Search Results (2,612)

Background: Preoperative differentiation between uncomplicated and complicated paediatric appendicitis remains challenging. This study aimed to evaluate the diagnostic performance of routine admission biomarkers and blood cell count-derived inflammatory indices for severity stratification and to determine whether fibrinogen provides additional predictive value beyond commonly used markers. Methods: We conducted a retrospective single-centre study (2018–2025) using electronically recorded clinical data. Patients with suspected appendicitis were identified through appendicitis-related ICD-10 codes and diagnostically validated. The final analytical cohort required complete admission laboratory data, including C-reactive protein (CRP), fibrinogen, and complete blood count parameters. Derived inflammatory indices included the neutrophil-to-lymphocyte ratio (NLR) and the systemic immune-inflammation index (SII). Diagnostic discrimination and multivariable prediction models were evaluated to assess the ability of these markers to distinguish complicated from uncomplicated appendicitis. Results: Of 1518 screened records, 1132 patients met inclusion criteria (620 complicated; 512 uncomplicated). Complicated appendicitis was associated with higher inflammatory markers and longer hospital stay (all p < 0.001). CRP demonstrated the strongest univariable discrimination (area under the curve [AUC] 0.785), while fibrinogen showed lower performance (AUC 0.744). A combined model including CRP, NLR, and SII achieved good discrimination (AUC 0.812), with minimal improvement after adding fibrinogen (AUC 0.813). In multivariable analysis, log-transformed CRP and SII remained independently associated with complicated appendicitis (both p < 0.001). A rule-out probability threshold of 0.303 achieved 90% sensitivity (negative predictive value 0.803), whereas a CRP cut-off ≥92.24 mg/L showed high specificity (0.943) and positive predictive value (0.900). Conclusions: Routine admission biomarkers and inflammatory indices derived from complete blood counts can support severity stratification in paediatric appendicitis. CRP and SII provide meaningful predictive information, whereas fibrinogen contributes little additional discriminatory value beyond CRP-based models. These findings suggest that a small set of routinely available laboratory markers may assist early risk stratification, although external validation is required before clinical implementation. Full article

Background: MicroRNAs (miRNAs) are stable, small non-coding RNAs involved in asthma-related pathways and are promising diagnostic biomarkers and therapeutic targets in childhood asthma. Objective: To identify miRNAs differentially expressed in preschool wheezing and childhood asthma, evaluate their association with asthma diagnosis and severity-related phenotypes, and explore their potential translational relevance through exploratory bioinformatic analyses. Methods: A systematic search of Medline, Embase, SCOPUS, PubMed, CINAHL, and Web of Science was conducted for English-language articles published up to March 19, 2025. Eligible human studies reported that miRNAs were differentially expressed in children with wheeze or asthma versus healthy controls (p < 0.05, fold change ≥ 1.5). Bioinformatic analysis identified hub genes, constructed protein–protein interaction networks, and predicted drug–gene interactions. Results: Forty-seven studies met the inclusion criteria, yielding 58 differentially expressed miRNAs (31 up, 27 down). Recurrently reported miRNAs included miR-497, let-7e, miR-98, miR-21, miR-126a, miR-196a2, miR-1, miR-146a-5p, miR-210-3p, miR-145-5p, and miR-200c-3p across blood, nasal swabs, BALF, and exhaled breath condensate. miR-26a showed strong diagnostic performance (sensitivity 83%, specificity 93%; p < 0.002, 95% CI 0.831–0.987). Functional enrichment implicated 56 differentially expressed genes in metabolic and immune processes. Ten hub genes (including TNF, IL5, IL13, TLR4) were linked to 339 potential therapeutic agents; the exploratory network analysis highlighted overlap between predicted miRNA-regulated hub genes and existing asthma-relevant drug targets, including approved biologics. Conclusions: Our review findings suggest that several miRNAs are promising candidate biomarkers for childhood asthma phenotyping and severity assessment; however, their diagnostic utility remains exploratory and requires rigorous external validation and standardisation before clinical application. Full article

Oleocanthal (OC), an anti-inflammatory and antioxidant phenolic compound exclusively found in extra virgin olive oil (EVOO), has emerged as a potential anticancer agent through multiple mechanisms of action, yet its impact on key processes such as cellular metabolism remains insufficiently characterized. Here, we investigated the metabolic and mitochondrial responses to OC across different breast cancer molecular subtypes. Triple-negative (MDA-MB-231) and luminal (MCF7, T47D) breast cancer cell lines were treated with OC to evaluate cell viability, cell cycle progression, metabolic enzyme expression, mitochondrial respiration, and mitochondrial network organization. OC responsiveness differed, being highest in MDA-MB-231 and lowest in T47D cells. Lactate dehydrogenase levels decreased in all cell lines, while mitochondrial response varied. MDA-MB-231 mitochondrial function was fully impaired, while MCF7 cells showed increased respiratory activity, with marked mitochondrial fragmentation, and T47D cells largely preserved mitochondrial integrity and function. Notably, the magnitude of OC effects correlated with MET expression, an established target of OC and a prognostic factor associated with reduced relapse-free survival within the triple-negative subtype. Collectively, these findings identify OC as a modulator of cancer cell metabolism and mitochondrial dynamics, with particular relevance in MET-high triple-negative breast cancers. Full article

As urbanization intensifies, improving street thermal comfort has become a critical issue in urban renewal. While existing studies generally assume that increasing the Green View Index (GVI) linearly improves pedestrian thermal comfort, this study identifies a significant “Decoupling Effect” in high-density commercial areas through field measurements and numerical simulations of three typical street types (commercial–service, ecological–recreational, and historical–cultural) in Shenyang. Integrating DeepLab V3 semantic segmentation with ENVI-met version 5.1.1 microclimate simulation, the results demonstrate a robust monotonic negative correlation between GVI and Physiological Equivalent Temperature (PET) in ecological streets (Spearman’s ρ = −0.692, p < 0.001), confirming the consistent cooling benefit of greenery in nature-dominated environments. However, a distinct “Threshold Effect” was identified in commercial streets using Piecewise Linear Regression (PLR). A critical breakpoint was detected at GVI = 22.08%. Below this threshold, visual greenery effectively contributes to cooling (slope = −0.454); yet, once GVI exceeds 22.08%, the cooling efficacy diminishes significantly (slope = −0.109), marking the onset of a “decoupling” phase. Specifically, despite Wenhua Road achieving a GVI of ~24.5% with a complex “three-board, four-belt” structure, its PET peak reaches 46.15 °C, approximately 5.5 °C higher than ecological streets. Mechanism analysis reveals that under peak thermal stress (Traffic Heat ≈ 75 W/m²), the high-intensity anthropogenic heat and hardscape radiation exceed the evaporative cooling threshold of vegetation. This study reveals the non-linear relationship between visual greenery and the physical thermal environment, suggesting that simply pursuing visual green quantity is ineffective in commercial canyon renewal; instead, a threshold-based synergistic optimization of canopy shading and pavement thermal performance is required. These findings provide a quantitative basis for sustainable street landscape planning and urban climate adaptation strategies in high-density cities. Full article

Background/Objectives: Intramuscular fat deposition is a key determinant of beef quality in Japanese Black cattle, and the fat area ratio of the rib eye (FAR) is highly correlated with Beef Marbling Standard scores. Methods: To identify genetic variants underlying variation in the FAR, we conducted a genome-wide association study (GWAS) followed by whole-genome sequence–based fine mapping in a Hyogo Japanese Black population (n = 432). Animals were genotyped using the Illumina BovineSNP50v3 BeadChip, and association analysis was performed using residuals derived from a linear mixed model accounting for fixed and random effects. Results: A significant association signal was detected on BTA17 (λ = 1.09), with the top single nucleotide polymorphism (SNP) located at 17:72,329,662 (p = 3.60 × 10⁻⁶). To refine the candidate region, we analyzed whole-genome resequencing data from 42 Hyogo Japanese Black cattle and identified a distinct linkage disequilibrium (LD) block spanning 71–74 Mbp on BTA17. Among 4292 variants within genes showing LD (r² ≥ 0.1) with the top SNP, 96 variants with strong LD and predicted functional effects were selected for validation. Genotyping in the Hyogo population revealed that a missense variant in gamma-glutamyltransferase 1 (GGT1) (c.589G>A, p.Asp197Asn) showed the strongest association with FAR (p = 3.89 × 10⁻⁶). A 5′UTR variant in GGT1 (c. −256G>T) and a missense variant in solute carrier family 5 member 1 (SLC5A1) (c.32C>T, p.Thr11Met) also exhibited significant associations and strong LD with the top SNP (r² > 0.7). GGT1 is involved in glutathione metabolism, whereas SLC5A1 encodes a sodium–glucose cotransporter implicated in nutrient sensing and metabolic regulation. Conclusions: Although functional validation is required, these variants represent strong positional and biological candidates underlying the BTA17 quantitative trait loci (QTL). The identified polymorphisms may provide useful molecular markers for optimizing genetic improvement of marbling-related traits within the Hyogo Japanese Black population. Full article

Background: Tendons adapt to mechanical loading by increasing cross-sectional area (CSA), stiffness, and matrix organization, with structural remodeling critical for both rehabilitation and performance. Collagen supplementation has been proposed to enhance this process by supplying key amino acids for collagen synthesis; however, inconsistent results across trials have limited its clinical and athletic application. Methods: A systematic review of randomized controlled trials evaluating collagen supplementation in humans was conducted. PubMed, EMBASE, CINAHL, and Web of Science were searched from database inception through May 2025. Risk of bias was assessed using the PEDro scale (≥6/10 classified as good-to-excellent quality). Due to substantial heterogeneity in supplementation protocols, training modalities, and outcome measures, results were synthesized narratively without meta-analysis. Data extraction included collagen type, dose, training modality, intervention duration, and outcome measures. Results: Of 887 unique citations, eight RCTs (n = 257; ages 18–52; 246 M:11 F) met the inclusion criteria. All studies incorporated resistance or plyometric training (3–15 weeks). Three of four studies reported significantly greater increases in tendon CSA in collagen groups versus placebo. Four studies investigated tendon stiffness and Young’s modulus; the two using higher doses (15–30 g/day) demonstrated significant between-group improvements favoring collagen, while lower-dose studies (~5 g) showed only within-group effects. Muscle strength improved with training in all trials, but no additive effects of collagen were observed. One study reported improvements in eccentric rate of force development and deceleration impulse with collagen, though gross explosive metrics (e.g., jump height) were unaffected. Conclusions: Collagen supplementation (15–30 g) with vitamin C (≥50 mg) may enhance tendon remodeling when combined with high-intensity resistance training (≥70% 1 RM). The current literature suggests strong evidence (GRADE A) for increases in tendon CSA and stiffness, strong evidence (GRADE A) against an effect on muscle strength, and conflicting evidence (GRADE C) for muscle cross-sectional area and physical performance. Limitations include small sample sizes, heterogeneous protocols, and short intervention durations. Full article

Urban overheating poses major challenges in Mediterranean cities, affecting public health and well-being. This study comparatively evaluates how alternative greening configurations influence urban microclimate and outdoor thermal comfort in a brownfield regeneration site in Imola, Italy, using ENVI-met simulations under a representative extreme summer condition. Eight scenarios with varying vegetation density, structure, and spatial arrangement were modelled on the hottest day of the year, and the Physiological Equivalent Temperature (PET) was evaluated at representative times. Results show that greening reduces heat stress, though its effectiveness varies over time and across configurations. No meaningful cooling occurred at 5:00 a.m., confirming that vegetation has a limited impact during nocturnal radiative processes. At 9:00 a.m., the medium-density scenario (S2b) achieved the greatest PET reduction (~2 °C), suggesting favorable evapotranspiration conditions under moderate radiation. At 4:00 p.m., the distributed high-density scenario (S3.2b) provided the strongest mitigation (~1.8–2 °C). Distributed layouts outperformed clustered ones, highlighting the non-linear nature of vegetation cooling. Zonal analysis showed the largest cooling in public green areas, followed by parking, building, and path zones, demonstrating the influence of surface type and shading geometry. Greening also produced modest improvements in surrounding neighborhoods (up to 0.8 °C in the morning), although impacts remained localized. Overall, results highlight how vegetation quantity, structure, and spatial distribution influence cooling performance under critical summer conditions, supporting climate-responsive urban regeneration design. These findings contribute to sustainable urban planning by supporting nature-based strategies for climate adaptation and improved environmental quality in regenerating urban districts. Future work should consider seasonal vegetation dynamics and multi-objective design optimization. Full article

Background: Difficult benign intracranial tumors (including meningiomas, schwannomas, neurofibromatosis-related tumors, and pituitary neuroendocrine tumors) have substantial morbidity in patients. Due to their limited treatment options, there is a need for individualized treatment beyond histological and surgical approaches. Objective: To summarize how novel treatment innovations have been implemented for these tumors, meningiomas and schwannomas are prioritized, followed by NF-associated neoplasms, and then pituitary neuroendocrine tumors in comparison to low-grade gliomas. Methods: We summarize the current knowledge relating to targeted therapies for gliomas, meningiomas, schwannomas, neurofibromatosis (NF) tumors, and pituitary neuroendocrine tumors to investigate an individual’s treatment options for difficult benign brain tumors. This review synthesizes evidence on tumor genomics and molecular markers, supported by methylation-based classification, immunohistochemistry, and functional assays, emphasizing current clinical applications. Evidence Synthesis: The recent data show that DNA methylation-based models can predict post-surgical outcomes and radiotherapy responses, enabling risk stratification and radiotherapy benefit prediction. Early signals support target-directed treatment, including cMET blockade that radiosensitizes NF2 schwannoma models, brigatinib-associated tumor shrinkage in NF2-deficient models, and PitNET organoid data. Conclusions: We support clinical decision-making that utilizes molecular profiling with functional testing to guide targeted treatment. We also identify evidence gaps such as biomarker-defined prospective trials that are needed for broader clinical implementation. Full article

This study addresses the critical challenge of optimizing outdoor thermal comfort for the aging population in old residential communities within China’s Hot-Summer and Cold-Winter (HSCW) climate zones. Against the backdrop of urban regeneration and rapid demographic aging, it investigates how key landscape elements—Square Reflectance, Greening Type, and Pergola Condition—influence the microclimate of community public spaces. The research employed an integrated methodology centered on numerical simulation. Using the ENVI-met 5.9.0 software and an L₉(3⁴) orthogonal experimental design, it simulated the microclimatic effects of nine combined scenarios on typical summer and winter days for a case study in Nanjing. The comprehensive thermal comfort index, Physiological Equivalent Temperature (PET), was used as the primary evaluation indicator to assess the thermal comfort performance for elderly occupants, with the assistance of air temperature, wind speed, and relative humidity, and the results were analyzed via range analysis and ANOVA. The key findings indicate that: (1) Greening Type and Pergola Condition are the dominant factors affecting microclimate and annual thermal comfort across seasons, while Square Reflectance has a comparatively minor influence. (2) The combination of deciduous trees with lawn achieves the optimal cross-seasonal PET gain. It provides effective shading and cooling in summer while allowing beneficial solar penetration for warming in winter, substantially outperforming evergreen-dominated configurations. (3) The presence of a pergola consistently enhances comfort by providing essential shade in summer and acting as a windbreak in winter. The combination dominated by deciduous trees + lawn and pergola yields an overall PET gain 1.097 °C higher than that of evergreen trees + shrub without pergola. This study provides evidence-based, elderly specific landscape design strategies to inform the thermal environment optimization of public spaces in old residential areas undergoing renewal. Full article

Sustainable development in cities has gained popularity due to the emergence of numerous urban challenges in harsh environments. Selecting an accurate turbulence model in CFD is crucial for assessing the outdoor environment. Among the widely used microclimate simulation tools, ENVI-met stands out for its convenience and its proven effectiveness in urban microclimate studies. Elevated design, often referred to as ‘lifted up design,’ is standard in architectural practice, serving both as recreational spaces and corridors, potentially improving thermal comfort. To ensure reliable microclimate modeling, assessments in such areas should be validated against empirical data. This study compares the microclimatic conditions in open space beneath an elevated building using ENVI-met with on-site meteorological data collected in Xi’an, China, across three days with varying weather conditions. The results show that ENVI-met can reasonably reproduce air temperature (R² = 0.80–0.96, RMSE = 0.67–1.42 °C), relative humidity (R² = 0.85–0.99, RMSE = 2.83–9.32%), and mean radiant temperature (R² = 0.87–0.90, RMSE = 4.11–7.23 °C) under different conditions, though some deviations exist—especially with diffuse radiation, which ENVI-met tends to underestimate beneath elevated structures. Despite these discrepancies, the model performance was evaluated by comparing field measurements with ENVI-met outputs, and the results indicate that ENVI-met can provide useful insights for simulating microclimate conditions in open spaces beneath elevated buildings under different weather conditions. Full article

To map and describe the scientific evidence on germicidal ultraviolet C (UV-C) light for hospital surface disinfection, this scoping review examined device types, reported operational parameters, microbiological and clinical outcomes, and implementation aspects. Primary studies conducted in hospital settings and evaluating UV-C or ultraviolet germicidal irradiation on environmental surfaces were searched in four databases without date restrictions. Data were synthesized descriptively in tables and narrative form following JBI and PRISMA-ScR guidance. Eleven studies (2007–2025) met the inclusion criteria. Reported microbial reductions ranged from 1 to ≥5 log₁₀. Higher and more consistent reductions were predominantly observed under laboratory or controlled experimental conditions, whereas reductions in real-world hospital surface sampling were more variable and influenced by pathogen type, surface material, room geometry, and shadowing. Integration of UV-C with manual cleaning and multi-position irradiation cycles was associated with greater effectiveness. Reporting of key radiometric parameters (dose, exposure time, and distance) was frequently incomplete, limiting reproducibility and cross-study comparability. Clinical findings were heterogeneous: some interrupted time-series analyses suggested reductions in healthcare-associated infections, although effects were not uniform across microorganisms. Implementation reports described room-level cycle times compatible with turnover, variable staffing requirements, and limited economic evaluation. Overall, UV-C appears to be a promising adjunct to standard cleaning practices in hospital environments. However, standardized radiometric reporting, multicenter studies, and robust clinical and economic evaluations are necessary to support safe, reproducible, and sustainable large-scale implementation. Full article

Currently, there are very few efficient treatment options for hepatobiliary pancreatic cancer (HPC), which comprises pancreatic ductal adenocarcinoma (PDAC), biliary tract cancer (BTC), and hepatocellular carcinoma (HCC). The HPC tumors are the most lethal malignant tumors in the world. Traditional chemotherapy offers little survival benefit and is associated with notable systemic toxicity, which has made antibody–drug conjugates (ADCs) a hopeful treatment option. Strong cytotoxic drugs combine with monoclonal antibodies to attack tumor-associated antigens. This review discusses the benefits and current developments of Antibody–Drug Conjugates (ADCs) in treating HPC. It also covers their mechanisms of action, ongoing clinical trials, and the challenges of targeting specific antigens like B7-H3, c-MET, and Trop-2. ADCs deliver chemotherapy directly to cancer cells while protecting healthy tissues. It also addresses the favorable outcomes of several preclinical and clinical studies and highlights future paths to enhance ADC efficacy, including addressing tumor heterogeneity, overcoming resistance, and optimizing drug-delivery techniques. This approach has the possibility to further increase patient survival and minimize side effects in HPC patients. To the best of our knowledge and based on the available literature, we have made every effort to include all relevant publications; any inadvertent omissions are entirely unintentional. Full article

Glutathione (GSH) is a central regulator of redox homeostasis, melanogenesis, and cellular repair, and has gained increasing attention in dermatology for its potential roles in skin brightening, anti-aging, and tissue regeneration. This systematic review evaluated molecular, clinical, and translational evidence of glutathione’s applications and safety across different delivery modalities. The review followed PRISMA guidelines and included studies published between 2000 and 2025. A total of 194 studies met the inclusion criteria, evaluating the effectiveness of glutathione in esthetic dermatology and regenerative medicine. Topical and oral glutathione demonstrated favorable effects on pigmentation, skin brightness, hydration, and oxidative stress markers. Injectable glutathione increases systemic levels rapidly, but is associated with short-lasting effects and potential safety concerns. Glutathione S-transferases facilitate the conjugation of glutathione to electrophilic xenobiotics, thereby protecting proteins and nucleic acids from electrophile-induced damage. Glutathione Peroxidase employs GSH as an electron donor to reduce hydrogen peroxide and lipid hydroperoxides, thus protecting membrane lipids, mitochondrial membranes, and DNA from oxidative damage. Glutathione facilitates the regeneration of other antioxidants, such as vitamin C and vitamin E, through redox cycling. A consistent correlation exists between reduced GSH levels and neuronal dysfunction. Elevated GSH levels enhance cellular resistance to oxidative stress and reduce apoptotic signaling. GSH plays a pivotal role in cutaneous aging and tissue repair through redox regulation, mitochondrial protection, and the modulation of inflammatory and extracellular matrix pathways. To elucidate the clinical significance of glutathione, future research should focus on conducting randomized controlled trials, developing standardized formulations, and performing long-term safety assessments. Full article

Background: Artificial intelligence (AI) shows promising results in lymphoma detection, prediction, and classification. However, translating these findings into practice requires a rigorous assessment of potential biases, clinical utility, and further validation of research models. Objective: The goal of this study was to summarize existing studies on artificial intelligence models for the histopathological detection of lymphoma. Design: This study adhered to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. A systematic search was conducted across three major databases (Scopus, PubMed, Web of Science) for English-language articles and reviews published between 2016 and 2025. Seven precise search queries were applied to identify relevant publications, accounting for variations in study modality, algorithmic architectures, and disease-specific terminology. Results: The search identified 612 records, of which 36 articles met the inclusion criteria. These studies presented 36 AI models, comprising 30 diagnostic and six prognostic applications, with Convolutional Neural Networks (CNNs) being the predominant architecture. Regarding data sources, 83% (30/36) of datasets utilized Hematoxylin and Eosin (H&E)-stained images, while the remainder relied on diverse modalities, including IHC-stained slides, bone marrow smears, and other tissue preparations. Studies predominantly utilized retrospective, private cohorts with sample sizes typically ranging from 50 to 400 patients; only a minority leveraged open-access repositories (e.g., Kaggle, TCGA). The primary application was slide-level multi-class classification, distinguishing between specific lymphoma subtypes and non-neoplastic controls. Beyond diagnosis, a subset of studies explored advanced prognostic tasks, such as predicting chemotherapy response and disease progression (e.g., in CLL), as well as automated biomarker quantification (c-MYC, BCL2, PD-L1). Reported diagnostic performance was generally high, with accuracy ranging from 60% to 100% (clustering around 90%) and AUC values spanning 0.70 to 0.99 (predominantly >0.90). Conclusions: While AI models demonstrate high diagnostic accuracy, their translation into practice is limited by unstandardized protocols, morphological complexity, and the “black box” nature of algorithms. Critical issues regarding data provenance, image noise, and lack of representativeness raise risks of systematic bias, hence the need for rigorous validation in diverse clinical environments. Full article

Background: Spirulina supplementation combined with structured exercise may improve obesity-related metabolic dysfunctions. This research examined whether this combination enhances body composition, glucose levels, lipid profile, and cardiorespiratory fitness in overweight and obese adults. Methods: Following PRISMA 2020 guidelines, a systematic search of Scopus, PubMed, and Web of Science identified randomized controlled trials (RCTs) evaluating spirulina (1–6 g/day) combined with structured exercise in individuals with overweight and obesity (BMI ≥ 25). The search retrieved 91 records, of which 10 studies met the inclusion criteria and were included in the systematic review. Nine studies provided sufficient post-intervention data and were included in the quantitative meta-analysis using a random-effects model, with heterogeneity assessed using τ², Q, and I² statistics. Publication bias was evaluated using rank correlation, regression-based tests, trim-and-fill, and fail-safe N analyses. Results: Combined spirulina supplementation and structured exercise (6–12 weeks) was associated with reductions in BMI (−1.34 kg/m²), body fat percentage (−3.03%), fasting glucose (−14.47 mg/dL), LDL-C (−12.68 mg/dL), and triglycerides (−9.81 mg/dL), along with increases in VO2max (3.25 mL/kg/min) and HDL-C (4.21 mg/dL). Effect estimates were generally larger in combined exercise–spirulina subgroups, particularly in HIITsupp and R-AEsupp conditions, whereas supplementation-only comparisons demonstrated smaller and less consistent changes. Inflammatory markers and adipokines (CRP, TNF-α, MCP-1, IL-6, IL-8) showed favorable directional changes in individual trials. Conclusions: Spirulina combined with structured exercise was associated with changes in anthropometric, glycemic, cardiorespiratory, and lipid parameters in individuals with overweight or obesity. Full article