Search Results (15,915)

Serotonergic psychedelics, particularly psilocybin, lysergic acid diethylamide (LSD), and dimethyltryptamine (DMT), are increasingly recognised as powerful tools to advance the understanding of consciousness and its relation to brain activity. Psychedelic research has informed neuroscientific theories that attempt to map neural observations of network connectivity and signal diversity to phenomenological qualities like psychological flexibility. Thus far, however, there have been relatively limited efforts to bridge the gap between psychedelic-informed theory and the experiential differences observed in neurodevelopmental conditions such as autism. In this narrative review and conceptual synthesis, we compare the psychedelic state and autism in adults from a neurophenomenological perspective. Predictive processing is invoked as a unifying framework. This procedure highlights both phenomena as involving a shift towards sensory information relative to prior knowledge, but potentially implicating alterations at opposite ends of the cortical hierarchy. This contrastive approach also reveals opportunities for refining concepts—including psychological flexibility—as well as interpretations of results across fields. However, neurobiological findings, especially in autism, are heterogeneous and there are inherent restrictions in comparing transient state and lifelong trait phenomena. Conclusions of this comparison are primarily conceptual and offer testable hypotheses for the neurophenomenology of the psychedelic state, autism, and their interaction. Full article

Background/Objectives: Anterior disc displacement (ADD) is a common temporomandibular joint (TMJ) disorder and may progress to internal derangements. Although arthroscopic discopexy (minimally invasive disc repositioning with fixation) has been adopted, suggested techniques and pooled outcomes have not been comprehensively synthesized. The aim of the present study was to summarize the effectiveness of arthroscopic discopexy in treating patients with disc-related TMJ disorders. Methods: This systematic review and meta-analysis followed Cochrane guidance and PRISMA 2020 protocol. Four databases were searched through 1 September 2025. A total of 26 studies were included in this review. Nine studies met the eligibility criteria for meta-analysis and were pooled. The remaining 17 studies were narratively described, focusing on surgical characteristics. Continuous outcomes (MIO, pain score (VAS 0–10)) were pooled as mean differences (MD) with 95% confidence intervals (CIs), and joint sounds were synthesized as dichotomous outcomes. Analyses and heterogeneity were performed in RevMan 5.4. Certainty was graded with GRADE. (PROSPERO: CRD420251145229). Results: 1086 TMJs were analyzed. Arthroscopic discopexy significantly improved MIO, pain, and joint sounds at all time points. The MD of MIO was 10.58 mm (95% CI: 4.46 to 16.70; p ≤ 0.001), 9.83 mm (95% CI: 4.09 to 15.57; p ≤ 0.001), and 13.06 mm (95% CI: 4.40 to 21.72; p ≤ 0.001), respectively. The MD of the pain score was −4.36 (95% CI: −6.89 to −1.82; p ≤ 0.001), −3.91 (95% CI: −6.23 to −1.59; p ≤ 0.001), and −4.56 (95% CI: −7.81 to −1.31; p < 0.01), respectively. At 12 months, joint sounds were less frequent than preoperatively (OR = 0.07; 95% CI: 0.01 to 0.37; p < 0.01). Overall, the certainty of evidence according to the GRADE approach was rated as low. Therefore, the results should be interpreted with caution, as high heterogeneity was observed across the three follow-up time points and the included studies were observational. Conclusions: These findings underscore the significance of arthroscopic discopexy in enhancing TMJ function and alleviating symptoms. Current evidence, characterized by a low risk of bias and low certainty, supports the advantage of arthroscopic discopexy. Due to the observational evidence base and heterogeneity, high-quality randomized trials conducted under standardized treatment protocols and with longer follow-up are needed. Full article

Contemporary architecture is undergoing a transformation from the modernist techno-functional paradigm towards practices that integrate technology with humanistic, cultural, and environmental values. Biophilia—understood as the innate human need for contact with nature—is becoming an important design category that supports health, well-being, and ecological awareness, yet it can also convey additional narratives. In this context, immersion plays a significant role: it is a process of deep engagement of the user with space, involving the senses, emotions, and imagination, while simultaneously fostering relationships between humans and their surroundings. The concept of immersiveness, originating in art theory and digital media studies, is now applied in architecture as a tool for creating spatial narratives and cultural experiences. Biophilic architecture employs immersive strategies to transform buildings into environments that support sensory, behavioural, and social practices. This article analyses selected examples of such projects (including the Rooftop Garden—Warsaw University Library, Musée du quai Branly, and apartment buildings Bosco Verticale) and proposes a Multi-criteria Method for Assessing Architectural Immersiveness (MMAAI). The findings indicate that the integration of nature, technology, and spatial narrative enables architecture to act as a mediator between humans and the environment, generating new qualities of spatial experience in the Anthropocene epoch. Full article

Enterocytozoon bieneusi is the most frequently diagnosed microsporidian parasite in humans and a recognized cause of diarrheal disease, particularly in immunocompromised individuals. Its broad host range, which includes livestock, companion animals, and wildlife, highlights its zoonotic potential and warrants careful epidemiological assessment. This narrative review synthesizes available data on the occurrence and genetic diversity of E. bieneusi in European domestic ungulates (cattle, pigs, sheep, goats, horses, and water buffaloes) and pets (dogs and cats), aiming to provide an integrated perspective on animal reservoirs and their relevance for public health. Publications retrieved from the Web of Science Core Collection database were systematically screened, and country-specific results were extracted, emphasizing prevalence rates, genotype distributions, and zoonotic implications. Across Europe, cattle and pigs emerged as the most studied hosts, frequently harboring zoonotic group 1 genotypes such as I, J, BEB4, BEB6, and EbpA, while small ruminants, horses, and buffaloes remain comparatively undocumented. In pets, the dog-adapted genotype PtEb IX was predominant, but several zoonotic genotypes were also identified. Overall, the current evidence confirms the wide host range of E. bieneusi in Europe but also reveals significant data gaps compared to regions such as China, underlining the need for broader surveillance and harmonized molecular approaches within a One Health framework. Full article

Background: Poor nutrition drives chronic disease, health disparities, and rising health care costs in the United States. Medically tailored meals (MTMs), designed by registered dietitians, are a Food-as-Medicine intervention with potential to improve outcomes and reduce costs. This review synthesizes evidence on the clinical, economic, and policy implications of MTMs. Methods: We conducted a narrative review of peer-reviewed studies, real-world program evaluations, and policy analyses. Sources included PubMed, Google Scholar, and grey literature from government, nonprofit, and industry organizations. Articles and reports were included if they examined MTMs in Medicare, Medicaid, or other high-risk populations. Results: Evidence demonstrates that MTMs improve health outcomes, reduce hospitalizations, and lower total cost of care. Case studies from Medicaid and Medicare Advantage plans, including those administered by Mom’s Meals^®, report reductions in emergency department visits, hospital readmissions, and total cost of care, alongside sustained high member satisfaction. Despite these findings, gaps in coverage and limited stakeholder awareness hinder broader access and adoption. Conclusions: Federal policy action can expand MTM availability and maximize utilization of existing benefits. Opportunities include establishing a Medicare Fee-for-Service demonstration, expanding and encouraging use in Medicare Advantage, and leveraging MTMs within Center for Medicare and Medicaid Innovation models. Broader implementation and utilization could reduce the nation’s chronic disease burden, advance health equity, and promote value-based care. Full article

Academic failure and social inequalities are becoming more prevalent in schools. While knowledge has evolved and society has undergone significant transformation, schools have largely remained structured around a uniform model applied indiscriminately to all. In Portugal, efforts were made to initiate change through the conceptualisation and implementation of innovation plans to alter the prevailing grammar of schooling, prompting an inquiry into whether these initiatives yielded the intended outcomes. To this end, a case study was conducted in two such schools, aiming to capture the perspectives, ideas, and perceptions of various stakeholders: students and teachers through questionnaires, coordinating teachers via narrative accounts, and school leaders through semi-structured interviews. The findings reveal that the contexts of implementation, the scale of the initiative, and the number of schools involved significantly influence both practices and leadership outcomes. Nonetheless, despite these constraints, the innovation plans facilitated the emergence of more collaborative dynamics and the creation of more meaningful learning environments, wherein students assumed a more active role in their educational processes. The results further indicate that these innovation plans encountered obstacles rooted in entrenched professional and organisational cultures, which hindered profound changes in the structuring of teaching and learning practices. Full article

Work-related musculoskeletal disorders (WMSDs) and psychological stress remain major occupational health challenges among teaching professionals in adult education, yet their interconnected causes are often underexplored. This narrative review aims to identify multifactorial risk factors that contribute to these conditions and to propose a comprehensive framework that enhances understanding of teaching professionals’ well-being. A systematic synthesis of recent epidemiological and occupational health studies was conducted to analyse both immediate and underlying determinants across human, workplace, organisational, and socioeconomic dimensions. The findings reveal that more than two-thirds of teaching professionals experience WMSDs, particularly in the neck and lower back, while psychological stress affects over seventy percent globally. The combined effects of poor ergonomics, prolonged static postures, excessive workload, and limited organisational support contribute significantly to both physical and psychological strain. Broader contextual influences such as job insecurity, insufficient institutional resources, and societal undervaluation further intensify these risks. The review identifies a reciprocal relationship between physical discomfort and psychological distress, where each condition amplifies the other through behavioural and physiological mechanisms. The proposed integrative framework establishes a foundation for targeted interventions and evidence-based policy, promoting a shift toward holistic, system-oriented approaches to occupational health for teaching professionals in professional education settings. Full article

Equine herpesvirus (EHV) infections represent a significant global veterinary and economic challenge affecting both horses and donkeys across all inhabited continents. This narrative review comprehensively examines the nine distinct EHV species (EHV-1 through EHV-9), their taxonomic classification within Alphaherpesvirinae and Gammaherpesvirinae subfamilies, and their diverse host tropism patterns. The complex molecular pathogenesis involves sophisticated viral glycoproteins (gK, gB, gC, gH, gM, gL, gG, gD, gI, gE) that orchestrate cellular invasion, immune evasion, and intercellular transmission. Clinical manifestations vary considerably, ranging from respiratory diseases and reproductive failures to severe neurological disorders, with EHV-1 demonstrating the most severe presentations including myeloencephalopathy. Global distribution analysis reveals widespread circulation across Europe, Asia, Africa, the Americas, and Oceania, with species-specific clinical patterns. Current therapeutic options remain largely supportive, with experimental compounds like berbamine and cepharanthine, celastrol, blebbistatin, and hyperoside showing promise in preclinical studies. Vaccination programs demonstrate limited effectiveness, failing to prevent transmission at population levels despite inducing individual immune responses. The sophisticated immune evasion strategies employed by EHVs, including the “Trojan horse” mechanism utilizing infected leukocytes, highlight the complexity of host–pathogen interactions and underscore the urgent need for innovative prevention and treatment strategies. Full article

Hepatorenal syndrome (HRS) is a high-mortality, potentially reversible form of kidney failure that arises from a tight hemodynamic–inflammatory coupling in cirrhosis. Contemporary redefinitions prioritize creatinine kinetics over static thresholds and recognize non-acute kidney injury (AKI) functional phenotypes, enabling earlier recognition but heightening the need for precise etiologic triage. This narrative synthesis integrates current concepts across pathophysiology, diagnosis and management. Portal hypertension, bacterial translocation and inflammatory mediators amplify splanchnic vasodilation and effective arterial underfilling. Compensatory neurohumoral activation precipitates renal vasoconstriction, intrarenal microcirculatory dysfunction and sodium–water retention. The pivotal diagnostic fork remains HRS–AKI versus acute tubular necrosis. A pragmatic, tiered strategy, structured volume assessment, filtration markers and a parsimonious tubular-injury panel offer actionable discrimination, whereas fractional excretion indices serve as adjuncts only. Initial therapy should be bundled and time-sensitive: remove nephrotoxins, treat infection and initiate albumin plus a vasoconstrictor. The transplant strategy should default to isolated liver transplantation unless end-stage renal disease is established. Future priorities include validated biomarker cut-offs, ultrasound-guided volume algorithms and pathway-based trials to reduce diagnostic delay and improve survival. Full article

Sessile serrated lesions (SSLs) are well-known precursors of colorectal cancer in the general population, but their role in inflammatory bowel disease (IBD) is less clear. This narrative review summarizes what is known about the prevalence, molecular features, endoscopic detection, malignant potential, and management of SSLs in patients with IBD, highlighting where evidence supports action nowadays and where prospective studies are urgently needed. IBD-associated colorectal cancer has long been considered a consequence of the inflammation–dysplasia–carcinoma sequence, distinct from the conventional adenoma–carcinoma pathway. Increasing evidence, however, suggests that the serrated pathway, typically characterized by SSLs and traditional serrated adenomas (TSAs), may also contribute to IBD-related oncogenesis. This review synthesizes histopathological, molecular, endoscopic, and clinical data on SSLs in patients with IBD, with contextual reference to TSAs, sessile serrated lesions with dysplasia, and serrated epithelial change only when relevant to their interpretation or risk stratification. SSLs are now more frequently identified in IBD surveillance, especially in ulcerative colitis and the proximal colon, although prevalence estimates remain heterogeneous due to evolving definitions and significant interobserver variability. Molecular studies indicate that IBD-associated serrated lesions often harbor BRAF mutations but display a lower CpG island methylator phenotype than their sporadic counterparts, suggesting an inflammation-modified biology. While most hyperplastic polyps and non-dysplastic SSLs appear to pose limited neoplastic risk, dysplastic serrated lesions carry a markedly higher likelihood of synchronous or metachronous advanced neoplasia. Advances in high-definition endoscopy and chromoendoscopy improve the detection of these subtle, mucus-capped, flat lesions, while endoscopic resection is nowadays feasible in expert hands. Future priorities should include prospective multicenter cohorts integrating molecular profiling to refine surveillance strategies. Full article

Leishmaniasis and Chagas disease, caused by Leishmania spp. and Trypanosoma cruzi, are neglected tropical diseases with significant global health burden, particularly in resource-limited regions. Despite their impact, diagnosis and treatment remain challenging due to limited diagnostic tools and the toxicity of available therapies. Our objective is to propose the incorporation of markers for the diagnosis of leishmaniasis and Chagas disease using ncRNA. This narrative review evaluates studies published between 2010 and 2024 (PubMed, Scopus, Google Scholar) using the SANRA scale to assess the potential of non-coding RNAs (ncRNAs) as biomarkers for these infections. Both parasites release small RNAs via extracellular vesicles that modulate host–pathogen interactions and gene expression. Although RNA interference machinery is absent in T. cruzi and most Leishmania species, it persists in early-diverging lineages. In leishmaniasis, distinct miRNA expression profiles—including miR-155-5p, miR-5011-5p, miR-6785-5p, and miR-361-3p—demonstrate high diagnostic accuracy for detecting infection (AUC up to 1.0). Serum long ncRNAs such as MALAT1 and NUTM2A-AS1 show potential diagnostic value, though clinical validation remains pending. For Chagas disease, the available evidence on ncRNAs primarily addresses the diagnosis of clinical manifestations rather than initial infection. Host miRNAs, including miR-21, miR-145, miR-146a/b, and miR-19a-3p, correlate with cardiac involvement, immune dysregulation, and inflammation during chronic T. cruzi infection. Circulating miRNAs exhibit modest sensitivity (57–67%) and specificity (57–80%) for diagnosing chronic Chagas cardiomyopathy, indicating their utility in assessing disease progression and organ damage rather than detecting early infection. This review distinguishes between ncRNAs that diagnose infection and those that evaluate disease severity or organ involvement. Altered ncRNA expression profiles represent promising biomarkers for species differentiation, treatment monitoring, and assessing cardiac complications in Chagas disease, with broader diagnostic applications emerging for leishmaniasis. Full article

Inflammatory Bowel Diseases (IBDs), including Crohn’s disease (CD) and ulcerative colitis (UC), have become a growing global health concern in children and adolescents. Pediatric-onset IBD presents unique challenges compared with adult-onset forms, including more extensive disease, impaired growth, delayed puberty, and psychosocial difficulties. While biologic and targeted therapies have advanced disease control, nutritional interventions remain a central component of management. Exclusive enteral nutrition (EEN) is recognized as the first-line therapy for inducing remission in pediatric CD, offering comparable efficacy to corticosteroids with additional benefits for mucosal healing, nutritional status, and growth. Modified dietary approaches, such as partial enteral nutrition and the Crohn’s Disease Exclusion Diet (CDED), show promise for improving adherence and maintaining remission. However, dietary restrictions may lead to deficiencies and psychosocial stress, underscoring the importance of individualized, dietitian-supervised care. The role of nutrition in UC is less defined, but balanced, anti-inflammatory dietary patterns appear beneficial. This narrative review summarizes current evidence on nutritional strategies in pediatric IBD, highlighting their therapeutic potential, limitations, and integration with pharmacologic treatment within a multidisciplinary framework aimed at optimizing outcomes and quality of life. Full article

Background: Nurses experience substantial anxiety and depression; robust, validated instruments are needed. We aimed to identify tools used to assess these conditions in nurses. Methods: A systematic review was conducted in December 2024 and registered in OSF and PROSPERO. MEDLINE, Embase, CINAHL, and PsycINFO were searched for quantitative studies (2014–2024) in English/Spanish that included nurses only and used standardized measures. Two reviewers screened and extracted the data; quality was appraised with JBI checklists, narrative synthesis only. Results: Twenty-two studies (n = 10,710 nurses) met the criteria. Most were cross-sectional with non-probability sampling; the overall risk of bias was moderate in 19 studies and high in 3. The most frequently used instruments were PHQ-9, GAD-7, GHQ-28, and BDI; across versions, PHQ (PHQ-2/PHQ-9) predominated. Heterogeneity precluded meta-analysis. Discussion: The available tools support routine screening in nursing populations, but reliance on self-reports and scarce formal cross-cultural validation in practicing nurses limit inference and generalizability. Conclusions: Screening programs in nursing should pair brief self-report instruments with objective indicators and standardized protocols; future studies should prioritize contextualized validation and robust longitudinal designs. Full article

Background and Objectives: Population rapid growth and demographic shift is leading to a rise in neurodegenerative disorders such as dementia and mild cognitive impairment (MCI). Evidence indicates that MCI is not the earliest phase of prodromal AD. Subjective Memory Decline (SMD) refers to a self-perceived decline in cognitive abilities compared to previous functioning levels in individuals with normal cognition. Language impairment represents a critical marker of neurodegenerative disorders and early memory decline in healthy older adults. Methods: This review was conducted in accordance with PRISMA Statement guidelines. The inclusion criteria of the selection process were set as follows: (1) All studies analyzed spontaneous speech samples in individuals with SMD or individuals with +αβ amyloid. (2) Studies reported language performance indicators (e.g., lexical, syntactic, semantic, phonetic, or fluency measures) derived from spontaneous speech. (3) The study population included participants with SMD based on recognized diagnostic criteria or self-reported cognitive complaints without objective cognitive impairment. (4) Studies were written in English. (5) The time frame of studies was 5 years. Results: The present work is a review of speech features—particularly from spontaneous and narrative speech—and methods that can serve as sensitive indicators of early cognitive changes due to AD pathology. Conclusions: Spontaneous speech analysis, through acoustic and temporal parameters such as silence duration, phrasal segment length, and speech segment frequency, offers a rich window into the subtle cognitive and linguistic changes that reflect early memory decline in healthy older adults. Spontaneous speech performance could be a scalable, low-cost, and non-invasive diagnostic tool in proactive cognitive health. Full article

Celiac disease (CD) is a chronic autoimmune condition traditionally recognized for its gastrointestinal symptoms. However, growing evidence indicates that CD can also affect social and emotional health, particularly among children. This narrative review explores how the autoimmunity of CD may contribute to social–emotional dysregulation through mechanisms such as neuroinflammation, nutrient deficiencies, and disruption of the gut–brain axis. It summarizes the current literature on anxiety, attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and autism spectrum disorder (ASD), highlighting how immune dysregulation may influence children’s social–emotional wellbeing. Delayed diagnosis, poor dietary adherence, and ongoing inflammation were recognized among children with social–emotional dysregulation. While digestive problems are commonly recognized and treated, social–emotional dysregulation among children with CD is frequently overlooked. However, a gluten-free diet without a confirmed diagnosis of CD is not sufficient to improve social–emotional outcomes. Children presenting with social–emotional dysregulation and clinical features suggestive of CD should be screened using standard serology and, when indicated, biopsy. Starting a gluten-free diet (GFD) without a confirmed diagnosis is not recommended. While mechanistic pathways are described, most evidence remains observational and clinically descriptive, underscoring the need for longitudinal and experimental studies to understand the intersectionality of CD with social–emotional dysregulation. Full article