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Feature Papers in Medical Research: 4th Edition

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A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 26 March 2027 | Viewed by 9802

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Prof. Dr. Christian Lehmann

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Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
Interests: cannabinoids; infection; sepsis and its early indications; intravital imaging microcirculation; septic shock stroke
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Special Issue Information

Dear Colleagues,

We are grateful to the researchers who contributed to the first three volumes of this issue:

Feature Papers in Medical Research: https://www.mdpi.com/journal/life/special_issues/SK0T5PC4U2

Feature Papers in Medical Research: 2nd Edition: https://www.mdpi.com/journal/life/special_issues/9GV5QM8A9T

Feature Papers in Medical Research: 3rd Edition：https://www.mdpi.com/journal/life/special_issues/FP_Medicalv3

We are pleased to announce the upcoming publication of our Special Issue, entitled “Feature Papers in Medical Research: 4th Edition".

We aim to collect research articles and systematic reviews in all fields of medical research. Since the goal of this Special Issue is to present novel medical research, we encourage the Editorial Board Members of Life to contribute papers reflecting the latest progress in their field or to invite relevant experts and colleagues to do so.

Topics include, but are not limited to, the following:

Dermatological research;
Cancer research;
Cardiovascular research;
General medicine;
Gastroenterological research;
Hematological research;
Immunological research;
Infectious diseases research;
Metabolism and endocrinology;
Nervous system research;
Nursing;
Pediatrics;
Pulmonary research;
Psychiatric research;
Rehabilitation;
Renal and urinary research;
Reproductive research and women's health;
Rheumatological research;
Skeletal and muscular research;
Vision research.

Prof. Dr. Christian Lehmann
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

dermatological research
cancer research
cardiovascular research
general medicine
gastroenterological research
hematological research
immunological research
infectious diseases research
metabolism and endocrinology
nervous system research
nursing
pediatrics
pulmonary research
psychiatric research
rehabilitation
renal and urinary research
reproductive research and women's health
rheumatological research
skeletal and muscular research
vision research

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Published Papers (8 papers)

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Research

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13 pages, 1856 KB

Open AccessArticle

Longitudinal Assessment of Joint Health in Paediatric Haemophilia Using the HEAD-US Ultrasound Scoring System: The ULTRA Study

by Aikaterini Michalopoulou, Olympia Papakonstantinou, Athina Dettoraki, Dimitrios Syrengelas, Vassiliki Bizimi, Konstantina Dakou, Miltiades Kyprianou, Vassiliki Spoulou, Helen Pergantou and Christina Kanaka-Gantenbein

Life 2026, 16(6), 1000; https://doi.org/10.3390/life16061000 - 14 Jun 2026

Viewed by 613

Abstract

Background: Early detection of joint damage in haemophilia is essential to prevent haemophilic arthropathy. This study longitudinally evaluated joint health in paediatric patients with haemophilia in Greece using the Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) scoring system. Methods: Children aged 5–18 years with haemophilia of any severity, all receiving prophylaxis, were assessed at baseline and during longitudinal follow-up visits scheduled at 6, 12, 24, and 36 months. Evaluations included HEAD-US and Haemophilia Joint Health Score (HJHS), functional ability (PedHAL), health-related quality of life (HRQoL), and pain (BPI). Results: Forty-seven boys (mean age 11.5 ± 3.7 years) were included (severe 83%, moderate 11%, mild 6%). Baseline HEAD-US scores were low (mean ± SE: 0.22 ± 0.069). No significant overall change was observed over time, although left knee showed significant improvement (p < 0.05). Ankles consistently exhibited higher scores compared to other joints (p < 0.05). Synovitis was the most frequent abnormality, while cartilage damage was infrequent and subchondral bone changes were negligible. HEAD-US detected more abnormalities than HJHS. Conclusions: Joint health was well preserved under prophylaxis, with synovitis representing the earliest detectable change, although interpretation is limited by incomplete long-term follow-up. HEAD-US proved more sensitive than clinical assessment, supporting its role in routine longitudinal monitoring. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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11 pages, 581 KB

Open AccessArticle

Enhancing Hemophilia Care: Real-World Outcomes Following Switching to Extended Half-Life Factor VIII in Greece—The TOOL Study

by Helen Pergantou, Sofia Vakalopoulou, Efrosyni Nomikou, Marina Economou, Anna Kouramba, Aikaterini Michalopoulou, Athina Dettoraki, Eleni Moka, Alkistis Adramerina and Olga Katsarou

Life 2026, 16(6), 881; https://doi.org/10.3390/life16060881 - 25 May 2026

Viewed by 607

Abstract

Introduction: Extended half-life (EHL) factor VIII (FVIII) products aim to reduce treatment burden and improve bleeding control in hemophilia A. Real-world evidence remains essential to complement clinical trials. Aim: To evaluate clinical outcomes following switching from standard half-life (SHL) rFVIII to efmoroctocog alfa in routine clinical practice in Greece. Methods: Multicenter observational pre–poststudy including patients with moderate to severe hemophilia A. Outcomes were assessed during the 12 months before and after switching. The primary endpoint was change in annualized bleeding rate (ABR). Secondary endpoints included annualized joint bleeding rate (AjBR), infusion frequency, joint health, pain, and FVIII consumption. Results: Sixty patients were included. Following switching, ABR decreased from 6.8 to 3.2 (53%), and AjBR from 6.4 to 2.9 (55%), p < 0.001. Reductions were more pronounced in patients switching from on-demand treatment, while more modest improvements were observed among patients already on prophylaxis. HJHS significantly decreased from 17.9 to 11.5 (p < 0.007), accompanied by a decrease in pain scores (p < 0.001), in available paired subsets. Weekly infusion frequency decreased (3.2 to 2.2; p < 0.001), while mean dose per infusion increased, resulting in no consistent reduction in total annual FVIII consumption. No inhibitor or treatment-related adverse events have been observed. Conclusions: Switching to efmoroctocog alfa in routine practice was associated with improved bleeding outcomes, reduced infusion frequency, and better joint-related parameters. These findings support the real world feasibility and clinical utility οf EHL FVIII therapy, while further controlled studies are needed to better define the independent effect of product switching from changes in treatment regimen and other potential confounders. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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13 pages, 760 KB

Open AccessArticle

Time to Epidural Steroid Injection and Complete Remission in Zoster-Associated Pain: A Multicenter Retrospective Cohort Study

by Yongsoo Lee, Eun Hee Chun, Hee Yong Kang, Harin Hong, Yeji Yang, Hye Sun Lee and Jung Eun Kim

Life 2026, 16(6), 869; https://doi.org/10.3390/life16060869 - 22 May 2026

Viewed by 383

Abstract

Background: In zoster-associated pain (ZAP), earlier epidural steroid injection (ESI) has been associated with better outcomes, but optimal timing remains unclear, and prior studies have largely relied on pain reduction alone. Methods: In this multicenter retrospective cohort, 215 patients with ZAP who completed a three-session ESI course were classified into early (<30 days) and delayed (≥30–≤180 days) groups. The primary endpoint was complete remission at 12 weeks (≥50% visual analog scale [VAS] reduction, VAS ≤ 2, and sensory normalization); successful response (≥50% VAS reduction) served as the secondary endpoint. An ordered three-category framework and an exploratory generalized Youden index threshold analysis were applied. Results: Complete remission occurred in 82.1% versus 39.0% and successful response in 91.7% versus 67.8%. Each additional day of delay was associated with lower odds of complete remission (adjusted odds ratio [aOR], 0.957; p < 0.001) and higher odds of a worse outcome category (aOR, 1.030; p < 0.001). Exploratory candidate boundaries were 22 and 42 days. Conclusions: Earlier ESI initiation was associated with a higher likelihood of complete remission incorporating pain reduction, low residual pain intensity, and sensory normalization. These findings highlight the clinical relevance of treatment timing and recovery assessment beyond pain reduction alone in ZAP. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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10 pages, 537 KB

Open AccessArticle

Is the Hallux Interphalangeal Ossicle Clinically Relevant? A Cross-Sectional Study on Its Prevalence and Biomechanical Implications

by Ana Isabel Marcos, Salomón Benhamú-Benhamú and Antonio Córdoba-Fernández

Life 2026, 16(5), 816; https://doi.org/10.3390/life16050816 - 14 May 2026

Viewed by 343

Abstract

Background: The hallux interphalangeal ossicle (HIO) is commonly considered as an incidental anatomical variant; however, its biomechanical role remains poorly understood. This study aimed to investigate the influence of HIO on hallux joint biomechanics. Methods: A cross-sectional correlational study was conducted, including 419 feet (218 individuals). The presence of HIO was assessed using ultrasound imaging. Range of motion (ROM) of the metatarsophalangeal joint (MTPJ) and interphalangeal joint (IPJ) were evaluated under both open kinetic chain and dynamic conditions. Statistical comparisons between HIO and non-HIO groups were made, and receiver operating characteristic (ROC) curve analysis was used to assess the discriminative capacity of IPJ ROM. Results: HIO was present in 48% of cases and was bilateral in all participants. Individuals with HIO exhibited significantly greater IPJ extension under both open kinetic chain and dynamic conditions (p < 0.05). No significant differences were observed in MTPJ ROM between groups. A positive, albeit variable, relationship was found between ossicle size and IPJ extension. ROC analysis demonstrated moderate discriminative ability of IPJ ROM for detecting HIO (sensitivity 63.2%, specificity 54.6%). Conclusions: The presence of HIO is associated with increased IPJ extension, suggesting a measurable influence on hallux biomechanics. These findings support the notion that the HIO is a biomechanically relevant structure rather than purely incidental an asymptomatic anatomical variant. Increased IPJ extension may represent an early functional adaptation with potential clinical implications. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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10 pages, 794 KB

Open AccessArticle

Hemoglobin-to-Red Cell Distribution Width Ratio and Vitamin D Status as Early Predictors of Cardiovascular Risk in Primary Sjögren’s Syndrome

by Francesca Coppi, Francesco Sbarra, Aurora Vicenzi, Cecilia Campani, Martina Moretti, Dilia Giuggioli, Caterina Vacchi, Amelia Spinella, Daniela Aschieri, Anna Vittoria Mattioli, Francesco Fedele, Alessio Baccarani, Marcello Pinti, Alessandra Dei Cas, Federica Fantuzzi, Leila Bigdelu, Gianluca Pagnoni and Susan Darroudi

Life 2026, 16(2), 190; https://doi.org/10.3390/life16020190 - 23 Jan 2026

Cited by 1 | Viewed by 989

Abstract

Introduction: Primary Sjögren’s (pSS) is an autoimmune disease that affects several organs, especially the heart, and raises cardiovascular risk. Investigating the associations of hemoglobin-to-red cell distribution width (RDW) ratio (HRR), vitamin D status, and cardiac function could provide valuable insights and biomarkers regarding early cardiovascular risk in patients with pSS. Method: This cross-sectional study involved 61 patients diagnosed with pSS based on ACR/EULAR criteria. Data on demographics, hematological (Hb, RDW), echocardiography, and serum vitamin D levels were collected. Echocardiograms were conducted by trained cardiologists following established guidelines, while vitamin D levels were measured using ELISA. Statistical analyses, including univariate linear regression, were performed with SPSS in order to identify whether HRR tertiles were related to cardiac function and vitamin D status. Results: A study of 61 pSS patients (mean age 59.8 years, 89% female) revealed that patients with a lower hemoglobin-to-RDW ratio (HRR ≤ 0.98) had significantly higher pulmonary artery pressures (PAPs) and lower values for the tricuspid annular plane systolic excursion (TAPSE)/PAPs ratio, contributing to poor right heart function. These associations were particularly strong in patients with insufficient levels of vitamin D (<30 ng/mL), while differences in other echocardiographic parameters remained nonsignificant between HRR groups. Conclusions: These findings underscore the clinical value of HRR as a composite biomarker that reflects the interplay between anemia, inflammation, and cardiovascular health in primary Sjögren’s disease. They also suggest that vitamin D status may be an important therapeutic consideration to mitigate cardiopulmonary risks in this population. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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Review

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20 pages, 1159 KB

Open AccessReview

Cytokine Toxicity and Bacterial Dysbiosis in Chemotherapy- and/or Radiotherapy-Induced Oral Mucositis: Pathophysiological Mechanisms and Therapeutic Interventions

by Pouria Abdolmohammadi, Maral Aali and Christian Lehmann

Life 2026, 16(4), 644; https://doi.org/10.3390/life16040644 - 11 Apr 2026

Viewed by 1349

Abstract

Chemotherapy- and/or radiotherapy-induced oral mucositis (CRIOM) is a common complication in patients with head and neck cancer, driven largely by excessive proinflammatory cytokine signalling and treatment-associated bacterial dysbiosis. This narrative review synthesizes current mechanistic evidence and summarizes emerging therapeutic strategies targeting these pathways. Research indicates that elevated levels of IL-1β, IL-6, TNF, iNOS, and nitric oxide amplify tissue injury and ulceration, while disruption of oral and gut microbial communities, characterized by loss of beneficial commensals and enrichment of pathogenic taxa, further exacerbates mucosal inflammation. Anti-inflammatory agents, including pentoxifylline, atorvastatin, trans-caryophyllene, azilsartan, recombinant human IL-11, and low-level laser therapy have been shown in preclinical models to reduce cytokine levels and promote mucosal healing. Similarly, microbiome-targeted approaches, such as oral microbiota transplantation and multi-strain probiotic formulations, have demonstrated potential in restoring microbial balance and attenuating CRIOM severity, with current evidence including both preclinical and clinical studies. Overall, current findings highlight cytokine toxicity and dysbiosis as synergistic drivers of CRIOM and support anti-inflammatory and microbiome-modulating strategies as promising adjunctive approaches; however, further well-designed clinical studies are required to validate their efficacy and guide clinical translation. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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19 pages, 871 KB

Open AccessReview

Advances in Insulin Delivery: Transdermal and Needle-Free Technologies as Emerging Strategies to Improve Metabolic Control and Treatment Adherence

by Manuel García-Sáenz, Oscar Josué Gómez-Romero, Etual Espinosa-Cárdenas, Claudia Ramírez-Rentería, José Luis Eduardo Doval-Caballero, Daniel Uribe-Cortés and Aldo Ferreira-Hermosillo

Life 2026, 16(3), 377; https://doi.org/10.3390/life16030377 - 26 Feb 2026

Cited by 1 | Viewed by 3201

Abstract

Insulin therapy remains essential for the management of diabetes mellitus; however, conventional subcutaneous injection continues to impose significant physical, psychological, and behavioral barriers that negatively affect treatment adherence and metabolic outcomes. Injection-related pain, fear of needles, local tissue complications, and psychological insulin resistance contribute to delayed insulin initiation, inadequate dose titration, and suboptimal glycemic control worldwide. In response, alternative insulin delivery routes (including oral, pulmonary, nasal, and transdermal strategies) have been explored to reduce invasiveness and improve patient experience. Among these, transdermal insulin delivery has emerged as a particularly promising approach due to its potential to bypass gastrointestinal degradation, provide controlled absorption, and enhance patient acceptance. Recent advances in microneedle-based systems and needle-free jet injectors have enabled effective transdermal insulin administration by overcoming the skin barrier while minimizing pain and discomfort. This narrative review synthesizes current evidence on insulin delivery technologies with a specific focus on transdermal and needle-free systems. We discuss the biological and physicochemical challenges of insulin transport, the mechanisms underlying emerging delivery platforms, and clinical evidence regarding metabolic efficacy, glycemic variability, and patient-reported outcomes. The integration of these technologies with continuous glucose monitoring is also explored. Finally, we address translational challenges and future perspectives, highlighting the role of needle-free insulin delivery as a patient-centered strategy to improve adherence and metabolic control in diabetes care. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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Other

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13 pages, 3138 KB

Open AccessSystematic Review

Langer’s Axillary Arch: A Systematic Review and Meta-Analysis of Its Prevalence and Clinical Relevance

by Cosmin Burta, Razvan Danau, Andrei Korodi, Flaviu Ionut Faur, Aida Iancu, Ciprian Duta, Ioana Adelina Faur, Paul Pasca, Catalin Prodan Barbulescu, Vlad Braicu and Amadeus Dobrescu

Life 2026, 16(7), 1112; https://doi.org/10.3390/life16071112 - 3 Jul 2026

Viewed by 374

Abstract

Langer’s axillary arch, also known as the axillopectoral muscle, represents a relatively uncommon anatomical variation of the axillary region. Although often asymptomatic, its presence may have important implications in surgical procedures involving the axilla, particularly during breast surgery, axillary lymph node dissection, and reconstructive procedures. Despite numerous anatomical and surgical reports describing this variation, the true prevalence of Langer’s axillary arch remains uncertain due to variability in study design and detection methods. Objective: The aim of this systematic review and meta-analysis was to evaluate the reported prevalence of Langer’s axillary arch and to assess methodological variability among anatomical and surgical studies. Methods: A systematic literature search was conducted in accordance with PRISMA guidelines using electronic databases including PubMed, Scopus, and Web of Science. Studies reporting original data on the presence or prevalence of Langer’s axillary arch in cadaveric or surgical populations were included. Data extraction included study characteristics, sample size, number of detected axillary arches, and reported prevalence. A random-effects meta-analysis was performed to estimate the pooled prevalence and to evaluate heterogeneity between studies. Results: The analysis included studies comprising both cadaveric anatomical investigations and surgical series. Considerable variability in reported prevalence was observed across studies. Cadaveric studies generally reported higher prevalence rates compared with surgical series, reflecting differences in detection methods. Meta-analytic synthesis demonstrated that Langer’s axillary arch represents a relatively uncommon but clinically relevant anatomical variation. Conclusions: Langer’s axillary arch should be recognized as an important anatomical variant of the axillary region. Awareness of this variation is essential for surgeons performing axillary procedures, as its presence may influence surgical exposure and lymph node identification. Further large-scale anatomical and clinical studies are needed to better define its prevalence and surgical implications. Full article

(This article belongs to the Special Issue Feature Papers in Medical Research: 4th Edition)

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