Safety Benefits Research Articles

Distal versus conventional transradial access for coronary angiography: a pooled analysis from the randomized RAPID trial

Abstract Background Transradial access (TRA) is the recommended approach for coronary procedures considering safety benefits over femoral access with radial artery occlusion (RAO) being the most frequent complication. Although usually not clinically significant, the presence of RAO affects potential future procedures and medical treatments. Distal TRA (dTRA) has been suggested to reduce the risk of postprocedural RAO compared to conventional TRA (cTRA) with, however, inconsistent results in clinical trials. Purpose This study aimed to compare the efficacy and safety of dTRA versus cTRA in patients undergoing diagnostic coronary angiography. Methods The RAPID trial is a single-center, open-label, 2x2 factorial, randomized study of patients undergoing coronary angiography through a 6-F radial access. The trial was stopped early by the data and safety monitoring board after the second pre-planned interim analysis and inclusion of 600 participants. Patients were randomized to dTRA or cTRA with further stratification according to periprocedural heparin use and preexisting oral anticoagulation. The primary endpoints were the incidence of RAO assessed by vascular ultrasound and puncture-site related bleedings. Results The final study population consisted of 298 patients randomized to dTRA and 302 patients to cTRA. Periprocedural heparin was administered in 382 patients (63.7%) and percutaneous coronary intervention was performed in 161 cases (26.8%) without differences between the study groups (p=0.700 and p=0.465; respectively). Distal TRA was associated with a significantly increased number of puncture attempts (2.4 ± 2.0 versus 1.5 ± 1.2; p<0.001) and failed punctures leading to access site crossover (11.7% versus 5.0%; p=0.003). Consequently, the total procedure time was longer in the dTRA group (30 min versus 25 min; p=0.004) without increasing fluoroscopy time (p=0.320), dose area product (p=0.245), or contrast volume (p=0.884). Patent hemostasis was achieved in 91.7% of patients with cTRA. The rates of RAO (16.1% versus 15.6%, p=0.855) and puncture-site related bleedings (6.7% versus 8.3%; p=0.466) were similar in both groups. Conclusions According to this study, dTRA does not reduce the risk of RAO or bleeding events compared to cTRA.

Initial Safety of Total Talus Replacement Used to Treat Talar Avascular Necrosis.

Total talus replacement (TTR) implants are designed to replace the diseased talar anatomy, reduce pain, maintain ankle range of motion, and restore ankle function after conservative treatments have failed. Currently TTR implants are produced by 3D printing a patient-specific implant designed from the patient's preoperative anatomy. TTR surgery using patient-specific implants is a relatively new technique that remains understudied in the literature. Therefore, the purpose of this investigation was to determine the early safety and potential benefit of the TTR implant in patients with talar avascular necrosis. This retrospective, multicenter, cohort study evaluates the safety and potential benefits of TTR using 3D-printed patient-specific implants across 4 US centers. The primary outcome was the occurrence of early adverse events after TTR surgery. Secondary outcomes including, pain, and physical function were assessed using the pain visual analog scale (VAS), and Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF), respectively. The study team analyzed 15 patients with more than 1 year of follow-up. The mean duration of follow-up was 25.9 months (range: 18.3-41 months). Although 33.3% (5 of 15) of patients experienced adverse events, primarily occurring within the initial 6 months postoperatively, 93% (14 of 15) of patients reported implant survivorship. Of the 5 cases (33.3%) resulting in an adverse event, 3 (60.0%) were determined to be unrelated to the subject device, 2 (40.0%) were determined to be possibly procedure-related, and none (0%) were determined to be device-related. Although further studies are needed to compare TTR with the standard of care, the results of this study demonstrate the relative early safety of TTR surgery using a 3D-printed implant for the treatment of challenging talar pathologies. A larger and longer clinical study is required to see if the efficacy of this approach will be statistically and clinically meaningful.

Strategies to promote safety for sexual and gender minority youth in secondary schools: A longitudinal analysis.

In order to promote school safety for sexual and gender minority youth (SGMY), many schools implement strategies such as SGM-focused policies and gender-sexuality alliances (GSAs). Little is known about the effects such strategies have over time on feelings of safety at school for SGMY. Hierarchical Linear Models were conducted using longitudinal data from 417 SGMY attending secondary schools to examine trajectories of feelings of safety and the effects of SGM-focused policies, GSA presence, or GSA membership on feelings of safety. Findings indicate that SGM-focused policies and GSAs had direct benefits for safety at school SGMY, both independently and in combination; however, GSA membership was not. Schools should implement a combination of school strategies to promote safer environments for SGMY.

Dual zinco-phobic/-philic ferroelectric nanorods coated mesh for stable Zn anode

Aqueous Zn-ion batteries are emerging as a promising option for energy storage systems due to their safety and environmental benefits. However, their stability and reversibility are often hindered by dendrite growth and interfacial side reactions. In this study, we introduce an innovative strategy to address these issues by engineering an artificial interfacial layer (AIL) on Zn anode surface. This AIL is composed of a dual zinco-phobic/-philic ferroelectric nanorods (FE NRs) mesh, which contrasts with the traditional BaTiO3 nanoparticles. The BTO NRs, particularly those with exposed P4/mmm (100) and (211) facets enriched with oxygen vacancy, facilitate a partial phase transition from the FE tetragonal P4mm phase to the paraelectric tetragonal P4/mmm phase, thereby creating dual zinco-phobic/-philic sites. Additionally, the integration of microchannels within the FE BTO NRs mesh can efficiently modulate the electric field distribution and Zn2+ concentration, leading to a more uniform Zn deposition, as conformed by electrochemical simulations. The Zn anode coated with the FE BTO NRs mesh exhibits impressive performance, achieving an ultralong cycle life of 3050 h at 1 mA cm−2 and 1mAh cm−2. It sustains a Coulombic efficiency exceeding 99.8 % over 2000 cycles, highlighting its exceptional reversibility. These findings underscore the potential of the dual zinco-phobic/-philic FE NRs mesh in overcoming the challenges faced in aqueous metal-ion batteries, showcasing its versatility and the significant performance enhancements it can offer.

Effect of organic corrosion inhibitors on the behaviour of repair mortars and reinforcement corrosion

Repairing concrete structures affected by reinforcement corrosion is vital to ensure their durability and safety. Organic corrosion inhibitors (OCIs) are widely used in the construction industry to prevent steel corrosion due to their effectiveness, sustainability, and health and safety benefits. However, the effects of these OCIs on different types of repair mortars have not been extensively studied. This study evaluated the fresh and hardened properties, as well as the corrosion resistance, of four types of repair mortars (polymer-modified, general cementitious, fine-grained, and alkali-activated) incorporated with two types of OCIs (amino alcohols and sodium gluconate-based) at dosages of 0.5 %, 1 %, and 2 %. Additionally, the corrosion kinetics of mortars under the influence of OCIs were analysed using the impressed current technique. The results indicated that OCIs generally enhanced workability and increased void content across all repair mortars. The amino alcohol inhibitor increased the drying shrinkage of general cementitious and fine-grained mortars by up to 33 % and 39 %, respectively, and reduced compressive strengths by 47 % and 26 %. However, it did not significantly affect water absorption. In contrast, the sodium gluconate inhibitor increased water absorption in all repair mortars but notably decreased drying shrinkage by up to 47 % in polymer-modified mortar and 66 % in alkali-activated mortar. Despite the variations in the properties of repair mortars, OCIs effectively resisted corrosion and delayed crack formation time by up to 400 %. The resistance to corrosion improved with increasing amounts of the inhibitor. The results of this study were used to develop a technical guide for the construction industry, facilitating the selection of appropriate mortar compositions to effectively repair corroded concrete structures and reduce the risk of further corrosion.

Near-Infrared Dual-Range Methane Sensor Using the OAIC-HC Mode Based on VMD-SG-Assisted Optical Noise Suppression.

Based on tunable diode laser absorption spectroscopy and off-axis integrated cavity output spectroscopy, a dual-range methane hybrid sensor was constructed utilizing the overtone absorption band of CH4 gas molecules at 1653.7 nm. By simultaneously utilizing an off-axis integrated cavity and Herriott cell with an effective absorption path of 11 and 405 m, respectively, the two received photoelectric signals are decomposed into different frequency components by VMD and then reconstructed after SG filtering. Applying the global optimization algorithm DA-ELM to CH4 concentration inversion, the correlation coefficient R2 is as high as 0.9995. Through long-term stability verification, the instrument's standard deviation at 1 ppm is 27 ppb. After Allan-Werle deviation analysis, the sensor's limit of detection is 2.298 ppb at an integration time of 138 s. Using the self-developed sensor, the detection of dual-range trace CH4 gas is achieved, enabling a dynamic detection range of trace CH4 gas ranging from 400 ppb to 1000 ppm. The sensor realizes dual-range methane trace detection and actively controls methane emissions to improve environmental quality while taking into account the safety benefits of reducing production accidents.

Innovative Zinc Anodes: Advancing Metallurgy Methods to Battery Applications.

Aqueous zinc metal batteries (AZMBs) are emerging as a powerful contender in the realm of large-scale intermittent energy storage systems, presenting a compelling alternative to existing ion battery technologies. They harness the benefits of metal zinc's high safety, natural abundance, and favorable electrochemical potential (-0.762V vs Standard hydrogen electrode, SHE), alongside an impressive theoretical capacity (820mAhg-1 and 5655mAhcm-3). However, the electrochemical performance of ZMBs is impeded by several challenges, including poor compatibility with high-loading cathodes and persistent side reactions. These issues are intricately linked to the inherent physicochemical properties of the zinc metal anodes (ZMAs). Here, this review delves into the traditional methods of ZMAs production, encompassing extraction, electrodeposition, and rolling processes. The discussion then progresses to an exploration of cutting-edge methodologies designed to enhance the electrochemical performance of ZMAs. These methods are categorized into alloying, pre-treatment of substrate, advanced electrodeposition techniques, and the development of composite anodes utilizing zinc powder. The review offers a comparative analysis of the merits and drawbacks of various optimization strategies, highlighting the beneficial outcomes achieved. It aspires to inspire novel concepts for the advancement and innovation of next-generation zinc-based energy storage solutions.

Effect of Anesthesia Type on Pain and Hemodynamic Parameters in Cesarean Section Surgery: Randomized Controlled Trial

Background: General and spinal anesthesia are commonly used for cesarean sections, each with implications for both the mother and the fetus. The choice of anesthesia technique depends on various factors. While spinal anesthesia is often preferred for cesarean surgeries due to its well-known benefits, general anesthesia may be chosen in emergency situations. The decision is ultimately based on the safety profile and benefits for both the mother and the fetus. Methods: This clinical trial was conducted at Fatemieh Hospital in Hamadan and involved 60 patients undergoing elective cesarean section. The patients were randomly divided into two groups of 30: One group received spinal anesthesia, and the other group received general anesthesia. Variables such as intraoperative bleeding, the Apgar score of the newborn, postoperative pain, and postoperative systolic and diastolic blood pressure were analyzed and compared between the two groups using SPSS software version 16. Results: The mean age of participants in the spinal and general anesthesia groups was 32 ± 3.5 years and 34 ± 3.4 years, respectively. The results showed that the amount of intraoperative bleeding in the general anesthesia group was higher than in the spinal anesthesia group, but this difference was not statistically significant (P = 0.85, P < 0.05). The Apgar scores at the first and fifth minutes in the spinal anesthesia group were higher than those in the general anesthesia group, but this difference was also not statistically significant (P = 0.32, P < 0.05). Postoperative pain in the spinal anesthesia group was significantly lower than in the general anesthesia group (P = 0.001, P < 0.05). Regarding hemodynamic parameters, systolic blood pressure after the operation was higher in the spinal anesthesia group compared to the general anesthesia group (P < 0.05). Conversely, diastolic blood pressure in the general anesthesia group was higher than in the spinal anesthesia group at all measurement stages, though not statistically significant in some measurements (P > 0.05). Conclusions: The results of our study indicate that spinal anesthesia is a preferable and safer method compared to general anesthesia, based on the parameters examined, particularly in emergency cesarean sections.

Acute Care Nurses' Partnership With Patients to Recognise and Respond to Changes in Patients' Clinical States: AQualitative Study.

To explore and describe acute care nurses' partnership with patients to recognise and respond to changes in patients' clinical states. Acute care nurses' decisions to partner with patients to recognise deterioration in clinical states and to respond by activating a rapid response system improves patient outcomes. Acutely unwell patients can also experience clinical changes that include improvement and deterioration that does not trigger rapid response system activation over the course of hospitalisation from illness and treatment. How acute care nurses partner with patients in response to improvement and deterioration not triggering a rapid response system is not well-understood. An exploratory, descriptive study underpinned by Tanner's Clinical Judgement Model. Using purposive and quota sampling, 20 nurses with direct patient care responsibilities on one medical and one surgical ward in a large Australian hospital were recruited. Nonparticipant observations followed by semistructured interviews were conducted between January and May of 2021. Nurse-patient interactions were observed for 4 h, and verbally described and recorded. Semistructured interviews were recorded and explored nurses' reasoning behind decisions observed. Reflexive thematic analysis was used to analyse the data. Three themes were identified from the data: nurses checking in for changes; nurses forming judgements; and nurses partnering with patients to respond. Acute care nurses promoted subjective assessment based on patients' safety risks. Patients' participation in response to changes was prioritised based on acute care nurses' judgement of safety. Patients receive significant safety benefits when acute care nurses partner with patients in response to their experience of improvement and deterioration during acute illness. Further research should evaluate the sensitivity of subjective cues in patient assessment. Partnership with patients in assessment and management of improvement and deterioration improves the quality and safety of patient care. Assessment frameworks should equally prioritise the use of objective and subjective cues. Nursing education should promote the safety benefits of patient partnerships in responding to patient changes. Equator checklist COREQ. Data collected included description of patients' interactions with study participants.

Estimating the impact on patient safety of enabling the digital transfer of patients’ prescription information in the English NHS

ObjectivesTo estimate the number and burden of medication errors associated with prescription information transfer within the National Health Service (NHS) in England and the impact of implementing an interoperable prescription...

Green Synthesis of Morpholines via Selective Monoalkylation of Amines.

Morpholines are common heterocycles in pharmaceutical and agricultural products, yet methods to synthesize them from 1,2-amino alcohols are inefficient. We report the simple, high yielding, one or two-step, redox neutral protocol using inexpensive reagents (ethylene sulfate and tBuOK) for the conversion of 1,2-amino alcohols to morpholines. Key to this methodology is the identification of general conditions that allow for the clean isolation of monoalkylation products derived from a simple SN2 reaction between an amine and ethylene sulfate. Experiments suggest that the degree of selectivity is dependent upon the structure of reacting 1,2-amino alcohol as well as the unique properties of ethylene sulfate. This method can be used for the synthesis of a variety of morpholines containing substituents at various positions, including 28 examples derived from primary amines and multiple examples contained in known active pharmaceutical ingredients. We have conducted multiple examples on >50 g scale. We have also demonstrated the formal synthesis of a morpholine from a simple primary amine using ethylene sulfate. Overall, while this new methodology has many environmental and safety benefits relative to the traditional methods used to prepare morpholines from 1,2-amino alcohols, the most striking feature is the facile selective monoalkylation of a variety of primary amines. We have also explored various reactions beyond those related to the synthesis of morpholines, including obtaining proof-of-principle that ethylene sulfate can be used for the synthesis of piperazines and as a 2-carbon electrophile for fragment couplings.

His Bundle Pacing and Left Bundle Branch Pacing in Patients with Heart Failure.

His bundle pacing (HBP) and left bundle branch pacing (LBBP) are emerging therapies for patients with heart failure and conduction disorders, offering potential advantages over traditional pacing methods. These approaches aim to restore physiological conduction and improve cardiac function more effectively. This study aims to evaluate the efficacy and safety of HBP and LBBP in patients with heart failure and conduction disturbances, comparing these techniques to conventional pacing. A comprehensive review of recent studies and clinical trials was conducted, focusing on the performance of HBP and LBBP in improving cardiac function, reducing QRS duration, and enhancing overall patient outcomes. The analysis includes data on clinical efficacy, procedural safety, and long-term benefits associated with these pacing modalities. Both HBP and LBBP have demonstrated significant improvements in cardiac function and clinical outcomes compared to conventional pacing. HBP effectively restores physiological conduction with improved synchronization and a reduction in QRS duration. LBBP has shown enhanced left ventricular activation, leading to better overall cardiac performance. Both techniques have been associated with a lower incidence of complications and a higher success rate in achieving optimal pacing thresholds. HBP and LBBP offer promising alternatives to traditional pacing for patients with heart failure and conduction disorders. These advanced pacing strategies provide superior clinical outcomes and improved cardiac function with reduced risk of complications. Further research and clinical trials are needed to fully establish the long-term benefits and safety profiles of these techniques in diverse patient populations.

EXPLORING THE FEASIBILITY OF PLATELET-RICH PLASMA INJECTIONS FOR INTERVERTEBRAL DISCOPATHY: A PILOT STUDY.

This longitudinal pilot study aimed to evaluate the feasibility, safety and potential benefits of Platelet-Rich Plasma injections into the lumbar intervertebral discs in patients with low back pain and degenerative intervertebral monodiscopathy, assessing potential efficacy on disability. Longitudinal pilot study. Six participants with chronic low back pain and lumbar degenerative intervertebral disc (monodiscopathy) disease underwent 1 Platelet-Rich Plasma injection, with a 1-year follow-up. Platelet-Rich Plasma injections were administered into the lumbar intervertebral disc, and outcomes were measured using the Roland Morris Disability Questionnaire, numeric rating scale for pain, Tampa scale for kinesiophobia and lumbar flexion range. Magnetic resonance imaging analysis assessed disc changes. No adverse events were reported. At the end of the 1-year follow-up, half of the patients showed significant improvements in disability scores at 1 year, while 3 of the 6 patients had no change. Magnetic resonance imaging revealed no significant disc changes. Platelet-Rich Plasma injections show promise for some patients with low back pain and degenerative intervertebral discopathy patients. However, caution is warranted due to study limitations, including small sample size and lack of a control group. Further research is needed to define Platelet-Rich Plasma therapy protocols.

Baseline characteristics of Ghanaian children and adults enrolled in PIVOT, a randomised clinical trial of hydroxyurea in HbSC disease in sub-Saharan Africa.

HbSC disease is a common form of sickle cell disease with significant morbidity and early mortality. Whether hydroxyurea is beneficial for HbSC disease is unknown. Prospective Identification of Variables as Outcomes for Treatment (PIVOT, Trial ID PACTR202108893981080) is a double-blind, randomised, placebo-controlled phase II trial of hydroxyurea for people with HbSC, age 5-50 years, in Ghana. After screening, participants were randomised to placebo (standard of care) or hydroxyurea. The primary outcome is the cumulative incidence of haematological toxicities during 12 months of blinded treatment; secondary outcomes include multiple laboratory and clinical assessments. Between April 2022 and June 2023, 112 children and 102 adults were randomised, including 44% females and average age 21.6 ± 14.5 years. Participants had substantial morbidity including previous hospitalisations (93%), vaso-occlusive events (86%), malaria (79%), often received transfusions (20%), with baseline haemoglobin 11.0 ± 1.2 g/dL and foetal haemoglobin 1.8% ± 1.5%. The spleen was palpable in six children and one adult, and ultrasonographic volumes were collected. Proliferative sickle retinopathy was common (30% children, 75% adults), but proteinuria was less common (3% children, 8% adults). Whole blood viscosity, ektacytometry, point-of-sickling, transcranial Doppler, near-infrared spectrometry (NIRS), 6-minute walk, and quality of life were also measured. Now fully enrolled, PIVOT will document the safety and potential benefits of hydroxyurea on clinical and laboratory outcomes in HbSC disease.

Pay more attention to vaccination to protect the health of the elderly

Vaccination has been implemented as a priority measure to control infectious diseases worldwide. The aging of the global population continues to intensify, and the process and level of aging in China are more prominent. As age increases, the immune function of people gradually declines, and the consequences of infectious diseases such as influenza, pneumococcal disease, and shingles are more severe in the elderly, which can exacerbate existing underlying diseases, leading to higher medical costs. In the process of achieving healthy aging, it is very necessary to protect vulnerable elderly people through vaccination. Despite the undeniable protective effects of the influenza, pneumococcal, and shingles vaccines for the elderly, coupled with excellent safety and significant health economic benefits, the current vaccination rates for these vaccines among the elderly in China remain low. Some factors, such as insufficient awareness of the necessity of vaccination, concerns about vaccine adverse reactions, lack of systematic and effective recommendations, and imperfect accessibility of vaccination services, affect the popularization of preventive vaccination among the elderly in China. This situation urgently calls for the attention of society as a whole, in order to maximize the role of vaccines in safeguarding the health of the elderly.

Impact of Dehydration Techniques on the Nutritional and Microbial Profiles of Dried Mushrooms.

The global consumption of dried mushrooms has increased worldwide because of their rich nutritional value and culinary versatility. Dehydration methods such as sun drying, hot air drying, freeze drying, and microwave drying are employed to prolong the shelf life of a food product. These methods can also affect the food product's nutritional value and the final product's microbial profile. Each technique affects the retention of essential nutrients like vitamins, minerals, and bioactive compounds differently. Additionally, these techniques vary in their effectiveness at reducing microbial load, impacting the dried mushrooms' safety and shelf life. This review addresses the gap in understanding how different dehydration methods influence dried mushrooms' nutritional quality and microbial safety, which is crucial for optimizing their processing and consumption. It targets researchers, food processors, and consumers seeking to improve the quality and safety of dried mushrooms. This review comprehensively examines the impact of major dehydration techniques, including sun drying, hot air drying, microwave drying, and freeze drying, on the nutritional and microbial profiles of dried mushrooms. Each method is evaluated for its effectiveness in preserving essential nutrients and reducing microbial load. Current research indicates that freeze drying is particularly effective in preserving nutritional quality, while hot air and microwave drying significantly reduce microbial load. However, more well-designed studies are needed to fully understand the implications of these methods for safety and nutritional benefits. These findings are valuable for optimizing dehydration methods for high-quality dried mushrooms that are suited for culinary and medicinal use.

The Safe System Approach and technology-what works?

The Safe System Approach is an evidence-based strategy committed to eliminating fatalities and serious injuries among all road users. The Safe System Approach as developed in Sweden, acknowledges that human errors will occur, but the cost of these mistakes should not be death or serious injury. Technology is an integral component of the Safe System Approach and can address equity and reduce human error among other safety benefits. A literature review will be conducted to compare high-income countries leveraging the Safe System Approach and assess opportunities for technology interventions in low- and middle-income contexts. Evidence will be analyzed, as well as implementation considerations of the recent National adoption of the Safe System Approach in the United States. As SSA evolves in a global context, further evaluation is needed on the role of technology and how government policies can restrict or advance its implementation.

Therapeutic Indices of Topical Antiseptics in Wound Care: A Systematic Review.

Chronic wounds place a heavy burden on healthcare systems and markedly reduce the ability of patients to engage in activities of daily living. One major factor contributing to impaired wound healing is bacterial bioburden. With the rise in antibiotic resistance and the slowdown in antibiotic development pipelines, alternative antimicrobial strategies are important. The objective of this systematic review is to determine the topical antiseptic therapeutic index values for bacterial species commonly isolated from chronic wounds. The therapeutic index is a ratio of the lowest concentration that causes mammalian cell cytotoxicity over the minimum bactericidal concentration. Higher values indicate greater safety and potential clinical benefit. A systematic literature search was performed in Medline and Embase, resulting in the inclusion of 37 articles that reported on the minimum bactericidal concentration in bacterial species commonly isolated from chronic wounds and their cytotoxicity concentrations in mammalian cells. The therapeutic indices for the topical antiseptics included in this study were generally low, with most ranging between 0.5-3.0. The highest therapeutic index values for Escherichia coli (5.49), Staphylococcus aureus (6.31) and Pseudomonas aeruginosa (8.81) were achieved by hypochlorous acid, whereas the highest therapeutic index values for methicillin resistant S aureus (12.1) was achieved by polyhexamethylenebiguanide. Antibiotic stewardship principles may need to be applied to topical antiseptics due to some isolated evidence of topical antiseptic resistance and cross-resistance to antibiotics. The choice of antiseptic should not be made solely based on therapeutic index values, but individualized to the patient, with consideration for the wound healing condition that may include covert infection.

Management of Gingivitis: Contemporary Approaches and Recent Therapeutic Advancements

Background: Gingivitis, commonly known as gum disease, refers to several types of inflammatory diseases that impact the connective tissues that surround the teeth. Gingivitis causes swelling, redness, and bleeding of the gums in its early stages. Objective: This article aims to describe the standard gingivitis medication. It emphasizes recent advancements in the initial therapy, treatment, and healing mechanisms of gingivitis for achievement in the clinical testing of medicines that promise to enable disease modification in patients. Also, it aims to review recent advancements and emerging therapeutic developments in the management of gingivitis, including gene-based therapies, nanotherapies, anti-cytokine therapies, stem cell-based therapies, and probiotic therapies. Methods: The information for the review articles was acquired by using Google Scholar and PubMed as search engines, as well as a number of publishers, including Springer Nature, Ben-tham Science, Taylor & Francis, Elsevier, and Frontier. Result and Discussion: Gingivitis is a gum disease and scaling root planning (SRP) is now the most common kind of periodontitis therapy available. It has the potential to deliver significant therapeutic success, but it can also have substantial problems that reduce the quality of life of a patient. Stem cell therapies, gingivitis genetic engineering, nuclear-based medicines, and other advances have given people hope that a wide range of illnesses, especially genetic disorders, can be cured. Conclusion: The current gingivitis therapies are successful and continually evolving, with sev-eral drugs currently in clinical trials. These innovative medicines, when combined, may alter gingivitis treatment in the next few years. Finally, gingivitis therapy requires professional dental care and patient education on oral hygiene. Nonetheless, further research and clinical studies are necessary to validate the efficacy, safety, and long-term benefits of these novel treatment modalities.

Enhancing road safety with the infrastructure-adaptable NDBA 2.0 concrete median barrier: An Italian experience

Road safety is a crucial global concern because of the high number of fatalities and injuries resulting from road crashes each year. Median crossover collisions are among the most dangerous crashes that happen on highways, frequently leading to serious or fatal injuries. The main approach to decreasing the occurrence of these types of crashes is the installation of median barriers. When the need for such installations arises, road agencies must choose from various options, including concrete barriers, cable barriers, or metal-beam guardrails. This paper is dedicated to the New Dynamic Barrier for Highways (NDBA 2.0), an innovative technology for median barriers developed by the Italian National Road Agency (ANAS), emphasizing its pivotal role in enhancing road safety. It incorporates high-tensile steel and advanced composites, offering robust protection while maintaining a lightweight profile. What distinguishes the NDBA 2.0 is its dynamic nature, featuring an intelligent system that seamlessly adapts to the road infrastructure. Its modular construction, with sections of only 200 cm, allows for easy installation and ensures compatibility across successive road segments. This adaptability reduces construction time while maintaining the highest standards of performance. From a road safety perspective, the NDBA 2.0 offers substantial advantages. Its design contributes to minimizing crash-related costs by reducing the severity of crashes, particularly in the transition zones. The barrier's design allows it to adapt to varying road conditions and traffic volumes, effectively addressing common installation challenges on existing roadways as well. Its ability to be directly supported on the road surface wear layer eliminates the need for costly foundation structures, facilitating quick installation and reducing maintenance expenses. The NDBA 2.0 barrier was designed to eliminate the need for future simulations in the design and verification of transitions between different barriers. For this reason, the NDBA 2.0 barrier has been tested in real-world conditions in class H4 and, consequently, is equipped with CE marking. This study offers a comprehensive analysis of the NDBA 2.0 barrier, whose implementation may provide significant benefits for road safety. Continued research, collaboration, and widespread adoption of the NDBA 2.0 barrier can further enhance road safety on a global scale.