Search Results (7,100)

Background: Hip fractures represent a major clinical challenge, particularly in elderly and frail patients, where postoperative pain control must balance effective analgesia with motor preservation to facilitate early mobilization. Various regional anesthesia techniques are used in this setting, including the pericapsular nerve group (PENG) block, fascia iliaca compartment block (FICB), femoral nerve block (FNB), and quadratus lumborum block (QLB), yet optimal strategies remain debated. Objectives: To systematically review the efficacy, safety, and clinical applicability of major regional anesthesia techniques for pain management in hip fractures, including considerations of fracture type, surgical approach, and functional outcomes. Methods: A systematic literature search was conducted following PRISMA 2020 guidelines in PubMed, Scopus, Web of Science, and the virtual library of the Hospital Central de la Defensa “Gómez Ulla” up to March 2025. Inclusion criteria were RCTs, systematic reviews, and meta-analyses evaluating regional anesthesia for hip surgery in adults. Risk of bias in RCTs was assessed using RoB 2.0, and certainty of evidence was evaluated using the GRADE approach. Results: Twenty-nine studies were included, comprising RCTs, systematic reviews, and meta-analyses. PENG block demonstrated superior motor preservation and reduced opioid consumption compared to FICB and FNB, particularly in intracapsular fractures and anterior surgical approaches. FICB and combination strategies (PENG+LFCN or sciatic block) may provide broader analgesic coverage in extracapsular fractures or posterior approaches. The overall risk of bias across RCTs was predominantly low, and certainty of evidence ranged from moderate to high for key outcomes. No significant safety concerns were identified across techniques, although reporting of adverse events was inconsistent. Conclusions: PENG block appears to offer a favorable balance of analgesia and motor preservation in hip fracture surgery, particularly for intracapsular fractures. For extracapsular fractures or posterior approaches, combination strategies may enhance analgesic coverage. Selection of block technique should be tailored to fracture type, surgical approach, and patient-specific functional goals. Full article

Recently, the usage of mobile phone-based games has increased due to the growing accessibility and convenience they provide. Using a descriptive-quantitative design, a disaster-based mobile application was developed in this study to enhance disaster literacy among the private senior high schools in science, technology, engineering, and mathematics (STEM) education in Davao City, the Philippines. The developed application was provided together with survey questionnaires to 364 students randomly selected from different schools in Davao City usingF a simple random sampling method. The technology acceptance (TAM) model was used to explain how users accepted the new technology. The mobile application was designed with features in four disaster scenarios—fire, flood, volcano, and earthquake. The results revealed a high acceptance, with an average score of the perceived usefulness (PE) of 4.52, perceived ease of use (PEOU) of 4.44, and a behavioral intention (BI) of 4.12. The students accepted the application to enhance disaster risk reduction and management. Aligned with SDG 4 and SDG 11, the application can be used to equip users with the knowledge to respond to disasters and ensure community resilience. Full article

Integrating BIM curriculum into traditional construction management (CM) programs is essential to meet the increasing industry demand for BIM-ready graduates. However, academia struggles with BIM curriculum integration due to unfamiliar emerging BIM technologies, and the increased workload associated with curriculum transformation. Disciplines including nursing, health science, and medical overcame the same challenges using the ability-desire-knowledge-ability-reinforcement (ADKAR) change management model, while CM programs have not explored this model for BIM curriculum development. Thus, this research introduces the ADKAR change management lens to BIM curriculum development by proposing a practically modified and replicable ADKAR model for CM programs. Focus group interviews with 14 academics from the UK, USA, Korea, and Australia, revealed establishing a sense of urgency by appointing a BIM champion is the most critical step before the BIM curriculum development. Instant advice demystifying uncertain BIM concepts is recognised the most effective motivation among academia. Well-balanced BIM concept integrations is ‘sine qua non’ since excessively saturating BIM aspects across the program can dilute students’ essential domain knowledge. Students’ evaluation over the BIM curriculum were collected through a six-year longitudinal focus group interviews, revealing that progressive BIM learnings scaffolded from foundational concepts to advanced applications throughout their coursework is the most valuable. Full article

The development of Industry 4.0 has accelerated the adoption of sophisticated technologies, including Digital Twins (DTs), Artificial Intelligence (AI), and cybersecurity, within Additive Manufacturing (AM). Enabling real-time monitoring, process optimization, predictive maintenance, and secure data management can redefine conventional manufacturing paradigms. Although their individual importance is increasing, a consistent understanding of how these technologies interact and collectively improve AM procedures is lacking. Focusing on the integration of digital twins (DTs), modular AI, and cybersecurity in AM, this review presents a comprehensive analysis of over 137 research publications from Scopus, Web of Science, Google Scholar, and ResearchGate. The publications are categorized into three thematic groups, followed by an analysis of key findings. Finally, the study identifies research gaps and proposes detailed recommendations along with a framework for future research. The study reveals that traditional AM processes have undergone significant transformations driven by digital threads, digital threads (DTs), and AI. However, this digitalization introduces vulnerabilities, leaving AM systems prone to cyber-physical attacks. Emerging advancements in AI, Machine Learning (ML), and Blockchain present promising solutions to mitigate these challenges. This paper is among the first to comprehensively summarize and evaluate the advancements in AM, emphasizing the integration of DTs, Modular AI, and cybersecurity strategies. Full article

Nanotechnology offers innovative methodologies for enhancing the diagnosis and treatment of ovarian cancer by utilizing specialized nanoparticles. The utilization of nanoparticles offers distinct advantages, specifically that these entities enhance the bioavailability of therapeutic agents and facilitate the targeted delivery of pharmacological agents to neoplastic cells. A diverse array of nanoparticles, including but not limited to liposomes, dendrimers, and gold nanoparticles, function as proficient carriers for drug delivery. Nevertheless, notwithstanding the auspicious potential of these applications, challenges pertaining to toxicity, biocompatibility, and the necessity for comprehensive clinical evaluations pose considerable barriers to the widespread implementation of these technologies. The incorporation of nanotechnology into clinical practice holds the promise of significantly transforming the management of ovarian cancer, offering novel diagnostic tools and therapeutic strategies that enhance patient outcomes and prognoses. In summary, the deployment of nanotechnology in the context of ovarian cancer epitomizes a revolutionary paradigm in medical science, amalgamating sophisticated materials and methodologies to enhance both diagnostic and therapeutic outcomes. Continued research and development endeavors are essential to fully realize the extensive potential of these innovative solutions and address the existing challenges associated with their application in clinical settings. 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

Acromegaly is caused by an excessive secretion of growth hormone and the secondary elevation of IGF-1 levels, leading to progressive changes in multiple body systems, including the craniofacial region and oral cavity. Dental manifestations such as mandibular overgrowth, macroglossia, malocclusion, periodontal disease, and prosthetic difficulties represent not only a clinical component of the disease but also a significant therapeutic and diagnostic challenge. The aim of this review is to present the current state of knowledge on the relationship between acromegaly and oral health and to analyze the role of interdisciplinary collaboration between endocrinologists and dentists in patient care. For this narrative review, a literature search was conducted in the PubMed, Scopus, and Web of Science databases covering the period from 2000 to 2025. Sixty-two peer-reviewed publications meeting the methodological and thematic criteria were included in the analysis, including original studies, meta-analyses, systematic reviews, and case reports. The results indicate significant correlations between disease activity and the severity of periodontal and microbiological changes, while effective endocrine treatment only results in the partial regression of morphological changes. Particular attention was given to the role of the dentist in recognizing the early symptoms of the disease, planning prosthetic and surgical treatment, and monitoring therapy-related complications. Interdisciplinary collaboration models, including integrated clinics and co-managed care, were also described as optimal systemic solutions for improving treatment quality. The conclusion drawn from the analysis are as follows: there is a need for the permanent integration of dentistry into the standard of interdisciplinary care for patients with acromegaly, in both diagnostic and therapeutic dimensions. Increasing awareness among dentists and developing integrated collaboration models may reduce the time to diagnosis, improve patients’ quality of life, and enable the more effective management of craniofacial complications in the course of this rare disease. Full article

Background/Objectives: Metabolic syndrome (MetS) is a multifactorial condition characterized by abdominal obesity, dyslipidemia, insulin resistance, hypertension, and chronic inflammation. As its global prevalence rises, there is increasing interest in natural, multi-targeted approaches to manage MetS. Curcuma longa Linn. (turmeric), especially its active compound curcumin, has shown therapeutic promise in preclinical studies. This systematic review and meta-analysis evaluated the effects of Curcuma longa and its derivatives on MetS-related outcomes in rodent models. Methods: A comprehensive search was conducted across six databases (PubMed, Scopus, AMED, LILACS, MDPI, and Google Scholar), yielding 47 eligible in vivo studies. Data were extracted on key metabolic, inflammatory, and oxidative stress markers and analyzed using random-effects models. Results were presented as mean differences (MD) with 95% confidence intervals (CI). Results: Meta-analysis showed that curcumin significantly reduced body weight (rats: MD = −42.10; mice: MD = −2.91), blood glucose (rats: MD = −55.59; mice: MD = −28.69), triglycerides (rats: MD = −70.17; mice: MD = −24.57), total cholesterol (rats: MD = −35.77; mice: MD = −52.61), and LDL cholesterol (rats: MD = −69.34; mice: MD = −42.93). HDL cholesterol increased significantly in rats but not in mice. Inflammatory cytokines were markedly reduced, while oxidative stress improved via decreased malondialdehyde (MDA) and elevated superoxide dismutase (SOD) and catalase (CAT) levels. Heterogeneity was moderate to high, primarily due to variations in curcumin dosage (ranging from 10 to 500 mg/kg) and treatment duration (2 to 16 weeks) across studies. Conclusions: This preclinical evidence supports Curcuma longa as a promising functional food component for preventing and managing MetS. Its multi-faceted effects warrant further clinical studies to validate its translational potential. Full article

The construction sector is responsible for over 40% of waste generated in Australia. Construction materials are responsible for around 11% of global carbon dioxide emissions, and a third of these materials can end up wasted on a construction site. Attention in research and industry has been directed towards waste management and recycling, resulting in 78% of construction and demolition waste being diverted from landfill. However, the waste hierarchy emphasises avoiding the generation of waste in the first place. In this paper, the PRISMA approach is used to conduct a systematic review with the objective of identifying waste reduction strategies employed across all stages of projects in the Australian construction industry. Scopus and Web of Science databases were used. The search returned 523 publications which were screened and reviewed; this resulted in 24 relevant publications from 1998 to 2025. Qualitative analysis identifies strategies categorised into five groupings: pre-demolition, design, culture, materials and procurement, and on-site activities. The review finds a distinct focus on strategies within the materials and procurement category. The reviewed literature includes fewer strategies for the avoidance of waste than for any of the other levels of the waste hierarchy, evidencing the need for further focus in this area. Full article

Against the backdrop of multifaceted strategies to combat climate change, understanding soil erosion’s role in carbon cycling is critical due to terrestrial carbon pool vulnerability. This study integrates bibliometric methods with visualization tools (CiteSpace, VOSviewer) to analyze 3880 Web of Science core publications (1994–2024, inclusive), constructing knowledge graphs and forecasting trends. The results show exponential publication growth, shifting from slow development (1994–2011) to rapid expansion (2012–2024), aligning with international climate policy milestones. The Chinese Academy of Sciences led productivity (519 articles), while the US demonstrated major influence (H-index 117; 52,297 citations), creating a China–US bipolar research pattern. It was also found that Dutch journals dominate this research field. A keyword analysis revealed a shift from erosion-driven carbon transport to ecosystem service assessments. Emerging hotspots include microbial community regulation, climate–erosion feedback, and model–policy integration, though developing country collaboration remains limited. Future research should prioritize isotope tracing, multiscale modeling, and studies in ecologically vulnerable regions to enhance global soil carbon management. This study provides a novel analytical framework and forward-looking perspective for the soil erosion research on soil carbon cycling, serving as an extension of climate change mitigation strategies. Full article

Background: Pain is a problem faced by critically ill surgical patients and has a major impact on their outcomes. Pain assessment is therefore essential for effective pain management, with a combination of pharmacological and non-pharmacological treatment. Clinical supervision, supported by models such as SafeCare, can improve professional development, safety and the quality of care in intensive care units. Objectives: This study aimed to: (1) assess current pain assessment practices in a polyvalent Intensive Care Unit (ICU) in the Porto district; (2) identify nurses’ training needs regarding the Clinical Supervision-Sensitive Indicator—Pain; and (3) evaluate the impact of clinical supervision sessions on pain assessment practices. Methods: A quantitative, quasi-experimental, cross-sectional study with a pre- and post-intervention design was conducted. Based on the SafeCare model, it included a situational diagnosis, 6 clinical supervision sessions (February 2023), and outcome evaluation via nursing record audits (November 2022 and May 2023) in 31 total critical ill patients. Pain was assessed using standardised tools, in line with institutional protocols. Data was analysed using Software Statistical Package for the Social Sciences v25.0. Results: Pain was highly prevalent in the first 24 h, decreasing during hospitalisation. Generalised acute abdominal pain predominated, with mild to moderate intensity, and was exacerbated by wound care and mobilisation/positioning. Pain management combined pharmacological and non-pharmacological treatment. There was an improvement in all the parameters of the pain indicator post-intervention. Conclusions: Despite routine assessments, gaps remained in reassessing pain post-analgesia and during invasive procedures. Targeted clinical supervision and ongoing training proved effective in improving compliance with protocols and supporting safer, more consistent pain management. Full article

Background/Objectives: Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder frequently associated with metabolic and inflammatory disturbances. Due to its antioxidant and anti-inflammatory properties, pomegranate juice has been proposed as a potential adjunctive therapy in managing PCOS. To evaluate the effects of pomegranate juice on hormonal, inflammatory, and lipid parameters and body mass index (BMI) in women with PCOS. Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. Comprehensive searches were performed in electronic databases including Medline, Scopus, Web of Science, Cochrane CENTRAL, and Embase from inception to July 2025, using keywords and MeSH terms related to “polycystic ovary syndrome” and “pomegranate juice” without language restrictions. The primary outcomes were changes in serum testosterone, luteinizing hormone (LH), high-sensitivity C-reactive protein (hs-CRP), lipid profile parameters (HDL, LDL, triglycerides, and total cholesterol), and body mass index (BMI). Results: Four RCTs published between 2020 and 2023, encompassing 128 women with PCOS, were included. The meta-analysis revealed significant reductions in testosterone (MD: −0.05; 95% CI: −0.07 to −0.03; p < 0.0001; I² = 0%, two studies, 85 participants) and hs-CRP (SMD: −0.85; 95% CI: −1.35 to −0.35; p = 0.0009; I² = 20%, two studies, 85 participants), along with increases in HDL (MD: 6.21; 95% CI: 2.43 to 10.00; p = 0.001; I² = 0%, two studies, 85 participants) and reductions in triglycerides (MD: −23.30; 95% CI: −45.19 to −1.42; p = 0.04; I² = 0%, two studies, 85 participants). No significant changes were observed in LH, LDL, total cholesterol, or BMI. Conclusions: Pomegranate juice demonstrates promising effects as an adjunctive intervention in women with PCOS, improving androgen levels, inflammatory markers, and certain lipid parameters. Further long-term studies are needed to confirm these findings. Full article

Arbuscular mycorrhizal fungi (AMF) play a vital role in the restoration of tropical forests by enhancing soil fertility, facilitating plant establishment, and improving ecosystem resilience. This study presents a comprehensive bibliometric analysis of global scientific output on AMF in the context of ecological restoration, based on 3835 publications indexed in the Web of Science and Scopus databases from 2001 to 2024. An average annual growth rate of approximately 9.45% was observed, with contributions from 10,868 authors across 880 journals. The most prominent journals included Mycorrhiza (3.34%), New Phytologist (3.00%), and Applied Soil Ecology (2.79%). Thematically, dominant research areas encompassed soil–plant interactions, phytoremediation, biodiversity, and microbial ecology. Keyword co-occurrence analysis identified “arbuscular mycorrhizal fungi,” “diversity,” “soil,” and “plant growth” as core topics, while emerging topics such as rhizosphere interactions and responses to abiotic stress showed increasing prominence. Despite the expanding body of literature, key knowledge gaps remain, particularly concerning AMF–plant specificity, long-term restoration outcomes, and integration of microbial community dynamics. These findings offer critical insights into the development of AMF research and underscore its strategic importance in tropical forest restoration, providing a foundation for future studies and informing ecosystem management policies. Full article

Smart cities are technologically advanced urban environments where interconnected systems and data-driven technologies enhance public service delivery and quality of life. These cities rely on information and communication technologies, the Internet of Things, big data, cloud computing, and other Industry 4.0 tools to support efficient city management and foster citizen engagement. Often referred to as digital cities, they integrate intelligent infrastructures and real-time data analytics to improve mobility, security, and sustainability. Ubiquitous sensors, paired with Artificial Intelligence, enable cities to monitor infrastructure, respond to residents’ needs, and optimize urban conditions dynamically. Given the increasing significance of Industry 4.0 in urban development, this study adopts a bibliometric approach to systematically review the application of these technologies within smart cities. Utilizing major academic databases such as Scopus and Web of Science the research aims to identify the primary Industry 4.0 technologies implemented in smart cities, assess their impact on infrastructure, economic systems, and urban communities, and explore the challenges and benefits associated with their integration. The bibliometric analysis included publications from 2016 to 2023, since the emergence of urban researchers’ interest in the technologies of the new industrial revolution. The task is to contribute to a deeper understanding of how smart cities evolve through the adoption of advanced technological frameworks. Research indicates that IoT and AI are the most commonly used tools in urban spaces, particularly in smart mobility and smart environments. Full article

Background and Objectives: Diabetes is a global public health challenge, with increasing prevalence worldwide. The implementation of artificial intelligence (AI) in the management of this condition offers potential benefits in improving healthcare outcomes. This study primarily investigates the barriers and facilitators perceived by healthcare professionals in the adoption of AI. Secondarily, by analyzing both quantitative and qualitative data collected, it aims to support the potential development of AI-based programs for diabetes management, with particular focus on a possible bottom-up approach. Materials and Methods: A scoping review was conducted following PRISMA-ScR guidelines for reporting and registered in the Open Science Framework (OSF) database. The study selection process was conducted in two phases—title/abstract screening and full-text review—independently by three researchers, with a fourth resolving conflicts. Data were extracted and assessed using Joanna Briggs Institute (JBI) tools. The included studies were synthesized narratively, combining both quantitative and qualitative analyses to ensure methodological rigor and contextual depth. Results: The adoption of AI tools in diabetes management is influenced by several barriers, including perceived unsatisfactory clinical performance, high costs, issues related to data security and decision-making transparency, as well as limited training among healthcare workers. Key facilitators include improved clinical efficiency, ease of use, time-saving, and organizational support, which contribute to broader acceptance of the technology. Conclusions: The active and continuous involvement of healthcare workers represents a valuable opportunity to develop more effective, reliable, and well-integrated AI solutions in clinical practice. Our findings emphasize the importance of a bottom-up approach and highlight how adequate training and organizational support can help overcome existing barriers, promoting sustainable and equitable innovation aligned with public health priorities. Full article