Search Results (25)

Background: Influenza poses a significant health threat to children under nine, who are at high risk of severe complications. Influenza vaccination is a key prevention strategy, but pediatric trials use heterogeneous safety and immunogenicity outcomes, follow-up windows, and dosing strata that hinder meaningful cross-trial comparison. Objective: To map how safety and immunogenicity outcomes are defined, collected, stratified, and reported across clinical trials of seasonal influenza vaccines in healthy children aged 6 months to 8 years, and to identify reporting patterns and gaps that limit cross-trial comparability. Methods: Studies were identified through a structured PubMed/MEDLINE search first conducted 20 April 2025 and last conducted June 2025, following JBI and PRISMA 2020 guidelines. We included clinical trials reporting at least one safety outcome in healthy children 6 months to 8 years old. Heterogeneity in outcome definitions, follow-up windows, and dose strata precluded meta-analysis; we conducted a narrative and per-study synthesis. Risk of bias was evaluated with RoB 2 for randomized trials and ROBINS-I (V2) for non-randomized studies following Cochrane guidance. Descriptive and visual syntheses were utilized. Results: Of 293 records, 20 studies comprising approximately [n = 12,267] pediatric participants met the inclusion criteria. All included studies evaluated inactivated, egg-based seasonal influenza intramuscular vaccines. Reporting windows and dose handling varied widely. Vaccine-related serious adverse events (SAEs) were rare (only four events, with reported SAEs happening in children 6–35 months old immunized with quadrivalent formulations; all SAEs resolved and did not result in participant withdrawal from the study). No SAEs were reported in children 3–8 years old. Immunogenicity outcomes are presented as reported by each trial, with baseline and post-vaccination sampling days reproduced; no cross-trial synthesis was performed. Conclusions: Seasonal, inactivated intramuscular influenza vaccines show a favorable safety and immunogenicity profile in healthy children 6 months to 8 years old. However, heterogeneous outcome definitions, variable safety follow-up windows, limited dose- and priming-specific reporting, and inconsistent immunogenicity schedules substantially constrain cross-trial comparability. Funding and Registration: Primary funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant HD109732). This review was registered in PROSPERO (registration number: CRD420251237499). Full article

Environmental education (EE) is central to achieving the Sustainable Development Goals (SDGs), particularly where inequalities constrain access to quality learning. Following PRISMA 2020, this review synthesizes 35 peer-reviewed studies and policy documents to examine Morocco’s EE policies and practices against global frameworks and post-pandemic challenges. A systematic search was conducted in Scopus, Web of Science, ERIC, ProQuest/EBSCO, Google Scholar, and national repositories (January 2000–December 2024; executed 15–17 March 2024). Findings show strong discursive alignment with SDG 4.7 and UNESCO’s ESD 2030 Roadmap but persistent implementation gaps: rural and peri-urban schools face resource shortages; teacher preparation for participatory, interdisciplinary approaches remains limited; and environmental clubs often rely on short-term projects without stable institutional support. The COVID-19 period exacerbated these pressures yet opened opportunities to integrate health–environment linkages, digital tools, and adaptive pedagogy. Equity reporting was limited (31% gender; 37% residence; 9% socio-economic status). Arabic-only records were identified (n = 42) and title/abstract-screened (n = 17) but excluded due to translation constraints (language bias). To advance transformative EE, we recommend prioritizing participatory, place-based teacher education; institutionalizing school clubs with light monitoring and baseline grants; targeting support to reduce territorial inequities; and developing an SDG-aligned national dashboard. Expanding longitudinal, quasi-experimental, and participatory designs is critical to strengthen causal claims and inform policy. Full article

Background/Objectives: Intense physical exercise leads to oxidative stress, causing cellular and DNA damage in athletes. Melatonin (MLT), a hormone with antioxidant and anti-inflammatory properties, is increasingly used to counteract these effects. However, its specific role in protecting DNA integrity and modulating repair mechanisms post-exercise remains unclear. This systematic review aimed to synthesize clinical evidence on the effects of exogenous MLT supplementation in reducing exercise-induced oxidative stress, reducing DNA damage, and influencing DNA integrity in healthy, physically active individuals. Methods: A comprehensive search was conducted in PubMed and Scopus up to 25 March 2025, for randomized or controlled clinical trials assessing exogenous MLT in healthy, physically active adults, with outcomes related to oxidative stress, DNA damage, or DNA repair. Risk of bias was evaluated using the RoB2 tool. Due to heterogeneity in study designs and outcomes, results were synthesized narratively. Results: Six clinical trials met the inclusion criteria, with MLT administered as a single dose (6–10 mg) or in repeated doses over 6 days to 4 weeks. Across the studies, MLT consistently reduced oxidative stress markers (malondialdehyde, advanced oxidation protein products), muscle damage indicators (creatine kinase, LDH), and inflammation, while increasing antioxidant enzyme activity (SOD, GPx). Only one study directly assessed DNA damage, reporting significantly reduced DNA fragmentation (comet assay) in the MLT group compared to placebo. No studies directly evaluated DNA repair pathways. Conclusions: Exogenous MLT supplementation appears effective in attenuating exercise-induced oxidative stress and may reduce DNA damage in athletes. While findings support its antioxidant and cytoprotective roles, further rigorous trials are needed to clarify its direct effects on DNA repair mechanisms in sports medicine. Funding: This review received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Registration: This review was prospectively registered in the PROSPERO database (CRD420231039805). Full article

Purpose: An innovative eyedrop formulation based on a combination of 0.2% hyaluronic acid and 0.001% hydrocortisone sodium phosphate (Idroflog^®, Alfa Intes, Italy; HAC eyedrops) was granted a European Patent in 2016 and has been available on the market since 2019 in Europe and in other countries around the world. HAC eyedrops aim to synergize the moisturizing effects of hyaluronic acid with the mild anti-inflammatory properties of low-dose hydrocortisone, offering a more effective and safer alternative for treating dry eye disease (DED), targeting both tear film instability and dysfunctional para-inflammation. The activity of HAC eyedrops has been explored in different post-marketing clinical trials, in addition to preclinical studies. In this narrative review, we explored the available evidence on the use of HAC eyedrops for the management of para-inflammation in DED patients to provide a comprehensive overview of efficacy and safety data related to the use of this medical device in routine clinical practice. Methods: A literature search for preclinical and clinical data involving treatment with HAC eyedrops was conducted using PubMed/MEDLINE, considering only original research articles published in English, without time restrictions. Results: One preclinical and four clinical papers were retrieved. Preclinical evidence suggests that 0.001% hydrocortisone is able to control the expression of inflammatory markers, and this, together with the hydrating and lubricating properties of hyaluronic acid, leads to improvements in DED clinical signs, such as tear volume and the stability of the tear film. The results of clinical trials demonstrate that HAC eyedrops are able to improve the signs and symptoms of DED and that 0.001% low-dosage hydrocortisone can be helpful in preventing the progression to chronic stages of DED. Conclusions: HAC eyedrops represent a promising therapeutic strategy for the management of dysfunctional para-inflammation and offer a valuable addition to the armamentarium of treatments for DED. Full article

In 2025, the English government will commence the roll out of a transformative new funding system for post-18 learners entitled the ‘Lifelong Learning Entitlement’ (LLE). This will be a single funding system for both higher and further education, which the government argues, will enable learners to pay for courses to develop new skills and gain new qualifications at a time that is right for them through full-time degree programmes, flexibly through part-time study, or by undertaking individual modules as and when they are needed. The focus is on training, retraining and upskilling at levels four to six (i.e., the first three years of a degree programme) and on high-value technical courses at levels four and five. Essentially, the LLE is a lifelong entitlement to access a loan fund to support higher level/higher education studies up to age 60. Some targeted maintenance grant funding will be provided to some students who require it to age 60 and beyond. The authors will provide a critical review of the LLE from a lifelong learning perspective. They will explore the complex multifaceted discourse embedded in LLE intentions, as presented in policy statements, some of which appear to be at odds with the claims made about the role of LLE, and identify the ways that it will need to be shaped to achieve the benefits sought by government. Using the critical themes underpinning this special edition of the journal, they will consider the role that education provided through the LLE ‘transformative agenda’ can play in enabling access by adult learners of all types and for multiple reasons. They will consider the interplay between these and neo-liberal values relating to the role of higher education in employment, training and skills-focused priorities. They will also reflect on the role that the HE sector will inevitably need to play in shaping course design and delivery to ensure that the LLE can deliver both the government’s goals and those of lifelong learners, particularly those from disadvantaged communities and backgrounds. Full article

With the rapid rollout and growing adoption of 3GPP 5thGeneration (5G) cellular services, including in critical infrastructure sectors, it is important to review security mechanisms, risks, and potential vulnerabilities within this vital technology. Numerous security capabilities need to work together to ensure and maintain a sufficiently secure 5G environment that places user privacy and security at the forefront. Confidentiality, integrity, and availability are all pillars of a privacy and security framework that define major aspects of 5G operations. They are incorporated and considered in the design of the 5G standard by the 3rd Generation Partnership Project (3GPP) with the goal of providing a highly reliable network operation for all. Through a comprehensive review, we aim to analyze the ever-evolving landscape of 5G, including any potential attack vectors and proposed measures to mitigate or prevent these threats. This paper presents a comprehensive survey of the state-of-the-art research that has been conducted in recent years regarding 5G systems, focusing on the main components in a systematic approach: the Core Network (CN), Radio Access Network (RAN), and User Equipment (UE). Additionally, we investigate the utilization of 5G in time-dependent, ultra-confidential, and private communications built around a Zero Trust approach. In today’s world, where everything is more connected than ever, Zero Trust policies and architectures can be highly valuable in operations containing sensitive data. Realizing a Zero Trust Architecture entails continuous verification of all devices, users, and requests, regardless of their location within the network, and grants permission only to authorized entities. Finally, developments and proposed methods of new 5G and future 6G security approaches, such as Blockchain technology, post-quantum cryptography (PQC), and Artificial Intelligence (AI) schemes, are also discussed to understand better the full landscape of current and future research within this telecommunications domain. Full article

The purpose of this article is to reflect on the sustainability of informal artisanal mining in the Peruvian Andean area until the year 2022. The research is basic and non-experimental in design and ex post facto in scope. The sample consisted of crime prevention statistics on socio-environmental conflict from guardianship institutions and a television program on mining. Our research procedure focused on gathering secondary information for a documentary review analysis based on past proven and disseminated facts. Informal artisanal mining is strengthened in the Peruvian Andean area due to the following influencing factors: support represented as the social license granted by communal assemblies; the flexibility of governmental management in relaxing compliance related to formalization and preventive laws regarding environmental protection; the resistance to formalization and the 50% increase in socio-environmental conflict; and the 25% increase in production costs related agricultural activities, which promotes the displacement towards mining activities. The environmental sustainability consequences are as follows: limited reconversion of agricultural land-use change in one-third of the communal territories at the headwaters of the basin, which generates the displacement of environmentally friendly economic activity, and a parallel positive action is the impossibility of modification or intervention affecting water surfaces and wetlands due to communal agreements that mining companies must respect during operation. Full article

U.S. based post-secondary educational institutions usually have violent origin stories that include land theft, genocide, and the participation in slavery. Schools of social work are no exception. In recent years, colleges and universities, including schools of social work, have started to confront their histories of and participation in racial-settler colonialism. The severance of land as kinship, and land theft, have been a significant part of the harms of racial-settler colonialism. Colleges and universities have benefited from land theft, primarily through land-grants. Still, institutional accountability has been minimal, including limited acknowledgment of harm and modest changes in curriculum and staff. This paper expands the terrain of institutional accountability in social work higher education to consider land-based healing initiatives as a critical remedy for the harms of racial settler colonialism. This paper provides a historical review and decolonial analysis of the connection between social work higher education and land-grant institutions. Building on social cartography literature, a mapping framework for decolonizing higher education is examined in relation to questions of institutional accountability by land-grant universities. This framework is offered in conjunction with contemporary examples of struggles for institutional accountability in and outside of higher education. The paper concludes with future recommendations for research related to institutional accountability and the implications of land-based healing as an approach. Full article

Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukemia (CML), granting patients a life expectancy close to that of the normal population and, in a subset of patients, the possibility to discontinue therapy. Nonetheless, for a not negligible minority of patients, TKIs are not able to control CML. Allogeneic hematopoietic cell transplantation (HCT) has long been a pivotal therapy for CML. At present, allogeneic HCT is considered an option in CML patients diagnosed or progressing to blast phase (BP), for those in chronic phase (CP) resistant to multiple lines of TKI therapy or for those experiencing severe toxicity, mostly hematologic, under TKIs. Moving from real-world cases, we reviewed the results of allogeneic HCT in the setting of advanced-phase CML or failure of TKIs, with a focus on the progresses in transplant technology that has extended transplant options in elderly CML patients and in those lacking a sibling donor, and on the post-HCT strategies for prevention and treatment of disease relapse. Full article

This study examined credit risk management and return on equity of Nigerian deposit money banks (DMBs) twelve (12) years (2010–2021) post-adoption of the common accounting year-end as mandated by the Central Bank of Nigeria (CBN) in 2009. Our data set comprises independent variables of capital adequacy ratio (CAR), liquidity ratio (LQR), loan-to-deposit ratio (LDR), risk asset ratio (RAR), non-performing loans ratio (NPLR), loan loss provision ratio (LLP), and size (SZ). Our dependent variable is the return on equity (ROE). Using a panel data regression analysis, we found that CAR, RAR, NPLR, and SZ are the significant determinants of ROE. We also found that Nigerian DMBs now significantly rely on offshore borrowings in Eurobonds to create risk assets to overcome CBN’s constriction on using local depositors’ funds to create risk assets. Furthermore, we found that shareholders of DMBs with international banking licenses in Nigeria within the study period were not significantly more compensated for their risk exposure than investors in risk-free assets (treasury bills). Therefore, the CBN should continue strengthening its regulatory functions with regular reviews that would compel improvements of the DMBs’ credit risk management systems to mitigate the likely failure of the credit life cycle of granted loans. Additionally, a review of its current regulatory cash reserve ratio of 37.5% is imperative to reduce DMBs’ dependence on offshore funding and its associated foreign exchange risk. Full article

The prevalence of Sickle Cell Disease (SCD) within the Caribbean region remains second only to that of West Africa. The Newborn Screening (NBS) Program in Antigua and Barbuda remains heavily dependent on grants, therefore ultimately facing sustainability challenges. Early intervention and implementation of preventative measures post-NBS result in significant improvements in morbidity, quality of life, and survival. This audit reviewed the pilot SCD NBS Program in Antigua and Barbuda from September 2020 to December 2021. A conclusive result was received by 99% of babies eligible for screening, 84.3% of which were HbFA, whilst 9.6% and 4.6% were HbFAS and HbFAC, respectively. This was comparable to other Caribbean countries. Sickle Cell Disease was noted in 0.5% of babies screened, which translates to 1 in 222 live births. Eighty-two percent of mothers were aware of their sickle cell status, compared to 3% of fathers. The importance of instituting a quality improvement team post the initiation of a screening program and the need for a robust public education program have been demonstrated by this audit. Full article

Background: Virtual reality used for the treatment of mental health disorders is showing promising potential in clinical practice. Increasing self-compassion and self-protections and decreasing self-criticism have been identified as trans-diagnostic mechanisms helping to build a resilient self. The goal of this systematic review was to provide an overview of research studies about virtual reality while exploring its effectiveness in increasing self-compassion and self-protection and decreasing self-criticism. Methods: On 6 December 2022, titles, abstracts, and, where available, keywords were searched in the following databases: PubMed, Scopus, and Web of Science. The inclusion criteria were: empirical study; quantitative methodology; outcomes measured, including self-compassion and/or self-protection, and/or self-criticism; pre/post and/or control group intervention measures of selected outcomes; participants aged 18 and above; application of virtual reality technology as part of the intervention; full study availability; and English language. Exclusion criteria were: ruminations related only to physical pain; self-protection in the context of physical survival; VR used to increase ruminations. Results: Selection criteria were met by 19 studies (two randomized controlled trials, 16 longitudinal studies, and one case study) with an overall number of 672 participants. Results suggest that VR interventions targeting self-criticism, self-compassion, and self-protection might be effective for non-clinical (self-compassion) as well as clinical (self-criticism and self-protection) samples. Discussion: The present systematic review partially supports the effectiveness of VR interventions on self-criticism, self-protection, and self-compassion. To properly answer the question of its effectiveness, more randomized control trials with larger samples from different populations are needed. The results are also limited by the variability of intervention protocols and the amount of exposure to VR. Other: This work was supported by the Vedecká grantová agentúra VEGA under Grant 1/0075/19. This systematic review has not been pre-registered. Full article

“How would you build a robot, the size of a bacteria, powered by light, that would swim towards the light source, escape from it, or could be controlled by means of different light colors, intensities or polarizations?” This was the question that Professor Diederik Wiersma asked PW on a sunny spring day in 2012, when they first met at LENS—the European Laboratory of Nonlinear Spectroscopy—in Sesto Fiorentino, just outside Florence in northern Italy. It was not just a vague question, as Prof. Wiersma, then the LENS director and leader of one of its research groups, already had an idea (and an ERC grant) about how to actually make such micro-robots, using a class of light-responsive oriented polymers, liquid crystal elastomers (LCEs), combined with the most advanced fabrication technique—two-photon 3D laser photolithography. Indeed, over the next few years, the LCE technology, successfully married with the so-called direct laser writing at LENS, resulted in a 60 micrometer long walker developed in Prof. Wiersma’s group (as, surprisingly, walking at that stage proved to be easier than swimming). After completing his post-doc at LENS, PW returned to his home Faculty of Physics at the University of Warsaw, and started experimenting with LCE, both in micrometer and millimeter scales, in his newly established Photonic Nanostructure Facility. This paper is a review of how the ideas of using light-powered soft actuators in micromechanics and micro-robotics have been evolving in Warsaw over the last decade and what the outcomes have been so far. Full article

PEARLS (Perspectives on Equity Advancement: Research and Learning Symposium) was a student-led, faculty-mentored, year-long initiative culminating in a symposium with three components: (1) “Change Agents”, where faculty leaders presented their research and advances in DEI and the impact on the community; (2) The “15% Better” initiative, which promoted individual commitments to improving DEI in the Frank H. Netter School of Medicine at Quinnipiac University through reflection on a monthly prompt and review of selected educational resources; and (3) “Grand Rounds Pitches’’ where student-designed scholarly DEI initiatives received competitive seed grants alongside a mentorship team that help support their project to completion. The 2022 post-event survey (RR 58%) showed that 100% of respondents felt inspired to engage more deeply in DEI after seeing the faculty’s work, felt committed to at least one action that furthers their learning or promotes DEI broadly, and were better able to describe student-led DEI projects. In total, 94% of respondents felt more connected to faculty and students advancing DEI in the school of medicine community and 91% felt a greater sense of belonging. The 15% Better initiative strengthened the belief that small individual DEI commitments can result in substantial positive changes for 73%, while 27% already believed this. In total, 61% were more likely to engage in DEI efforts this year and 36% already planned to engage. Qualitative data highlighted themes of inspiration, positive impact, and actionable change. PEARLS stands as an easily reproducible way for higher education institutions to engage their community in DEI strategies through its foundational elements of promoting belonging, fostering inspiration, and encouraging commitment to action. Full article

Objective: The primary treatment for sudden hearing loss is high-dose steroid therapy. In some countries, hospitalization has been taken for granted. Although most countries appear to treat sudden hearing loss on an outpatient basis, some other countries have considered hospitalization as necessary. Only a few studies have been conducted on the effect of hospitalization on hearing outcomes. Therefore, we compared the hearing outcome of inpatient- and outpatient-based treatments to determine whether hospitalization affects the recovery of sudden hearing loss. Methods: We conducted a retrospective case review of patients diagnosed with sudden sensorineural hearing loss (SSNHL). In total, 439 patients with SSNHL were enrolled and categorized as either inpatients (group I) or outpatients (group O). Pure-tone audiometry was initially performed before the treatment and 3 months post-treatment. “Recovery” was defined as a hearing gain of 15 dB HL and a final hearing of better than 25 dB. “No recovery” was defined as an improvement of hearing gain of <15 dB 3 months after treatment. To exclude the effect of the level of pretreatment hearing loss, we divided the patients into three subgroups based on their hearing level: <40 dB, 40–70 dB, and >70 dB. To assess the effect of the treatment modality, the patients were divided into three treatment subgroups: systemic steroids (SS), intratympanic steroids (ITS), and a combination of both (SS and ITS). Results: The pretreatment hearing level was significantly higher in group I (61.5 ± 25.4 dB) than in group O (50.3 ± 23.0 dB; p < 0.05). The hearing gain was significantly higher in group I (33.3 ± 24.4 dB) than in group O (24.0 ± 21.8 dB; p < 0.05). The “Recovery” ratio was significantly higher in group I (70.2%) than in group O (63.1%) (p < 0.05). A repeated measures ANOVA was performed to assess the statistical differences between hospitalization, treatment modalities, and pretreatment subgroups. The inpatient group showed a significant hearing improvement in all SSNHL patients (p < 0.05). There was a significant hearing improvement in the inpatient group with pretreatment hearing <40 and 40–70 dB (p < 0.05). There was no significant difference between the inpatient and outpatient groups in pretreatment hearing >70 dB (p > 0.05). Conclusions: This retrospective study showed that inpatient treatment for sudden hearing loss is more beneficial for hearing improvement than outpatient treatment. The positive effect of inpatient treatment appears to be significant in patients with a pretreatment hearing level of 70 dB or less. Full article