Search Results (494)

Global population growth and numerous anthropogenic activities are putting increasing pressure on island aquifers. This situation is exacerbated in popular tourist destinations where seasonal population fluctuations increase water consumption. Most island aquifers are threatened by overexploitation, contamination, and seawater intrusion (SWI), which threaten these resources’ sustainability. In this study, the vulnerability of the Bozcaada Island (Türkiye) to SWI during peak seasons (summer) was assessed using the GALDIT approach. The GALDIT index takes into account six key hydrogeological characteristics, including groundwater occurrence (G), which represents the type of aquifer (confined, unconfined, or semi-confined) and influences the interface between freshwater and saline water; aquifer hydraulic conductivity (A), where higher conductivity increases the risk of SWI and determines how easily water flows; groundwater level above mean sea level (L), which indicates hydraulic pressure against SWI; distance from the coast (D), which implies higher SWI risk when close to the coast; existing intrusion status (I), which takes into account current SWI detections based on the ratio of chloride ions to bicarbonate ions in a groundwater sample; and aquifer thickness (T). Bozcaada Island hosts a large number of tourists during the summer months, when agricultural production is at its peak, with a high demand for irrigation. This significantly increases the demand for groundwater and leads to saltwater intrusion. Based on the results of the GALDIT index, the island’s groundwater reserves are heavily used throughout the summer. The GALDIT index for the summer shows that this increased groundwater abstraction intensifies the SWI problem. In summer, the island is vulnerable with 6.11 km² of extremely high SWI, 7.88 km² of high SWI, 7.34 km² of moderate SWI, 7.40 km² of low SWI and 8.50 km² of very low SWI. This study emphasizes how urgently Bozcaada Island needs sustainable water management techniques. Full article

Vocational integration (VI) services aim to support sustainable employment for persons with disabilities. However, in individuals with spinal cord injury, evidence on effective intervention targets and the evaluation of sustainable integration remains limited. The Work–Life Study aims to build an evidence base for supporting sustainable employment in Switzerland by (1) identifying typical work–life trajectories; (2) examining key work–life transitions and their predictors; (3) establishing a multi-state model for intervention targets; (4) exploring individual work–life narratives; and (5) developing guidelines for personalized VI practice. The study combines a mixed methods design with a collaborative Integrated Knowledge Translation approach, actively involving VI professionals and individuals with spinal cord injury. Participants are recruited from the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Work–life history data are collected through a Biographical Survey and Biographical Interviews and analyzed alongside SwiSCI data. Guideline development includes a stakeholder meeting with representatives from the Swiss Paraplegic Group, spinal cord injury clinics, individuals with spinal cord injury, employers, and disability insurers. Of 2041 eligible SwiSCI participants, 478 (23.4%) completed the Biographical Survey (median age 57.5 years; median time since injury 19.1 years), with responders and non-responders showing comparable characteristics. Work–life data closely matched existing SwiSCI data (rho > 0.8), indicating good recall. The resulting guidelines will help VI providers coordinate rehabilitation services to optimally promote sustainable employment for individuals with spinal cord injury. Full article

This study applies the GALDIT index within a GIS environment to assess groundwater vulnerability to seawater intrusion (SWI) in the coastal aquifer of Katerini, Greece. In addition, a single-parameter sensitivity analysis (SPSA) is performed to evaluate the relative influence of the GALDIT parameters and to produce a modified vulnerability map based on SPSA-derived weights. The results indicate that, in both cases, most of the study area exhibits low and moderate vulnerability, with high vulnerability limited to small areas along the coastal zone. Minor differences were observed between the two approaches, with the modified GALDIT map showing a slightly larger proportion of moderate-vulnerability areas. The SPSA further revealed that L is the most influential parameter in the GALDIT index, whereas G and I have the least influence. Overall, the study findings may serve as a valuable basis for prioritizing groundwater monitoring and management in the study area, and for guiding targeted measures to help prevent SWI. Full article

In vertebrates, SWI/SNF complexes, also known as BRG1/BRM-associated factor (BAF) complexes, come in three major subtypes, canonical BAF (cBAF or BAF), polybromo-associated BAF (PBAF) and non-canonical BAF (ncBAF), that are targeted to different types of chromosomal cis-regulatory gene expression control elements. Approximately 20% of malignancies exhibit mutations in genes coding for subunits of the SWI/SNF family of ATP-dependent chromatin remodelling complexes. SMARCD is an essential evolutionarily conserved subunit of these complexes in all eukaryotes. Whilst the integral role of SMARCD in targeting and stabilising the SWI/SNF complexes is conserved from yeast to plants to humans, the three human SMARCD paralogs display specific expression patterns underlying their functional divergence. Although, all three SMARCD paralogs exhibit context-dependent roles in cancer, acting as both tumour suppressors and oncogenes, it is SMARCD1 that appears to show the broadest oncogenic footprint across malignancies, driving proliferation, invasion and metastasis in diverse cancer types. Here we review the recent literature pertaining to the molecular and cellular roles of the mammalian SMARCD paralogs and discuss their roles in oncogenesis from those perspectives. 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

Background/Objective: Persistent dry mouth, associated with poor oral health and lower quality of life (QoL), affects approximately 20% of adults in the global population. Indicating a potential role in nutrition, Camellia sinensis tea leaves contain bioactive compounds that may help prevent and manage dry mouth. This review aimed to evaluate the effects of different tea types on salivary flow rate (SFR), salivary pH, and QoL in healthy and at-risk patients and patients with hyposalivation or xerostomia. Methods: A systematic review without meta-analysis (SWiM) was conducted. Pre-defined inclusion and exclusion criteria were applied to databases: PubMed, Scopus, Web of Science, and the Cochrane Library. Results: Eighteen studies met the eligibility criteria for inclusion in the review. Over 50% of studies investigated either black or green tea, with most conducted in healthy young adults (67%) and predominantly among females. Fifteen of the studies reported that tea intervention improved at least one outcome of interest. In general, green tea improved SFR and salivary pH more consistently than black, oolong, or matcha tea, particularly in at-risk populations and patients diagnosed with xerostomia. Conclusions: Tea consumption, particularly of green and black tea, showed a transient enhancement of salivary flow, pH, and QoL, offering a low-cost non-pharmacological approach to supporting oral health. Definitive recommendations were limited by heterogeneity in study interventions and outcome measurements, small sample sizes, and incomplete reporting of study details. However, tea’s potential as an adjunct for the prevention and management of dry mouth warrants further study in larger, well-designed studies that employ standardized protocols. Full article

Background/Objectives: Peritoneal metastases from breast cancer (PMBC) are rare, aggressive, and lack standardized management. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as a potential locoregional strategy for highly selected patients. This PRISMA-informed narrative review used a structured and reproducible search and study-selection process, SWiM-guided narrative synthesis, and descriptive pooled individual-patient data (IPD) analysis to evaluate the feasibility, safety, and reported oncologic outcomes of CRS plus HIPEC in PMBC. Methods: The English-language literature was searched in PubMed/MEDLINE, Embase, and Google Scholar up to 31 December 2025. Eligible peer-reviewed full-text articles reported PMBC patients treated with CRS plus HIPEC and at least one perioperative or oncologic outcome. Patient-level data were extracted when explicitly reported and were summarized descriptively; no inferential survival analysis was performed. Risk of bias was assessed using JBI checklists for case reports/series and ROBINS-I for the multicenter cohort. Results: Six peer-reviewed studies were included (66 PMBC patients); 30 patients underwent CRS plus HIPEC. Five studies provided sufficient patient-level data for descriptive pooled IPD analysis (n = 17). Median age at CRS/HIPEC was 56 years (n = 13 with reported age), and the median interval between breast cancer diagnosis and PMBC was 12 years (range 0–30 years; available-case analysis). Median PCI was 21.5 (n = 16), and complete cytoreduction (CC-0) was achieved in 9 of 17 patients. Major postoperative morbidity occurred in 17.6%, while no in-hospital or 30-day mortality was reported. Reported disease-control and survival outcomes were heterogeneous and are therefore summarized only descriptively. In the multicenter cohort, curative-intent CRS with or without HIPEC was associated with a median overall survival of 61.5 months measured from diagnosis of peritoneal metastases; however, HIPEC-specific baseline characteristics and oncologic outcomes were not separately stratified. Conclusions: CRS plus HIPEC appears feasible in highly selected PMBC patients and may be associated with favorable outcomes when complete cytoreduction is achievable. However, the evidence is sparse, heterogeneous, and highly prone to selection and publication bias. Therefore, no causal inference regarding the independent benefit of HIPEC can be drawn, and this approach should be considered investigational pending prospective multicenter registries. Full article

Background: Dural venous sinus thrombosis (DVST) is an uncommon but potentially life-threatening cerebrovascular disorder requiring early diagnosis to prevent serious complications. Although CE-MRV is the reference standard, routine brain MRI is often the first imaging study in patients with nonspecific neurological symptoms, and the sinus-specific diagnostic performance of individual sequences remains incompletely defined. Purpose: To evaluate the diagnostic performance and inter-reader agreement of routine brain MRI sequences for DVST detection using a sinus-specific framework. Methods: This retrospective case–control study included 140 patients (34 with DVST, 106 age-matched controls) imaged on 1.5 T and 3.0 T scanners. Two blinded neuroradiologists evaluated six unenhanced sequences (sagittal/axial T1WI, T2WI, FLAIR, DWI [b = 1000 s/mm²], and SWI) across four dural sinuses, using CE-MRV and CE-3D T1WI as the reference standards. Logistic regression and Cohen’s κ assessed diagnostic performance and inter-reader agreement, respectively. Results: Globally, DWI with FLAIR achieved 97.9% accuracy, 91.2% sensitivity, and 100% specificity (AUC = 0.997). Optimal sequences varied by sinus: sagittal T1WI with SWI for the superior sagittal sinus (accuracy = 99.3%), DWI with SWI for the transverse sinus (97.9%), DWI with FLAIR and T2WI for the sigmoid sinus (98.6%), and SWI with axial T1 for the straight sinus (100%). Inter-reader agreement was substantial to almost perfect for routine sequences (mean κ = 0.874) and almost perfect for CE-MRV and CE-3D T1WI (κ = 0.98). Conclusions: Routine brain MRI provides reliable DVST detection with a sinus-tailored multisequence strategy. DWI and FLAIR offer robust diagnostic performance in global evaluation, while T1WI, SWI and T2WI add segment-specific value, reserving CE-MRV and CE-3D T1WI for equivocal or clinically suspicious cases. Full article

Retail service workers face complex occupational demands across psychosocial, environmental, and physical domains; however, integrated multidomain workload assessments remain limited. A cross-sectional study among 253 retail workers used the Find My Stress Progressive Web Application (PWA)—a digital tool assessing subjective workload (Subjective Workload Index; SWI), psychosocial factors, environmental discomfort, musculoskeletal symptoms, and handgrip strength. Hierarchical multiple regression identified four significant SWI predictors: postural difficulty (β = 0.176, p = 0.012), workplace bullying (β = 0.175, p = 0.008), task duration (β = −0.179, p = 0.004), and air quality (β = 0.171, p = 0.011; Adjusted R² = 0.199, ΔR² = 0.227, p < 0.001; VIF: 1.03–1.57). Grip strength was retained as a functional capacity indicator. Sex-stratified analyses revealed distinct risk profiles: postural difficulty and task duration predicted SWI in men (Adjusted R² = 0.224); workplace bullying was the sole predictor in women (Adjusted R² = 0.170). The PWA demonstrated excellent reliability (α = 0.97) and usability (87%; n = 359). The Find My Stress PWA provides a scalable platform for multidomain stress screening. Integrated ergonomic, organisational, and environmental interventions guided by digital screening offer targeted strategies for reducing occupational workload burden in retail settings. Full article

Background and Clinical Significance: SWI/SNF chromatin remodeling complex-deficient malignancies constitute an aggressive group of undifferentiated tumors defined by inactivation of core subunits including SMARCA4 (BRG1) or SMARCB1 (INI1). In the head and neck, these tumors predominate in the sinonasal tract; oral cavity presentations are exceedingly rare, with reported cases predominantly representing metastatic disease. Peri-implant gingival masses in clinical practice are overwhelmingly reactive, but their occasional malignant nature mandates timely biopsy and thorough pathologic workup. We report the first comprehensively molecularly characterized case of a peri-implant gingival SWI/SNF complex-deficient tumor with confirmed biallelic SMARCA4 inactivation. Case Presentation: A 75-year-old man presented with a one-week history of a rapidly enlarging exophytic erythematous peri-implant gingival mass in the right posterior mandible (region 44–47). Incisional biopsy demonstrated an undifferentiated high-grade tumor with epithelioid, plasmablastoid, and focally rhabdoid morphology with necrosis. Immunohistochemistry showed complete loss of BRG1 (SMARCA4) with retained INI1 (SMARCB1), EMA positivity, Ki-67 of approximately 100%, and negativity across all lineage-specific markers (hematolymphoid, epithelial, melanocytic, endothelial, squamous). Comprehensive next-generation sequencing (Oncomine Comprehensive Assay Plus) confirmed biallelic SMARCA4 inactivation via a truncating nonsense mutation (p.Trp1346Ter; VAF 73.85%) combined with copy number loss, establishing the molecular mechanism underlying BRG1 protein loss. Co-occurring alterations included homozygous CDKN2A/CDKN2B deletion, MTAP loss (9p21.3), clonal TP53 and KEAP1 mutations, and intermediate–high tumor mutational burden (13.3 mutations/Mb) with microsatellite stability. The patient initiated carboplatin–paclitaxel and achieved a partial response at one month with further shrinkage by four months. This case illustrates a rare oral cavity manifestation of SWI/SNF complex deficiency arising in a peri-implant location, with a diagnostic workup that required integration of immunohistochemistry and molecular profiling for definitive characterization. The MTAP deletion co-occurring with homozygous CDKN2A/B loss identifies a potentially actionable synthetic lethal vulnerability to MAT2A and PRMT5 inhibitors currently under clinical investigation. An occult primary site could not be fully excluded due to absence of a dedicated staging workup. Conclusions: Rapidly enlarging peri-implant gingival masses should prompt timely biopsy and SWI/SNF marker testing when histology is high-grade and lineage-ambiguous. NGS-based molecular profiling confirms diagnosis, elucidates mechanism, and reveals actionable targets in this rare tumor class. Full article

Leydig cells play a crucial role in male development, fertility, and overall health through hormone production. Brahma-related gene 1 (BRG1), the catalytic subunit of the mammalian SWI/SNF complex, is a key regulator of chromatin accessibility and governs the development and function of diverse tissues. However, its role in Leydig cells remains unclear. In this study, we first characterized the expression pattern of PR-Cre in the testes, as this Cre mouse line has been widely used for gene targeting in the female reproductive system, but its activity in the testis has never been systematically reported. We found that PR-Cre drives recombination in multiple testicular cell types, including stem/progenitor adult Leydig cells (ALCs), peritubular myoid cells, and elongated spermatids. Using PR-Cre to conditionally delete BRG1 in ALCs, we observed no detectable abnormalities in ALC development, spermatogenesis, or male fertility. Similar results were obtained using the Cyp17a1-iCre mouse line and AAV8-iCre viral delivery for BRG1 deletion. Collectively, this work demonstrates that BRG1 is dispensable for ALC development and function, while providing a comprehensive characterization of PR-Cre as a valuable new tool for male reproductive research. Full article

Background: Long COVID, or post-COVID-19 condition (PCC), affects around 36% of individuals following SARS-CoV-2 infection, manifesting as persistent fatigue, cognitive dysfunction, and dysautonomia among its hallmark features. Affecting an estimated 400 million individuals globally, it imposes an annual economic burden exceeding $1 trillion, yet no pharmacological therapy has demonstrated consistent efficacy in adequately powered randomized controlled trials. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a candidate intervention targeting the autonomic dysfunction and neuroinflammation responsible for PCC pathophysiology. Methods: We conducted a PRISMA 2020-compliant systematic review (PROSPERO: CRD420261287286) searching PubMed, Scopus, Cochrane, and Web of Science databases from inception to January 2026 for studies evaluating any form of VNS in adults with Long COVID. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, the JADAD scale, and the PEDro scale. Certainty of evidence was evaluated using the GRADE framework. Narrative synthesis followed SWiM guidelines. Results: Five studies (n = 154 participants) (three randomized controlled trials (RCTs) and two single-arm studies) met inclusion criteria. Three of five studies (60%) were rated high overall risk of bias; only two RCTs achieved “some concerns.” The only adequately double-blinded RCT found no significant between-group differences across all outcomes. Paradoxically, in the best-powered RCT (Percin et al.), sham stimulation produced significantly greater fatigue improvement than active taVNS, despite active taVNS producing significant HRV increases consistent with cardiac autonomic modulation. All efficacy outcomes were rated “very low” certainty (GRADE); safety was rated “low” certainty. Conclusions: Currently available evidence supporting the use of taVNS for Long COVID remains limited, and the absence of reliable target engagement markers in the included studies constrains confidence in this approach. Nonetheless, the physiological rationale remains sound, and the favorable safety profile across all included studies supports the feasibility of future investigation. However, given that positive findings were confined to inadequately controlled studies, enthusiasm for further research should be directed first toward mechanistic clarification and rigorous dose-finding work. Large-scale, double-blind, sham-controlled trials incorporating validated markers of vagal engagement are required before taVNS can be firmly recommended for COVID-19 sequelae management. Full article

Reclaimed water-receiving rivers face increased hypoxic and malodorous risks after stormwater runoff. To investigate how initial runoff drives the co-variation of pollutants and microbial communities at the sediment–water interface (SWI), this study constructed a four-channel simulated river system based on the Froude similarity criterion, including two low-intensity rainfall (R-L) treatments and two high-intensity rainfall (R-H) treatments. Each experiment consisted of a 48 h runoff disturbance stage followed by a 48 h recovery stage. The dynamics of carbon (C), nitrogen (N), and phosphorus (P) in both water and sediments were systematically analyzed, together with variations in dissolved organic matter (DOM) composition, microbial communities based on 16S rRNA, and predicted N-cycling functional potential. Results showed that R-H exerted a pronounced dilution effect on pollutants in water but significantly enhanced SWI disturbance, facilitating nutrient accumulation within the system. DOM profiles indicated active microbial metabolism, consistent with long-term reclaimed water inputs. Microbial analyses revealed that TN was a key environmental factor influencing community differences. Nitrification and denitrification potentials were higher under R-H, whereas ammonia assimilation was higher under R-L. These findings highlight the importance of managing N accumulation and transformation following rainfall events in reclaimed water-receiving rivers. Full article

Flow over permeable beds is important in sediment transport and mixing processes, yet detailed velocity and stress measurements remain difficult to obtain, particularly close to the sediment–water interface (SWI). In this work, we use refractive-index-matched PIV to study turbulent open-channel flow over and within a permeable bed composed of monodisperse borosilicate glass beads. Measurements are reported for three low-$R{e}_K$ cases, $R{e}_K=0.224$, $R{e}_K=0.335$, and $R{e}_K=0.360$, to resolve the mean velocity structure and the associated viscous, turbulent, Reynolds, and dispersive stress distributions. The results show that both the mean velocity and the turbulence intensity decrease rapidly below the SWI, indicating strong damping within the porous bed. Above the bed, the flow retains a boundary-layer structure, and increasing $R{e}_K$ enhances the turbulence intensity without changing the overall regime. The results indicate a shift from turbulent transport above the bed to viscous control within the porous layer, while dispersive stresses peak near the interface. Overall, the SWI controls momentum exchange within a thin region and the porous bed suppresses turbulence penetration into the subsurface. Full article

Neuroendocrine differentiation in tumors of the female genital tract is an uncommon but diagnostically consequential finding. Its interpretation is challenging because neuroendocrine marker expression does not necessarily define a neuroendocrine neoplasm. Focal or aberrant staining for synaptophysin, chromogranin A, CD56 or INSM1 may occur in otherwise conventional gynecologic carcinomas, whereas true poorly differentiated neuroendocrine carcinomas represent aggressive tumors with distinct prognostic and therapeutic implications. This narrative review examines neuroendocrine differentiation across the cervix, endometrium, ovary, vagina and vulva from an integrated clinicopathologic perspective. We emphasize that neuroendocrine differentiation should be approached as a diagnostic and biological spectrum, ranging from incidental immunophenotypic expression to carcinoma with neuroendocrine differentiation, mixed neuroendocrine/non-neuroendocrine tumors, well-differentiated neuroendocrine tumors and poorly differentiated neuroendocrine carcinomas. Morphology remains the diagnostic anchor, while immunohistochemistry, molecular context and clinicoradiologic correlation refine classification and help exclude mimics or metastatic disease. Site-specific interpretation is essential: cervical neuroendocrine carcinoma is commonly HPV-associated and clinically aggressive; endometrial tumors require integration with p53, mismatch repair, POLE and SWI/SNF-related contexts; ovarian lesions demand distinction between primary well-differentiated neuroendocrine tumors, poorly differentiated carcinomas and metastases; and vaginal or vulvar tumors require careful exclusion of adjacent extension, cutaneous mimics and extragenital primaries. We propose a practical diagnostic framework that separates incidental marker expression from clinically meaningful neuroendocrine differentiation and links this distinction to reporting, prognosis and treatment. The central diagnostic question is not whether neuroendocrine markers are expressed but whether their expression defines a morphologically, biologically and clinically meaningful tumor category. Full article