Search Results (5,855)

Background/Objectives: Scabies is a disease that disproportionately affects young children. Oral ivermectin is a mainstay of scabies therapy, yet children <15 kg are excluded due to insufficient safety data and the lack of age-appropriate formulations. To address this gap, we developed CHILD-IVITAB, a 1 mg ivermectin orodispersible tablet based on the Template Inverted Particle technology, which enables rapid disintegration and intrinsic taste masking in a mechanically robust tablet. Methods: We report the pharmaceutical characterization of CHILD-IVITAB tablets. The EPIC-15 trial (NCT06404333) was a randomized clinical trial administering CHILD-IVITAB to children weighing 5 to <15 kg with uncomplicated scabies in Brazil. Acceptability was assessed at two administrations (D0, D7) using the ClinSearch Acceptability Score Test (CAST^®), wherein CHILD-IVITAB was compared to a reference dataset. Results: The 40 mg tablets had a tensile strength of 1.87 ± 0.16 MPa, and met Ph. Eur. requirements for uniformity of mass and dosage units. CHILD-IVITAB tablets disintegrated in vitro in 18.3 ± 1.1 s and released >50% of the dose within 1 min in artificial saliva. Thirteen children were enrolled in the trial. The full dose was taken in 100% of the 26 evaluations, 73% of administrations elicited a neutral or positive reaction, and no dosage form alteration, food/drink co-administration, or extra device was required. The barycenter of all evaluations fell within the positive zone of the CAST^® framework. Conclusions: These results support CHILD-IVITAB as a child-friendly ivermectin formulation suitable for children 5 to <15 kg, a population currently excluded from ivermectin treatment and prevention programs. Full article

Wastewater treatment systems are under increasing pressure to improve nitrogen removal while reducing carbon emissions, yet the deployment of anaerobic ammonium oxidation (anammox) remains constrained by uncertainty about technical readiness, operational robustness, nitrous oxide (N₂O) emissions, life-cycle carbon performance, monitoring capacity, and transferability across wastewater contexts. This study uses dynamic topic modelling and trend assessment of 998 publications from 2001 to 2025 to synthesize deployment-relevant evidence for anammox-based wastewater treatment. The results indicate that the field has shifted from reactor start-up and process-parameter optimization toward microbial regulation, mainstream process integration, coupled nitrogen-removal strategies, and intelligent control. Building on these topic-evolution patterns and reported engineering evidence, this study provides an evidence-based qualitative appraisal of deployment-readiness signals and evidence gaps, distinguishing comparatively mature side-stream applications from mainstream systems that still require monitored demonstrations, transparent N₂O accounting, life-cycle assessment, and locally validated operating data. The study argues that anammox should be evaluated as a technology with potential but conditional carbon-saving benefits: its potential carbon-saving benefits depend on operational evidence specific to each application stage, carbon-accounting credibility, and implementation capacity, rather than assuming that research activity alone justifies broad deployment. Full article

The increasing generation of plastic waste has intensified the search for sustainable recycling technologies capable of recovering valuable resources while minimizing environmental impacts. Among emerging solutions, thermochemical recycling processes such as pyrolysis, gasification, and hydrothermal liquefaction have gained significant attention. However, the presence of chlorine-containing polymers, particularly poly(vinyl chloride) (PVC), represents a major challenge due to the release of hydrogen chloride (HCl), catalyst deactivation, equipment corrosion, and contamination of valuable products. Consequently, effective dechlorination pretreatments are essential for improving process performance and product quality. This review provides a comprehensive overview of current pretreatment technologies for chlorine management in plastic solid waste. Mechanical sorting, density-based separation, chemical extraction, alkaline treatments, hydrothermal processing, thermal dehydrochlorination, catalytic methods, and emerging photocatalytic approaches are critically analyzed and compared. The mechanisms, operating conditions, chlorine removal efficiencies, technological readiness levels, and industrial applicability of each method are discussed. Moreover, particular attention will be devoted to integrating different pretreatment technologies to achieve an overall enhanced chlorine removal efficiency before thermochemical technologies. Finally, reported techno-economic, environmental, and safety indicators are compared where quantitative data are available, while the principal data gaps and technological barriers to large-scale implementation are identified. Full article

The role of hospital pharmacists is broadening from primarily operational responsibilities towards greater involvement in clinical and research activities. Poland’s growing position in the clinical-trials sector and recent legislative changes create new opportunities for pharmacists to manage investigational medicinal products (IMPs) and contribute to multidisciplinary research teams. This narrative review and commentary, based on 27 sources, examines pharmacists’ roles and contributions in clinical trials. The reviewed literature describes pharmacists as contributors to medication safety, pharmacovigilance, drug-interaction assessment, IMP management, and maintenance of blinding. Their involvement may also support protocol adherence, patient education and participant care; however, the available evidence does not yet permit firm conclusions regarding its impact on medication-error rates, treatment adherence, recruitment, dropout rates, or clinical outcomes. In oncology and advanced therapy medicinal product (ATMP) trials, pharmacists may provide specialised expertise in complex medication-management and logistical processes. Nevertheless, a gap appears to persist in Poland between pharmacists’ professional readiness and their practical involvement in clinical research. Key barriers include minimum staffing requirements, insufficient protected research time and organisational constraints. Hospital pharmacists therefore represent a valuable but underused resource in clinical research. Appropriate training, institutional support, dedicated research time, and regulatory development could facilitate their broader participation in clinical-trial conduct and enable future evaluation of their effects on trial quality and participant safety. Full article

Osteosarcoma clinical presentation, treatment tolerance, and treatment delivery differ across the age spectrum. Adult cohorts are more heterogeneous, with higher proportions of axial and secondary osteosarcoma and greater variation in comorbidity and treatment intensity. Furthermore, emerging genomic studies suggest age-associated differences in tumor complexity and stress-response pathways, whereas direct age-stratified epigenomic and immune-microenvironment data remain limited. These molecular observations are hypothesis-generating and data currently do not support age-specific treatment selection. This narrative review summarizes clinical and biological evidence across age groups, distinguishes prognostic associations from predictive treatment effects, and identifies major confounders and evidence gaps. The available evidence supports age-inclusive prospective trials that model age explicitly, incorporate biomarker-stratified analyses, and report delivered dose intensity, toxicity, and host factors. Full article

Peri-urban belts are where most metropolitan residents actually meet farmland, and where urban food policy and agroecological transition physically overlap. They are also where wild food plants (WFPs) grow: on verges, ditch bank, and field margins, the interstitial biodiversity that complements cultivated crops. We ask whether the knowledge that makes those plants usable survives peri-urbanisation, and whether it can serve as a proxy for the resilience of the surrounding agroecosystem. Two Northern Italian landscapes with comparable perennial monoculture but opposite positions on the urban–rural gradient were compared through a diachronic design: the peri-urban lowland of the Trevigiano (Veneto), inside the dispersed-city fabric of the Venice–Padua–Treviso region and under rapid Prosecco expansion, and the Langhe (Piedmont), a UNESCO-listed hill district of low settlement density whose agriculture is nonetheless fully industrialised around wine grapes, hazelnuts, and tourism. Interviews with 74 informants were conducted through complementary designs: a cohort-structured approach in the Trevigiano and actor-diversified and diachronic interviews in the Langhe, recorded 13 folk food taxa in the Trevigiano against 43 in the Langhe (Jaccard 0.19). The peri-urban repertoire is thin and mostly inert: recognition survives while practice does not, with gaps of up to 86 percentage points between the two, and only Humulus lupulus, anchored in ritual, dialect, and a commercial product, is transmitted intact. The non-peri-urban repertoire is broader and still mobile, relocated by younger foragers onto unmanaged refugia and partly professionalised. The proxy, however, has a precondition. WFP knowledge indexes a healthy agroecosystem only where the land is clean enough to gather from, and the Trevigiano is not: informants avoid treated margins. The one EU instrument that would have banned pesticides in public green areas was withdrawn in 2024. We conclude that peri-urban planning should treat edges, unmanaged interstitial land, and treatment transparency as food-system infrastructure, and propose paired habitat and knowledge indicators for peri-urban agroecological assessment. Full article

Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), exposed critical gaps in global preparedness for rapidly evolving viral pandemics. Though current antiviral treatments have shown some efficacy in managing COVID-19, substantial limitations, such as inefficient targeted drug delivery, aberrant host immune responses, and inadequate preparedness for future viral pandemics, were also evident. These challenges underscore the urgent need for target-specific, precise and efficient therapeutic strategies to modulate viral entry and immune dysregulation. Extracellular vesicles (EVs), cell-released cargo-carrying nanoscale vesicles, can both facilitate and inhibit viral infection depending on their cargo composition. Thus, endogenous EVs can promote or inhibit COVID-19 pathogenesis by modulating critical pathways, including angiotensin-converting enzyme 2 (ACE2)-mediated viral entry, transmembrane protease serine 2 (TMPRSS2)- dependent spike protein activation, nuclear factor kappa B (NF-κB)-driven inflammatory signaling, and NLRP3 inflammasome activation. In contrast, engineered EVs, such as ACE2-expressing EVs, mesenchymal stem cell-derived EVs and microRNA-enriched EVs, have therapeutic potential as they can facilitate antiviral defense through immune modulation, viral neutralization and suppression of cytokine storm. Moreover, EV-associated nucleic acids, proteins and lipids can act as biomarkers for disease detection and severity stratification. A deeper understanding of EV-virus mechanistic insights can enhance preparedness for similar viral diseases. In this review, we provide a comprehensive analysis of the molecular mechanisms underlying EV-virus interactions highlighting the therapeutic and diagnostic potential of EVs in tackling COVID-19 and future viral pandemics. Full article

Background/Objectives: Electrotherapy encompasses diverse therapeutic modalities used in Physical and Rehabilitation Medicine, but pediatric evidence varies substantially across modality–indication pairs. This structured narrative review mapped the available pediatric clinical evidence and provided a clinically structured synthesis of clinical applications, treatment parameters, reported therapeutic outcomes, safety, and evidence gaps in pediatric rehabilitation. Methods: PubMed, Scopus, and Web of Science were searched for publications from 1 January 2000 to 17 July 2026. Evidence was synthesized by electrotherapy modality and clinical indication and classified using Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence. Formal methodological quality and risk-of-bias appraisal using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) and Risk of Bias 2 (RoB 2) was performed for the evidence underpinning OCEBM Level 1 classifications; no formal GRADE certainty-of-evidence assessment was performed. Results: A comparatively more developed pediatric evidence base was identified for radial extracorporeal shock wave therapy (rESWT) in cerebral palsy-related spasticity; transcutaneous electrical nerve stimulation (TENS) and interferential current therapy (IFC) in bladder and bowel dysfunction; and neuromuscular electrical stimulation (NMES)/functional electrical stimulation (FES), repetitive transcranial magnetic stimulation (rTMS), and transcranial direct current stimulation (tDCS) for selected motor rehabilitation outcomes. Photobiomodulation (PBM)/low-level laser therapy (LLLT), pulsed electromagnetic field therapy (PEMF), and high-intensity laser therapy (HILT) showed promising but indication-specific evidence, whereas Transfer of Energy Capacitive and Resistive (TECAR) had preliminary adjunctive evidence. Therapeutic ultrasound and Deep Oscillation Therapy were supported by insufficient pediatric clinical evidence, while several modalities lacked eligible pediatric clinical studies. Short-term tolerability was generally favorable, but long-term safety data remain limited. Conclusions: Electrotherapy has an adjunctive role in selected pediatric rehabilitation indications, but prescription should be based on specific modality–indication pairs. The available evidence does not support comparative effectiveness conclusions between modalities. Standardized multicenter trials and long-term safety studies are required. Full article

Background: Patient-centered care is particularly important in assisted reproductive technology, where treatment is clinically demanding and emotionally intensive. This study documented a preliminary cultural and linguistic adaptation of a fertility-care survey for Kazakhstan and evaluated patient–staff perception gaps, item-level priorities, preliminary reliability, and exploratory associations with global care ratings. Methods: A cross-sectional survey was conducted in two assisted-reproduction clinics in Almaty. The analytic workbook contained 273 patient and 74 staff records; 173 patient response patterns were unique and 100 records matched an earlier exact pattern. Group-level patient–staff comparisons between independent respondent samples used prespecified harmonized indices, Welch tests, false-discovery-rate correction, clinic-stratified analyses, and one-pattern-per-record sensitivity analyses. Importance–experience differences were calculated within respondents with both values available. Global-rating regressions used HC3 robust inference and were treated as exploratory. Results: Staff rated cost, attitude and communication, information and education, and participation more favorably, whereas patients rated privacy, emotional support, and continuity more favorably. Accessibility and competence showed little difference. Clinic-stratified and one-pattern-per-record analyses preserved the principal contrast directions, although the Physical Comfort proxy was not robust. Several indices showed weak or negative internal consistency. Global ratings had a marked ceiling, with 79.1% at 10/10, and the HC3 joint test for the added care-index block was not significant (p = 0.080). Conclusions: This exploratory survey identified substantial, bidirectional group-level patient–staff differences and concrete item-level priorities, but the scoring and psychometric evidence are insufficient to interpret the domain indices as established measurement scales. Source-codebook verification and broader structural validation are required. Full article

Background: Teledentistry is widely seen as a promising route to widening access to dental care and narrowing social inequalities. For dental implantology—a technically demanding and costly field that unfolds across several treatment steps—it remains largely unclear whether and, if so, how remote approaches actually make care fairer. The aim of this scoping review was to map the available evidence and organise it in accordance with an established access framework. Methods: A systematic search was conducted, covering PubMed, Scopus, and Web of Science, which was complemented by a manual search. After deduplication, 68 records were subjected to title and abstract screening, and 17 reached the full-text stage. Thirteen studies were obtained (two through supplementary searching), while four could not be retrieved and thus remained unevaluated. This retrieval shortfall (24%) is a material limitation, and it is weighed accordingly throughout. Data were charted using the PCC scheme, and the analysis followed the access model developed by Levesque et al. Results: Five primary studies met the criteria, alongside one conceptual perspective paper without clinical data. Four secondary reviews and five background sources supplied context. The clinical studies were methodologically heterogeneous and mostly small, ranging from case reports to a single randomised pilot study. Structured appraisal revealed that none met all five quality criteria, and only three met the majority of them. Only two of the studies examined implant care directly. The remaining conclusions drew on broader teledentistry or general dental evidence. The findings point to high acceptance, shorter travel distances, and comparable clinical assessments; furthermore, they indicate that, while access has improved, disparities between underserved and better-served groups have not been reduced. Not one source linked teledentistry, implantology, and care equity in any measurable way. Conclusions: The evidence base is scarce, indirect, and rarely framed explicitly around equity. Teledentistry can lower access barriers, yet improved access is not the same as reduced inequality and, through the digital divide, remote care may even deepen existing disparities. This scoping review is therefore best interpreted as identifying an important research gap rather than demonstrating an equity benefit. Targeted, equity-sensitive studies on implantology are needed. Until such data exist, the desired equity benefit remains plausible but unproven. Full article

Nutrition is an essential component of colorectal cancer (CRC) care, influencing treatment tolerance, functional status, and quality of life, yet it remains inconsistently integrated into practice. This study examined experiences with nutrition management and gaps in nutrition care among patients with CRC, caregivers, and healthcare professionals across Canada through a multi-center, cross-sectional survey conducted from July 2025 to February 2026. A total of 243 participants completed the survey, including 121 patients, 45 caregivers, and 77 healthcare professionals. Among patients, 51.2% reported that nutritional status was discussed or assessed during treatment, while 24.0% reported it was never discussed. More than half of patients (55.4%) said they did not receive adequate information regarding weight loss during treatment. Caregivers described substantial nutrition impact symptoms and identified a need for clearer guidance, emotional support, and improved access to dietitians. Healthcare professionals rated nutrition care as highly important yet reported barriers to effective delivery, including limited staffing, lack of standardized screening, and reactive care processes. Across groups, respondents emphasized the importance of timely, personalized, and culturally relevant nutrition care. Overall, nutrition remains insufficiently embedded in CRC care, highlighting the need for routine screening, standardized referral pathways, earlier intervention, and integrated patient-centered nutrition care models to improve CRC care. Full article

Total postharvest losses of fresh fruits and vegetables in tropical and subtropical agricultural systems frequently exceed 30 percent, driven by high crop perishability, limited cold-chain infrastructure, and the geographic concentration of conventional processing facilities far from production zones. This review examines the engineering principles, operational architecture, and applied performance of mobile aseptic processing platforms (MAPPs) as a decentralized strategy for postharvest stabilization of perishable agricultural commodities. MAPPs integrate in-line homogenization, high-temperature short-time (HTST) or ultra-high-temperature (UHT) thermal treatment, clean-in-place (CIP) and sterilization-in-place (SIP) cycles, and aseptic filling within transportable, modular units engineered for field deployment. Projected MAPP capacities reach up to approximately 11,300 kg (25,000 lb) per 8 h shift, while still complying with internationally recognized food safety frameworks, including HACCP, ISO 22000, and SQF. Comparative analysis with centralized processing infrastructure and earlier decentralized initiatives, including the EU Horizon 2020 Food Processing in a Box (FOX) project, indicates that mobile aseptic systems uniquely combine field mobility with the production of ambient-stable shelf-life formats independent of refrigerated distribution. Conservative impact modeling suggests that single-unit deployments may recover on the order of 3000 t of edible product annually, with corresponding water, fertilizer, and greenhouse gas externality reductions. The review synthesizes the current state of the technology, identifies engineering and socioeconomic knowledge gaps, and proposes research priorities for scaled adoption in tropical and subtropical food systems. Full article

When a water treatment plant, power grid, or pipeline is compromised, the consequences extend beyond data loss: a manipulated sensor reading can trigger physical damage, and a disabled safety interlock can endanger lives. Cyber–physical systems (CPSs) sit at this intersection of digital control and physical process, yet existing security reviews treat threats and defences in separate silos, leaving practitioners without a clear picture of which defences fail against which attacks, and why. This paper fills that gap with a structured narrative review of 82 sources (70 from the primary window January 2020 to April 2026, plus 12 foundational pre-2020 works), organised through the CPS Defence-Gap Taxonomy (CPS-DGT)—a framework that classifies 14 attack mechanisms by architectural layer and physical impact, evaluates six defensive technology categories against documented failure modes, and maps five governance dimensions to the institutional conditions required for deployment. Across five intrusion detection system (IDS) studies that differ in dataset, attack selection, training regime and evaluation scope, reported F1 scores lie between 0.796 and 0.969 under each study’s own standard conditions; these values are not a controlled comparison and are reported descriptively. For the one architecture evaluated under adversarial evasion, F1 falls by 37.4 percentage points in absolute terms, a relative reduction of 38.6%. The defence-gap matrix identifies seven entries with insufficient coverage. Five of the 14 attack mechanisms are uncovered: A03, A09, A10, A11 and A14. Two further mechanisms, A01 and A12, have only partial defences. Adversarial evasion of learned detectors is reported separately as a transversal failure mode of one defensive category rather than as an attack mechanism. The uncovered mechanisms cluster at the cyber–physical boundary and in supply-chain channels. We conclude with five concrete research challenges, each with a direct path from the identified gap to a tractable research agenda. Full article

The intensification of Cannabis sativa cultivation has increased the need for effective and sustainable plant-health strategies. Pathogen control is particularly challenging because pesticide residues may compromise product safety and quality, while repeated chemical treatments can favour the emergence of fungicide-resistant populations. Microbial biological control agents (BCAs) represent a promising component of integrated disease management, although their discovery and validation remain largely empirical. This narrative review examines the current literature on the biological control of fungal and oomycete diseases of cannabis, with particular emphasis on Fusarium-associated syndromes, Golovinomyces-associated powdery mildew, grey mould caused by Botrytis cinerea and major oomycete root rots. Cannabis-specific research remains limited and heterogeneous regarding reproducible efficacy across host genotypes, pathogens, and environments; mechanisms of protection; and application-oriented assessment of biosafety, crop quality, and formulation performance. To address these gaps, available evidence is organised within a prospective multi-omics-guided framework combining host and pathogen genomic characterisation, microbiome profiling, targeted BCA isolation, strain-level genomic analysis, preliminary safety screening and comparative in planta evaluation. Transcriptomic, metabolomic, and microbiome analyses can complement these stages by identifying molecular and community-level patterns potentially related to direct antagonism, resource competition, host defence priming and microbiome-mediated protection. The relevance of these patterns to disease suppression requires functional validation, while the resulting evidence may inform the design and evaluation of synthetic microbial communities. Integrating omics across these stages could support more traceable and application-relevant BCA development by enabling mechanistic investigation while providing a structured roadmap for advancing biological control strategies against fungal and oomycete pathogens of cannabis. Full article

Rabbit odontogenic abscesses are among the most challenging chronic infections encountered in exotic animal medicine because of their polymicrobial etiology, biofilm-associated persistence, and poor response to conventional antimicrobial therapy. Biofilm formation plays a central role in disease pathogenesis by promoting bacterial adhesion, extracellular polymeric substance (EPS) production, quorum sensing (bacterial cell-to-cell communication), metabolic heterogeneity, and the persister-cell formation (transiently antibiotic-tolerant bacterial subpopulations), collectively reducing antimicrobial susceptibility and contributing to treatment failure and recurrence. In addition to biofilm-mediated tolerance, antimicrobial resistance (AMR) further complicates disease management through mechanisms including horizontal gene transfer, efflux pump activation, enzymatic antibiotic degradation, reduced membrane permeability, and target modification. This review summarizes current knowledge on the microbiology, biofilm dynamics, and resistance mechanisms associated with rabbit odontogenic infections while examining recent advances in molecular diagnostics, including culture-independent sequencing technologies, metagenomics, and advanced imaging approaches. Current and emerging anti-biofilm strategies, such as local antimicrobial delivery systems, enzymatic biofilm disruption, quorum-sensing inhibitors, bacteriophage therapy, antimicrobial peptides, photodynamic therapy, and nanotechnology-based approaches, are critically discussed in the context of their potential application in rabbits. Comparative evidence from human endodontic infections and other veterinary biofilm-associated diseases highlights the translational relevance of rabbit odontogenic abscesses as a naturally occurring model for chronic polymicrobial infections. Finally, key research gaps are identified, emphasizing the need for standardized experimental models, integrated multi-omics analyses, combining genomic, transcriptomic, proteomic, and metabolomic data, longitudinal clinical investigations, and evidence-based antimicrobial stewardship. By integrating microbiology, biofilm biology, antimicrobial resistance, and One Health concepts, this review provides a comprehensive framework to support future research and improve the diagnosis, treatment, and prevention of rabbit odontogenic infections. Full article