Search Results (1,081)

Background and Objectives: Oral Janus kinase (JAK) inhibitors have become an important therapeutic class in dermatology, with approved indications including atopic dermatitis and alopecia areata. Owing to their broad immunomodulatory effects and rapid onset of action, these agents are increasingly used off label for a variety of inflammatory skin disorders that are often refractory to standard therapies. The objective of this review was to provide a comprehensive overview of the published literature on the off-label dermatologic use of oral JAK inhibitors, summarizing clinical outcomes, safety profiles and treatment durations reported in real-world settings. Materials and Methods: A literature search was conducted in PubMed to identify case reports and case series describing off-label dermatologic use of baricitinib, abrocitinib, upadacitinib, and ritlecitinib. Extracted data included authorship and year, article type, treatment regimen, treatment duration and follow-up, prior systemic therapies, clinical outcomes, and reported adverse events. Results: A total of 136 articles were included, comprising 45 articles on abrocitinib (63 patients), 55 on upadacitinib (94 patients), 35 on baricitinib (45 patients), and 2 on ritlecitinib (2 patients). Across a wide spectrum of dermatological conditions, oral JAK inhibitors showed consistent clinical efficacy. Responses were frequently rapid and disease control was often maintained over several months of treatment. In many cases, dose reduction or treatment discontinuation did not lead to immediate relapse. Overall tolerability was favorable, with adverse events reported in a minority of patients and predominantly described as mild and transient. Conclusions: Although our data is limited to case-based literature, this review highlights the broad off-label therapeutic potential of oral JAK inhibitors in dermatology. Their rapid onset of action, sustained clinical responses, frequent maintenance of remission after dose tapering or discontinuation and generally acceptable safety profile support their consideration as treatment options in selected patients. Full article

Climate change and sea-level change (SLC) are intensifying flooding in U.S. coastal communities, with disproportionate impacts on Black and minority neighborhoods that face displacement, economic hardship, and heightened health risks. In Norfolk, Virginia, sea levels are projected to rise by at least 0.91 m (3 ft) by 2100, placing underserved neighborhoods such as Oakleaf Forest at particular risk. This study investigates the compounded impacts of flooding at both the building and urban scales, situating the work within the framework of the UN Sustainable Development Goals (UN SDGs). A mixed-method, community-based approach was employed, integrating literature review, field observations, and community engagement to identify flooding hotspots, document lived experiences, and determine preferences for adaptation strategies. Community participants contributed actively through mapping sessions and meetings, providing feedback on adaptation strategies to ensure that the process was collaborative, place-based, and context-specific. Preliminary findings highlight recurring flood-related vulnerabilities and the need for interventions that address both environmental and social dimensions of resilience. The study proposes multi-scale, nature-based solutions (NbS) to mitigate flooding, restore ecological functions, and enhance community capacity for adaptation. Ultimately, this work underscores the importance of coupling technical strategies with participatory processes to strengthen resilience and advance climate justice in vulnerable coastal neighborhoods. Full article

Background: Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease. Certain clinical forms of the disease may cause significant discomfort and negatively impact patients’ quality of life. The first-line treatment is topical corticosteroids. The purpose of this narrative review is to evaluate the influence of corticosteroid injections in the treatment of OLP. Methods: A search of the literature was conducted in October 2025 using the following databases: PubMed, Web of Science, Scopus, and Cochrane. Results: Fifteen studies were evaluated. Injections with triamcinolone acetonide at a concentration of 10–40 mg/mL at weekly intervals demonstrated efficacy in reducing pain and healing OLP lesions in these studies. They showed minor adverse effects. Conclusions: Noting the limitations of this narrative review, intralesional corticosteroid injections are an effective and safe method of treating OLP. They should be considered in patients with symptomatic OLP. Full article

Improving the architecture and control strategies of thermal management systems (TMSs) is crucial for minimizing energy consumption in heating and cooling components, thereby enhancing the driving range of Battery Electric Vehicles (BEVs). This study presents a holistic approach for developing an Integrated Thermal Management System (ITMS) based on an Octo-valve-type architecture, designed to efficiently manage the thermal demands of both the cabin and powertrain components. Empirical data were collected under various heating and cooling scenarios across a wide operating temperature range (−20 °C to 40 °C), and these data were used to parametrize and validate key ITMS components. Experimental results demonstrated that the parametrized simulation model closely replicated the cabin and battery thermal behavior observed in vehicle tests, particularly under cooling conditions. Minor deviations, such as cabin temperature overshoot during heating scenarios, were attributed to duct thermal effects and control tuning limitations. Overall, the optimized Octo-valve-based ITMS architecture exhibited thermal trends consistent with literature references and effectively validated the proposed control strategy, demonstrating improved thermal efficiency and potential range enhancement for BEVs across diverse environmental conditions. Furthermore, ITMS energy consumption over the indicated temperature range is quantified in this research paper. Full article

Sulfides are essential tracers for understanding the redox conditions, diffusion processes, and thermal mechanisms involved in the formation of ordinary chondrites. Their mineralogical and textural evolution provides valuable constraints on the metamorphic history of parent bodies. In this context, the Ksar El Goraane meteorite, which fell in Morocco in 2018 and is classified as an H5 ordinary chondrite, represents a particularly instructive case for investigating sulfur behavior during thermal metamorphism. Petrographic observations combined with geochemical data obtained by electron probe microanalysis (EPMA) and energy-dispersive X-ray spectroscopy (EDS) were used to characterize the main silicate and sulfide phases and to evaluate their degree of chemical equilibration. The compositions of olivine (Fa_18–20), Mg-Rich orthopyroxene, and sodic plagioclase (An_10–15) display limited analytical dispersion and well-recrystallized textures, confirming that Ksar El Goraane experienced an equilibrated metamorphic grade consistent with an H5 ordinary chondrite. The sulfide assemblage is dominated by troilite (FeS), iron-rich pyrrhotite (Fe_1−xS), and pentlandite ((Fe,Ni)₉S₈), with minor occurrences of pyrite (FeS₂). Textural relationships and chemical homogeneity observed in backscattered electron images and elemental maps indicate progressive re-equilibration during thermal metamorphism. Formation and transformation temperatures of the sulfide phases are inferred through comparison with experimental and empirical constraints reported in the literature. These results suggest early high-temperature crystallization of troilite, followed by sulfur depletion leading to pyrrhotite formation, subsequent low-temperature exsolution of pentlandite, and localized late-stage pyrite crystallization. Full article

Salmonella is a globally important pathogen and one of the World Health Organization and One Health priority organisms. Reptiles represent environmental reservoirs of Salmonella serovars that can cause reptile-associated salmonellosis (RAS) in humans. Due to distinct biochemical features and uncommon O and H antigen variants, reptile-associated isolates may be difficult to identify using standard microbiological diagnostics. This study analyzed 62 Salmonella isolates obtained from wild and kept snakes in Poland. Samples originated from Natrix natrix, N. tessellata, Coronella austriaca, Zamenis longissimus, Elaphe dione and Nerodia fasciata species. Serovar prediction using SeqSero1.2 was compared with classical slide agglutination. Seventeen serovars were confirmed, with S. enterica subsp. diarizonae (IIIb) 38:r:z being the most frequent. For seven isolates, molecular and serological results were inconsistent. Among three isolates from Coronella austriaca predicted as IIIb 38:z₁₀:z₅₀, three distinct second-phase flagellar phenotypes were detected. Slide agglutination confirmed the presence of serovar 38:z₁₀:z₆, which has not been previously listed in the White–Kauffmann–Le Minor scheme or described in the scientific literature. The findings highlight the utility of genetic serovar prediction while emphasizing the need for continuous validation, particularly for the identification of rare or atypical Salmonella serovars associated with reptiles. Full article

Introduction: The Diagnostic and Statistical Manual of Mental Disorders has been criticized for its reliability and validity, including for the major psychological injuries [Posttraumatic Stress Disorder (PTSD), chronic pain-related disorders, and neurocognitive disorders, pertinent for mild traumatic brain injury (MTBI)/persistent post-concussion syndrome (PPCS)]. Methods: This review article examines both the mental health/psychiatric and legal literature on the DSM-5 and its criticisms. The DSM-5 uses a polythetic approach, which leads to many complicating ways of expressing disorders (e.g., PTSD). Disorders related to chronic pain refer to somatic symptom disorders (e.g., with predominant pain), which leads to less focus on the chronic pain itself. The neurocognitive disorder diagnosis includes minor and major classifications, but excludes moderate ones. The international diagnostic system (International Classification of Diseases (ICD-11)) and alternate approaches to psychiatric nosology [the Research Domain Criteria (RDoC) and Hierarchal Taxonomy of Psychopathology (HiTOP)] do not help resolve these issues. Results: The comprehensive literature review undertaken indicates the limitations of the DSM-5 clinically and in court, especially for psychological injuries. The article includes tables and boxes that complement the text with specificities related to the issues raised. Conclusions: The article recommends supplementary diagnostic criteria for the three major psychological injuries (PTSD, chronic pain, and MTBI) for forensic use. This paper is an original contribution to improving the diagnostics/description and forensic use of the major psychological injuries: aside from the paper’s clinical contributions, these disorders/conditions are contentious in court, and their better specification in diagnosis, as attempted herein, is important to undertake forensically. Full article

Self-efficacy beliefs and mindset influence student success, impacting how a learner experiences and responds to learning situations and setbacks. Accordingly, mindset interventions, are successful at increasing student performance with particular efficacy with historically underserved students such as those attending HBCUs. This paper studies a classroom-based mindset intervention that was implemented with the goal of increasing learning and achievement through improving the students’ cognitive disposition. The intervention, implemented at a mid-Atlantic minority serving institution of higher education, involved the creation of a custom-designed three-tool self-assessment developed to engender students’ critical reflection. The scales in question measured self-efficacy, growth mindset, and mastery goal orientation. This paper presents the results of reliability testing via Cronbach’s alpha and inter-item covariance. According to the findings, all three tools showed strong (good to excellent) reliability with acceptable positive covariance indicating that they are capable of serving as appropriate instruments for further adoption, usage, and analysis. It is the goal that this paper contributes to the body of literature on mindset interventions encouraging more individuals working with traditionally underserved learners to consider exploring efforts to increase students’ positive mindsets. Full article

Introduction: Refractory Status Epilepsy Syndrome is a heterogeneous group of diseases associated with status epilepsy. Literature and definition have been conflicting and confusing in terms of their nomenclatures. New-onset refractory status epilepticus (NORSE) is a syndrome characterized by new onset refractory seizures in a previously health child. Febrile infection-related epilepsy syndrome (FIRES) is a similar syndrome now considered a variant of NORSE and is defined as a febrile event taking place between twenty-four hours and two weeks prior to the commencement of refractory status epilepticus. An autoimmune or inflammatory etiology is often implied in both conditions because infection is rarely identified. Aim: This review provides an update on hypotheses, etiology, pathophysiology, clinical features, diagnosis, laboratory evaluation, treatment, and perspectives for NORSE/FIRES. Methods: A PubMed Clinical Queries search is performed using keywords of NORSE and FIRES, on human subjects up to May 2025. All reviews, systematic reviews, case series and case reports were included. Results: Seizures are typically recalcitrant in NORSE/FIRES. Treatments include anti-seizure medications (ASM), ketogenic diet, immunotherapy (intravenous immunoglobulin ± plasmapheresis ± corticosteroid). The prognosis is usually poor. Most children would suffer refractory epilepsy and associated cognitive impairment if they survived. Guidelines and new consensus on NORSE/FIRES terminology have aided clinicians in managing status epilepticus in a previously healthy child that occurs ± a minor febrile episode. When an autoimmune or paraneoplastic condition is subsequently identified, the condition will be named accordingly. Conclusions: NORSE and FIRES are similar conditions except that vagus nerve stimulation appears to be more efficacious in NORSE than FIRES. We propose to define these heterogeneous and confusing conditions as “NOSES” as a two-criteria syndrome: New Onset + Status Epilepticus Syndrome, lasting for over 24 h despite the use of two standard ASM. Autoimmune, paraneoplastic and infectious encephalitis are specific diagnoses of NOSES with etiology subsequently identified. Full article

Background: Femoral neck fractures in the elderly often necessitate hemiarthroplasty, but the optimal surgical approach remains a highly debated topic. The postero-lateral and direct lateral approaches are commonly employed, each with benefits and drawbacks. Despite their widespread use, robust, long-term comparative studies on definitive outcomes, including pain, functional recovery, and complication rates, are notably lacking. This systematic review and meta-analysis aim to address this critical gap by meticulously comparing these approaches with long-term follow-up. Methods: A systematic literature search was performed, including only comparative studies with a minimum 1-year follow-up. A meta-analysis was performed for the primary outcome measures: operative time, dislocations, infections, perioperative fractures and reoperations. Secondary outcomes included a qualitative synthesis of patient-reported outcomes (quality of life, pain, and satisfaction). Methodological quality was assessed using RoB 2.0 for randomized controlled trials and MINORS criteria for cohort studies. Results: Our meta-analysis provides robust quantitative evidence. The direct lateral approach is associated with a significantly lower risk of post-operative dislocations (I² = 58%; OR = 2.86, 95% CI: 2.53 to 3.22; p < 0.00001) and a significantly lower rate of reoperation (I² = 0%; OR = 1.25, 95% CI: 1.12 to 1.40; p = 0.0001) compared to postero-lateral approach. Operative time, infection, and perioperative fracture rates were found to be statistically comparable. However, patient-reported outcomes yielded inconsistent results across studies, often becoming non-significant after adjusting for confounders. Conclusions: This meta-analysis shows that the direct lateral approach is associated with lower rates of dislocation and reoperation compared with the postero-lateral approach, while patient-reported outcomes remain variable across studies. Further high-quality comparative trials are needed to confirm these associations and guide surgical decision-making. Full article

Fritillaria pallidiflora Schrenk ex Fisch. & C.A.Mey. (Yi Beimu) is a culturally significant Beimu drug in Northwest China, officially listed in the Chinese Pharmacopoeia and traditionally used to clear heat, moisten the lung, resolve phlegm, and relieve cough and wheeze. This narrative, critical review synthesizes current evidence on ethnopharmacology, phytochemistry, pharmacology, pharmacokinetics/toxicology, and conservation of F. pallidiflora to support sustainable, evidence-based development. Literature was retrieved from major English and Chinese databases and screened for studies that unambiguously involved Yi Beimu or its key constituents. Ethnomedicinal records consistently support antitussive, expectorant, and anti-asthmatic use in Xinjiang and the Ili River Valley. Chemically, F. pallidiflora is rich in cevanine-type steroidal alkaloids (e.g., imperialine, peimine, yibeinones), steroidal saponins (pallidiflosides), polysaccharides, and minor phenolics. Preclinical data show that alkaloids relax airway smooth muscle, suppress inflammatory mediators, and contribute to antitussive and anti-asthmatic effects, while polysaccharides and total alkaloid extracts exhibit antioxidant and cytoprotective activity in cell and animal models of airway injury. Additional studies report cytotoxic saponins and seed-derived antimicrobial peptides. Pharmacokinetic work highlights low to moderate and variable oral bioavailability, shaped by P-glycoprotein efflux and CYP-mediated metabolism, and reveals potential hERG channel inhibition for peimine as a cardiac safety concern. Overharvesting and habitat loss have reduced wild resources, underscoring the need for conservation, cultivation, and marker-guided quality control. Overall, Yi Beimu shows credible ethnopharmacological rationale and promising multi-target pharmacology for respiratory disorders, but translation will require bioactivity-guided isolation coupled with PK–PD-guided in vivo studies, rigorous safety evaluation, and conservation-aware cultivation to move from traditional remedy toward validated therapeutic resource. Full article

Drawing on social comparison and attribution theories, this study examines how employees’ attitudinal dissimilarity within work groups shapes their willingness to speak up or remain silent. We conceptualize dissimilarity in psychological ownership and job stress as individual-level differences that trigger internal attributions, leading employees to direct attention inward and reduce their likelihood of speaking up. In contrast, dissimilarity in perceived status conflict, an individual-level perception of a structural feature of the group, induces external attributions toward the social system, motivating employees to express voice aimed at preserving or challenging the status quo. Using multi-source data from 202 employees nested in 39 work groups in South Korea, hierarchical regression analyses support all proposed hypotheses: individual-level dissimilarities are negatively related and structural-level dissimilarity is positively related to voice. These findings reveal that the behavioral consequences of difference depend on where attribution is directed—toward the self or the system. The study contributes to the voice literature by integrating attributional reasoning into social comparison processes and by identifying two forms of attitudinal minorities: invisible minorities who remain silent, and boisterous minorities who speak up for change. Full article

Since local egg production using Pasteur’s method began in 1895, two local silkworm breeds have mostly been reared in Bulgaria, namely, Yellow local and White Baghdad. The Yellow local breed is said to have originated and been reared from local breeds spread in northern and southwestern Bulgaria in the 16th–19th centuries, while White Baghdad originated from Asia Minor and was reared in southeastern Bulgaria. The Yellow local breed is characterized by yellow cocoons with an elongated shape with slight constriction. The white Baghdad breed consists of three types, namely the Edirne, Improved Bulgarian, and Bulgarian types. The cocoon color varies from snow white to light green, but the prevailing color is white. The cocoon shape is elongated, with constriction. The old silkworm breeds reared in 1920s–1930s Bulgaria were generally characterized by a non-uniformity of larval color and markings, as well as of cocoon color and shape, with comparatively high cocoon weights but lower silk shell percentages and filament lengths; they were also comparatively tolerant to NPV disease. Due to the long maintenance of these breeds in Bulgaria, they have become well adapted to the local food and climatic conditions. Presently, the Yellow local strain displays high hatchability and survivability, shorter fifth-instar duration, and a comparatively good reproduction capacity. On the other hand, it manifests lower values of main productive characteristics, such as cocoon weight, silk shell weight and percentage, silk filament length and weight, reelability, and raw silk percentage as compared with commercial Bulgarian white-cocoon breeds. Therefore, in order for this breed to be commercialized today, it needs to be improved by way of genetics and breeding. This paper includes a review of the literature on the inheritance of main qualitative characteristics in silkworms, as well as recommendations for future studies on improving old silkworm breeds. Full article

Background: Secondary pathogenic/likely pathogenic germline variants (P/LPGVs) identified on solid tumor genomic profiling (TGP) are a commonly encountered clinical issue. A proportion of oncology patients that undergo TGP will have a secondary P/LPGV identified that may not have been otherwise discovered based on clinical and family history criteria for hereditary cancer syndrome screening. The confirmation of P/LPGVs on germline sequencing has potential treatment implications for patients. Methods: The study design was a retrospective review for secondary data analysis. The inclusion criteria for this study were adult patients with solid tumor malignancy who underwent TGP and germline sequencing. The objective of this study is to evaluate the concordance rate of secondary P/LPGVs on TGP of adult patients with solid tumor malignancy at Hoag Presbyterian Hospital and Tower Health-Reading Hospital. The second and third aims are to analyze if the confirmed P/LPGVs are concordant with the patient’s tumor type and to analyze the variant allele frequencies (VAFs) of the identified secondary P/LPGVs on the tumor genomic profiling. Results: The data included 75 patients who underwent both TGP and germline sequencing, with a median age of 62.5 years. The most represented genes with P/LPGVs in the combined data included BRCA1 and BRCA2, both with 14, and MSH2, with 9. The overall germline concordance rate for the combined population was 64.1%, with 59 out of 92 P/LPGVs identified on both germline and somatic tumor testing. Conclusions: The overall germline concordance rate of 64% for the combined population is in accordance with the reported literature. Possible reasons for the variability in rates could be related to reporting guidelines for secondary germline variants, which can vary by company, and differences between somatic and germline variant curation. The study of P/LPGVs in populations from community cancer centers has the potential to increase the data of underrepresented minority groups regarding this important clinical issue and help expand understanding of hereditary cancer syndrome phenotypes. Full article

Microwave-Induced Hydrogen Plasma (MIHP) is introduced as a novel synthesis route for producing high-entropy carbides (HECs), offering an alternative to conventional mechanical alloying and/or sintering techniques. In this study, a representative HEC composition, ${\mathrm{MoNbTaVWC}}_5$, was successfully synthesized using MIHP processing at 200 Torr. The process employs microwave energy to generate hydrogen plasma to facilitate carbothermal reduction of metal oxide precursors. The plasma environment generates abundant reactive atomic hydrogen species, which enhance reaction spontaneity and promote efficient HEC formation. X-ray diffraction confirmed the formation of a single-phase rocksalt-type face-centered cubic structure. Scanning electron microscopy combined with energy-dispersive X-ray spectroscopy confirmed uniform elemental distribution within the synthesized microstructure. Nanoindentation measurements yielded hardness and elastic modulus values consistent with literature reports for similar compositions. X-ray photoelectron spectroscopy confirmed the chemical state of carbon to be primarily bonded with metals as carbides, with only minor oxygen present as metal-oxides. Raman spectroscopy performed over the 750–1900 ${\mathrm{cm}}^{-1}$ range yielded a featureless spectrum with no detectable D or G bands often observed for sp²-hybridized disordered carbon, graphite, or graphene materials. These results validate the structural and chemical purity of the synthesized HECs. This work aims to demonstrate the feasibility and reproducibility of MIHP as a synthesis method for HECs. Full article