Search Results (60)

Globally, over 350 million tonnes of thermoplastic waste are generated annually, with more than 60% either landfilled or mismanaged. This attracts innovative pathways to increase their recyclability, among which particulate-filled recycled thermoplastic composites (RTCs) are emerging as a potential waste reuse strategy for diverse civil and industrial applications. This review systematically analyses the current understanding of the physical, mechanical, and durability performance of RTCs, focusing on how various particulate filler types, content, and interfacial compatibility influence key properties. Reported studies show that incorporating particulate organic or inorganic fillers such as waste glass, sand, wood flour, etc., can increase density by 10–45%, tensile and flexural moduli by 30–120%, and thermal stability by up to 40%, though strength and ductility often decrease by 15–50% due to poor filler–matrix adhesion. This review further evaluates durability enhancements under prolonged exposure to water, thermal, and UV radiation, where filler addition reduces water absorption and UV degradation by 20–60%. Despite these advancements, challenges remain in optimising interfacial bonding, long-term performance modelling, and scalability for civil infrastructure. This review also outlines research directions to advance high-performance, sustainable RTCs through a structured review approach using defined keywords on recycled thermoplastics, fillers, and durability. Full article

This review comprehensively assesses the clinical applications and future potential of alpha-emitting radionuclides available for targeted alpha-particle therapy (TAT) in cancer treatment. The approval of radium-223 therapy in 2013 marked a significant advancement in alpha-emitting therapeutic radiopharmaceuticals, which are primarily used in treatment of prostate cancer. The EU SECURE project was introduced as a major initiative to enhance the sustainability and safety of medical alpha-emitting radionuclides production in Europe. This literature review was conducted by a multidisciplinary team on selected radionuclides, including actinium-225, bismuth-213, astatine-211, lead-212, terbium-149, radium-223 and thorium-227. These were selected based on their clinical significance, as identified in the EU PRISMAP project and subsequent literature searches. The review process involved searching major databases using specific keywords related to alpha-emitter therapy and was limited to articles in English. For each selected radionuclide, the physical characteristics, the radiochemistry, and the pre-clinical and clinical studies are explored. Actinium-225 is the most widely studied alpha emitter, with several preclinical and clinical studies on prostate cancer and neuroendocrine tumours. Other types of tumours (such as glioblastoma) still require preclinical and clinical development. Bismuth-213 bound to antibodies, peptides and nanobodies has shown optimal results in preclinical and clinical studies, with increased median survival and no significant toxicity. Astatine-211 differs from most other α-emitters relevant to TAT, since it yields one α-particle per decay. This offers certain translational advantages, including the simplification of radiation dosimetry calculations and quality control (QC). Lead-212 has the advantage of being an in situ generator with likely widespread availability. Although clinical data are limited, the findings are promising at this stage. The unconventional production of Terbium-149 is the primary reason it has not yet progressed to clinical trials. Overcoming this production obstacle would allow more detailed preclinical investigations. Optimal results with Thorium-227-labelled agents have been observed in preclinical studies, including delays in cellular growth, multiple double-strand breaks and complete regression. Intermediate phase I trial results have also been reported, demonstrating safety and tolerability, as well as an objective response rate of 25%.: The results highlight the advantages of alpha particles in targeting cancer cells with minimal radiation to normal tissue, emphasising the need for high specificity and stability in delivery mechanisms, as well as suggesting that the full clinical potential of alpha particle therapy remains unexplored. Theranostic approach and dosimetric evaluations still represent relevant challenges. Full article

Background and Objectives: Primary vesicoureteral reflux (VUR) is a common pediatric urological disorder that can lead to significant renal morbidity if undetected or improperly managed. Ultrasound (US) plays a pivotal role in its assessment, providing a radiation-free tool to prenatal assessment, diagnosis, treatment, and long-term follow-up. This study aims to systematically review the literature on the use of US in pediatric primary VUR, emphasizing its applications in prenatal and postnatal diagnosis, intraoperative guidance, and follow-up monitoring. Methods: A systematic review of the literature was performed on PubMed in accordance with PRISMA guidelines. The research strategy used the following keywords: Ultrasound Vesicoureteral reflux, VUR Ultrasound, and VUR Sonography. A total of 2222 records were initially identified. After screening titles and abstracts for relevance, 2165 studies were excluded because they did not focus on ultrasound procedures, did not specify age limits, were redundant, involved non-homogeneous populations, or were unavailable in full text. Results: Prenatal US enables early identification of urinary tract anomalies suggestive of VUR, facilitating targeted postnatal evaluation. Postnatally, contrast-enhanced voiding ultrasound (CEVUS) offers a non-ionizing method for VUR confirmation or exclusion. Intraoperatively, US improves the accuracy and efficacy of bulking agent placement, potentially enhancing surgical outcomes. In follow-up, US remains essential for both conservatively managed and surgically treated patients, enabling timely detection of complications or recurrence. Conclusions: Ultrasound represents a useful tool in the management of pediatric primary VUR, applicable across all clinical stages, avoiding radiation exposure, and improving surgical effectiveness and follow-up management. Full article

Objective: Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer. Although immunotherapy has transformed MCC management, published data remain limited. This comprehensive review evaluates current evidence on immune checkpoint inhibitors (ICIs) in MCC, in relation to other treatment modalities such as surgery and radiotherapy. Methods: Peer-reviewed articles published between January 2000 and August 2025 were searched manually in four databases: Scopus, ScienceDirect, PubMed and MEDLINE, using the keywords “Merkel cell carcinoma” AND “immunotherapy” AND “immune checkpoint inhibitors”. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology was employed. Results: ICIs can be given in different settings: (A) Neoadjuvant: The CheckMate 358 trial reported a 54.5% response rate among 33 radiologically evaluable patients treated with nivolumab, each showing over 30% tumor reduction. (B) Adjuvant: (1) The ADMEC-O phase II trial demonstrated improved disease-free survival with adjuvant nivolumab. (2) The ADAM phase III trial evaluates adjuvant avelumab in node-positive patients post-surgery/radiation, with common side effects including nausea, fatigue, and itching. (3) STAMP, a phase III trial, investigates pembrolizumab in stage I–III MCC. Both ADAM and STAMP have completed accrual and results are pending. (C) Primary therapy: KEYNOTE-017 and JAVELIN trials reported a 60% overall response rate and ~40% 3-year progression-free survival with first-line pembrolizumab or avelumab. Both agents also show promise as salvage therapies. Conclusions: ICIs demonstrate encouraging outcomes in MCC across various treatment stages. Continued research is essential to optimize treatment timing and integrate multimodal therapies. Full article

Background: Pancreatic and hepatobiliary tumors continue to rank among the deadliest cancers worldwide. Due to a low response rate to treatment, these tumors continue to have a high death rate, a poor prognosis and survival rate, and an overall poor patient outcome. The multimodal strategy used in current treatment includes systemic therapy, radiation therapy, and surgery. However, surgery remains the only treatment with curative intent. Preoperative biliary drainage has a direct impact on the perioperative prognosis of patients with obstructive jaundice and significantly compromised liver function due to hepato-bilio-pancreatic malignancies. Our study’s goal was to determine the safest and most efficient preoperative biliary drainage technique by conducting a systematic review and meta-analysis of resectable periampullary cancers. Methods: Our approach consisted of searching PubMed, BMC Medicine, and Scopus databases using keywords with a result of 1104 articles from 2010 to 2023. The remaining 24 articles that met our inclusion criteria were subjected to meta-analysis using R Commander 4.3.2. Results: Endoscopic retrograde biliary drainage (ERBD) demonstrated a higher rate of postprocedural pancreatitis (RR = 2.22, p < 0.01), intra-abdominal abscess (RR = 1.64, p < 0.01), and delayed gastric emptying (DGE) (RR = 2.07, p < 0.01) than percutaneous transhepatic biliary drainage (PTBD) or endoscopic nasobiliary drainage (ENBD). Plastic stent (PS) had higher rates of catheter occlusion (RR = 2.20, p < 0.01) and POPF (RR = 1.66, p < 0.01) compared to self-expandable metallic stent (SEMS), which could explain a longer hospital stay (MD = 2.41 days, p < 0.01). However, PS had lower rates of grade 1–2 complications (RR = 0.79, p = 0.017) and wound infection rates (RR = 0.66, p = 0.017) than self-expandable metallic stent (SEMS). Conclusions: The choice of a preoperative drainage method can influence postprocedural and postoperative complications rates. ERBD appears to be associated with higher procedure-related and postoperative complication rates and may be linked to a prolonged hospital stay compared to ENBD or PTBD. Moreover, the type of stent placed through ERBD procedure had an important impact on prognosis, as PS had a higher rate of catheter occlusion and POPF, with a prolonged hospital stay compared to SEMS, while mild complications and wound infections were less common in PS group. Full article

Atmospheric aerosols significantly influence photosynthetically active radiation (PAR), critical for plant photosynthesis and ecosystem functioning. This study systematically reviewed recent research (2021–2025) on aerosol–PAR interactions. Using targeted keywords, 22 open-access articles from Scopus and Google Scholar were analyzed via VOSviewer for thematic, methodological, and geographic trends. Analysis revealed a strong concentration in Earth and Environmental Sciences, showcasing significant advances in radiative transfer modeling, remote sensing, and machine learning for estimating aerosol impacts on PAR. Studies primarily utilized satellite data and models (e.g., DART, SCOPE) to assess diffuse/direct radiation changes. The literature consistently demonstrates how aerosols modulate PAR, influencing canopy light penetration and photosynthetic efficiency. However, critical gaps persist, including limited field validation in tropical biomes (e.g., Amazon, Cerrado, Pantanal) and a lack of studies differentiating aerosol types like black and brown carbon. This synthesis underscores the need for expanded monitoring and integrated modeling efforts to improve understanding of aerosol–PAR interactions, particularly in underrepresented tropical regions. Full article

The lips, due to their unique anatomical characteristics of a thin stratum corneum, the absence of sebaceous glands, and limited melanin content are particularly vulnerable to ultraviolet (UV) radiation, necessitating specialized photoprotective care. While facial sunscreens are widely available, the development of lip-specific sun protection products remains underexplored. This study aims to analyze technological trends and innovations in lip photoprotection by reviewing patents published between 2014 and 2024. A comprehensive patent search using the IPC code A61Q19 and the keywords “lip” and “sunscreen” identified 17 relevant patents across China, the United States, and Japan. The patents were examined for active ingredients, formulation strategies, and use of botanical or sustainable excipients. The findings revealed that patented formulations predominantly rely on well-established UV filters such as zinc oxide, titanium dioxide, octyl methoxycinnamate, and avobenzone, often combined with antioxidants like ferulic acid and rutin for enhanced efficacy. Lipid-based excipients were widely used to improve texture, hydration, and product stability. Although many formulations exhibit a conservative ingredient profile, the strategic combination of UV filters with natural antioxidants and moisturizing lipids demonstrates a multifunctional approach aimed at enhancing both protection and user experience. Full article

Background/Objectives: Aseptic loosening is a major challenge in hip and knee arthroplasty. While radiostereometric analysis (RSA) is the gold standard for detecting early migration, it is static, costly, and requires metal beads. Provocation CT-based analysis studies implants under physiological stresses and offers a marker-free alternative with comparable accuracy. This systematic review evaluates its effectiveness, cost, and role in orthopedic imaging. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Three databases were searched, with no date restrictions, using keywords related to the research area. The risk of bias was assessed using the RoB-1 tool. Results: The initial search identified 42 studies, with 6 ultimately included in the review. These studies involved 198 patients with an average age of 65.0 years. Provocation CT demonstrated higher sensitivity and specificity than standard radiographs, particularly in cases with inconclusive X-rays. Additionally, the radiation dose for CT scans varied across studies, with effective doses ranging from 0.2 mSv to 4.5 mSv per scan. Compared to X-ray, CT-based methods showed comparable or superior performance in motion detection, though direct clinical comparisons with RSA remain lacking. Conclusions: Provocation CT-based analysis is a valuable diagnostic tool for early detection of implant loosening, offering a potentially feasible, accurate, and cost-effective alternative to traditional methods. However, standardized protocols, broader economic evaluations, and prospective multicenter trials are needed to confirm its routine clinical applicability. Full article

Background/Objectives: Non-small-cell lung cancer (NSCLC) frequently metastasizes to the brain, significantly impacting patient prognosis and quality of life. Anlotinib, a novel tyrosine kinase inhibitor, has shown promise in treating NSCLC with brain metastasis. So, we aimed to evaluate the clinical efficacy of anlotinib and various types of radiotherapy combinations used to treat NSCLC patients with brain metastasis regarding overall survival and the treatment of internal and external lesions. Methods: A comprehensive literature search was conducted in the databases PubMed, Scopus, WoS, MedLine, and Cochrane Library up to April 2024. Studies assessing the efficacy of anlotinib combined with whole-brain radiotherapy (WBRT), stereotactic radiosurgery (SRS), or other radiotherapy modalities in NSCLC patients with brain metastasis were included. The primary outcomes were (a) the efficacy of anlotinib and radiotherapy on the intracranial lesions and OS and (b) the effectiveness of combined anlotinib and radiotherapy versus radiotherapy alone in NSCLC patients with brain metastasis. The secondary outcome was the efficacy of anlotinib and radiotherapy on extracranial progression. We used a combination of keywords and MeSH terms including ‘non-small cell lung cancer’ OR ‘NSCLC’, ‘brain metastases’, ‘anlotinib’, ‘radiotherapy’, ‘radiation therapy’, and ‘combined treatment’, among others. Boolean operators (AND, OR) were applied as appropriate to optimize the search strategy across databases. Results: Nine studies met the inclusion criteria, comprising 210 patients in the combination group and 228 patients in the radiotherapy alone group. The combination of anlotinib with radiotherapy showed a significant improvement in iPFS compared to radiotherapy alone, with a pooled risk ratio (RR) for iORR of 1.18 (95% CI: 1.00–1.39) and a pooled SMD for OS of 0.03 (95% CI: −0.29, 0.36). Radiotherapy combined with anlotinib also demonstrated enhanced intracranial and extracranial control rates. Conclusions: Anlotinib combined with radiotherapy, especially WBRT, offers a promising treatment strategy for NSCLC patients with brain metastasis, improving intracranial control. Further large-scale randomized controlled trials are needed to confirm these findings and optimize treatment protocols. Full article

The widespread presence of antibiotics in aquatic environments poses significant ecological and public health risks due to their persistence, antimicrobial activity, and contribution to resistance gene proliferation. This review systematically evaluated the advancements in antibiotic degradation using ionizing radiation (γ-rays and electron beam) from laboratory studies to practical applications. By using keywords such as “antibiotic degradation” and “ionizing irradiation OR gamma radiation OR electron beam,” 328 publications were retrieved from Web of Science, with China contributing 33% of the literature, and a number of global representative studies were selected for in-depth discussion. The analysis encompassed mechanistic insights into oxidative (•OH) and reductive (e_aq⁻) pathways, degradation kinetics influenced by absorbed dose (1–10 kGy), initial antibiotic concentration, pH, and matrix complexity. The results demonstrated ≥90% degradation efficiency for major antibiotic classes (macrolides, β-lactams, quinolones, tetracyclines, and sulfonamides), though mineralization remains suboptimal (<50% TOC removal). Synergistic integration with peroxymonosulfate (PMS), H₂O₂, or O₃ enhances mineralization rates. This review revealed that ionizing radiation is a chemical-free, compatible, and highly efficient technology with effective antibiotic degradation potential. However, it still faces several challenges in practical applications, including incomplete mineralization, matrix complexity in real wastewater, and operating costs. Further improvements and optimization, such as hybrid system development (e.g., coupling electron beam with other conventional technologies, such as flocculation, membrane separation, anaerobic digestion, etc.), catalytic enhancement, and life-cycle assessments of this emerging technology would be helpful for promoting its practical environmental application. Full article

Background/Objectives: Despite conventional cytotoxic chemotherapy treatments, soft tissue sarcoma continues to remain a terminal diagnosis for most patients. Numerous chemotherapeutic agents have been trialed in soft tissue sarcoma, with marginal improvement in overall survival. Novel therapeutic approaches are needed to improve outcomes for this entity. Methods: the literature was reviewed, including a summary of pertinent adjuvant/neoadjuvant clinical trials and trials for metastatic disease. Results: Chemotherapeutic agent use in adjuvant/neoadjuvant trials provided limited if any evidence of the benefit of chemotherapy in this space. Despite multiple trials in the metastatic space, novel chemotherapeutic agents appear to have limited long-term benefits for the management of soft tissue sarcoma. Suggestions for further research, particularly with neoadjuvant clinical trials, were made. Conclusions: Chemotherapy remains an inadequate treatment option for soft tissue sarcoma, and novel therapies are needed. The neoadjuvant space provides an excellent opportunity to study the effects of innovative treatments in soft tissue sarcoma. Full article

Background/Objectives: Salivary adenoid cystic carcinoma (ACC) is a rare but aggressive neoplasm that predominantly arises from the salivary glands, accounting for a significant proportion of salivary gland cancers. The aim of this literature review is to illustrate the current insights on ACC with regards to related genes and molecular pathways by analyzing original research articles from the period 2015–2025. Methods: An electronic search of literature was performed between January and February 2025 to identify all articles investigating the current insights on salivary gland adenoid cystic carcinoma and its related genes and molecular pathways. The search was conducted using MEDLINE (National Library of Medicine)-PubMed with restrictions concerning the date of publication. In particular, we focused on the period 2015–2025 using the following keywords: Salivary gland adenoid cystic carcinoma AND genes AND molecular pathways. This was followed by a manual search, and references were used to identify relevant articles. Results: In total, 41 articles were identified through the keywords. After the implementation of the time frame 2015–2025, 31 articles remained. Subsequently, by reading the titles and abstracts and thereby excluding non-original research articles and articles written in a language other than English, 23 articles remained. Conclusions: These studies identified 23 relevant genes or pathways whose analysis yielded the most recent data regarding their function. The classification of ACC is multifaceted, encompassing distinct histological subtypes that are crucial for determining prognosis and treatment approaches. Current oncological practices classify ACC based on these histological features alongside emerging genetic and molecular markers that promise to enhance our understanding of the disease’s biology. Diagnostic strategies have evolved, leveraging techniques such as biopsy and molecular diagnostics, which have significantly improved the detection and characterization of ACC. Regarding treatment, the management of ACC remains a challenge due to its propensity for local invasion and metastasis, with surgery, radiation, and chemotherapy being the mainstays of therapy. The development of targeted therapies based on ACC’s molecular profile will allow for a better prognosis and an enhanced quality of life of patients. Full article

Background/Objectives: Given the significant economic and social burden of osteoporosis, there is growing interest in developing an efficient alternative to the traditional dual-energy X-ray absorptiometry (DXA). Radiofrequency Echographic Multi Spectrometry (REMS) is an innovative, non-ionizing imaging technique that recently emerged as a viable tool to diagnose osteoporosis and estimate the fragility fracture risk. Nevertheless, its clinical use is still limited due to its novelty and continuing uncertainty of long-term performance. Methods: In order to evaluate the accuracy of the REMS, a systematic review of the English-language literature was conducted. Three databases were searched for relevant publications from 1 January 2015 until 1 December 2024 using the keyword combinations “(radiofrequency echographic multi spectrometry OR REMS) AND (dual-energy X-ray absorptiometry OR DXA)”. The initial search yielded 602 candidate articles. After screening the titles and abstracts following the eligibility criteria, 17 publications remained for full-text evaluation. Results: The reviewed studies demonstrated strong diagnostic agreement between REMS and DXA. Additionally, REMS showed enhanced diagnostic capabilities in cases where lumbar bone mineral density measurements by DXA were impaired by artifacts such as vertebral fractures, deformities, osteoarthritis, or vascular calcifications. REMS exhibited excellent intra-operator repeatability and precision, comparable to or exceeding the reported performance of DXA. The fragility score (FS), a parameter reflecting bone quality and structural integrity, effectively discriminated between fractured and non-fractured patients. Moreover, REMS proved to be a radiation-free option for bone health monitoring in radiation-sensitive populations or patients requiring frequent imaging to assess fracture risk. Conclusions: This current study underscores the robustness of REMS as a reliable method for diagnosing and monitoring osteoporosis and evaluating bone fragility via the FS. It also identifies critical knowledge gaps and emphasizes the need for further prospective studies to validate and expand the clinical applications of REMS across diverse patient populations. Full article

Background: The purpose of this systematic review was to investigate the clinical outcome measures, either in separation or in conjunction with the Cobb angle, that were employed in randomized controlled trials to evaluate posture and spinal deformity. Methods: The PubMed, PEDro, OVID, and Scopus electronic databases were used to search for published articles from January 2004 to May 2024. All the searches included English language studies. Keywords were determined as “scoliosis, exercise, physical activity, brace, bracing, conservative treatment, rehabilitation, physiotherapy and physical therapy”. Results: The most commonly used clinical evaluation parameters other than the Cobb angle in the studies were the ATR and surface topography measurements. The most commonly used assessment methods were POTSI asymmetry assessment performed with measurements made on photographs, the WRVAS, a deformity perception assessment evaluated with different photographs, and the SRS-22 scale, a disease-specific quality of life assessment. Conclusions: New developments in the treatment of scoliosis have brought about alternative measurement techniques that offer a more comprehensive view of patient outcomes. As a result of the review of the literature, it has emerged that radiation-free, valid, and reliable multidimensional evaluations should be performed in follow-up and treatment efficacy evaluations after initial diagnosis in adolescent idiopathic scoliosis. Full article

Exposure to ultraviolet (UV) radiation from the sun significantly damages the skin, leading to premature aging, hyperpigmentation, and oxidative stress that disrupts skin homeostasis. UV radiation increases the production of reactive oxygen species (ROS), accelerating skin deterioration. Although sunscreens remain the primary method for UV protection, chemical-based formulations are often associated with side effects, such as allergic reactions and acne. To address these concerns, the inclusion of natural ingredients in sunscreen formulations has gained attention. Curcumin, an active compound found in turmeric (Curcuma longa) and Java turmeric (Curcuma xanthorrhiza), is well-known for its antioxidant and anti-inflammatory properties. This review explores the potential of curcumin as a natural ingredient for enhancing the Sun Protection Factor (SPF) of sunscreen products. A systematic literature review was conducted, analyzing 200 articles sourced from Google Scholar and PubMed using keywords such as “Curcumin”, “Curcuma”, “Antioxidant”, “Anti-Inflammatory”, and “Sun Protection Factor”. Studies unrelated to UV protection were excluded. The findings, presented in tabular form, indicate that curcumin and Curcuma exhibit significant potential to enhance SPF values due to their antioxidant, anti-inflammatory, and UV-absorbing properties. Additionally, curcumin may aid in skin repair following UV-induced damage. However, the specific concentration of curcumin in various Curcuma species remains unknown, and further research is necessary to determine its optimal use. Consideration of additional excipients in sunscreen formulations is also required to maximize efficacy. In conclusion, curcumin demonstrates considerable promise as a sustainable and effective natural ingredient for protecting the skin from UV radiation, offering a safer alternative to conventional chemical-based sunscreens. Full article