Search Results (3,096)

This study examines non-standard comparative and superlative adjective forms in Ukrainian and English, emphasizing their evaluative meanings and grammatical deviations. While prescriptive grammar dictates conventional comparison patterns, modern discourse—particularly in advertising, informal communication, and literary texts—exhibits an increasing prevalence of innovative comparative structures. Using a corpus-based approach, this research identifies patterns of positive and negative evaluative meanings, revealing that positive evaluations dominate non-standard comparatives in both languages, particularly in advertising (English: 78.5%, Ukrainian: 80.2%). However, English exhibits a higher tolerance for grammatical flexibility, while Ukrainian maintains a more restricted use, primarily in commercial and expressive discourse. The findings highlight the pragmatic and evaluative functions of such constructions, including hyperbolic emphasis, rhetorical contrast, and branding strategies. These insights contribute to research on comparative grammar, sentiment analysis, and natural language processing, particularly in modeling evaluative structures in computational linguistics. Full article

Measuring antimicrobial use (AMU) in animal production can provide useful data for monitoring AMU over time, which will promote antimicrobial resistance (AMR) reduction. This study involved the daily collation and validation of active primary drug sales and prescription data from veterinary outlets and clinics of the Kaduna metropolis. In total, 83.7% of the identified antimicrobials were in the form of oral medication, and most were registered antibiotics (52.8%). Parenteral and topical forms were also identified, with 94% also being antibiotics. The estimated AMU was 282 mg/kg population correction unit (PCU). Poultry represented the most significant population, constituting 99% (31,502,004) of the study population. The class-specific AMU was antibiotics, with 274 mg/kg PCU. The antiprotozoal AMU was 418 mg/kg PCU. The anthelminthic AMU was the highest at 576 mg/kg PCU. This study has provided useful and practical information on the trends in antimicrobial use in animals, with poultry being the most important animal population involved in AMU and oxytetracycline being the most abused antibiotic in animal production. Antimicrobial stewardship (AMS) should be targeted at poultry populations, with an emphasis on reducing antibiotic use/consumption. Full article

This study investigates the critical capabilities and integration mechanisms that enable organizations to achieve substantive sustainability transformations. Using a mixed-methods approach combining survey data (n = 234), in-depth interviews (n = 42), and comparative case studies (n = 6), the research identifies how organizations effectively navigate sustainability paradoxes while developing integration practices that embed sustainability throughout organizational systems. Our research is primarily grounded in paradox theory, complemented by insights from organizational learning theory, institutional logics, and power dynamics perspectives to develop a comprehensive theoretical framework. Statistical analysis reveals strong relationships between paradox navigation capabilities and transformation outcomes (β = 0.31, p < 0.01), with integration practices emerging as the strongest predictor of sustainability success (β = 0.42, p < 0.01). Qualitative findings illuminate four essential integration mechanisms—governance integration, strategic integration, operational integration, and performance integration—and their temporal development. The significant interaction between power mobilization and integration practices (β = 0.19, p < 0.01) demonstrates that structural interventions are insufficient without attention to power relationships. The research contributes to sustainability science by advancing theory on paradoxical tensions in transformation processes, demonstrating how organizations can transcend the gap between sustainability rhetoric and substantive action through both structural integration and power-conscious approaches. By identifying contextual contingencies across sectors and organizational types, the study challenges universal prescriptions for sustainability transformation, offering instead a nuanced framework for creating organizational conditions conducive to context-specific transformation toward more sustainable futures. Our findings offer practical guidance for organizations navigating the complex landscape of sustainability transformation and contribute to the implementation of UN Sustainable Development Goals, particularly SDG 12 (Responsible Consumption and Production) and SDG 17 (Partnerships for the Goals). Full article

Background/Objectives: Antibiotic prophylaxis is a key component of infection prevention strategies. This study aimed to evaluate whether the duration of antibiotic prophylaxis influences the incidence of HAIs in patients undergoing elective colorectal surgery. Methods: This prospective cohort study included 278 adult patients who underwent elective colorectal surgery at a single tertiary care center. Patients were categorized into two groups based on the duration of antibiotic prophylaxis: one day or more than one day. Data on demographics, clinical characteristics, perioperative variables, and infection outcomes were collected. Results: The overall incidence of HAIs was 16.9%, with no significant difference between patients receiving one-day versus extended antibiotic prophylaxis. However, traditional multivariate analysis showed that prophylaxis lasting more than one day was independently associated with a significantly lower risk of HAI (RR = 0.30, 95% CI: 0.12–0.75, p = 0.010) and surgical site infections (RR = 0.24, 95% CI: 0.08–0.72, p = 0.011). After adjusting for confounders using propensity score matching, this association was no longer statistically significant. No significant association was found between prophylaxis duration and urinary tract infections. Regarding antibiotic selection, first-generation cephalosporins were the most commonly used agents, accounting for 78.8% of prophylactic prescriptions. This was followed by fluoroquinolones (14.4%) and third-generation cephalosporins (5.0%). All patients received metronidazole, a nitroimidazole-class antimicrobial, in combination with the above agents. Conclusions: One day of prophylactic antibiotics may be sufficient in SSI prevention in patients undergoing elective colorectal surgery. The use of extended antibiotic prophylaxis beyond one day should be considered for high-risk patients at high risk of infection, particularly those requiring ICU care. Full article

This study investigates the effectiveness of passive design in low-rise residential buildings located in arid desert climates, using the Dubai Solar Decathlon Middle East (SDME) competition as a case study. This full-scale experiment offers a unique opportunity to evaluate design solutions under controlled, realistic conditions; prescriptive, modeled performance; and monitored performance assessments. The prescriptive assessment reviews geometry, orientation, envelope thermal properties, and shading. Most houses adopt compact forms, with envelope-to-volume and envelope-to-floor area ratios averaging 1 and 3.7, respectively, and window-to-wall ratios of approximately 17%, favoring north-facing openings to optimize daylight while reducing heat gain. Shading is strategically applied, horizontal on south façades and vertical on east and west. The thermal properties significantly exceed the local code requirements, with wall performance up to 80% better than that mandated. The modeled assessment uses Building Energy Models (BEMs) to simulate the impact of prescriptive measures on energy performance. Three variations are applied: assigning minimum local code requirements to all the houses to isolate the geometry (baseline); removing shading; and applying actual envelope properties. Geometry alone accounts for up to 60% of the variation in cooling intensity; shading reduces loads by 6.5%, and enhanced envelopes lower demand by 14%. The monitored assessment uses contest-period data. Indoor temperatures remain stable (22–25 °C) despite outdoor fluctuations. Energy use confirms that houses with good designs and airtightness have lower cooling loads. Airtightness varies widely (avg. 14.5 m³/h/m²), with some well-designed houses underperforming due to construction flaws. These findings highlight the critical role of passive design as the first layer for improving the energy performance of the built environment and advancing toward net-zero targets, specifically in arid desert climates. Full article

Background: Statins exhibit pleiotropic anti-inflammatory, antioxidant, and immunomodulatory effects, suggesting their potential in non-cardiovascular conditions. However, evidence supporting their repurposing remains limited, and off-label prescribing policies vary globally. Objective: To systematically review evidence on statin repurposing in oncology and infectious diseases, and to assess Hungarian regulatory practices regarding off-label statin use. Methods: A systematic literature search (PubMed, Web of Science, Scopus, ScienceDirect; 2010–May 2025) was conducted using the terms “drug repositioning” OR “off-label prescription” AND “statin” NOT “cardiovascular,” following PRISMA guidelines. Hungarian off-label usage data from the NNGYK (2008–2025) were also analyzed. Results: Out of 205 publications, 12 met the inclusion criteria—75% were oncology-focused, and 25% focused on infectious diseases. Most were preclinical (58%); only 25% offered strong clinical evidence. Applications included hematologic malignancies, solid tumors, Cryptococcus neoformans, SARS-CoV-2, and dengue virus. Mechanisms involved mevalonate pathway inhibition and modulation of host immune responses. Hungarian data revealed five approved off-label statin uses—three dermatologic and two pediatric metabolic—supported by the literature and requiring post-treatment reporting. Conclusions: While preclinical findings are promising, clinical validation of off-label statin use remains limited. Statins should be continued in cancer patients with cardiovascular indications, but initiation for other purposes should be trial-based. Future directions include biomarker-based personalization, regulatory harmonization, and cost-effectiveness studies. Full article

Background: Pain is a complex phenomenon characterized by unpleasant experiences with profound heterogeneity influenced by biological, psychological, and social factors. According to the National Health Interview Survey, 50.2 million U.S. adults (20.5%) experience pain on most days, with the annual cost of prescription medication for pain reaching approximately USD 17.8 billion. Theranostic pain nanomedicine therefore emerges as an attractive analgesic strategy with the potential for increased efficacy, reduced side-effects, and treatment personalization. Theranostic nanomedicine combines drug delivery and diagnostic features, allowing for real-time monitoring of analgesic efficacy in vivo using molecular imaging. However, clinical translation of these nanomedicines are challenging due to complex manufacturing methodologies, lack of standardized quality control, and potentially high costs. Quality by Design (QbD) can navigate these challenges and lead to the development of an optimal pain nanomedicine. Our lab previously reported a macrophage-targeted perfluorocarbon nanoemulsion (PFC NE) that demonstrated analgesic efficacy across multiple rodent pain models in both sexes. Here, we report PFC-free, biphasic nanoemulsions formulated with a biocompatible and non-immunogenic plant-based coconut oil loaded with a COX-2 inhibitor and a clinical-grade, indocyanine green (ICG) near-infrared fluorescent (NIRF) dye for parenteral theranostic analgesic nanomedicine. Methods: Critical process parameters and material attributes were identified through the FMECA (Failure, Modes, Effects, and Criticality Analysis) method and optimized using a 3 × 2 full-factorial design of experiments. We investigated the impact of the oil-to-surfactant ratio (w/w) with three different surfactant systems on the colloidal properties of NE. Small-scale (100 mL) batches were manufactured using sonication and microfluidization, and the final formulation was scaled up to 500 mL with microfluidization. The colloidal stability of NE was assessed using dynamic light scattering (DLS) and drug quantification was conducted through reverse-phase HPLC. An in vitro drug release study was conducted using the dialysis bag method, accompanied by HPLC quantification. The formulation was further evaluated for cell viability, cellular uptake, and COX-2 inhibition in the RAW 264.7 macrophage cell line. Results: Nanoemulsion droplet size increased with a higher oil-to-surfactant ratio (w/w) but was no significant impact by the type of surfactant system used. Thermal cycling and serum stability studies confirmed NE colloidal stability upon exposure to high and low temperatures and biological fluids. We also demonstrated the necessity of a solubilizer for long-term fluorescence stability of ICG. The nanoemulsion showed no cellular toxicity and effectively inhibited PGE2 in activated macrophages. Conclusions: To our knowledge, this is the first instance of a celecoxib-loaded theranostic platform developed using a plant-derived hydrocarbon oil, applying the QbD approach that demonstrated COX-2 inhibition. Full article

This study investigates the relationship between the compressive strength of two-course masonry specimens and three-course masonry specimens extracted from previously constructed walls, to correlate the execution control specimens with the retest specimens. Compressive strength tests were performed on clay masonry units, laboratory-built two-course masonry specimens, and three-course masonry specimens extracted from constructed walls, following the prescriptions of NBR 15270 and NBR 16868-3. The results demonstrate that three-course masonry specimens exhibit lower compressive strength (characteristic and average, 44.83% and 40.29%, respectively) compared to two-course masonry specimens. Additionally, it was found that the dispersion of results is greater in three-course masonry specimens. Given that three-course specimens are typically used when it becomes necessary to verify the structural compliance of executed masonry—usually following unsatisfactory results from execution control using two-course specimens—more data are needed to compare such results. Factors such as increased height-to-thickness ratio, the presence of head joints, and the influence of execution conditions at the construction site seem to influence the difference between two and three-course specimens, as well as the dispersion of the results. Therefore, it is essential that technical standards provide supporting criteria to enable a reliable comparison between two-course specimens used for execution control and three-course specimens used as retest elements. Full article

Context: Many patients at the end of life receive antibiotics to alleviate symptoms and improve quality of life; however, clear guidelines supporting decision making about the use of antibiotics are still lacking. Objectives: This study aimed to evaluate the benefits and harms of antibiotic use among patients under a palliative care community support team in Portugal. Methods: An observational, cross-sectional, retrospective study was conducted on 249 patients who died over a two-year period, having been followed for at least 30 days prior to their death. Data included patient demographics, clinical diagnoses, antibiotic prescriptions, and symptomatic outcomes. The effects of commonly prescribed antibiotics—amoxicillin + clavulanic acid, cefixime, ciprofloxacin, and levofloxacin—were compared using statistical analyses to assess survival, symptom intensity, and functional scales. Results: Adverse events, primarily infections and secretions, occurred in 57.8% of cases, with 33.7% receiving antibiotics. No significant difference in survival was observed across the antibiotic groups (p = 0.990). Symptom intensity significantly reduced after 72 h of treatment (p < 0.05), with ciprofloxacin demonstrating the greatest symptom control. The Palliative Outcome Scale decreased uniformly, with higher scores associated with amoxicillin + clavulanic acid (p = 0.004). The Palliative Performance Scale declined post-treatment, with significant changes noted for cefixime and ciprofloxacin (p < 0.05). Conclusions: Antibiotics may improve symptom control and quality of life in the end-of-life stage. While second-line antibiotics may offer additional benefits, the heterogeneity of the sample and limited adverse effect data underscore the need for further research to guide appropriate prescription practices in palliative care. Full article

In today’s dynamic and highly uncertain environment, organizations, particularly in the aviation sector, face increasing challenges that demand resilient, flexible, and data-driven change management decisions. Responding to the growing need for structured approaches to managing complex uncertainties—geopolitical tensions, economic volatility, social shifts, rapid technological advancements, environmental pressures and regulatory changes—this research proposes a theoretical change management model for aviation service providers, such as airports. Integrating three analytical approaches, the model offers a robust, multi-method approach for supporting sustainable transformation under uncertainty. Normative analysis using Bayesian decision theory identifies influential external environmental factors, capturing probabilistic relationships, and revealing causal links under uncertainty. Prescriptive planning through scenario theory explores alternative future pathways and helps to identify possible predictions, offer descriptive evaluation employing fuzzy comprehensive evaluation, and assess decision quality under vagueness and complexity. The proposed four-stage model—observation, analysis, evaluation, and response—offers a methodology for continuous external environment monitoring, scenario development, and data-driven, proactive change management decision-making, including the impact assessment of change and development. The proposed model contributes to the theoretical advancement of the change management research area under uncertainty and offers practical guidance for aviation organizations (airports) facing a volatile external environment. This framework strengthens aviation organizations’ ability to anticipate, evaluate, and adapt to multifaceted external changes, supporting operational flexibility and adaptability and contributing to the sustainable development of aviation services. Supporting aviation organizations with tools to proactively manage systemic uncertainty, this research directly supports the integration of sustainability principles, such as resilience and adaptability, for long-term value creation through change management decision-making. Full article

Background/Objectives: Antibiotic use is common among hospitalized pediatric patients. However, inappropriate use, including excessive use of Watch antibiotics, can contribute to antimicrobial resistance, adverse events, and increased healthcare costs. Consequently, there is a need to continually assess their usage among this vulnerable population. This was the objective behind this study. Methods: The medical records of all pediatric patients (under 12 years) admitted and treated with antibiotics at a Ghanaian Teaching Hospital between January 2022 and March 2022 were extracted from the hospital’s electronic database. The prevalence and appropriateness of antibiotic use were based on antibiotic choices compared with current guidelines. Influencing factors were also assessed. Results: Of the 410 admitted patients, 319 (77.80%) received at least one antibiotic. The majority (68.65%; n = 219/319) were between 0 and 2 years, and males (54.55%; n = 174/319). Ceftriaxone was the most commonly prescribed antibiotic (20.69%; n = 66/319), and most of the systemic antibiotics used belonged to the WHO Access and Watch groups, including a combination of Access and Watch groups (42.90%; n = 136/319). Neonatal sepsis (24.14%; n = 77/319) and pneumonia (14.42%; n = 46/319) were the most common diagnoses treated with antibiotics. Antibiotic appropriateness was 42.32% (n = 135/319). Multivariate analysis revealed ceftriaxone prescriptions (aOR = 0.12; CI = 0.02–0.95; p-value = 0.044) and surgical prophylaxis (aOR = 0.07; CI = 0.01–0.42; p-value = 0.004) were associated with reduced antibiotic appropriateness, while a pneumonia diagnosis appreciably increased this (aOR = 15.38; CI = 3.30–71.62; p-value < 0.001). Conclusions: There was high and suboptimal usage of antibiotics among hospitalized pediatric patients in this leading hospital. Antibiotic appropriateness was influenced by antibiotic type, diagnosis, and surgical prophylaxis. Targeted interventions, including education, are needed to improve antibiotic utilization in this setting in Ghana and, subsequently, in ambulatory care. Full article

Though previous studies have demonstrated the protective benefits of sports participation against illicit drug use for a general population, how these findings apply to LGBTQ youth remains unknown. This study specifically looks at the relationship between sports participation and prescription drug misuse among sexual and gender minority youth. Using secondary data from the 2019 YRBS, we analyze associations among sports participation, sexual orientation, gender identity, and prescription drug misuse among a representative sample of U.S. high school students in Florida. Our results show that sexual and gender minority youth are at increased risk for prescription drug misuse compared to their heterosexual and cisgender peers. Moreover, sports participation is associated with higher rates of prescription drug misuse among all students, and the nuances of these trends are discussed with particular attention paid to sexual and gender minority youth. These results challenge conventional wisdom about sports participation. Without the addition of new demographic survey questions and LGBTQ youth participation in the YRBS, common myths about sports might have persisted. Our findings point to the meaningful presence of LGBTQ youth in sports, call for research and programming on LGBTQ athletes’ unique needs regarding substance misuse risk, and encourage LGBTQ-inclusive policies and practices within schools and sports programs in particular. Full article

Background: Chemotherapy-induced peripheral neuropathy is a common and debilitating side effect of cancer treatment. While exercise has shown promise in alleviating this burden, it remains underutilised in clinical practice due to the lack of accessible, clinician-friendly guidance. Aim: This review aimed to synthesise current evidence on exercise interventions for managing chemotherapy-induced peripheral neuropathy and provide practical insights to support clinicians in integrating these approaches into patient care. Methods: A search was conducted across MEDLINE, CINAHL, and SPORTDiscus using keywords related to exercise and CIPN. Studies were included if they involved adults receiving neurotoxic chemotherapy and exercise-based interventions. Two authors independently screened studies and resolved conflicts with a third author. Study quality was assessed using the JBI Critical Appraisal Tools, and only studies meeting a minimum quality standard were included. A balanced sampling approach was employed. Data on study design, participant characteristics, interventions, and outcomes were extracted. Results: Eleven studies were included, covering various exercise modalities: multimodal (n = 5), yoga (n = 2), aerobic (n = 1), resistance (n = 1), balance (n = 1), and sensorimotor (n = 1). Exercise interventions, particularly multimodal exercise, significantly improved symptom severity, functionality, and quality of life (p < 0.05). The studies had high methodological quality, with randomised controlled trials scoring between 9/13 and 11/13, and quasi-experimental studies scoring 8/9 on JBI tools. Conclusions: This review highlights the significant benefits of exercise, especially multimodal exercise, for managing CIPN and provides guidance for integrating these strategies into clinical practice. Future research is needed to refine exercise prescriptions and develop standardised guidelines. Full article

Hemorrhoidal disease remains a prevalent yet often overlooked condition, affecting millions worldwide and imposing a substantial healthcare burden. Despite the availability of multiple treatment options, gaps persist in patient education, early symptom recognition, and optimal treatment selection. Recent advancements are evolving the pharmacist’s role in hemorrhoid management beyond traditional over-the-counter (OTC) and prescription approaches. The 2024 American Society of Colon and Rectal Surgeons (ASCRS) guidelines introduce updates on the use of phlebotonics, a class of venoactive drugs gaining recognition for their role in symptom management, yet largely underutilized in U.S. clinical practice. In parallel, novel clinical tools are reshaping how pharmacists engage in assessment and care. The integration of digital decision-support platforms and structured evaluation algorithms now empowers them to systematically evaluate symptoms, identify red flag signs, and optimize patient triage. These tools reduce diagnostic variability and improve decision-making accuracy. Given their accessibility and trusted role in frontline healthcare, pharmacists are well-positioned to bridge these critical gaps by adopting emerging treatment recommendations, leveraging algorithm-driven assessments, and reinforcing best practices in patient education and referral. This narrative review aims to equip pharmacists with updated insights into evidence-based hemorrhoid management strategies and provide them with structured assessment algorithms to standardize symptom evaluation and treatment pathways. By integrating these innovations, pharmacists can enhance treatment outcomes, promote patient safety, and contribute to improved quality of life (QoL) for individuals suffering from hemorrhoidal disease. Full article

Background/Objectives: Early experiences can significantly influence brain development, particularly when they occur during specific time windows known as sensitive or critical periods. Therefore, the early promotion of neurodevelopmental functions is crucial in children at risk for neurodevelopmental disabilities, such as those with cerebral palsy. This article introduces AMIRA (A Multidimensional and Integrated Rehabilitation Approach), a rehabilitative framework designed for infants at risk of neurodevelopmental disabilities. Methods: AMIRA is intended to guide clinical–rehabilitation reasoning rather than prescribe a rigid sequence of predetermined activities for the child. The theoretical foundation and structure of AMIRA are presented by formalizing its criteria, objectives, tools, and intervention procedures. The framework comprises four distinct sections, each supported by adaptive strategies to facilitate access to materials and to promote play-based interactions among the child, their environment, and communication partners. Particular attention is given to optimizing both micro- and macro-environments for children with, or at risk of, co-occurring visual impairment. Each rehabilitative section includes three progressive phases: an initial observation phase, a facilitation phase to support the child’s engagement, and an active experimentation phase that gradually introduces more challenging tasks. Results: The intervention pathways in AMIRA are organized according to six core developmental domains: behavioral–emotional self-regulation, visual function, postural–motor skills, praxis, interaction and communication, and cognitive function. These are outlined in structured charts that serve as flexible guidelines rather than prescriptive protocols. Each chart presents activities of increasing complexity aligned with typical developmental milestones up to 24 months of age. For each specific ability, the corresponding habilitation goals, contextual recommendations (including environmental setup, objects, and tools), and suggested activities are provided. Conclusions: This study presents a detailed intervention approach, offering both a practical framework and a structured set of activities for use in rehabilitative settings. Further studies will explore the efficacy of the proposed standardized approach. Full article