Review Article Research Articles

Navigating the complexities of perianal Crohn’s disease: Diagnostic strategies, treatment approaches, and future perspectives

This article discusses the literature review article by Pacheco et al published in July 2024; the authors provided good reviews of perianal Crohn’s disease (CD), and challenges faced by clinicians in the management. CD, characterized by its chronic and relapsing nature, is an idiopathic condition that can involve any segment of the gastrointestinal tract. Perianal disease impacts up to 40% of patients with CD, with perianal fistulas constituting up to 80% of perianal lesions. Perianal CD can be highly incapacitating and profoundly diminish the overall well-being of patients. The management focuses on controlling the perianal sepsis and treating luminal CD. Biologics are crucial to the treatment approach, and results have been encouraging. The surgery focuses on controlling the sepsis, with more definitive treatments being fistula surgery, fecal diversion, and proctectomy as the last resort. This manuscript briefly describes the burden of CD, the challenges posed by perianal CD, and the role of different treatment modalities from colorectal surgeon’s perspective.

Kill two birds with one stone: Hapatologist’s approach to metabolic dysfunction-associated steatotic liver disease and heart failure

Heart failure (HF) is a major global public health concern, and one of the less commonly known risk factors for HF development is metabolic dysfunction-associated steatotic liver disease (MASLD), as they share a similar pathophysiological background. In this article, we evaluated a recently published review article by Arriola-Montenegro et al . This article briefly summarizes the common pathophysiology of HF and MASLD development and evaluates the available therapeutic options to treat both conditions. Clinical practice guidelines highlight the importance of initiating and titrating guideline-directed medication therapy (GDMT) for patients with HF with reduced ejection fraction. GDMT is comprised of the four pillars currently proposed in most clinical practice guidelines, namely angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), angiotensin receptor-neprilysin inhibitors, beta-blockers, mineralocorticoid receptor antagonists, and sodium-glucose co-transporter 2 inhibitors (SGLT-2i). Given the similarity of pathophysiology and risk factors, recent studies for GDMT regarding ACEIs, ARBs, mineralocorticoid receptor antagonists, and SGLT-2i have shown beneficial effects on MASLD. Nonetheless, other medications for both conditions and novel therapies require more robust data and well-designed clinical studies to demonstrate their efficacies in both conditions.

Benefits and Risks of AI in Health Care: Narrative Review

Background The integration of artificial intelligence (AI) into health care has the potential to transform the industry, but it also raises ethical, regulatory, and safety concerns. This review paper provides an in-depth examination of the benefits and risks associated with AI in health care, with a focus on issues like biases, transparency, data privacy, and safety. Objective This study aims to evaluate the advantages and drawbacks of incorporating AI in health care. This assessment centers on the potential biases in AI algorithms, transparency challenges, data privacy issues, and safety risks in health care settings. Methods Studies included in this review were selected based on their relevance to AI applications in health care, focusing on ethical, regulatory, and safety considerations. Inclusion criteria encompassed peer-reviewed articles, reviews, and relevant research papers published in English. Exclusion criteria included non–peer-reviewed articles, editorials, and studies not directly related to AI in health care. A comprehensive literature search was conducted across 8 databases: OVID MEDLINE, OVID Embase, OVID PsycINFO, EBSCO CINAHL Plus with Full Text, ProQuest Sociological Abstracts, ProQuest Philosopher’s Index, ProQuest Advanced Technologies & Aerospace, and Wiley Cochrane Library. The search was last updated on June 23, 2023. Results were synthesized using qualitative methods to identify key themes and findings related to the benefits and risks of AI in health care. Results The literature search yielded 8796 articles. After removing duplicates and applying the inclusion and exclusion criteria, 44 studies were included in the qualitative synthesis. This review highlights the significant promise that AI holds in health care, such as enhancing health care delivery by providing more accurate diagnoses, personalized treatment plans, and efficient resource allocation. However, persistent concerns remain, including biases ingrained in AI algorithms, a lack of transparency in decision-making, potential compromises of patient data privacy, and safety risks associated with AI implementation in clinical settings. Conclusions In conclusion, while AI presents the opportunity for a health care revolution, it is imperative to address the ethical, regulatory, and safety challenges linked to its integration. Proactive measures are required to ensure that AI technologies are developed and deployed responsibly, striking a balance between innovation and the safeguarding of patient well-being.

Electrospun silk for biomedical applications

AbstractElectrospinning technology, capable of creating nanofiber-based materials with large specific surface areas and exceptional breathability, has become an important tool in the biomedical field. Silk, as a well-known natural biopolymer, features good biocompatibility, customizable biodegradability, and superior mechanical properties. The conversion of silk into nanofibers via electrospinning allows for the fine-tuning of its properties, thereby enhancing its suitability for a variety of biomedical applications. Electrospun silk not only inherits the natural advantages of silk but also acquires optimized characteristics such as increased surface area, high porosity, and good air permeability. This review article begins by summarizing the latest advances in the rational design and controlled fabrication of electrospun silk. Then, the biomedical applications of electrospun silk in three main areas: health monitoring, regenerative medicine, and personal protection, are reviewed. Lastly, the existing challenges and future perspectives of electrospun silk are discussed. This review aims to highlight the cutting-edge role of electrospun silk in biomedical applications, potentially revolutionizing traditional healthcare into a personalized model. Graphical Abstract

Overview on Design and Synthesis of Sulfonamide Derivative through Condensation of Amino Group Containing Drug

In medicinal and non-pharmacological chemistry, sulfonamides (SN) are an advisory functional group that forms the basis of many drugs. As such, they are very important. Recently, very significant techniques for the synthesis of sulfonamides have been developed. Numerous pharmacologic activities, including anti-dydropteroate synthetase and anti-carbonic anhydrase, are displayed by sulfonamides. Derivatives of sulfonamides can be used to treat a range of medical conditions, including glaucoma, hypoglycemia, stasis, diarrhea, and inflammation. Our current work has concentrated on creating and synthesizing sulfonamide derivatives via condensation reaction between amino group-containingdrugs.The functionality of sulfonamideinthe clinical trial for the treatment of various medical conditions. For these reasons, development of an efficient process for the synthesis of sulfonamides has always been in the focus for research in organic field synthesis. The most typical method for the synthesis involves reaction between primary or secondary amines and sulfonyl chloride in presence of organic or inorganic bases. Although this method is effective, but the nucleophilicity of amines may vary depending on the groups attached to it. In general, primary amines are highly reactive, whereas secondary amines show very low to almost nil reactivity. In this study, we have reviewed past and recent biological effects of some sulfonamide derivatives and some advances efficient synthetic procedures for some types of sulfonamides. A sulfonamide is a functional group that is the basis of several sulfa drugs and thereby are very much important scaffolds in medicinal as well as in synthetic organic chemistry. Recently very important methodologies have been developed for the synthesis of sulfonamide. This complex review article covers the recent developments (mainly in period 2013- 2019) of powerful methodologies for the synthesis of sulfonamide compounds, particularly where SO2N(R) moiety is not present in a cyclic structure and their applications in various fields during this period. A critical view of the mechanisms of the developed methodologies together with the scope and limitation of these methods adds an extra dimension to the text

Global disparities in cancer care: Bridging the gap in affordability and access to medications between high and low‐income countries

AbstractBackgroundCancer remains a significant challenge for health care systems, despite notable progress in the field. These advancements have significant financial implications that disproportionately affect low‐income countries. This review article aims to explore the present state of drug development, assessing the availability of drugs in different income countries, and proposing potential solutions to address the inequality in access to new cancer treatments.MethodsA search was conducted on MEDLINE and PubMed on October 2, 2023 and updated on December 14, 2023, limited to English language articles.ResultsThere is a projected rise in cancer cases worldwide, particularly in low‐income countries where most cancer‐related deaths are expected. Although the approval rate of cancer treatments has risen, their excessive cost and lack of affordability pose significant barriers to widespread access. Disparities in the costs of crucial cancer medications are influenced by geographic location and procurement connections. Potential solutions to address the inequity in drug distribution include sharing production secrets, implementing price discrimination, international funding, improved primary health care measures, and the implementation of cost‐effective screening methods.ConclusionPreventing, screening for, and treating cancer should be a global priority with minimal differences in access to therapy among various countries.

Endoscopic ultrasound‐guided gallbladder drainage for acute cholecystitis

With technological advances in endoscopic ultrasonography, endoscopic ultrasound‐guided gallbladder drainage (EUS‐GBD) was introduced as a treatment option for acute cholecystitis. Recently, new studies have emerged, suggesting that EUS‐GBD has a lower adverse event rate and reintervention rate, when compared to percutaneous drainage and endoscopic transpapillary gallbladder drainage. There is growing interest in the different technical aspects of EUS‐GBD, such as the puncture approach, choice of stents, and long‐term management. There are also cohorts on performing EUS‐GBD in potential surgical candidates. This review article gathers the latest evidence on EUS‐GBD, including its indications, procedural techniques, choice of equipment, outcomes, postprocedural care, and the controversial extended indications.

Marine Operations in the Norwegian Sea and the Ice-Free Part of the Barents Sea with Emphasis on Polar Low Pressures

The Arctic Seas are attractive for shipping, fisheries, and other marine activities due to the abundant resources of the Arctic. The shrinking ice cover allows for the opening of activities in increasingly larger areas of the Arctic. This paper evaluates the possibility of executing all-year complex marine activities, here termed “marine operations”, in the Norwegian Sea and the ice-free part of the Barents Sea. The approach used during the preparation of this review paper is to identify constraints to marine operations so users can be aware of the limitations of performing such operations. The weather conditions in the Norwegian Sea and the Barents Sea are well known, and these seas are considered representative of ice-free or partly ice-free Arctic Seas with considerable marine activities. Similar conditions could be expected for other Arctic Seas during periods without ice cover. Marine operations require safe and stable working conditions for several days. The characteristics of marine operations are discussed, and the particulars of the Norwegian Sea and the Barents Sea physical environments are highlighted. Emphasis is on the wind and wave conditions in unpredictable polar low-pressure situations. Furthermore, situations with fog are discussed. The large uncertainties in forecasting the initiation and the tracks of polar lows represent the main concern for executing marine operations all year. Improvements in forecasting the occurrence and the path of polar lows would extend the weather window when marine operations could be carried out. Discussions of the potential for similar conditions in the wider Arctic Seas during ice-free periods are presented.

Revolutionizing smart textiles: a comprehensive review of conductive ink printing for sustainable and adaptive wearable applications

Purpose The demand of species monitoring for the benefit of various sectors such as industrial, medicinal and ecological has surged rapidly in the recent past. Therefore, the purpose of this paper is to articulate the major developments in synthesizing conductive inks for the structurization of miniaturized as well as disposable or reusable electrochemical equipments. Design/methodology/approach This section is not applicable to a review paper. Findings Numerous times the need for the use point becomes significant for achieving accurate as well as swift quantification. As an alternate, the wearable and effectual reuseable electrochemical sensors are being practiced. The technique of fabricating devices using conductive inks encompasses novelty, as it provides flexibility in designing the electrodes. The increase in the popularity of inks development is governed by its features of simplicity, reduced cost and waste generation, high production and eco-friendly engineering procedures. Further, the electrochemistry aspects of conductive inks highlighting the importance of their compounds and binders has also been discussed emphasizing on the conductive materials. Originality/value This paper is an original review work. This paper will be helpful for manufacturers/researchers from smart wearable textile sector in envisaging innovative developing techniques of sensors as well as biosensors through conductive inks.

A review of AI and machine learning contribution in business process management (process enhancement and process improvement approaches)

PurposeThe significance of business processes has fostered a close collaboration between academia and industry. Moreover, the business landscape has witnessed continuous transformation, closely intertwined with technological advancements. Our main goal is to offer researchers and process analysts insights into the latest developments concerning artificial intelligence (AI) and machine learning (ML) to optimize their processes in an organization and identify research gaps and future directions in the field.Design/methodology/approachIn this study, we perform a systematic review of academic literature to investigate the integration of AI/ML in business process management (BPM). We categorize the literature according to the BPM life-cycle and employ bibliometric and objective-oriented methodology to analyze related papers.FindingsIn business process management and process map, AI/ML has made significant improvements using operational data on process metrics. These developments involve two distinct stages: (1) process enhancement, which emphasizes analyzing process information and adding descriptions to process models and (2) process improvement, which focuses on redesigning processes based on insights derived from analysis.Research limitations/implicationsWhile this review paper serves to provide an overview of different approaches for addressing process-related challenges, it does not delve deeply into the intricacies of fine-grained technical details of each method. This work focuses on recent papers conducted between 2010 and 2024.Originality/valueThis work addresses a significant gap by employing a pioneering approach to introduce challenges in BPM alongside AI/ML techniques and integrated tools. Hence, it offers comprehensive guidelines that elucidate the alignment between ML methods and solutions to current challenges across the BPM life-cycle, including process enhancement and process improvement. Additionally, by detailing various aspects of the life-cycle phases and highlighting ML technique characteristics, this research demonstrates potential approaches for future exploration, thereby enhancing applicability for both process analysts and researchers in this context.

Intra- and early postoperative complications of laparoscopic and robot-assisted radical prostatectomy

Radical prostatectomy is the gold standard for the treatment of localized prostate cancer. In the last decade, new surgical technologies have been actively implemented that certainly increases the efficiency of oncourological treatment. The rate of intra- and postoperative complications of radical prostatectomy yet remains quite high. In this regard, crucial tasks of modern urology are minimizing of their number and effective treatment. In the review article, intra- and early postoperative complications of laparoscopic and robot-assisted radical prostatectomy have been considered.

Evidence Supporting Conservative Scar Management Interventions Following Burn Injury: a review article.

Conservative management for hypertrophic scars (HSc) and scar contractures is of utmost importance to optimally reintegrate burn survivors into society. Many conservative treatment interventions have been described in the literature for the management of HSc. Recent advancements in the literature pertaining to post-burn scarring and HSc formation, have advanced our understanding of the mechanisms that support or refute the use of common rehabilitation treatment modalities after burn injury. This is particularly relevant for recent advancements in the fields of mechanotransduction and neurogenic inflammation resulting in the need for rehabilitation clinicians to reflect upon commonly employed treatment interventions. The aim of this review article is to summarize and clinically apply the evidence that supports or refutes the use of common conservative treatment interventions for scar management employed after burn injury. The following treatments are discussed and mechanotransduction and neurogenic inflammation concepts are highlighted: 1) edema management (compression, positioning/elevation, pumping exercises, retrograde massage, manual edema mobilization), 2) pressure therapy (including custom fabricated pressure garments, inserts, face masks, and other low-load long duration orthotic devices), 3) gels or gel sheets, 4) combined pressure therapy and gels, 5) serial casting, 6) scar massage, and 7) passive stretching. This review supports the following statements: 1) Compression for edema reduction should be initiated 48-72 hrs post-injury and continued for wounds that require longer than 21 days to heal until scar maturation; 2) Elevation, pumping exercises and retrograde massage/MEM should be used in combination with other edema management techniques; 3) Custom fabricated pressure garments should be applied once the edema is stabilized and adequate healing has occurred. Garments should be monitored on a regular basis to ensure that optional pressure, >15mm Hg, is maintained, adding inserts when necessary. The wearing time should be >16 hrs/day; 4) Gels for post-burn scar management should extend beyond the scar; 5) Serial casting should be applied when contractures interfere with function; 6) Forceful scar massage should be avoided early in the wound healing process or when the scar is inflamed or breaks down; 7) Other treatment modalities should be prioritized over passive stretching for scar management.

Extreme Events Contributing to Tipping Elements and Tipping Points

AbstractThis review article provides a synthesis and perspective on how weather and climate extreme events can play a role in influencing tipping elements and triggering tipping points in the Earth System. An example of a potential critical global tipping point, induced by climate extremes in an increasingly warmer climate, is Amazon rainforest dieback that could be driven by regional increases in droughts and exacerbated by fires, in addition to deforestation. A tipping element associated with the boreal forest might also be vulnerable to heat, drought and fire. An oceanic example is the potential collapse of the Atlantic meridional overturning circulation due to extreme variability in freshwater inputs, while marine heatwaves and high acidity extremes can lead to coral reef collapse. Extreme heat events may furthermore play an important role in ice sheet, glacier and permafrost stability. Regional severe extreme events could also lead to tipping in ecosystems, as well as in human systems, in response to climate drivers. However, substantial scientific uncertainty remains on mechanistic links between extreme events and tipping points. Earth observations are of high relevance to evaluate and constrain those links between extreme events and tipping elements, by determining conditions leading to delayed recovery with a potential for tipping in the atmosphere, on land, in vegetation, and in the ocean. In the subsurface ocean, there is a lack of consistent, synoptic and high frequency observations of changes in both ocean physics and biogeochemistry. This review article shows the importance of considering the interface between extreme events and tipping points, two topics usually addressed in isolation, and the need for continued monitoring to observe early warning signs and to evaluate Earth system response to extreme events as well as improving model skill in simulating extremes, compound extremes and tipping elements.

A Review Article Niosomal Drug Delivery for Oral Route

A Review Article Niosomal Drug Delivery for Oral Route

Formulation and Evaluation of Anti-Hyperlipidemic Tablet

Hyperlipidemia is one of the leading causes of mortality in developed as well as in developing countries like India. It attributes to the high risk of coronary heart disease and atherosclerosis which is referred as a silent killer. Herbal treatment for hyperlipidemia is inexpensive, readily available locally, and has no negative side effects. Medicinal plants are the "backbone" of traditional medicine so considered as good source of life for all people due to its wealthy therapeutic properties and being 100% natural. Several drugs in Siddha have been found to be beneficial in lowering lipid levels without any major adverse effects. Numerous plants like arjuna, ashwagandha, garlic, guggul, etc. have been reported to have lipid-lowering effects. The goal of the review paper is to examine the potential anti-hyperlipidemic effects of herbal plants using a variety of models. The anti-hyperlipidemic activity of the most well-known medicinal herbs is the focus of this review.

Microbial Bioremediation of Petroleum Contaminated Soil: Structural Complexity, Degradation Dynamics and Advanced Remediation Techniques

Soil contamination with petroleum hydrocarbons poses a significant environmental challenge, necessitating effective remediation strategies to mitigate ecological risks. This review paper systematically examines the current state of knowledge regarding soil contamination with petroleum hydrocarbons, focusing on diverse sources and the extent of contamination. The investigation encompasses a range of hydrocarbon compounds, including aliphatic and aromatic fractions, emphasizing the dynamic nature of the contamination scenarios. A thorough review of bioremediation techniques, which have shown promise and sustainability as methods for cleaning up soil contaminated with petroleum hydrocarbons are also involved in order to solve these issues. Each of the three microbial processes, biodegradation, bioaugmentation, and biostimulation, is covered in detail in the paper, along with the complex mechanics underlying each technique. The report also emphasises new developments in genetics and molecular biology that add to our understanding of the metabolic pathways and microbial interactions involved in hydrocarbon breakdown. The effectiveness of plant-assisted bioremediation coupled with bioaugmentation and stimulation, specifically phytoremediation, is also explored, emphasizing the potential of certain plant species to enhance the removal of petroleum hydrocarbons from contaminated soils through rhizosphere interactions and plant-associated microbial activities. Furthermore, the paper evaluates the influence of environmental variables including soil composition, temperature, and moisture content on the effectiveness of bioremediation techniques, offering valuable perspectives on enhancing remediation efficiency through optimal conditions. The possibility for enhancing conventional bioremediation techniques through the incorporation of cutting-edge technology like nano-remediation is also explored.

ADVANCEMENTS IN UNDERSTANDING AND MANAGING ALCOHOL WITHDRAWAL SYNDROME: A COMPREHENSIVE REVIEW

Alcohol withdrawal syndrome (AWS) is a clinically significant condition that can arise upon abrupt cessation or reduction of alcohol consumption in individuals with alcohol dependence. This review article provides a comprehensive overview of AWS, encompassing its epidemiology, pathophysiology, clinical manifestations, assessment tools, and management strategies. We discuss the neurobiological mechanisms underlying AWS, including the role of neurotransmitter systems such as gamma-aminobutyric acid (GABA) and glutamate, as well as neuroadaptive changes that occur with chronic alcohol use. Furthermore, we explore the spectrum of clinical manifestations associated with AWS, ranging from mild withdrawal symptoms to severe complications such as delirium tremens and seizures. Diagnostic tools and scoring systems commonly used for assessing AWS severity are examined, along with evidence-based approaches for pharmacological and non-pharmacological management of AWS. Additionally, we highlight emerging research areas and future directions in the field of AWS, including novel treatment modalities and potential biomarkers for predicting withdrawal severity and treatment response. This comprehensive review aims to provide clinicians, researchers, and healthcare professionals with a thorough understanding of AWS to facilitate early recognition, appropriate management, and improved outcomes for individuals affected by this condition.

Illuminating Malaria: Spectroscopy’s Vital Role in Diagnosis and Research

Spectroscopic techniques have emerged as crucial tools in the field of malaria research, offering immense potential for improved diagnosis and enhanced understanding of the disease. This review article pays tribute to the pioneering contributions of Professor Henry Mantsch in the realm of clinical biospectroscopy, by comprehensively exploring the diverse applications of spectroscopic methods in malaria research. From the identification of reliable biomarkers to the development of innovative diagnostic approaches, spectroscopic techniques spanning the ultraviolet to far-infrared regions have played a pivotal role in advancing our knowledge of malaria. This review will highlight the multifaceted ways in which spectroscopy has contributed to the field, with a particular emphasis on its impact on diagnostic advancements and drug research. By leveraging the minimally invasive and highly accurate nature of spectroscopic techniques, researchers have made significant strides in improving the detection and monitoring of malaria parasites. These advancements hold the promise of enhancing patient outcomes and aiding in the global efforts towards the eradication of this devastating disease.

Swine Industry in Canada: Biosecurity in Live Animal, Semen Transportation, and Embryo Transfer

The pork industry, a key player in the Canadian economy, significantly contributes to livestock production, international trade markets, and employment. The multi-faceted swine industry is comprised of nucleus, multiplier, and commercial herds. The recognition and application of exemplary internal and external biosecurity measures are paramount for maintaining sustainable swine production. Historically, live animal transport has been an important means of disseminating superior genetics between production herds and poses a considerable risk for disease transmission and biosecurity breach points. The industry has evolved over time to employ other methods, through the shipping of boar semen and the adoption of artificial insemination practices to acquire genetic resources with a lower risk of disease transmission. These effective changes have led to an improvement in herd health, production performance, and efficiency. In particular, the industry’s dedication to enhanced biosecurity is evident in the effort to streamline embryo collection and transfer procedures. Such advances reduce the potential need to transport live animals, thereby lowering the risk of introducing infectious agents. This review article explores the different forms of disseminating swine genetics, namely, live animal, semen transportation, and embryo transfer, examining potential breaches in biosecurity, and discussing mitigation strategies that reduce disease transmission to protect the health of animal stock.

SUPERLOTAÇÃO DOS SERVIÇOS DE EMERGÊNCIA: IMPLICAÇÕES PARA A SEGURANÇA DO PACIENTE E PARA O TRABALHO DA EQUIPE DE SAÚDE

Introduction: Overcrowding in emergency services is a reality that is likely to worsen, making it necessary to implement measures to ensure patient safety in the care provided. Objective: To describe the implications of overcrowding for patient safety and the work/daily routine of the healthcare team. Methodology: This is a bibliographic review article in which an exploratory, qualitative approach was used. The search for articles, theses, dissertations, book chapters was conducted in databases such as Lilacs BDNF, Medline, Scielo, and university repositories containing scientific journals. Publications were sought that addressed the topic in Portuguese, within the period of 2015 to 2024. The results yielded 34 articles related to the topic, of which 12 were selected for this study, in addition to the book by the Joint Commission International (JCI), “Managing Patient Flow: Strategies and Solutions for Overcoming Overcrowding.” Results and Discussion: It is well known that patient safety is a globally discussed topic and a recurring requirement for institutions undergoing accreditation processes. In this context are healthcare professionals, who, due to the nature of their work, are subject to committing/experiencing adverse events within their professional environment. Final Considerations: The consequences of overcrowding bring numerous implications for the work of healthcare professionals and for patient safety, such as reduced quality of care, exhaustion of healthcare professionals, increased risk of infections, inequality in access to care, impact on the efficiency of the healthcare system, and increased costs, making it a critical challenge for both public and private healthcare systems.