Search Results (4,394)

The aim of this review was to harmonize major consensus statements (European Working Group on Sarcopenia in Older People 2; Asian Working Group for Sarcopenia 2019; Foundation for the National Institutes of Health Sarcopenia Project operational criteria) into a stage- and setting-stratified algorithm. It maps diagnostic strata to dose-defined resistance and combined training, integrates multimodal and technology-enabled options (whole-body electrical muscle stimulation, whole-body vibration, virtual reality, AI-assisted telerehabilitation) with safety cues, and embeds nutrition (≥1.2 g/kg/day protein, vitamin D, key micronutrients) and education to sustain adherence. Sarcopenia is a consequential geriatric syndrome linked to falls, loss of independence, hospitalization, mortality, and psychosocial burden, yet translation to practice is hindered by heterogeneous definitions, diagnostics, and treatment guidance. Literature searches via PubMed/MEDLINE, EBSCO, SciELO, and Google Scholar (January 2000 to August 2025) yielded 354 records; after screening and deduplication, 132 peer-reviewed studies were included. We summarize tools for screening, strength, muscle mass, and function (e.g., Sarcopenia Five-Item Questionnaire, grip strength, dual-energy X-ray absorptiometry, gait speed) and identify resistance exercise as the cornerstone, with aerobic, balance, and flexibility training adding functional and metabolic benefits. Clinic-ready tables and figures operationalize a stepwise program across primary to severe sarcopenia and across acute or iatrogenic to community settings. Early screening plus structured, exercise-centered care, augmented by targeted nutrition and education, offers pragmatic, scalable benefits. Full article

Background: Pertussis is a respiratory infection that represents a significant threat worldwide, especially for infants. The global incidence of pertussis is on the rise, with 20–40 million cases occurring every year. Maternal vaccination offers protection to newborns and, therefore, is recommended by numerous healthcare organizations. The aim of this study was to systematically assess the level of knowledge regarding pertussis and the pertussis vaccine, as well as the willingness to receive the vaccine among pregnant women, and identify the most significant reasons for vaccine hesitancy among the obstetric population. Methods: A systematic literature search was conducted in the Web of Science, Embase, and Scopus databases between 1 April 2024, and 31 July 2024. Our search strategy aimed to identify studies published from 1 January 2014 to July 2024 in order to capture a decade’s worth of the most recent evidence and updates in maternal pertussis vaccination. Results: We screened 955 articles altogether, with 11 studies included in the analysis. The general awareness of pertussis infection prior to participation in the study varied from 5% in a study performed in Turkey to 95.9% in the Norwegian population. Moreover, the willingness to receive the vaccine ranged from 11.2% in the Turkish population to 94.8% in the Netherlands. Several statistically important factors affecting the decision have been identified, such as belief in safety and effectiveness, fear of adverse reactions, or healthcare professional recommendation. Conclusions: The general awareness regarding pertussis vaccine in pregnant women differs significantly depending on the population studied. However, it remains unsatisfactory even in populations with a high declared level of knowledge if asked specific questions. Presented results may indicate the need for studies on the efficacy of educational interventions for raising awareness about the meaning of pertussis immunization during pregnancy and preventing infection among neonates. Full article

Antidepressant drugs (ADDs) are one of the most widely prescribed pharmaceuticals globally and are widely detected in the environment. They are designed to target monoamine neurotransmission—a highly conserved pathway between humans and animal species. Monoamines are particularly involved in the regulation of a wide array of key biological functions in molluscs, an ecologically important group of animals. Despite this, the target-specific effects of environmental concentrations of different classes of ADDs in molluscs remain poorly understood. The present study seeks to understand the target-specific effects of environmental concentrations of different classes of ADDs in molluscs through a systematic review of the literature. This study, following our published systematic review protocol, analyzed 51 studies after deduplication and screening of 1156 identified records. Included studies reported on a range of outcomes, including reproductive, (loco)motor, developmental, behavioral, immuno-modulating and neurophysiological effects. Data synthesis was performed with a harvest plot of exposures, effect direction and risk of bias. We found evidence (weak to moderate) for (i) immunosuppression, resulting from tissue serotonin level elevation, (ii) larval development impairment, and (iii) acetylcholinesterase inhibition, at environmental concentrations of ADDs. Most study outcomes, in addition to data-deficient outcomes, were inconclusive due largely to methodological limitations such as the use of wild-derived species with minimal or no acclimation (65.38% of included studies), lack of proper controls and replicates, and unrealistic exposures, affecting the reliability of existing data. Although the observed effects—particularly immunosuppressive ones—provide critical insight into the ecological risks posed by ADDs, their impacts at environmentally relevant concentrations remain poorly characterized for most endpoints. Given the ecological importance of molluscs, further studies addressing the identified methodological and research gaps are urgently needed to better characterize the hazards posed by environmental concentrations of ADDs. Full article

Background: Meta-analyses on the prevalence and clinical significance of breast incidental uptake (BIU) at PET/CT are available only for [¹⁸F]FDG, showing that BIU is rare but malignant in a substantial proportion of cases. This study aimed to update the pooled prevalence and malignancy risk of BIU using different PET radiotracers, expanding [¹⁸F]FDG-based evidence. Methods: A comprehensive literature search of studies on BIU was carried out in two bibliographic databases, and the literature was screened up to 25 May 2025. Only original articles reporting BIU were selected. A proportion meta-analysis was conducted on a patient-based analysis using a random-effects model to estimate pooled prevalence, malignancy rate, and histological distribution. Results: In total, 29 studies were included in the systematic review and meta-analysis. PET/CT was performed using [¹⁸F]FDG (n = 25), radiolabeled somatostatin analogues (SSAs) (n = 3), or [¹⁸F]fluorocholine (n = 1). The pooled prevalence of BIU was 0.5% for [¹⁸F]FDG PET/CT, 3.4% for SSA PET/CT, and 2.6% for [¹⁸F]fluorocholine. The pooled malignancy rate among BIUs (female patients) was 33.5% for [¹⁸F]FDG, 86.4% for SSA, and 70% for [¹⁸F]fluorocholine PET/CT. Histological data were mainly available for [¹⁸F]FDG PET/CT, showing ductal carcinoma as the most frequent malignant histotype (pooled value 42.2%) and fibroadenoma (pooled value 14.8%) as the most frequent benign histotype. Conclusions: Similar to the case for [¹⁸F]FDG, BIU using other PET radiopharmaceuticals is uncommon but often malignant. Therefore, BIU should prompt dedicated breast imaging and, when indicated, histopathological confirmation. Further well-designed studies are needed to clarify the clinical impact of BIU detection and the prevalence and clinical significance of BIU using tracers other than [¹⁸F]FDG. Full article

Dermatomyositis (DM) is a prototypic idiopathic inflammatory myopathy in which characteristic skin disease frequently precedes or parallels muscle involvement and signals risks such as interstitial lung disease (ILD) and malignancy. This literature review integrates recent advances across dermatology, neuromuscular medicine, and immunology to refine diagnosis and management. We surveyed the literature from 2000 to 2025, prioritizing randomized trials, large cohorts, and translational studies that spanned classic and juvenile DM, amyopathic/hypomyopathic variants, and overlap phenotypes. Key insights include the diagnostic weight of pathognomonic cutaneous lesions with nailfold microangiopathy; the utility of myositis-specific autoantibodies for endotyping and risk (e.g., anti-TIF1-γ/anti-NXP2 and cancer, anti-MDA5 and rapidly progressive ILD); and the value of myxovirus-resistance protein A (MxA) immunohistochemistry and muscle MRI patterning (including distinctions from immune-mediated necrotizing myopathy) when enzymes are normal, or biopsies are treatment-modified. Management is anchored in early steroid-sparing immunosuppression tailored to phenotype, with evidence for IVIG in active DM and growing support for JAK inhibition, particularly in interferon-high or anti-MDA5 ILD, alongside selective use of calcineurin inhibitors and rituximab, with plasma exchange considered for refractory, rapidly progressive ILD. We highlight risk-stratified malignancy screening (IMACS 2023) and complications, including calcinosis, lipodystrophy, and chronic cutaneous damage. Skin-led recognition coupled with antibody-guided, phenotype-directed therapy and interdisciplinary care offers a pragmatic precision framework to improve outcomes and reduce long-term disability. Full article

Urban modeling is being reshaped by advances in artificial intelligence (AI) and data-rich sensing. This review assembles an integrated evidence base connecting spatial dynamic modeling (SDM), planning support systems (PSSs), urban analytics, and governance concerns. We analyze 1290 publications (2000–2025) using a reproducible pipeline that combines structured literature retrieval with retrieval-augmented generation (RAG) for semantic screening and evidence extraction. Bibliometric mapping and a rigorous coding framework structure the synthesis. The results reveal three linked trajectories. First, SDM has progressed from rule-based simulation toward learned spatial representations using deep and multimodal learning. Second, PSS has evolved from static analytical tools to interactive and participatory environments that embed AI for scenario exploration and stakeholder engagement. Third, governance themes such as transparency, fairness, and accountability have gained importance but remain unevenly implemented in modeling workflows. Building on these findings, we advance AI-aligned SDM, which integrates explainability, uncertainty reporting, documentation, and participation into model design to strengthen institutional accountability and evidence-based planning. A forward research agenda emphasizes methodological fusion between simulation and learning, institutional design for continuous model stewardship, and epistemic pluralism connecting local knowledge with AI to advance equitable and transparent urban governance. Full article

Background: Primary cardiac tumors are exceedingly rare, with myxomas representing the most common benign type among these tumors, predominantly located in the left atrium. Biatrial involvement is an exceptional presentation, reported in less than 2.5% of cases. The terms bilateral and biatrial atrial myxoma are often confused and used interchangeably. We present a rare case of atrial myxoma involving both chambers, resected via a minimally invasive endoscopic approach, accompanied by a literature review. Case Presentation: A 52-year-old male with a three-month history of progressive fatigue and exertional dyspnea was found, on transthoracic echocardiography and cardiac MR, to have two intracardiac masses affecting both atria. Intraoperative transesophageal echocardiography confirmed the presence of mirror-image myxomas attached to the interatrial septum, in the absence of any septal defect. The tumors were excised en bloc, including the septal attachment, using a minimally invasive endoscopic approach. Histopathological examination confirmed the diagnosis of atrial myxoma, and the postoperative course was uneventful. Conclusions: Bilateral and biatrial atrial myxomas are exceedingly rare forms of cardiac tumors. In many cases, the first clinical manifestations may arise from cerebral or peripheral embolic events or from pulmonary thromboembolism. For this reason, screening echocardiography may be useful, particularly in cases of familial myxoma. Transthoracic and transesophageal echocardiography, combined with careful inspection of all cardiac chambers, play a crucial role in preventing recurrence by detecting small or overlooked tumor fragments. The minimally invasive endoscopic approach offers a safe and effective surgical option for biatrial myxomas, providing excellent visualization and facilitating thorough exploration of the cardiac cavities. Full article

This study explores how research on carbon capture technologies (CCTs) has developed over time and shows how semantic text mining can improve the analysis of technology trajectories. Although CCTs are widely viewed as essential for net-zero transitions, the literature is still scattered across many subthemes, and links between engineering advances, infrastructure deployment, and policy design are often weak. Methods that rely mainly on citations or keyword frequencies tend to overlook contextual meaning and the subtle diffusion of ideas across these strands, making it difficult to reconstruct clear developmental pathways. To address this problem, we ask the following: How do CCT topics change over time? What evolutionary mechanisms drive these transitions? And which themes act as bridges between technical lineages? We first build a curated corpus using a PRISMA-based screening process. We then apply BERTopic, integrating Sentence-BERT embeddings with UMAP, HDBSCAN, and class-based TF-IDF, to identify and label coherent semantic topics. Topic evolution is modeled through a PCC-weighted, top-K filtered network, where cross-year connections are categorized as inheritance, convergence, differentiation, or extinction. These patterns are further interpreted with a Fish-Scale Multiscience mapping to clarify underlying theoretical and disciplinary lineages. Our results point to a two-stage trajectory: an early formation phase followed by a period of rapid expansion. Long-standing research lines persist in amine absorption, membrane separation, and metal–organic frameworks (MOFs), while direct air capture emerges later and becomes increasingly stable. Across the full period, five evolutionary mechanisms operate in parallel. We also find that techno-economic assessment, life-cycle and carbon accounting, and regulation–infrastructure coordination serve as key “weak-tie” bridges that connect otherwise separated subfields. Overall, the study reconstructs the core–periphery structure and maturity of CCT research and demonstrates that combining semantic topic modeling with theory-aware mapping complements strong-tie bibliometric approaches and offers a clearer, more transferable framework for understanding technology evolution. Full article

Reverse transcription quantitative PCR (RT-qPCR) is a powerful and widely used technique for quantifying alterations in gene expression. Cassava bacterial blight caused by Xanthomonas phaseoli pv. manihotis severely constraints cassava growth and yield. Accurate evaluation of the expression levels of genes following infection by X. phaseoli pv. manihotis is crucial for the identification of potential cassava resistance genes. In this study, thirty-two novel potential reference genes were screened from the cassava–X. phaseoli pv. manihotis transcriptome. Their expression, along with that of seven literature-reported cassava reference genes, was evaluated in two susceptible and two resistant cassava varieties at six time points post-inoculation by X. phaseoli pv. manihotis through RT-qPCR analysis. The stability of thirty-nine candidate reference genes was assessed by four algorithms: geNorm, NormFinder, Delta Ct, and RefFinder. The results demonstrated that serving as new reference genes, MehnRNPR and MePRPF38B consistently exhibited superior expression stability over seven established reference genes under X. phaseoli pv. manihotis infection, regardless of the susceptible or resistant cassava varieties. The reliability of the reference genes was validated by assessing the expression pattern of MeNAC35 and MeSWEET10a under X. phaseoli pv. manihotis infection. The findings of this study provide valuable insights for advancing the precision of the quantification of cassava candidate genes associated with disease resistance. Full article

Background: Interstitial lung disease (ILD) involves numerous chronic pulmonary conditions that damage the lung parenchyma and alveolar interstitium. ILD has overlapping clinical and radiological features with other commonly seen cardiac and respiratory conditions. If not identified and treated in a timely manner, it may lead to irreversible fibrosis and a poor prognosis in the patient. The current diagnostic methods are either invasive or reliant on imaging or specialist interpretation, which can lead to diagnostic delay, increased radiation exposure, and healthcare costs. Lung crackles, often under-recognized as a non-specific feature of ILD, may serve as an important diagnostic clue in identifying not only the early stages of ILD but also its subtypes. This review explores the potential of analyzing the lung sounds in ILD through AI-based auscultation. Objective: To provide a comprehensive analysis of the pathophysiological stages of lung injury in ILD, the specific acoustic features, and the location associated with each ILD subtype and to evaluate the current state-of-the-art non-AI and AI methodologies that are used to diagnose ILD. This review aims to analyze the limitations associated with the current modalities and to envision AI-integrated auscultation as a powerful, cost-effective, non-invasive, radiation-free screening tool for early detection of ILD and its subtypes. Content Overview: The review begins with a detailed analysis of the lung sound pathophysiology, exploring the two-stage mechanism of alveolar epithelial injury and fibrosis formation. Existing hypotheses explaining the mechanism behind crackle production and the role of structural anatomy and surface tension in the generation of pathological lung sounds are examined. A tabulated summary of common ILD subtypes is provided, including their inciting events, pathogenesis, anatomical auscultation locations, and prognostic implications. Current diagnostic modalities for ILD, both non-AI and AI-based, are summarized along with their limitations, emphasizing the need for improved diagnostic tools. Discussion: Existing studies suggest that AI-based auscultation can match or exceed the current modalities in its sensitivity and specificity for detecting ILD-related crackles. Clinicians can identify the specific sound pattern and then correlate it with the ILD subtype and understand the prognosis in real time, thereby providing timely intervention to the patient. Additionally, AI-based auscultation can be used in resource-limited settings and can potentially reduce dependence on pulmonology expertise and radiation-based imaging for monitoring the condition. Conclusions: This literature review highlights the clinical potential of AI-based auscultation for early and accurate diagnoses of ILD. Understanding the associated pathological sounds, biomarkers, and genetic mutations linked to different subtypes opens avenues for future development of non-invasive diagnostic panels for ILD in clinical practice. Full article

Background: Women from Roma communities face considerable health inequalities, primarily due to limited access to healthcare systems, alongside broader social and structural disadvantages. Among Roma women these disparities are reflected in poorer perinatal outcomes when compared to non-Roma populations. This systematic review aims at: (a) exploring disparities in neonatal health outcomes between Roma and non-Roma populations in relation to maternal factors such as health status, lifestyle, and education; (b) summarizing key perinatal characteristics in these groups; (c) assessing the influence of prenatal care on neonatal outcomes. Comprehending these disparities is crucial for guiding effective interventions and promoting health equity. Methods: A systematic literature review was conducted in major databases, such as PubMed and Scopus, to identify studies published up to 2025. The eligible studies focused on observational research that compared perinatal outcomes, including preterm birth, low birth weight (LBW), stillbirth, and neonatal mortality, between Roma and non-Roma populations. The potential discrepancies between these populations are thoroughly discussed in the review. Results: A comprehensive search yielded a total of 157 studies. After meticulous screening, 48 relevant studies were identified, reporting substantial health disparities between Roma and non-Roma mothers and their newborns. Roma populations exhibited significantly increased rates of preterm birth, LBW, and neonatal mortality vs. non-Roma populations. Socioeconomic status, access to prenatal care, maternal education, and systemic discrimination were identified as the primary contributing factors to these disparities. Conclusions: The findings highlight the significant and enduring disparities in perinatal health between Roma and non-Roma populations. In order to effectively address these disparities, it is necessary to have a comprehensive and multi-level strategy that prioritizes the social determinants of health, ensures equitable access to high-quality maternal care, and mitigates actively systemic discrimination. Future research should prioritize the development and rigorous evaluation of targeted interventions to reduce these inequities and improve perinatal outcomes among Roma populations. Full article

Objectives: This review aims to review the application of deep learning (DL) techniques in the imaging analysis of abdominal aortic aneurysm (AAA), with a specific focus on the segmentation of intraluminal thrombus (ILT). Methods: A comprehensive literature review was conducted through searches of PUBMED and Web of Science up to September 2025. Only English-language studies applying DL-based networks for ILT segmentation in patients with AAA on computed tomography angiography were included. After screening 664 articles, 22 met the eligibility criteria and were included. The reported methodological frameworks and segmentation performance metrics were extracted for comparison and analysis. Results: Among the studies included, the reported Dice similarity coefficients ranged from 0.81 to 0.93 for 2D networks and from 0.804 to 0.9868 for 3D networks. Notably, 2D Multiview fusion models outperform other 2D approaches, while 3D U-Net remains a strong baseline. Methods using preoperative images demonstrated great applicability for surgical planning, while postoperative segmentation faced challenges related to imaging artifacts caused by stent. Conclusions: This review provides a comprehensive overview of recent DL-based ILT segmentation methods for AAA patients on CTA, offering perspectives for applications in advanced preoperative planning and postoperative surveillance. Despite the promising results, the lack of standardized datasets limits model development and external validation. Future research should address these limitations by focusing on multicenter standardized datasets and seamless integration into clinical workflows. Full article

This study presents the results of a multi-technique forensic investigation of suspicious soft capsules seized by law enforcement during a criminal case. The unlabeled samples, sold as therapeutic and “regenerative” food supplements, were examined using liquid chromatography–tandem mass spectrometry (LC-MS/MS), Fourier-transform infrared spectroscopy with attenuated total reflection (ATR-FTIR), chemiluminescence, and brightfield/confocal microscopy. These complementary analytical approaches revealed that the capsules contained biological material of unknown origin, including blood-derived compounds, lipid constituents, and cellular structures. The findings indicate biological adulteration, possibly due to deliberate falsification or severe contamination. To place these results in a broader biomedical context, a scoping review of literature on blood- and tissue-derived materials used in biomedical and nutraceutical applications was conducted. This review underscores how such products are developed, promoted, and regulated, highlighting the potential health and biosafety risks associated with unregulated biologically themed supplements. Overall, this study demonstrates a transferable analytical workflow suitable for forensic laboratories and emphasizes the need for continued regulatory vigilance to protect public health. Given the evidentiary constraints typical of forensic casework—specifically, the small amount of seized material—the workflow was optimized to maximize information yield through minimally destructive, orthogonal, non-genetic screening methods, with LC-MS/MS reserved for final molecular confirmation. DNA typing was not performed because, after confirmatory analyses, the remaining material was insufficient for reliable genotyping. Full article

Long COVID, a condition marked by persistent symptoms following COVID-19 infection, poses significant challenges in regard to clinical management. While emerging pharmacological treatments have demonstrated limited benefits in isolated studies, clinical experience and the literature suggest that low-dose naltrexone (LDN) may be a promising therapeutic option. Therefore, in this systematic review, we aim to synthesise findings from the available literature and evaluate the overall safety and efficacy of LDN as a potential treatment for long COVID. A literature search was conducted using a combination of key terms—‘COVID’, ‘COVID-19’, ‘SARS-COV-2’, and ‘Naltrexone’— and the following databases: MEDLINE, Web of Science (Clavirate), Embase, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index in Nursing and Allied Health Literature (CINAHL). The methodology is available on the PROSPERO database (CRD42025630362). Screening identified five eligible articles. Four studies were included, but only two provided comparable data suitable for meta-analysis. Meta-analysis demonstrated statistically significant improvements in fatigue, brain fog, and headaches. Preliminary evidence suggests LDN has potential benefits in the treatment of long COVID, particularly with respect to fatigue, brain fog, and headaches, but more robust studies, such as randomised controlled trials, are urgently needed to confirm LDN’s safety and efficacy. Full article

Large-scale river degradation constitutes a global challenge, rendering the ecological restoration of impaired rivers ever more crucial. While ecological restoration projects have enhanced the quality of river habitats, given the dynamic nature and complexity of river and lake ecosystems, the achievement of sustainable restoration of fish habitats and the assurance of its effectiveness continue to face numerous challenges. Consequently, this study proposes an improved approach to determine the ecological flow requirements of fish habitats in impaired rivers. In relation to the screening of key species, a bespoke evaluation index system has been developed specifically for impaired rivers lacking rare and endemic fish species. Primary data were collected via field surveys, ecological monitoring, and a review of the literature, while the analytic hierarchy process (AHP) was utilized to quantitatively identify key species. In the development of the assessment framework, three core indicators were integrated: habitat-weighted usable area (WUA), habitat connectivity index (HCI), and microhabitat heterogeneity index (RMH). Incorporating the ecological requirements of key fish species across different life stages, a systematic analysis was undertaken to explore the ecological response effects of different indicator combinations under varying flow regimes. The results revealed that a flow rate of 160 m³/s gives rise to an inflection point in the RMH diversity index at 1.618, whereas a flow rate of 240 m³/s results in a significant inflection point in the HCI at 0.652. At a flow rate of 260 m³/s, the WUA attains 2,007,928 m². The optimal ecological flow range was determined to be 160–240 m³/s for the breeding period (March–June), 240–260 m³/s for the foraging period (July–October), and 120 m³/s for the winter period. These findings provide a theoretical framework for the restoration of target fish populations in similarly degraded rivers. Full article