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Search Results (809)

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24 pages, 1794 KB  
Review
Maintenance of Custom-Made Subperiosteal Implants: A Narrative Review of Indirect Evidence and Preliminary Clinical Considerations
by Valentina Dessì and Luigi Angelo Vaira
J. Clin. Med. 2026, 15(11), 4333; https://doi.org/10.3390/jcm15114333 - 3 Jun 2026
Abstract
Background: Custom-made subperiosteal implants have re-emerged as a valuable option for the rehabilitation of patients with severe maxillofacial atrophy and post-oncological defects. Despite advances in digital workflows and implant design, their unique anatomical, biological, and prosthetic characteristics pose specific challenges for long-term maintenance, [...] Read more.
Background: Custom-made subperiosteal implants have re-emerged as a valuable option for the rehabilitation of patients with severe maxillofacial atrophy and post-oncological defects. Despite advances in digital workflows and implant design, their unique anatomical, biological, and prosthetic characteristics pose specific challenges for long-term maintenance, and no dedicated standardized guidelines are currently available. Methods: This narrative review critically appraises the available literature on implant maintenance and related fields. A comprehensive search was conducted across PubMed, Scopus, and Web of Science, including studies on peri-implant maintenance, supportive periodontal therapy, full-arch and zygomatic implant rehabilitations, and subperiosteal implants. Due to the lack of direct evidence, a qualitative narrative synthesis was adopted to develop preliminary clinical considerations for maintenance of custom-made subperiosteal implants. These considerations should be interpreted as an expert-informed perspective rather than validated clinical guidelines. Results: Conventional maintenance protocols developed for endosseous implants are not directly transferable to subperiosteal implants due to differences in the implant–tissue interface, biomechanics, diagnostic parameters, and hygiene accessibility. Key challenges include the absence of a conventional peri-implant sulcus, possible implant exposure, complex prosthetic geometries, and potential susceptibility to biofilm accumulation in areas with limited access. Evidence from related fields highlights the importance of structured maintenance, individualized risk-based follow-up, effective biofilm control, and patient-specific home-care strategies. Conclusions: Preliminary evidence-informed clinical considerations for the maintenance of subperiosteal implants are proposed, with emphasis on plaque control, individualized follow-up, descriptive clinical monitoring, and hygiene-oriented prosthetic and surgical planning. These considerations are not intended as validated guidelines, but as a practical starting point for clinical reasoning in an area where dedicated evidence remains limited. Full article
(This article belongs to the Special Issue New Technologies for Personalized Medicine in Head and Neck Surgery)
15 pages, 2065 KB  
Review
Psoriasis in Obese Patients: Pathophysiological Interactions, Clinical Consequences, and Therapeutic Implications
by Gustavo Almeida-Silva, Joana Antunes, João Ferreira and Paulo Filipe
J. Clin. Med. 2026, 15(11), 4302; https://doi.org/10.3390/jcm15114302 - 2 Jun 2026
Abstract
Background/Objectives: Psoriasis is a chronic immune-mediated inflammatory disease increasingly recognized as a systemic disorder associated with significant metabolic and cardiovascular comorbidities. Among these, obesity (defined as BMI > 30 kg/m2) plays a pivotal role, acting both as a risk factor [...] Read more.
Background/Objectives: Psoriasis is a chronic immune-mediated inflammatory disease increasingly recognized as a systemic disorder associated with significant metabolic and cardiovascular comorbidities. Among these, obesity (defined as BMI > 30 kg/m2) plays a pivotal role, acting both as a risk factor for psoriasis development and as a modifier of disease severity, clinical phenotype, and therapeutic response. The relationship between psoriasis and obesity is bidirectional and sustained by shared inflammatory and metabolic pathways. This review aims to provide a comprehensive and updated synthesis of the epidemiological association between psoriasis and obesity, to elucidate the underlying pathophysiological mechanisms, and to discuss the clinical and therapeutic implications of excess body weight in psoriasis management. Methods: A narrative review of the literature was conducted, including epidemiological studies, mechanistic research, clinical trials, and real-world evidence addressing the interplay between psoriasis and obesity. Relevant data were identified from peer-reviewed publications focusing on inflammatory pathways, metabolic dysfunction, cardiovascular risk, and treatment outcomes in obese patients with psoriasis. The graphical figures included in this manuscript were created with the assistance of a large language model–based image-generation tool, ChatGPT-5 by OpenAI, using author-defined prompts. The prompts requested schematic medical illustrations summarizing the pathophysiological links between obesity and psoriasis, including adipose tissue dysfunction, adipokine imbalance, systemic inflammation, and activation of the IL-23/Th17 axis. For the therapeutic algorithm, the prompt requested a stepwise clinical flowchart for obese patients with psoriasis, including BMI assessment, comorbidity screening, universal weight-management measures, psoriasis severity stratification, obesity-adapted biologic selection, and management of suboptimal response. The generated images were subsequently reviewed, edited, and approved by the authors to ensure scientific accuracy, clarity, and consistency with the manuscript content. Results: Epidemiological evidence consistently demonstrates a higher prevalence of obesity among patients with psoriasis, with obesity independently associated with increased disease severity. Shared mechanisms include adipose tissue–driven cytokine production, dysregulated adipokine secretion, insulin resistance, endothelial dysfunction, and activation of the IL-23/Th17 axis, collectively contributing to systemic inflammation and accelerated atherogenesis. Obesity negatively impacts the efficacy, pharmacokinetics, and long-term drug survival of conventional systemic agents and biologic therapies, leading to suboptimal clinical outcomes. Conclusions: Obesity is a key determinant of psoriasis burden, influencing disease expression, comorbidities, and therapeutic response. Integrating weight reduction strategies into personalized psoriasis management may improve both dermatological outcomes and overall cardiometabolic health, supporting a holistic approach to patient care. Full article
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16 pages, 626 KB  
Review
Psychedelic-Assisted Interventions in Palliative Care: A Narrative Overview and Critical Evaluation
by Daniele Almeida Soares and Alessandro Gonçalves Campolina
Healthcare 2026, 14(11), 1550; https://doi.org/10.3390/healthcare14111550 - 2 Jun 2026
Abstract
Background/Objectives: Patients in palliative care frequently experience multidimensional suffering that extends beyond physical symptoms to include existential distress, demoralization, and loss of meaning. Psychedelic-assisted therapies (PAT), including ketamine-assisted psychotherapy (KAP), have re-emerged as promising interventions for these domains. This study aimed to [...] Read more.
Background/Objectives: Patients in palliative care frequently experience multidimensional suffering that extends beyond physical symptoms to include existential distress, demoralization, and loss of meaning. Psychedelic-assisted therapies (PAT), including ketamine-assisted psychotherapy (KAP), have re-emerged as promising interventions for these domains. This study aimed to provide a narrative overview and critical evaluation of the existing secondary literature on PAT in palliative care and serious illness and to examine the extent to which emerging best-practice recommendations are reflected in this literature. Methods: An overview of reviews with framework-based narrative synthesis was conducted, including narrative reviews, systematic reviews, scoping reviews, and meta-analyses addressing psychedelic-assisted interventions in patients with life-limiting illness. A comprehensive search of major databases was performed from inception to February 2026. Data extraction and narrative synthesis focused on clinical outcomes, safety, and the incorporation of key domains derived from recent interdisciplinary best-practice recommendations for PAT in palliative care. Results: Twenty-two reviews were included, synthesizing evidence primarily from early-phase clinical trials and observational studies, predominantly in oncology populations. Across reviews, PAT was consistently associated with reductions in depression, anxiety, and existential distress, along with improvements in quality of life and spiritual well-being. Safety profiles were generally favorable under controlled conditions. However, the incorporation of key therapeutic domains—such as preparation and integration, therapeutic setting, clinician training, and relational and biographical factors—was heterogeneous and often incomplete. Most reviews emphasized outcomes over process and context. Conclusions: The current body of secondary literature suggests potential application of PAT to address psychological and existential suffering in palliative care. However, the available evidence remains preliminary and is predominantly derived from small early-phase studies characterized by methodological heterogeneity, limited blinding, and highly selected populations. At the same time, the partial incorporation of emerging best-practice recommendations highlights a gap between evidence synthesis and normative clinical guidance. Full article
(This article belongs to the Section Palliative Care)
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25 pages, 1488 KB  
Review
Deciphering the Structure–Immunomodulatory Function Relationships of Homopolysaccharides
by Gege Hu, Bingyu Yang, Han Song, Yuehan Zeng, Zhuoting Zhang, Yuwen Li, Jian Zhang and Fenghuan Wang
Nutrients 2026, 18(11), 1782; https://doi.org/10.3390/nu18111782 - 31 May 2026
Viewed by 229
Abstract
Natural homopolysaccharides (HoPSs), composed of a single monosaccharide type, are increasingly recognized as bioactive macronutrients with broad relevance to nutrition and health. This review summarizes the extraction, structural characterization, and structure-immunomodulatory activity relationships of HoPSs. Drawing on a comprehensive synthesis of existing studies, [...] Read more.
Natural homopolysaccharides (HoPSs), composed of a single monosaccharide type, are increasingly recognized as bioactive macronutrients with broad relevance to nutrition and health. This review summarizes the extraction, structural characterization, and structure-immunomodulatory activity relationships of HoPSs. Drawing on a comprehensive synthesis of existing studies, we integrate current knowledge into a unified hierarchical framework of HoPS structure–function relationships. This framework organizes the literature into three hierarchical levels, including primary structural recognition, mid-level regulatory mechanisms, and functional refinement, while integrating key determinants such as molecular weight, glycosidic linkages, chain conformation, branching, and chemical modifications. By bridging structural glycomics and nutritional immunology, this framework synthesizes current evidence and provides a structured reference for future investigations. HoPSs exert well-established anti-infection and anti-inflammatory effects, alongside important nutritional and metabolic benefits. These outcomes are supported by evidence from cellular receptor signaling (e.g., TLRs, Dectin-1; NF-κB, MAPK pathways), gut microbiota remodeling, and metabolite network interactions. Finally, we discuss current research gaps, particularly in fine structural analysis and multidimensional mechanistic studies, and propose future directions based on precise structural elucidation, multidimensional structure–activity relationship modeling, and interdisciplinary integration. This review aims to bridge structural glycomics with human nutritional immunology, providing a theoretical basis for the structural optimization, immune activity enhancement, and functional food development of natural HoPSs to promote their industrial application in medicine, nutrition, and health. Full article
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31 pages, 1160 KB  
Systematic Review
Benefits and Challenges of Blockchain Technology in Real Estate: A Systematic Literature Review
by Dengjin Wu, Xin Janet Ge and Jianlong Zhou
Real Estate 2026, 3(2), 6; https://doi.org/10.3390/realestate3020006 - 31 May 2026
Viewed by 97
Abstract
The real estate sector continues to face challenges such as inefficiencies, fraud risks, and high transaction costs stemming from opaque processes and heavy reliance on intermediaries. These challenges highlight the need for transparent and efficient solutions to support secure real estate transactions and [...] Read more.
The real estate sector continues to face challenges such as inefficiencies, fraud risks, and high transaction costs stemming from opaque processes and heavy reliance on intermediaries. These challenges highlight the need for transparent and efficient solutions to support secure real estate transactions and management. While a growing body of literature has examined blockchain applications in real estate, existing studies are often fragmented and predominantly descriptive, with limited systematic synthesis of evidence and insufficient attention to governance and institutional contexts. This study aims to systematically examine and synthesise the benefits and challenges of blockchain technology in real estate, providing evidence-based insights for practitioners and policymakers. Using a Systematic Literature Review (SLR) approach, peer-reviewed publications from 2016 to 2025 were analysed to identify blockchain applications, reported outcomes, and implementation barriers. The findings reveal that blockchain has been applied in land registration (e.g., Sweden, India, Serbia), valuation systems, decentralised housing finance, and tokenised investment platforms (e.g., Exporo, RealT). The reported benefits include reduced fraud, enhanced transaction efficiency, transparency, and expanded investment access through fractional ownership. However, regulatory uncertainty, scalability limitations, data privacy risks, and low stakeholder awareness remain key barriers. Ethical issues such as digital exclusion and data exposure also require further consideration. Compared with the more advanced adoption observed in Europe and North America, supported by established regulatory frameworks and digital land governance initiatives, this review identifies relatively slower uptake in parts of the Asia-Pacific region, particularly in Australia and Malaysia. It highlights a critical need for future research on legal recognition, privacy-enhancing technologies, and governance frameworks, particularly regarding blockchain applications in property development and urban planning processes. By integrating technological and governance perspectives, this study provides a more comprehensive and structured understanding of blockchain adoption in real estate systems. Full article
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14 pages, 2983 KB  
Case Report
NR0B1 Gene Variants as Rare Forms of Primary Adrenal Insufficiency in Children: Case Report and Narrative Review
by Ilaria Montafia, Sotirios Dimarakis, Cristina Partenope, Ivana Rabbone, Simonetta Bellone, Antonella Petri, Simona Mellone, Mara Giordano and Flavia Prodam
Genes 2026, 17(6), 640; https://doi.org/10.3390/genes17060640 - 31 May 2026
Viewed by 162
Abstract
Primary adrenal insufficiency (PAI) is a severe and potentially life-threatening condition characterised by the inability of the adrenal cortex to produce enough glucocorticoids and/or mineralocorticoids. The clinical signs of PAI are primarily due to deficient steroid hormone synthesis and include weight loss, orthostatic [...] Read more.
Primary adrenal insufficiency (PAI) is a severe and potentially life-threatening condition characterised by the inability of the adrenal cortex to produce enough glucocorticoids and/or mineralocorticoids. The clinical signs of PAI are primarily due to deficient steroid hormone synthesis and include weight loss, orthostatic hypotension secondary to dehydration, hyponatremia, hyperkalaemia, and hypoglycaemia. In the paediatric population, PAI is most commonly associated with inherited monogenic disorders, particularly enzyme deficiencies. X-linked adrenal hypoplasia congenita (AHC) is a rare condition caused by deletions or single-nucleotide variants in the NR0B1 (DAX1) gene, which encodes the DAX1 protein expressed in the adrenal cortex, gonads, hypothalamus and pituitary gland. Although molecular genetics has significantly expanded our understanding of the aetiology of PAI, clinical diagnosis remains challenging when the initial hormonal findings are atypical, often delaying recognition and treatment. Pathogenic variants of DAX1 can lead to a spectrum of phenotypes, ranging from isolated adrenal insufficiency (AI) to complex syndromic presentations combining AI with hypogonadotropic hypogonadism and impaired spermatogenesis. Here, we report a case of a male patient with AI due to a de novo pathogenic variant in the NR0B1 gene. Furthermore, we provide a non-systematic review of the available literature on the diagnostic challenges facing and clinical variability in AHC, with a particular focus on the paediatric population. This case highlights the importance of a stepwise, comprehensive diagnostic approach to suspected PAI, particularly when initial biochemical and genetic testing is inconclusive. Considering rare causes—such as NR0B1 pathogenic variants in men—can be crucial for establishing a definitive diagnosis, with significant implications for the management of patients and their families. Full article
(This article belongs to the Section Genetic Diagnosis)
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24 pages, 2463 KB  
Review
The Capability Approach in Ageing Research: A Bibliometric Mapping and Qualitative Interpretive Synthesis
by Shuo Wu, R. B. Radin Firdaus, Chunyan Li, Chunyan Zhu and Jinxiao Yang
J. Ageing Longev. 2026, 6(2), 42; https://doi.org/10.3390/jal6020042 - 29 May 2026
Viewed by 89
Abstract
Population ageing has renewed interest in the capability approach (CA) as a framework for understanding wellbeing in later life. Yet research applying the CA to ageing remains fragmented, and its empirical focus is still not well understood. This study examines how CA-based ageing [...] Read more.
Population ageing has renewed interest in the capability approach (CA) as a framework for understanding wellbeing in later life. Yet research applying the CA to ageing remains fragmented, and its empirical focus is still not well understood. This study examines how CA-based ageing research has developed and how it explains capability constraints and adaptive responses in later life. Using Web of Science Core Collection records from 2000 to 2025, we combine comparative bibliometric analysis with a focused qualitative interpretive synthesis. A general CA corpus (n = 3416) was first constructed and then refined to identify a CA-in-ageing subset (n = 142). The bibliometric results suggest that CA-in-ageing research is more problem-oriented than the broader CA literature, with health and care evaluation, as well as mobility and accessibility, emerging as particularly prominent thematic concentrations in the retrieved corpus. The qualitative synthesis of five appraised studies further shows how capability loss may be experienced in everyday life through shrinking life-space, disrupted social participation, and threats to dignity. It also identifies adaptive strategies through which older adults rebuild routines, negotiate selective support, and re-establish participation through enabling environments and services. Given the small qualitative corpus, its reliance on several COVID-19-related studies, and its Western empirical contexts, the findings should be read as an explanatory account of possible mechanisms rather than as a comprehensive representation of later-life capability loss across all ageing settings. By integrating bibliometric mapping with qualitative evidence, this study clarifies how the CA has been operationalised in ageing research and highlights the importance of environmental accessibility, service stability, and participation opportunities in sustaining wellbeing in later life. Full article
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26 pages, 1696 KB  
Review
Limited Clinical Benefit of Immune Checkpoint Inhibition in Ovarian Cancer with Opportunities in Selected Subtypes
by Zuzanna Ratka, Andrzej Gamian and Marta Woźniak
Int. J. Mol. Sci. 2026, 27(11), 4923; https://doi.org/10.3390/ijms27114923 - 29 May 2026
Viewed by 103
Abstract
Epithelial ovarian cancer (EOC) remains one of the most lethal gynecologic malignancies, largely owing to advanced-stage presentation, high rates of relapse, and the eventual emergence of therapeutic resistance. Despite the transformative success of immune checkpoint inhibitors (ICIs) across multiple solid tumors, their clinical [...] Read more.
Epithelial ovarian cancer (EOC) remains one of the most lethal gynecologic malignancies, largely owing to advanced-stage presentation, high rates of relapse, and the eventual emergence of therapeutic resistance. Despite the transformative success of immune checkpoint inhibitors (ICIs) across multiple solid tumors, their clinical impact in ovarian cancer has been comparatively modest. This literature review provides a comprehensive synthesis of recent advances in ICI strategies for ovarian cancer (OC), with particular emphasis on phase II and III clinical trials evaluating programmed cell death protein 1 (PD-1), programmed death-ligand 1 (PD-L1), cytotoxic T-lymphocyte–associated protein 4 (CTLA-4), and T cell immunoglobulin and mucin-domain-containing-3 (TIM-3)-directed therapies. Accumulating evidence indicates that PD-1/PD-L1 monotherapy yields limited clinical activity in unselected OC populations, with low objective response rates and minimal survival benefit. Dual checkpoint blockade with PD-1 and CTLA-4 inhibitors demonstrates enhanced antitumor activity, particularly in clear cell ovarian carcinoma (CCOC), albeit at the expense of increased immune-related toxicity. Large randomized trials incorporating ICI into first-line chemotherapy or maintenance settings have largely failed to improve outcomes in biomarker-unselected cohorts. Available evidence demonstrates that combinatorial approaches integrating ICI with anti-angiogenic agents, PARP inhibitors, or neoadjuvant chemotherapy provide modest benefit in selected molecular and histologic subgroups. Early-phase investigations of TIM-3–targeting strategies further expand the immunotherapeutic landscape, although clinical efficacy remains preliminary. Current evidence underscores that OC is not uniformly responsive to immunotherapy and that rational combination strategies, biomarker-driven patient selection, and improved understanding of tumor immune microenvironment heterogeneity are essential to unlocking the full therapeutic potential of ICI in this disease. Full article
(This article belongs to the Special Issue Ovarian Cancer: Pathogenesis, Biomarkers and Treatment)
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46 pages, 1743 KB  
Review
Canine Idiopathic Epilepsy as a Natural Animal Model for Human Epilepsy: A Scoping Review Highlighting Metabolic Perspectives Beyond the Brain
by Giulia Cabri, Sofie F. M. Bhatti, Lieselot Y. Hemeryck, Paul Boon, Holger A. Volk, Myriam Hesta and Fien Verdoodt
Nutrients 2026, 18(11), 1734; https://doi.org/10.3390/nu18111734 - 28 May 2026
Viewed by 270
Abstract
Background: Emerging evidence indicates that epilepsy extends beyond the brain, involving systemic metabolic, immune, and microbiome perturbations that shape neuronal excitability and treatment response. Canine idiopathic epilepsy (CE) offers a naturally occurring model with strong electrophysiological, pharmacological, and clinical homology to human epilepsies. [...] Read more.
Background: Emerging evidence indicates that epilepsy extends beyond the brain, involving systemic metabolic, immune, and microbiome perturbations that shape neuronal excitability and treatment response. Canine idiopathic epilepsy (CE) offers a naturally occurring model with strong electrophysiological, pharmacological, and clinical homology to human epilepsies. Methods: This scoping review was conducted according to the PRISMA-ScR guidelines. A systematic literature search was performed in Web of Science and MEDLINE (PubMed) to identify original studies reporting metabolic, immunometabolic, or neurochemical alterations in CE compared with healthy controls. Eligible studies included peer-reviewed original research involving client-owned dogs diagnosed with CE according to international consensus criteria (IVETF guidelines). Studies focusing exclusively on genetics or neuroimaging without metabolic outcomes were excluded. Titles, abstracts, and full texts were screened for eligibility, and data were extracted from included studies using a standardized approach. Identified metabolic domains were synthesized narratively and grouped into functional systems, including amino acid and lipid metabolism, micronutrients, neurotransmission, oxidative stress, inflammation and immunology, endocannabinoid signalling, microRNAs, and gut–brain axis-related pathways. In a second step, the identified metabolic domains were evaluated for translational relevance through a targeted, non-systematic narrative synthesis of the human epilepsy literature. This approach aimed to assess cross-species parallels and to provide a conceptual framework to guide future research, rather than to perform a comprehensive systematic review of metabolic alterations in human epilepsy. Results: Across CE studies, consistent alterations were observed in multiple interconnected functional systems, including metabolic, immune, and gut–brain axis pathways, in agreement with findings reported for human epilepsy. These data support a model of epileptogenesis involving systemic dysfunction beyond the central nervous system. Translationally, these findings suggest opportunities for biomarker development, patient stratification, and mechanism-based interventions, including dietary and metabolic approaches (e.g., medium-chain triglyceride supplementation), microbiome modulation, and immunometabolic targeting. The current evidence is limited by small and heterogeneous cohorts, potential confounding effects of antiseizure medications, variability in dietary and fasting conditions, breed-related effects, and a predominance of associative over causal relationships. Conclusions: This review positions CE as a reference framework for future research into epilepsy metabolism, integrating current evidence and its translational relevance to human disease. The findings support a shift toward a systems-level view of epileptogenesis, involving interconnected metabolic, immune, and gut–brain axis pathways beyond the brain. CE represents a valuable translational model to identify shared mechanisms, inform biomarker discovery, and guide the development of mechanism-based therapeutic strategies across veterinary and human epilepsy. Full article
(This article belongs to the Special Issue Advanced Research on Nutrition and Gut–Brain Axis)
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20 pages, 658 KB  
Review
Septic Cardiomyopathy in the ICU: Echocardiographic Phenotypes, Global Longitudinal Strain, and Right Ventricular Assessment
by Saeed Torabi, Philipp K. Omuro, Elisabeth H. Adam and Tobias Kammerer
Diagnostics 2026, 16(11), 1664; https://doi.org/10.3390/diagnostics16111664 - 28 May 2026
Viewed by 233
Abstract
Background/Objectives: Septic cardiomyopathy (SC) is a frequent and clinically relevant complication of sepsis, characterized by acute, typically reversible myocardial dysfunction in the absence of primary coronary artery disease. Its clinical presentation is highly heterogeneous, and conventional diagnostic parameters frequently fail to capture the [...] Read more.
Background/Objectives: Septic cardiomyopathy (SC) is a frequent and clinically relevant complication of sepsis, characterized by acute, typically reversible myocardial dysfunction in the absence of primary coronary artery disease. Its clinical presentation is highly heterogeneous, and conventional diagnostic parameters frequently fail to capture the full extent of cardiac impairment. This narrative review aims to synthesize current evidence on the echocardiographic assessment of SC, with a focused emphasis on global longitudinal strain (GLS), right ventricular (RV) dysfunction, and diastolic impairment, and to discuss their prognostic and therapeutic implications. Methods: A comprehensive literature search was performed in PubMed/MEDLINE for publications between 2010 and March 2026, supplemented by seminal historical studies. A second, structured literature search was performed in PubMed/MEDLINE for publications between 2010 and April 2026, supplemented by seminal historical studies. Eligible study types included original research articles, systematic reviews, meta-analyses, and clinical guidelines. The search and selection workflow followed the principles of PRISMA-ScR. A qualitative narrative synthesis was performed. Results: SC encompasses distinct echocardiographic phenotypes—global hypokinesia, hyperdynamic function, RV dysfunction, and diastolic impairment—each carrying specific pathophysiological and prognostic implications. Left ventricular ejection fraction (LVEF) is highly load-dependent and may be misleading in vasoplegic states. GLS derived from speckle-tracking echocardiography defects may detect subclinical myocardial dysfunction earlier than LVEF, and provides independent prognostic information in observational studies. RV dysfunction occurs in 20–50% of sepsis patients and represents a powerful robust independent predictor of mortality. Diastolic dysfunction Grade ≥ 2 is independently associated with adverse outcomes through elevated filling pressures and reduced cardiac reserve. Conclusions: A multiparametric echocardiographic approach integrating LVEF, GLS, RV function indices, and diastolic parameters is essential and may improve the accurate phenotyping and hemodynamic management of SC. Structured diagnostic algorithms, expert-based diagnostic frameworks incorporating these tools which may facilitate phenotype-guided therapy and improve clinical outcomes, are proposed to facilitate phenotype-guided therapy; their impact on patient outcomes warrants confirmation in prospective multicenter studies. Full article
(This article belongs to the Special Issue Echocardiography in the Intensive Care Unit)
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19 pages, 2466 KB  
Article
Three Decades of Social Mobility and Social Policy: Bibliometric Analysis of Global Research Trends
by Suraj B. Patil, Mahesh Chougule and Channaveer R. M.
Soc. Sci. 2026, 15(6), 348; https://doi.org/10.3390/socsci15060348 - 25 May 2026
Viewed by 267
Abstract
Social mobility is a central indicator of socioeconomic development. It indicates the improvement of an individual’s socioeconomic position across generations. Recently, welfare policies, education, and redistribution schemes have received increasing attention from the academic community as they affect social mobility outcomes. Despite the [...] Read more.
Social mobility is a central indicator of socioeconomic development. It indicates the improvement of an individual’s socioeconomic position across generations. Recently, welfare policies, education, and redistribution schemes have received increasing attention from the academic community as they affect social mobility outcomes. Despite the growing volume of literature, there is an inadequate linkage between research on social mobility and social policy. This study uses a bibliometric analysis of 389 Scopus-indexed articles to examine research on social mobility and social policy from 1990 to 2025. The findings highlight the relationship between the impacts of policy interventions on social mobility. Performance analysis and science mapping are used, which provide insight into publication trends and leading contributors and reveal the intellectual and conceptual structures of the research field. Studies are concentrated in developed economies such as the United States and the United Kingdom. Further, in the science mapping analysis, co-word analysis is followed by bibliographic coupling, which reveals emerging trends and promising themes. The study provides a comprehensive synthesis of the conceptual and intellectual evolution of social mobility research, offers insights for policymakers and highlights the future direction of interdisciplinary research. Full article
(This article belongs to the Section Social Stratification and Inequality)
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35 pages, 4443 KB  
Article
Climate and Energy Security Nexus in the Pacific: An Integrative Thematic Review
by Ravita D. Prasad
World 2026, 7(6), 88; https://doi.org/10.3390/world7060088 - 25 May 2026
Viewed by 280
Abstract
Despite accounting for less than 0.03% of the world’s greenhouse gas emissions, the Pacific Small Island Developing States (PSIDS) face existential threats to their environment, livelihoods, and regional stability due to their heavy dependence on imported fossil fuels and disproportionate climate vulnerability. To [...] Read more.
Despite accounting for less than 0.03% of the world’s greenhouse gas emissions, the Pacific Small Island Developing States (PSIDS) face existential threats to their environment, livelihoods, and regional stability due to their heavy dependence on imported fossil fuels and disproportionate climate vulnerability. To address this “Justice Paradox,” this study utilises a Nexus Mapping framework to qualitatively synthesise the non-linear causal pathways between climate stressors and energy system vulnerabilities. Through an integrative thematic synthesis of literature and regional policy documents, the research identifies systemic bottlenecks, including the “fiscal trap” of post-disaster reconstruction, the “demand-utility paradox” of rising temperatures, and the logistical premiums of archipelagic energy distribution. The analysis suggests that energy decarbonisation represents a strategic opportunity to strengthen climate security across four dimensions: human, national, international, and ecological. To facilitate a secure transition, the study proposes a comprehensive “policy mix” of regulatory standards (sticks), economic de-risking through mechanisms such as Sovereign Green Bonds (carrots), and the institutionalisation of local technical sovereignty (sermons). This research offers an interpretive analytical framework for Pacific policymakers, arguing that decentralised, modular renewables may serve as a strategic shield against climatic instability and support the preservation of regional statehood. Full article
(This article belongs to the Section Climate Transitions and Ecological Solutions)
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18 pages, 5465 KB  
Article
Enhanced Removal of Copper Ions from Aqueous Solution by Citrate-Stabilized Amorphous Calcium Phosphate Nanoparticles/Sodium Alginate Composite Hydrogel Beads
by Miaomiao Wang, Yuwei Jiang and Junjun Tan
Nanomaterials 2026, 16(11), 662; https://doi.org/10.3390/nano16110662 - 24 May 2026
Viewed by 334
Abstract
Although amorphous calcium phosphate (ACP) has been extensively employed as a biomaterial in dental and orthopedic fields, its exploration for environmental applications—particularly in potentially toxic element remediation—remains notably limited in the scientific literature. This study reports the rational design of a multifunctional adsorbent [...] Read more.
Although amorphous calcium phosphate (ACP) has been extensively employed as a biomaterial in dental and orthopedic fields, its exploration for environmental applications—particularly in potentially toxic element remediation—remains notably limited in the scientific literature. This study reports the rational design of a multifunctional adsorbent by integrating sodium citrate-stabilized ACP (Cit-ACP) nanoparticles into calcium-crosslinked sodium alginate (SA) hydrogel beads for selective Cu2+ sequestration from aqueous systems. Comprehensive sorption assessments revealed that equilibrium uptake aligned with the Freundlich isotherm (indicating heterogeneous surface interactions), while kinetic profiles adhered to pseudo-second-order behavior, characteristic of chemisorption-driven processes. Under optimized operational parameters (pH 5.0, 45 °C), the Cit-ACP/SA composite attained an exceptional maximum adsorption amount of 307.76 mg/g. Thermodynamic analysis further confirmed the spontaneity (ΔG° < 0) and endothermic nature (ΔH° > 0) of the process. Multi-technique characterization (XPS, FTIR, XRD, pH trajectory) elucidated a dual-mode adsorption mechanism: (i) ion exchange between aqueous Cu2+ and structural Ca2+ within both the alginate matrix and ACP framework; and (ii) in situ surface precipitation yielding copper-substituted hydroxyapatite. Owing to its facile aqueous-phase synthesis, superior adsorption performance, biodegradability, macroscopic bead morphology enabling rapid separation, and robust selectivity in complex matrices, the Cit-ACP/SA composite presents a sustainable, scalable, and eco-compatible platform for practical remediation of copper-contaminated wastewater. Full article
(This article belongs to the Section Environmental Nanoscience and Nanotechnology)
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35 pages, 2667 KB  
Review
The Benefits of Using Exosomes in Professional Cosmetic Products: From Theory to Practice
by Gabrielle Costa, Elisa Silva, Fátima Silva, Ana Casas, Bernardo Bastos, Clévio Nóbrega, Maria Beatriz P. P. Oliveira and Hugo Almeida
Cosmetics 2026, 13(3), 131; https://doi.org/10.3390/cosmetics13030131 - 24 May 2026
Viewed by 577
Abstract
The integration of exosomes into professional cosmetics marks a significant paradigm shift from traditional passive formulations to advanced regenerative esthetics. Rather than being defined solely by their nanometric dimensions or classical association with endosomal biogenesis, these vesicles function as highly targeted intercellular messengers [...] Read more.
The integration of exosomes into professional cosmetics marks a significant paradigm shift from traditional passive formulations to advanced regenerative esthetics. Rather than being defined solely by their nanometric dimensions or classical association with endosomal biogenesis, these vesicles function as highly targeted intercellular messengers capable of delivering complex bioactive payloads to modulate tissue repair and collagen synthesis. While robust preclinical and clinical trials validate their remarkable potential in skin rejuvenation, hair restoration, and hyperpigmentation management, significant translational barriers remain. A critical analysis of the current literature reveals that successful clinical outcomes frequently rely on physical penetration enhancers, such as microneedling or fractional lasers, making it challenging to isolate the autonomous efficacy of topical vesicles from the trauma-induced regenerative response. Furthermore, commercial viability is dictated by stringent regulatory frameworks. In the European Union, Regulation (EC) No 1223/2009 strictly prohibits human-derived biologicals, while the US Food and Drug Administration (FDA) aggressively monitors the unsubstantiated marketing of cellular therapies. To navigate these biosafety and legal constraints, the aesthetic industry is increasingly pivoting toward non-human and legally compliant alternatives. Consequently, Plant-Derived Extracellular Vesicles (PDEVs), microbiome-derived exosomes (such as those obtained from bacterial fermentation), and bioengineered synthetic analogues have become the focal point of market innovation. A practical evaluation of the MCCM Medical Cosmetics portfolio illustrates this strategic shift, demonstrating the clinical versatility of botanical sources. To secure the long-term credibility of exosome technology, the industry must overcome current manufacturing heterogeneity by aligning with international standardization frameworks, such as the MISEV2023 guidelines, thereby ensuring reliable delivery systems, batch-to-batch consistency, and uncompromised consumer safety. This review provides a comprehensive overview of the biological mechanisms, clinical efficacy, and translational challenges associated with exosome-based cosmetics. Full article
(This article belongs to the Section Cosmetic Formulations)
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17 pages, 4489 KB  
Review
Recent Advances in Responsive Microgels for Biomedical Application
by Hongtao Zhang, Wenkai Zhang and Yongfeng Gao
Bioengineering 2026, 13(6), 609; https://doi.org/10.3390/bioengineering13060609 - 23 May 2026
Viewed by 281
Abstract
Responsive microgels have emerged as a versatile class of soft materials for biomedical applications owing to their tunable physicochemical properties, high water content, and ability to respond dynamically to external and biological stimuli. This review summarizes recent advances in the design, synthesis, and [...] Read more.
Responsive microgels have emerged as a versatile class of soft materials for biomedical applications owing to their tunable physicochemical properties, high water content, and ability to respond dynamically to external and biological stimuli. This review summarizes recent advances in the design, synthesis, and biomedical utilization of responsive microgels, with a focus on their functional roles across key application domains. First, the fundamental principles governing microgel responsiveness and structure–property relationships are briefly introduced. The application of responsive microgels in controlled drug delivery is then discussed, highlighting stimulus-triggered release mechanisms, payload protection, and spatiotemporal control of therapeutic delivery. Advances in tissue engineering are reviewed with emphasis on microgel-based scaffolds, injectable constructs, and cell–matrix interactions that promote tissue regeneration. The use of microgels in biomedical imaging is examined, including their roles as contrast agents, signal amplifiers, and carriers for imaging probes. Finally, recent developments in microgel-enabled diagnostics are presented, showcasing their utility in biosensing, biomarker detection, and point-of-care platforms. The literature was selected based on the authors’ expertise, focusing on representative and recent studies, and identified through general academic databases and key references. Collectively, this review provides a comprehensive overview of the multifunctional capabilities of responsive microgels and discusses current challenges and future opportunities toward their clinical translation. Full article
(This article belongs to the Special Issue Smart Polymer Hydrogels for Advanced Biomedical Applications)
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