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The wind movement is a crucial factor in enhancing thermal comfort, forming an essential part towards friendly and sustainable urban environment. Air movement, as a prominent climatic factor, reduces heat stress with improving ventilation quality. Effective natural ventilation and heat stress mitigation can be achieved by orientation, planning and shaping the urban blocks in urban environments. Air movement represents the most important element in improving environmental adaptation, as the rapid airflow reaching buildings can significantly reduce their temperature. Site planning requires precise knowledge of the main wind directions and speeds. The research utilized the ENVI-met Models program for modeling urban environments and predicting thermal effects in the built environment. This program plays a crucial role in understanding and analyzing environmental conditions and their impact on thermal comfort. The research addressed the knowledge gap and lack of local studies in highlighting the role of wind movement in enhancing thermal comfort in urban environments using ENVI-met Models. The research aimed to provide specific knowledge in measuring wind movement and its role in enhancing thermal comfort in urban environments using the program. The research hypothesized that analyzing and modeling wind movement with ENVI-met Models can effectively contribute to understanding and improving thermal comfort in urban environments. One of the key findings is that studying the impact of wind movement with this program is essential for providing scientific and technical foundations to improve urban design and enhance thermal comfort in urban areas, promoting sustainability and environmental quality in cities. [ABSTRACT FROM AUTHOR]

Context: The demand of palliative care is increasing due to the aging population and treatment hesitancy or intentional avoidance compromises symptom management. Objectives: To identify patient beliefs associated with medication hesitancy by using the theory of planned behavior (TPB) namely, attitudes, subjective norms, behavioral intention, and perceived behavioral control associated with medication hesitancy or intentional noncompliance by avoidance. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline was followed to conduct a systematic literature search involving the CINAHL, Embase, MEDLINE, and PsycINFO databases from inception until March 2022. Hand-searched articles from reference lists and gray literature were included. Thematic analysis was conducted on qualitative data and triangulated with quantitative data. Results: About 554 articles were retrieved from the literature search and 17 articles were included based on the eligibility criteria. Three subthemes that were identified under TPB constructs were attitude : negative attitude toward medications, passive attitude toward illness and inaccurate information about disease or medication; one subtheme was identified under subjective norms : perceived negative opinions from others; and one subtheme was identified under perceived behavioral control : perception of manageable symptoms. Quantitative data provided triangulation of qualitative findings related to fear of addiction and side effects, feelings of hopelessness, unclear direction and information, social stigma, endurable symptoms, and illness as determinants for medication avoidance. Significance of results: This systematic review highlighted some patient beliefs related to medication hesitancy or avoidance. Clinicians should take patient beliefs and concerns into consideration when creating treatment regimens for people receiving palliative care to optimize medication adherence and the quality of care. [ABSTRACT FROM AUTHOR]

Aim: To compare the efficacy and safety of trastuzumab biosimilars to reference trastuzumab in patients with breast cancer. Trastuzumab, a biologic pharmaceutical product, has improved survival in hormone‐oestrogen receptor 2 positive breast cancer. However, due to its high economic burden, 'highly similar' products known as biosimilars have been developed. Yet, concerns remain around the equivalency of efficacy and safety between biosimilars and their reference biologic. Data Sources: A systematic review with meta‐analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. MEDLINE, EMBASE, and Cochrane Central databases were searched from inception to 26 April 2021 to obtain all randomised control trial data reporting on safety and efficacy outcomes of patients with breast cancer treated with trastuzumab biosimilars. Study Selection: Studies were required to investigate and report on the safety and/or efficacy of trastuzumab. No restrictions were placed on study setting or intervention type and any study which reported at least one efficacy or safety outcome was included. A head‐to‐head comparison between the biosimilar and its reference biologic was not required for inclusion in the results. Only studies using randomised control trials were included. There was no restriction on the language the study was published in, and all abstracts, raw clinical trial data, and full‐text studies were eligible. Results: Forty‐one studies were identified to report on patients treated with trastuzumab. The odds of achieving an overall response rate in patients treated with a trastuzumab biosimilar compared to the reference over at least 24 weeks of treatment was 1.10 (95% confidence interval [CI] 0.94–1.29). The proportion of patients experiencing any treatment emergent adverse events were comparable between the two study arms, 1.07 (95% CI 0.87–1.32). The switching group contained one study with 342 patients in the meta‐analysis. Conclusion: Trastuzumab biosimilars have comparable efficacy and safety to reference trastuzumab in treatment‐naïve patients. However, evidence is lacking for switching patients from reference trastuzumab to biosimilars, so further work is required in the switch‐over population. [ABSTRACT FROM AUTHOR]