide temporal frame since ancient times. Initially, fundamental theorems were formulated to demonstrate their geometrical properties. Philosophy and art leveraged the peculiar aspects of triangles as building blocks for more complex geometrical shapes. This paper will review triangles by adopting a multidisciplinary approach, recalling ancient science and Plato’s arguments in relation to their connection with philosophy. It will then consider the artistic utilization of triangles, particularly in compositions created during the medieval era, as exemplified by the Cosmati Italian family’s masterpieces. Various scientific environments have explored triangular 2D and 3D shapes for different purposes, which will be briefly reviewed here. After that, Sierpiński geometry and its properties will be introduced, focusing on the equilateral shape and its internal complexity generated by subdividing the entire triangle into smaller sub-triangles. Finally, examples of triangular planar shapes that fulfill the Sierpiński geometry will be presented as an application in signal processing for high-frequency signals in the microwave and millimeter-wave range. Full article

Background and Objectives: International guidelines differ on short-term (4-week) oral anticoagulation (OAC) indication after acute cardioversion for recent-onset atrial fibrillation (AF < 12–48 h) in low-risk patients (CHA₂DS₂-VA = 0). While Canadian and Chinese guidelines recommend OAC for all, European, Australian and New Zealand, and American guidelines state that such treatment is optional due to the absence of high-quality evidence supporting its indication in this specific scenario. This study aimed to assess physicians’ management of a simple clinical case at an international level, focusing on how they balance ischemic and bleeding risks in a setting lacking any strong evidence-based recommendations. Materials and Methods: Six different AF guidelines were evaluated regarding the recommendation for and scientific evidence justifying short-term OAC in this specific setting. Following review, an international questionnaire was developed with Google Forms 2024 (Mountain View, CA, USA) and circulated among physicians working in the fields of cardiology, internal medicine, intensive care unit, geriatrics, and emergency medicine at 17 centres in Italy, France, and Canada. Results: A total of 78 responses were obtained. Younger physicians and cardiologists appeared to administer OAC more frequently compared to older physicians or those working in other specialties (95% CI Fisher’s Exact Test p = 0.049 and 0.029, respectively). Significant differences were observed in the use of periprocedural imaging, with transoesophageal echocardiogram (TOE) prior to cardioversion being performed more often in Europe vs. Canada (p = 0.006) and in long-term rhythm control, with first-line pulmonary vein isolation (PVI) being offered more frequently by European cardiologists (p = 0.013). No statistically significant association was found regarding guideline adherence for OAC administration (p = 0.120). Conclusions: The real-world antithrombotic management of low-risk (CHA₂DS₂-VA = 0), acutely cardioverted AF patients varies significantly among different healthcare systems. Particularly in cardiology departments, reducing the time limit for safely not prescribing OAC to < 12 h, ensuring local access to direct oral anticoagulants (DOACs) and considering regional stroke risk profiles, as well as actively preventing haemorrhage in patients receiving short-term OAC could all limit cardioversion-related complications in this low-risk population. Full article

Weathering steel has a fascinating history that dates back to the 1930s, and its evolution has left an indelible mark on various industries, from railways to architecture. Thanks to its high corrosion resistance with respect to conventional steel, weathering steel has assumed key roles in structural applications (buildings, bridges, railways, etc.), non-structural elements (facades, decorative elements), and installations at archaeological sites (retrofitting, sculptures), especially when exposed to aggressive environments. This paper is aimed at providing a state-of-the-art overview of the application of weathering steel in architecture and engineering applications, focusing on the development of scientific and technical knowledge on the subject and on future directions arising from current utilization. An evolution timeline of weathering steel-based constructions and their structural/typological classification is illustrated and discussed. In such a context, pros and cons related to maintenance aspects of weathering steel structures are also discussed, accounting for costs relative to structural and nonstructural maintenance and those related to environmental sustainability with respect to other traditional constructions. From a structural design point of view, the rules and recommendations provided by the main national and international standards—concerning material properties and types, design, and checks on structural members made with weathering steel—are analyzed, critically discussed, and compared, also with the aim of identifying possible gaps in comparison with other construction materials. Full article

This study presents a bibliometric review aimed at mapping and analyzing the scientific literature related to the ethical implications of artificial intelligence (AI) in livestock farming, which is a rapidly emerging yet still underexplored field in international research. Based on the Scopus database, 151 documents published between 2015 and 2025 were identified and analyzed using the VOSviewer version 1.6.20 and Biblioshiny for Bibliometrix (RStudio version 2023.12.1) tools. The results show a significant increase in publications from 2021 onwards, reflecting the growing maturity of discussions around the integration of digital technologies in the agricultural sector. Keyword co-occurrence and bibliographic coupling analyses revealed the formation of four main thematic clusters, covering technical applications in precision livestock farming as well as reflections on governance, animal welfare, and algorithmic justice. The most influential authors, high-impact journals, and leading countries in the field were also identified. As a key contribution, this study highlights the lack of robust ethical guidelines and proposes future research directions for the development of regulatory frameworks, codes of conduct, and interdisciplinary approaches. The findings underscore the importance of aligning technological innovation with ethical responsibility and social inclusion in the transition to digital livestock farming. Full article

Ultraprocessed foods (UPFs), now dominant in global diets, pose health risks that go beyond poor nutrition due to the synergistic effects of compounds in their ultracomplex industrial formulations. This narrative review aims to provide researchers and health professionals in the field of cancer with updated and critical information, as they are often unaware of the complex and evolving evidence linking UPFs to carcinogenesis. The review discusses potential mechanisms through which UPFs may contribute to cancer development, including harmful additives, neo-formed contaminants, and packaging-derived substances, as well as the displacement of protective nutrients found in whole foods. Despite limitations in establishing direct causality, epidemiological studies consistently associate high UPF intake with increased incidence of various cancers, notably colorectal, breast, and pancreatic cancers. These findings reflect a broader paradigm shift in nutritional epidemiology, recognizing that food processing is an essential dimension of diet-related health risks. To mitigate the impact of UPFs, the review emphasizes the need for preventive strategies that integrate clear dietary guidelines, regulatory measures on food labeling and additives, and public education campaigns. Successful international experiences in regulating marketing and improving transparency serve as important references. Moreover, eliminating corporate influence and conflicts of interest is crucial to ensure that public health, rather than industry agendas, guides nutrition policy. As scientific research advances to clarify the mechanisms of action and synergistic effects of harmful compounds in UPFs, coordinated efforts are needed to reduce their consumption and ultimately alleviate the global cancer burden. Full article

Fusariosis is an infection caused by the fungus Fusarium spp., which is pathogenic to both plants and humans. The disease presents several clinical manifestations and epidemiological patterns. Current treatment relies on azoles and polyenes, but increasing antifungal resistance requires the exploration of new therapeutic options. This study reviewed patents related to the treatment of Fusariosis from the last 15 years (up to June 2023). The search identified 318 patents, categorized by identification code, publication date, type of application and mechanism of action, using the International Patent Classification and Cooperative Patent Classification systems. In addition, we conducted a bibliographic search in the PubMed database using the same criteria to identify the number of scientific articles. Of the 318 patents, 21 targeted Fusarium infections in humans. The years 2014 and 2018 stood out with three patents each, while the same period recorded an average of 58 published articles. The patents addressed mechanisms such as drug delivery, gene expression, immunotherapy, engineered drugs, and novel compounds. This research highlights the urgent need for continued innovation in therapeutic technologies to effectively treat Fusarium wilt. Full article