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17 pages, 2233 KB  
Article
On-the-Ground Application of Cloud Evaluation: Big Data Reveals Experiential Effectiveness of Industrial Heritage Revitalization
by Xuesen Zheng, Timothy Heath and Sifan Guo
Appl. Sci. 2025, 15(19), 10388; https://doi.org/10.3390/app151910388 - 24 Sep 2025
Viewed by 252
Abstract
Post-occupancy evaluation is a critical mechanism for ensuring the sustained success and continuous improvement of industrial heritage revitalization initiatives. The quality of the visitor experience plays a key role in determining a project’s long-term vitality. This study focuses on assessing user satisfaction with [...] Read more.
Post-occupancy evaluation is a critical mechanism for ensuring the sustained success and continuous improvement of industrial heritage revitalization initiatives. The quality of the visitor experience plays a key role in determining a project’s long-term vitality. This study focuses on assessing user satisfaction with a revitalized industrial heritage site by employing web crawling and data mining techniques to systematically collect and analyze user-generated reviews from major online platforms. Using the 1933 Old Millfun in Shanghai, China, as an example, this research identifies six core evaluation dimensions derived from extensive user commentary: project accessibility, cultural legibility, aesthetic distinctiveness, commercial appeal, facility completeness, and sense of security. These dimensions are integrated into a comprehensive analytical framework, with the Fuzzy Comprehensive Evaluation (FCE) method applied to quantitatively assess the site’s performance across each category. By combining qualitative sentiment data with quantitative evaluation techniques, the data-driven presentation provides nuanced insights into the evolving user experience. The research results contribute to the development of a replicable and scalable paradigm for measuring user experience in industrial heritage revitalization and highlights the potential of digital platforms as valuable tools for heritage site management and continuous optimization. Full article
(This article belongs to the Special Issue Cultural Heritage: Restoration and Conservation)
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15 pages, 832 KB  
Review
Unlocking the Therapeutic Potential: Selenium and Myo-Inositol Supplementation in Thyroid Disorders—Efficacy and Future Directions
by Chinnu George Samuel, Parul Singh, Hala Abdullahi and Ibrahim Ibrahim
Life 2025, 15(10), 1500; https://doi.org/10.3390/life15101500 - 24 Sep 2025
Viewed by 1642
Abstract
Background/Objectives: Thyroid disorders such as Hashimoto’s thyroiditis and Graves’ disease represent major endocrine challenges worldwide, often requiring long-term management. Recently, nutritional supplementation with selenium and myo-inositol has been proposed as a supportive strategy. This review aims to summarize the current evidence regarding [...] Read more.
Background/Objectives: Thyroid disorders such as Hashimoto’s thyroiditis and Graves’ disease represent major endocrine challenges worldwide, often requiring long-term management. Recently, nutritional supplementation with selenium and myo-inositol has been proposed as a supportive strategy. This review aims to summarize the current evidence regarding their efficacy in improving thyroid function, reducing thyroid autoantibodies in Hashimoto’s disease, and restoring biochemical euthyroidism in Graves’ disease. Methods: A narrative review of the available literature was undertaken, concentrating on randomized controlled trials and observational studies evaluating selenium and myo-inositol, alone or in combination (MYO+Se), in patients with autoimmune thyroid disorders and benign thyroid nodules. Search Strategy and Study Selection: We searched MEDLINE/PubMed, Embase, Cochrane CENTRAL, and Scopus from inception to 31 July 2025. The search used Boolean operators to combine the following keywords: (“selenium” OR “selenomethionine”) AND (“myo-inositol” OR “inositol”) AND (thyroid OR Hashimoto* OR Graves’ OR hyperthyroid* OR hypothyroid* OR nodule* OR goiter OR orbitopathy). We included human studies in English. Inclusion criteria: Research designs include RCTs, quasi-experimental studies, cohort/case-control studies, and big case series (n ≥ 30). Exclusion criteria: Animal-only or in vitro studies (unless mechanistic), pediatric case reports, and editorials/commentaries. Study selection and data extraction: Two reviewers screened independently; discrepancies were settled through consensus. The data retrieved included the population, baseline iodine/selenium status (if reported), dose/formulation, treatment duration, outcomes (TSH, FT4, FT3, TPOAb, TgAb, TRAb, nodule metrics), and adverse events. Quality assessment: The risk of bias was assessed using the RoB-2 for RCTs and the Newcastle-Ottawa Scale or JBI checklists for observational studies. A qualitative synthesis emphasized study quality, consistency, directness, and accuracy. Results: Clinical research indicate that selenium supplementation may reduce thyroid peroxidase antibody (TPOAb) levels in Hashimoto’s disease, thereby attenuating autoimmune activity. Myo-inositol, particularly when combined with selenium, has been proven to improve thyroid hormone profiles while also lowering nodule size or growth. In Graves’ disease, supplementation has been linked to the restoration of biochemical euthyroidism in certain patients, albeit data are limited. Despite these encouraging results, diversity in trial design, treatment length, and dosages restrict the robustness of existing recommendations. Conclusions: Selenium and myo-inositol supplementation have shown promise as adjuvant treatments for autoimmune thyroid diseases and benign thyroid nodules. However, further large-scale, well-designed clinical trials are needed to determine the appropriate dosages, treatment duration, and patient selection criteria. Personalized supplementation solutions may improve medication efficacy and help with more comprehensive thyroid disease care. Full article
(This article belongs to the Section Medical Research)
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17 pages, 675 KB  
Systematic Review
Stereotactic Radiosurgery for Recurrent Meningioma: A Systematic Review of Risk Factors and Management Approaches
by Yuka Mizutani, Yusuke S. Hori, Paul M. Harary, Fred C. Lam, Deyaaldeen Abu Reesh, Sara C. Emrich, Louisa Ustrzynski, Armine Tayag, David J. Park and Steven D. Chang
Cancers 2025, 17(17), 2750; https://doi.org/10.3390/cancers17172750 - 23 Aug 2025
Viewed by 1396
Abstract
Background/Objectives: Recurrent meningiomas remain difficult to manage due to the absence of effective systemic therapies and comparatively high treatment failure rates, particularly in high-grade tumors. Stereotactic radiosurgery (SRS) offers a minimally-invasive and precise option, particularly for tumors in surgically complex locations. However, [...] Read more.
Background/Objectives: Recurrent meningiomas remain difficult to manage due to the absence of effective systemic therapies and comparatively high treatment failure rates, particularly in high-grade tumors. Stereotactic radiosurgery (SRS) offers a minimally-invasive and precise option, particularly for tumors in surgically complex locations. However, the risks associated with re-irradiation, and recent changes in the WHO classification of CNS tumors highlight the need for more personalized and strategic treatment approaches. This systematic review evaluates the safety, efficacy, and clinical considerations for use of SRS for recurrent meningiomas. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature search was conducted using the PubMed, Scopus, and Web of Science databases for studies reporting outcomes of SRS in recurrent, pathologically confirmed intracranial meningiomas. Studies were excluded if they were commentaries, reviews, case reports with fewer than three cases, or had inaccessible full text. The quality and risk of bias of the included studies were assessed using the modified Newcastle-Ottawa Scale. Data on patient and tumor characteristics, SRS treatment parameters, clinical outcomes, adverse effects, and statistical analysis results were extracted. Results: Sixteen studies were included. For WHO Grade I tumors, 3- to 5-year progression-free survival (PFS) ranged from 85% to 100%. Grade II meningiomas demonstrated more variable outcomes, with 3-year PFS ranging from 23% to 100%. Grade III tumors had consistently poorer outcomes, with reported 1-year and 2-year PFS rates as low as 0% and 46%, respectively. SRS performed after surgery alone was associated with superior outcomes, with local control rates of 79% to 100% and 5-year PFS ranging from 40.4% to 91%. In contrast, tumors previously treated with radiotherapy, with or without surgery, showed substantially poorer outcomes, with 3- to 5-year PFS ranging from 26% to 41% and local control rates as low as 31%. Among patients with prior radiotherapy, outcomes were particularly poor in Grade II and III recurrent tumors. Toxicity rates ranged from 3.7% to 37%, and were generally higher for patients with prior radiation. Predictors of worse PFS included prior radiation, older age, and Grade III histology. Conclusions: SRS may represent a reasonable salvage option for carefully selected patients with recurrent meningioma, particularly following surgery alone. Outcomes were notably worse in high-grade recurrent meningiomas following prior radiotherapy, emphasizing the prognostic significance of both histological grade and treatment history. Notably, the lack of molecular and genetic data in most existing studies represents a key limitation in the current literature. Future prospective studies incorporating molecular profiling may improve risk stratification and support more personalized treatment strategies. Full article
(This article belongs to the Special Issue Meningioma Recurrences: Risk Factors and Management)
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10 pages, 478 KB  
Review
Chewing Matters: Masticatory Function, Oral Microbiota, and Gut Health in the Nutritional Management of Aging
by Monia Lettieri, Alessio Rosa, Fabrizio Spataro, Giovanni Capria, Paolo Barnaba, Marco Gargari and Mirko Martelli
Nutrients 2025, 17(15), 2507; https://doi.org/10.3390/nu17152507 - 30 Jul 2025
Viewed by 1409
Abstract
Aging is a multifactorial process that affects various physiological functions, including masticatory performance, which is crucial for oral health and nutritional well-being. Impaired masticatory function, often due to factors such as tooth loss, reduced salivation, or muscle atrophy, can lead to significant nutritional [...] Read more.
Aging is a multifactorial process that affects various physiological functions, including masticatory performance, which is crucial for oral health and nutritional well-being. Impaired masticatory function, often due to factors such as tooth loss, reduced salivation, or muscle atrophy, can lead to significant nutritional challenges and compromise the overall health of elderly individuals. Recent research has illuminated the interconnectedness of masticatory function, oral microbiota, and gut health, suggesting that altered chewing ability may disrupt oral microbial communities, which in turn affect gastrointestinal health and systemic inflammation. This commentary review provides a comprehensive analysis of the role of masticatory function in aging, exploring its impact on the oral microbiota, gut health, and broader nutritional status. We discuss the potential consequences of impaired mastication, including malnutrition, dysbiosis, and gastrointestinal disorders, and explore possible strategies for improving masticatory function and maintaining a healthy gut microbiome through interventions like dietary modifications, oral care, and rehabilitation. We aim to underscore the importance of integrating masticatory function management into the broader context of aging-related healthcare, promoting holistic, multidisciplinary approaches to support nutritional needs and quality of life in older adults. Full article
(This article belongs to the Special Issue Exploring the Lifespan Dynamics of Oral–Gut Microbiota Interactions)
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35 pages, 2884 KB  
Commentary
Regulatory Integrity and Welfare in Horse Sport: A Constructively Critical Perspective
by Mette Uldahl and David J. Mellor
Animals 2025, 15(13), 1934; https://doi.org/10.3390/ani15131934 - 30 Jun 2025
Viewed by 3878
Abstract
This commentary evaluates contemporary equestrian sport governance through the lens of equine welfare science. Drawing on evidence from the FEI Sport Forum 2025 debates, the IFHA Racing Integrity Handbook, media coverage of horse sport, recent scientific presentations, regulatory texts, and published research, we [...] Read more.
This commentary evaluates contemporary equestrian sport governance through the lens of equine welfare science. Drawing on evidence from the FEI Sport Forum 2025 debates, the IFHA Racing Integrity Handbook, media coverage of horse sport, recent scientific presentations, regulatory texts, and published research, we identify systemic shortcomings in how horse welfare is assessed, prioritised, and protected. Key issues include reliance on performance as a proxy for welfare, inadequate “fit-to-compete” protocols, neglect of horses’ mental states, coercive tack and equipment practices (e.g., double bridles, tight nosebands, ear hoods), pharmacological and surgical interventions that mask pain, euphemistic regulatory language (e.g., whip “encouragement”), and inconsistent implementation of welfare rules. Through a series of case studies, from dressage and show jumping forums to racing integrity handbooks, we illustrate euphemistic language, defensive group dynamics, dismissive rhetoric towards evidence-based criticism, and a troubling “stable blindness” that sidelines the horse’s perspective. We conclude that meaningful reform requires (1) embedding validated behavioural and physical welfare indicators into all competition and pre-competition protocols, (2) transparent, evidence-inclusive rule-making under a precautionary principle, (3) genuine engagement with independent equine welfare experts, and (4) establishment of empowered, impartial oversight bodies to ensure that stated codes of conduct translate into consistent, enforceable practice. Only by catering to the horse’s subjective experiences and applying modern ethological and bioethical standards can equestrian sport retain its social licence and ensure integrity in all areas of competition management. Full article
(This article belongs to the Section Equids)
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31 pages, 2065 KB  
Review
Unique Considerations in Caring for Rural Patients with Rectal Cancer: A Scoping Review of the Literature from the USA and Canada
by Lydia Manela Rafferty, Bailey K. Hilty Chu and Fergal Fleming
J. Clin. Med. 2025, 14(12), 4106; https://doi.org/10.3390/jcm14124106 - 10 Jun 2025
Viewed by 712
Abstract
Background: Rural patients, including those with rectal cancer, continue to be underrepresented in research and medically underserved with unique challenges to accessing care. Like the rest of America, rural patients are experiencing rising rates of rectal cancer; however, unlike the rest of the [...] Read more.
Background: Rural patients, including those with rectal cancer, continue to be underrepresented in research and medically underserved with unique challenges to accessing care. Like the rest of America, rural patients are experiencing rising rates of rectal cancer; however, unlike the rest of the country, they also have rising rectal cancer-related mortality. This study aims to review the literature regarding care for patients with rectal cancer in rural settings, from presentation and diagnosis to treatment algorithms, oncologic outcomes, their unique preferences, and the goals of care. Methods: A literature search was performed on PubMed, on 31 October 2024, using synonyms of “rural” and “rectal cancer” to identify relevant articles. Articles from outside the USA and Canada and those offering only commentary were eliminated during the initial screening/retrieval. A full-text review was performed on the remaining articles; all the studies that did not address the identified primary or secondary outcomes in rural rectal cancer patients were then excluded. All the primary and secondary outcomes are briefly summarized in narrative form, with more detail on the primary outcomes provided in tables. The variability in the key criteria between the studies is also summarized in the tables and appendices provided. Results: Thirty studies were identified that addressed the outcomes of interest in rural rectal cancer patient populations. The total number of participants could not be assessed given the use of overlapping databases. Of the articles, 21 addressed treatment modalities (surgery, chemotherapy, radiation), 13 addressed oncologic outcomes, and a mix of additional studies addressed the diagnostic work up, costs, and patient preferences. The studies addressing treatment demonstrated similar practices in regard to chemotherapy and surgical management, aside from lower rates of minimally invasive surgery, along with decreased neoadjuvant radiotherapy use and increased under-dosing in rural patients. The oncologic outcomes were overall similar to worse for rural patients as compared to urban patients, even for those receiving treatment at high-volume urban centers. Additionally, rural patients have higher healthcare costs for rectal cancer care. Discussion/Conclusions: Rural patients are an at-risk group, with a rising disease burden and worsening rectal cancer outcomes, despite advances in rectal cancer care and improving oncologic outcomes in the general population. Analysis of the situation is complicated due to the underrepresentation of rural patients in research and the lack of uniformity in the definition of “rural”. Moreover, significant gaps in the literature remain, such that the evaluation of guideline-concordant care is incomplete, including an absence of literature about watch-and-wait approaches in rural populations. While regionalization of rectal cancer care has shown promise, the improvements in outcomes may not be commensurate for rural patients. Thus, a specific focus on the impact of this shift for rural patients is necessary to mitigate unintended consequences. Full article
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16 pages, 569 KB  
Systematic Review
Diagnostic Challenges and Management Strategies of Pelvic Inflammatory Disease in Sexually Inactive Pediatric and Adolescent Patients: A Systematic Review of Case Reports
by Adrian Surd, Rodica Mureșan, Andreea Oprea, Kriszta Snakovszki, Lucia Maria Sur, Lia-Oxana Usatiuc, Carmen-Iulia Ciongradi and Ioan Sârbu
J. Clin. Med. 2025, 14(11), 3971; https://doi.org/10.3390/jcm14113971 - 4 Jun 2025
Viewed by 2133
Abstract
Background and objectives: Pelvic inflammatory disease (PID), primarily associated with sexually transmitted infections (STIs), represents a diagnostic challenge in virgin pediatric patients due to the often vague, non-specific symptomatology, which can mimic other conditions. Management prioritizes targeted antimicrobial therapy, with surgical intervention reserved [...] Read more.
Background and objectives: Pelvic inflammatory disease (PID), primarily associated with sexually transmitted infections (STIs), represents a diagnostic challenge in virgin pediatric patients due to the often vague, non-specific symptomatology, which can mimic other conditions. Management prioritizes targeted antimicrobial therapy, with surgical intervention reserved for complications like tubo-ovarian abscess (TOA). The present systematic review aimed to critically evaluate the available evidence from case reports of PID in virgin pediatric and adolescent patients. Methods: The search strategy was in accordance with PRISMA guidelines. Case reports published up to March 2025 were searched through PubMed, Embase, Scopus, and Google Scholar databases. We included English-language case reports on non-sexually active pediatric and adolescent patients with available full text, excluding commentaries, reviews, and editorials. The Critical Appraisal Checklist for Case Reports was used for the quality assessment of case reports. Through descriptive analysis, PID symptoms, diagnostic, and management modalities were reviewed. The quality of the included case reports was assessed using the JBI Critical Appraisal Checklist. This review was not registered and did not receive external funding. Results: Among the 56 case reports searched, 20 reports were selected and analyzed based on eight criteria. The most frequently reported symptoms were lower abdominal pain (95.8%), fever (63.6%), and gastrointestinal symptoms (50%). Common comorbidities included urinary tract infections (22.7%), congenital anomalies (18.1%), and appendicitis history (18.1%). Escherichia coli and Streptococcus species were the predominant pathogens identified. All patients received antibiotic therapy, while 90.9% underwent surgical intervention. Favorable outcomes were achieved in 72.7% of cases, though 27.2% experienced complications or recurrences. Conclusions: Although commonly linked to sexual activity, PID should be considered in sexually inactive pediatric patients presenting with abdominal pain and adnexal masses. Early diagnosis, appropriate imaging, and timely treatment are crucial to improve outcomes and reduce complications. The evidence in this review is limited by its reliance on case reports, which may introduce bias and restrict generalizability. Full article
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22 pages, 399 KB  
Review
Management and Prevention of Multidrug-Resistant Bacteria in War Casualties
by Diana Isabela Costescu Strachinaru, Céline Ragot, Anke Stoefs, Nicolas Donat, Pierre-Michel François, Peter Vanbrabant, Alexia Verroken, Frédéric Janvier and Patrick Soentjens
Trop. Med. Infect. Dis. 2025, 10(5), 128; https://doi.org/10.3390/tropicalmed10050128 - 8 May 2025
Cited by 1 | Viewed by 1794
Abstract
The growing threat of antimicrobial resistance (AMR) is a critical issue for both civilians and the military. With each successive conflict, pathogens become more resistant, making the management of infections in casualties increasingly challenging. To better understand the scope and characteristics of conflict-related [...] Read more.
The growing threat of antimicrobial resistance (AMR) is a critical issue for both civilians and the military. With each successive conflict, pathogens become more resistant, making the management of infections in casualties increasingly challenging. To better understand the scope and characteristics of conflict-related AMR, a comprehensive literature search was conducted in the PubMed database in April 2025, using defined search terms related to war casualties and antimicrobial resistance. We screened and included 117 relevant publications, comprising original research articles, reviews, case series, case reports, editorials, and commentaries, published in English or French, with no date restriction. This narrative review synthesizes current evidence on multidrug-resistant bacteria most commonly isolated from war casualties, their associated resistance mechanisms, and the microbiological diagnostic tools available at various levels of the military continuum of care (Roles 1–4). It also presents strategies for preventing cross-contamination and infection in resource-limited combat settings and provides practical, field-adapted recommendations for clinicians, from first responders to specialized care providers, aiming to improve infection management in armed conflict zones and mitigate the spread of AMR. Full article
14 pages, 1670 KB  
Systematic Review
IOTA Three-Step Strategy for Classifying Adnexal Masses: A Systematic Review and Meta-Analysis
by Juan Luis Alcázar, Francisco Vargas, Guillem Boscá, Blanca Salazar, Juan Carlos Aguilar, Cynthia Catalan, Arleana Balazs, Daniela Burky, Magdalena Pertkiewicz, José Carlos Vilches and Rodrigo Orozco
Onco 2025, 5(2), 22; https://doi.org/10.3390/onco5020022 - 1 May 2025
Viewed by 2408
Abstract
Background: Our goal was to assess the diagnostic performance of the IOTA 3-step strategy for discriminating benign from malignant adnexal masses. Methods: Systematic review and meta-analysis design. A systematic search across three databases (Medline [PubMed], SCOPUS, and Web of Science) was conducted to [...] Read more.
Background: Our goal was to assess the diagnostic performance of the IOTA 3-step strategy for discriminating benign from malignant adnexal masses. Methods: Systematic review and meta-analysis design. A systematic search across three databases (Medline [PubMed], SCOPUS, and Web of Science) was conducted to identify primary studies reporting on the use of the IOTA three-step strategy from January 2012 to July 2024. Prospective cohort studies utilizing the three-step strategy, with histologic diagnosis or conservative management confirming spontaneous resolution or persistence in cases of benign-appearing masses for at least one year of follow-up, were used as the reference standard. Studies unrelated to the topic, those not addressing the IOTA three-step strategy, studies focusing on other prediction models, letters to the editor, commentaries, narrative reviews, consensus documents, and studies lacking data for constructing a 2 × 2 table were excluded. Quantitative synthesis was done, calculating the pooled sensitivity, specificity, and positive and negative likelihood ratios. Qualitative synthesis was done using QUADAS-2. Results: A total of 448 citations were initially identified, with 7 studies meeting inclusion criteria, comprising 5722 patients. The mean prevalence of ovarian malignancy was 28%. The quality of the studies was considered good. IOTA 3-step strategy showed a pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of the three-step strategy for adnexal mass classification were 94% (95% CI = 91–95%), 94% (95% CI = 91–97%), 17.0 (95% CI = 10–28.8), and 0.07 (95% CI = 0.05–0.1), respectively. Heterogeneity for sensitivity was moderate, and for specificity it was high. Conclusions: We conclude that the three-step strategy has good diagnostic performance, reducing the need for expert examiner evaluation. Full article
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17 pages, 1406 KB  
Review
Updates on the Prevalence, Quality of Life, and Management of Chronic Cough in Interstitial Lung Diseases
by Natalia V. Trushenko, Olga A. Suvorova, Anna E. Schmidt, Svetlana Y. Chikina, Iuliia A. Levina, Baina B. Lavginova and Sergey N. Avdeev
Diagnostics 2025, 15(9), 1139; https://doi.org/10.3390/diagnostics15091139 - 29 Apr 2025
Cited by 1 | Viewed by 1293
Abstract
Background: Chronic cough is a common symptom in patients with interstitial lung diseases (ILDs), which significantly affects health-related quality of life (HRQoL). The prevalence of chronic cough varies from 30% to almost 90% in different ILDs, with the highest rate in patients with [...] Read more.
Background: Chronic cough is a common symptom in patients with interstitial lung diseases (ILDs), which significantly affects health-related quality of life (HRQoL). The prevalence of chronic cough varies from 30% to almost 90% in different ILDs, with the highest rate in patients with idiopathic pulmonary fibrosis. However, the pathophysiology of cough in ILDs remains poorly understood, with multiple proposed mechanisms contributing to its development. This knowledge gap complicates both clinical assessment and treatment, as current therapeutic strategies target general cough mechanisms rather than ILD-specific pathways. This review synthesizes existing data to clarify distinct cough mechanisms across ILD subtypes and identify opportunities for more targeted therapeutic strategies in this challenging patient population. Moreover, cough can be a clinical marker of disease severity and a predictor of ILD progression and transplant-free survival. Effective cough-specific therapeutic options that consider potential mechanisms, comorbidities, and individual effects on HRQoL are needed for cough associated with ILD. Therefore, the aim of this review was to analyze the prevalence, the impact on HRQoL, the pathophysiology, and the management of chronic cough in ILDs. Methods: We performed a comprehensive search in PubMed, MEDLINE, Embase, and the Cochrane Library. This review included randomized clinical trials, observational studies, systematic reviews, and meta-analyses in adults with chronic cough comparing ILD types. The following were excluded: commentaries, letters, case reports and case series, conference abstracts, and studies and publications lacking cough-specific outcomes. Results: Several approaches to reduce cough frequency and severity were described: antifibrotic agents, neuromodulators, opiates, inhaled local anesthetics, oxygen, speech therapy, and anti-reflux therapy. Some therapeutic approaches, such as oral corticosteroids and thalidomide, can cause significant side effects. Novel agents, such as P2X3 receptor antagonists, which are in phase III trials (COUGH-1/2), show promising results for refractory cough and may benefit ILD-related cough. Conclusions: Thus, a comprehensive assessment of cough is required for effective cough treatment in patients with ILDs considering possible mechanisms and individual impact on QoL. Full article
(This article belongs to the Special Issue Respiratory Diseases: Diagnosis and Management)
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21 pages, 1978 KB  
Commentary
Translating Ethical Principles into Law, Regulations and Workable Animal Welfare Practices
by David J. Mellor and D. Mette Uldahl
Animals 2025, 15(6), 821; https://doi.org/10.3390/ani15060821 - 13 Mar 2025
Cited by 1 | Viewed by 5409
Abstract
The ethical theories considered in this commentary include Anthropocentrism, Dominionism, Utilitarianism, Reverence for Life, Animal Rights, Biocentrism, Ecocentrism and Care Ethics. It is apparent that Utilitarianism provides a motivating rationale for devising legal instruments to manage animal welfare in many countries. The emphasis [...] Read more.
The ethical theories considered in this commentary include Anthropocentrism, Dominionism, Utilitarianism, Reverence for Life, Animal Rights, Biocentrism, Ecocentrism and Care Ethics. It is apparent that Utilitarianism provides a motivating rationale for devising legal instruments to manage animal welfare in many countries. The emphasis of different laws spanning many decades paralleled the trajectory of changing attitudes to animals. Initial laws focussed on serious abuse, and were enacted to deal with relative indifference to animal suffering. Anticruelty laws followed; they dealt with a wider range of noxious acts that also cause suffering. Animal Protection laws accommodated a growing acceptance that much less severe, yet still very unpleasant experiences, are of significant welfare concern. These laws and their amendments, plus the associated instruments (e.g., Codes of Welfare/Practice), were increasingly couched using animal welfare terminology. Finally, contemporary laws that focus directly to animal welfare, increasingly refer to a ‘duty of care’ towards animals, entailing responsibilities to minimise negative experiences and to promote positive ones. Outlined here is an example of an ethically-based legal structure for providing guidance and outlining requirements for animal welfare management nationally. It has four interacting levels: Level 1—Law; Level 2—Codes of Welfare/Practice; Level 3—Regulations; and Level 4—Cooperation at a National Level. It is noted that although the framing of this legal structure is based on ethical principles, the expression of those principles is more implicit than explicit. However, expression of the ethical principles can be made much more explicit when putting into effect legal requirements to assess the acceptability of different practices in animal welfare terms. There are four interacting steps in this process: Step 1—the Primary Assumption: Animals have intrinsic value and an interest in having good lives. Step 2—Distribution of Responsibility: Humans usually control human-animal interactions and have an overarching responsibility to operate two principles: (1) If in doubt err on the side of the animal; (2) If there are justified concerns, a lack of evidence can never in itself justify a practice. Step 3—Assessment of Impact on the Animals: Use a structured framework to assess the impact of human-initiated activities. The Five Domains Model is suggested as a suitable device for this. Step 4—Rigorous Evaluation: the aim, to choose the least noxious intervention as required by the Principle of Proportionality which, once chosen, supports a justification to proceed. This commentary provides examples of how ethical reasoning, and its operational consequences, can be made visible at every stage of developing, introducing and operating infrastructures for managing animal welfare nationally. Full article
(This article belongs to the Section Animal Welfare)
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12 pages, 879 KB  
Perspective
The Mpox Response Among Key Populations at High Risk of or Living with HIV in Rwanda: Leveraging the Successful National HIV Control Program for More Impactful Interventions
by Gallican Rwibasira, Tafadzwa Dzinamarira, Jean Claude Semuto Ngabonziza, Albert Tuyishime, Ayman Ahmed and Claude Mambo Muvunyi
Vaccines 2025, 13(3), 307; https://doi.org/10.3390/vaccines13030307 - 13 Mar 2025
Cited by 2 | Viewed by 1271
Abstract
Mpox, an emerging zoonotic infectious disease, presents a significant public health threat, especially among high-risk groups like female sex workers and men who have sex with men. This commentary reviews and summarizes Rwanda’s response to mpox, focusing on its intersection with HIV. Rwanda [...] Read more.
Mpox, an emerging zoonotic infectious disease, presents a significant public health threat, especially among high-risk groups like female sex workers and men who have sex with men. This commentary reviews and summarizes Rwanda’s response to mpox, focusing on its intersection with HIV. Rwanda has adopted an integrated strategy to tackle both mpox and HIV by leveraging lessons and experience from the country’s success in the management of HIV and COVID-19, enhancing community engagement and health outcomes. To ensure long-term resilience, Rwanda must continue to invest in surveillance and research, expand vaccination efforts, address stigma, and foster regional impactful partnerships. Investing in fostering scientific and operational research will generate invaluable evidence that could lead to the implementation of evidence-based policymaking and cost-effective interventions. Full article
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24 pages, 1135 KB  
Article
Developing a Novel Audit Risk Metric Through Sentiment Analysis
by Xiao Wang, Feng Sun, Min Gyeong Kim and Hyung Jong Na
Sustainability 2025, 17(6), 2460; https://doi.org/10.3390/su17062460 - 11 Mar 2025
Viewed by 1272
Abstract
This study introduces the Audit Risk Sentiment Value (ARSV), a novel audit risk proxy that leverages sentiment analysis to address limitations in traditional audit risk measures such as audit fees (LNFEE), audit hours (LNHOUR), and discretionary accruals (|MJDA|). Traditional proxies primarily capture quantitative [...] Read more.
This study introduces the Audit Risk Sentiment Value (ARSV), a novel audit risk proxy that leverages sentiment analysis to address limitations in traditional audit risk measures such as audit fees (LNFEE), audit hours (LNHOUR), and discretionary accruals (|MJDA|). Traditional proxies primarily capture quantitative dimensions, overlooking qualitative insights embedded in audit report narratives. By systematically analyzing sentiment and tone, ARSV captures nuanced audit risk dimensions that reflect the auditor’s risk perception. The study validates ARSV using a dataset of South Korean firms listed on the KOSPI from 2018 to 2023. The results demonstrate the ARSV’s superior explanatory power, as confirmed through the Vuong test, showing consistent performance across binary and continuous measures of explanatory language. ARSV bridges the gap between qualitative and quantitative audit risk assessments, offering significant benefits to auditors, regulators, and investors. Its ability to enhance the interpretability of audit reports improves transparency and trust in financial reporting, addressing stakeholder demands for actionable, forward-looking information. Furthermore, ARSV aligns with global trends emphasizing sustainability and accountability by integrating qualitative insights into audit practices. While this study provides robust evidence supporting ARSV effectiveness, its focus on South Korean firms may limit its generalizability. Future research should explore ARSV application in diverse regulatory and cultural contexts and refine the sentiment analysis tools using advanced machine learning techniques. Expanding ARSV to include other unstructured data, such as management commentary, could further enhance its applicability. This study marks a significant step toward modernizing audit methodologies, aligning them with evolving demands for comprehensive and transparent financial reporting. The empirical analysis reveals that ARSV outperforms traditional audit risk proxies with significantly higher explanatory power. Specifically, ARSV achieved a pseudo R2 of 0.786, compared to 0.608 for LNFEE, 0.604 for LNHOUR, and 0.578 for |MJDA|. The Vuong test results further validate ARSV superiority, with Z-statistics of −12.168, −12.492, and −9.775 when compared against LNFEE, LNHOUR, and |MJDA|, respectively. The model incorporating ARSV demonstrated a 62.454 F-value and an Adjusted R2 of 0.599, highlighting its robustness and reliability in audit risk assessment. These quantitative metrics underscore ARSV’s effectiveness in capturing qualitative audit risk dimensions, offering a more precise and informative measure for stakeholders. Full article
(This article belongs to the Section Economic and Business Aspects of Sustainability)
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15 pages, 600 KB  
Systematic Review
The Interplay Between Cervicovaginal Microbiota Diversity, Lactobacillus Profiles and Human Papillomavirus in Cervical Cancer: A Systematic Review
by Giosuè Giordano Incognito, Carlo Ronsini, Vittorio Palmara, Paola Romeo, Giuseppe Vizzielli, Stefano Restaino, Marco La Verde, Orazio De Tommasi, Marco Palumbo and Stefano Cianci
Healthcare 2025, 13(6), 599; https://doi.org/10.3390/healthcare13060599 - 10 Mar 2025
Cited by 4 | Viewed by 1880
Abstract
Background and Objectives: Interest in defining the characteristics of the cervicovaginal microbiota (CVM) in invasive cervical cancer (ICC) is growing, particularly concerning Lactobacillus species, as evidence suggests that these may differ in affected women and potentially interact with Human Papillomavirus (HPV) infection. Understanding [...] Read more.
Background and Objectives: Interest in defining the characteristics of the cervicovaginal microbiota (CVM) in invasive cervical cancer (ICC) is growing, particularly concerning Lactobacillus species, as evidence suggests that these may differ in affected women and potentially interact with Human Papillomavirus (HPV) infection. Understanding these features could have important implications for disease management. Thus, this study aims to systematically review the main characteristics of available literature exploring the relationship between CVM diversity, Lactobacillus profiles, and HPV in ICC; Methods: A comprehensive bibliographic search was conducted across databases, including Medline, Embase, Scopus, the Cochrane Database of Systematic Reviews, and ClinicalTrials.gov, in accordance with the to the PRISMA guidelines. The review included studies that met the following inclusion criteria: studies comparing CVM in women with ICC to controls, focusing on Community State Types (CSTs), Lactobacillus profiles, and microbial diversity. Exclusion criteria included commentaries, letters, reviews, and studies without control groups. Variables were analyzed using the Kruskal–Wallis and Fisher’s exact tests, with statistical significance level set at 0.05. Data analysis was conducted and reviewed in a blinded manner. Results: A total of 28 studies published between 2015 and 2024 met the inclusion criteria. A total of 2082 patients were included, with 323 (41.9%) of the 770 cases testing positive for HPV and 327 (24.9%) of the 1312 controls testing positive for HPV. A total of 18 studies specifically examined HPV genotypes. Cervical swabs were employed in 19 out of 28 studies (67.9%), while vaginal swabs were used in 17 studies (60.7%). Additionally, two studies included samples collected via cervical biopsy (7.1%), four studies utilized cervicovaginal lavage (14.3%), and one study used a cervical brush for sample collection (3.6%). Regarding microbiota profiling, 26 studies (92.9%) employed 16S rRNA analysis, while one study (3.6%) utilized whole-genome sequencing (WGS), and another (3.6%) used 16s rDNA. A total of 10 studies (35.7%) examined the distribution of CSTs. Five studies (17.9%) reported on Lactobacillus profiles. Different levels of Lactobacillus crispatus and Lactobacillus iners were observed, along with variations between Lactobacillus-dominant and Lactobacillus-depleted communities. A total of 22 studies (78.6%) assessed α-diversity, and 17 studies (60.7%) examined β-diversity; Conclusions: This study emphasizes the heterogeneous features of the studies exploring the association between alterations in the CVM, HPV, and the development of ICC, suggesting the need for further research to better understand this relationship. These findings could inform new strategies for prevention and treatment. Full article
(This article belongs to the Section Women’s and Children’s Health)
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17 pages, 525 KB  
Commentary
Data Ownership and Privacy in Dairy Farming: Insights from U.S. and Global Perspectives
by Richard Barton, Javier Burchard, Victor E. Cabrera, David Cook, Walter Cooley, Roger Cue, Liliana Fadul, Jay Mattison and Amit Saha
Animals 2025, 15(4), 524; https://doi.org/10.3390/ani15040524 - 12 Feb 2025
Cited by 2 | Viewed by 2095
Abstract
In the evolving landscape of dairy farming, data ownership and privacy have become critical issues. This commentary paper delves into the complexities and implications of data management in the dairy industry, informed by insights from a multidisciplinary group of stakeholders. While the authors [...] Read more.
In the evolving landscape of dairy farming, data ownership and privacy have become critical issues. This commentary paper delves into the complexities and implications of data management in the dairy industry, informed by insights from a multidisciplinary group of stakeholders. While the authors bring a U.S. perspective, the challenges discussed are globally relevant, given the dominant role of multinational corporations in shaping data practices across regions. The discussions, conducted through structured meetings and iterative online exchanges, emphasized the pressing legal and ethical concerns, the role of technology, and the necessity of developing comprehensive guidelines to safeguard data integrity and benefit all stakeholders. Key points include the global nature of data protection regulations, the potential of blockchain and IoT devices to enhance transparency, and the importance of equitable value distribution. By fostering an environment of transparency and fairness, the dairy industry can harness the power of data to drive innovation and sustainability while protecting the rights of those who generate it. This paper provides a pathway to address these challenges by raising awareness and proposing general actions for the industry’s future. Full article
(This article belongs to the Section Animal System and Management)
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