Search Results (582)

Background: Medical resident burnout is a critical threat to healthcare workforce sustainability, with physical activity (PA) posited as a protective factor. This bibliometric analysis maps the global research landscape on this topic from 2005 to 2025. Methods: Systematic search of the Web of Science Core Collection identified 110 relevant English-language articles. Performance analysis and scientific mapping were conducted using R and VOSviewer. Results: The field saw an annual growth rate of 3.35%, with a peak of 16 publications in 2019. The United States was the dominant contributor, accounting for 68% of the total output. Analysis identified several major thematic areas, including stress and behavioral factors, occupational mental health, and institutional support mechanisms. The findings reveal a rapidly growing but geographically concentrated body of research, underscoring a significant gap in globally representative evidence. Conclusions: This analysis provides a foundational map for future research, underscoring the need for institutional wellness programs incorporating PA, international collaborative studies, and policy-level interventions. We conclude that integrating physical activity is not a luxury but a critical strategy for healthcare system sustainability. Full article

Citrus fruits and related processed products represent a major agricultural sector worldwide, contributing to food supply chains and to regional economies, particularly in Mediterranean and subtropical areas. Citrus processing generates significant amounts of post-processing waste, and their sustainable management is a critical challenge, driving growing scientific interest in exploring environmentally sustainable and profitable valorisation strategies. This study aimed at mapping the sustainability of post-processing citrus valorisation strategies documented in the scientific literature, through a scoping literature review based on the PRISMA-ScR model. Only peer-reviewed studies in English were selected from Scopus and Web of Science; in detail, 29 life cycle assessment studies (LCAs) focusing on the valorisation of citrus by-products have been analysed. Most of the studies were focused on essential oil extraction and energy production. Most of the biorefinery systems and valorisation aims proposed were found to be better than the business-as-usual solution. However, results are strongly influenced by the functional unit and allocation method. Economic allocation to the main product resulted in better environmental performances. The major environmental hotspot is the agrochemicals required for crop management. The analysis of LCAs facilitated the identification of valorisation strategies that deserve greater interest from the scientific community to propose sustainable bio-circular solutions in the agro-industrial and agricultural sectors. Full article

Fire spotting (FS), the process by which firebrands are lofted, transported, and ignite new fires ahead of the main flame front, plays a critical role in escalating extreme wildfire events. This systematic literature review (SLR) analyzes peer-reviewed articles and book chapters published in English from 2000 to 2023 to assess the evolution of FS models, identify prevailing methodologies, and highlight existing gaps. Following a PRISMA-guided approach, 102 studies were selected from Scopus, Web of Science, and Google Scholar, with searches conducted up to December 2023. The results indicate a marked increase in scientific interest after 2010. Thematic and bibliometric analyses reveal a dominant research focus on integrating the FS model within existing and new fire spread models, as well as empirical research and individual FS phases, particularly firebrand transport and ignition. However, generation and ignition FS phases, physics-based FS models (encompassing all FS phases), and integrated operational models remain underexplored. Modeling strategies have advanced from empirical and semi-empirical approaches to machine learning and physical-mechanistic simulations. Despite advancements, most models still struggle to replicate the stochastic and nonlinear nature of spotting. Geographically, research is concentrated in the United States, Australia, and parts of Europe, with notable gaps in representation across the Global South. This review underscores the need for interdisciplinary, data-driven, and regionally inclusive approaches to improve the predictive accuracy and operational applicability of FS models under future climate scenarios. Full article

Background/Objectives: Natural products, especially plant metabolites, play a crucial role in drug development and are widely used in medicine, cosmetics, and nutrition. The present review aims to provide a comprehensive overview of the pharmacological profile of Glycyrrhizin (GL), with a specific focus on its molecular targets. Methods: Scientific literature was thoroughly retrieved from reputable databases, including Scopus, Web of Science, and PubMed, up to 30 July 2025. The keywords “glycyrrhizin” and “glycyrrhizic acid” were used to identify relevant references, with a focus on pharmacological applications. Studies on synthetic analogs, non-English publications, non-pharmacological applications, and GL containing crude extracts were largely excluded. Results: Glycyrrhizin, the major bioactive constituent of Glycyrrhiza glabra, exhibits diverse pharmacological activities, including anti-inflammatory, antiviral, hepatoprotective, antitumor, neuroprotective, and immunomodulatory effects. These actions are primarily mediated through the inhibition of high-mobility group box 1 (HMGB1) and the modulation of key signaling pathways, including nuclear factor kappa B (NF-κB), mitogen-activated protein kinase (MAPK), phosphoinositide 3-kinase/protein kinase B (PI3K/Akt), and various cytokine networks. As a result of its therapeutic potential, GL-based formulations, including Stronger Neo-Minophagen C, and GL-rich extracts of G. glabra are commercially available as pharmaceutical preparations and food additives. Conclusions: Despite its therapeutic potential, the clinical application of GL is limited by poor oral bioavailability, metabolic variability, and adverse effects such as pseudoaldosteronism. Hence, careful consideration of pharmacokinetics and safety is essential for translating its therapeutic potential into clinical practice. Full article

Infections caused by Staphylococcus aureus pose significant public health challenges, particularly due to antibiotic-resistant strains like MRSA. In this context, Streptomyces, a genus known for producing natural antibiotics, emerges as a promising source for novel therapeutic agents. In this study, a bibliometric analysis of the scientific literature (2015–2024) on Streptomyces as antibiotic biofactories against S. aureus was performed, aiming to identify publication trends, collaborative networks, and emerging research areas. Using the Web of Science database, searches were performed with descriptors (“Streptomyces” AND “Staphylococcus aureus”), including original articles and reviews in English. Data were analyzed with VOSviewer and Biblioshiny to visualize collaborative networks, keyword co-occurrences, and trends. A total of 755 articles from 3705 authors were analyzed, highlighting significant collaboration (98.7%). Publications showed marked growth, particularly in Microbiology (21.7%), Pharmacology and Pharmacy (16.8%), and Biotechnology and Applied Microbiology (16.1%). China and India led in publication volume, whereas the United States exhibited the highest citation impact. Key emerging research topics include biosynthesis and metabolic optimization, antimicrobial activity and bioprospecting, mechanisms of antibiotic action and bacterial resistance, and genomic analyses. Research on Streptomyces for antibiotic production against S. aureus demonstrates continuous expansion and global interest, emphasizing the importance of international collaboration and multidisciplinary approaches. Future studies should intensify exploration of biodiverse environments, genetic engineering applications, and combinatorial strategies to effectively address antimicrobial resistance. Full article

This single case study examines the implementation of a co-designed fifth-grade science unit enhanced by using Virtual Reality (VR) and integrating translingual and transmodal scaffolding strategies to support students’ participation and quality of talk during scientific sensemaking. The co-designed science unit covered physical and chemical changes as part of the fifth-grade science curriculum. The research involves a fifth-grade science teacher and her class of 22 students comprising multilingual learners (ML) and English monolingual learners (EML). This study examines the learning experience of 3 student pairs grouped as ML-ML, EML-ML and EML-EML. Using content analysis, we analyzed 911 min of video data on the six students’ learning in this unit. The results indicate that when the teacher used translingual and transmodal scaffolding strategies introduced during the co-design process, equal participation across MLs and EMLs was observed. The VR pair programming worked well for student pairs in increasing active participation regardless of the pairing, although active participation did not necessarily lead to high quality science talk. Findings of this study provide implications and recommendations for leveraging the scaffolding from teachers, materials, and VR pair programing activity to support the equal participation and quality of talk among all learners during scientific sensemaking. Full article

The literature provides evidence of the negative impact of depression on mortality among cancer patients. Depression is also a common comorbidity in pancreatic cancer (PC). The objective of this systematic review was to provide a state-of-the-art overview of the potential role of depression in the excess mortality observed in patients with PC. Based on PRISMA guidelines, a systematic review (PROSPERO: CRD420251135451) was conducted in August 2025 using the Pubmed-Medline and Scopus database. After assessment by two readers of the 325 identified articles, 8 articles (n = 143,033) published between 1 January 2010 and 15 August 2025 investigating the specific impact of depression (diagnosed by psychiatric interviews, self-report questionnaires, or diagnostic codes) on mortality in patients with PC (diagnosed by clinical diagnosis or diagnostic codes) were included in this systematic literature review. Articles that were not research studies and were written in a language other than English/French were not included. Risk of bias was assessed using the ROBINS-I tool. A narrative synthesis of the results was performed for the potential impact of depression on mortality in patients with PC. The reported prevalence of depression in this population ranged from 7.4% to 51.8% (seven studies, n = 142,983), depending on the studies considered. Most of the included studies (seven studies, n = 141,728) consistently reported an increased risk of mortality associated with depression, regardless of cancer stage or treatment received. However, the scientific quality of these studies was generally low, with a significant risk of bias. These results suggest that better integration of depression management in the care of patients with PC could potentially improve clinical outcomes in this high-risk population. Full article

Background/Objectives: The search for natural alternatives to enhance wound healing has driven the investigation of bioactive compounds, such as Spirulina. This microalga, rich in antioxidant, anti-inflammatory, and antimicrobial properties, contains compounds like phycocyanin (C-PC), which promote cell repair, reduce inflammatory markers, and combat bacteria. Although its effects are promising, its efficacy still requires validation through human clinical trials. This article aims to review scientific publications on the use of Spirulina in skin regeneration using animal wound models. Methods: A database search was conducted for studies published between 2017 and 2024 on the effects of Spirulina on tissue regeneration in rats, chosen for their genetic similarity to humans. In vitro studies, those using other animal models, or studies published in languages other than Spanish or English were excluded. The review followed the PRISMA 2020 guidelines. Results: Four studies were analyzed, all of which demonstrated promising results in wound healing in rats. Spirulina was administered through oral supplements, hydrogels, and nanophytosomal formulations. These treatments accelerated wound closure and improved granulation tissue formation, vascularization, and epithelialization. Additionally, they exhibited antihyperglycemic effects in diabetic rats. Conclusions: The reviewed studies highlight the potential of Spirulina platensis to enhance wound healing, particularly in cases of diabetes and burns. Its antioxidant and anti-inflammatory properties play a crucial role in accelerating cellular regeneration and reducing inflammation, contributing to faster and more effective recovery. However, further research in humans is necessary to confirm its safety and clinical efficacy. Full article

This systematic review analyzed a total of 109 scientific articles with the aim of identifying, organizing, and synthesizing academic output related to digital literacy, technology adoption in agricultural sectors, digital skills, and socioeconomic and cultural factors that influence the implementation of emerging technologies. Peer-reviewed academic publications available in open access and written in English were reviewed, complying with the PRISMA protocol guidelines. They came predominantly from Europe, Asia, and Latin America, which allowed for a global perspective. Quantitative, qualitative, and mixed approaches were applied, highlighting the use of surveys, interviews, and bibliometric analysis. Factors affecting the adoption of precision agriculture by smallholder farmers, challenges for the implementation of technologies in rural contexts, and sociocultural barriers to technological innovation were evaluated. The trend focuses on the need for sound public policies, continuous training strategies, technological accessibility, and contextualized approaches to ensure effective technology adoption. In conclusion, a broad and critical overview of the advances, limitations, and challenges surrounding digital literacy and technology adoption is provided as a basis for an in-depth debate on the digital transformation of contemporary agriculture. Full article

Background and Objectives: Turner Syndrome (ORPHA:881) is a rare genetic disorder characterized by complete or partial loss of one of the X chromosomes (monosomy X). In addition to specific somatic features and hormonal imbalances, affected individuals often face challenges related to quality of life (QoL). The aim of this review is to analyze the available scientific literature on the QoL in patients with Turner Syndrome. Materials and Methods: A systematic literature review was conducted using the databases Scopus, PubMed, and Web of Science, using specific key words. The search was performed from the date of inception of each database through July 2025. Only full-text articles in English assessing the QoL in individuals with Turner Syndrome were included. Results: The search identified 843 records, of which 12 studies met the eligibility criteria and were included in the final analysis. These studies consistently reported significant differences in the QoL between patients with Turner Syndrome and healthy controls. Factors such as hormone replacement therapy, social support, and comorbid conditions were highlighted as key determinants of QoL. Conclusions: Assessing the QoL in patients with Turner Syndrome is essential for understanding their overall adaptation and the need for a multidisciplinary approach to care. The findings highlight the necessity of additional long-term studies to better understand the impact of various therapeutic strategies on the QoL. The systematic review of the literature underscores the importance of a multidisciplinary approach in the care of patients with Turner Syndrome and the need for individualized therapeutic strategies aimed at improving their health-related quality of life. Full article

Listeria monocytogenes is a major public health concern in milk and ready-to-eat dairy products. To meet consumer demand for fresher, minimally processed foods with high nutritional and sensory quality, several non-thermal technologies are being explored as alternatives to conventional heat treatments. This systematic review (2020–2025), following PRISMA guidelines, examines recent applications of selected non-thermal technologies to control Listeria in milk and dairy matrices. Peer-reviewed studies available in full-text, in English or Spanish, focusing on applications at laboratory or pilot plant scales, with milk or dairy produced onsite or purchased, containing Listeria sp., were included. Studies with applications to plant-based or non-dairy products or those not inoculated with Listeria, were excluded. Conference abstracts, corrections, editorials, letters, news, and scientific opinions were excluded as well. The databases searched were Web of Science, Scopus, and ProQuest, which were last consulted in April 2025. Given the naturality of the review, the risk of bias was assessed through independent screening by two of the researchers, focusing on clear objectives, analytical validity, statistical analysis, and methodology. The results are presented in tabulated format. Of the 157 records identified, 22 were included in this review. Seven of the records reported hurdle technologies, while fifteen reported single technology applications, with high-pressure processing being the most frequent. Limitations observed are primarily the use of unreported strains, a lack of information regarding the initial load of inoculum, and expected log reductions. The equipment used is mostly at the laboratory scale, except for HPP. Non-thermal technologies present a promising option for the control of Listeria in dairy products. The basic principles of GMP, HACCP, and cold-chain control in dairy processing are of special importance in safety assurance. This research was funded by Vicerrectoría de Investigación, Universidad de Costa Rica, grant number 735-C3-460. Full article

Background/Objectives: Children with Down syndrome (DS) present unique and multifaceted nutritional challenges arising from genetic, metabolic, and developmental factors. Despite growing interest in the health of individuals with DS, dedicated nutritional guidelines tailored to their specific needs remain lacking. This narrative review aims to summarize current scientific evidence on nutritional status, challenges, and therapeutic strategies in children with DS, with an emphasis on clinical implications and practical recommendations for healthcare professionals. Methods: A literature search was conducted across four databases (PubMed, Scopus, Web of Science, and Google Scholar) for English-language publications from 1993 to June 2025. Thirty-five peer-reviewed articles were included, comprising original studies, narrative reviews, and expert guidelines (e.g., the American Academy of Pediatrics [AAP], the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN], and the European Federation of Associations of Dietitians [EFAD]). The selection process followed the PRISMA protocol. Studies were categorized according to key themes: energy requirements, comorbidities, feeding difficulties, nutrient needs, and therapeutic interventions. Results: Children with DS typically exhibit lower basal metabolic rates and altered body composition (i.e., higher fat mass and reduced lean mass), which increase their risk of both obesity and nutrient deficiencies. Common comorbidities—such as hypothyroidism, celiac disease, and gastrointestinal or immune disorders—further complicate dietary management. Feeding difficulties, including sucking/swallowing impairments, food selectivity, neophobia, and delayed independence in eating, are prevalent and significantly affect diet quality. Key nutrients of concern include protein, omega-3 fatty acids, fiber, vitamins B12 and D, iron, and antioxidants. Although no official nutrition guidelines currently exist for this population, existing recommendations from pediatric and dietetic organizations provide partial guidance that can be adapted to clinical practice. Conclusions: There is an urgent need to develop evidence-based, population-specific dietary guidelines for children with Down syndrome. Clinical nutrition care should be individualized, multidisciplinary, and proactive, integrating regular assessments of growth, feeding abilities, and biochemical markers. Dietitians must play a central role in both early intervention and long-term management. Further research, particularly interventional studies, is essential to optimize dietary strategies and improve health outcomes in this vulnerable population. Full article

Background: Scientific evidence plays a critical role in informing public health decision-making processes. However, the extent, nature, and effectiveness of its use remain uneven across contexts. Despite the increasing volume of literature on the subject, previous syntheses have often suffered from narrow thematic, temporal, or geographic scopes. Objectives: This study undertook a comprehensive systematic literature review spanning 50 years to (i) synthesise current knowledge on the use of scientific evidence in public health decisions, (ii) identify key determinants, barriers, and enablers, (iii) evaluate implementation patterns, and (iv) propose future directions for research and practice. Methods: We adopted the PRISMA model (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Moreover, we researched three large databases (Web of Science, Embase, and PubMed), and this study focused on articles published in the English and French languages between January 1974 and December 2024. Studies were analysed thematically and descriptively to identify trends, patterns, and knowledge gaps. Results: This review reveals a growing corpus of scholarship with a predominance of qualitative studies mainly published in public health journals. Evidence use is most frequently analysed at the national policy level. Analyses of the evolution of scientific production over time revealed significant shifts beginning as early as 2005. Critical impediments included limited access to reliable and timely data, a lack of institutional capacity, and insufficient training among policy-makers. In contrast, enablers encompass cross-sector collaboration, data transparency, and alignment between researchers and decision-makers. Conclusions: Addressing persistent gaps necessitates a more nuanced appreciation of interdisciplinary and contextual factors. Our findings call for proactive policies aimed at promoting the use of scientific evidence by improving the accessibility of health data (addressing the absence or lack of data, as well as its reliability, timeliness, and accessibility), and by training decision-makers in the use of scientific evidence for decision making. Furthermore, our findings advocate for better alignment between the agendas of healthcare professionals (e.g., data collection), researchers (e.g., the selection of research topics), and decision-makers (e.g., expectations and needs) in order to develop and implement public health policies that are grounded in and informed by scientific evidence. Full article

Context and objective: Post-amputation pain (PAP) is an umbrella term that includes residual limb pain (RLP) and phantom limb pain (PLP), posing a significant challenge to recovery and quality of life after limb loss. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, has gained interest for its potential to manage PAP, particularly in refractory cases. This narrative review explores the efficacy of ketamine for PAP and the emerging role of pharmacogenomics in guiding its use. Methods: A literature review of PubMed, Embase, and Cochrane databases was conducted, focusing on clinical trials, systematic reviews, and genetic influences on ketamine metabolism and response. Studies suggest that perioperative ketamine can reduce PAP severity and opioid use. However, outcomes vary, with some patients experiencing transient relief and others achieving prolonged benefit. Results: This variability may be linked to genetic differences in CYP2B6, CYP3A4/5, COMT Val158Met, SLC6A2, and KCNS1, which affect ketamine’s metabolism, efficacy and side effect profile. Understanding these pharmacogenomic factors could enable more personalized and effective ketamine therapy. Conclusion: Despite its promise, inconsistent dosing regimens and limited integration of genetic data hinder standardization. Further research into genotype-guided ketamine protocols may improve treatment outcomes and support precision analgesia in amputee care. Full article

The Qinghai-Tibet Plateau is a sensitive area of global climate change and an “Asian water tower” and lakes in Qinghai-Tibet Plateau changes are of great significance to the regional hydrological cycle and ecological balance. However, the existing research mostly focuses on a single lake or short-term monitoring, and lacks a systematic review of the evolution of knowledge structure and interdisciplinary dynamics. Based on 354 literatures from CNKI (China National Knowledge Infrastructure) and Web of Science, this study used CiteSpace 6.3.R1 software to construct a scientific knowledge map of lake changes in the Qinghai-Tibet Plateau under the background of climate change for the first time. By analyzing the number of publications, research hotspots, institutional cooperation networks and keyword emergence rules, the core triangle structure of ”climate change–Qinghai-Tibet Plateau–lake” was revealed, and the three stages of sedimentary reconstruction (2002–2008), glacier–lake coupling (2005–2014) and human–land system comprehensive research (2015–2025) were divided. The study found that the scientific literature written in Chinese and the scientific literature written in English focused on empirical cases and model simulations, respectively, The research frontiers focused on hot karst lakes (burst intensity 3.71), lake water level (2.97) and carbon cycle (2.13). The research force is centered on the Chinese Academy of Sciences, forming a cluster of institutions in the northwest region, but international cooperation only accounts for 12.3%. Future research needs to deepen multi-source data fusion, strengthen cross-regional comparison, and build an international cooperation network to cope with the complex challenges of plateau lake systems under climate change. This study provides a scientific basis for the paradigm shift and future direction of plateau lake research. Full article