Search Results (12,366)

Tuberculosis remains a serious infectious disease that causes over 1.3 million deaths annually. Following the COVID-19 pandemic, the global incidence of tuberculosis has increased to 10.8 million cases. Pregnant women represent a particularly vulnerable population requiring tailored approaches to the prevention, diagnosis, and treatment of tuberculosis. SARS-CoV-2 infection may have impacted existing clinical protocols. Implementing updated methods of tuberculosis prevention, diagnosis, and treatment in pregnant women could help reduce adverse maternal and fetal outcomes. The aim of this review was to explore potential modifications in tuberculosis management among pregnant women in the post-COVID-19 era, including co-infection with SARS-CoV-2. Methods: A review was conducted, incorporating a systematic literature search across major international databases, including Medline, PubMed, Web of Science, Scopus, and Google Scholar. The search covered publications released between December 2019 and September 2024 and used targeted keywords such as “COVID-19” OR “SARS-CoV-2”, “tuberculosis” OR “TB” OR “latent tuberculosis infection” OR “pulmonary tuberculosis”, and “pregnancy” OR “pregnant women”. Results: Pregnant women living with HIV are at increased risk of developing tuberculosis, which can negatively affect both maternal and perinatal outcomes. Screening for tuberculosis is recommended for all HIV-positive pregnant women, even in the absence of clinical symptoms. Notably, immunological testing before and during pregnancy facilitates the timely and safe detection of tuberculosis infection, enabling preventive and therapeutic interventions during any stage of gestation and the early postpartum period, for the benefit of both mother and child. Drug–drug interactions play a significant role in tuberculosis management, both among anti-tuberculosis agents and with medications for comorbid conditions. Current knowledge of the pharmacokinetics and pharmacodynamics of antituberculosis agents, coupled with therapeutic drug monitoring, supports the development of individualized and effective treatment regimens, which are particularly critical for pregnant patients. Recommendations for managing tuberculosis in pregnant women after COVID-19 infection include measuring D-dimer levels, performing echocardiography, and consulting cardiologists to prevent treatment-related complications. Conclusions: Pregnant women represent a distinct subgroup of tuberculosis patients requiring individualized management. Changes observed in tuberculosis progression and treatment responses in pregnant women before and after SARS-CoV-2 infection should inform therapeutic choices, especially in cases of drug-resistant tuberculosis treated with bedaquiline. COVID-19 has been associated with increased cardiovascular risk, which may heighten the likelihood of adverse drug reactions in this population, especially given the limited therapeutic options. Further research is required to assess the long-term outcomes of latent tuberculosis infection in pregnant women and to evaluate the safety and efficacy of novel regimens for drug-resistant TB during pregnancy. Full article

The growing environmental and economic impacts of agri-food waste have intensified interest in digital and circular strategies for more sustainable resource management. This study investigates how digital technologies are being applied to enhance the circular management of agri-food waste. A systematic literature review was conducted following PRISMA guidelines, using Scopus as the primary database. The bibliometric analysis included 373 publications from 2015 to 2025 and was complemented by a thematic review of the 20 most cited articles. Results revealed six major research clusters, ranging from predictive waste analytics and smart traceability systems to circular bioeconomy applications such as anaerobic digestion and pyrolysis. In addition, the study examined structural indicators such as food waste per capita and hunger indices to contextualize geographic disparities in research output. The findings underscore the dual role of digital technologies as both operational tools and mechanisms for reducing systemic inequalities. Overall, the integration of intelligent systems and circular models offers promising pathways to support the Sustainable Development Goals and foster a more inclusive and resilient agri-food sector. Full article

The sustainable management of global groundwater resources is increasingly challenged by climatic uncertainty and escalating anthropogenic stress. Thus, there is a need for simulation tools that are more robust and flexible. This systematic review addresses the integration of two dominant modeling paradigms: the physically grounded Modular Finite-Difference Flow (MODFLOW) model and the data-agile Artificial Neural Network (ANN). While the MODFLOW model provides deep process-based understanding, it is often limited by extensive data requirements and computational intensity. In contrast, an ANN offers remarkable predictive accuracy and computational efficiency, particularly in complex, non-linear systems, but traditionally lacks physical interpretability. This review synthesizes existing research to present a functional classification framework for MODFLOW–ANN integration, providing a systematic analysis of the literature within this structure. Our analysis of the literature, sourced from Scopus, Web of Science, and Google Scholar reveals a clear trend of the strategic integration of these models, representing a new trend in hydrogeological simulation. The literature reveals a classification framework that categorizes the primary integration strategies into three distinct approaches: (1) training an ANN on MODFLOW model outputs to create computationally efficient surrogate models; (2) using an ANN to estimate physical parameters for improved MODFLOW model calibration; and (3) applying ANNs as post-processors to correct systematic errors in MODFLOW model simulations. Our analysis reveals that these hybrid methods consistently outperform standalone approaches by leveraging ANNs for computational acceleration through surrogate modeling, for enhanced model calibration via intelligent parameter estimation, and for improved accuracy through systematic error correction. Full article

Objective: This scoping review aims to comprehensively map the existing literature on the mechanisms of action of Alamandine (ALA), a peptide within the renin–angiotensin system, and its effects across various physiological systems. Materials and Methods: Utilizing the Joanna Briggs Institute methodology, a thorough search of databases including PubMed, Embase, Scopus, and Web of Science was conducted up to 30 January 2025. The review focused on identifying studies that explore the biological and therapeutic roles of ALA in different contexts, incorporating in vivo, in vitro, and in silico research. Results: A total of 590 records were initially identified, with 25 meeting the eligibility criteria for inclusion in this review. China emerged as the leading contributor to the research in this area, with a significant focus on the cardiovascular system. The studies revealed that ALA exhibits a range of beneficial effects, including anti-inflammatory, vasodilatory, antifibrotic, and antiapoptotic actions. These effects are primarily mediated through the inhibition of the mitogen-activated protein kinase (MAPK) signaling pathway and modulation of the nitric oxide pathway. The review also highlighted AL’s potential in mitigating oxidative stress and its implications in treating cardiovascular diseases, fibrosis, and cancer. Conclusions: The findings suggest that ALA holds significant therapeutic potential, offering antihypertensive, anti-inflammatory, antifibrotic, and anticancer benefits without notable adverse effects, warranting further research to explore its full potential and mechanism of action. Full article

Autism spectrum disorder (ASD) is a complex neurodevelopmental disease of multifactorial etiologies, manifesting as persistent challenges in social interactions, restrictive interests, and repetitive behaviors. Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzymopathy affecting red blood cell function. Although G6PD enzyme deficiency is known for its role in hemolytic anemia, emerging studies have suggested a potential association between G6PD deficiency and neurodegenerative and neurodevelopmental disorders, including autism. This narrative review explores the possible connection between G6PD deficiency and autism by analyzing relevant literature from the PubMed and Scopus databases. Current evidence points to plausible biological links, particularly oxidative stress and folate metabolism, warranting further investigation into G6PD deficiency as a potential risk modifier in ASD. Moreover, further research is necessary to elucidate the nature of this relationship and its implications for clinical practice. Full article

Background: Chronic illness affects children’s health and disrupts the spatial and temporal aspects of schooling by complicating attendance, interrupting learning routines, and exposing institutional rigidity. While many educational systems treat chronicity as an exception to be managed, this review reconceptualizes it as a pedagogical and symbolic challenge to normative assumptions about inclusion, care, and participation. Objective: To systematically examine how school-based behavioral and psychosocial interventions support children and adolescents with chronic health conditions (CHCs) in inclusive educational settings and to analyze what these interventions reveal about institutional practices of care and recognition. Methods: Following PRISMA 2020 guidelines, we conducted a systematic search across five databases, PubMed, ERIC, PsycINFO, Scopus, and Web of Science, for studies published between January 2010 and April 2025. Of 420 records screened, 28 studies met inclusion criteria. Eligible studies reported on school-based interventions for students aged 5–18 with chronic conditions. Methodological quality was appraised using the Cochrane Risk of Bias 2 tool (for RCTs) and the Joanna Briggs Institute checklist (for quasi-experimental designs). Findings were synthesized narratively and thematically. Results: The included studies addressed asthma, attention-deficit/hyperactivity disorder (ADHD), diabetes, epilepsy, autism, cancer, and food allergies. Interventions ranged from nurse-led management and teacher training to peer education and executive function coaching. Most reported improvements in symptom control, school attendance, academic performance, and psychosocial wellbeing. Several studies also demonstrated how interventions reshaped institutional routines and distributed responsibility for care, challenging rampant assumptions about autonomy, ability, and normativity. Conclusions: School-based interventions for chronic illness operate as health strategies and as symbolic and structural enactments of inclusion. When designed relationally, they modulate schools into responsive institutions where care is integrated in everyday pedagogical and organizational practices. Future research prioritizes longitudinal studies, underrepresented contexts, and the active participation of youth in shaping interventions. Full article

Purpose: Thoracolumbar burst fractures represent a significant proportion of spinal injuries, with management strategies remaining a subject of debate. While four-screw (4S) short-segment posterior fixation is commonly used, recent biomechanical studies suggest that adding pedicle screws at the fractured level (six-screw, 6S, construct) may improve stability and clinical outcomes. However, the clinical relevance of these findings remains uncertain. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Three databases (Scopus, PubMed/MEDLINE, Cochrane Library) were searched for studies comparing 4S and 6S constructs in thoracolumbar fractures. Inclusion criteria encompassed comparative clinical studies reporting perioperative, functional, and radiological outcomes. Data were extracted and analyzed using Review Manager 5.4.1, applying fixed- or random-effects models based on heterogeneity. Results: Twenty-two studies involving 1595 patients were included. The 6S group showed significantly improved postoperative pain scores (VAS), better short- and long-term sagittal alignment, and a lower implant failure rate. However, this technique was associated with longer operative times, increased intraoperative blood loss, and extended hospital stays. No significant differences in long-term functional disability (ODI) or infection rates were found. Conclusions: The addition of intermediate screws improves radiological outcomes and reduces implant failure but increases surgical burden. Further high-quality studies focusing on patient-reported outcomes and specific fracture subtypes are needed to refine clinical indications. Full article

This article systematically reviews biopolymer phase change materials (PCMs) for TES applications. The review was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using databases from Scopus, Web of Science, and Google Scholar. The biopolymer PCMs are categorized as natural, synthetic, and hybrid (a combination of natural and synthetic). A total of 82 articles were included in the analysis. Several thermal properties, mechanical properties, advancements, and challenges are discussed. This article aims to review biopolymer PCMs and identify research gaps for future development. Natural biopolymer PCMs include lipid, lignin, polysaccharides, proteins, etc. Synthetic biopolymer PCMs include supramolecular, polyethylene glycol, polyurethane, polyrotaxane, polylactic acid, etc. Hybrid biopolymer PCMs combine natural and synthetic polymers with conductive fillers, balancing high latent heat with improved thermal stability and durability, although issues, like leakage and low conductivity, persist. It is found that biopolymers can be used as the core and supporting matrix of PCMs. Several cases and configurations of core, supporting matrix, and fillers in the development of PCM from biopolymers are discussed. This article also demonstrates that several natural, synthetic, and hybrid biopolymer PCMs hold promise for demanding TES applications due to their tunable properties and reliability. Biopolymer PCMs offer a sustainable alternative to petroleum-derived substances by minimizing environmental harm, cutting carbon emissions, and promoting a circular economy. This review also highlights several challenges, such as feedstock selection, purification and encapsulation, system compatibility, and standardization, that future research might address to enable scalable, safe, and cost-effective biopolymer PCM solutions. Full article

Background/Objectives: Parental mental representations play a crucial role in shaping early parent–child relationships, particularly during the perinatal period. These internal models influence caregiving behaviors, emotional attunement, and the intergenerational transmission of attachment. The present systematic review aims to address this gap by examining the nature of both maternal and paternal mental representations in the perinatal period (involving pregnancy and the first postnatal time), with a particular emphasis on reflective functioning, and by outlining the variables that are influenced by these representations. Methods: Following PRISMA guidelines, eligible peer-reviewed studies were identified through a comprehensive literature search of major scientific databases (Scopus, Web of Science, PsychArticle/PsycInfo). Qualitative assessment and detailed description were carried out. Results: In total, 28 studies were selected and analyzed. Findings reveal that while representations tend to organize around shared psychological domains—such as expectations regarding the child, parental identity, and the anticipated relationship—there is significant heterogeneity in how these are conceptualized and measured across studies. Risk factors such as maternal depression, low social support, and adverse life experiences were consistently linked to disengaged or distorted representations, whereas balanced representations were associated with greater RF, emotional availability, and protective relational contexts. Conclusions: Overall, the review highlights the clinical relevance of assessing parental mental representations and RF during the perinatal period, suggesting that early, targeted interventions may enhance parental sensitivity and promote secure parent–infant bonds. Future research should adopt integrated theoretical models, include diverse family configurations, and evaluate the efficacy of preventive programs that support reflective and adaptive representations. Full article

The present study aimed to systematically review the anxiolytic and analgesic effects of gabapentin and pregabalin in domestic cats to assess the quality of using these medications for stress, fear, and anxiety management, and the treatment of both acute and chronic pain. The search was carried out between March and May 2025 using four databases: PubMed, Scopus, ScienceDirect, and Google Scholar. The keywords used were the combination of “pregabalin,” “gabapentin,” “analgesia,” “anxiety,” “stress”, and “cats”. Narrative reviews, as well as experimental and observational studies, were included. Experimental studies were classified as randomized controlled trials, controlled clinical trials, and prospective clinical trials, using the GRADE Pro GDP software (FP7-HEALTH.2010.3.1-1-two stage) to assess the certainty and confidence of the evidence. The initial search identified 57 manuscripts, of which 40 met the inclusion criteria. These studies focused on the management of stress, fear, and anxiety, as well as the control of acute and chronic pain in cats. Of these, 21 mention the use of gabapentin as an anxiolytic, while five report similar therapeutic effects of pregabalin. Regarding pain treatment, 12 papers and 2 papers support the use of gabapentin and pregabalin, respectively. This study confirms the validity of both drugs as therapeutic options for the management of stress, fear, and anxiety that impact the emotional welfare of cats. Furthermore, these drugs have been included in therapeutic guidelines for the control and treatment of acute and chronic pain in domestic cats. In conclusion, this systematic review supports the use of both drugs. Still, it highlights the need for more in-depth research and additional clinical trials to complement the existing evidence on the use of gabapentin and pregabalin. Full article

Background and Objectives: Patent ductus arteriosus (PDA) is one of the most common cardiovascular conditions affecting preterm infants, with incidence rates reaching 60% in neonates born before 28 weeks gestation. Traditional clinical assessment alone often proves inadequate for accurate diagnosis, potentially leading to both overtreatment and undertreatment. Targeted neonatal echocardiography (TnECHO) has emerged as a powerful bedside tool that enables neonatologists to perform focused cardiac evaluations, providing real-time assessment of ductal significance and systemic hemodynamics. This systematic review aimed to comprehensively evaluate the clinical utility of TnECHO in the management of PDA in preterm infants, with specific focus on its diagnostic accuracy, impact on treatment decisions, and influence on clinical outcomes. Materials and Methods: Following PRISMA guidelines, we conducted a systematic search of PubMed, Web of Science, and Scopus from inception (earliest available date of each database) through February 2025. The search strategy combined terms for “Targeted Neonatal Echocardiography” and “Patent Ductus Arteriosus.” We included observational studies and randomized controlled trials (RCTs) evaluating TnECHO in PDA management, while excluding reviews and case reports. Data extraction focused on study design, population characteristics, TnECHO protocols, and clinical outcomes. Results: From 173 initial records, 11 studies met inclusion criteria. Eight studies were rated as high-quality (NOS score ≥ 7). TnECHO implementation was associated with a 49% reduction in PDA ligation rates and decreased need for multiple treatment courses. Studies demonstrated improved diagnostic precision in assessing shunt significance and myocardial function, leading to more tailored therapeutic approaches. The establishment of dedicated TnECHO services enhanced interdisciplinary collaboration between neonatologists and cardiologists. However, limitations included operator dependence, variable institutional protocols, and occasional missed minor cardiac anomalies. Conclusions: TnECHO represents a transformative approach to PDA management in preterm infants, enabling physiology-guided decision-making that reduces unnecessary interventions while maintaining patient safety. Current evidence supports its role in improving diagnostic accuracy and optimizing treatment timing. Future research should prioritize multicenter RCTs to establish standardized protocols and evaluate long-term neurodevelopmental outcomes. The integration of TnECHO into routine neonatal practice requires investment in training programs and quality assurance measures to maximize its clinical potential. Full article

The genus Bauhinia has over 350 species distributed on different continents of the world. The vast majority of the species in this genus possess interesting biological activities. Also, they are good sources of flavonoids, which are known to elicit excellent pharmacological properties and are well-positioned as potential drug candidates. A literature search was performed with proper consideration of articles published and indexed in PubMed, Scopus, Springer Link, Google Scholar, ScienceDirect, SciFinder, and Medline databases between 1980 and 2023. A total of 164 flavonoids isolated from the genus Bauhinia were reviewed, and biological activities including antidiabetic, anti-cancer, antibacterial, cytotoxicity, antidiarrheal, antioxidant, anti-inflammatory, and anti-cataract were all reported. This study gave a comprehensive review of these flavonoids through detailed classification, structural diversity, and pharmacological activities. Full article

Background/Objectives: Esaxerenone, a novel non-steroidal mineralocorticoid receptor antagonist, has shown promising results in the treatment of essential hypertension (HTN). This study aims to comprehensively analyze the effectiveness of esaxerenone to control BP in patients with essential HTN. Methods: A systematic search was performed on PubMed, Scopus, Web of Science (WOS), and Cochrane Library from inception until January 2025 for randomized controlled trials (RCTs) comparing esaxerenone with standard HTN usual care. The primary outcome of interest was mean changes in sitting systolic (SBP) and diastolic blood pressure (DBP). Other secondary outcomes were mean changes in 24 h-SBP and 24 h-DBP, and target BP achievement. Safety outcomes, such as adverse events and increased levels of potassium/uric acid, were also assessed. Results: Our meta-analysis included four studies with a total of 1981 patients, all conducted in Japan. Esaxerenone demonstrated dose-dependent blood pressure reductions. At 5 mg, sitting DBP decreased by 4.22 mmHg (95% CI −8.72 to 0.29; p = 0.07) and SBP by 9.07 mmHg (95% CI −17.69 to −0.45; p = 0.04), while the 1.25 mg dose showed smaller, non-significant reductions. For 24 h measurements, only the 5 mg dose achieved significant reductions. Target BP achievement increased by 48% overall (RR 1.48, 95% CI 1.11 to 1.96; p = 0.007), with stronger effects at 5 mg (RR 2.05, 95% CI 1.03 to 4.08; p = 0.04). Esaxerenone significantly reduced nocturnal SBP by 10.62 mmHg (95% CI −14.01 to −7.23; p < 0.001). Conclusions: In patients with essential HTN, esaxerenone was shown to be safe and well-tolerated compared with usual care. Long-term data on safety is warranted. Full article

Organ-on-a-chip (OoC) devices simulate human organs within a microenvironment, potentially surpassing traditional preclinical methods and paving the way for innovative treatments. A thorough understanding of the current state of OoC design enables the development of more precise and relevant models that replicate not only the structure of organs but also their intricate cellular interactions and responses to external stimuli. This knowledge facilitates the optimization of biomimetic materials and allows for the real-time simulation of physiological microenvironments. By keeping abreast of new microfabrication techniques, we can explore opportunities to create customized and highly functional OoCs. Objective: To provide a comprehensive overview of microphysiological platform designs. Methods: This systematic review was registered in PROSPERO under the number CRD42022352569. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The eligibility criteria included studies utilizing human tissue, either primary or secondary lineage cells. Results: A total of 9.790 papers were retrieved from the Scopus, Embase, IEEE and Web of Science databases. After removing duplicates and applying a 10-year publication filter, 3.150 articles were screened by title and abstract. Full-text analyses were then performed. Eighteen studies met the eligibility criteria and were included in this systematic review. In this review, we examine the principles of OoC design, focusing on structure, dimensions, cell culturing options and manufacturing techniques. We also examine recent advances and future prospects in the field. Conclusions: Microphysiological devices in health research can facilitate drug discovery and improve our understanding of human physiology. They contribute to more ethical research by reducing the number of animals used in experiments. Full article

Skin aging is a complex biological process influenced by intrinsic factorssuch as genetic predispositions and hormonal changes as well as extrinsic factors including ultraviolet radiation, environmental pollution, and lifestyle habits. This process culminates in a progressive decline in the structural and functional integrity of the skin. This review delves into the protective roles of carotenoids, highlighting their significant anti-oxidative, anti-inflammatory, and photoprotective properties. We included studies that investigated the effects of dietary or topical carotenoids on skin aging markers in human and animal models. Eligible studies were identified through searches of PubMed, Scopus, Web of Science, Embase, Google Scholar, and the Cochrane Library from January 2000 to March 2025. Risk of bias was assessed using the Cochrane RoB tool for randomized trials and animal studies. A total of 176 studies were included, and data were synthesized narratively due to heterogeneity in study designs and outcomes. The findings indicate that carotenoids mitigate oxidative stress-induced cellular damage by scavenging reactive oxygen species (ROS) and Reactive Nitrogen Species (RNS), attenuating chronic inflammation, and enhancing dermal matrix integrity via collagen biosynthesis and modulation of matrix metalloproteinases. Additionally, they support skin hydration and elasticity by indirectly regulating aquaporins and promoting hyaluronic acid synthesis. This review further explores emerging strategies that incorporate carotenoid supplementation in lifestyle medicine and preventive dermatology. By elucidating the cellular pathways through which carotenoids exert their effects and modulate mitochondrial function, this review highlights their translational potential in anti-aging skincare. Ongoing research is essential to comprehend the complex connections between carotenoids, skin physiology, and overall health. This understanding will ultimately facilitate the creation of personalized nutritional and dermocosmetic strategies. Full article