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Abstract Oral squamous cell carcinoma (OSCC) poses significant health risks with increasing incidence and mortality rates. In this context, there is an urgent need to explore novel biomarkers to enhance therapeutic strategies and improve survival. Understanding apoptotic evasion in cancer pathogenesis, this pioneering study aims to investigate the correlation between a pro-apoptotic protein Smac/DIABLO and patient prognosis within the OSCC cohort. Immunohistochemistry (IHC) was employed to analyze Smac/DIABLO protein expression and correlate with clinicopathological and prognostic factors during a long-term follow-up. Smac/DIABLO low expression was associated with worse overall survival (OS), relapse-free survival (RFS), disease-specific survival (DSS), and an increase in risk of lymph node metastasis (LNM) in univariate analyses. Furthermore, multivariate analyses confirmed Smac/DIABLO as an independent prognostic factor, predicting poorer OS [Hazard Ratio (HR) = 3.6 (95% CI 1.7–7.6), p

Inland waterway transport (IWT) is recognized by its social, environmental, and economic advantages if compared with other transportation means. Nevertheless, several barriers have been identified which require the implementation of solutions that lead to the sustainable development of IWT. After reviewing the literature, this paper presents a framework of barriers and solutions for the sustainable development of IWT. The data were classified within the main elements of the IWT system: ports, fleet, and waterway, and subsequently grouped into one of the five proposed factors (governance and policies, management, operational, infrastructure and technology, and human resources). The basis for the enhancement of IWT is the attitude and change of mindset of governments towards IWT development. From there, several solutions can be implemented, such as policies that stimulate IWT growth aligned with the environmental requirements of each basin and encourage the private sector to take part in the search for alternatives in Favor of IWT development as a reliable, sustainable, and economically viable means of transport.

This study argues that port decarbonisation is not only a technological challenge, but also an implementation issue. Hence, other determinants of implementation should be considered. Yet, the existing scant literature has never addressed this phenomenon. The purpose of this study is to provide insights about determinants of port decarbonisation implementation. The implementation theory (ImpThry) lens and port decarbonisation literature were reviewed and then both bodies of literature were cross analysed to demonstrate the applicability of ImpThry to port decarbonisation and identify determinants of successful implementation. Results have presented six constructs, i.e., implementation schemes, level of governance, interorganisational relationships, disposition and commitment of managers, capacities and economic conditions, and engagement with target groups, as determinants of port decarbonisations. Additionally, measurement items were identified, and several hypotheses were proposed. While the results presented a new conceptualisation based on ImpThry and paved the way of empirical investigation in future research, it also has managerial implications. The various demonstrated determinants inspire and direct the attention of port business managers and decision-makers to implementation pathways to achieve the decarbonation goal. Also, determinants draw attention to why port decarbonisation implementation succeeds or fails. While this is the first study that addresses this topic, it is considered as an extended application of the ImpThry in port decarbonisation. Nonetheless, the findings from this research make a desirable contribution to smooth port decarbonisation implementation.

In policy design, the contribution of ports to shipping decarbonization has been underestimated. Port incentive programmes have not contributed significantly to shipping decarbonization, and in the implementation of energy regulations, the role of the port state control has been exclusively limited to document control. This study aims to analyse the role of ports in shipping decarbonization by conducting an online survey and interviewing experts. We examine two proposals: first, a global incentive scheme focused solely on CO2 reduction, supported by the GHG Fund of the future IMO carbon pricing mechanism, acting as a rebate mechanism, and second, a voyage-based data collection and verification system. Experts have strongly supported the first proposal. The second proposal is technically feasible, since some verification firms and pioneer shipping companies have already started this practice. It is economically also feasible at a minor cost. A differentiated bunker levy based on these proposals is recommended at the end, in which ports play a significant role.

This study presents the first results from the analysis of water mites collected in Portugal as part of the Biodiversity Genomics Europe project. 307 COI DNA barcodes clustered into 75 BINs are provided, with 38 BINs being unique and deposited for the first time in the Barcode of Life Data Systems (BOLD). 65 species have been identified, of which 36 are new to the water mite fauna of Portugal. Two species, Torrenticola soniae Pešić, sp. nov. and T. elisabethae Pešić, sp. nov. (Torrenticolidae), are described as new to science. 47% of the water mite species currently known from Portugal now have reference barcodes in BOLD. High intraspecific distances were recorded for some species, suggesting the presence of cryptic diversity and species complexes that needs further study. Our results improve the DNA barcode reference database for Portuguese water mites, enhancing species identification accuracy and stimulating future investigation.

ABSTRACT Objectives One of the primary objectives in endodontics is to achieve thorough cleaning and disinfection of the root canal system during an endodontic procedure. This aims to reduce microbial contamination and prevent the development of endodontic lesions. To attain this goal, it is imperative to establish access to the endodontic space that allows for the complete removal of pulp tissue and the accurate identification of canal orifices while preserving the anatomical integrity of the root floor and pulp chamber as much as possible. In this scoping review, we aim to explore aspects related to the identification of canal orifices and the presence of pulp debris and residues during endodontic treatment. Specifically, we aim to assess whether and to what extent the design of the access cavity impacts these factors. Material and Methods The scoping review was conducted and prepared following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines (PRISMA Extension for Scoping Reviews [PRISMA‐ScR]). Results The search yielded a total of 3697 bibliographic sources. After eliminating duplicates and applying eligibility criteria, only 10 studies were included. Conclusions In conclusion, our review, conducted following PRISMA guidelines, includes 10 studies and suggests a potential trend: conservative techniques may generate more debris, whereas guided techniques exhibit superior precision in locating canal openings.

Cancer represents a major global health burden, prompting continuous research for effective therapeutic strategies. Natural compounds derived from plants have emerged as potential strategies for preventing cancer and treatment because of their inherent pharmacological properties. This comprehensive review aimed to evaluate the therapeutic potential of five key natural compounds: apigenin, quercetin, piperine, curcumin, and resveratrol in cancer prevention and therapy. By examining their molecular mechanisms and preclinical evidence, this review seeks to elucidate their role as potential adjuvants or stand-alone therapies in cancer management. The exploration of natural compounds as cancer therapeutics offers several advantages, including low toxicity, wide availability, and compatibility with conventional chemotherapeutic agents. We highlighted the current understanding of their anticancer mechanisms and clinical applications for advancing personalized cancer care to improve patient outcomes. We discussed the empirical findings from in vitro, in vivo, and clinical studies reporting biological activity and therapeutic efficacy in antioxidant, immunomodulatory, anti-carcinogenic, and chemo-sensitizing modes. Innovative delivery systems and personalized treatment approaches may further enhance their bioavailability and therapeutic utility in a synergistic approach with chemo- and radiotherapeutic disease management. This review underscores the importance of natural compounds in cancer prevention and treatment, promoting a multidisciplinary approach to the development of innovative therapeutic strategies.

The pancreas is a vital organ nestled deep within the abdomen, playing a crucial role in both endocrine and exocrine functions. It is elongated and tadpole-shaped, with a head, body, and tail. The intricate connections to adjacent structures through a network of blood vessels, ducts, and supportive tissue transform pancreatic cancer into one of the most fatal malignancies globally as a result of a typically late diagnosis and metastatic form of the disease. Lymph node metastasis (LNM) is prevalent in the majority of individuals diagnosed with pancreatic cancer, signifying a critical factor influencing prognostic outcomes. The para-aortic lymph nodes (PALN) play an important role in the lymphatic drainage of various organs, including the kidneys, pancreas, and parts of the gastrointestinal tract. In pancreatic cancer, the risk of PALN metastasis holds considerable clinical significance, and diagnosing your involvement is primordial to therapeutic decisions and to increase the survival expectations of these patients.

Abstract Objectives Odontogenic keratocysts exhibit frequent recurrence, distinctive histopathological traits, a tendency towards aggressive clinical behavior, and a potential linkage to the nevoid basal cell carcinoma syndrome. The aim of this systematic review is to compile insights concerning the control of this condition and assess the effectiveness of various treatment approaches in reducing the likelihood of recurrence. Materials and methods The following systematic review adhered to the PRISMA guidelines. The systematic revision was registered on PROSPERO and structured around the questions related to the population, intervention, control, outcome and study design (PICOS). Results After conducting a search on the PubMed database, we initially identified 944 records. After using end-note software to remove duplicate entries, results totally with 462 distinct records. A thorough review of the titles and abstracts of these articles led to the selection of 50 papers for in-depth examination. Ultimately, following the application of our eligibility criteria, we incorporated 11 articles into our primary outcome analysis. Conclusion Among the studies examined, the most common location for these lesions was found to be in the area of the mandibular ramus and the posterior region of the mandible. In cases where the exact location wasn’t specified, the mandible emerged as the predominant site. When we considered the characteristics of these lesions in studies that mentioned locularity, most were described as unilocular in two studies, while in two other studies, the prevalence of multilocular lesions was observed. Risk factors associated with keratocyst recurrence include younger patient age, the presence of multilocular lesions, larger lesion size, and a longer anteroposterior dimension. Certain treatment methods have demonstrated a lack of relapses. These include the use of 5-fluorouracil, marsupialization, enucleation with peripheral ostectomy or resection, enucleation and curettage, as well as resection without creating continuity defects. However, it is important to note that further research is essential. Prospective studies and randomized trials are needed to collect more comprehensive evidence regarding the effectiveness of various treatment approaches and follow-up protocols for managing odontogenic keratocysts. Clinical relevance Odontogenic keratocysts still enter into differential diagnoses with other lesions that affect the jaw bones such as ameloblastama and other tumor forms, furthermore it is not free from recurrence, therefore the therapeutic approach to the lesion aimed at its elimination can influence both the possible recurrence and complications, knowledge of the surgical methods that offer the most predictable and clinically relevant result for the management of follow-up and recurrences.

IntroductionCerebrovascular stroke, a leading cause of global morbidity and mortality, is influenced by several modifiable risk factors such as hypertension, diabetes, and smoking. Emerging evidence highlights the significant role of inflammation in stroke pathogenesis, with conditions like periodontitis potentially exacerbating this risk. The aim of this systematic review was to identify and quantify the real impact of periodontal disease in individuals with cerebral stroke through the analysis of inflammatory periodontal indicesMethodsFollowing PRISMA guidelines, we conducted a systematic review and meta-analysis of case-control studies assessing periodontal indices in stroke patients. Data sources included PubMed, Scopus, and Cochrane Library, with searches extended to grey literature. The review protocol was registered on PROSPERO (CRD42024529767). Studies were evaluated using the Newcastle-Ottawa Scale to assess risk of bias, and meta-analyses were conducted using Review Manager 5.4 and TSA software.ResultsThe review included seven case-control studies, comprising 723 stroke patients and 787 controls. Meta-analyses revealed significant differences between stroke and control groups in clinical attachment loss [MD 1.04 mm, 95% CI (0.54, 1.54)], probing pocket depth [MD 0.68 mm, 95% CI (0.31, 10.6)], and radiological bone loss (MD 2.15 mm, 95% CI [−1.58, 5.89]. These findings indicate that stroke patients exhibit worse periodontal health compared to controls, supporting a potential link between periodontal inflammation and stroke.ConclusionThis study confirms the significant impact of periodontal disease on stroke patients and highlights the importance of oral health in preventing adverse cerebrovascular events.Systematic Review RegistrationPROSPERO, identifier (CRD42024529767).

The introduction of Maritime Autonomous Surface Ships (MASS) into the maritime transport sector has significantly accelerated, as illustrated by the growth of project prototypes and by academic research throughput. While the MASS race accelerates, motivated by recent discussions in the IMO, there are still critical barriers and considerable challenges awaiting the materialisation and integration of MASS into the maritime sector. This study reviews the literature and builds homogeneous clusters in relation to MASS drivers and opportunities, including barriers and solutions. The results show that many benefits will result from MASS, while at the same time there are still many barriers that may hinder the full integration of MASS into commercial ships and oceangoing vessels. Though some solutions and recommendations were discussed, it is suggested that the barriers are taken into consideration in all project prototypes and research, and by policy makers. Identification of drivers, opportunities, and barriers serves as a holistic tool for port policymakers, designers and builders (of project prototypes), and managers. The results envision the current and future needs of MASS in line with the transition toward smart and automated industry. Academically, the study enriches scholarly discussions on MASS while the clusters can be cross-pollinated in further empirical investigation.

Abstract Objectives Historically, the prevalence of caries has undergone significant changes, particularly increasing with the industrialization of sugar consumption. When examining ancient populations, lower caries rates are discovered, attributed in part to dietary factors. These populations consumed abrasive foods, leading to occlusal wear and reduced non-axial occlusal forces, potentially influencing Non-Carious Cervical Lesions (NCCLs). Although some attribute NCCLs to abfraction, the mechanism remains debated. This systematic review aims to evaluate the presence of NCCLs in ancient populations, shedding light on the factors contributing to their occurrence. Materials and Methods The present systematic review was registered on PROSPERO, and the manuscript was prepared following PRISMA guidelines. Results After the literature search and article screening, data from 6 studies were included in the meta-analysis, with only 2 reporting NCCLs in ancient skulls, encopassing 17 subjects in 805 examined skulls, suggesting their presence even before the widespread use of toothbrushes. This finding indicates a potential etiopathogenic mechanism linked to abfraction, but the cause is complex and involves abrasive and erosive factors closely tied to dietary habits. Conclusions In summary, NCCLs were present in ancient populations, albeit with a much lower prevalence. Their occurrence cannot be solely attributed to wear mechanisms but must be connected to abrasive factors related to diet or practices with religious and cultural significance, such as the use of labrets. Clinical relevance: Th the knowledge of NCCLs presence in acient sculls is crucial today for better understand the associated risk factors. In this context, the analysis of ancient skulls allows us to discern the role that tooth brushing and diet played in the formation of NCCLs, over the past century.

Abstract Background Hunter–Schreger bands (HSB) are optical phenomena observed on tooth surfaces under polarized light, resulting from the intersection of enamel prisms. Anthropological studies demonstrate the prevalence of HSB in large mammals, contributing to enamel resistance. Historically, John Hunter and Schreger depicted HSB in dental literature. In dentistry, HSB play a role in non-carious cervical lesions (NCCL) and internal dental perikymata, suggesting their potential for personal identification. Personal identification, crucial in both daily and professional life, involves biometric characteristics, such as fingerprints or facial recognition. The need for non-invasive, rapid, and user-friendly methods has prompted the exploration of using HSB dental images for personal identification. The review aimed to consolidate studies employing HSB for personal identification. Methods The scoping review was carried out strictly following the PRISMA–ScR checklist; the search was carried out on tree databases (PubMed, Scopus, Science Direct,) and a register (Cochrane library). Results The research produced a number of bibliographic sources totaling 410. With the removal of duplicates, 334 were obtained; potentially eligible articles amounted to 14, of which only 4 fully complied with the criteria of eligibility. Conclusions From the data in the literature, we can assert that HSB could be used in personal identification, as they are characteristics that are difficult to change and easily detectable.

Abstract Background Investigations on plant-pathogen interactions require quantitative, accurate, and rapid phenotyping of crop diseases. However, visual assessment of disease symptoms is preferred over available numerical tools due to transferability challenges. These assessments are laborious, time-consuming, require expertise, and are rater dependent. More recently, deep learning has produced interesting results for evaluating plant diseases. Nevertheless, it has yet to be used to quantify the severity of Septoria tritici blotch (STB) caused by Zymoseptoria tritici—a frequently occurring and damaging disease on wheat crops. Results We developed an image analysis script in Python, called SeptoSympto. This script uses deep learning models based on the U-Net and YOLO architectures to quantify necrosis and pycnidia on detached, flattened and scanned leaves of wheat seedlings. Datasets of different sizes (containing 50, 100, 200, and 300 leaves) were annotated to train Convolutional Neural Networks models. Five different datasets were tested to develop a robust tool for the accurate analysis of STB symptoms and facilitate its transferability. The results show that (i) the amount of annotated data does not influence the performances of models, (ii) the outputs of SeptoSympto are highly correlated with those of the experts, with a similar magnitude to the correlations between experts, and (iii) the accuracy of SeptoSympto allows precise and rapid quantification of necrosis and pycnidia on both durum and bread wheat leaves inoculated with different strains of the pathogen, scanned with different scanners and grown under different conditions. Conclusions SeptoSympto takes the same amount of time as a visual assessment to evaluate STB symptoms. However, unlike visual assessments, it allows for data to be stored and evaluated by experts and non-experts in a more accurate and unbiased manner. The methods used in SeptoSympto make it a transferable, highly accurate, computationally inexpensive, easy-to-use, and adaptable tool. This study demonstrates the potential of using deep learning to assess complex plant disease symptoms such as STB.

Background: The surgical removal of impacted mandibular third molars is routine in oral and maxillofacial surgery and common postoperative complications are widely reported in the literature. Therefore, this prospective split-mouth study aims to compare the postoperative sequelae of piezoelectric surgery versus conventional surgery of the lower third molar, focusing on pain and swelling. Methodology: In total, 41 patients were treated under local anesthesia and surgical removal on one side of their mouth was performed using conventional rotary surgery (micromotor) while the other side’s was by piezosurgery, with an interval of 15 days from the previous procedure (82 extraction sites); in addition, pain and swelling analyses were conducted. Results: The pain analysis demonstrated a median of one day of pain in patients treated with piezoelectric surgery compared to two days with conventional surgery (p < 0.001). The probability of not feeling pain was greater in sites treated with experimental surgery on the first and second days (p < 0.001). The swelling was worse in places treated with the conventional method, with the most significant difference being the distance between the angle of the mandible and the upper lip vermilion on both days and the more subtle difference between the angle of the mandible and the anterior nasal spine on the seventh day. Conclusions: When a piezosurgical unit is used, according to the literature, is well known that it takes more time to perform the surgical extraction of third molars. Despite that, our results show that it causes less pain postoperatively, with faster improvement and a quicker reduction in swelling compared to conventional surgery.

Abstract Over the years, the demand for transportation has experienced a consistent rise, which has exacerbated a multitude of issues including environmental, visual, and noise pollution, congestion, land use conflicts, and various other related challenges. In this regard, the pursuit of alternatives aimed at mitigating these adverse effects stands as a priority for governments and policymakers. Consequently, inland waterway transport (IWT) emerges as an appealing solution, due to its advantages across the social, environmental, and economic considerations. However, in relation to IWT the concept of sustainable development is insufficiently investigated. The objective of this paper is to undertake a comprehensive review of how the concept of sustainable development is addressed and applied within the framework of IWT systems. To achieve this goal, a systematic literature review was meticulously conducted, utilizing three academic databases (Scopus, Google Scholar, and EBSCO). The review process yielded a total of 51 papers that proved to be pertinent and relevant to the subject matter. The comprehensive literature review facilitated the delineation of the principal elements, factors, and characteristics of the IWT system, as well as the primary drivers for its sustainable development. However, the implications for further research were identified, such as a comprehensive examination of each case due to the distinct geographical, social, economic, and political conditions inherent to each individual basin. That is essential for understanding the unique barriers present within each context and for formulating viable solutions aimed at fostering and incentivizing the sustainable development of IWT systems.

Abstract Our current approaches to resource management are not sustainable. Businesses typically follow a linear approach where resources are not well utilized. Maritime ports are part of the problem, as they need to optimize the use of resources and generate negative externalities. However, they can also be important drivers of sustainability if they effectively transition to Circular Economy (CE). In this study, eight principles of CE and ten CBMs, are discussed and used to analyze ports in three areas of intervention. This paper analyzes current CE practices in European ports and the potential to adopt Circular Business Models (CBMs) to create value for port stakeholders and contribute to the United Nations Sustainable Development Goals (SDGs). Drivers and barriers to CE were analyzed, and the level of development was assessed. The ports studied are in Europe and are generally regarded as Maritime Industrial Ports (MIP). The methodology includes a Semi-Systematic Literature Review (SSLR) and a SWOT analysis to examine CE practices in maritime ports. This methodology helped enhance the analysis of Drivers and Barriers to CE transition. This study concludes that ports are developing circular practices and business models on the technical and biological flows, but the level of implementation is moderated to low. Six drivers for adopting CE principles were identified, including European ports’ experience in circular activities and the Quality & Environmental Management System (EMS). In addition, seven barriers to CE were highlighted, including the diversity of port characteristics and the different interests and ambitions of port stakeholders that make it difficult to standardize measurements and transition to circularity. Circular development goals in ports should be integrated, and development must balance social, economic, and environmental sustainability. The findings and implications of this study will help Port Authorities (PA) in the strategy, policy development, and implementation of CBMs.

The uterus is a highly innervated organ, and during labor, this innervation is at its highest level. Oxytocinergic fibers play an important role in labor and delivery and, in particular, the Lower Uterine Segment, cervix, and fundus are all controlled by motor neurofibers. Oxytocin is a neurohormone that acts on receptors located on the membrane of the smooth cells of the myometrium. During the stages of labor and delivery, its binding causes myofibers to contract, which enables the fundus of the uterus to act as a mediator. The aim of this study was to investigate the presence of oxytocinergic fibers in prolonged and non-prolonged dystocic delivery in a cohort of 90 patients, evaluated during the first and second stages of labor. Myometrial tissue samples were collected and evaluated by electron microscopy, in order to quantify differences in neurofibers concentrations between the investigated and control cohorts of patients. The authors of this experiment showed that the concentration of oxytocinergic fibers differs between non-prolonged and prolonged dystocic delivery. In particular, in prolonged dystocic delivery, compared to non-prolonged dystocic delivery, there is a lower amount of oxytocin fiber. The increase in oxytocin appeared to be ineffective in patients who experienced prolonged dystocic delivery, since the dystocic labor ended as a result of the altered presence of oxytocinergic fibers detected in this group of patients.

Abstract Electrode grids are used in neuroscience research and clinical practice to record electrical activity from the surface of the brain. However, existing passive electrocorticography (ECoG) technologies are unable to offer both high spatial resolution and wide cortical coverage, while ensuring a compact acquisition system. The electrode count and density are restricted by the fact that each electrode must be individually wired. This work presents an active micro‐electrocorticography (µECoG) implant that tackles this limitation by incorporating metal oxide thin‐film transistors (TFTs) into a flexible electrode array, allowing to address multiple electrodes through a single shared readout line. By combining the array with an incremental‐ΔΣ readout integrated circuit (ROIC), the system is capable of recording from up to 256 electrodes virtually simultaneously, thanks to the implemented 16:1 time‐division multiplexing scheme, offering lower noise levels than existing active µECoG arrays. In vivo validation is demonstrated acutely in mice by recording spontaneous activity and somatosensory evoked potentials over a cortical surface of ≈8×8 mm2. The proposed neural interface overcomes the wiring bottleneck limiting ECoG arrays, holding promise as a powerful tool for improved mapping of the cerebral cortex and as an enabling technology for future brain‐machine interfaces.