Search Results (675)

In women in post-menopause, the presence of severe vasomotor symptoms is associated with sleep disorders and a depressive mood. Vasomotor symptoms, sleep disorders, and a depressive mood are all related to an increased risk of cardiovascular events and bone fractures. The association is still elusive, but some mechanisms may sustain a hypothetical causal relation. During flush, the heart rate increases, augmenting blood turbulence and possibly posing a risk for endothelial damage. Altered sleep is associated with a reduced nocturnal blood pressure decline, which represents a risk factor for cardiovascular disease. Cortisol levels rise during each flush but also following sleep deprivation or in individuals with depression. Increased cortisol was found in women with menopausal symptoms and can induce insulin resistance, metabolic syndrome, cardiovascular disease, and bone demineralization. An elevated oxidative state is associated with vasomotor symptoms, sleep disturbances, and depression and increases the risk of cardiovascular events and osteoporosis. The use of non-hormonal remedies for symptom management leads to a decrease in blood pressure and a reduction of 24 h urinary cortisol, contingent upon the extent of symptom alleviation. Recent evidence indicates that fezolinetant, a neurokinin-3 receptor antagonist and elinzanetant, a neurokinin-1-3 receptor antagonist, diminish the frequency and severity of vasomotor symptoms. As the secondary endpoint of these studies, some amelioration of patients reported that sleep disturbance was observed during fezolinetant and more consistently during elinzanetant. Some improvement in the quality of life and depressive mood were also observed during elinzanetant. The causal relation of symptoms with cortisol levels and oxidative stress, and the reduction in cortisol and blood pressure by symptom improvements, support the possibility that neurokinin antagonists may decrease those factors linking menopausal symptoms with cardiovascular disease and osteoporosis. Dedicated studies are needed to test the hypothetical possibility that neurokinin receptor antagonists contribute to reduce the long-term burden of cardiovascular disease and osteoporosis of symptomatic women in post-menopause unwilling or with contraindication to the use of menopause hormone therapy. Full article

Adverse climate events have recently highlighted an increasing need to deploy sustainable energetic infrastructures. The existing electric conversion circuits for solar energy provide high efficiency; however, gaps in sustainability and robustness can be identified by considering their operation during intense perturbations, potentially occurring for interplanetary energy transfer. Additionally, charging characteristics for energy storage units influence differently the operation life of battery arrays, with increased stability providing favorable operating conditions. Therefore, the present study develops an alternative controller for managing solar energy as well as a prototype for tracking the maximum power point, both constrained by robustness and renewability studies. For the presented design, stability analyses and simulations validated the management of electric energy from solar panels and the developed configuration resulted in improving current peak integral transient characteristics by using an alternative control method, demonstrating stability for an indefinite number of energy storage units. Furthermore, the estimation for VLSI (Very-Large-Scale Integration) of this constrained design has been concluded to potentially provide a solution with adequate performance, comparable to state-of-the-art computational circuits. However, certain limitations could arise when substituting the main computation parts with analyzed solutions and proceeding with integration-based manufacturing. Full article

In recent years, animal welfare scientists working in professionally managed settings have increasingly focused on promoting resilience to enhance the quality of life of individual animals. Resilience—defined as an animal’s capacity to be minimally affected by a disturbance or to rapidly return to the physiological, behavioral, cognitive, health, affective, and production states that pertained before exposure to a disturbance—involves various systems and dynamic processes. There is evidence that resilience can be measured using a suite of species-specific indicators, including both behavioral measures and physiological biomarkers. These indicators should be tracked for individuals of the same species over time and across various conditions, events, and experiences. Large-scale, multi-institutional studies allow welfare scientists to collect cross-sectional data to identify “resilient phenotypes” for the species of interest. Ultimately, the focus should be on improving outcomes for individual animals as they face particular stressors, challenges, and environmental disturbances over their lifetime. Animal care specialists play a crucial role in helping animals build resilience by providing opportunities to engage in cognitive challenges, stimulating environments, and species-appropriate social interactions. This review defines resilience for animal welfare scientists, as well as discusses how to measure and promote resilience in animals residing in zoos and aquariums. Full article

Global temperature increases and more frequent extreme climate events have intensified the challenges faced by oil-based lubricants, including environmental impact and resource depletion. In recent years, glycerol ethoxylate (GE), a non-toxic and low-cost compound, has shown promise as a water-based lubricants capable of replacing conventional oil-based systems. Boric acid (BA) is an effective additive that significantly improves the extreme pressure performance of water-based lubricants. This study demonstrates that adding BA to a GE aqueous solution decreases the friction coefficient by five times and increases extreme pressure by 12.5%. Higher concentrations of BA promote the formation of a lubricating film, enhancing the hydrodynamic pressure effect. The findings provide valuable insights into the formulation and tribological behavior of eco-friendly lubricants, promoting sustainable manufacturing, longer equipment life, and improved reliability. Full article

Acute pulmonary embolism can range from being completely asymptomatic to causing life-threatening events, which underscores the importance of effective risk stratification. Intermediate-risk patients represent a distinct subgroup characterized by specific clinical, laboratory, and imaging features. Although the majority have favorable outcomes, a significant proportion may still experience adverse events, presenting an ongoing challenge in determining the optimal therapeutic approach. This comprehensive review explores the characteristics of intermediate-risk pulmonary embolism patients, focusing on key diagnostic and prognostic factors, current treatment practices, and the evolving role of novel, specifically catheter-directed interventions. We also provide an overview of current guideline recommendations and discuss recent advancements in the field. Full article

Background: During the COVID-19 pandemic, analgesic use increased significantly, primarily due to self-medication for symptom relief. In Brazil, metamizole (dipyrone) is widely used despite international restrictions, highlighting the importance of evaluating its consumption patterns. Objective: To assess analgesic use during the COVID-19 pandemic. Methods: This cross-sectional study was conducted via a household survey in Alegre, Espírito Santo, Brazil. Structured questionnaires were used to collect data on sociodemographic characteristics, clinical conditions, and medication use. Descriptive statistics included frequency distributions, medians, and interquartile ranges. Factors associated with analgesic use were analyzed using Poisson regression with robust variance. Results: Among 694 participants, 31.6% reported using analgesics, with metamizole being the most frequently used (87.2%), followed by acetaminophen (paracetamol) (24.7%). Analgesic use was more common among individuals with polypharmacy, lower self-reported quality of life, better self-perceived health, and recent dental appointments. Conclusions: A high prevalence of analgesic use was identified, particularly of metamizole. Given its over-the-counter availability and growing evidence of risks such as liver injury and other adverse events, ongoing monitoring is essential. These findings underscore the need for public health strategies and pharmacist involvement to promote the rational and safe use of analgesics. Full article

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition leading to declining lung function, dyspnea, and reduced quality of life. Pulmonary rehabilitation (PR) remains a cornerstone in COPD management; however, access remains limited, with less than 3% of eligible patients participating. Inspiratory muscle training (IMT), especially through novel methods like the Test of Incremental Respiratory Endurance (TIRE), offers a potential home-based alternative to traditional rehabilitation services. Despite growing interest, a key knowledge gap persists: few randomized trials have directly compared TIRE with threshold loading IMT over extended, largely unsupervised home-based periods while concurrently evaluating inspiratory muscle endurance and adherence. This randomized controlled trial aimed to evaluate the long-term efficacy of TIRE IMT compared to traditional threshold IMT and sham training in COPD patients. The study also assessed adherence to these home-based interventions, focusing on unsupervised periods without additional motivational support. Methods: A total of 52 COPD patients were randomly assigned to one of three groups: TIRE IMT, Threshold IMT, or Sham IMT. The study consisted of an 8-week supervised Phase I followed by a 24-week unsupervised Phase II. Training details: TIRE—session template set to 50% of the day’s maximal sustained effort; 6 levels × 6 inspirations (total 36) with preset inter-breath recoveries decreasing from 60 s to 10 s. Threshold IMT—spring-loaded valve set to 50% MIP (re-set at week 4); 36 inspirations completed within ≤30 min. Sham—valve set to minimal resistance (9 cmH₂O); 36 inspirations within ≤30 min. Primary outcomes included changes in maximal inspiratory pressure (MIP) and sustained maximal inspiratory pressure. Secondary outcomes focused on adherence rates and correlations with functional capacity. Results: Of the 52 participants, 36 completed the study. Participant details: TIRE n = 12 (mean age 60.9 ± 12.9 years), Threshold n = 12 (67.4 ± 6.9 years), Sham n = 12 (67.3 ± 8.7 years); overall 21/36 (58%) men; mean BMI 30.0 ± 7.5 kg/m². The TIRE IMT group demonstrated significantly greater improvements in MIP (31.7%) and SMIP compared to both the Threshold and Sham groups at 24 weeks (p < 0.05). Despite a decline in adherence during the unsupervised phase, the TIRE group maintained superior outcomes. No adverse events were reported during the intervention period. Conclusions: In this randomized trial, TIRE IMT was associated with greater improvements in inspiratory muscle performance than threshold and sham IMT. While adherence was higher in the TIRE group, it declined during the unsupervised phase. The clinical interpretation of these findings should consider the relatively wide confidence intervals and modest sample size. Nevertheless, the mean change in MIP in the TIRE arm exceeded a recently proposed minimal important difference for COPD, suggesting potential clinical relevance; however, no universally accepted minimal important difference exists yet for SMIP. Further adequately powered trials are warranted. Full article

Herpesviruses are prevalent infectious agents in humans, with complex structures and life cycles. The viability and detail of a model of capsid assembly and maturation can now be examined against the recently available mature herpesvirus capsids structures. The first large assembly product is the icosahedral procapsid with an outer shell composed of major capsid proteins (MCPs) connected by triplexes (heterotrimers composed of one Tri1 protein and two Tri2 proteins), and an inner shell of scaffold proteins. The asymmetric triplexes have specific and conserved orientations, suggesting a key role in assembly. In the mature capsid structures, triplexes bound to three MCPs may represent an assembly unit where, in most cases, the N-terminus of one MCP wraps around the E-loop of another MCP. The model accommodates the incorporation of a portal into capsid, required for genome encapsidation and viral viability. Cleavage of the scaffold triggers maturation of procapsid. Each of the MCPs rotates mostly as a rigid body, except for the flexible peripheral parts that remodel to close the capsid inner surface. Angularization of the capsid shifts the portal outward to a better contact with the capsid shell. Understanding these events in the herpesvirus life cycle to atomic detail could facilitate the development of drugs that uniquely target assembly and maturation. Full article

Mass shootings are forms of loosely defined violent crimes typically involving four or more casualties by firearm and have become increasingly more frequent, and organized and speedy responses from police are necessary to mitigate harm and neutralize the perpetrator. Recent, widely publicized police responses to mass shooting events have been criticized by the media, government, and public. With the advancements in artificial intelligence, specifically single-shot detection (SSD) models, computer programs can detect harmful weapons within efficient time frames. We utilized YOLO (You Only Look Once), an SSD with a Convolutional Neural Network, and used versions 5, 7, 8, 9, 10, and 11 to develop our detection system. For our data, we used a Roboflow dataset that contained almost 17,000 images of real-life handgun scenarios, designed to skew towards positive instances. We trained each model on our dataset and exchanged different hyperparameters, conducting a randomized trial. Finally, we evaluated the performance based on precision metrics. Using a Python-based design, we tested our model’s capabilities for surveillance functions. Our experimental results showed that our best-performing model was YOLOv10s, with an mAP-50 (mean average precision 50) of 98.2% on our dataset. Our model showed potential in edge computing settings. Full article

Turning-point memories, experiences that impact personal development, may be interpreted in ways that emphasize positive, negative, or mixed development because the memory prompt is open-ended with regard to event valence (i.e., it does not elicit ‘high’-point or ‘low’-point life events). Broadly, narratives that articulate how one has grown or changed for the better over time are positively associated with beneficial psychological characteristics and well-being, and are thought to be a cultural master narrative template in the United States (US). Recent work suggests cultural differences in the narration of adversity. Our mixed-methods study expands the literature on cultural comparisons of turning-point autobiographical memories by comparing themes in turning-point memory narratives of US and UK college-going emerging adults and by assessing whether or not narrative differences relate to changes in well-being and emotions after narration. Results suggest that turning points are characterized by memories of adversity and that redemptive narration is similar across samples in its frequency and associations with well-being and emotions. Discussion explores when and why redemptive narration may be beneficial for people from broad backgrounds. Full article

Conventional reports on wildfire damage focus on damage to built structures and life loss without capturing the long-term loss of many environmental benefits provided by natural capital. The assessment of the full cost of a wildfire event can be very challenging and time-consuming due to its broad range of impacts traversing decades. Two major wildfires, the 2021 Caldor Fire and 2022 Mosquito Fire, impacted rural communities and burned nearly 30 percent of the approximately 1 million acres of forests and private timber lands in the Upper American River Watershed (UARW) in California’s Sierra Nevada headwaters. The UARW provides a stock of natural capital that provides a flow of environmental benefits, or ecosystem goods and services, including California statewide water supply that was not recognized in the conventional reporting to properly inform decisions and investments for mitigation and recovery. Leveraging new tools available through the recent valuation of the UARW’s ecosystem goods and services, this study provides a first look at the magnitude of damage to the headwaters’ ecosystem from wildfires and, thus, informs proactive, adaptive management actions and post-disaster recovery and restoration. Using burn severity data and per-acre estimates of ecosystem goods and services, we estimate natural capital damage of over USD 14.8 billion across an optimistically estimated period of 20 years. Several recovery time horizons are used to evaluate the sensitivity of the analysis. These findings provide important benchmarks and a viable approach for all levels of government and private entities responsible for allocating resources, mitigating wildfire risks, and improving watershed health. Full article

Background: Thyroid eye disease (TED) is a rare autoimmune orbital disorder predominantly associated with Graves’ disease. It is characterized by orbital inflammation, tissue remodeling, and potential visual morbidity. Conventional therapies, particularly systemic glucocorticoids, offer only partial symptomatic relief, failing to reverse chronic structural changes such as proptosis and diplopia, and are associated with substantial adverse effects. This review aims to synthesize recent developments in understandings of TED pathogenesis and to critically evaluate emerging therapeutic strategies. Methods: A systematic literature review was conducted using MEDLINE, Embase, and international clinical trial registries focusing on pivotal clinical trials and investigational therapies targeting core molecular pathways involved in TED. Results: Current evidence suggests that TED pathogenesis is primarily driven by the autoimmune activation of orbital fibroblasts (OFs) through thyrotropin receptor (TSH-R) and insulin-like growth factor-1 receptor (IGF-1R) signaling. Teprotumumab, a monoclonal IGF-1R inhibitor and the first therapy approved by the U.S. Food and Drug Administration for TED, has demonstrated substantial clinical benefit, including improvements in proptosis, diplopia, and quality of life. However, concerns remain regarding relapse rates and treatment-associated adverse events, particularly hearing impairment. Investigational therapies, including next-generation IGF-1R inhibitors, small-molecule antagonists, TSH-R inhibitors, neonatal Fc receptor (FcRn) blockers, cytokine-targeting agents, and gene-based interventions, are under development. These novel approaches aim to address both inflammatory and fibrotic components of TED. Conclusions: Teprotumumab has changed TED management but sustained control and toxicity reduction remain challenges. Future therapies should focus on targeted, mechanism-based, personalized approaches to improve long-term outcomes and patient quality of life. Full article

Cutaneous and oral mucosal adverse events (AEs) are among the most common non-hematologic toxicities observed during breast cancer treatment. These complications arise across various therapeutic modalities including chemotherapy, targeted therapy, hormonal therapy, radiotherapy, and immunotherapy. Although often underrecognized compared with systemic side effects, dermatologic and mucosal toxicities can severely impact the patients’ quality of life, leading to psychosocial distress, pain, and reduced treatment adherence. In severe cases, these toxicities may necessitate dose reductions, treatment delays, or discontinuation, thereby compromising oncologic outcomes. The growing use of precision medicine and novel targeted agents has broadened the spectrum of AEs, with some therapies linked to distinct dermatologic syndromes and mucosal complications such as mucositis, xerostomia, and lichenoid reactions. Early detection, accurate classification, and timely multidisciplinary management are essential for mitigating these effects. This review provides a comprehensive synthesis of current knowledge on cutaneous and oral mucosal toxicities associated with modern breast cancer therapies. Particular attention is given to clinical presentation, underlying pathophysiology, incidence, and evidence-based prevention and management strategies. We also explore emerging approaches, including nanoparticle-based delivery systems and personalized interventions, which may reduce toxicity without compromising therapeutic efficacy. By emphasizing the integration of dermatologic and mucosal care, this review aims to support clinicians in preserving treatment adherence and enhancing the overall therapeutic experience in breast cancer patients. The novelty of this review lies in its dual focus on cutaneous and oral complications across all major therapeutic classes, including recent biologic and immunotherapeutic agents, and its emphasis on multidisciplinary, patient-centered strategies. Full article

Background/Objectives: Acne vulgaris is a widespread, chronic inflammatory skin condition that significantly impacts patients’ quality of life. Although oral isotretinoin remains the most effective treatment, recent evidence suggests that H₁-antihistamines such as desloratadine and levocetirizine may enhance acne therapy. This study assesses whether combining H₁-antihistamines to isotretinoin enhances treatment efficacy in acne vulgaris compared to isotretinoin alone. Methods: Our analysis included 10 randomized controlled trials involving 675 patients collectively, predominantly from Asia and the Middle East. Data were extracted by two independent reviewers, with discrepancies resolved by a third. Risk of bias was assessed using the Cochrane RoB 2 tool. Analyses were performed using RevMan 5.4 with random-effects models, and heterogeneity was evaluated via I² and Q tests. Sensitivity analyses were conducted to assess result robustness. Results: Combination therapy with isotretinoin and desloratadine showed a significantly greater reduction in GAGS (Global Acne Grading Scale) score by week 12 (p < 0.00001; MD 2.68, 95% CI 1.60 to 3.75; I² = 0%) while earlier timepoints showed non-significant or borderline results. For inflammatory lesions, significant improvements with desloratadine emerged at weeks 4, 8, and 12 after excluding an influential outlier, with low heterogeneity and consistent direction of effect. Non-inflammatory lesions did not differ significantly at weeks 4 or 8. At week 12, a significant reduction was seen in the desloratadine subgroup (OR 2.61, p = 0.003, I² = 11%) and in overall pooled analysis (OR 2.77, p < 0.0001, I² = 2%). Among side effects, acne flare-ups, pruritus, and cheilitis were significantly reduced in the desloratadine group, as well as in pooled analysis. Xerosis did not consistently differ between groups. Overall, desloratadine improved tolerability and reduced mucocutaneous adverse events more than levocetirizine. Conclusions: Current evidence suggests that combining oral antihistamines with isotretinoin may offer therapeutic benefits in acne management, particularly in enhancing tolerability and potentially improving clinical outcomes, as reflected by significant reductions in GAGS scores and mucocutaneous adverse effects such as cheilitis, pruritus, and acne flare-ups. Full article

Wildfires increasingly threaten human life, ecosystems, and infrastructure, with events like the 2025 Palisades and Eaton fires in Los Angeles County underscoring the urgent need for more advanced prediction frameworks. Existing physics-based and deep-learning models struggle to capture dynamic wildfire spread across both 2D and 3D domains, especially when incorporating real-time, multimodal geospatial data. This paper explores how generative artificial intelligence (AI) models—such as GANs, VAEs, and transformers—can serve as transformative tools for wildfire prediction and simulation. These models offer superior capabilities in managing uncertainty, integrating multimodal inputs, and generating realistic, scalable wildfire scenarios. We adopt a new paradigm that leverages large language models (LLMs) for literature synthesis, classification, and knowledge extraction, conducting a systematic review of recent studies applying generative AI to fire prediction and monitoring. We highlight how generative approaches uniquely address challenges faced by traditional simulation and deep-learning methods. Finally, we outline five key future directions for generative AI in wildfire management, including unified multimodal modeling of 2D and 3D dynamics, agentic AI systems and chatbots for decision intelligence, and real-time scenario generation on mobile devices, along with a discussion of critical challenges. Our findings advocate for a paradigm shift toward multimodal generative frameworks to support proactive, data-informed wildfire response. Full article