Search Results (376)

City–port thresholds are increasingly exposed to multi-risk, including climate change impacts, pollution, and obsolescence of buildings and infrastructure as well as socio-economic marginalization. This paper aims to understand what role co-design—and more generally collaborative planning processes—can play in enabling communities and institutions to learn how to live with risk when managing water, city–port interfaces, and coastal public spaces. To do so, this paper analyses the experience of a co-design workshop held in Castellammare di Stabia, in the Metropolitan Area of Naples, organized within the framework of the research MIRACLE and SPArTaCHus. The results of the workshop show that co-design can act as an effective instrument for developing strategies aimed at the regeneration and valorization of underused, abandoned, or polluted spaces in the coastal thresholds of City–Port areas—wastescapes—that are exposed to multiple risks. In these complex territories new methods are needed to understand, describe and interpret the fuzzy boundaries between the city and the port to collaboratively envision sustainable strategies for urban regeneration of coastal wastescapes. Full article

Objectives: Real-world data on surgical and multimodal management of upper tract urothelial carcinoma (UTUC) are limited. This study examined epidemiological trends, nephron-sparing surgery adoption, and the perioperative impact of lymphadenectomy (LND) and neoadjuvant chemotherapy (NAC). Methods: The German Nationwide Inpatient Data (GRAND) registry (2005–2023) identified UTUC patients undergoing radical nephroureterectomy (RNU), endoscopic laser destruction, or segmental ureteral resection (SUR) using OPS codes. Demographics, comorbidities, complications, and in-hospital mortality were extracted from ICD-10-GM data. Multivariable regression adjusted for baseline comorbidities assessed associations between treatment type, LND, NAC, and perioperative outcomes. Results: Among 53,427 UTUC patients, 77.3% underwent RNU, 13.8% endoscopic laser destruction, and 8.9% SUR. Endoscopic laser use rose from <10% (2005) to about 20% (2023). LND was performed in 13% of RNU cases, increasing from 1.1% to 19%. LND was associated with higher risks of transfusion (OR 1.47, 95% CI 1.37–1.57), acute kidney injury (OR 1.19, 95% CI 1.07–1.32), and ICU admission (OR 1.21, 95% CI 1.13–1.30), without affecting in-hospital mortality. NAC was given to 1.7% of patients, with a five-fold increase over time, and was associated with more transfusions (OR 1.28, 95% CI 1.07–1.52) and urinomas (OR 2.31, 95% CI 1.31–3.78), but not mortality. Conclusions: UTUC management is evolving, with growing use of endoscopic laser therapy and guideline-aligned lymphadenectomy during nephroureterectomy. Neoadjuvant chemotherapy remains underused despite acceptable perioperative safety, highlighting the need for increased awareness to optimize multimodal treatment. Full article

Natural grasslands are among the most endangered habitats in Northern, Central and Eastern Europe due to the agricultural intensification, land abandonment and afforestation, urban expansion, and the loss of traditional low-intensity management, on which their biodiversity depends. One way to increase the number of natural grasslands is by integrating them into urban green infrastructure as a nature-based solution to enhance ecological resilience and urban livability: diverse grassland systems support pollinators, improve soil structure and stormwater infiltration, mitigate urban heat and provide restorative, experience-rich public spaces. The aim of the study is to explore opportunities and barriers to integrating different types of grasslands into the green infrastructure of Latvian cities, with a primary focus on public perceptions and institutional aspects of urban grassland implementation and management. A mixed-methods approach was applied, combining resident surveys, interviews with municipal experts—territorial development specialists, planners and maintenance managers—and comparative policy analysis. Results show that although residents acknowledge the ecological benefits of urban grasslands, they prefer them in peripheral or underused areas rather than in city centres and residential zones, as these areas are often aesthetically perceived as “untidy” or neglected, conflicting with cultural norms that favour short, intensively mown lawns and raising concerns about insects. Acceptance increases through communication and participatory practices. Municipal approaches range from structured maintenance guidelines, including delayed mowing, biomass removal, and invasive species control, to flexible experimentation. The study contributes scientifically grounded insights into governance, perception, and management interfaces critical for mainstreaming socially accepted urban grasslands. Full article

Scarce global resources and reliance on non-renewable materials demand ecological, technology-integrated solutions. In Brazil, abundant wood resources remain underused in architectural education and practice. Introducing skills in curricula is essential for change and future adoption. This study developed a computational and digital fabrication methodology to rethink wood, exploring collaborative robotic assembly to build an embodied understanding of construction constraints. The Wood Innovation for Architecture in Brazil (WI-FAB) unites LAMO UFRJ and SDU CREATE robotics expertise and frames a pedagogical experiment in sustainable wood-structure design. The semester-long course tested whether the design framework could link computation, material behaviour, and assembly constraints as a pedagogical tool; the intensive workshop investigated how robotic assembly can enhance physical–digital workflows and inform future integration. The research-through-teaching methodology consisted of three phases: preliminary research, course testing, and a robotics workshop testing assembly workflows. Preliminary research developed a pedagogical framework comprising a kit of parts, joint types and string grammars tested within the semester-long course to support parametric rules and assembly sequencing. Participants assembled component “letters” that combined into “words” and then into “phrases”, developing computational and constructional understanding and converting parametric rules into tangible prototypes through iterative design-build-test cycles. Key outcomes include validation of parametric assembly rules through string grammars in the course; analysis of the robotics workshop applied four criteria (Assembly Movement; Component Geometry and Dimensions; Component Number and Slot Number; Complexity and Assembly Time) to evaluate assembly performance and workflow integration. Robotics stimulated physical–digital loops, accelerating design-to-assembly learning and informing full-scale developments. WI-FAB promotes reversible assembly, material reuse and circular-economy principles and contributes to the development of the forthcoming Sabiá parametric plugin for wooden joint design. Full article

Chamomile flowers are established in the industry due to their therapeutic characteristics. The leaves are an underused fraction of chamomile production that contains phytochemicals with bioactive properties. This work investigated the extraction of chamomile leaves with supercritical CO₂ (SC-CO₂). The effect of supercritical extraction conditions was evaluated on extraction yield, and the mass transfer process was analyzed by modeling the overall extraction curve (OEC) with empirical and mass balance-based models. Gas chromatography coupled with a mass spectrometer (GC-MS) was used to determine the volatile compounds of the extract. The highest extract yield (1.52 ± 0.01%) was obtained at 300 bar and 45 °C, although similar yields were obtained under conditions of 200 bar/45 °C, 200 bar/35 °C, and 350 bar/35 °C. The 2-straight-line spline promoted the best adjustment to the OEC and described convection as the dominant mass transfer mechanism. The compounds (Z)-2-(Hexa-2,4-diyn-1-ylidene)-1,6-dioxaspiro[4.4]non-3-ene, 2H-1-Benzopyran-2-one,7-methoxy-, cis-beta-Farnesene, alpha-Farnesene, phytol, and (E)-2-(Hepta-2,4-diyn-1-ylidene)-1,6-dioxaspiro[4.4]non-3-ene were the most abundant in the chamomile leaves extracts. SFE extract from chamomile leaves is a promising source of phytochemicals for producing functional products. Full article

In response to flood risks, nature-based solutions are increasingly recommended as resilience strategies. Wetlands are proposed as natural levers given their regulatory properties. This represents another way of promoting wetlands and, consequently, a call for their conservation. However, for nature-based solutions to be implemented effectively, residents’ perceptions and practices must be taken into account. To this end, in the flood-prone Greater-Nokoué region, this study highlighted residents’ perceptions and practices on the issue. Questionnaire surveys were conducted among 430 wetland residents with diverse socio-demographic profiles, who were either new or long-term residents living near wetlands (swamp formations and water bodies). The main results show that nearly half of the residents recognise the usefulness of wetlands in flood management. Both positive and negative perceptions are influenced by socio-demographic factors (gender, age, level of education) and residential factors (duration of residence near wetlands). Despite this fairly positive perception, wetlands are underused in flood management. Similarly, nature-based solutions are not exploited in alternative flood management approaches. Full article

Dental hard tissues, through their remarkable resistance to degradation, represent one of the most durable biological materials available for postmortem investigation. The preparation of undecalcified or ground sections allows microscopic visualization of enamel, dentin and cementum structures, which can preserve chronological, physiological, or environmental information. This review provides a comprehensive overview of the forensic applications of dental hard tissue ground sections, focusing on methodological principles, interpretive potential and practical constraints. The literature in forensic odontology highlights their relevance for age estimation through tooth cementum annulation, identification of neonatal and accentuated stress lines, and the assessment of thermal or chemical alterations. While these methods have proven scientific validity in anthropology and histology, their forensic implementation remains limited by heterogeneity in protocols and interpretative subjectivity. Standardization of preparation techniques, digital imaging, and integration with complementary analyses such as micro-CT or SEM could enhance the reliability and medico-legal relevance of this classical but underused approach. Full article

Non-recyclable plastic waste (PSW) and residual lignocellulosic biomass (WP) represent abundant yet underused resources whose conversion can generate renewable fuels with synergistic benefits. While conventional pyrolysis remains limited by slow heat transfer and poor adaptability to heterogeneous feeds, microwave-assisted pyrolysis (MAP) offers faster volumetric heating and improved syngas quality, though it is still largely confined to the laboratory scale due to limited understanding of feedstock interactions and process behaviour. In this context, the present work provides a laboratory-scale experimental investigation of the MAP co-pyrolysis of PSW/WP blends, focusing on gas yield and syngas quality, and complements the experimental analysis with a preliminary scale-up assessment for a continuous microwave reactor. The results reveal clear synergistic effects, with gas yields exceeding those predicted by linear mixing. A 70/30 wt% PSW/WP blend produced a hydrogen-rich syngas with H₂ concentrations of approximately 42 vol% and an H₂/CO ratio of 2–3. Compared to conventional pyrolysis under analogous conditions, MAP increased hydrogen content by around 35% and reduced CO₂ concentrations by up to 40%, resulting in a cleaner and more energy-dense gas. Overall, the findings highlight the strong potential of MAP for the valorization of mixed plastic–biomass wastes. Full article

Waste lignin from the hydrolysis of lignocellulosic materials is an abundant but underused by-product of the pulp and biorefinery industries. Phenolic compounds derived from lignin, rich in aromatic structures, show strong antioxidant potential and can be applied in polymer stabilization, food, and medical fields. This study evaluated the radical-scavenging activity of phenolic fractions obtained from alkaline-treated waste lignin against DPPH● and ABTS•⁺, using Trolox as a reference. Both spectrophotometric and electrochemical techniques were employed, providing deeper insight into the underlying mechanisms. Depending on the assay, the phenolic extracts demonstrated substantial radical-scavenging capacity, in some cases matching or surpassing that of Trolox. This behavior was linked to electron/proton transfer pathways, radical reactivity, and solubility effects. The combined use of multiple antioxidant tests offered a comprehensive characterization of the bioactivity of lignin-derived phenolics and supports their potential as sustainable sources of antioxidant compounds within a circular economy framework. Furthermore, the study examined how toluene-extracted phenolics affect the thermo-oxidative stability of model polyurethane films. Incorporating small amounts (1%, 3%, 5%) into the polymer matrix showed that a 1% loading provides the most effective stabilization. At higher concentrations, however, additional oxidative processes seem to be activated, as indicated by FTIR measurements and thermogravimetric analysis. Full article

Walking (or gait) speed is recognised as a robust indicator of health status, functional capacity, and physiological reserve across the lifespan; however, its objective measurement remains underused in routine musculoskeletal physiotherapy practice. This commentary argues that gait speed is underutilised in musculoskeletal physiotherapy despite its strong prognostic and functional relevance, and proposes its cautious adoption as a functional vital sign to support more objective, standardised, and interpretable rehabilitation decision making. Evidence from an orthopaedic population undergoing total hip and knee arthroplasty illustrates the persistent gap between surgical success and functional recovery, as reflected in sustained deficits in walking speed relative to healthy benchmarks. Methodological issues in gait speed assessment are considered, and the potential future role of wearable sensors and digital health technologies in capturing real-world locomotor performance is highlighted. Overall, the evidence suggests that gait speed can provide an objective, low-cost, and scalable measure that integrates multiple domains of musculoskeletal function. Therefore, the routine integration of gait speed into physiotherapy assessment may help to quantify functional impairment, support personalised rehabilitation, reduce practice variation, and align musculoskeletal care with contemporary adaptive and digitally enabled healthcare models. Full article

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) remain underused in routine practice, particularly among women. Aim: This study evaluated gender differences in mortality among patients with T2DM and established atherosclerotic cardiovascular disease (ASCVD) and examined whether disparities in SGLT2i and GLP-1RA dispensing contribute to mortality. Methods: The CARDIAB cohort included 138,397 patients with T2DM and established ASCVD, categorized by gender into male and female groups. The primary endpoint was all-cause mortality, and the secondary outcome was the dispensing rates of SGLT2i and GLP-1RA. Results: Of the 138,397 patients, 40.3% were women and 59.7% were men. The overall dispensing rates of SGLT2i and GLP-1RA were 37.1% and 23.4%, respectively, and were significantly lower among women compared with men for both SGLT2i (27.8% vs. 43.3%; p < 0.001) and GLP-1RA (21.3% vs. 24.9%; p < 0.001). Women exhibited higher mortality rates, as reflected by deaths per 10,000 patient-years (9724 vs. 7744; p < 0.001). However, in multivariable analysis, gender was not an independent predictor of mortality. Notably, the use of cardioprotective medications was strongly associated with reduced mortality, with the greatest benefit observed for SGLT2i (HR 0.307; 95% CI 0.299–0.316; p < 0.001) and GLP-1RA (HR 0.466; 95% CI 0.451–0.482; p < 0.001). Conclusions: Women with T2DM and ASCVD were treated less often with SGLT2i and GLP-1RA, therapies strongly associated with lower mortality. Their higher unadjusted mortality appears to reflect undertreatment rather than sex-related risk. Action is needed to improve the use of these cardioprotective medications, especially in women. Full article

Radiotherapy has been a central component of cancer therapy for over a century, with the field rapidly evolving over time, resulting in improved outcomes. These advances have contributed to a changing demographic, with growing numbers of people living longer with, and surviving the disease. This has been accompanied by an increasing burden of chronic physical and psychological side effects, including radiotherapy-related toxicity. These long-term consequences have a substantial impact on patients, their carers, and healthcare systems. Significant global inequities persist, particularly in low- and middle-income countries (LMICs), where access to radiotherapy and comprehensive supportive and palliative care remains limited. Supportive oncology has emerged as a new field focusing on the management of acute, chronic, and emergent problems in people living with and beyond cancer. Despite its benefits, palliative radiotherapy continues to be underused, especially in specific patient groups including paediatrics, older age adults, and those with a short prognosis. Often treatment decisions in these patient groups are challenging and the integration of supportive oncology could help overcome this. Furthermore, radiotherapy toxicity and its management has been under-researched despite huge advancements in cancer treatments leading to a lack of guidelines and varied practice globally. Supportive oncology offers a framework to address these challenges through earlier integration into treatment pathways, multidisciplinary collaboration, and a stronger focus on symptom control, survivorship, and equity. Embedding supportive oncology within radiotherapy services is essential to delivering high-quality, patient-centred cancer care worldwide. Full article

Whilst youth offending has been declining, there have been increases in serious youth violence in the last decade. Therefore, there is a pressing need to prevent youth crime and violence owing to its prevalence, harms and cost to society. Part of the effort to address this involves identifying and disseminating evidence-based practice. We explore key challenges in this endeavour and offer ideas for how to address them. These fall into two categories. The first concerns the focus and nature of interventions and the imperative to increase the effectiveness of our collective efforts. We start by considering neglected issues and groups in need of intervention responses, arguing that interventions too often do not consider relevant risk and contextual factors. Next, we explore emerging means of designing and delivering interventions that warrant greater investment, including those that extend beyond a traditional focus on programmes. Finally, we highlight cross-cutting issues affecting the delivery and uptake of interventions and therefore their success. The second set of challenges concerns intervention evaluation and the need to maximise the usefulness of our cumulative evaluation activity in this field. Here, we start by discussing common challenges involved in moving through the pipeline of feasibility, pilot and definitive (often trial-based) evaluations. We then explore issues concerning the actual design and conduct of such studies, before closing with thoughts on the potential value of underused (non-trial) methods of impact evaluation. Throughout the article, we draw on the scientific literature and our collective experience over many years of developing, adapting, evaluating and promoting interventions and other forms of evidence-based practice in this space. Full article

Acute and Chronic Coronary Syndromes represent two major medical challenges and are the leading cause of cardiovascular mortality and morbidity. While Chronic Coronary Syndrome (CCS) can be defined as the whole group of structural and/or functional abnormalities involving coronary arteries before and after an acute event, Acute Coronary Syndrome (ACS) encompasses the condition of acute myocardial ischemia (with or without consequent myocardial injury and troponin release) due to dynamic mechanisms such as athero-thrombosis or vasospasm. Because of this complex interplay between structural and functional mechanisms arising from both the epicardial and microvascular compartments, a comprehensive approach to fully investigate the whole spectrum of coronary disease is therefore essential. To address this issue, the invasive functional assessment has evolved through the years, from a way to guide revascularization to a meticulous protocol for characterizing ischemia-leading mechanisms and stratifying prognosis both in ACS and CCS. However, coronary physiology remains underused in clinical practice, and multiple gaps in knowledge still exist; on top of this, there is increasing heterogeneity regarding how to perform functional assessment, with different protocols proposed by various centers. The aim of this review is to summarize the evidence in the field of coronary physiology, and to discuss how and when to use it at its best. Full article

Considering the present environmental concerns, nanomaterial-based methods should be applied to achieve the bioeconomic sustainability initiatives and climate change mitigation. Plants and plant extracts are one of the most underused biomass and bioactive ingredients resources. Moreover, nowadays crop loss is one of the main problems that the world faces, together with the depletion of natural resources, increasing population and limited arable land, leading to increased food scarcity and demand. To correctly attribute/use plant-based bioresources or to rapidly decide which farming operations should be performed before crop loss, we should be able to properly characterize plants or plant-based resources by the desired useful characteristics, such as (bio)chemical characteristics, rather than simply observing physical traits of plants (because, when these traits become visible, it may be too late for crop loss mitigation). Plant crops could be optimized, for example, using electrochemical methods that assess the nutrient uptake and nutrient use efficiency (NUE) or the oxidative stress burst encountered before crop loss, in order to improve crop yields and crop quality. Other different important analytes (such as hormones, pathogens, metabolites, etc.) or plant characteristics (such as genus, species, phylogenetic analysis, etc.) can be evaluated with these electrochemical sensors and methods. In the present review, we focus on the application of nanomaterials/nanotechnologies for the development of fast, accurate, accessible, cost-effective, sensitive and selective analytical electrochemical methods for the detection of different relevant biomolecules in plants or plant-related samples (plant extracts, plant cells, plant tissues, and/or plant-derived natural drinks/foods, as well as entire plants/plant parts), both in vivo vs. ex vivo and in situ vs. ex situ. This review systematically presents and critically discusses the outcomes of current electrochemical methods (both applied in the lab or as wearable/implantable sensors) and the future perspectives of these nanotechnology-based sensors, with an accent on wearable sensors for smart and precision agriculture, as real-world sensing technologies with significant practical impact. The novelty of this article is the abundance of electrochemical analytical parameters gathered and discussed, for such a large number of analyte categories. Full article