Search Results (21,013)

Diagnostic imaging is central to clinical decision-making across many care pathways, yet the expertise needed to use these images well is unevenly distributed across health systems, with workforce limitations identified as a major barrier to equitable access, particularly in low- and middle-income countries. Digital education has emerged as one response to this gap, offering scalability, asynchronous and just-in-time access, and the cost-efficiency required for global deployment. This paper examines the digital education portfolio of the International Atomic Energy Agency’s Nuclear Medicine and Diagnostic Imaging Section, hosted mainly on the open-access Human Health Campus, which in 2025 recorded approximately 45,800 active users and 150,000 views across 159 countries. The portfolio combines structured e-learning courses, interactive webinars, virtual conference access through the Livestream programme, and a broader repository of publications, teaching cases, and reference resources, supported by an internal e-learning framework and learning management system infrastructure. Partnerships with international scientific societies further extend the reach of expert knowledge and professional exchange. The paper argues that these initiatives are best understood not as content delivery alone but as a coordinated strategy to support diagnostic quality at the level of the practising physician, extending access to expertise and strengthening the conditions for better practice, while remaining a complement to, rather than a substitute for, supervised clinical training. Full article

Background: In rodent models of intracranial tumor development, evaluating the actual burden experienced by animals beyond procedural severity is essential for ethical and legal compliance. This study examined whether voluntary wheel running (VWR) could serve as a sensitive indicator of post-surgical burden following subcutaneous transmitter implantation, tumor cell injection, and tumor resection. It also assessed whether VWR supports the detection of humane endpoints. VWR outcomes were compared with body weight, clinical scores, heart rate, and activity levels recorded via telemetry. Methods: Fourteen male BDIX rats were housed individually in cages equipped with a running wheel. Under general anesthesia, telemetric devices to monitor heart rate and activity were subcutaneously implanted. After recovery, glioblastoma BT4Ca cells were stereotaxically injected into the right frontal cortex. Eight days later, the resulting tumors were microsurgically resected. Body weight, VWR, heart rate, and general activity were continuously monitored until the animals reached humane endpoint criteria, indicated by sudden weight loss and clinical deterioration. Results: On average, body weight and VWR declined significantly after all surgical procedures, with tumor resection causing the most pronounced effect. As animals approached the endpoint, a marked drop in these parameters was observed, along with an increased clinical score (p < 0.05). Activity measures supported these findings, though less consistently than weight and VWR. Conclusions: Monitoring body weight and VWR enables an effective assessment of the actual postoperative burden experienced by rats undergoing surgeries of different procedural complexity. Moreover, VWR is a valuable supplementary tool for identifying humane endpoints alongside body weight and clinical scoring. Full article

Cardiac rehabilitation (CR) is strongly recommended in secondary cardiovascular prevention; indeed, in patients after cardiac surgery or with coronary artery disease or heart failure, this intervention is recommended to decrease mortality, morbidity, and disability, and to improve quality of life and cardiorespiratory fitness. Moreover, each step of the cardiovascular continuum denotes a potential risk factor for the progression of cognitive frailty; this interaction is highly prevalent, affecting approximately one-third of all patients in cardiology settings. For these reasons, CR should consider the patient’s cognitive domain; however, cognitive assessment is still rarely integrated into standard CR protocols. Therefore, this comprehensive review presents current evidence and recent updates on the interaction between CR and cognitive impairment, focusing on physiological mechanisms, core components, benefits, and strategies for implementing CR in patients with cognitive frailty to optimize recovery and prognosis. Full article

Background/Objectives: The Leiden University Medical Center (LUMC) and the Medical University of Vienna (MUV) both implemented video recording and review in their neonatal intensive care unit (NICU). The two centers initiated collaborative, multicenter video review sessions to facilitate international knowledge exchange. Methods: In this exploratory, descriptive study, collaborative video review sessions were organized with the interprofessional NICU staff of the LUMC and the MUV. We aimed to describe our experience with organizing these sessions and to report procedural variations, and document lessons learned that led to new perspectives on care. Results: We conducted five sessions using recordings of different patients undergoing intubation, less invasive surfactant administration, umbilical, central-catheter insertion and physiologically based cord clamping after birth. The videos were selected to ensure technical and clinical comparability. Sessions were attended by a mean of eight providers per center. A total of 19 relevant differences were described, of which seven (37%) prompted changes in practice or new insights for one or both centers. Finally, we developed a roadmap for organizing multicenter video review sessions. Conclusions: This study shows that multicenter video review may represent a feasible and innovative educational approach for identifying practice variations and fostering cross-institutional clinical refinement. Full article

Allergy is the most common hypersensitivity disorder, affecting around 30% of the global population. Due to its rapidly increasing prevalence and significant reduction in quality of life for patients, allergy represents a major public health problem, and the improvement of diagnostic and treatment options for allergic diseases is of utmost importance. Moreover, the development of preventive allergen-specific immunization strategies is an emerging research direction in mitigating allergy incidence, especially for respiratory diseases such as allergic rhinitis and asthma. Since environmental allergen exposures differ substantially depending on climatogeographical, ecological, and behavioral factors, investigating local IgE sensitization profiles could significantly contribute to optimizing allergy management. We performed a systematic database review to summarize available knowledge on IgE sensitization profiles in Russia across different regions of the country. The study was conducted in compliance with PRISMA and SWiM guidelines and registered in the PROSPERO database (CRD420250650847). We identified major differences in sensitization profiles across certain geographical areas, reported in 60 studies. However, heterogeneity of methods and gaps in the existing evidence were noted, and, as the available data appear insufficient for reliable profiling, an outline was proposed for systematic and methodologically harmonized studies necessary to develop further region-tailored approaches. Full article

Elevated particulate matter (PM) concentrations pose severe health risks, necessitating green infrastructure mitigation. While deposition is well documented, wind-induced remobilization remains insufficiently quantified. This study establishes a size-fractionated (PM_1–2.5 and PM_2.5–10) wind-induced resuspension and net removal values for six Central European shrub and climbing species (Parthenocissus quinquefolia, Hedera helix, Viburnum opulus, Viburnum lantana, Ligustrum ovalifolium, and Cornus mas) under controlled laboratory conditions. Following standardized aerosol chamber loading, leaves were subjected to constant, laminar airflow velocity of 3 m/s. Numerical quantification of particle counts per unit area (cm²) was performed via scanning electron microscopy with backscattered electron signal processing. Results demonstrate significant interspecific variations. Parthenocissus quinquefolia was most efficient, retaining the highest particle counts (121.6 × 10³ particles/cm² for PM_2.5–10) and achieving net removal rates of 46.3% and 60.5% for PM_1–2.5 and PM_2.5–10, respectively, relative to initial deposition. Cornus mas exhibited the lowest net removal efficiency for coarse particles (21.2% for PM_2.5–10), while Hedera helix showed the highest fractional resuspension rates (k = 1.93 × 10⁻⁴ ∙ s⁻¹ and 2.01 × 10⁻⁴ ∙ s⁻¹, respectively). These species-specific traits are vital for optimizing urban green infrastructure. Ultimately, these findings provide actionable recommendations for targeted plant selection to maximize urban air purification. Full article

Climate hazards increasingly unfold as information crises alongside physical impacts, producing rapid shifts in what people search for and discuss online. This case study demonstrates how AI-supported analysis of online data can complement conventional disaster intelligence by providing a scalable social sensing layer for climate hazard resilience in Galicia. It integrates Google Trends as a proxy for changing public attention and information demand, and YouTube videos and comment threads to capture public sensemaking and resilience-relevant signals. Monthly Google Trends series were used for eight hazards, with floods showing the highest mean interest, followed by wildfires and heatwaves. For the three highest-salience hazards, the study analyzed YouTube comments using gpt-5-mini to extract sentiment, emotions, topics, institutional trust cues, collective efficacy cues, calls to action, impacts, vulnerable groups, and coping actions. The corpus included 184 heatwave comments, 20,427 wildfire comments, and 4882 flood comments. Across hazards, discourse is predominantly negative but differs in structure. Heatwave threads skew toward mockery and normalization, wildfire threads center on anger, governance and low institutional trust, and flood threads combine solidarity with demands for localized warnings and guidance. The study translates comment-level signals into traceable policy recommendations emphasizing actionable risk communication, early warning and response capacity, and trust-building practices. The study concludes with an operational pipeline concept for continuous monitoring and dashboard-based decision support, while emphasizing limitations related to Google Trends sampling and normalization, platform and API biases, and model-mediated uncertainty. Full article

Recent land use and land cover (LULC) transformation in Vietnam raises the question of whether recent changes reflect a uniform national trend or differentiated regional patterns. This study assesses provincial LULC dynamics across 34 provinces using nationally consistent remote-sensing data for 2000, 2020, and 2023. We combine annualized intensity analysis, transition matrices, Shannon entropy, dominant transition analysis, and spatial autocorrelation to compare the magnitude, structure, and spatial organization of LULC change before and after 2020. The results show that annualized land-change rates were substantially higher during 2020–2023 than during 2000–2023, with all provinces showing increased rates of transformation. However, this more recent intensification has not been spatially uniform. Higher increases have been concentrated in southern and delta provinces, while several northern and upland provinces showed lower acceleration. Structural responses also varied across provinces: only four of 34 provinces (11.8%) were classified as both accelerated and structurally concentrated, whereas diversified regimes accounted for about two-thirds of the provinces. Population density was moderately associated with post-2020 magnitude of change but only weakly related to structural configuration, indicating that the magnitude and composition of LULC change represent distinct dimensions. By separating change intensity from structural configuration, this study provides a reproducible framework for identifying differentiated provincial land-change regimes. The results show that recent land cover transformation in Vietnam is not a single national process, but a mosaic of spatially and structurally distinct change patterns. Full article

Perinatal mental illness affects up to 20% of new mothers worldwide, yet despite a growing research interest over the past decade, the etiology is still not fully understood, and clinical treatment guidelines remain inconsistent across countries and services. In this review, recent findings on neurobiological processes and evolutionary mechanisms, as they occur during the menstrual cycle, pregnancy, birth, postpartum and breastfeeding, are discussed. The intention is to raise awareness of physiological changes in pregnancy that might be relevant to the differential diagnosis and clinical treatment of perinatal psychiatric disorders such as depression, anxiety, PTSD after childbirth, bipolar relapse, postpartum psychosis, obsessive-compulsive symptoms, substance-use disorders, and suicidality. Areas addressed include the activities of the immune system, thyroid gland, cortisol, sleep and individual sensitivity to ovarian hormone fluctuations. Evolutionary biological mechanisms intended to sustain pregnancy and to ensure the survival of the newborn are assumed to have potent effects on the maternal brain. These non-pathological adaptations could provide grounds for a better understanding of risk factors and the etiology of perinatal mental illness. Full article

Lipedema is a chronic adipose tissue disorder characterized by disproportionate and often painful enlargement of the extremities, occurring predominantly in women. Despite increasing clinical recognition, the underlying pathophysiology remains incompletely understood and is likely multifactorial. Existing evidence suggests contributions from vascular alterations, adipose tissue remodeling, inflammatory activation, hormonal influences, and lymphatic dysfunction. This review proposes a hypothesis-generating integrative framework in which lipedema may reflect a regenerative imbalance of subcutaneous adipose tissue. Within this model, genetically and hormonally modulated endothelial permeability could promote activation of perivascular adipose-derived stromal/stem-cell niches and stromal vascular fraction signaling pathways, thereby facilitating coupled angiogenesis and adipogenesis. Progressive adipocyte hyperplasia and hypertrophy may subsequently contribute to inflammatory remodeling, pain generation, and secondary impairment of dermal and subdermal lymphatic drainage. The proposed framework attempts to integrate clinical, histological, imaging, molecular, and endocrine observations into a biologically coherent conceptual model. At the same time, the review emphasizes the current limitations of the available evidence, the heterogeneity of lipedema phenotypes, and the ongoing controversies regarding disease progression, obesity overlap, and the relative role of lymphatic dysfunction. Finally, the potential mechanistic rationale of lymphatic-sparing liposuction is discussed in the context of tissue decompression, restoration of lymphatic transport, and interruption of persistent adipose remodeling. The model presented here should be interpreted as a hypothesis-generating conceptual scaffold requiring prospective validation. Importantly, the present framework should be interpreted as a biologically plausible and hypothesis-generating conceptual model rather than a definitive mechanistic doctrine. Several proposed interactions remain associative and require prospective biological validation. Full article

Tool wear significantly impacts the productivity and efficiency of sheet metal stamping operations, particularly in high-volume progressive die applications. This study presents an iterative calibration framework for Archard’s wear model, tailored to industrial stamping processes. The proposed methodology integrates finite element simulations with experimentally measured wear data obtained from production components, enabling data-driven calibration of the wear coefficient $K_{sim}$. The framework achieves high predictive accuracy, with deviations of 1.4–3.7% between simulated and optically measured wear depths and localization, after more than 15 million strokes. Rapid convergence is obtained within two to three calibration cycles, significantly reducing computational effort while maintaining physical fidelity. The simulation setup incorporates detailed modelling of contact pressure, sliding velocity, and stress distribution, validated using optical surface measurement systems and coordinate-based metrology. Beyond the specific industrial case, the framework demonstrates transferability to other sheet metal forming processes, such as bending, blanking, and coining, by leveraging physically based parameter adaptation across comparable pressure–velocity regimes. The approach enables predictive wear modeling in data-scarce environments and supports early-stage tool design workflows. Overall, the proposed methodology bridges the gap between empirical calibration and generalized simulation, contributing both methodological rigour and practical applicability to manufacturing science. Full article

Background and Clinical Significance: We report an exceptionally rare case of mechanical aortic valve replacement necessitated by self-inflicted needle penetration with aortic valve and left ventricular involvement in a patient with recurrent self-harm behavior. Case Presentation: A 24-year-old female with post-traumatic stress disorder and emotionally unstable personality disorder, borderline type, presented with dyspnea two weeks after self-inserting multiple needles into her thorax. Computed tomography revealed a needle lodged in the aortic root and an intramyocardial needle with hemorrhagic pericardial effusion. Emergency sternotomy revealed inflammatory destruction of the right coronary aortic cusp with complete perforation. Following failed reconstruction attempts, mechanical aortic valve replacement was performed. The patient survived the immediate postoperative period but demonstrated recurrent non-adherence to oral anticoagulation, including multiple episodes of over- and under-anticoagulation. More than six years after surgery, she presented with cardiogenic shock due to prosthetic valve thrombosis after discontinuing warfarin for two weeks. Despite venoarterial ECMO and fibrinolytic therapy, she died from refractory left ventricular failure. Conclusions: This case highlights critical challenges in managing patients with severe psychiatric disorders requiring mechanical valve prostheses and suggests that bioprosthetic valves may warrant careful consideration in patients with major concerns regarding long-term anticoagulation adherence. Full article

Trail running imposes highly variable biomechanical demands due to steep, irregular terrain that renders flat-road pacing models inadequate. We present a physics-based digital twin that integrates a terrain-adaptive grade-adjusted pace (GAP) model with individualised physiological calibration to predict finish time across heterogeneous trail-running races. The GAP core applies Minetti’s fifth-degree metabolic cost polynomial to map slope-dependent energy cost across the full range of uphill and downhill gradients encountered in trail racing. Segment-by-segment pace is further modulated by an altitude–VO₂max correction, a Banister TRIMP-based fatigue term, and a progressive pacing-decay factor. Course-elevation profiles are extracted from 1 Hz barometric altimeter data through a five-step normalisation pipeline. Individual parameters (sustainable VT₂ fraction α; pacing-decay slope μ) were calibrated by grid search against 13 race sessions. A sequential validation across four model-complexity stages showed R² increasing from 0.763 to 0.905. Leave-one-out cross-validation (n = 13) yielded R² = 0.864, MAE = 18.2 min, MAPE = 11.1%, and a small positive bias (+2.0 min). The framework demonstrates that integrating biomechanical terrain correction with individual physiological calibration substantially improves race-time prediction for trail running, offering a promising foundation for athlete-specific pre-race simulation. Full article

Rivers have always been essential to humankind. They are used for many purposes and, as a result, have been heavily modified. Human impacts, many of them still poorly understood, interfere with river ecosystems, making them vulnerable to disturbances. Amongst these, mega events along riverbanks are listed. We studied the effects of the “FM4 Frequency Festival,” which attracted more than 200,000 visitors, on microalgae in the channelized section of the River Traisen in St. Pölten, the capital of Lower Austria. During the festival, phosphorus, dissolved organic carbon, and chloride increased significantly during the whole study period compared with before and after. Although the overall epilithic biomass remained unchanged during the festival period, the phytobenthos community experienced an increase in taxonomic richness downstream of the festival area. Both the Shannon diversity (mean ± SD = 2.89 ± 0.34) and Pielou’s evenness (mean ± SD = 0.73 ± 0.08) did not differ significantly between the sampling dates before, during, and after the festival. We found a shift towards Achnanthidium minutissimum as the dominant species during the festival. Diatoma ehrenbergii, which is sensitive to nutrient enrichment and organic pollution, disappeared during the event. Overall, the biofilm shifted towards a community dominated by heterotrophs during the festival, likely due to high organic loading. Pelagic microalgae experienced a rise in the total taxa number during the festival, which was partly caused by resuspension of phytobenthos. Our results reflect significant impacts from visitors to the Traisen ecosystem. Not only short-term changes in the hydrochemical environment but also mechanical disturbances of the phytobenthos caused by visitors were demonstrated. We suggest continuous monitoring to verify that such events will not have long-term impacts on the system. Full article