Journals
2025 EN
Qader Ghulam · Rehman Junaid · Shamsi Muhammad Ibrahim
+1 more
ABSTRACT The contemporary challenges and risks including the climate change, social inequalities, trade tariffs and war situations have posed disruptive impacts on the global supply chain operations, thus reshaping the way modern firms survive, operate and compete at a global business landscape. Hence, integrating sustainable and robust supply chain models has become a strategic organizational necessity and basis for long‐term survival and growth. This study empirically examines the role of dynamic capabilities and Industry4.0 technologies in boosting supply chain resilience and driving sustainable economic, environmental and social performance. Drawing upon the dynamic capability theory (DCT) and organizational information processing theory (OIPT) and by examining the interplay between Industry4.0 technologies, Resilience and Sustainable Performance, this study suggests an empirically‐validated “sustainable supply chain performance framework” for the pharmaceutical manufacturing firms of Pakistan. In this regard, a quantitative survey‐based approach was employed to collect data from 485 managers working in the pharmaceutical manufacturing firms of Pakistan. The data analysis was conducted using the Smart‐PLS based SEM technique. Theoretically speaking, the results highlight that Industry4.0 technologies act as catalyst for achieving sustainable supply chain performance (SSCP) under the mediating effect of supply chain resilience (SCR) and moderating effect of supply chain dynamic capabilities (SCDC). From the practical perspective, the results highlight that leveraging digital innovation capabilities enhances the adaptability, operational agility and long‐term sustainability of the pharmaceutical firms. The results also imply that Industry4.0, when effectively integrated with resilience and firm dynamic capabilities, can drive smart, competitive and future‐ready supply chains. From the viewpoint of its contribution to UN SDGs, this study significantly contributes to the SDGs related to technological innovation, industrial growth and resilient infrastructure. Overall, by offering a “SSCP Framework”, this study bridges the gap between technological progress and environmental responsibility, providing valuable insights for the supply chain leaders, practitioners and policymakers in the pharmaceutical firms striving to build more resilient, inclusive and sustainable supply chains.
Journals
2025 EN
Madaninasab Pegah · Mohammadzadeh Mahsa · Labbaf Sheyda
Abstract This comprehensive review explores the therapeutic potential of carbon nanomaterials, including carbon nanotubes, graphene, carbon dots, and other related materials, in wound healing applications. These materials offer a cutting‐edge approach by modulating critical cellular processes, addressing current challenges in wound care, and advancing tissue regeneration techniques. The article thoroughly examines recent developments in carbon nanomaterials, highlighting their integration into wound care strategies and the ongoing efforts to overcome limitations such as biocompatibility, toxicity, and long‐term safety. Unlike previous reviews, this work not only acknowledges recent advancements but also provides a critical analysis of the still existing barriers and novel strategies for effectively translating these materials from research to clinical applications. By emphasizing both the potential and the challenges, the review aims to present a unique perspective on the future of carbon nanomaterials in wound healing, paving the way for more efficient and personalized treatment options.
Journals
2025 EN
Zhu Gaoxia · Kow Jason Fok · Fan Xiuyi
+3 more
ABSTRACT Students with strong Computational Thinking (CT) skills possess a unique ability to analyze problems, devise efficient solutions, and navigate the intricacies of a rapidly evolving digital landscape. Given the conceptual overlapping between CT skills and engineering design competencies, engineering design processes provide students with a context for applying and developing CT skills. However, how to promote students to develop CT skills through pedagogical design in engineering education needs further research, especially in the formal higher education context. To address this gap, we constructed a model and designed a course that supports students in applying CT (i.e., decomposition, pattern recognition, abstraction, algorithm design, and troubleshooting/debugging) skills during multiple engineering design iterations. We collected 13 group design reports from 62 undergraduate students regarding their efforts in designing and solving mazes over three design iterations by applying CT skills. Using mixed methods, we examined what and how CT skills were demonstrated in the group reports, and what changes groups made between design iterations and why. We found that the participants demonstrated five CT skills with differing frequencies and needed more support in troubleshooting. When making changes between design iterations, groups mainly considered enabling users to apply CT skills, avoiding hard coding, adjusting the complexity of the mazes, considering design constraints to meet engineering design requirements, and enhancing user experience. The findings underscore the pressing need to equip students with the ability to navigate and resolve intricacies, particularly in troubleshooting, and groups' abilities to consider various elements when making engineering design decisions.
Journals
2025 EN
Ibrahim Ibrahim · Kouli Omar · Ilangovan Sanjana
+6 more
ABSTRACT Background To assess how centralisation of cancer services via robotic surgery influenced positive surgical margin (PSM) occurrence and its associated risk of biochemical recurrence (BCR) in cases of pT2 prostate cancer (PC). Methods Retrospective analysis of all radical prostatectomy (RP) cases performed in the West of Scotland during the period from January 2013 to June 2022. Primary outcomes were PSM and BCR. The secondary outcomes compared the impact of centralisation and surgical approach on PSM and BCR; and margin length and location on BCR. Propensity score matching and Cox regression models were performed using R. Results A total of, 907 patients were included; 662 robot assisted radical prostatectomy (RARP), 245 open RP. PSM rate was 17.7% (161/907), similar in RARP and open cohorts. Patients with PSM had higher rates of BCR; 26.7%, compared to 8.7% in patients with no PSM. Patients with margins of ≥ 1 mm had higher risk of developing BCR. Patients who underwent open RP had increased incidence of PSM ≥ 1 mm; 40/43 (93%) compared to 83/117 (71%) in robotic approach ( p = 0.003). Limitations include the study being retrospective, introduction of centralisation and robot concurrently, and evolution of practice. Discussion PSMs in pT2 PC are associated with higher rates of BCR. Introduction of centralisation via the robot had no impact on PSM occurrence or BCR, although did demonstrate a reduction in PSM length.
Journals
2025 EN
Sahin Taha Koray · Sahin Ezgi Aysu · Gungor Hande Nur
+3 more
ABSTRACT Background Fear of cancer recurrence (FCR) is a pervasive concern among lymphoma survivors and their family caregivers, influencing psychological and physical health. Given the substantial burden of FCR, identifying its predictors is crucial for targeted interventions that could enhance palliative care. We aimed to evaluate the prevalence of FCR in lymphoma survivors and their caregivers, as well as associated factors Methods A total of 118 patients with lymphoma, along with their family caregivers, were recruited from Hacettepe University Cancer Institute between March 2024 and May 2024. Psychological assessments were conducted using the Depression Anxiety Stress Scales (DASS‐21), the Fear of Cancer Recurrence Inventory‐Short Form (FCRI‐SF) and the Functional Assessment of Cancer Therapy‐Lymphoma (FACT‐Lym) Results High levels of FCR were experienced by 50.8% ( n = 60) of lymphoma survivors and 57.6% ( n = 68) of their caregivers. There was a positive correlation between the FCR of the survivors and caregivers ( r = 0.349, p < 0.001). Poor overall quality of life (QoL) (aOR: 4.279, 95% CI: 1.738–10.531, p = 0.002), recent diagnosis (< 3 year) (aOR: 5.135, 95% CI: 1.852–14.238, p = 0.002), survivors' anxiety (aOR: 2.540, 95% CI: 1.014–6.363, p = 0.002) and caregivers' FCR (aOR: 2.970, 95% CI: 1.119–7.879, p = 0.029) were associated with high levels of FCR in lymphoma survivors. Conclusion We observed high FCR levels in over half the survivors with lymphoma and a higher FCR risk in patients with anxiety, poor QoL and caregiver FCR. These findings highlight the critical need for developing comprehensive care plans and interventions targeting FCR in patients with lymphoma.
Journals
2025 EN
Ashaye Ajibade · Shi Ling · Aldoss Ibrahim
+11 more
ABSTRACT Background In the phase 3 ponatinib‐3001 trial (PhALLCON, NCT03589326), ponatinib demonstrated superior efficacy over imatinib with comparable safety in patients with newly diagnosed Philadelphia‐positive acute lymphoblastic leukemia (Ph+ ALL). This post hoc analysis evaluated the net benefits of ponatinib using a quality‐adjusted time without symptoms of disease or toxicity (Q‐TWiST) approach. Methods Overall survival (OS) time for patients from PhALLCON was partitioned into three health states: TOX (time with grade 3+ treatment‐emergent adverse events [TEAEs] before disease progression), TWiST (time without toxicity before progression), and REL (time from progression until death or end of follow‐up). Q‐TWiST was calculated as the sum of health utility‐weighted restricted mean durations of the three states. A relative Q‐TWiST gain of ≥ 10% was considered clinically important. Sensitivity analyses were conducted by varying TOX and REL utilities, follow‐up time, and the TOX definition (using grade 2+ TEAEs or patient‐perceived treatment tolerability assessed by the FACT‐GP5). Results Among all randomized patients (ponatinib n = 164, imatinib n = 81), restricted mean OS was similar between arms (1082.2 vs. 1024.8 days; p = 0.373). In the base‐case analysis, mean TWiST was 214.5 days longer with ponatinib versus imatinib (95% CI 70.3–358.7; p = 0.004), REL was shorter by 175.9 days (325.4–26.5; p = 0.021), and TOX was not significantly different between arms ( p = 0.228). The relative Q‐TWiST gain (10.98%) was clinically important. Sensitivity analyses consistently supported the robustness of the base‐case findings. Conclusion Ponatinib may prolong quality‐adjusted survival compared with imatinib, supporting the benefit–risk profile of ponatinib as a front‐line treatment for Ph+ ALL. Trial Registration NCT03589326
Journals
2025 EN
Atallah N. M. · Makhlouf S. · Nabil M.
+4 more
ABSTRACT Introduction Human epidermal growth factor receptor 2‐positive (HER2‐positive) breast cancer (BC) is a heterogeneous disease. In this study, we hypothesised that the degree of HER2 oncogenic activity, and hence response to anti‐HER2 therapy is translated into a morphological signature that can be of prognostic/predictive value. Methods We developed a HER2‐driven signature based on a set of morphometric features identified through digital image analysis and visual assessment in a sizable cohort of BC patients. HER2‐enriched molecular sub‐type (HER2‐E) was used for validation, and pathway enrichment analysis was performed to assess HER2 pathway activity in the signature‐positive cases. The predictive utility of this signature was evaluated in post‐adjuvant HER2‐positive BC patients. Results A total of 57 morphometric features were evaluated; of them, 22 features were significantly associated with HER2 positivity. HER2 IHC score 3+/oestrogen receptor‐negative tumours were significantly associated with HER2‐related morphometric features compared to other HER2 classes including HER2 IHC 2+ with gene amplification, and they showed the least intra‐tumour morphological heterogeneity. Tumours displaying HER2‐driven morphometric signature showed the strongest association with PAM50 HER2‐E sub‐type and were enriched with ERBB signalling pathway compared to signature‐negative cases. BC patients with positive HER2 morphometric signature showed prolonged distant metastasis‐free survival post‐adjuvant anti‐HER2 therapy ( p = 0.007). The clinico‐morphometric prognostic index demonstrated an 87% accuracy in predicting recurrence risk. Conclusion Our findings underscore the strong prognostic and predictive correlation between HER2 histo‐morphometric features and response to targeted anti‐HER2 therapy.
Journals
2025 EN
Aakel Nada · Mohammed Rawdhah · Fathima Aseela
+3 more
ABSTRACT Background Exosomes are extracellular vesicles ranging from 40 to 100 nm in diameter that mediate intercellular communication by transferring proteins, lipids, nucleic acids, and other metabolites. In the context of cancer, exosomes influence the tumor microenvironment by carrying regulatory RNAs such as miRNA, circRNA, and lncRNA. They originate from various cells, including adipocytes, fibroblasts, and hepatocellular carcinoma (HCC) cells, and can either promote or inhibit cancer progression through pathways like MAPK and PI3K‐Akt. Aim This review aims to explore the role of exosomes in the progression of solid cancers, emphasizing their self‐induced activation mechanisms and how they modulate tumor behavior. Methodology A comprehensive review of recent literature was conducted, focusing on studies that investigated the biological functions of exosomes in solid tumor progression, including their molecular cargo, cellular origin, and involvement in signaling pathways. Results Findings from multiple studies indicate that cancer‐derived exosomes contribute to tumor proliferation, metastasis, and therapy resistance by enhancing communication within the tumor microenvironment. These vesicles activate oncogenic pathways and can serve as biomarkers or therapeutic targets due to their role in disease modulation. Conclusion Exosomes play a pivotal role in solid cancer progression and offer significant potential in advancing our understanding of tumor biology. Their capacity to influence key signaling pathways and facilitate intercellular communication makes them promising candidates for novel diagnostic and therapeutic strategies.
Journals
2025 EN
Attique Iqra · Haider Zahra · Khan Maha
+4 more
ABSTRACT Background Reactive oxygen species (ROS), a class of highly reactive molecules, are closely linked to the pathogenesis of various cancers. While ROS primarily originate from normal cellular processes, external stimuli can also contribute to their production. Cancer cells typically exhibit elevated ROS levels due to disrupted redox homeostasis, characterized by an imbalance between antioxidant and oxidant species. ROS play a dual role in cancer biology: at moderate levels, they facilitate tumor progression by regulating oncogenes and tumor suppressor genes, inducing mutations, promoting proliferation, extracellular matrix remodeling, invasion, immune modulation, and angiogenesis. However, excessive ROS levels can cause cellular damage and initiate apoptosis, necroptosis, or ferroptosis. Methods This review explores molecular targets involved in redox homeostasis dysregulation and examines the impact of ROS on the tumor microenvironment (TME). Literature from recent in vitro and in vivo studies was analyzed to assess how ROS modulation contributes to cancer development and therapy. Results Findings indicate that ROS influence cancer progression through various pathways and cellular mechanisms. Targeting ROS synthesis or enhancing ROS accumulation in tumor cells has shown promising anticancer effects. These therapeutic strategies exhibit significant potential to impair tumor growth while also interacting with elements of the TME. Conclusion The ROS serve as both promoters and suppressors of cancer depending on their intracellular concentration. Their complex role offers valuable opportunities for targeted cancer therapies. While challenges remain in precisely modulating ROS for therapeutic benefit, they hold promise as synergistic agents alongside conventional treatments, opening new avenues in cancer management.
Journals
2025 EN
Aini Khairunnisa Nur · Raisution Halimah · Sari Utami Dinda
+4 more
Abstract Citrus hystrix essential oil (CHEO) have shown various pharmacological properties including antibacterial activity. This EO also possessed antibacterial effect against foodborne pathogens. There is less information available about the synergy interaction between CHEO and tetracycline, as well as their mechanism of action. Therefore, this study was conducted to evaluate the synergistic effect of CHEO and tetracycline against clinical isolate of Escherichia coli . Antibiofilm, bacteriolytic, and efflux pump inhibitor activities were also performed. The chemical composition of CHEO was analysed using GC‐MS. Three major compounds, D‐limonene (25.02 %), β‐pinene (23.37 %), and β‐sabinene (22.20 %) were identified. CHEO exhibited moderate antibacterial activity with MIC value of 250 μg/mL. The combination of CHEO (7.8 μg/mL) and tetracycline (62.5 μg/mL) produced a synergistic effect on E. coli with fractional inhibitory concentration index of 0.5. This mixture inhibited biofilm formation in E. coli . The combination of 7.8 μg/mL CHEO and 62.5 μg/mL tetracycline demonstrated bacteriolytic activity. In addition, the CHEO at 250 μg/mL showed a significant effect in inhibiting efflux pump. D‐limonene has a binding free energy value of −20.13 kcal/mol with ompA transmembrane domain of E. coli . This finding indicates that CHEO has a potency to be developed as natural antibacterial against E. coli .