Search Results (1,139)

Approximately 185,000 people in the United states experience limb loss each year. There is a need for an intuitive neural interface that can offer high-fidelity control signals to optimize the advanced functionality of prosthetic devices. Regenerative peripheral nerve interface (RPNI) is a pioneering advancement in neuroengineering that combines surgical techniques with biocompatible materials to create an interface for individuals with limb loss. RPNIs are surgically constructed from autologous muscle grafts that are neurotized by the residual peripheral nerves of an individual with limb loss. RPNIs amplify neural signals and demonstrate long term stability. In this narrative review, the terms “Regenerative Peripheral Nerve Interface (RPNI)” and “RPNI surgery” are used interchangeably to refer to the same surgical and biological construct. This narrative review specifically focuses on RPNIs as a targeted approach to enhance prosthetic control through surgically created nerve–muscle interfaces. This area of research offers a promising solution to overcome the limitations of existing prosthetic control systems and could help improve the quality of life for people suffering from limb loss. It allows for multi-channel control and bidirectional communication, while enhancing the functionality of prosthetics through improved sensory feedback. RPNI surgery holds significant promise for improving the quality of life for individuals with limb loss by providing a more intuitive and responsive prosthetic experience. Full article

Background/Objectives: Adult Spinal Deformity (ASD) is a pathologic malalignment of the spine that can lead to significant reductions in quality of life, functional limitations, and increased morbidity. While poor mental health is commonly observed among patients undergoing ASD surgery, its impact on surgical outcomes remains poorly understood. We conducted a systematic review and meta-analysis to examine the association between preoperative mental health and outcomes following surgical correction for ASD. Methods: A comprehensive search of MEDLINE, Embase, Web of Science, and Scopus was performed from inception to April 2025 to identify studies investigating the relationship between preoperative mental health and postoperative health-related quality of life outcomes or complications. Data was pooled using a restricted maximum likelihood (REML) random-effects model. Heterogeneity was assessed using Cochran’s Q statistic, and between-study variance was reported as τ². Study quality was assessed with the Newcastle–Ottawa Scale, and risk of bias was evaluated using the ROBINS-I tool. Results: Twenty-four studies comprising a total of 248,427 patients met inclusion criteria. In pooled analyses, patients with poor preoperative mental health showed comparable improvements in health-related quality of life measures after surgery (standardized mean difference [SMD] −0.04, 95% CI −0.30 to 0.22; I² = 91.5%, τ² = 0.42) and in pain scores (SMD −0.15, 95% CI −0.42 to 0.11; I² = 71.8%, τ² = 0.09). However, patients with poor mental health had significantly higher odds of postoperative complications (odds ratio [OR] 1.44, 95% CI 1.23 to 1.67; I² = 97.4%, τ² = 0.08). These patients also demonstrated worse preoperative disease severity (SMD –0.94, 95% CI −1.41 to −0.47; I² = 95.5%, τ² = 1.64) and worse postoperative disease severity (SMD –0.34, 95% CI −0.44 to −0.25; I² = 48.9%, τ² = 0.03). Conclusions: While patients with poor preoperative mental health have a greater disease severity both before and after ASD surgery, they appear to experience comparable benefits from surgical intervention compared to those without. Recognizing and managing mental health may be useful in preoperative management of ASD patients. Further prospective studies to further elucidate these associations are necessary. Full article

Cutaneous and oral mucosal adverse events (AEs) are among the most common non-hematologic toxicities observed during breast cancer treatment. These complications arise across various therapeutic modalities including chemotherapy, targeted therapy, hormonal therapy, radiotherapy, and immunotherapy. Although often underrecognized compared with systemic side effects, dermatologic and mucosal toxicities can severely impact the patients’ quality of life, leading to psychosocial distress, pain, and reduced treatment adherence. In severe cases, these toxicities may necessitate dose reductions, treatment delays, or discontinuation, thereby compromising oncologic outcomes. The growing use of precision medicine and novel targeted agents has broadened the spectrum of AEs, with some therapies linked to distinct dermatologic syndromes and mucosal complications such as mucositis, xerostomia, and lichenoid reactions. Early detection, accurate classification, and timely multidisciplinary management are essential for mitigating these effects. This review provides a comprehensive synthesis of current knowledge on cutaneous and oral mucosal toxicities associated with modern breast cancer therapies. Particular attention is given to clinical presentation, underlying pathophysiology, incidence, and evidence-based prevention and management strategies. We also explore emerging approaches, including nanoparticle-based delivery systems and personalized interventions, which may reduce toxicity without compromising therapeutic efficacy. By emphasizing the integration of dermatologic and mucosal care, this review aims to support clinicians in preserving treatment adherence and enhancing the overall therapeutic experience in breast cancer patients. The novelty of this review lies in its dual focus on cutaneous and oral complications across all major therapeutic classes, including recent biologic and immunotherapeutic agents, and its emphasis on multidisciplinary, patient-centered strategies. Full article

Autonomous vehicles (AVs) have emerged as a promising sustainable urban mobility solution, expected to lead to enhanced road safety, smoother traffic flows, less traffic congestion, improved accessibility, better energy utilization and environmental performance, as well as more efficient passenger and freight transportation, in terms of time and cost, due to better fleet management and platooning. However, challenges also arise, mostly related to data privacy, security and cyber-security, high acquisition and infrastructure costs, accident liability, even possible increased traffic congestion and air pollution due to induced travel demand. This paper presents the results of a survey conducted among 654 residents who experienced an autonomous bus (AB) service in the city of Trikala, Greece, in order to assess their willingness to use (WTU) and willingness to pay (WTP) for ABs, through testing a range of factors based on a literature review. Results useful to policy-makers were extracted, such as that the intention to use ABs was mostly shaped by psychological factors (e.g., users’ perceptions of usefulness and safety, and trust in the service provider), while WTU seemed to be positively affected by previous experience in using ABs. In contrast, sociodemographic factors were found to have very little effect on the intention to use ABs, while apart from personal utility, users’ perceptions of how autonomous driving will improve the overall life standards in the study area also mattered. Full article

Dysbiosis is a strategy to control insect pests through disrupting symbiotic bacteria essential for their life cycle. The olive fly, Bactrocera oleae, has been considered a suitable system for dysbiosis, as the insect is strictly dependent on its unique symbiont Candidatus Erwinia dacicola. Here, we review older and recent results from studies of the interaction of the symbiont and its host fly. We then discuss possible methods for disrupting the symbiosis as a means to control the fly. Specifically, we summarize studies using microscopy methods that have investigated in great detail the organs where the bacterium resides and it is always extracellular. Furthermore, we discuss how genome sequences of both host and bacterium can provide valuable resources for understanding the interaction and transcriptomic analyses that have revealed important insights that can be exploited for dysbiosis strategies. We also assess experiments where compounds have been tested against the symbiont. The hitherto limited efficacy in decreasing bacterial abundance suggests that novel molecules and/or new ways for the delivery of agents will be important for successful dysbiosis strategies. Finally, we discuss how gene drive methods could be implemented in olive fly control, though a number of hurdles would need to be overcome. Full article

Palliative care aims to alleviate suffering and prioritize the quality of life of patients facing serious and fatal diseases, such as cancer. Cancer patients, especially in advanced stages, often have many difficult-to-control symptoms, such as pain, fatigue, dyspnea, anxiety, and depression, requiring the attention of a multidisciplinary team highly trained in palliative care and end-of-life management. Pain, dyspnea, nausea, and vomiting are the focus of symptomatic assessment in palliative care, but patients experience other equally important symptoms that do not receive as much attention and are often overlooked, which negatively impacts the quality of life of these patients. One of the main aims of palliative care is to provide patients with the best possible quality of life through adequate symptom control, teamwork, and psychosocial support based on the principles, values, and wishes of the patient and family. In this review, the authors summarize the management of common symptoms in patients in oncology and palliative care, as well as present a brief reflection on quality of life in this context. Full article

Background/Objectives: It is essential to explore and disseminate positive deviance strategies that promote resilience, mindfulness, and well-being beyond stress and burnout reduction strategies for residents and physicians who experience high levels of occupational stress. This scoping review maps studies that investigate positive deviance strategies to enhance the well-being of residents and physicians. Methods: A scoping review was conducted by PRISMA guidelines to identify English-language studies on strategies for physician well-being. PubMed, MEDLINE, Embase, and ERIC were searched using terms related to well-being, coping, and medical education. Results: Among the 38 studies included, 17 (44.7%) targeted physicians in graduate medical education (GME), while 19 (50%) focused on continuing medical education (CME). Positive deviance strategies were identified in 26 studies and were most frequently implemented at the microsystem level, such as small group interventions (e.g., coaching, mentoring, and workshops). These strategies addressed individual and organisational factors that contribute to physician well-being and were associated with improvements in life satisfaction, resilience, professional identity, and psychological safety. The review found that positive deviance strategies were often proactive, values-driven, and disseminated organically over time, emphasising the importance of longitudinal engagement and sustained institutional support. Conclusions: This scoping review highlights the growing use of positive deviance strategies, especially at the microsystem level, to promote physician well-being. These approaches emphasise sustainable, values-driven practices and may offer effective, context-sensitive solutions within healthcare systems. Full article

This review examines advancements in smart home security through the integration of home automation technologies. Various security systems, including surveillance cameras, smart locks, and motion sensors, are analyzed, highlighting their effectiveness in enhancing home security. These systems enable users to monitor and control their homes in real-time, providing an additional layer of security. The document also examines how these security systems can enhance the quality of life for users by providing greater convenience and control over their domestic environment. The ability to receive instant alerts and access video recordings from anywhere allows users to respond quickly to unexpected situations, thereby increasing their sense of security and well-being. Additionally, the challenges and future trends in this field are addressed, emphasizing the importance of designing solutions that are intuitive and easy to use. As technology continues to evolve, it is crucial for developers and manufacturers to focus on creating products that seamlessly integrate into users’ daily lives, facilitating their adoption and use. This comprehensive state-of-the-art review, based on the Scopus database, provides a detailed overview of the current status and future potential of smart home security systems. It highlights how ongoing innovation in this field can lead to the development of more advanced and efficient solutions that not only protect homes but also enhance the overall user experience. Full article

Breast cancer (BC) is the most prevalent malignancy in women worldwide. Despite most cases being diagnosed in the early stages, patients typically require a multimodal treatment approach. This typically involves a combination of surgery, radiotherapy, systemic treatments (including chemotherapy or immunotherapy), targeted therapy, and endocrine therapy, depending on the disease subtype and the risk of recurrence. Moreover, patients with BC and germline mutations in the breast cancer genes 1 or 2 (BRCA1/BRCA2), (gBRCAm), who are typically young women, often require more aggressive therapeutic interventions. These mutations present unique characteristics that necessitate a distinct treatment approach, potentially influencing the side effect profiles of patients with BC. Regardless of the clear benefit observed with these treatments in terms of reduced recurrence and mortality rates, long-term, treatment-related adverse events occur that negatively affect the health-related quality of life (HRQoL) of BC survivors. Thus, long-term adverse events need to be factored into the treatment decision algorithm of patients with early BC (eBC). Physical, functional, emotional, and psychosocial adverse events can occur and represent a significant concern and a challenge for clinicians, patients, and their families. This review article provides an overview of the various long-term adverse events that patients with eBC may experience, including their associated risk factors, as well as management and prevention strategies. We also explore the evidence of the long-term impact of treatment on the HRQoL of patients with gBRCAm. By providing a comprehensive overview of current evidence and recommendations regarding patients’ HRQoL, we aim to equip clinicians with scientific and clinical knowledge and provide guidance to optimize care and improve long-term outcomes. Full article

Objective: To compare the effect of different bone augmentation procedures, namely, autogenous bone blocks (ABBs) versus guided bone regeneration (GBR), on patient-reported outcomes (PROMs). Methods: This systematic review was conducted according to the PRISMA guidelines. A MEDLINE, Embase, and Web of Science search was conducted by two independent reviewers in combination with a free-hand search in relevant journals until June 2025. Outcomes were PROMs to enhance our understanding of the evolution of these procedures. Results: The electronic search yielded 6291 articles. After title screening, 67 articles were further analyzed for abstract review, which resulted in 14 articles eligible for full-text reading. Six articles were finally included based on the exclusion and inclusion criteria with a total of 295 patients. The overall study quality was low, since only two RCTs could be included. One study demonstrated a high risk of bias. Different PROMs were examined and compared such as pain, edema, neurosensory disturbance, Patient-Reported Predominant Symptom, OHIP-14, postoperative analgesic usage, willingness to repeat, and likelihood to recommend. Meta-analysis was not achievable due to a lack of direct comparisons and heterogeneity in terms of PROMs. Evaluation points varied between pretreatment and up to nearly 10-years of follow-up. Conclusions: Despite significant heterogeneity and reporting, this systematic review concluded that ABB and GBR are well-tolerated procedures. Trends such as transient postoperative pain and swelling with a minor occurring of neurosensory disturbances were reported in a few studies. Overall, a good perception of postoperative recovery was reported for both treatment modalities. Good quality of life was noted related to GBR procedures. Patient-reported outcomes were only analyzed for patients who completed the entire follow-up period. This may introduce bias, as patients who dropped out and were more likely to experience complications were not represented, potentially resulting in a more favorable portrayal of the outcomes. Further well-conducted prospective studies with a long follow-up are needed for an evidence-based evaluation and comparison of PROMs for these procedures. Full article

Sexual consent is one of the most important tools used in the prevention of sexual violence, for which adolescents are especially vulnerable. However, it is unclear how sexual consent processes are defined and used by this population. To bridge this gap in knowledge, this scoping review sought to identify and synthesize the existing empirical research findings on sexual consent conceptualizations and processes among adolescents, as well as determine critical gaps in knowledge. Forty-three articles were reviewed following a systematic search of six academic databases. Articles were included if they were original empirical work published in English between January 1990 and March 2020, included adolescents aged 10 to 17 in their sample, and specifically studied sexual consent conceptualization, communication, and/or behavior. Seventeen articles, diverse in study design and geography, met these criteria and were analyzed. The findings suggest a propensity for adolescents to abstractly define sexual consent as verbal and direct in nature while simultaneously espousing indirect and non-verbal behavioral processes when presented with “real life” scenarios (e.g., vignettes, reflections on personal experience). In addition, the results reveal the significance of concepts like gender norms, normative refusals, and silence as key aspects of adolescent sexual consent. This review demonstrates that research on sexual consent among adolescents is highly limited overall, and the findings that are available indicate some concerning perceptions. Full article

Based on a literature review, the present article aims to present ecotourism as a transformative factor in the economic, social, cultural, and environmental contexts, revealing key elements for the sustainable development of ecotourism. To ensure that this objective is met, the review combines the insights of classical authors and many recent authors who have best addressed the subject. The review carefully selected consensual and contradictory arguments, reflecting on the relevance of each group, particularly in aspects such as the influence of emotional experience on behaviour and satisfaction, strategy and competitive advantage, cooperation and sustainability, and the influence of resilience on ecotourism. The impact of each perspective was presented without ignoring the major constraints that ecotourism faces in its search for a position in the tourism industry. This led the study to accept the fact that the active participation of the community is indispensable in the formula for the success of ecotourism. Some statistical data were consulted and analysed, which enabled the study to determine the quantitative impact of ecotourism on economic, social, and environmental life. In terms of benefits to communities, the review clarifies the fact that ecotourism serves as an instrument that mobilizes not only the additional value of products and services traded in the process, but also the return on investments and job creation. The combination of visiting activities with the involvement of tour guides contributes to maximizing profits in the destinations, thus supporting solid economic, social, and environmental development for the benefit of both ecotourism promoters and local communities. However, the analysis makes it clear that the economic, social, and environmental benefit depends on the degree of involvement of the local population. In terms of usability, for other studies, this review can contribute to the understanding and positioning of ecotourism in the search for a balance between satisfying socioeconomic and environmental interests. Additionally, it can serve as an aid to policy makers in their decisions related to ecotourism. Full article

Children living with chronic diseases represent a great challenge for the health care system, their families, and communities. These young patients face continuous medical needs that affect not only their health but also their daily routines, emotional well-being, and family dynamics. In response, clinical practice is increasingly integrating psychosocial indicators alongside traditional medical parameters. Consequently, there is a growing consensus that the evaluation of pediatric chronic diseases should address not only clinical dimensions but also the disease’s impact on socialization, emotional health, and daily functioning. This narrative review explores the role of psychosocial variables in the management of pediatric chronic illnesses, including the experiences of parents and siblings, with a focus on effective strategies to improve everyday life. The integration of quality of life and well-being within a multidimensional care model could be instrumental in both symptom management and psychosocial support. Recognizing that children with chronic conditions are at increased risk for long-term adverse outcomes, it is critical to develop interventions that go beyond clinical care, encompassing education, coping reinforcement, and family-centered approaches. Full article

This research explores the concept of open building (OB) in the context of low-cost housing, focusing on its historical applications in Egypt during the 1980s. By evaluating past experiences, the study aims to extract key lessons that can inform the design and implementation of contemporary social housing projects. The goal is to foster resilience and diversity in housing typologies to ensure they align with the evolving needs of residents. To achieve these objectives, the research employed a multi-dimensional strategy, beginning with a comprehensive literature review of the open building movement (OB); then, the study traced the evolution of the OB movement in Egypt using a qualitative analysis approach, which involved analyzing its implementation in low-cost housing projects over the past four decades. Through this historical lens, the study identifies design principles and strategies that can enhance social housing projects by applying OB. Considering the life cycle cost, OB enables an incremental process that would align with users’ financial capacities. The research revealed the substantial capacity of open building (OB) to address Egypt’s social housing challenges, primarily by fostering user-driven flexibility in housing unit design and area selection. This empowers occupants to choose spaces perfectly suited to their family’s evolving needs. Moreover, the findings provide a roadmap for revitalizing the OB movement by analyzing and overcoming past implementation difficulties, consequently balancing the initial cost and long-term economics for citizens and significantly reducing the governmental sector’s expenditure. Full article

Children and adolescents with type 1 diabetes (T1D) often experience abnormalities in bone health. Studies have consistently demonstrated that youth with T1D have lower bone mineral density (BMD) compared to their healthy peers. Additionally, children with T1D show impaired bone microarchitecture and reduced bone turnover. These factors collectively contribute to an increased risk of fractures across the life span of this population. To optimize bone accrual and reduce fracture risk, several strategies can be employed during childhood and adolescence. First, maintaining good glycemic control is critical, as poor glycemic control has been associated with lower BMD and an increased risk of fractures. Second, specific nutritional recommendations can help improve bone health, including a balanced diet, adequate calcium and vitamin D intake, and careful monitoring of both macronutrient and micronutrient intake. Third, regular physical activity plays a vital role. A systematic review and meta-analysis have shown that youth with T1D are generally less physically active, more sedentary, and have lower cardiorespiratory fitness levels than their non-diabetic peers. This review emphasizes targeted strategies aimed at optimizing skeletal health in the pediatric population with T1D, with a particular focus on the critical roles of glycemic control, nutritional adequacy, and regular physical activity. These modifiable factors may contribute to the reduction of fracture risk across the life span in individuals with T1D. Full article