Search Results (776)

Background: Transjugular intrahepatic portosystemic shunt (TIPS) has emerged as a feasible therapeutic option for cirrhotic patients with portal vein thrombosis (PVT). This study aimed to assess the long-term outcomes and factors associated with TIPS dysfunction in cirrhotic patients with PVT over an 18-year period in our institution. Methods: A retrospective study was conducted at Hospital Universitario Reina Sofía (Córdoba, Spain), including adult and pediatric cirrhotic patients with PVT who underwent TIPS between January 2006 and December 2024. Patient characteristics, procedural techniques, and clinical outcomes were evaluated. The primary outcomes were TIPS insertion success rate, primary patency, and dysfunction (stenosis or occlusion). Bivariate comparisons, logistic regression and receiver-operating characteristic (ROC) analyses were performed to identify potential predictors of TIPS dysfunction. Survival analyses using the Kaplan–Meier method and log-rank test, complemented by Cox regression, were also conducted. Results: A total of 36 patients (mean age, 44.8 ± 20.1 years old; 22.2% women; 19.4% children) were included, with a mean follow-up of 66.3 ± 45.9 months and nine deaths (one attributable to the procedure). The primary success rate of TIPS placement was 100%, and mean primary patency was 40.3 ± 40.2 months. TIPS dysfunction occurred in 30.3% of patients. Logistic regression identified age as the only significant predictor of TIPS dysfunction (OR = 0.949; 95%CI, 0.907–0.985, p = 0.011). ROC analysis demonstrated an AUC of 0.737 (95%CI, 0.547–0.927), with an optimal age cut-off of 21 (equivalent to 18 years; sensitivity = 91.3%, specificity = 50%). When age was dichotomized into adult versus pediatric groups, the OR was 0.095 (95%CI, 0.011–0.560), consistent with survival analyses (log-rank p = 0.007; HR = 4.85; 95%CI 1.36–16.88, p = 0.015). Conclusions: TIPS is an effective treatment for cirrhotic patients with PVT, achieving high technical success and long-term patency. However, it is not exempt from complications, including death, and potential dysfunction remains a concern, particularly in pediatric patients. Further prospective studies with larger cohorts are warranted to refine patient selection and optimize outcomes. Full article

Percutaneous coronary angiography remains the diagnostic gold standard for coronary artery disease. However, the complex and high-volume nature of the imaging data renders the clinical interpretation of coronary lesions a time-consuming, labor-intensive, and inherently subjective process. This retrospective study collected and preprocessed Coronary artery angiography (CAG) image data from 408 patients with acute myocardial infarction (AMI). An improved YOLOv4 algorithm was developed, validated on standard VOC datasets, and subsequently calibrated via transfer learning on the CAG training set for automated lesion detection and classification. The model-derived lesion characteristics were then statistically correlated with the occurrence of Major Adverse Cardiovascular Events (MACEs) during patient follow-up. The improved model achieved a post-modification mean Average Precision (mAP) of 84.72% (95% CI: 83.44–85.99%) on the VOC dataset. For coronary lesion detection, the model yielded an overall mean Average Precision (mAP) of 55.01%. Importantly, lesion characteristics automatically detected by the model—specifically completely occluded lesions (Log-rank p = 0.003) and multibranching lesions (Log-rank p = 0.033)—demonstrated a significant association with the cumulative incidence of MACEs. The innovative, improved YOLOv4 model exhibits robust performance in effectively and accurately detecting and classifying coronary lesions within AMI patient angiography imagery. This study provides a valuable AI-assisted diagnostic tool and offers preliminary insights for long-term prognostic assessment by seamlessly integrating deep learning-derived anatomical features with MACEs prediction. Full article

Background: Children with spastic hand impairments resulting from cerebral palsy or neuromuscular disorders often exhibit a restricted range of motion and diminished functional use. Rehabilitation devices that assist joint mobilization can enhance therapeutic outcomes, yet few solutions target pediatric populations. Methods: This study aimed to design, implement, and preliminarily evaluate a biomechanical device tailored to promote flexo-extension, radial–ulnar deviation, and supination movements in spastic hands of school-aged children. A prototype combining a motor-driven actuation system, adjustable wrist and finger supports, and a MATLAB-based graphical user interface was developed. Two participants (aged 8 and 10) with clinically diagnosed spastic hemiparesis underwent 25-minute sessions over 15 consecutive days. Joint angles were recorded before and after each session using an electro-goniometer. Data normality was assessed via the Shapiro–Wilk test, and pre–post differences were analyzed with the Wilcoxon signed-rank test (α = 0.05). Results: Both participants demonstrated consistent increases in their active range of motion across all measured planes. Median flexo-extension improved by 12.5° (p = 0.001), ulnar–radial deviation by 7.3° (p = 0.002), and supination by 9.1° (p = 0.001). No adverse events occurred, and device tolerance remained high throughout the intervention. Conclusions: The device facilitated statistically significant enhancements in joint mobility in a small pediatric cohort, supporting its feasibility and safety in spastic hand rehabilitation. These preliminary findings warrant larger controlled trials to confirm the device’s efficacy, optimize treatment protocols, and assess its long-term functional benefits. Full article

The three northeastern provinces of China are the country’s most important grain-producing region, particularly for maize, soybean, and rice, and form its largest commercial grain base. Over the past two decades, cropping structures in this region have undergone notable shifts driven by both climate change and human activities. Generating long-term, high-resolution maps of multi-crop distribution and evaluating their suitability is essential for understanding cropping dynamics, optimizing land use, and promoting sustainable agriculture. In this study, we integrated multi-source satellite imagery from Landsat and Sentinel-2 to map the distribution of rice, maize, and soybean from 2000 to 2023 using a Random Forest classifier. A crop suitability assessment framework was developed by combining a multi-criteria evaluation model with the MaxEnt model. Reliable training samples were derived by overlaying suitability evaluation results with stable crop growth areas, and environmental variables—including climate, topography, soil, hydrology, and anthropogenic factors—were incorporated into MaxEnt to assess suitability. Furthermore, the spatial consistency between actual cultivation and suitability was evaluated to identify areas of misallocated land use. The results show that: (1) the six classification maps achieved an average overall accuracy of 91.05% and a Kappa coefficient of 0.857; (2) the cultivation area of all three crops expanded, with maize showing the largest increase, followed by soybean and rice, and the dominant conversion being from soybean to maize; (3) suitability areas ranked as soybean (376,692 km²) > maize (329,056 km²) > rice (311,869 km²), with substantial spatial overlap, particularly between maize and soybean, suggesting strong competition; and (4) in 2023, highly suitable zones accounted for 57.39% of rice, 39.69% of maize, and 28.89% of soybean cultivation, indicating a closer alignment between actual distribution and suitability for rice, weaker for maize, and weakest for soybean, whose suitable zones were often displaced by rice and maize. These findings provide insights to guide farmers in optimizing crop allocation and offer a scientific basis for policymakers in designing cultivated land protection strategies in Northeast China. Full article

The Priority-Flood algorithm, widely recognized for its computational efficiency in hydrological analysis, serves as the fundamental method for depression identification in DEMs, and the efficiency of the Priority-Flood algorithm hinges largely on the core component—priority queue implementation. Existing studies have focused predominantly on reducing the amount of data processed by queues, with few systematic reports on concrete queue implementations and corresponding performance analyses. In this study, six priority queues in the Priority-Flood algorithm are compared: a mini-heap (Heap), an AVL tree, a red-black tree (RBTree), a pairing heap (PairingHeap), a skip list (SkipList), and the Hash Heap (HHeap) structure proposed herein. Using multiscale DEM datasets as benchmarks, the results show that HHeap consistently outperforms the other structures across all scales, with particular advantages in ultralarge queues and in scenarios with high data duplication, rendering it the most effective choice for priority queues. The pairing heap approach typically ranks second in terms of overall runtime, whereas the AVL tree exhibits stable performance across scales; min-heap shows pronounced weaknesses under large-scale data conditions. This study provides empirical evidence to guide efficient priority queue selection and implementation and offers a viable technical pathway for ultralarge-scale terrain analysis. Future work will explore integrating HHeap with learning-based sorting and parallelization to further enhance processing performance and robustness in massive DEM contexts. Full article

University advising at matriculation must operate under strict information constraints, typically without any post-enrolment interaction history.We present a unified, leakage-free pipeline for predicting early dropout risk and generating cold-start programme recommendations from pre-enrolment signals alone, with an optional early-warning variant incorporating first-term academic aggregates. The approach instantiates lightweight multimodal architectures: tabular RNNs, DistilBERT encoders for compact profile sentences, and a cross-attention fusion module evaluated end-to-end on a public benchmark (UCI id 697; n = 3630 students across 17 programmes). For dropout, fusing text with numerics yields the strongest thresholded performance (Hybrid RNN–DistilBERT: f1-score ≈ 0.9161, MCC ≈ 0.7750, and simple ensembling modestly improves threshold-free discrimination (Area Under Receiver Operating Characteristic Curve (AUROC) up to ≈0.9488). A text-only branch markedly underperforms, indicating that numeric demographics and early curricular aggregates carry the dominant signal at this horizon. For programme recommendation, pre-enrolment demographics alone support actionable rankings (Demographic Multi-Layer Perceptron (MLP): Normalized Discounted Cumulative Gain @ 10 (NDCG@10) ≈ 0.5793, Top-10 ≈ 0.9380, exceeding a popularity prior by $25–27$ percentage points in NDCG@10); adding text offers marginal gains in hit rate but not in NDCG on this cohort. Methodologically, we enforce leakage guards, deterministic preprocessing, stratified splits, and comprehensive metrics, enabling reproducibility on non-proprietary data. Practically, the pipeline supports orientation-time triage (high-recall early-warning) and shortlist generation for programme selection. The results position matriculation-time advising as a joint prediction–recommendation problem solvable with carefully engineered pre-enrolment views and lightweight multimodal models, without reliance on historical interactions. Full article

Digital skills represent a key dimension of digital transformation, shaping the innovation potential, competitiveness, and long-term sustainability of the European economy. The aim of this paper is to compare the development of digital skills in EU-27 countries from 2018 to 2024 and identify the strengths and weaknesses within the European context. The analysis is based on secondary data from the Digital Economy and Society Index (DESI). From the total of 36 indicators included in DESI, 12 variables were selected, with an emphasis on 3 core digital-skills metrics: Internet use, ICT specialists, and ICT graduates. To assess their interrelationships and linkages with overall digital transformation performance, non-parametric correlation analyses (Kendall’s Tau and Spearman’s rank correlation) were applied. Furthermore, across-year nonparametric tests (Friedman ANOVA with Kendall’s coefficient of concordance, W) were used to evaluate year-to-year differences and the stability of country rankings over 2018–2024. The empirical results confirmed that higher levels of digital skills are associated with stronger digital transformation performance among EU member states, while significant cross-country disparities persist. Germany and the Nordic economies (Finland, Sweden, and Denmark) achieved the best results, while Southern and Eastern European countries such as Bulgaria, Portugal, and Greece lagged behind. These findings highlight the strategic role of digital education, ICT specialization, and lifelong learning initiatives in promoting sustainable digital transformation and competitiveness across Europe. In addition, panel regression analysis confirmed that digital infrastructure, particularly FTTP coverage and Very High Capacity Networks, is a key driver of digital skills development, whereas the effects of business digitalization appear indirect or delayed. The outcomes provide relevant implications for broadband deployment and user-centric digital public services to support the objectives of the EU Digital Decade 2030. The study contributes to a deeper understanding of the determinants of digital skills and digital transformation performance, providing evidence-based guidance for targeted digital policies aimed at reducing the digital divide and strengthening digital transformation performance within the European Union. Full article

In multi-UAV cooperative tasks, dynamic communication topologies and resource heterogeneity present significant challenges for distributed task allocation, leading to high communication overhead and poor task-resource matching, which in turn increases computational costs. While the Consensus-Based Bundle Algorithm (CBBA) offers a robust decentralized framework, its scalability and adaptability in heterogeneous, large-scale scenarios are limited. To overcome these issues, this paper introduces a novel Two-Level Clustered CBBA (TLC-CBBA). In the first-layer clustering, UAVs are grouped based on communication topology using graph-theoretic centrality measures to rank node importance, followed by clustering based on shortest-path distances to minimize communication costs. In the second-layer clustering, a resource-balanced and distance-aware K-medoids algorithm is applied within each subgroup obtained from the first-layer clustering, taking into account UAV resource heterogeneity and spatial proximity. This method ensures spatial compactness among UAVs within each subgroup while achieving a more balanced distribution of total resources across clusters. Finally, after completing the two-level clustering, each subgroup executes CBBA for local task bundling and consensus, while the cluster centers coordinate inter-cluster communication to guarantee globally consistent and conflict-free task allocation. Simulations across diverse mission scenarios and UAV team sizes demonstrate that TLC-CBBA substantially outperforms CBBA and its variants (DMCHBA, G-CBBA, and Clustering-CBBA) in terms of communication efficiency, total task score, runtime, and significance analysis. The proposed TLC-CBBA demonstrates strong robustness and scalability for heterogeneous multi-UAV task allocation in dynamic environments. Full article

Background: Swallowed topical corticosteroids (STCs) are used as the first-line therapy for eosinophilic esophagitis (EoE) and have been extensively studied in randomized controlled trials (RCTs); however, the presentation and doses varied widely among the studies. Aim: The goal of this study was to compare the safety and effectiveness of the different STC-based options in EoE patients. Methods: We performed a literature search for RCTs, spanning a time period from database inception to July 2024, in order to compare the efficacy and safety of all STCs used to induce or maintain EoE remission each other and also with placebo or proton pump inhibitors (PPIs) in a network meta-analysis. Outcomes are expressed as pooled risk ratios (RRs) of failure and 95% confidence intervals (CIs), and we aimed to evaluate histological remission at <15–20 eosinophils per high-power field (eos/hpf), <5–6 eos/hpf, and <1 eos/hpf. The effect sizes for symptomatic improvement and the mean differences for endoscopic EREFS improvement with 95% CIs were also measured. Adverse events were evaluated using RRs, and these included oropharyngeal and esophageal candidiasis and adrenal suppression. Results: Twenty studies involving 1455 patients with active EoE reported on STC effectiveness to induce remission; three additional studies on 232 patients assessed the maintenance of remission. Budesonide 1 mg orodispersible tablets ranked highest in SUCRA in terms of all histological remission endpoints. Budesonide from inhalation devices was the only option superior to placebo in improving symptoms. Budesonide viscous suspension was the only option superior to placebo in improving endoscopy. No therapy was significantly associated with the risk of any adverse event. Significant inconsistencies and small study effects were detected in multiple comparisons. Conclusions: Budesonide orodispersible tablets were the best option for achieving EoE histological remission, but not symptomatic or endoscopic improvement. STC formulations were as safe as placebo or PPI. Full article

To systematically investigate the diversity and distribution patterns of Dendrocalamus in Yunnan Province, we integrated field surveys, literature reviews, specimen records, and existing research data to compile and analyze the distribution of Dendrocalamus species across the region. The results revealed the following: (1) A total of 3730 valid distribution points were compiled, representing 38 taxa of Dendrocalamus (including 32 species, 3 varieties, and 3 forms), reflecting remarkably high species diversity. These account for approximately 52% (38/73) of the global species and 69% (38/55) of those recorded in China. (2) Horizontal Distribution Pattern: In terms of distribution points, Pu’er had the highest count (929), followed by Xishuangbanna (759) and Lincang (586). Honghe, Wenshan, and Dehong also showed substantial records. Regarding species richness, Xishuangbanna ranked highest with over 20 species, while Pu’er and Honghe contained 15–20 species. Yuxi and Kunming supported 10–15 species, and Baoshan, Nujiang, Chuxiong, Wenshan, Qujing, and Zhaotong each hosted 5–10 species. In contrast, Dali, Lijiang, and Diqing recorded only 0–5 species. (3) Vertical Distribution Pattern: Distribution points were predominantly concentrated in the 1000–1500 m elevation range, whereas species richness peaked in the 500–1000 m band. Both the number of distribution points and species richness were lowest at elevations above 2500 m. (4) Based on the collected 3730 distribution points, kernel density analysis and hot spot analysis (Getis-Ord Gi*) were performed in ArcGIS 10.8. Both analyses indicated that southern Yunnan (centered on Xishuangbanna and Pu’er) exhibits significant spatial clustering characteristics, identifying it as the core distribution area for Dendrocalamus species in Yunnan Province. (5) During field surveys, a distinctive new species characterized by swollen internodes was discovered. Morphological comparison and phylogenetic analysis confirmed it as a new species of Dendrocalamus and named Dendrocalamus turgidinodis C.M.Hui, M.S.Sun & J.W.Li, it is similar to D. hamiltonii, D. fugongensis, and D. sinicus, but can be easily distinguished by culm diameter 13–16 cm, intranode swollen, culm leaf sheath deciduous, culm blade erect, culm leaf ligule ca. 5 mm tall., Foliage leaf ligule 1–1.5 mm tall (vs. 1.5–2 mm). In conclusion, this study demonstrates that Yunnan Province serves as a major distribution center for Dendrocalamus, with the genus primarily distributed from the southeastern to southwestern parts of the region, and concentrated most densely in the southern area encompassing Xishuangbanna and Pu’er. Full article

The fusion of infrared and visible images provides critical value in computer vision by integrating their complementary information, especially in the field of industrial detection, which provides a more reliable data basis for subsequent defect recognition. This paper presents STGAN, a novel Generative Adversarial Network framework based on a Swin Transformer for high-quality infrared and visible image fusion. Firstly, the generator employs a Swin Transformer as its backbone for feature extraction, which adopts a U-Net architecture, and the improved W-MSA is introduced into the bottleneck layer to enhance local attention and improve the expression ability of cross-modal features. Secondly, the discriminator uses a Markov discriminator to distinguish the difference. Then, the core GAN framework is leveraged to guarantee the retention of both infrared thermal radiation and visible-light texture details in the generated image so as to improve the clarity and contrast of the fused image. Finally, simulation verification showed that six out of seven indicators ranked in the top two, especially in key indicators such as PSNR, VIF, MI, and EN, which achieved optimal or suboptimal values. The experimental results on the general dataset show that this method is superior to the advanced method in terms of subjective vision and objective indicators, and it can effectively enhance the fine structure and thermal anomaly information in the image, which gives it great potential in the application of industrial surface defect detection. Full article

(1) Background: Climate change has intensified extreme heat and localized rainfall, exposing South Korea’s protected trees to new risks. Despite their ecological and cultural value, prior research has been largely local or qualitative, leaving little basis for nationwide prioritization. (2) Methods: We developed a composite risk index that integrates heat and rainfall exposure with species sensitivities, covering nearly the entire national inventory (≈10,000 individuals). Risks were calculated at the tree level, aggregated to district, provincial, and national scales, and tested for robustness across weighting and normalization choices. Spatial clustering was assessed with Moran’s I and LISA. (3) Results: High-risk clusters were consistently identified in southern and southwestern regions. Mean and tail indicators showed that average-based approaches obscure extreme vulnerabilities, while LISA confirmed significant High–High clusters. Rankings proved robust across scenarios, indicating that results reflect structural signals rather than parameter settings. Priority areas defined by the presence of extreme-risk individuals emerged as stable candidates for intervention. (4) Conclusions: The study establishes a transparent, operational rule for prioritization and offers tailored strategies—such as drainage infrastructure, shading, and root-zone management—while informing medium-term planning. It provides the first nationwide, empirically grounded framework for conserving protected trees under climate transition. Full article

Background: Patients with atrial fibrillation (AF) who have a high bleeding risk or contraindications to anticoagulation may be candidates for left atrial appendage closure (LAAC). However, the presence of a thrombus in the left atrial appendage (LAA) is generally considered a contraindication to the procedure. While the feasibility and short-term safety of LAAC in patients with pre-existing LAA thrombus has been reported, data on long-term outcomes remain limited. Objective: To assess the long-term clinical outcomes of AF patients undergoing LAAC in the presence of an LAA thrombus. Methods: This retrospective, single-center registry included all AF patients who underwent LAAC between June 2010 and April 2024. Patients were stratified based on the presence or absence of LAA thrombus at the time of the procedure. The primary endpoint was a 5-year composite of stroke, systemic embolism, or all-cause mortality. Results: A total of 403 patients underwent LAAC, of whom 24 (6%) had an LAA thrombus at the time of the procedure. During a median follow-up of 3.9 years, the primary endpoint occurred in 116 patients: 110 events (41%) in the no-thrombus group and 6 events (38%) in the thrombus group. There was no statistically significant difference in major adverse cardiovascular events (MACE) between groups (log-rank p = 0.862). Conclusions: LAAC may be performed safely in selected patients with distal LAA thrombus, with long-term outcomes comparable to those without thrombus. Full article

Post-traumatic stress disorder (PTSD) is associated with long-term disturbances in stress regulation, neuroinflammation, and oxidative stress and reduced psychological coping capacity. The aim of the study was to assess the relationship between selected neurobiological biomarkers (Insulin-like Growth Factor 1—IGF-1; Caspase-9—CASP-9; Neuronal Nitric Oxide Synthase—nNOS; and Interleukin-10—IL-10) and coping styles evaluated using the Brief Coping Orientation to Problems Experienced (Brief-COPE) questionnaire in men with trauma experience. Particular emphasis was placed on analyzing the effect of PTSD chronicity (≤5 years vs. >5 years) on these relationships. The study included 92 adult men with a history of life-threatening situations. Participants were divided into three groups: PTSD within the past ≤5 years (n = 33), PTSD within the past >5 years (n = 31), and a No PTSD group (n = 28). Biomarkers were measured in blood serum. Coping strategies were assessed using the Brief-COPE questionnaire, which includes four subscales: task-oriented, emotion-oriented, avoidant, and general coping. Due to the lack of normal distribution, the Kruskal–Wallis test and Dunn’s post hoc test were used. Correlations between biomarkers and Brief-COPE subscales were calculated using Spearman’s Rank Correlation Coefficient (Rho). Significant differences between groups were found in all four biomarkers (p < 0.001). IGF-1 and IL-10 reached the highest values in the No PTSD group and the lowest in the PTSD ≤ 5 years group, indicating neuroprotective and anti-inflammatory deficits in PTSD. Conversely, CASP-9 and nNOS levels (markers of apoptosis and oxidative stress) were highest in PTSD ≤ 5 years, with partial normalization in the PTSD > 5 years group. In terms of coping strategies, the No PTSD group displayed a highly adaptive profile (task-oriented: 30/32; emotion-oriented: 43/48; and avoidant: 12/32). Individuals with PTSD ≤ 5 years presented a maladaptive pattern (task-oriented: 13/32; avoidant: 26/32; and emotion-oriented: 27/48), while in PTSD > 5 years, a further decline in emotion-oriented (21/48) and general coping (59/112) was observed, suggesting progressive depletion of psychological resources. The strongest correlations between biomarkers and coping strategies occurred in PTSD groups. Low IGF-1 levels in PTSD ≤ 5 years correlated negatively with emotion-oriented coping (Rho = −0.39) and general coping (Rho = −0.35). High CASP-9 levels were associated with reduced task-oriented coping in PTSD > 5 years (Rho = −0.29). Similar trends were observed for nNOS and IL-10, indicating a disturbance in neurobiological balance that favors persistence of PTSD symptoms. PTSD, both in its acute and chronic phases, is associated with an abnormal profile of neuroprotective, apoptotic, and inflammatory biomarkers, which correlates with impaired adaptive coping capacity. Although partial normalization of biological parameters is observed in chronic PTSD, deficits in emotion-oriented and task-oriented coping persist. The Brief-COPE questionnaire, combined with biomarker analysis, may serve as a useful clinical tool for assessing psychophysiological balance and designing early interventions. These results highlight the potential of IGF-1, CASP-9, nNOS, and IL-10 as biomarkers of stress adaptation and therapeutic targets in PTSD. Full article

Background/Objectives: Impaired angiogenesis and vascular dysfunction are central features of chronic diseases such as cardiovascular disorders, neurodegeneration, and metabolic syndrome. Vascular endothelial growth factor (VEGF) plays a pivotal role in vascular repair and metabolic regulation, yet its responses to exercise remain inconsistently reported. This study aimed to systematically compare the effects of different exercise modalities and doses on VEGF levels across diverse populations. Methods: This review was registered in PROSPERO (CRD42025643709) and followed PRISMA guidelines. PubMed, Web of Science, Embase, and Cochrane Library were searched until 16 January 2025. Eligible studies were randomized or quasi-experimental trials reporting exercise-induced changes in serum/plasma VEGF. Data were extracted and assessed independently using JBI tools. Exercise types were categorized and doses standardized as metabolic equivalents (METs). Network meta-analysis was performed in Stata17.0 (SMD as effect size), with SUCRA used for ranking. Dose–response relationships were examined by meta-regression (remr package), and publication bias was assessed via funnel plots. Results: Twenty-eight studies (N = 1138) were included. In healthy adults, lower-limb resistance training produced the greatest VEGF increase, with benefits observed above ~600 METs-min/week and peaking near 1950 METs-min/week. Among obese individuals, combined aerobic and resistance training under hypoxic conditions showed the highest VEGF response, though dose-specific effects were not significant. In patients with chronic conditions, upper-limb resistance training within 756–950 METs-min/week was most effective, displaying a U-shaped dose–response relationship. No substantial publication bias was detected. Conclusions: The VEGF response to exercise appears to be influenced by both population characteristics and training dosage. High-intensity lower-limb resistance training may provide greater benefits for healthy adults, while obese individuals might experience enhanced responses with combined training under hypoxic conditions. For clinical populations, moderate-dose upper-limb resistance training may be particularly beneficial. Large-scale, long-term trials are needed to further clarify and refine exercise prescriptions targeting VEGF-mediated vascular adaptations. Full article