Search Results (1,335)

Radiation-induced oral mucositis (RIOM) frequently causes severe pain and treatment interruptions in patients with head and neck cancer. While earlier guidelines suggested zinc supplementation, updated MASCC/ISOO guidelines downgraded it to ‘No Guideline Possible’ due to highly conflicting evidence. This study aims to resolve these inconsistencies by evaluating zinc’s prophylactic efficacy and investigating whether the route of administration determines its clinical benefit. Following PRISMA guidelines and INPLASY registration (INPLASY202620063), we searched PubMed, Embase, and the Cochrane Library through February 2026. We included randomized controlled trials (RCTs) comparing prophylactic zinc versus placebo or standard care in head and neck cancer patients receiving radiotherapy. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. The primary outcome was severe (Grade 3–4) RIOM incidence. Data from five RCTs (332 patients) were pooled using a random-effects model. Overall, zinc significantly reduced severe mucositis risk (RR = 0.35, 95% CI: 0.17–0.73, p = 0.005). Crucially, an exploratory subgroup analysis revealed a striking divergence based on delivery route. Topical zinc mouthwash demonstrated encouraging protection (RR = 0.16, 95% CI: 0.05–0.49, p = 0.001) with zero heterogeneity (I² = 0%). In contrast, systemic zinc yielded borderline, inconsistent benefits (RR = 0.52, 95% CI: 0.27–1.01, p = 0.055, I² = 37%). In conclusion, the localized pool of contemporary evidence clearly demonstrates that the systemic oral ingestion of zinc supplements does not provide a reliable prophylactic benefit against severe radiation-induced oral mucositis in head and neck cancer care. Conversely, topical zinc mouthwashes exhibit an encouraging protective trend; however, the severe paucity of available randomized trials and low cumulative patient volume preclude definitive clinical verification. While these exploratory findings suggest that topical administration may provide a more consistent protective trend compared to systemic routes, they should be interpreted as hypothesis-generating rather than definitive. Future large-scale, multi-center RCTs are strictly warranted to validate these promising route-specific benefits before formal guideline integration. Full article

In light of the growing prominence of environmental issues, the frequent occurrence of unexpected incidents, and the dynamic challenges of a changing market environment, suppliers must possess comprehensive capabilities that encompass both green and sustainable development as well as resilience to risks. Consequently, green supplier selection has emerged as a critical research topic. By integrating virtual and physical systems, digital twin technology enhances supply chain transparency and efficiency—a capability that plays a significant role in advancing sustainable supply chain development. In view of this, this study incorporates risk factors into the green supplier evaluation system, introduces indicators related to digital twin technology, and proposes a stochastic slack-based measure data envelopment analysis method, namely SSBM, for evaluating green suppliers. This approach expands and refines the existing evaluation criteria and the decision-making model. Finally, a numerical case study is conducted to validate the feasibility of the proposed method. This research provides more systematic and scientific decision support for green supplier selection, enriching the theoretical and practical applications in the fields of green supply chain and multi-criteria decision-making. Full article

Heraclitus’ phrase “everything flows and nothing remains” perfectly captures the modern era, as conditions are changing at high speed and scientific knowledge is growing exponentially. Academic fields that attract significant attention often experience rapid expansion, driven by the growing global pool of researchers, the increased accessibility of scientific publishing platforms, and the overall rise in scientific output. Literature concerning energy security, a topic as old as fire, has become vital to modern economies due to geopolitical upheaval, adapting traditional considerations to new realities, and the extensive body of literature serves as clear evidence of this fact. Thus, there is a clear need for innovative, scalable, and objective methodologies to systematically assess the existing body of knowledge and prioritize areas for further study. This paper proposes implementing a novel machine learning approach leveraging the BERTopic topic modeling algorithm to conduct a comprehensive and efficient exploratory analysis of energy security literature. The analysis is based on a bibliographic corpus extracted from the Scopus database covering the period 1999–2025, and identifies 14 distinct thematic clusters which indicate that energy security research is undergoing structural transformation, marked by strong emphasis on technology-specific renewable energy transitions, geographic concentration on China and Europe, and increasing integration with climate and sustainability frameworks. While contextual embedding improves semantic coherence, topic interpretation still requires expert validation as model performance is sensitive to hyperparameter configuration, potentially affecting topic stability and reproducibility. Full article

The global transition toward renewable energy has intensified interest in dispatchable low-carbon sources that can support reliability-critical infrastructure in smart grid systems. Data centers represent one of the fastest-growing electricity loads globally, yet their compatibility with biomass-based energy systems as a dispatchable renewable source within smart grid architectures remains poorly understood. This study presented a comprehensive review of biomass power generation, data center energy management, and smart grid integration, drawing on a corpus of 347 peer-reviewed sources. A staged analytical design separated demand characterization from supply evaluation, ensuring that data center energy requirements emerged independently of supply-side assumptions. Using Latent Dirichlet Allocation topic modeling validated with BERTopic and VOSviewer network analysis, the study identified four distinct thematic clusters and found no single topic spanning data center reliability requirements, biomass supply dynamics, and smart grid integration simultaneously, a pattern that points to an underexplored cross-domain space in the literature. A demand–supply–grid alignment framework was introduced to illustrate compatibility conditions across temporal resolution, reliability requirements, and grid management dimensions. The alignment framework and illustrative simulation developed here are offered as analytical starting points to guide future engineering and empirical investigation rather than as demonstrations of operational readiness. An illustrative application demonstrated that biomass feedstock logistics constraints create persistent availability gaps at data center operational timescales, suggesting that supply chain resilience and grid-mediated buffering are likely necessary conditions for viable integration, a proposition that warrants empirical validation through full-scale engineering studies. The findings indicate that integration constraints reflect temporal and operational misalignment rather than technological infeasibility, providing a new analytical perspective for evaluating renewable energy integration in reliability-critical digital infrastructure. Full article

Cat welfare assessment in Animal-assisted aervices (AAS) is necessary to ensure engagement in AAS does not impair welfare. An initial systematic search conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines revealed a complete lack of studies specifically addressing this topic. Consequently, a second-step search was performed, widened to the existing tools for monitoring cat welfare in general. Three scoping reviews using PRISMA guidelines were performed, focusing on the three principal fields of welfare assessment: health, behaviour, and physiology/endocrinology. Studies published on Scopus in 2011–2026, written in English and assessing feline (Felis catus) welfare were selected. A total of 2728 records were identified, of which 43 met the inclusion criteria (including 7 reviews and 1 scientific report); the methods used to assess cat welfare were summarized and discussed for their potential application in AAS. Although multiple tools are available, most are context- or disease-specific and some are not validated. Approximately half of the studies employed more than one indicator or method, with behavioural parameters being the most frequently used through questionnaires or scores. This work provides a practical framework to support veterinarians, handlers, and researchers in the selection of appropriate tools for cat welfare monitoring in AAS. Full article

Background: Oxidative stress contributes significantly to premature skin aging and inflammatory dermatological conditions. While plant-derived antioxidants have demonstrated considerable promise in topical applications, Bougainvillea glabra Choisy remains underexplored in standardized pharmaceutical dosage form development despite its documented phytochemical richness. Objective: This study aimed to develop, standardize, and characterize topical cold cream formulations incorporating B. glabra ethanolic leaf extract, with HPTLC-based quantification of marker compounds, validated antioxidant assessment, and preliminary dermal safety evaluation. Methods: The ethanolic leaf extract was prepared by maceration and characterized by preliminary phytochemical screening and HPTLC fingerprinting with quantitative densitometric analysis of quercetin and pinitol. Three cold cream formulations were developed at 10% (F1), 20% (F2), and 30% (w/w) (F3) extract loading. Formulations were evaluated for organoleptic properties, pH, homogeneity, spreadability, and viscosity. Antioxidant activity was assessed using a validated methanol extraction procedure followed by DPPH radical scavenging and potassium permanganate reduction assays. Ex vivo skin permeation was evaluated using Franz diffusion cells with freshly excised goat skin. Accelerated stability was conducted at 40 ± 2 °C/75 ± 5% RH for 90 days with HPTLC-based marker retention monitoring. Primary dermal safety was assessed in Wistar albino rats (n = 6) following OECD Test Guideline 404. Results: Quantitative HPTLC confirmed quercetin (4.82 ± 0.14 mg/g dry extract) and pinitol (2.31 ± 0.09 mg/g) as marker compounds, with linearly increasing content across F1–F3. All formulations demonstrated acceptable physicochemical properties (pH 5.7–5.9, viscosity 440,000–460,000 cP, spreadability 11.8 ± 0.3 cm·g/s). F3 exhibited the highest DPPH scavenging activity (56.68 ± 1.05%) with IC₅₀ of 1.3 ± 0.1% w/v, demonstrating a 3.2-fold improvement over F1. Extraction recovery from the cream matrix was 96.4–97.1%, validating the antioxidant data. Ex vivo quercetin permeation through goat skin reached 51.3 ± 2.8 μg/cm² at 24 h for F3, following Higuchi diffusion kinetics (R² > 0.99). No dermal irritation was observed (Primary Irritation Index = 0). Accelerated stability confirmed ≥98.3% retention of both marker compounds and antioxidant activity after 90 days. Conclusions: B. glabra leaf extract was successfully incorporated into a physicochemically stable, non-irritating cold cream with demonstrated dose-dependent antioxidant efficacy and cutaneous delivery capability. The study establishes preliminary dermal safety and in vitro antioxidant efficacy warranting further controlled clinical evaluation. Full article

Background: The management of white spot caries lesions (WSCLs) presents a clinical challenge due to a lack of standardized protocols. This study aimed to evaluate the knowledge, attitudes, and practices of dental practitioners in Russia regarding the diagnosis and treatment of WSCLs. Methods: A cross-sectional online survey was conducted from October 2024 to July 2025 among 397 dental professionals in Russia. A validated questionnaire assessed four domains: demographics, knowledge, attitudes, and clinical practices concerning WSCL management. Data were analyzed using descriptive statistics, Kruskal–Wallis tests, and Spearman’s correlation. Results: The majority of respondents were females (83%), with over half having less than five years of experience (55%). A majority of the practitioners (62.5%) demonstrated a good level of knowledge (mean score 12.8 ± 2.2). Knowledge was significantly better among female practitioners (p < 0.001) and inversely correlated with years of clinical experience (p < 0.001). Attitudes towards minimally invasive treatment were mainly positive (mean score 13.5 ± 2.6), with 86% of respondents showing a positive score (>10 points). While awareness of minimally invasive techniques like resin infiltration (84%) and remineralization (79.1%) was high, clinical practice varied. Remineralization was the most frequently used treatment (68% used casein phosphopeptide–amorphous calcium phosphate and 62% used fluoride), whereas resin infiltration was used by 46% and microabrasion by only 5% of the respondents. A majority of dentists (52%) preferred monitoring lesions rather than immediate intervention. Conclusions: Russian dental practitioners possess good theoretical knowledge and positive attitudes toward contemporary, minimally invasive management of WSCLs. However, a significant gap exists between knowledge and clinical practice, particularly concerning the use of resin infiltration and microabrasion. These findings underscore the need for continuous education on the topic. Full article

This study addresses the high degree of subjectivity and the supply–demand imbalance in wetland park science communication. Taking the Nanjing Longpao Yangtze River Provincial Wetland Park as a case study, it develops a data-driven, sustainability-oriented design framework integrating NVivo (qualitative data analysis software), the Analytic Hierarchy Process (AHP), the KANO model, Artificial Intelligence Generated Content (AIGC), and Fuzzy Comprehensive Evaluation (FCE) into a closed-loop methodology. A wetland database was constructed through field research and a literature review. User interviews (N = 73) were analysed using NVivo to distill core themes. AHP, based on 15 expert pairwise comparisons, identified Distinctive Plants (global weight 0.314) and Rare Bird Species (0.275) as priority design elements. The KANO model classified 20 science topics into Must-be (N = 5), One-dimensional (N = 2), and Attractive (N = 8) attributes. AIGC was then employed to generate a three-module promotional brochure (wetland flora, avifauna, and culture). FCE with 60 valid respondents confirmed all three modules achieved an ‘Excellent’ rating, validating the framework’s effectiveness. This study provides a replicable, sustainable design paradigm for wetland science communication. Full article

Large language models (LLMs) have achieved strong performance in many linguistic tasks, but their ability to process discourse-level information structure remains insufficiently understood. In particular, current models may identify locally coherent spans while failing to determine the minimal constituent that carries informational prominence in context. Chinese “shi…de” cleft constructions provide a theoretically important testing ground for this problem because they combine a stable formal pattern with context-dependent focus interpretation, exhaustivity, and discourse-sensitive boundary variation. This study investigates whether current LLMs can identify the minimal focus domain in Chinese “shi…de” clefts and whether their performance goes beyond simple surface-form heuristics. Based on 105 human-validated gold-standard samples, we compared three API-accessible models, ChatGPT 5.4, Claude Opus 4.6, and DeepSeek-V4-Pro, with two rule-based baselines. Baseline 1, which extracted the full span between “shi” and “de”, achieved only 2.86% accuracy, while Baseline 2, a stronger minimal-cue heuristic, reached 46.67%. Under the main prompt condition, DeepSeek-V4-Pro achieved the highest accuracy (65.71%), followed by Claude Opus 4.6 (60.00%), whereas ChatGPT 5.4 (41.90%) did not outperform Baseline 2. A prompt-level QUD ablation showed no stable or statistically significant improvement, indicating that explicit discourse-question guidance alone is insufficient for minimal focus-boundary identification. Performance across focus types further showed that topical focus was relatively easier than informational and contrastive focus, suggesting the importance of topic continuity. Overall, the findings reveal both symmetry and asymmetry in LLM focus processing: models share certain task-level constraints, but differ in cue weighting and boundary-compression strategies. The study argues that Chinese “shi…de” focus identification is better modeled as a multi-cue focus-span ranking problem rather than as direct QUD-answer matching. Future research should extend the dataset and further test whether explicit multi-cue ranking methods can improve focus-boundary identification across models and languages. Full article

Background: Parents play a pivotal role in influencing children’s oral health; thus, effective oral health education (OHE) is essential to equip them with the knowledge needed to support their children’s oral health care. In countries such as Pakistan, apart from limited access to dental care and socioeconomic barriers, the widespread lack of OHE is also an important factor contributing to the high prevalence of oral diseases. Conventional OHE approaches are often limited by passive delivery, lack of tailored content and poor accessibility. Social media platforms such as Facebook offer an accessible platform for health education; however, structured, validated, and tailored content is required. Aim: This study aims to develop and validate an online OHE module for Pakistani parents using the ADDIE instructional design model. Materials and Methods: The study was conducted in two phases using the ADDIE model. Parental OHE needs were identified through a questionnaire. An Urdu-language module was developed based on these needs and expert recommendations. Content validation was performed by six experts, followed by face validation with 15 parents. Results: Needs assessment guided the development of a culturally appropriate module covering six main topics. Item-level Content Validity Index ranged from 0.83 to 1.00, with a Scale-level Content Validity Index of 0.94 and a Scale-level Face Validity Index of 0.97. Conclusions: The developed Facebook-delivered OHE module demonstrated high content and face validity and may serve as an accessible and practical strategy for improving parental OHE. Further studies are required to evaluate its effectiveness in improving oral health-related behaviours and outcomes. Full article

Background: Increasing antifungal resistance, poor mucosal retention, and systemic side effects limit the effectiveness of currently available drugs. This study explores a novel topical nanotherapeutic approach for the targeted treatment of vulvovaginal candidiasis (VVC), employing green-synthesized silver nanoparticles (AgNPs) derived from Ascophyllum nodosum (AN) and incorporating ibrexafungerp citrate (IBC) into a liposomal formulation. Methods: AgNPs were biosynthesized using AN extract and characterized. Liposomes were prepared by thin-film hydration, and optimised using Central Composite design and characterized and optimized. Optimised liposomes, co-loaded with IBC and AN-AgNPs, were incorporated into a Carbopol-CMC-based topical gel. Results: FTIR shifts in the –OH (3332.31 cm⁻¹) and carbonyl (1636.87 cm⁻¹) bands with reduced intensity confirmed their involvement in Ag⁺ reduction and nanoparticle surface coordination, while the persistence of the 1015 cm⁻¹ band indicated the role of polysaccharides in capping and stabilizing the AN-AgNP. Characterization of the optimized liposomes (IBCL-11) revealed a particle size of 127.2 nm, a zeta potential of −43.8 mV, and a polydispersity index (PDI) of 0.35. Transmission Electron Microscopy (TEM) confirmed the presence of intact, spherical vesicles, while Differential Scanning Calorimetry (DSC) and X-ray diffraction (XRD) validated the molecular dispersion and amorphous characteristics of the films. In vitro evaluations of the IBC liposomal gel demonstrated a sustained drug release of 72.6% over 24 h, alongside enhanced drug penetration across all skin layers. Antifungal assays highlighted the formulation’s potent efficacy, yielding Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (MFC) values below 1 µg/mL. Furthermore, the treatments exhibited strong anti-biofilm properties; at MIC and MBC levels, AN-AgNPs achieved biofilm reductions of 45.27 ± 3.16% and 27.62 ± 2.13%, respectively, whereas IBCL-11 produced reductions of 34.25 ± 2.43% and 16.28 ± 1.72%. Conclusion: Ultimately, this study successfully developed an eco-friendly liposomal formulation co-loaded with AN-AgNPs and IBC, offering a promising and targeted therapeutic approach for the treatment of vulvovaginal candidiasis. Full article

Background: Squalene is a key sebum lipid that plays an important role in skin barrier function, suppleness, and antioxidant protection. Age-related or disease-associated reductions in squalene levels—for example, in atopic dermatitis—reduce skin resilience and increase susceptibility to environmental stressors. However, its oxidation products can have inflammatory, comedogenic, and pro-aging effects on the skin, which is why adequate stabilization is essential when used in topical formulations. Objective: Therefore, identifying sustainable sources of stable squalene with beneficial skin-care properties is of considerable interest. Methods: This review employed an application-focused literature search and comparative analysis of established and new squalene sources, evaluating chemical composition, manufacturing processes, stability, and biological effects following topical applications based on predefined analytical criteria across peer-reviewed studies. Results: Silphium oil appears to be a promising novel source of highly concentrated, sustainable, and stable squalene with potential skin-conditioning properties at concentrations typically used in cosmetic products (2.1–12.6%) while preliminary formulation tests indicate emulsifiability even at concentrations up to 15%. It contains over 3% squalene, a fatty acid profile with over 66% PUFA, and negligible levels of oxidation byproducts (hexanal < 3 ppm) even after years of storage in various types of packaging. Although independent validation and broader comparative studies are limited, these results reveal new possibilities for the use of previously underutilized plant sources in skin care applications. Full article

Background: Dietitians play a critical role in preventing food–drug interactions (FDIs) and drug–nutrient interactions (DNIs); however, evidence regarding their knowledge, attitudes, and practices (KAP) in Saudi Arabia remains limited. Objective: The aim of this study was to assess dietitians’ KAP regarding FDIs and DNIs and examine their associations with socio-demographic and professional characteristics. Methods: A national cross-sectional study was conducted among 353 dietitians using a validated and modified questionnaire. Knowledge was assessed via 15 multiple-choice items (score range 0–15) and categorized as poor (0–5), moderate (6–10), or good (11–15). Attitudes were assessed using 8 Likert-scale statements (score range 8–40) and classified as negative (8–19), neutral (20–29), or positive (30–40). Practices were assessed via 6 frequency-scale items (score range 6–30) and categorized as poor (6–14), moderate (15–23), or good (24–30). Associations were analyzed using chi-square tests. Results: In total, 65.2% of participants demonstrated poor knowledge. Knowledge level was significantly associated with nationality (p = 0.011), educational qualification (p = 0.042), attendance at FDI/DNI training courses (p = 0.003), and inclusion of related topics during university education (p = 0.013). Higher knowledge levels were also associated with managing digestive diseases (p = 0.001), cardiovascular diseases (p = 0.020), and cancer (p = 0.031). Positive attitudes were reported by 77.6% of participants and were significantly associated with managing cardiovascular disease (p < 0.001) and obesity (p = 0.008). Good practices were observed in 36.3% of dietitians and were significantly associated with younger age (p = 0.024), more recent graduation (p = 0.006), fewer years of professional experience (p = 0.002), and managing obesity (p = 0.016). Knowledge was positively associated with practice (p < 0.001). Conclusions: Despite generally positive attitudes, substantial gaps in knowledge and practice regarding FDIs and DNIs exist among dietitians in Saudi Arabia. Strengthening academic curricula and continuing professional education is essential to enhance competency and improve patient safety. Full article

Artificial Intelligence is increasingly used to support decision-making across many domains. However, concerns related to transparency, reliability and human oversight indicate the need for improved human-centered AI (HCAI) approaches in decision support systems (DSSs). In this paper, a systematic review was conducted in accordance with PRISMA 2020 in the Web of Science database: ninety research articles published between 2015 and 2025 were analyzed to investigate how HCAI is applied within DSSs in multiple application domains. HCAI + DSS research outcomes were analyzed and explored, first identifying the main architectural designs and discussing the involved components integrating human interaction, generative AI models, data and knowledge management, decision logic, and orchestration mechanisms, then focusing on specific domains and highlighting impact achieved, technologies used, and validation strategies employed. In addition, alignment with United Nations’ Sustainable Development Goals (SDG) was considered, and the temporal evolution of the most relevant topics was studied to identify more interesting trends and less investigated areas. Finally, findings were summarized, current limitations were discussed, and future research directions for helping researchers and practitioners in developing more reliable, explainable, and human-aware decision support systems were outlined. Full article

This title and theme of this study will be preoccupied with the discipline of the psychology of religion. It aims at bringing closer the psychology of religion and the writings of the St Maximus the Confessor in an interdisciplinary perspective. Its objective will be focused on illustrating elements of spirituality as a psychological trend under modern psychological endeavours, such as those associated with cognitive behavioural therapy (CBT), and in terms of identifying mental disorders, like anxiety and depression, and therapeutic interventions of change on them. In addition, it will present and discuss St. Maximus the Confessor’s psychological aspects on man that relate to fallenness, intrapsychic upheaval, and therapeutic suggestions. This topic will be presented as an empirical study, based on an inventory (PIPR—Philautia Inventory for the Psychology of Religion) that I have developed, which outlines items from St. Maximus the Confessor’s Christian Orthodox Psychology that are relevant to the spiritual anthropology and exegetical paradigm of that father’s interpretation of the condition of man. This is the second time that I have employed this inventory, for I have constructed it to be pilot-studied, and then to use it in a main study in the future. The items of the PIPR are validated through this pilot study (the present paper). The discussion which will derive from such a pilot empirical study will look into the interdisciplinary elements of spirituality according to a psychology of religion perspective, and the convergence and divergence between the psychology of religion and St. Maximus the Confessor’s writings. This empirical study will concentrate on the inventory I have suggested based on the pilot study that was conducted on each of its items. Last, but not least, I will also discuss and suggest how, by studying the writings of St. Maximus the Confessor, the psychology of religion can benefit, in view to presenting, discussing, and studying the human condition as a psychosomatic endeavour, and not simply as a psychological edifice, and connecting to how the faculties of the human mind operate and function. Full article