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22 pages, 1701 KB  
Review
Catalase Functions and Glycation: Their Central Roles in Oxidative Stress, Metabolic Disorders, and Neurodegeneration
by Fahad A. Alhumaydhi, Hina Younus and Masood Alam Khan
Catalysts 2025, 15(9), 817; https://doi.org/10.3390/catal15090817 (registering DOI) - 27 Aug 2025
Abstract
Catalase, a pivotal antioxidant enzyme, plays a central role in converting hydrogen peroxide (H2O2) into oxygen and water, thereby safeguarding cells from oxidative damage. In patients with diabetes, obesity, Alzheimer’s disease (AD), and Parkinson’s disease (PD), catalase becomes increasingly [...] Read more.
Catalase, a pivotal antioxidant enzyme, plays a central role in converting hydrogen peroxide (H2O2) into oxygen and water, thereby safeguarding cells from oxidative damage. In patients with diabetes, obesity, Alzheimer’s disease (AD), and Parkinson’s disease (PD), catalase becomes increasingly susceptible to non-enzymatic glycation, resulting in enzyme inactivation, oxidative stress, and defective mitochondrial function. This review uniquely emphasizes catalase glycation as a converging pathological mechanism that bridges metabolic and neurodegenerative disorders, underscoring its translational significance beyond prior general reviews on catalase function. In patients with metabolic diseases, glycation impairs β-cell function and insulin signaling, while in patients with neurodegeneration, it accelerates protein aggregation, mitochondrial dysfunction, and neuroinflammation. Notably, the colocalization of glycated catalase with amyloid-β and α-synuclein highlights its potential role in protein aggregation and neuronal toxicity, a mechanism not previously addressed. Therapeutically, targeting catalase glycation opens up new avenues for intervention. Natural and synthetic agents can be used to protect catalase activity by modulating glyoxalase activity, heme integrity, or carbonyl stress. Vitamins C and E, along with agents like sulforaphane and resveratrol, exert protection through complementary mechanisms, beyond ROS scavenging. Moreover, novel strategies, including Nrf2 activation and receptor for advanced glycation end products (RAGE) inhibition, are showing promise in restoring catalase activity and halting disease progression. By focusing on glycation-specific mechanisms and proposing targeted therapeutic approaches, this review positions catalase glycation as a novel and clinically relevant molecular target in patients with chronic diseases and a viable candidate for translational research aimed at improving clinical outcomes. Full article
(This article belongs to the Section Biocatalysis)
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20 pages, 2384 KB  
Article
Comprehensive Assessment of Prognostic Factors for Immune-Related Adverse Events in Immune Checkpoint Inhibitor-Treated Melanoma
by Julian Kött, Myriam Merkle, Lina Bergmann, Noah Zimmermann, Tim Zell, Isabel Heidrich, Glenn Geidel, Klaus Pantel, Stefan W. Schneider, Christoffer Gebhardt and Daniel J. Smit
Cancers 2025, 17(17), 2806; https://doi.org/10.3390/cancers17172806 (registering DOI) - 27 Aug 2025
Abstract
Background: Immune checkpoint inhibition (ICI) is the standard treatment for advanced melanoma patients. Despite its high efficacy compared to previous treatment options, immune-related adverse events (irAEs) occur frequently. While most of the patients experience mild to moderate irAEs, some patients develop severe [...] Read more.
Background: Immune checkpoint inhibition (ICI) is the standard treatment for advanced melanoma patients. Despite its high efficacy compared to previous treatment options, immune-related adverse events (irAEs) occur frequently. While most of the patients experience mild to moderate irAEs, some patients develop severe to lethal irAEs under ICI treatment; hence, biomarkers are urgently required. Methods: In this retrospective single-center study, 157 advanced melanoma patients treated with ICI at the University Medical Center Hamburg–Eppendorf were included. IrAEs were correlated with clinico-pathological parameters, disease-related outcomes, and irAE-free survival. Results: In our cohort, 130 out of 157 patients receiving immunotherapy experienced irAE, of which more than half experienced irAE Grade ≥ 3. The most common irAE independent of its grade included cutaneous irAE, colitis, endocrine irAE, and hepatitis. Patients experiencing irAE had significantly longer progression-free survival (PFS) and overall survival (OS) compared to patients who did not experience irAE under ICI therapy. Stratification by irAE groups revealed that musculoskeletal irAEs are associated with the longest, whereas myocarditis is associated with the shortest OS and PFS. IrAE was a significant beneficial prognosticator for PFS in univariate, but not in multivariate Cox regression analysis. With respect to OS, the occurrence of irAE was an independent prognostic factor among ECOG status ≥ 2 and uveal melanoma. ROC analysis demonstrated that D-dimers have moderate predictive capability for irAE occurrence. Cox regression analysis demonstrated that elevated D-dimers and PD-1 monotherapy vs. CTLA-4 and PD-1 combination regimen are the only independent prospective prognostic markers for irAE-free survival. Conclusions: Our study demonstrates that different irAE across the irAE spectrum have a different impact on the PFS and OS of advanced melanoma patients. D-dimers may be used as a blood-based biomarker for irAE prediction, warranting future validation in multi-center studies. Full article
(This article belongs to the Section Cancer Immunology and Immunotherapy)
32 pages, 3817 KB  
Article
Unraveling the Strange Case of the First Canarian Land Fauna (Lower Pliocene)
by Antonio Sánchez-Marco, Romain Amiot, Delphine Angst, Salvador Bailon, Juan Francisco Betancort, Eric Buffetaut, Emma García-Castellano, Lourdes Guillén-Vargas, Nicolas Lazzerini, Christophe Lécuyer, Alejandro Lomoschitz, Luis Felipe López-Jurado, Àngel H. Luján, María Antonia Perera-Betancort, Manuel J. Salesa, Albert G. Sellés and Gema Siliceo
Foss. Stud. 2025, 3(3), 13; https://doi.org/10.3390/fossils3030013 - 27 Aug 2025
Abstract
Geological data of the region indicate that the Canary Islands have not been connected to the mainland before. However, fossil evidence suggests some kind of faunal exchange with Africa during the late Neogene. After extensive field work during past years, a re-evaluation of [...] Read more.
Geological data of the region indicate that the Canary Islands have not been connected to the mainland before. However, fossil evidence suggests some kind of faunal exchange with Africa during the late Neogene. After extensive field work during past years, a re-evaluation of the fossil remains of the first terrestrial vertebrates that settled and thrived on the Canary Islands is presented, with special attention to the long-debated identity of birds that laid large-sized eggs, reported some decades ago on Lanzarote Island. The age of the eggshell-bearing deposits has been recently updated as Early Pliocene (ca. 4 Ma). The dispersal mode of these terrestrial birds to reach the island was an unsolvable challenge in previous studies because the regional geography of the sea bottom was neglected, as well as the chronological succession of events in the formation of the Canary Eastern Ridge, which increased attention to a unique case of arrival of ratites on an island never before united with the mainland. The few animals found in northern Lanzarote (ratites, snakes, turtles, terrestrial snails and bite marks on eggshells pointing to a jagged and unknown large predator) probably made the sea crossing from the mainland in different ways. Two scenarios are contemplated. In both, the circumstances facilitating the faunal transit from Africa to the Canaries ceased after the early Pliocene, around 4 Ma, since these animals have never managed to cross the Canary Channel again. Full article
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13 pages, 303 KB  
Article
On Connected Subsets of a Convergence Space
by Bryan Gerardo Castro Herrejón and Frédéric Mynard
Int. J. Topol. 2025, 2(3), 13; https://doi.org/10.3390/ijt2030013 - 27 Aug 2025
Abstract
Though a convergence space is connected if and only if its topological modification is connected, connected subsets of a convergence space differ from those of its topological modification. We explore which subsets exhibit connectedness for the convergence or for the topological modification. In [...] Read more.
Though a convergence space is connected if and only if its topological modification is connected, connected subsets of a convergence space differ from those of its topological modification. We explore which subsets exhibit connectedness for the convergence or for the topological modification. In particular, we show that connectedness of a subset is equivalent for a convergence or for its reciprocal modification and that the largest set enclosing a given connected subset of a convergence space is the adherence of the connected set for the reciprocal modification of the convergence. Full article
20 pages, 4015 KB  
Article
Geospatial Model Suggests Sterilizing Free-Roaming Domestic Cats Reduces Potential Risk of Toxoplasma gondii Infection
by Sue M. Neal, Peter J. Wolf and Melanie E. Anderson
Zoonotic Dis. 2025, 5(3), 24; https://doi.org/10.3390/zoonoticdis5030024 - 27 Aug 2025
Abstract
Although trap-neuter-return (TNR) is a popular method for managing free-roaming domestic cat populations, a common criticism is that sterilization fails to mitigate the public health risks posed by free-roaming cats. One of these risks is the environmental contamination of Toxoplasma gondii, a [...] Read more.
Although trap-neuter-return (TNR) is a popular method for managing free-roaming domestic cat populations, a common criticism is that sterilization fails to mitigate the public health risks posed by free-roaming cats. One of these risks is the environmental contamination of Toxoplasma gondii, a parasite that can be spread in the feces of actively infected felids (both domestic and wild). In healthy humans, toxoplasmosis tends to be mild or asymptomatic; however, the disease can have severe consequences (e.g., for pregnant women) and even be fatal in immunocompromised individuals. Previous research has examined the extent to which free-roaming domestic cats might contaminate sites frequented by young children (e.g., schools and parks). However, the model used included several assumptions that are not reflective of sterilized cats in an urban setting (e.g., smaller home range). By properly accounting for several key factors (e.g., reproductive status, home range), our modeling revealed considerably lower rates of potential incursions by sterilized free-roaming cats than those reported previously. More importantly, our results show that sterilization contributes to a considerable reduction in the risk of environmental contamination; TNR therefore appears to be a valuable harm reduction strategy in mitigating the risks of T. gondii infection. Full article
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14 pages, 312 KB  
Article
Methane and the Warming Blame Game
by Joseph Wheatley
Methane 2025, 4(3), 20; https://doi.org/10.3390/methane4030020 - 27 Aug 2025
Abstract
Methane emissions are responsible for approximately 0.5°C, or about 30%, of total greenhouse-gas-induced warming. For many countries, methane represents an even larger share of their overall warming footprint. Assessing the warming contributions of individual methane-emitting countries to global warming is [...] Read more.
Methane emissions are responsible for approximately 0.5°C, or about 30%, of total greenhouse-gas-induced warming. For many countries, methane represents an even larger share of their overall warming footprint. Assessing the warming contributions of individual methane-emitting countries to global warming is not straightforward due to methane’s short atmospheric lifetime and the non-linear (convex) relationship between radiative forcing and the atmospheric concentration of this gas. This study addresses this challenge using a simple climate model in combination with a warming allocation approach derived from cooperative game theory. Applying this method, the warming contributions of several high-methane-emitting countries and regional groupings are quantified relative to the early industrial period. The analysis reveals that the commonly used marginal attribution method underestimates methane-induced warming by approximately 20%. This discrepancy is due to the substantial rise in the atmospheric concentration of methane since early industrial times. Full article
15 pages, 311 KB  
Article
Aging, Sleep Disturbance and Disease Status: Cross-Sectional Analysis of the Relationships Between Sleep and Multimorbidity Across the Lifespan in a Large-Scale United States Sample
by Melissa Baker, Jillian Crocker, Barry Nierenberg and Ashley Stripling
J. Ageing Longev. 2025, 5(3), 29; https://doi.org/10.3390/jal5030029 - 27 Aug 2025
Abstract
Multimorbidity, or the presence of two or more co-occurring chronic medical conditions, is extremely prevalent within the United States (US), with disproportionately high incidence rates in individuals with minoritized identities. Sleep disturbances are an empirically supported risk factor contributing to disease status and [...] Read more.
Multimorbidity, or the presence of two or more co-occurring chronic medical conditions, is extremely prevalent within the United States (US), with disproportionately high incidence rates in individuals with minoritized identities. Sleep disturbances are an empirically supported risk factor contributing to disease status and maintenance throughout the lifespan. Given this, this study examines the relationship between disturbed sleep and multiple chronic conditions (MCCs) in adults using cross-sectional data from (n = 1013) participants enrolled in the Survey of Midlife Development in the US Study (MIDUS-2). Participants within this study were predominantly female (54.9%), white (93.2%), middle-aged (MAGE = 58 years old), and experienced multimorbidity (56.6%) by having two or more (MCHRON = 2.25) chronic health conditions in the past year. A negative binomial regression indicated that sleep disturbances significantly predict the number of chronic health conditions, with sleep-disturbed individuals reporting a 41% increase in reported health conditions (IRR = 1.407, p < 0.001). Findings suggest that disturbed sleep is significantly related to disease presence in aging populations and should be addressed through early intervention to mitigate negative health consequences. Full article
16 pages, 2734 KB  
Article
Justification of Complex Physical–Chemical Criteria for Flotation Processing Efficiency in Waste Recycling Using Paper De-Inking as an Example
by Tatyana Aleksandrova, Valentin Kuznetsov and Nikita Shlykov
AppliedChem 2025, 5(3), 20; https://doi.org/10.3390/appliedchem5030020 - 27 Aug 2025
Abstract
In this work, a set of methods for the study of the physical–chemical properties of flotation processing products was applied to establish parameters for the technological mode of anthropogenic raw material flotation processing using waste paper as an example. The proposed methods include [...] Read more.
In this work, a set of methods for the study of the physical–chemical properties of flotation processing products was applied to establish parameters for the technological mode of anthropogenic raw material flotation processing using waste paper as an example. The proposed methods include the criterion Ef estimation, which characterizes the interfacial characteristics during flotation, and the criterion J determination, which characterizes the degree of purification of the obtained paper mass. The estimation of criterion Ef is based on the measurement of electric potential difference during flotation. The estimation of criterion J is based on spectrophotometric studies of the flotation product’s optical properties. Based on dispersion analysis, it was established that the proposed criteria are statistically dependent on the variation of the flotation purification mode parameters. The results of the study of flotation processing products show that the criterion Ef is sensitive to the recovery selectivity of dye particles in the froth product. In conjunction with the criterion of optical purity, J, it can be used to assess the effectiveness of proposed solutions of hardware design and the technological mode of flotation separation. Full article
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20 pages, 1484 KB  
Article
Novel Computed Tomography Perfusion and Laboratory Indices as Predictors of Long-Term Outcome and Survival in Acute Ischemic Stroke
by Eray Halil, Kostadin Kostadinov, Nikoleta Traykova, Neli Atanasova, Kiril Atliev, Elizabet Dzhambazova and Penka Atanassova
Neurol. Int. 2025, 17(9), 136; https://doi.org/10.3390/neurolint17090136 - 27 Aug 2025
Abstract
Background/Objectives: Acute ischemic stroke is a leading cause of mortality and long-term disability globally, with limited reliable early predictors of functional outcomes and survival. This study aimed to assess the prognostic value of two novel predictors: the hypoperfusion intensity ratio calculated from mean [...] Read more.
Background/Objectives: Acute ischemic stroke is a leading cause of mortality and long-term disability globally, with limited reliable early predictors of functional outcomes and survival. This study aimed to assess the prognostic value of two novel predictors: the hypoperfusion intensity ratio calculated from mean transit time and time-to-drain maps (HIR-MTT–TTD), derived from computed tomography perfusion (CTP) imaging parameters, and the Inflammation–Coagulation Index (ICI), which integrates systemic inflammatory (C-reactive protein and white blood cell count) and hemostatic (D-dimer) markers. Methods: This prospective, single-center observational study included 60 patients with acute ischemic stroke treated with intravenous thrombolysis and underwent pre-treatment CTP imaging. HIR-MTT–TTD evaluated collateral status and perfusion deficit severity, while ICI integrated C-reactive protein (CRP), white blood cell (WBC) count, and D-dimer levels. Functional outcomes were assessed using the National Institutes of Health Stroke Scale (NIHSS), Barthel Index, and modified Rankin Scale (mRS) at 24 h, 3 months, and 1 year. Results: Of 60 patients, 53.3% achieved functional independence (mRS 0–2) at 1 year. Unadjusted Cox models showed HIR-MTT–TTD (HR = 6.25, 95% CI: 1.48–26.30, p = 0.013) and ICI (HR = 1.08, 95% CI: 1.00–1.17, p = 0.052) were associated with higher 12-month mortality, worse mRS, and lower Barthel scores. After adjustment for age, BMI, smoking status, and sex, these associations became non-significant (HIR-MTT–TTD: HR = 2.83, 95% CI: 0.37–21.37, p = 0.314; ICI: HR = 1.07, 95% CI: 0.96–1.19, p = 0.211). Receiver operating characteristic (ROC) analysis indicated moderate predictive value, with ICI (AUC = 0.756, 95% CI: 0.600–0.867) outperforming HIR-MTT–TTD (AUC = 0.67, 95% CI: 0.48–0.83) for mortality prediction. Conclusions: The study introduces promising prognostic tools for functional outcomes. Elevated HIR-MTT–TTD and ICI values were independently associated with greater initial stroke severity, poorer functional recovery, and increased 1-year mortality. These findings underscore the prognostic significance of hypoperfusion intensity and systemic thrombo-inflammation in acute ischemic stroke. Combining the use of the presented indices may enhance early risk stratification and guide individualized treatment strategies. Full article
(This article belongs to the Section Movement Disorders and Neurodegenerative Diseases)
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19 pages, 3496 KB  
Article
Sulbactam: A β–Lactam Compound with Neuroprotective Effects in Epilepsy
by Fang-Chia Chang, Chiung-Hui Liu, Wen-Chieh Liao, Yu-Shiuan Tzeng, Ru-Yin Tsai, Li-Ho Tseng, Ching-Sui Hung, Shey-Lin Wu and Ying-Jui Ho
Neurol. Int. 2025, 17(9), 135; https://doi.org/10.3390/neurolint17090135 - 27 Aug 2025
Abstract
Background: The pathophysiology of epilepsy is characterized by increased neuronal activity due to an excess of the excitatory neurotransmitter glutamate and a deficiency in the inhibitory neurotransmitter gamma–aminobutyric acid (GABA). Epilepsy presents with seizures, neuronal loss, and hyperactivity in the subthalamic nucleus (STN). [...] Read more.
Background: The pathophysiology of epilepsy is characterized by increased neuronal activity due to an excess of the excitatory neurotransmitter glutamate and a deficiency in the inhibitory neurotransmitter gamma–aminobutyric acid (GABA). Epilepsy presents with seizures, neuronal loss, and hyperactivity in the subthalamic nucleus (STN). Astrocytes play a crucial role by absorbing extracellular glutamate through glutamate transporter–1 (GLT–1), thereby reducing neuronal excitation. Upregulating the expression of astrocytic GLT–1 is a promising therapeutic strategy for epilepsy. Sulbactam (SUL), a β–lactam antibiotic, has been demonstrated to exert neuroprotective effects by upregulating GLT–1 expression. Objectives: This study investigated the impact of SUL on neuronal and behavioral changes in epilepsy by using a pentylenetetrazol (PTZ)-induced rat model of epilepsy. Methods: Rats were treated with saline, SUL (50 and 150 mg/kg), or a combination of SUL and the GLT–1 blocker dihydrokainate (DHK) for 20 days. Subsequently, behavioral tasks were conducted to assess recognition, anxiety, and memory. Results: Histological analyses revealed that SUL ameliorated neuronal deficits, increased astrocytic GLT–1 expression, and reduced hyperactivity in the STN. Additionally, SUL promoted astrocyte proliferation, indicating a new dimension of its neuroprotective properties. However, the beneficial effects of SUL were prevented by DHK. Conclusions: This pioneering study highlights multiple benefits of SUL, including seizure suppression, increased GLT–1 expression, and astrocyte proliferation, underscoring its high potential as a treatment for epilepsy. Full article
(This article belongs to the Topic Applications of Biomedical Technology and Molecular Biological Approach in Brain Diseases, 2nd Edition)
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40 pages, 4926 KB  
Article
Using Artificial Intelligence to Determine the Impact of E-Commerce on the Digital Economy
by Florin Cornel Dumiter and Klaus Bruno Schebesch
J. Theor. Appl. Electron. Commer. Res. 2025, 20(3), 219; https://doi.org/10.3390/jtaer20030219 - 27 Aug 2025
Abstract
E-commerce indicators are very complex and have a wide range of levels of complexity and applications. The digital economies that we are oriented towards also have complex features in terms of consumers and businesses. The research objectives are focused on determining the impact [...] Read more.
E-commerce indicators are very complex and have a wide range of levels of complexity and applications. The digital economies that we are oriented towards also have complex features in terms of consumers and businesses. The research objectives are focused on determining the impact of e-commerce on the digital economy within countries with different stages of economic development, digitalization techniques, and e-commerce usage. This study evaluates how AI-based clustering reveals patterns in the e-commerce indicators influencing the digital economy. The research methods used are focused on AI techniques in order to evaluate and assess the usage of e-commerce in the digital economy. In this sense, the methods used in this research are clustering techniques in order to determine the stage of implementation of the digital economy. The research implications have a worldwide impact and soundness in establishing the evolution of the e-economy in different types of countries with different stages and levels of digitalization and different e-commerce development paths. The empirical results show there are significant differences between countries due to cultural, economic, social, and judicial differences. The conclusions of this study highlight that using AI techniques can be a solution for enhancing future digital economy development and labor market consolidation, especially by strengthening e-commerce indicator usage and application. Full article
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12 pages, 450 KB  
Entry
Problem-Based Learning Beyond Teaching: Case of Social Science Education in Latvia
by Linda Veliverronena, Ilze Grinfelde, Zane Kudure and Ilgvars Abols
Encyclopedia 2025, 5(3), 131; https://doi.org/10.3390/encyclopedia5030131 - 27 Aug 2025
Definition
Problem-based learning (PBL) is a student-centered instruction approach focused on skills development in problem-solving, interaction, autonomy, and critical thinking to learn and act to co-create new knowledge and solutions. Rarely, but authors sometimes identify the benefits of PBL for educators, for example, by [...] Read more.
Problem-based learning (PBL) is a student-centered instruction approach focused on skills development in problem-solving, interaction, autonomy, and critical thinking to learn and act to co-create new knowledge and solutions. Rarely, but authors sometimes identify the benefits of PBL for educators, for example, by allocating instructional time more flexibly for monitoring student performance and discussing issues. However, in the era where collaboration among universities and industries is emphasized, the authors pay little attention to contextualizing PBL in a broader context, such as bringing benefits for relationship management with the industry and alumni, promoting regional development, corporate and social responsibility, marketing of educational organizations, and talent development to create a mutual benefit-based ecosystem. Academic discussions about PBL planning and implementation also neglect the needs and motivation of industry stakeholders to get involved, thus narrowing not only the possibilities for cooperation between both parties but also negatively affecting student learning outcomes, which also directly depend on industry partners. Full article
(This article belongs to the Section Social Sciences)
10 pages, 2816 KB  
Field Guide
Morphometric Characterization of Bacteria Associated with Bacteremia
by Ladees Al Hafi and Evangelyn C. Alocilja
Encyclopedia 2025, 5(3), 130; https://doi.org/10.3390/encyclopedia5030130 - 27 Aug 2025
Abstract
Among the leading causes of bacteremia are Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. E. coli and K. pneumoniae are increasingly exhibiting resistance to last-resort antibiotics, such as carbapenems. Rapid and accurate identification of these pathogens is critical for timely [...] Read more.
Among the leading causes of bacteremia are Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. E. coli and K. pneumoniae are increasingly exhibiting resistance to last-resort antibiotics, such as carbapenems. Rapid and accurate identification of these pathogens is critical for timely treatment and infection control. This paper aimed to develop a computer-aided bacterial morphometric technique for identifying and classifying wild-type E. coli, K. pneumoniae, and S. aureus in a field guide fashion. A 3D laser scanning confocal microscope was used to gather key parameters of each organism: length (L, µm), circular diameter (CD, µm), volume (V, µm3), surface area-to-cross-sectional area ratio (SA/CSA, unitless), surface uniformity ratio (Str), and surface texture ratio (Sdr). Microscope images and measurement results showed that S. aureus was spherical with the shortest length (1.08 µm) and smallest volume (0.52 µm3). E. coli and K. pneumoniae were rod-shaped with lengths >2.0 µm and volumes >1.0 µm3. Carbapenem-resistant (CR) strains exhibited larger volumes than their wild-type counterparts. Surface parameters further differentiated strains: wild-type E. coli had a greater surface texture or a less smooth surface (larger Sdr) than K. pneumoniae (lower Sdr) did. CR E. coli had more surface uniformity (lower Str) than CR K. pneumoniae did. A dichotomous key based on shape, circular diameter, volume, length, and surface characteristics was developed to classify the species using a series of paired, contrasting features. This morphometric analysis can aid researchers in quickly identifying bacteria, leading to faster diagnosis of life-threatening diseases and improved treatment decisions. Full article
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14 pages, 652 KB  
Article
Outcome Analysis of Intensive Pulmonary Rehabilitation in Patients with COPD Exacerbation and Acute Respiratory Failure: A Single-Center Audit Aligned with Italian National Guidelines
by Luigi Di Lorenzo, Andrea Esposito, Nicola Pirraglia, Chiara Capaldi, Gianleno De Vita and Carmine D’Avanzo
Physiologia 2025, 5(3), 27; https://doi.org/10.3390/physiologia5030027 - 27 Aug 2025
Abstract
Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and acute respiratory failure (ARF) are leading causes of hospitalization and functional decline in Italy, posing a significant burden on the healthcare system. In 2024, new national guidelines mandated the use of Intensive Care [...] Read more.
Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and acute respiratory failure (ARF) are leading causes of hospitalization and functional decline in Italy, posing a significant burden on the healthcare system. In 2024, new national guidelines mandated the use of Intensive Care Rehabilitation Units (ICRUs) within MDC4 to provide structured post-acute respiratory rehabilitation. Objective: This study aimed to evaluate functional outcomes in patients with AECOPD and ARF treated in a single ICRU, assessing the effectiveness of guideline-based rehabilitation protocols. Methods: A retrospective audit was conducted on patients admitted in 2024 to a dedicated ICRU. Functional outcomes were assessed using the Barthel Index, Six-Minute Walking Test (6MWT), and Rehabilitation Complexity Index (RCI-e13). Correlation analyses were performed to explore relationships between baseline status, rehabilitation progression, and discharge outcomes. Results: Thirty-six patients were included. Significant improvements were observed across all scales from admission to discharge. The Barthel Index showed a strong positive correlation between initial and final scores (r = 0.72), while the 6MWT indicated a similarly robust correlation (r = 0.73). Greater functional gains were noted among patients with lower baseline scores, especially in mobility. The RCI-e13 reflected decreased clinical complexity by discharge, with moderate correlations to baseline severity. Age moderately correlated with length of stay (r = 0.30), but not with outcome scores. Conclusions: The implementation of early, intensive rehabilitation in an ICRU setting—aligned with Italy’s 2024 national guidelines—led to measurable functional improvements in patients with AECOPD and ARF. These findings support the utility of structured outcome monitoring and reinforce the role of ICRUs in optimizing post-acute care pathways within respiratory rehabilitation services. Full article
(This article belongs to the Special Issue Feature Papers in Human Physiology—3rd Edition)
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19 pages, 5636 KB  
Article
Complete Workflow for ER-IHC Pathology Database Revalidation
by Md Hadayet Ullah, Md Jahid Hasan, Wan Siti Halimatul Munirah Wan Ahmad, Mohammad Faizal Ahmad Fauzi, Zaka Ur Rehman, Jenny Tung Hiong Lee, See Yee Khor and Lai-Meng Looi
AI 2025, 6(9), 204; https://doi.org/10.3390/ai6090204 - 27 Aug 2025
Abstract
Computer-aided systems can assist doctors in detecting cancer at an early stage using medical image analysis. In estrogen receptor immunohistochemistry (ER-IHC)-stained whole-slide images, automated cell identification and segmentation are helpful in the prediction scoring of hormone receptor status, which aids pathologists in determining [...] Read more.
Computer-aided systems can assist doctors in detecting cancer at an early stage using medical image analysis. In estrogen receptor immunohistochemistry (ER-IHC)-stained whole-slide images, automated cell identification and segmentation are helpful in the prediction scoring of hormone receptor status, which aids pathologists in determining whether to recommend hormonal therapy or other therapies for a patient. Accurate scoring can be achieved with accurate segmentation and classification of the nuclei. This paper presents two main objectives: first is to identify the top three models for this classification task and establish an ensemble model, all using 10-fold cross-validation strategy; second is to detect recurring misclassifications within the dataset to identify “misclassified nuclei” or “incorrectly labeled nuclei” for the nuclei class ground truth. The classification task is carried out using 32 pre-trained deep learning models from Keras Applications, focusing on their effectiveness in classifying negative, weak, moderate, and strong nuclei in the ER-IHC histopathology images. An ensemble learning with logistic regression approach is employed for the three best models. The analysis reveals that the top three performing models are EfficientNetB0, EfficientNetV2B2, and EfficientNetB4 with an accuracy of 94.37%, 94.36%, and 94.29%, respectively, and the ensemble model’s accuracy is 95%. We also developed a web-based platform for the pathologists to rectify the “faulty-class” nuclei in the dataset. The complete flow of this work can benefit the field of medical image analysis especially when dealing with intra-observer variability with a large number of images for ground truth validation. Full article
(This article belongs to the Section Medical & Healthcare AI)
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15 pages, 662 KB  
Article
Examining the Mediation Effect of Anti-Citizen Behaviour in the Link Between Job Insecurity and Organizational Performance: Empirical Evidence from Tunisian Hotels
by Nadir Aliane, Hassane Gharbi and Abu Elnasr E. Sobaih
Tour. Hosp. 2025, 6(4), 162; https://doi.org/10.3390/tourhosp6040162 - 27 Aug 2025
Abstract
Grounded in Social Exchange Theory (SET) and Conservation of Resources (COR) theory, this study tests the influence of job insecurity (JI) on organisational, particularly hotel, performance (OP) via the adoption of anti-social behaviour (ACB). To this end, responses were collected from 429 employees [...] Read more.
Grounded in Social Exchange Theory (SET) and Conservation of Resources (COR) theory, this study tests the influence of job insecurity (JI) on organisational, particularly hotel, performance (OP) via the adoption of anti-social behaviour (ACB). To this end, responses were collected from 429 employees working in three renowned five-star hotels in Hammamet, Tunisia. By analysing the data with AMOS (v.25), we found that the research hypotheses were confirmed. The results showed, on one hand, that JI significantly and negatively affects OP and, on the other hand, significantly and positively affects ACB, which, in turn, significantly and negatively affects OP. Additionally, the link between JI and OP became insignificant post the initiation of ACB as a mediator. As a result, we found that ACB fully mediates the link between JI and OP. This undoubtedly shows that when employees experience JI, they adopt ACB to restore equilibrium, with adverse consequences for hotel performance. In addition to the theoretical implications, managerial recommendations for practitioners are presented. Full article
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16 pages, 654 KB  
Article
Control-Oriented and Escape-Oriented Coping: Links to Social Support and Mental Health in Early Adolescents
by Megan Cherewick, Madison R. Davenport, Rinzi Lama, Priscilla Giri, Dikcha Mukhia, Roshan P. Rai, Christina M. Cruz and Michael Matergia
Eur. J. Investig. Health Psychol. Educ. 2025, 15(9), 172; https://doi.org/10.3390/ejihpe15090172 - 27 Aug 2025
Abstract
This study examined the factor structure of the Kidcope and its associations with social support, psychological symptoms, and mental wellbeing among early adolescents (ages 10–14) in Darjeeling, India. Confirmatory factor analysis supported a two-factor structure: control-oriented and escape-oriented coping. Multivariable regression and structural [...] Read more.
This study examined the factor structure of the Kidcope and its associations with social support, psychological symptoms, and mental wellbeing among early adolescents (ages 10–14) in Darjeeling, India. Confirmatory factor analysis supported a two-factor structure: control-oriented and escape-oriented coping. Multivariable regression and structural equation models indicated escape-oriented coping was associated with higher emotional symptoms (b = 3.19; p ≤ 0.001) and peer problems (b = 1.43; p ≤ 0.003), whereas control-oriented coping was linked with lower conduct problems (b = −1.11; p = 0.006), and hyperactivity (b = −1.28; p = 0.001). Control-oriented coping also correlated with higher mental wellbeing (b = 11.59; p = 0.004), prosocial behavior (b = 0.50; p ≤ 0.001), and resilience (b = 4.49; p ≤ 0.001). Results suggest control-oriented coping mediates 23% of the total effect of social support on psychological difficulties and 15% on resilience. Findings highlight early adolescence as a sensitive window for strengthening coping skills to protect mental health and enhance wellbeing in high-adversity settings. Full article
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14 pages, 559 KB  
Article
Emotion Regulation as a Predictor of Disordered Eating Symptoms in Young Female University Students
by Marina Rojas-Valverde and Elena Felipe-Castaño
Eur. J. Investig. Health Psychol. Educ. 2025, 15(9), 171; https://doi.org/10.3390/ejihpe15090171 - 27 Aug 2025
Abstract
Eating disorders are characterised by concerns about food, body image, and weight control and/or reduction. They are more frequently described in women, and emotion regulation plays a central role in both their development and persistence. The aim of this study was to analyse [...] Read more.
Eating disorders are characterised by concerns about food, body image, and weight control and/or reduction. They are more frequently described in women, and emotion regulation plays a central role in both their development and persistence. The aim of this study was to analyse the sensitivity and specificity of emotion regulation in predicting disordered eating symptoms in a sample of female university students. Non-probabilistic sampling was used to recruit 558 female university students, with a mean age of 20.63 years (SD = 1.88). An adaptation in Spanish of the Difficulties in Emotion Regulation Scale (DERS) and the Spanish version of the Eating Disorder Examination Questionnaire (S-EDE-Q) were administered. The findings suggested that scores related to emotion dysregulation, emotional rejection, and emotional interference may help distinguish women with disordered eating symptoms associated with food restriction and eating concerns. It is important to have sensitive tools that can identify at-risk populations as well as relevant psychological constructs linked to eating disorders when developing intervention programmes. Full article
(This article belongs to the Special Issue Risky Behaviors Among Youth: Assessment, Prevention, and Intervention)
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16 pages, 643 KB  
Article
The Impact of Basal Inflammatory Status on Post-CABG Atrial and Ventricular Ectopy and Remodeling Pathways
by Dan-Alexandru Cozac, Cristina Somkereki, Adina Huțanu, Tunde Renata Nicoara and Alina Scridon
Medicina 2025, 61(9), 1545; https://doi.org/10.3390/medicina61091545 - 27 Aug 2025
Abstract
Background and Objectives: Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) commonly occur after coronary artery bypass grafting (CABG) surgery, with frequent ectopics linked to atrial fibrillation risk and reduced heart function. While CABG-induced inflammation causes arrhythmogenic changes, the connection between preoperative [...] Read more.
Background and Objectives: Premature atrial contractions (PACs) and premature ventricular contractions (PVCs) commonly occur after coronary artery bypass grafting (CABG) surgery, with frequent ectopics linked to atrial fibrillation risk and reduced heart function. While CABG-induced inflammation causes arrhythmogenic changes, the connection between preoperative inflammatory markers and postoperative ectopic burden has not been studied. Therefore, the aim of the present study is to evaluate the association between preoperative inflammatory biomarkers and postoperative atrial and ventricular ectopic burden, and to determine their influence on clinical outcomes following elective CABG procedures. Materials and methods: This study assessed preoperative plasma levels of highly sensitive C-reactive protein (hs-CRP), von Willebrand factor (vWF), transforming growth factor-β (TGF-β), interleukin (IL)-2, IL-1β, IL-6, IL-8, and vascular endothelial growth factor (VEGF) using the Multiplex technique in patients undergoing elective CABG. A continuous 24-h ECG Holter monitoring was performed one day before CABG, as well as on days 2, 3, and 4 post-CABG. The PACs and PVCs burdens were quantified, and correlations with clinical parameters were analyzed. Results: Preoperative plasma concentrations of vWF, TGF-β, and IL-8 exhibited significant positive correlations with postoperative PACs (p < 0.001, p = 0.03, and p < 0.001, respectively). Preprocedural hs-CRP, TGF-β, IL-6, and IL-8 levels showed significant positive associations with PVCs (p < 0.0001, p < 0.0001, p = 0.02, and p < 0.0001, respectively). However, none of the tested biomarkers could predict other postoperative outcomes, such as acute kidney injury, acute liver failure, duration of inotropic support, and days of hospitalization. Conclusions: Preoperative inflammatory biomarkers may serve as predictive tools for postoperative ectopic activity following CABG. Early identification of high-risk patients could enable prophylactic strategies and improve post-CABG outcomes. Full article
(This article belongs to the Special Issue Cardiovascular Disease: From Clinical Diagnosis to Management and Treatment)
15 pages, 1018 KB  
Article
Development and Validation of a NEWS2-Enhanced Multivariable Prediction Model for Clinical Deterioration and In-Hospital Mortality in Hospitalized Adults
by Sofia Lo Conte, Guido Fruscoloni, Alessandra Cartocci, Martin Vitiello, Maria Francesca De Marco, Gabriele Cevenini and Paolo Barbini
Medicina 2025, 61(9), 1543; https://doi.org/10.3390/medicina61091543 - 27 Aug 2025
Abstract
Background and Objectives: Early identification of patients at risk of clinical deterioration is essential for optimizing therapeutic management and improving outcomes in general medicine wards. The National Early Warning Score 2 (NEWS2) is a validated tool for predicting patient worsening but integrating [...] Read more.
Background and Objectives: Early identification of patients at risk of clinical deterioration is essential for optimizing therapeutic management and improving outcomes in general medicine wards. The National Early Warning Score 2 (NEWS2) is a validated tool for predicting patient worsening but integrating it with additional clinical and demographic data can enhance its predictive accuracy and support timely clinical decisions. Material and methods: In this retrospective cohort study, 2108 patients admitted to the general medicine department of the University Hospital of Siena were analyzed. Logistic regression models incorporating NEWS2 alongside key clinical variables—including age, presence of central venous catheter (CVC), and functional status measured by the Barthel Index—were developed to predict high clinical risk (HCR) and mortality. Model performance was assessed using the area under the ROC curve (AUC). Results: High clinical risk status developed in 29% of patients. Older age, presence of CVC, lower Barthel Index, and higher NEWS2 scores were significantly associated with both HCR and mortality. The integrated predictive model demonstrated good accuracy, with an AUC of 0.798 for HCR and 0.716 for mortality prediction. Conclusions: This study suggests that NEWS2, when combined with additional patient-specific variables from the electronic health record, can become a more sophisticated tool for early risk stratification. Such a tool has the potential to support timely clinical intervention and optimized therapeutic management, potentially contributing to improved patient outcomes. While the model may indirectly support nurse workload balancing by identifying patients requiring intensified care, its ultimate impact on patient outcomes requires confirmation through prospective studies. Full article
(This article belongs to the Section Epidemiology & Public Health)
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11 pages, 694 KB  
Article
Impact of Adipokine Expression on Tumor Characteristics and Survival Outcomes in Patients with Renal Cell Carcinoma
by Oktay Halit Aktepe, Tugce Ulasli, Aytac Terzi, Fatma Gundogdu, Eda Caliskan Yildirim, Ahmet Melih Arslan, Huseyin Salih Semiz, Kemal Kosemehmetoglu, Aziz Karaoglu, Mustafa Erman and Suayib Yalcin
Medicina 2025, 61(9), 1544; https://doi.org/10.3390/medicina61091544 - 27 Aug 2025
Abstract
Background and Objectives: To investigate the clinical significance of adipokines’ [leptin, leptin receptor (leptin-R), adiponectin, and resistin] expression on the characteristics and survival outcomes of patients with renal cell carcinoma (RCC). Materials and Methods: A total of 81 patients were included. [...] Read more.
Background and Objectives: To investigate the clinical significance of adipokines’ [leptin, leptin receptor (leptin-R), adiponectin, and resistin] expression on the characteristics and survival outcomes of patients with renal cell carcinoma (RCC). Materials and Methods: A total of 81 patients were included. The expressions of adipokines in the nephrectomy material of the patients were assessed using immunohistochemistry. Staining patterns were divided into two groups for statistical analyses: negative (no staining) and positive. Univariable and multivariable Cox regression models were used to evaluate the impact of the expression of adipokines on the survival outcomes of the patients. Results: The percentages of patients expressing leptin, leptin-R, adiponectin, and resistin were 36.4%, 30.7%, 32%, and 60.2%, respectively. The median overall survival (OS) of all patients was 53.7 months (95% confidence interval [CI]: 39.9–67.5). In the multivariate analyses, only leptin expression status was associated with OS among adipokines (hazard ratio [HR]: 1.98, 95%CI: 1.03–3.78, p = 0.039) in addition to the presence of distant metastasis (HR: 2.48, 95%CI: 1.16–5.29, p = 0.018). No significant associations were determined between adipokine expression and pathologic determinants of RCC, including tumor stage, grade, and histological subtype. Conclusions: Our study demonstrated that leptin expression was an independent prognostic factor for inferior OS in RCC patients treated with nephrectomy, even after adjusting for disease stage in multivariate analysis. Full article
(This article belongs to the Section Oncology)
10 pages, 417 KB  
Review
The Journey of Sentinel Lymph Node Biopsy in Cutaneous Melanoma: A Brief Narrative Review from Scalpel to Smart Tech
by Rǎzvan Ioan Andrei, Silviu Cristian Voinea, Cristian Ioan Bordea, Aniela Roxana Nodiți, Teodora Mihaela Peleașă and Alexandru Blidaru
Medicina 2025, 61(9), 1542; https://doi.org/10.3390/medicina61091542 - 27 Aug 2025
Abstract
Sentinel lymph node biopsy (SLNB) has transformed the management of cutaneous melanoma, emerging as a cornerstone in evaluating regional lymphatic spread while minimizing surgical morbidity. From its theoretical foundation laid by Cabanas to its refinement and clinical validation through landmark trials, SLNB has [...] Read more.
Sentinel lymph node biopsy (SLNB) has transformed the management of cutaneous melanoma, emerging as a cornerstone in evaluating regional lymphatic spread while minimizing surgical morbidity. From its theoretical foundation laid by Cabanas to its refinement and clinical validation through landmark trials, SLNB has evolved into a standard of care with significant prognostic value. This review traces the historical trajectory of SLNB, analyzes current guidelines and controversies and explores future directions. Novel imaging technologies, such as indocyanine green fluorescence and augmented reality-assisted mapping, promise to enhance accuracy and reduce invasiveness. Furthermore, the advent of effective systemic therapies and neoadjuvant protocols is reshaping the therapeutic landscape, potentially redefining the role of SLNB in melanoma management. As precision medicine advances, SLNB remains an essential procedure, with its utility continually redefined by technological innovation and evolving oncologic strategies. Full article
(This article belongs to the Section Oncology)
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17 pages, 687 KB  
Article
Association Between Current Suicidal Ideation and Personality Traits: Analysis of the Personality Inventory for DSM-5 in a Community Mental Health Sample
by Valeria Deiana, Pasquale Paribello, Federico Suprani, Andrea Mura, Carlo Arzedi, Mario Garzilli, Laura Arru, Mirko Manchia, Bernardo Carpiniello and Federica Pinna
Medicina 2025, 61(9), 1541; https://doi.org/10.3390/medicina61091541 - 27 Aug 2025
Abstract
Background and Objectives: Suicide is one of the leading causes of death worldwide. Identifying psychopathological factors and personality traits associated with suicidal ideation is crucial for improving prevention. This study investigates the association between current suicidal ideation—measured by item 4 of the [...] Read more.
Background and Objectives: Suicide is one of the leading causes of death worldwide. Identifying psychopathological factors and personality traits associated with suicidal ideation is crucial for improving prevention. This study investigates the association between current suicidal ideation—measured by item 4 of the Brief Psychiatric Rating Scale-24 items (BPRS-24)—and personality traits assessed with the Personality Inventory for DSM-5 (PID-5) in a transdiagnostic outpatient psychiatric population. The association of BPRS-24 item 4 with early traumatic experiences, attachment styles, and dissociative phenomena is also explored as a secondary objective. Materials and Methods: We propose a secondary analysis on a sample of 137 individuals receiving care at an academic community mental health center. Personality traits were assessed using the PID-5, while attachment styles were assessed with the Experiences in Close Relationships-Revised (ERC-R), childhood traumas with the Childhood Experience of Care and Abuse Questionnaire (CECA.Q), and dissociative experiences with the Dissociative Experience Scale II (DES-II). Suicidal ideation was measured with item 4 of the BPRS-24. Associations were examined using Spearman’s correlation and ordinal logistic regression models, adjusted for age, sex assigned at birth, and global clinical severity (CGI-S). Results: We found statistically significant associations between suicidal ideation and the PID-5 trait of depressivity (OR = 1.80, 95 % CI 1.23–2.63, p = 0.002, p-value adjusted Holm’s method 0.012). However, this association lost significance after adjusting for depressive symptoms (BPRS-24 item 3), suggesting a mediating role of depression. We found no significant associations with childhood trauma, attachment styles, or dissociative experiences. Conclusions: Our findings suggest a potential link between specific personality traits and suicidal ideation, mediated by depressive symptomatology. We explore how future studies may evaluate PID-5 as a clinical tool to support the identification of individuals at long-term risk of suicidality or for targeting specific populations for tailored interventions. Full article
(This article belongs to the Section Psychiatry)
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22 pages, 1072 KB  
Systematic Review
Using Computerised Gait Analysis to Assess Changes After Rehabilitation in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Gait Speed Improvement
by Mihaela Minea, Sermina Ismail, Lucian Cristian Petcu, Andreea-Dalila Nedelcu, Adina Petcu, Alexandra-Elena Minea and Mădălina-Gabriela Iliescu
Medicina 2025, 61(9), 1540; https://doi.org/10.3390/medicina61091540 - 27 Aug 2025
Abstract
Background and objectives: Knee osteoarthritis (KOA) is a degenerative joint disorder often associated with altered gait mechanics. This systematic review aims to evaluate the effect of rehabilitation treatment on walking, with a focus on gait speed. Material and methods: A systematic [...] Read more.
Background and objectives: Knee osteoarthritis (KOA) is a degenerative joint disorder often associated with altered gait mechanics. This systematic review aims to evaluate the effect of rehabilitation treatment on walking, with a focus on gait speed. Material and methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane, and PEDro databases, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Randomised controlled trials published in English between 2015 and 2025, involving patients with KOA undergoing rehabilitation and using computerised gait measurements, including 3D motion capture, force plates, and instrumented treadmills, were included. A meta-analysis was conducted on the selected studies assessing gait speed, with the risk of bias being evaluated using the Cochrane Risk of Bias 2 tool for RCTs. Results: Out of 2143 articles, 7 studies met the inclusion criteria. These studies showed increased gait speed in patients with KOA following exercise therapy, various walking training programmes, massage, or dietary interventions. The meta-analysis revealed a standardised mean difference (SMD) of 1.807, with a 95% confidence interval (CI) of [1.637, 1.977] (p < 0.001). The interventions were associated with improvements in walking parameters and quality of life, as well as reductions in pain and fall risk. Substantial heterogeneity was noted, likely due to variations in intervention types and study populations. Conclusions: The results suggest an overall improvement in gait speed in the intervention groups compared to the control groups. However, only a limited number of studies have investigated the effects of physiotherapy, bath therapy, or mud therapy on gait mechanics in patients with KOA. Full article
(This article belongs to the Special Issue Advances in Pathogenesis, Rehabilitation, and Treatment of Knee Osteoarthritis)
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3 pages, 185 KB  
Editorial
Editorial for Special Issue “Ophthalmology: New Diagnostic and Treatment Approaches”
by Stephen G. Schwartz, Krishna S. Kishor, Victor M. Villegas, Christopher T. Leffler and Andrzej Grzybowski
Medicina 2025, 61(9), 1539; https://doi.org/10.3390/medicina61091539 - 27 Aug 2025
Abstract
There have been many recent advances in the diagnosis and treatment of eye diseases [...] Full article
(This article belongs to the Special Issue Ophthalmology: New Diagnostic and Treatment Approaches)
13 pages, 465 KB  
Review
Transient-Evoked Otoacoustic Emissions May Reveal Damage to Outer Hair Cells Caused by Exposure to Recreational Noise: A Narrative Review
by Ziqi Zhou, Xingqian Shen, Linlin Wang, Xiaoye Chen, Ting Li, Bo Liu and Hongjun Xiao
Medicina 2025, 61(9), 1538; https://doi.org/10.3390/medicina61091538 - 27 Aug 2025
Abstract
Recreational noise-induced hearing loss (RNIHL) is a significant factor contributing to hearing loss in young people. Its process is irreversible, and early symptoms are hidden. Therefore, early identification is of great significance. Otoacoustic emissions (OAEs) are commonly used to detect the function of [...] Read more.
Recreational noise-induced hearing loss (RNIHL) is a significant factor contributing to hearing loss in young people. Its process is irreversible, and early symptoms are hidden. Therefore, early identification is of great significance. Otoacoustic emissions (OAEs) are commonly used to detect the function of outer hair cells. It is widely used for early diagnosis of occupational noise-induced hearing loss, but it remains underutilized in RNIHL detection. In order to explore the characteristics of RNIHL and the early detection value of different types of OAEs, this study reviewed the detection results of OAEs in previous studies on noise-induced hearing loss and analyzed the differences and causes among the studies. The study found that, through the detection of distortion product otoacoustic emissions (DPOAEs), there were differences in the sensitive frequency bands of outer hair cell damage between recreational noise and occupational noise, particularly in the high-frequency region. Transient-evoked otoacoustic emissions (TEOAEs) can fully reflect the damage to cochlear outer hair cells caused by RNIHL. This study indicates that OAEs, particularly TEOAEs, can serve as a highly sensitive and objective detection tool for RNIHL, whereas DPOAEs are more appropriate for the early screening of occupational noise-induced hearing loss. Full article
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