Search Results (23,159)

(1) Background: With the acceleration of globalization, various risks are intertwined and coupled, and community emergency management is facing greater pressure than before. The continuous development of digital technology has made it possible to empower community emergency management with digital technology. Therefore, it is urgent to have a clear understanding of the research status and future development direction of digital empowering community emergency management. (2) Methods: This study is based on the Web of Science database and utilizes the CiteSpace knowledge graph visualization method to analyze the research progress of community digital emergency management. (3) Results: The results indicate that from 2000 to 2024, the amount of research on community digital emergency management has been on the rise, involving multiple disciplines, but there has not been a close and mature cooperation network between different countries, institutions, and authors. The research topic has shifted from early single-emergency management to integration with emerging science and technology, with a greater emphasis on the role of communities. Big data, machine learning, technological innovation, digital healthcare, and community resilience are important research directions for the future. (4) Conclusions: In the future, we should strengthen cooperation in this field, overcome issues such as the digital divide and digital security, and promote further development of community digital emergency management. Full article

Over the past few years, transcatheter aortic valve implantation (TAVI) imposed itself as the first-choice therapy for symptomatic aortic stenosis (AS) in elderly patients at surgical risk. There have been continuous technological advancements in the latest iterations of TAVI devices and implantation techniques, which have bolstered their adoption. Moreover, the favorable outcomes coming out from clinical trials represent an indisputable point of strength for TAVI. As indications for transcatheter therapies now include a low surgical risk and younger individuals, new challenges are emerging. In this context, the matter of prosthesis durability is noteworthy. Initial evidence is beginning to emerge from the studies in the field, but they are still limited and compromised by multiple biases. Additionally, the physiopathological mechanisms behind the valve’s deterioration are nowadays somewhat clearer and classified. So, who outlasts who—the valve or the patient? This review aims to explore the available evidence surrounding this intriguing question, examining the various factors affecting prosthesis durability and discussing its potential implications for clinical management and current interventional practice. Full article

Ventricular pre-excitation (VP) is a cardiac disorder characterized by the presence of an accessory pathway (AP) that bypasses the atrioventricular node (AVN), which, although often asymptomatic, exposes individuals to an increased risk of re-entrant supraventricular tachycardias and sudden cardiac death (SCD) due to rapid atrial fibrillation (AF) conduction. This condition is particularly significant in sports cardiology, where preparticipation ECG screening is routinely performed on athletes. Professional athletes, given their elevated risk of developing malignant arrhythmias, require careful assessment. Early identification of VP and proper risk stratification are crucial for determining the most appropriate management strategy and ensuring the safety of these individuals during competitive sports. Non-invasive tools, such as resting electrocardiograms (ECGs), ambulatory ECG monitoring, and exercise stress tests, are commonly employed, although their interpretation can sometimes be challenging. This review aims to provide practical tips and electrocardiographic clues for detecting VP beyond the classical triad (short PR interval, delta wave, and prolonged QRS interval) and offers guidance on non-invasive risk stratification. Although the diagnostic gold standard remains invasive electrophysiological study, appropriate interpretation of the ECG can help limit unnecessary referrals for young, often asymptomatic, athletes. Full article

This review aims to compare the effect of photobiomodulation therapy (PBMT) using visible and near-infrared diode laser wavelengths to that of the dry needling technique (DNT) on the management of orofacial pain in patients with Temporomandibular Disorder Myofascial Pain Syndrome (TMD/MPS) in term of effectiveness, speed of recovery, and lasting of treatment. A systematic search of multiple electronic databases was carried out to identify the relevant clinical trials published between 1 January 2010 and 1 January 2024. The included studies were limited to human subjects who had orofacial pain associated with Axis 1 of TMD/MPS, involving two genders with age >18 years and were treated either with photobiomodulation using diode laser with wavelengths ranging from 600 up to 1200 nanometer (nm), or with the dry needling (DN) technique (superficial SDN or deep DDN), as a non-pharmacological therapies to decrease the intensity of orofacial pain associated with TMD/MPS. The risk of bias for included studies was assessed using the Cochrane RoB tool (for randomized studies). Three distinct meta-analyses were performed to quantify the pooled effects of PBM and DN in the management of TMD/MPS myofascial pain and deactivation of myofascial trigger points (MTPs). The meta-analyses were performed using Review Manager (RevMan) 5.3 from Cochrane. The confidence interval (CI) was established at 95% and p-values of less than 0.05 (p < 0.05) were considered statistically significant. Statistical heterogeneity was assessed using I2. Qualitative data were extracted and summarized in tables for each group study, while quantitative data were reported as Mean and Standard Deviation (SD) values for assessment variables in each sub-group study. The results among groups were systematically evaluated to draw the final conclusion. A rigorous electronic and manual search revealed 4150 possible articles. Following the application of the inclusion and exclusion criteria, twelve eligible studies were included in the analysis. Both PBMT and DNT were found to be effective in controlling the myalgia pain and primary symptoms associated with TMD/MPS, as well as deactivating the MTPs. DNT was statistically superior in terms of recovery time while PBMT was the more effective long-term therapy. Full article

Background: The aging population drives a growing demand for care, particularly in Europe. It is estimated that approximately 1.5–2 million individuals have a chronic wound. Among these, pressure ulcers (PUs) are one of the most prevalent complications in vulnerable individuals. Malnutrition is a primary risk factor, yet it can be mitigated through proper nutrition and adequate community support. The community nurse plays a crucial role in managing chronic conditions and nutrition through constant and professional monitoring. Aim: This article presents a comprehensive systematic review (SR) protocol to examine the role of community nursing of nutritional intervention of frail population with wound care. Methods: A SR will be conducted according to international standards and reported following the PRISMA Guidelines for SRs. The search will be conducted in PubMed/Medline, Scopus, Embase, and CINAHL, supplemented by grey literature sources. The methodological quality and risk of bias will be assessed using the Critical Appraisal Skills Programme (CASP) framework. The protocol has been registered in the Open Science Framework (OSF). Conclusions: It is anticipated that the findings of this SR will provide new evidence on the relationships between nutritional nursing interventions and wound care management primarily in the community setting. Full article

This study evaluates the thermal impact of a one-drill protocol for osteotomy preparation in dental implant surgery. Our findings demonstrate a significant reduction in heat generation compared to traditional sequential drilling, suggesting potential benefits for implant osseointegration and patient comfort. Specifically, the one-drill protocol was associated with lower peak temperatures and a reduced duration of elevated temperatures. These findings suggest that the one-drill protocol may contribute to improved implant stability and reduce the risk of thermal-induced bone damage. While further research is needed to confirm these findings in clinical settings, the results of this study provide promising evidence for the potential advantages of the one-drill protocol in dental implant surgery. Additionally, the one-drill protocol may offer simplified surgical workflows and reduced instrument management, potentially leading to improved efficiency and cost-effectiveness in dental implant procedures. Full article

Fetal growth restriction (FGR) is a common complication of pregnancy, associated with major perinatal mortality and morbidity, and with an increased risk to develop cardiometabolic diseases later in life. There is currently no effective approach to prevent or treat FGR, despite numerous animal and human studies assessing substances likely to improve fetal growth. Phosphodiesterase (PDE) inhibitors appeared as promising drugs to improve FGR management. However, to date, studies have led to somewhat disappointing or controversial results. In this Opinion article, we would like to draw attention to the need to consider the biological sex and the relative reactivity of human umbilical vein and arteries when developing therapeutic interventions to improve human umbilical circulation using PDE inhibitors. Indeed, we suspect that fetal sex, vessel type and the presence of FGR may influence subcellular compartmentation, which could jeopardize beneficial effects of PDE inhibitors. Full article

World’s Best Practice management of locusts and grasshoppers requires accurate forecasting that helps determine where and when surveys are preferentially conducted so that infestations can be found quickly as part of ensuring early intervention treatments. Using survey data downloaded directly into a Geographic Information System (GIS), as well as rainfall and other factors important in the population dynamics of the species concerned, models within the GIS provide forecasts of future developments. The GIS provides forecasts of likely events and is used by locust and grasshopper experts to make decisions; that is, the forecasting is part of a Decision Support System for improved locust and grasshopper management. Surveys are generally conducted by ground vehicles, but for locusts, surveys by aircraft can be an important way to rapidly find bands. In Australia, dense bands can often be seen from an aircraft flying overhead at a height of 300 m, and similar detection of bands of the desert locust by aircraft has been conducted in Somalia. Swarms can be detected by ground vehicles, but because swarms move, surveying by aircraft is also an important way of locating swarms for treatment. When locust infestations are found, they are rapidly treated as part of early intervention preventive management. However, it is generally recognized that it is extremely difficult for landholders alone to protect crops against locusts and grasshoppers, so government intervention is often necessary. These organizations use a variety of treatment techniques to reduce the amount of chemical pesticide applied either by strip spraying or treating very dense infestations, such as roosting swarms, or using biopesticides. These techniques, as used in a number of countries, have proven to be very effective in managing locust populations while reducing the risk to the natural environment and human health. Full article

This study investigates the interannual variations in regional mean sea levels (MSLs) of the northeast Asian marginal seas (NEAMS) during August, focusing on the role of typhoon activity from 1993 to 2019. The NEAMS are connected to the Pacific through the East China Sea (ECS) and narrow, shallow straits in the east, where inflow from the southern boundary (ECS), unless balanced by eastern outflow, leads to significant convergence or divergence, as well as subsequent changes in regional MSLs. Satellite altimetry and tide-gauge data reveal that typhoon-induced Ekman transport plays a key role in MSL variability, with increased inflow raising MSLs during active typhoon seasons. In contrast, weak typhoon activity reduces inflow, resulting in lower MSLs. This study’s findings have significant implications for coastal management, as the projected changes in tropical cyclone frequency and intensity due to climate change could exacerbate sea level rise and flooding risks. Coastal communities in the NEAMS region will need to prioritize enhanced flood defenses, early warning systems, and adaptive land use strategies to mitigate these risks. This is the first study to link typhoon frequency directly to NEAMS MSL variability, highlighting the critical role of wind-driven processes in regional sea level changes. Full article

Due to the increased unpredictability and severity of weather patterns caused by climate change, traditional farming practices and risk management strategies are becoming increasingly inadequate. In this paper, we explore the literature to understand the potential of artificial intelligence (AI) in mitigating climate-related agricultural risks and the pivotal role that public institutions play in encouraging farmers to adopt such technologies. We propose a framework to integrate AI into government-subsidized insurance structures, focusing on reduced premiums through government intervention. We argue that AI’s potential to reduce the uncertainty and severity of climate-induced damages could lower the overall risk profile of insured farmers, thereby justifying lower premiums in the long run. We further discuss the implications of such policies on insurance markets, agricultural sustainability, and global food security. Our initial exploration contributes to the literature by addressing a relatively underexplored intersection of two critical fields—agricultural insurance and artificial intelligence—suggesting directions for future research. Full article

Non-contact anterior cruciate ligament injuries (NC-ACLs) represent a significant concern in sports medicine, particularly among athletes and physically active individuals. These injuries not only result in immediate functional impairment but also predispose individuals to long-term issues such as recurrent instability and early-onset osteoarthritis. This narrative review examines the biomechanical, neuromuscular, and environmental factors that contribute to the high incidence of NC-ACLs and evaluates the effectiveness of current prevention and rehabilitation strategies. The review identifies key risk factors, including improper landing mechanics, deficits in neuromuscular control, and muscle imbalances, which are pivotal in the etiology of NC-ACLs. Prevention programs that incorporate plyometric exercises, strength training, and neuromuscular education have shown efficacy in reducing injury rates. Rehabilitation protocols that emphasize a gradual return to sport, focusing on pain management, restoration of range of motion, and progressive strengthening, are critical for successful recovery and prevention of re-injury. The evidence suggests that an integrated approach, combining prevention and rehabilitation strategies tailored to the individual, is essential for minimizing NC-ACL risk and improving outcomes in affected populations. Full article

Background/Objective: Medullary thyroid carcinoma (MTC) is a rare yet aggressive form of thyroid cancer comprising a disproportionate share of thyroid cancer-related mortalities, despite its low prevalence. MTC differs from other differentiated thyroid malignancies due to its heterogeneous nature, presenting complexities in both hereditary and sporadic cases. Traditional management guidelines, which are designed primarily for papillary thyroid carcinoma (PTC), fall short in providing the individualized care required for patients with MTC. In recent years, the sheer volume of data generated from clinical evaluations, radiological imaging, pathological assessments, genetic mutations, and immunological profiles has made it humanly impossible for clinicians to simultaneously analyze and integrate these diverse data streams effectively. This data deluge necessitates the adoption of advanced technologies to assist in decision-making processes. Holomics, which is an integrated approach that combines various omics technologies, along with artificial intelligence (AI), emerges as a powerful solution to address these challenges. Methods: This article reviews how AI-driven precision oncology can enhance the diagnostic workup, staging, risk stratification, management, and follow-up care of patients with MTC by processing vast amounts of complex data quickly and accurately. Articles published in English language and indexed in Pubmed were searched. Results: AI algorithms can identify patterns and correlations that may not be apparent to human clinicians, thereby improving the precision of personalized treatment plans. Moreover, the implementation of AI in the management of MTC enables the collation and synthesis of clinical experiences from across the globe, facilitating a more comprehensive understanding of the disease and its treatment outcomes. Conclusions: The integration of holomics and AI in the management of patients with MTC represents a significant advancement in precision oncology. This innovative approach not only addresses the complexities of a rare and aggressive disease but also paves the way for global collaboration and equitable healthcare solutions, ultimately transforming the landscape of treatment and care of patients with MTC. By leveraging AI and holomics, we can strive toward making personalized healthcare accessible to every individual, regardless of their economic status, thereby improving overall survival rates and quality of life for MTC patients worldwide. This global approach aligns with the United Nations Sustainable Development Goal 3, which aims to ensure healthy lives and promote well-being at all ages. Full article

Background/Objectives: Diagnosing acute pulmonary embolism (PE) is challenging due to its wide range of symptoms and numerous differential diagnoses. Medical professionals must balance performing all essential examinations and avoiding unnecessary testing. This study aimed to retrospectively audit the diagnosis and treatment of acute PE at a Swiss public teaching hospital to determine the adherence to current guidelines and to identify the factors associated with the delayed initiation of anticoagulation in PE patients. Methods: In this retrospective observational cohort study, we included all adult patients hospitalized with PE at the Cantonal Hospital Baselland (KSBL) between November 2018 and October 2020, where the diagnosis was made within the first twelve hours of their arrival to the emergency department (ED). LASSO regression was employed to identify clinical characteristics associated with delayed anticoagulation initiation. Results: A total of 197 patients were included (mean age: 70 years, 54% female). The audit revealed that diagnostic workup was conducted according to guidelines in 57% of cases. Often, D-dimer levels were measured although not strictly necessary (70%). Pretest probability was assessed and documented using the Wells or Geneva score in only 3% of patients, and risk assessment via the Pulmonary Embolism Severity Index (PESI) score was documented in 21% of patients. The median time from ED arrival to CT scan was 120 min (IQR 89.5–210.5), and the median time to anticoagulation initiation was 193 min (IQR 145–277). Factors identified by LASSO associated with delayed anticoagulation included prolonged time from ED arrival to CT scan, the presence of distended jugular veins on examination, ED arrival in the morning, and presenting symptoms of weakness or tiredness. Complementary leg ultrasound was performed in 57% of patients, with 38% of these cases lacking prior clinical examination for deep vein thrombosis. The duration of the anticoagulation treatment was not specified in the discharge report for 17% of patients. A medical follow-up after discharge was recommended in 75% of the patients. Conclusions: In conclusion, while the management of PE at the KSBL generally adheres to high standards, there are areas for improvement, particularly in the morning performance, the use of a pretest probability assessment, D-dimer measurement, risk assessment via the PESI score, the performance of complementary leg ultrasounds, clarification of the anticoagulation duration, and follow-up management. Full article

Existing tools for predicting postoperative complications in women undergoing surgery for gynecological neoplasms are evaluated in this narrative review. Although surgery is a very efficient therapy for gynecological tumors, it is not devoid of the possibility of negative postoperative outcomes. Widely used tools at present, such as the Surgical Apgar Score and the Modified Frailty Index, fail to consider the complex characteristics of gynecological malignancies and their related risk factors. A thorough search of the PubMed database was conducted for our review, specifically targeting studies that investigate several aspects impacting postoperative outcomes, including nutritional status, obesity, albumin levels, sodium levels, fluid management, and psychological well-being. Research has shown that both malnutrition and obesity have a substantial impact on postoperative mortality and morbidity. Diminished sodium and albumin levels together with compromised psychological well-being can serve as reliable indicators of negative consequences. The role of appropriate fluid management in enhancing patient recovery was also investigated. The evidence indicates that although current mechanisms are useful, they have limitations in terms of their range and do not thoroughly address these recently identified risk factors. Therefore, there is a need for a new, more comprehensive tool that combines these developing elements to more accurately forecast postoperative problems and enhance patient results in gynecological oncology. This paper highlights the need to create such a tool to improve clinical practice and the treatment of patients. Full article

Crigler–Najjar Syndrome (CNS) is a rare genetic disorder caused by mutations in the UGT1A1 gene, leading to impaired bilirubin conjugation and severe unconjugated hyperbilirubinemia. CNS presents in the following forms: CNS type 1 (CNS1), the more severe form with the complete absence of UGT1A1 activity, and CNS type 2 (CNS2), with partial enzyme activity. This narrative review aims to provide a detailed overview of CNS, highlighting its clinical significance and the need for new, more effective treatments. By summarizing current knowledge and discussing future treatments, this article seeks to encourage further research and advancements that can improve outcomes for CNS patients. The literature analysis showed that CNS1 requires aggressive management, including phototherapy and plasmapheresis, but liver transplantation (LT) remains the only definitive cure. The timing of LT is critical, as it must be performed before the onset of irreversible brain damage (kernicterus), making early intervention essential. However, LT poses risks such as graft rejection and lifelong immunosuppression. CNS2 is milder, with patients responding well to phenobarbital and having a lower risk of kernicterus. Recent advancements in gene therapy and autologous hepatocyte transplantation offer promising alternatives to LT. Gene therapy using adeno-associated virus (AAV) vectors has shown potential in preclinical studies, though challenges remain in pediatric applications due to liver growth and pre-existing immunity. Autologous hepatocyte transplantation avoids the risk of rejection but requires further research. These emerging therapies provide hope for more effective and less invasive treatment options, aiming to improve the quality of life for CNS patients and reduce reliance on lifelong interventions. Full article