Search Results (2,836)

Objective: To map and synthesize the published literature on the epidemiological burden of urinary tract infections (UTIs) in adults with spinal cord injury (SCI) or multiple sclerosis (MS) using intermittent catheterization (IC). Methods: We conducted a comprehensive literature review following PRISMA guidelines, searching PubMed, Scopus, and Web of Science for studies published since 2014. A total of 30 studies met the inclusion criteria. Results: Reported UTI incidence varied widely from 24% to 93.1%, highlighting significant heterogeneity across the evidence base. Annually, 15–17% of patients experienced 4–6 UTIs, and up to 16.4% required hospitalization for UTI-related complications. A critical evidence gap was exposed, with only one study focusing specifically on the MS population. Conclusions: Despite its clinical benefits, IC remains underutilized and inconsistently supported. Addressing systemic delivery gaps is essential. UTIs in neurogenic bladder care should be recognized as a modifiable public health issue requiring equity-driven interventions and strengthened implementation frameworks. This review underscores the urgent need for methodologically rigorous research to establish clear best practices. Full article

Summer Bridge Programs (SBPs) support students’ personal, organizational, content-related, and social challenges as they transition from high school to postsecondary education. However, the research is not conclusive on the overall effect of these programs on academic performance. Prior systematic reviews and meta-analyses have raised critical methodological concerns. Following the PRISMA framework, this scoping review examines the methodological aspects when assessing the academic effects of SBPs on incoming STEM (Science, Technology, Engineering, and Mathematics) students. The inclusion criteria were studies that quantitatively assessed the academic performance of SBPs offered during the summer prior to the start of classes for incoming first-year STEM students and that included a control group. We searched ERIC, Web of Science, SciELO, and ProQuest databases. This review included 37 studies evaluating 33 programs. The majority of academic evaluations relied on course performance, graduation or retention rates, and GPA (Grade Point Average) outcomes. Moreover, the evidence is mainly descriptive or observational, with no control variables. We found a lack of studies that used an experimental or observational approach while also controlling for participants’ background variables. Finally, the reported outcomes are mainly short-term, with only a small number of studies assessing longer-term effects of SBPs, such as graduation rates. Full article

Background: Approximately two-thirds of individuals with spinal cord injury (SCI) become overweight or obese. Weight loss surgery, including vertical sleeve gastrectomy (VSG), is one of the most effective long-term treatments for obesity and type 2 diabetes. Introduction: The main objective of this study was to test in our diet induced obesity rat model whether subjects respond to VSG in the same way as subjects with or without SCI. Methods: To address this question, male Wistar rats underwent either T3 contusion injuries or sham spinal surgeries (Sham). Following recovery, all rats were fed a high-energy, high-fat diet (HFD) for six weeks before undergoing VSG. Taste responsivity and preferences were assessed at multiple time points. Results: Prior to HFD exposure, SCI rats exhibited significantly reduced lick responses for sucrose at higher concentrations and increased licking for low concentrations of sodium, although 2BC sucrose preference was unchanged. HFD feeding in SCI rats enhanced salt and sucrose licking overall. Importantly, VSG reduced sucrose licking, with SCI rats showing greater sensitivity to this effect. cFos immunohistochemistry further revealed enhanced neuronal activation to sucrose ingestion in the dorsal vagal complex, including the rostral subnucleus of the nucleus of the solitary tract. Discussion and Conclusions: Together, these findings support the hypothesis that SCI alters taste functions, thereby increasing vulnerability to diet-induced obesity and that VSG may restore sweet taste responsivity even more effectively in SCI-associated obesity than in non-SCI obesity. Future studies are needed to clarify the neural and hormonal mechanisms mediating these effects and to determine their translational relevance to human SCI populations. Full article

Background: Spinal cord injury (SCI) represents a form of traumatic damage to the central nervous system, and oligodendrocytes play a central role in SCI recovery. Ferroptosis is a major factor in the pathophysiological development of SCI symptoms. Pterostilbene (Pte) has antioxidant, anti-inflammatory, and neuroprotective effects. This study aims to investigate the potential role of Pte in SCI. Methods: A SCI model of rats was constructed. The BBB score assessment, the footprint test, EC staining, immunofluorescence (IF), and Western blot (WB) were conducted to observe the neuroprotective effects of Pte. The factors of ferroptosis, such as Glutathione (GSH), Malondialdehyde (MDA), Fe²⁺, solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4), were assessed. Then, transcriptomic data, network pharmacology, molecular docking analysis, and the erastin-induced ferroptosis model of OLN-93 cell lines were used to investigate the mechanism of inhibiting ferroptosis by Pte. Results: Pte treatment restored motor function and spinal cord tissue in SCI rats. Furthermore, Pte dramatically decreased oligodendrocyte ferroptosis. Finally, we discovered that Pte can repair SCI by blocking ferroptosis via the Keap1/Nrf2/SLC7A11/GPX4 axis. Conclusions: Pte reduces lipid peroxidation via the Keap1/Nrf2/SLC7A11/GPX4 axis, which reduces the development of ferroptosis in oligodendrocytes and improves locomotor function in rats with SCI. Full article

Background: Thoracic endovascular aortic repair (TEVAR) has evolved the management of descending thoracic aortic disease, but neurological complications—particularly spinal cord ischemia (SCI), stroke, and postoperative delirium—remain among the most feared adverse events, adversely affecting survival, quality of life, and functional independence. Objectives: The aim of this study was to provide a contemporary narrative synthesis (2000–2025) of the incidence, mechanisms, risk factors, prevention, and management of neurological complications after TEVAR, emphasizing how current evidence supports individualized and risk-adapted strategies for prevention and management. Methods: A narrative, non-systematic search (PubMed/MEDLINE, Scopus, Cochrane Library; 2000–2025) was conducted using terms related to TEVAR, SCI, cerebrovascular events, delirium, and cognitive dysfunction. Priority was given to large registries, cohort studies, and systematic reviews in adult TEVAR populations. Results: Perioperative stroke occurs in ~2–6% of TEVAR cases, with higher rates in arch/zone 0–2 procedures and when the left subclavian artery (LSA) is covered without revascularization. SCI incidence ranges from ~2–9%, influenced by aortic extent and urgency; Vascular Quality Initiative data report SCI in 3.7% of procedures, with markedly reduced 1-year survival. Major SCI risk factors include extensive thoracic coverage, prior aortic repair, vertebral or hypogastric occlusion, emergency presentation, low perioperative mean arterial pressure, anemia, and chronic kidney disease. Postoperative delirium occurs in ~13% of TEVAR-treated type B dissections and correlates with longer hospitalization and early complications. Emerging nomograms for SCI and delirium enable individualized risk stratification. Conclusions: Neurological complications after TEVAR remain clinically significant. Contemporary evidence supports personalized prevention—selective cerebrospinal fluid (CSF) drainage, LSA revascularization, staging, neuromonitoring, and tailored hemodynamic targets—guided by anatomical complexity, comorbidities, collateral network integrity, and prior aortic history. Further research should refine prediction tools, standardize definitions, and evaluate individualized neuroprotective bundles. Full article

High-quality synthetic text can mitigate annotation scarcity in text classification. However, standard preference optimization often produces samples that are fluent but weakly label-specific. We present Utility-weighted Direct Preference Optimization (U-DPO), a preference-optimization framework for class-conditional synthetic data generation. In U-DPO, a task-specific classifier provides a margin-based external score for each candidate generation, which is combined with an embedding-based internal similarity score to form an overall utility. These utilities are used (i) to mine preference pairs from multiple candidates per class and (ii) to weigh each DPO update by the utility gap between preferred and dispreferred samples. This design encourages the generator to concentrate on learning informative, label-discriminative preference comparisons rather than treating all pairs equally. Across two multiclass scientific-abstract benchmarks (arXiv and WOS-11967), U-DPO consistently improves downstream SciBERT classification accuracy compared with both vanilla synthetic generation and standard DPO fine-tuning, with gains up to 0.88 percentage points on arXiv and 0.83 percentage points on WOS-11967 depending on the generator. An additional GPT-4.5-based evaluation also indicates a higher mean quality score for U-DPO samples with reduced variance. Full article

Background/Objectives: In patients with spinal cord injury (SCI), quality of life (QoL) is increasingly recognized as an important indicator of their ability to sustain both the rehabilitation process and post-rehabilitation community reintegration, and it plays a crucial role in prognosis. The primary purpose of this study was to identify the demographic and clinical correlates of different QoL domains as perceived by patients hospitalized after SCI. Methods: We conducted a cross-sectional study on a single day in the units of the Montecatone Rehabilitation Institute (MRI), the largest Italian center for intensive rehabilitation of individuals with SCI. We administered the World Health Organization Quality of Life–Short Version (WHOQOL-BREF), which consists of 26 items rated on a five-point Likert scale. Study participants included 88 adults with SCI; a total of 74% were male, with a mean age of 53.3 years (SD = 15.05). The lesion was traumatic in 74% of cases and complete in 59%. Physical health showed a weak negative association with age (r = −0.213, p = 0.05), whereas social QoL demonstrated a significant positive association with age (r = 0.215, p = 0.046). Psychological QoL was significantly lower in females compared with males (46.9 vs. 55.1, p < 0.05) and in patients living alone compared with those not living alone (46.1 vs. 54.6, p < 0.05). Conclusions: Clinicians should consider routine assessment of QoL to personalize post-discharge therapeutic plans and to implement targeted interventions aimed at improving outcomes in patients with SCI. Full article

Background/Objectives: Cystic fibrosis (CF) is a genetic condition with an increasing life expectancy in recent years. As a result, addressing psychosocial aspects in this population has become an increasingly important concern. This mixed-methods systematic review aimed to update the current knowledge on the psychosocial aspects of living with CF in adults. Methods: Following PRISMA guidelines, a literature search was conducted in November 2024 across several databases, including Scopus, ScienceDirect, Academic Search Complete, MEDLINE, Supplemental Index, Complementary Index, APA PsycInfo, Business Source Complete, SciELO, and the Directory of Open Access Journals via EBSCO. Results: Of the 701 articles retrieved, 24 were analyzed, including a total of 2023 participants (mean age: 31.2 years; 57.2% female). Quantitative findings identified optimistic coping as the most frequent strategy associated with improved survival. High social support and gratitude emerged as key factors for treatment adherence and quality of life, while depression remained the primary mental health concern. Qualitatively, the findings highlighted concerns with adult life transitions and financial stressors. Participants described experiences of social stigma and embarrassment linked to chronic symptoms, often leading to selective disclosure to avoid discrimination. Conclusions: This review confirms that psychosocial factors are central to the adult CF experience, shifting the focus beyond biological survival and highlighting areas that require clinical intervention. As life expectancy increases, clinical care must evolve to incorporate interventions that address these factors to improve mental health and overall quality of life (QoL), ensuring that patients are supported through the unique challenges of extended adulthood. Full article

Background: Hyperbaric oxygen therapy (HBOT) has been proposed as an adjunctive treatment for spinal cord injuries (SCIs) to mitigate a secondary injury and enhance neurological recovery. While the preclinical evidence is consistently supportive, clinical data remain heterogeneous across traumatic (TSCI) and non-traumatic (NTSCI) etiologies. Methods: A hybrid systematic review was conducted in accordance with the PRISMA 2020 guidelines and included an illustrative single-center clinical case. PubMed, OVID Medline, and Google Scholar were searched for studies published between 1978 and 2024. Due to methodological heterogeneity, qualitative synthesis was performed. Results: Fifty studies comprising 1102 patients were included. Neurological improvement was more frequently observed in incomplete injuries and when HBOT was initiated early. Conclusions: HBOT may represent a useful adjunct in selected SCI patients, although standardized protocols and controlled trials are required to better define its role. Full article