Search Results (1,515)

The internal mammary arteries (IMAs) and coronary arteries share many common characteristics. The inner layer (tunica intima, or intima) of both arteries is lined with a smooth, longitudinally orientated monolayer of endothelial cells (ECs), connective tissue, and an internal elastic lamina that separates the tunica intima from the tunica media (middle layer). The intima of IMAs is lined with an additional protective layer, the neointima, containing vascular smooth muscle cells (VSMCs). The neointima, located between the intima and internal elastic lamina, protects IMAs from damage by assisting in the remodeling of VSMCs. Coarse longitudinal folds in the internal elastic lamina of IMAs partially prevent the infiltration of VSMCs into damaged IMAs, and intimal thickening is thus less likely to occur. Inflamed IMAs resist the migration of monocytes across the endothelial layer and prevent the formation of lipid-rich macrophages (foam cells) within the subintimal or medial layers of arteries. IMAs are thus less likely to form plaques and develop atherosclerosis (AS). Higher levels of prostacyclin (PGI2) in IMAs prevent blood clotting. The anti-thrombotic agents, and production of tumor necrosis factor α (TNF-α), interferon-γ (INF-γ), and visfatin render IMAs more resistant to inflammation. An increase in the production of nitric oxide (NO) by ECs of IMAs may be due to small ubiquitin-like modifier (SUMO) proteins that alter the nuclear factor kappa B (NF-κB) and TLR pathways. The production of reactive oxygen species (ROS) in IMAs is suppressed due to the inhibition of NADPH oxidase (NOX) by a pigment epithelium-derived factor (PEDF), which is a serine protease inhibitor (SERPIN). In this review, a comparison is drawn between the anatomy of IMAs and coronary arteries, with an emphasis on how ECs of IMAs react to immunological changes, rendering them more suited for coronary artery bypass grafts (CABGs). This narrative review covers the most recent findings published in PubMed and Crossref databases. Full article

Sarcopenia and type 2 diabetes mellitus (T2DM) are chronic conditions that gradually affect the elderly, often coexisting and interacting in complex ways. Sarcopenia, which is characterized by the progressive loss of muscle mass and function, is frequently observed in individuals with T2DM. Although the clinical association is well known, the molecular mechanisms remain unclear. Gene expression datasets were retrieved from the Gene Expression Omnibus database. DEGs were identified using the limma package in R (R 4.4.0). Shared DEGs were subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Protein–protein interaction networks were constructed using the STRING database and were visualized with Cytoscape. Hub genes were identified via six topological algorithms in the CytoHubba plugin. Pearson’s correlation analysis was conducted between hub genes and selected metabolic regulators. GO and KEGG enrichment analyses indicated that mitochondrial function, oxidative phosphorylation, and immune–inflammatory responses were significantly enriched. A PPI network revealed a mitochondrial hub of five key genes involved in energy metabolism, whose downregulation suggests mitochondrial dysfunction as a shared mechanism in sarcopenia and T2DM. Our results provide new insight into the molecular overlap between T2DM and sarcopenia, highlighting potential biomarkers and therapeutic targets for addressing both metabolic disruption and muscle decline. Full article

The Encyclopaedia Cloacae is a novel and centralised digital platform designed to support and advance wastewater-based epidemiology (WBE) by cataloguing pathogens detectable in wastewater and their relevance to public health surveillance. The platform is hosted on the EU Wastewater Observatory for Public Health (EU4S) website, where it is populated with peer-reviewed research through a structured workflow under harmonised criteria which address the presence of pathogens in human excreta, detectability in wastewater, and integration into public health systems. This tri-criteria approach ensures that the database is both scientifically robust and operationally actionable. Complemented by the Visualising the Invisible dashboard, the platform offers geospatial insights into global WBE research activity. By consolidating peer-reviewed evidence on pathogen detectability in wastewater and human excreta, the Encyclopaedia Cloacae enables early detection of infectious diseases, whether already known or newly emerging. The continuously updated repository and geospatial dashboards help to identify surveillance gaps and research hotspots, to support timely public health responses, enhance pandemic preparedness, and strengthen global health security. In addition, it supports One Health strategies, connecting the health of humans, animals, and the shared environment. This article outlines the platform’s architecture, data curation methodology, and future directions, including automation and expansion to encompass broader health determinants such as antimicrobial resistance and chemical hazards. Full article

Background: In an increasingly globalized context marked by growing professional mobility, establishing shared standards for assessing nursing competencies is essential. The licensure examination represents a critical gateway between academic preparation and professional practice. However, significant ambiguity remains regarding what competencies are assessed and how this assessment is conducted internationally. Objective: This scoping review aimed to map the international literature on nursing licensure examinations by comparing frameworks and domains, performance levels, and assessment tools to identify similarities and differences in the core competencies required for entry into practice. Methods: The review followed Arksey and O’Malley’s methodological framework. Comprehensive searches were conducted across PubMed, CINAHL, Scopus, ERIC, Cochrane Library, ProQuest, and OpenGrey databases. Studies addressing competency frameworks, performance levels, and assessment tools in undergraduate nursing licensure were included. Results: Twenty-three studies were analyzed. The most frequently cited framework was ‘Client Needs’. Competency domains commonly addressed patient needs, professional roles, and healthcare settings. The dominant performance level was cognitive, typically assessed through multiple-choice questions; practical skills were often evaluated via ‘bedside tests’. Despite variations in frameworks and domains, cognitive performance expectations and assessment tools showed some consistency. Conclusions: These findings underscore the need for a context-sensitive, internationally adaptable framework to promote fairness and support nurse mobility. Full article

The World Health Organization (WHO) declared snakebite envenoming (SBE) as a neglected tropical disease in 2017. Antivenom is the gold standard of treatment, but many healthcare barriers exist, and hence, affected populations are often unable to access it. The challenge is further perpetuated by the lack of attention from national health authorities, poor regulatory systems and policies, and mismanagement of antivenom. This study aims to map the evidence regarding snake antivenom regulations globally and identify gaps in the literature to inform future research and policy. This review was conducted using the original Arksey and O’Malley framework by three independent reviewers, and the results were reported using the Preferred Reporting Items for Systematic reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR). A search strategy was developed with assistance from a librarian, and six databases were searched: PubMed, SCOPUS, ProQuest Central, Africa Wide Web, Academic Search Output, and Web of Science. Screening was conducted independently by the reviewers, using Rayyan, and conflicts were resolved with discussions. A total of 84 articles were included for data extraction. The major themes that emerged from the included studies were regarding antivenom availability, accessibility, manufacturing, and regulations. The study revealed massive gaps in terms of policies governing antivenom management, especially in Asia and Africa. The literature does not offer sufficient evidence on management guidelines for antivenom in the endemic regions, despite identifying the challenges in supply. However, significant information from Latin America revealed self-sufficient production, involvement of national health bodies in establishing efficient regulations, effective distribution nationally and regionally, and technology sharing to reduce SBE-related mortality. Full article

Cytochrome P450 (CYP450) enzymes play an essential role in the metabolism of drugs, particularly in phase I metabolic reactions. In this article, we present a comprehensive review of fifteen selected enzymes belonging to the CYP450 family. The enzymes included in this analysis are CYP7A1, CYP3A4, CYP3A5, CYP2D6, CYP2E1, CYP2C8, CYP2C18, CYP2C9, CYP2C19, CYP2B6, CYP2A6, CYP2A13, CYP1B1, CYP1A1, and CYP1A2. We examined the influence of natural, polymorphic variations within their primary amino acid sequences on their enzymatic function and mechanisms of action. To begin, we compiled a dataset of naturally occurring polymorphic variants for these enzymes. This was achieved through a detailed analysis of entries in the UniProt database, as well as an extensive review of the current scientific literature. For each variant, we included commentary regarding its potential impact on enzyme activity or drug response, based on evidence observed in in vitro experiments, in vivo studies, or clinical trials. Particular emphasis was placed on how such polymorphisms might alter the metabolism of xenobiotics, thereby potentially affecting pharmacological outcomes. In this respect, the work represents the first comprehensive source in the scientific literature that systematically gathers and organizes data on CYP450 polymorphisms, including an assessment of their potential significance in processes mediated by these enzymes. A more detailed comparison of the polymorphism-related in vitro studies is devoted to CYP3A4, an enzyme that displays the largest fraction of clinically significant polymorphs. Secondly, we aimed to establish possible molecular explanations for why specific polymorphisms exhibit clinically or experimentally observable effects. To explore this, we performed a qualitative structural analysis of the enzymes, focusing on shared structural characteristics among the examined members of the CYP450 family. The results of this analysis demonstrate that there is no single universal mechanism by which polymorphisms influence the function of CYP450 enzymes. Instead, the mechanisms vary and may include alterations in the orientation of the enzyme within the lipid membrane, changes affecting the association or dissociation of substrates and products at the active site, structural stabilization or destabilization of the enzyme’s reactive centers, modifications in the way the enzyme interacts with its ligand, or alterations in the character of the interface involved in contact with its redox partner (electron transfer protein). Furthermore, among the polymorphisms that significantly impact enzyme function, mutations involving the substitution of arginine residues for other amino acids appear to be overrepresented. Full article

Among the shared pathogenetic mechanisms leading to neurodevelopmental disorders (NDDs), a dysregulated inflammatory response has been described as a convergent pathway in NDDs. This scoping review was registered in the OSF database. It was conducted in accordance with the PRISMA Extension for Scoping Reviews, utilizing a comprehensive literature search of major academic databases, including PubMed and Web of Science. The search was performed until 1 March 2025, using a combination of predefined search terms and Boolean operators (AND, OR) to ensure a comprehensive identification of relevant studies. A comprehensive summary of the evidence on immunological and neuroinflammatory pathways underlying the NDDs is shown. This review also reports evidence on early-onset presentation of schizophrenia spectrum and obsessive–compulsive disorder since clinical researchers are beginning to consider these conditions neurodevelopmental disorders. Furthermore, this review outlines the recently described clinical entity, PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome), and its clinical and pathogenetic contact points with NDDs, delineating a spectrum of disorders that share common pathogenetic pathways. This scoping review improves the awareness of immune/neuroinflammatory correlates supporting NDDs. Furthermore, it suggests adopting a transnosographic approach to neuropsychiatric disorders, including PANS as a syndromic construct that overlaps with NDDs. Full article

Background/Objectives: Parental mental representations play a crucial role in shaping early parent–child relationships, particularly during the perinatal period. These internal models influence caregiving behaviors, emotional attunement, and the intergenerational transmission of attachment. The present systematic review aims to address this gap by examining the nature of both maternal and paternal mental representations in the perinatal period (involving pregnancy and the first postnatal time), with a particular emphasis on reflective functioning, and by outlining the variables that are influenced by these representations. Methods: Following PRISMA guidelines, eligible peer-reviewed studies were identified through a comprehensive literature search of major scientific databases (Scopus, Web of Science, PsychArticle/PsycInfo). Qualitative assessment and detailed description were carried out. Results: In total, 28 studies were selected and analyzed. Findings reveal that while representations tend to organize around shared psychological domains—such as expectations regarding the child, parental identity, and the anticipated relationship—there is significant heterogeneity in how these are conceptualized and measured across studies. Risk factors such as maternal depression, low social support, and adverse life experiences were consistently linked to disengaged or distorted representations, whereas balanced representations were associated with greater RF, emotional availability, and protective relational contexts. Conclusions: Overall, the review highlights the clinical relevance of assessing parental mental representations and RF during the perinatal period, suggesting that early, targeted interventions may enhance parental sensitivity and promote secure parent–infant bonds. Future research should adopt integrated theoretical models, include diverse family configurations, and evaluate the efficacy of preventive programs that support reflective and adaptive representations. Full article

In the present study, the changes in the groundwater quality in a Hungarian settlement, Báránd, were examined, nine years after the construction of a sewerage network. The sewerage network in the study area was completed in 2014, with a household connection rate exceeding 97% in 2023. In the summer of 2023, water samples were taken from 37 dug groundwater wells. Changes in the water quality were assessed using three water quality indicators (the Water Quality Index (WQI), Contamination degree (Cd), and Canadian Council of Ministers of the Environment Water Quality Index (CCME WQI)) and geographic information (GIS), data visualization systems, and artificial intelligence (AI). During the evaluation of the quality of the groundwater, eight water chemical parameters were used (pH, EC, NH₄⁺, NO₂⁻, NO₃⁻, PO₄³⁻, COD, Na⁺). Based on interpolated maps and water quality indices, it was established that while an increasing portion of the area exhibits adequate or good water quality compared to the pre-sewerage period, a deterioration has occurred relative to recent years. Even nine years after the sewerage network construction, elevated concentrations of inorganic nitrogen forms and organic matter persist, indicating the continued presence of accumulated pollutants, as confirmed by all three water quality indicators to varying degrees and spatial patterns. The interactive data visualization and cloud-based sharing of the data of the water quality geodatabase were made freely available with the help of Tableau Public. A Feed-Forward Neural Network (FFNN) was developed to predict the groundwater quality, estimating the water quality statuses of three water quality indicators based on water chemistry parameters. The results showed that the applied training algorithms and activation functions proved to be the most effective in the case of different network structures. The most accurate prediction of the WQI and CCME WQI indicators was provided by the Bayesian control algorithm (trainbr), which achieved the lowest mean-squared error (RMSE_WQI = 0.1205, RMSE_{CCME WQI} = 0.1305) and the highest determination coefficient (R²_WQI = 0.9916, R²_{CCME WQI} = 0.9838). For the Cd index, the accuracy of the model was lower (RMSE = 0.1621, R² = 0.9714), suggesting that this indicator is more difficult to predict. With regard to our study, it should be emphasized that data visualization is a particularly practical tool for the post-processing of spatial monitoring data, as it is suitable for displaying information in an intuitive, visual form, for discovering spatial patterns and relationships, and for performing real-time analyses. AI is expected to further increase visualization efficiency in the future, enabling the rapid processing of large amounts of data and spatial databases, as well as the identification of complex patterns. Full article

This study reviews how technology-based interventions have been designed and implemented to promote lung cancer screening (LCS), support shared decision-making, and enhance patient engagement. A systematic search of six databases in February 2025 identified 28 eligible studies published between 2014 and 2025. Most interventions were home-based and self-guided, including videos, websites, mobile apps, telehealth, and patient portal messages. Common features included risk calculators, multimedia content, simplified navigation, and integration with electronic medical records. These tools aim to raise awareness, improve informed decision-making, and support smoking cessation. While 82% of studies reported positive effects on knowledge and decision-making confidence, only some showed an increased screening uptake. Key barriers included limited internet access, low digital literacy, provider time constraints, fear or anxiety, and concerns about radiation or cost. Despite these challenges, digital tools show promise in advancing LCS promotion. Their effectiveness, however, depends on thoughtful design, integration into clinical workflows, and equitable access. Future work should address structural and contextual challenges to scale digital health solutions and reduce disparities in screening participation. This review identifies both the potential and limitations of current interventions and offers guidance for enhancing impact through targeted, accessible, and user-informed approaches. Full article

The monitoring of algal communities has traditionally relied on optical microscopy. However, this technique is time-consuming and requires significant expertise to accurately identify species. In recent years, molecular techniques such as environmental DNA (eDNA) metabarcoding have facilitated the identification of algal communities. This study aims to compare both approaches for assessing planktonic microalgal communities in three areas of Lake Titicaca, using inverted light microscopy and eDNA metabarcoding. We found that the taxonomic composition obtained using the two methods differs significantly for Bacillariophyta, Chlorophyta, Charophyta, and Cyanobacteria, although genus- and order-level richness was similar across both approaches. A pronounced shift in species composition between techniques was revealed, with few shared genera and a high proportion of unassigned sequences (>50%) for Bacillariophyta. While microscopy provided more accurate estimates of microalgal density, metabarcoding revealed greater diversity, particularly among nanoplanktonic microalgae from the phyla Cryptophyta, Ochrophyta, Haptophyta, and Rhodophyta. To improve the accuracy and complementarity of these methodologies, it is essential to expand regional reference databases and work toward standardizing both approaches, allowing them to be used synergistically rather than independently. Full article

Background/Objectives: While elevated Lp(a) levels are associated with incident heart failure development, the role of Lp(a) in established heart failure with reduced ejection fraction (HFrEF) versus heart failure with preserved ejection fraction (HFpEF) remains unexplored. Methods: We conducted a retrospective analysis of 387 heart failure patients from our institutional database (January 2018–June 2024). Patients were categorized as HFrEF (n = 201) or HFpEF (n = 186) using ICD-10 codes. Categorical variables were compared between heart failure types using the Chi-square test or Fisher’s Exact test, and continuous variables were compared using the two-sample t-test or Wilcoxon rank-sum test, as appropriate. Logistic regression was utilized to assess heart failure type as a function of Lp(a) levels, adjusting for covariates. Spearman correlation assessed relationships between Lp(a) and pro-BNP levels. Results: Despite significant demographic and clinical differences between HFrEF and HFpEF patients, Lp(a) concentrations showed no significant variation between groups. Median Lp(a) levels were 60.9 nmol/dL (IQR: 21.9–136.7) in HFrEF versus 45.0 nmol/dL (IQR: 20.1–109.9) in HFpEF (p = 0.19). After adjusting for demographic and clinical covariates, Lp(a) showed no association with heart failure subtype (OR: 1.001, 95% CI: 0.99–1.004; p = 0.59). Conclusions: Lp(a) levels do not differ significantly between HFrEF and HFpEF phenotypes, suggesting possible shared pathophysiological mechanisms rather than phenotype-specific biomarker properties. These preliminary findings may support unified screening and treatment strategies for elevated Lp(a) across heart failure, pending confirmation in larger studies. Full article

Orange allergy is estimated to account for up to 3–4% of food allergies. Major allergens identified in orange (Citrus sinensis) include Cit s 1 (germin-like protein) and Cit s 2 (profilin), while Cit s 3 (non-specific lipid transfer protein, nsLTP) and Cit s 7 (gibberellin-regulated protein) have also been described. The objective of this study was to investigate the presence and IgE-binding capacity of germin-like proteins in citrus fruits other than oranges. We describe five patients with immediate allergic reactions after orange ingestion. All patients underwent skin prick tests (SPT) to aeroallergens and common food allergens, prick-by-prick testing with orange, lemon, and mandarin (pulp, peel, seeds), total IgE, specific IgE (sIgE), anaphylaxis scoring (oFASS), and the Food Allergy Quality of Life Questionnaire (FAQLQ-AF). Protein extracts from peel and pulp of orange, lemon, and mandarin were analyzed by Bradford assay, SDS-PAGE, and IgE immunoblotting using patient sera. Selected bands were identified by peptide mass fingerprinting. A 23 kDa band was recognized by all five patients in orange (pulp and peel), lemon (peel), and mandarin (peel). This band was consistent with Cit s 1, a germin-like protein already annotated in the IUIS allergen database for orange but not for lemon or mandarin. Peptide fingerprinting confirmed the germin-like identity of the 23 kDa bands in all three citrus species. Germin-like proteins of approximately 23 kDa were identified as IgE-binding components in peel extracts of orange, lemon, and mandarin, and in orange pulp. These findings suggest a potential shared allergen across citrus species that may contribute to allergic reactions independent of LTP sensitization. Full article

Background Sex disparity has been highlighted in personalized medicine for various human diseases including acute/chronic liver diseases. In the transplant community, greater graft failure risk in female-to-male liver transplantation (LT) has been repeatedly reported, and a recent study in living donor LT reported that the inferiority of female-to-male LT is shown only when donor age is ≤40 y. We aimed to analyze the United Network for Organ Sharing (UNOS) database to test if the poorer outcome of female-to-male LT changes by donor age of 40 y in deceased donor LT, as shown in living donor LT. Methods In this retrospective cohort study, 11,752 adult patients in the UNOS registry who underwent deceased donor LT between 2000–2023 were analyzed. Multivariable analysis was performed to adjust the effects from transplant years, graft ischemia time, disease severity, and others. The primary outcome was graft failure. Results Within the subgroup of recipients with ≤40 y donors, graft failure risk was significantly greater in female-to-male LT than others (vs. female-to-female, HR = 1.43 [1.16–1.76], p < 0.001; vs. male-to-female, HR = 1.46 [1.18–1.81], p < 0.001; vs. male-to-male, HR = 1.26 [1.16–1.49], p = 0.009). In contrast, within the subgroup of recipients with >40 y donors, the risk was comparable between female-to-male LT and other donor-recipient sex groups (vs. female-to-female, p = 0.907; vs. male-to-female, p = 0.781; vs. male-to-male, p = 0.937). We tested various cutoff donor ages and determined that 40 y is the best cutoff value to define the risk subgroup in female-to-male LT. Conclusions In the current study, we found that the sex disparity shown in living donor LT is also observed in deceased donor LT. That is, post-transplant graft failure risk was greater in female-to-male LT than other donor–recipient sex groups only when donor age was ≤40 y. In contrast, graft failure risk was comparable irrespective of donor-recipient sex combinations when donor age was >40 y. Full article

Water quality (WQ) monitoring is critical for Mexico and the world due to water pollution and scarcity problems in recent years. In this article, a systematic review was conducted considering only forecasting models focused on lentic freshwater bodies (to specialize the analysis of variables, problems, considerations, etc.) from 2019 to 2025 (to ensure the inclusion of the most relevant and new studies). This review analyzes 52 articles focused on the monitoring place, predictors, forecasted variables, configuration of each forecasting model, results with or without multiple forecast horizons, monitoring conditions, forecasting horizon, data availability, and model replicability. Our review shows that the main models documented used to predict WQ are based on machine learning (where RFs are the most used), AI (where ANNs are the most used and LSTM-based architectures are the most implemented), and statistical methods (where MLR is the most used). The principal forecasted WQ variables are Chl-α, DO, and TP. In comparison, the most used predictors are TP, temperature, and Chl-α. Furthermore, only 10 articles have made their databases available, and nine articles share the configuration of their models. Future research should investigate the real impact of data (quantity and inputs) variation in forecasting values for multiple forecast horizons. Full article