Search Results (4,651)

This study aims to advance knowledge in the concept of therapeutic milieus by connecting nature, spirituality, and health to develop sustainable destinations. It combines the advantages of a conceptual paper and a multi-case study, offering a range of solutions demonstrated with three types of settlements: a county capital, a middle-sized town, and a small town. The GIS analysis identified several areas where the co-existence of thermal water, sacred sites, and verdant landscapes is in abundance, and five potential study areas were selected. Additional selection criteria included the GDP of the counties, visitation data, and synergy potential. Field work using field notes and photographs reconfirmed the results of the mapping and found unique value propositions that could enhance the value of health tourism. The theoretical research suggested three areas with synergy potential: culture, gastronomy, and sports. Based on the findings, a framework for therapeutic milieus showing three different scenarios was prepared. As for the economic and social implications, the research highlighted that adopting a multidisciplinary approach, incorporating insights from geography, cultural studies, and psychology, could make destinations more resilient, thus benefiting both tourists and locals. This study represents a substantial contribution to the milieu theories by incorporating natural, cultural, and spiritual elements into a flexible framework for therapeutic milieus. Future research may explore therapeutic milieus outside the Christian context or investigate the demand side. Full article

This study combines a multidisciplinary approach to Pyrenean and Alpine glacial lakes to characterize the sensitivity of Late Glacial to Holocene subaquatic flood deposits in deltaic environments to slope failures triggered either by earthquakes, rockfalls, or snow avalanches. To clarify the possible interactions between environmental changes and these natural hazards in mountain and piedmont lakes, we analyze the lacustrine sedimentary records of key historical events and discuss the recurrence of similar regional events in the past. High-resolution seismic profiles and sediment cores from large perialpine lakes (Bourget, Geneva, and Constance) and from small mountain lakes in the French Alps and the Pyrenees were used to establish a conceptual model linking environmental changes, tributary flood sedimentary processes, subaquatic deltaic depocenters, and potentially tsunamigenic mass-wasting deposits. These findings illustrate the specific signatures of the largest French earthquakes in 1660 CE (northern Pyrenees) and in 1822 CE (western Alps) and suggest their recurrence during the Holocene. In addition, the regional record in the Aiguilles Rouges massif near Mont Blanc of the tsunamigenic 1584 CE Aigle earthquake in Lake Geneva may be used to better document a similar Celtic event ca. 2300 Cal BP at the border between Switzerland and France. Full article

Background: Angle’s dental class asymmetries not associated with crossbite are malocclusions that are often underestimated in pediatric patients. However, they may be associated with alterations in the development of the stomatognathic system. Objective: The objective of this study was to evaluate the prevalence of Angle’s class asymmetries without crossbite in primary-school-aged children and to investigate possible associations with perinatal, clinical, and functional variables. Materials and Methods: This cross-sectional observational study analyzed a sample of 391 children aged 6 to 11 years, attending a primary school in the metropolitan area of Milan, Italy. Data were systematically collected through both clinical examination and patient history, with the aim of identifying significant correlations with the occurrence of dental asymmetries in the absence of crossbite. Results. The results revealed a higher prevalence of occlusal asymmetries associated with factors such as oral breathing, low tongue posture, type of delivery, formula feeding, and systemic diseases during the first three years of life. Advanced carious lesions and inclination of the occlusal plane were significantly associated with asymmetry. Conclusions: The study highlights the importance of early diagnosis and a multidisciplinary approach to prevent malocclusions and complex craniofacial dysfunctions later in life. Full article

Viral diseases remain a persistent threat to global health, agriculture, and biodiversity, as demonstrated by recent pandemics. The high mutation rates, diversity, and intricate replication mechanisms within a host can often challenge conventional detection and therapeutic approaches. The emergence of novel viruses underscores the critical importance of innovative and multidisciplinary strategies to outpace these diseases. In this context, nanotechnology has emerged as a transformative frontier, offering unique tools to address the limitations of traditional virology. This review examines the latest nanotechnological innovations designed to combat viral diseases. Like the development of advanced nanoplatforms, metallic and polymeric nanostructures, and carbon-based materials, and evaluating their roles in viral theranostics. This article provides critical biomedical insights into the function and relationship of nanomaterials, mechanisms of action, and their interaction with biological systems. This work aims to provide a valuable resource for guiding future research toward the clinical translation of nanomaterial-based strategies for the prevention, diagnosis, and treatment of viral infections. Full article

Fracture-related infections (FRIs) represent a significant complication in orthopedic trauma care, often leading to delayed bone healing, prolonged hospital stays, and increased patient morbidity. Pathogenesis involves microbial contamination during injury or surgery, compounded by patient-related risk factors such as diabetes, smoking, or immunosuppression. Diagnosis of FRI relies on a combination of clinical, radiological, and microbiological criteria. Common signs include persistent pain, swelling, erythema, purulent discharge, and non-union of the fracture. FRIs are classified based on the timing of infection onset into acute, delayed, and chronic forms, each requiring tailored management strategies. Treatment generally involves aggressive surgical debridement, possible hardware removal or retention, and targeted antibiotic therapy. In cases of severe tissue loss, reconstructive procedures may be necessary to restore bone and soft tissue integrity. Treatment strategies include early administration of prophylactic antibiotics, meticulous surgical technique, and timely soft tissue coverage in open fractures. A multidisciplinary approach involving orthopedic surgeons, infectious disease specialists, and microbiologists is essential for successful management. Early recognition and appropriate intervention are crucial to improving outcomes and minimizing long-term disability in patients with fracture-related infections. Full article

Melanoma poses a growing concern for women of reproductive age, especially during pregnancy, when physiological changes can influence disease presentation and management. While women generally engage more in protective behaviors than men, significant disparities in awareness and preventive practices persist, particularly among racial and ethnic minorities. Pregnancy-associated hormonal and mechanical changes may alter the morphology of nevi, necessitating vigilant dermatologic monitoring. Photoprotection strategies should prioritize safety for both mother and fetus, emphasizing mineral-based sunscreens and behavioral interventions. Although standard diagnostic and treatment approaches remain broadly applicable during pregnancy, advanced melanoma presents unique therapeutic challenges. Targeted therapies like BRAF inhibitors may offer maternal benefits in selected cases, although data are limited, whereas immunotherapies require cautious consideration due to potential fetal risks. Ultimately, optimal care of melanoma during pregnancy demands a multidisciplinary approach that integrates dermatologic, obstetric, oncologic, and pediatric expertise to balance maternal health needs with fetal safety. This review addresses awareness and preventive behaviors in women of reproductive age, pregnancy-related changes in melanocytic nevi, and management considerations during pregnancy. Full article

This study explores the role of olfaction in linking Brazilian cultural expressions with Yoruba heritages. Brazilian culture is deeply rooted in African traditions brought across the Atlantic, and this connection is evident in its foods, celebrations, and practices. Through a multidisciplinary approach combining bibliometric and historic review, fieldwork, and sensory analysis, the research reveals how distinct aromas, ranging from the scent of aromatic plants used in celebrations to culinary ingredients, act as olfactory markers of identity and collective memory in the state of Bahia and in a religious community in São Paulo. Historically, the transatlantic slave trade brought Yoruba peoples to Brazil, embedding their traditions deeply into the region’s cultural and everyday life. By documenting the shared olfactory elements between Bahian festivals such as the Lavagem do Bonfim and the practices observed within Yoruba-based cultural expressions in the Oduduwa Temple in São Paulo, the study underscores the significance of olfactory heritage to Afro-Brazilian culture and calls for greater scholarly attention to it. Recognizing smell as a dynamic conduit for history and emotion offers new insights into the survival and evolution of cultural traditions, urging further transdisciplinary research into the sensory narratives that shape our collective identities. Full article

This paper presents a systematic methodology for identifying and integrating safety and security requirements in autonomous driving systems, demonstrated through the case of an autonomous intersection. The study focuses on modeling the intelligent intersection using the MBSE Grid Framework, the SysML modeling language, and the Cameo Systems Modeler tool. Two specific use cases are modeled to illustrate the system’s functionality. A multidisciplinary approach is developed to incorporate safety and security requirements into the system model, combining theoretical foundations with practical implementation techniques. The methodology includes both a generalizable framework and domain-specific strategies tailored to autonomous driving. The proposed approach is applied and critically evaluated using the intelligent intersection as a case study. By extending SysML to systematically address safety and security concerns, the work contributes to the development of safer and more efficient autonomous transportation systems. The results provide a foundation for future research and practical applications in the field of intelligent mobility and cyber–physical systems. Full article

Background and Clinical Significance: Adult small intestinal intussusception is rare and, in this population, is usually secondary to a pathological lead point, such as benign or malignant masses. The symptoms are non-specific, and patients frequently present with intermittent abdominal pain, diarrhea, nausea, vomiting, and, in rare cases, bleeding. There are currently no specific guidelines. Surgery remains the gold standard treatment. Case Presentation: We report the case of a 55-year-old female affected by Shone’s syndrome, presenting to the emergency department with melena, severe anemia, diffuse abdominal pain, weakness, and palpitations. Diagnostic tests showed active bleeding in the small intestine and a subocclusive condition. Urgent surgery was performed, revealing an intussusception. Conclusions: A multidisciplinary approach is essential for its management. Surgical resection is the only option in these cases, as it allows histological examination to rule out malignancy. Full article

Background and Clinical Significance: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis in adults, typically following a chronic course that often leads to end-stage kidney disease. Rapidly progressive glomerulonephritis is a rare and severe variant of IgAN with a poor prognosis. Case Presentation: We present the clinical case of a 68-year-old Caucasian female with a history of systemic lupus erythematosus and untreated chronic hepatitis B, who was admitted to the Transplant-Nephrology Department, University Hospital Martin, with acute kidney injury and nephrotic syndrome accompanied by hematuria. The clinical picture was marked by lower limb oedema and poorly controlled hypertension, both of which responded well to conservative management. Extrarenal causes were excluded through otolaryngologic, stomatologic, and gynecologic assessments, and autoantibody screening was negative. Renal biopsy revealed crescentic glomerulonephritis with endocapillary and mesangial proliferation and IgA deposits. Due to active hepatitis B, initial treatment was limited to corticosteroids. Following a decrease in viral load, pulse therapy with cyclophosphamide was administered, followed by mycophenolic acid; however, renal function did not recover. Conclusions: The rapidly progressive form of IgA nephropathy in the context of active hepatitis B presents a rare and challenging clinical case. Management requires a highly individualised, multidisciplinary approach due to the risk of infectious complications and the need to preserve renal function. Full article

Acute pain is a significant clinical challenge in primary and secondary care. If inadequately managed, acute pain is a major risk factor for the development of chronic postsurgical pain and persistent postoperative opioid use. In this perspective article, we offer the authors’ viewpoints informed by selective literature with the aim of helping identify avenues to improve the quality and safety of acute pain management. Current evidence in the quality and safety of pain management shows that the role of primary care staff in education, follow-up, and tapering remains largely unaddressed, while patient perspectives and experiences reveal gaps in communication, stigma, and trust. Screening tools, guidelines, and strategies to reduce variations in the prescription and use of opioids remain inconsistently developed. In conclusion, if pain is multifaceted and should be approached in a multidisciplinary way, strong integration between primary and secondary care is essential. Communication with primary care, tapering, or referral should be facilitated. Patient experience should receive more attention, and future studies should focus on implementing guidelines and multidisciplinary guidance, as well as providing continuous feedback to clinicians on their practice and outcomes. Full article

Background: The reported data on ECG screening are focused on the last two decades. The objectives of this review were bifold: (i) to identify, within a timespan of twenty years, the most recent literature data on cardiac screening in children and adolescents and (ii) to provide data on the procedures used. Methods: Queries were conducted using PubMed, Scopus, and Google Scholar databases for the time window of 2005–2025. The mesh terms used were “ECG”, “Universal Screening”, “Cardiac Pathologies”, “Heart Rate”, and “Sports Pre-participation Evaluation”. Only research articles and review papers were included. The standard English language filter was used. Successively, only research articles were selected. Results: Data from 14 papers were considered, reflecting the lack of information about subjects <16 years of age. Conclusions: The information on objective ECG screening measures is quite scarce, and it is an urgent need to introduce a multidisciplinary approach to differentiate between ECG physiological changes due to growth and ECG pathological changes due to early pathology. Full article

Background: Fractured ribs remain a significant cause of morbidity and are associated with severe injuries requiring several healthcare resources and may be associated with prolonged hospital stays that may require an ICU facility. In our facility, we have a high burden of patients sustaining rib fractures, and we aim to compare management options, outcomes, and factors associated with mortality from a single center. Methods: A retrospective review was performed on patients who presented with rib fractures at a Level 1 Trauma facility in Johannesburg, undergoing medical or surgical management. The study included data from 1 July 2011 until 31 December 2020. All patients were identified using the Medibank database. STATA Version 18 software was used for all data analysis. A p-value of <0.05 was considered statistically significant. Injuries were subdivided according to the Abbreviated Injury Severity score as follows, Mild = AIS Grade I–II, Moderate = AIS Grade III, Severe AIS Grade IV–V. Results: There was a total of 940 patients. The median age was 45 (IQR: 34–55) years, with 22% female patients in a cohort of 940. The mechanism of injury was blunt in 96%. Most patients (93%) fractured 3/> ribs. Only 4.6% sustained a flail chest. The median SBP was 126 mmHg (IQR:109–144), and the pulse rate was 91 (IQR: 79–108) beats per minute. The mean Injury Severity Score (ISS) and New Injury Severity Score (NISS) were 17 (IQR: 10–29) and 22 (IQR: 14–34), respectively. The most common associated injuries were chest trauma in 42%, combined abdominal and pelvic trauma in 35%, and severe extremity trauma in 37%. The mortality rate was 17% (159/940). Most patients required medical and supportive management, with only 8% undergoing rib plating (76/940). The mean length of stay was 14 days (IQR: 6–25). Statistically significant factors associated with mortality were rib fractures 3≥, flail chest, higher ISS, severe head, neck, chest, abdomen and pelvis injuries (p-value 0.001) and severe extremity injury (p-value 0.006). Conclusions: Rib fractures remain a common pathology in the trauma population, and these patients can have significant associated injuries. With an appropriate multidisciplinary approach, our study found an 83% survival rate, and only 8% of patients requiring surgical intervention. Poor outcomes in patients are directly linked to the number of ribs involved, the injury severity score, associated injuries, and advanced age. Full article

This review paper explores the role of artificial intelligence (AI)-driven technologies in transforming road transportation systems within smart cities. Adopting a granular approach to the selected research, it examines the extent to which these technologies contribute to creating intelligent road networks, beginning with their integration into the conceptualization and design of road space. Through a comprehensive review of recently published indexed articles, the study addresses key questions regarding AI’s contribution to smart road systems and their ability to adapt during the transition toward sustainable, technology-enabled urban environments. Additionally, it investigates the boundaries between relevant disciplines, areas of overlap and integration, and the benefits of interdisciplinary dialogue in developing effective AI-driven approaches for the design, implementation, and management of smart urban road systems. The findings aim to guide future research, policymaking, and practical applications, ultimately enhancing urban mobility, quality of life, and user experience within smart city contexts. The scope of this research encompasses a wide range of stakeholders involved in transportation and related fields, fostering a multidisciplinary perspective on sustainable urban mobility. Full article

Background: Chronic skin ulcers are characterized by an impaired and delayed wound healing process, posing a major economic and healthcare burden. These multifactorial conditions are influenced by both biological, clinical and psychosocial factors. The aim of our cross-sectional study was to investigate the influence of psychosocial and lifestyle factors—specifically adherence to the Mediterranean diet, emotional health, sleep quality and demographic characteristics—on physical symptoms and clinical severity in patients with skin ulcers, using a multidisciplinary approach to identify key predictors of disease burden. Methods: A cross-sectional analysis was conducted on patients with skin ulcers, using data from a monocentric pathology registry. Collected variables included gender, age, dietary habits (specifically, adherence to the Mediterranean diet), sleep disturbances, educational level, anxiety and depressive symptoms, Physician Global Assessment (PGA), Patient Global Assessment (PtGA), and Skindex-17 (a dermatology-specific quality of life measure). Hierarchic multivariate linear regression models were applied to identify predictors of physical symptoms and clinical severity, while simultaneously controlling for potential confounders. Results: Older age, poorer adherence to the Mediterranean diet, and elevated anxiety levels emerged as the strongest predictors of worse physical symptoms, as measured by the Skindex-17. Male sex and more severe depressive symptoms were significantly associated with higher PGA scores. Our data also suggest older age and poorer Mediterranean diet adherence to influence clinical severity. Lastly, sleep disturbances were also found to correlate with patient-reported severity. Conclusions: Our study underscores the impact of psychosocial and behavioral/lifestyle factors on the clinical burden of skin ulcers through a comprehensive multidisciplinary approach. In particular, our data indicate that dietary patterns and emotional health appear to shape both symptom perception and clinical evaluation, emphasizing the need for holistic management strategies. Full article