Search Results (377)

Background/Objectives: Highly branched cyclic dextrin (HBCD) may improve carbohydrate (CHO) availability during soccer-specific intermittent exercise via favorable gastrointestinal properties. Whether co-ingestion with whey protein confers additional ergogenic benefits beyond HBCD alone remains unclear. Methods: Nine male soccer players completed a single-blind, randomized crossover trial (≥7-day washout) with three conditions, Placebo (water), CHO, and isocaloric HBCD plus whey protein isolate (CHOP), during a standardized, ~120-min laboratory-based soccer-specific intermittent exercise protocol (not an actual match). The 500-mL beverage, split into two 250-mL servings, was consumed before exercise and at half-time during the exercise protocol. Respiratory quotient (RQ), substrate oxidation, heart rate, RPE, digestive symptoms, running time, and distance were assessed, with condition effects tested via repeated-measures ANOVA at each cycle. Results: Compared with Placebo, CHO increased RQ (p = 0.042) and carbohydrate oxidation (p = 0.048) while reducing fat oxidation (p = 0.034) at the final cycle, reflecting greater late-exercise CHO utilization without improving endurance performance. Compared with Placebo, CHOP significantly improved both running time (p = 0.019) and running distance (p = 0.025), with no significant difference from CHO on either outcome. RPE was significantly lower in CHOP than in Placebo during the latter stage of exercise (p = 0.016). Conclusions: HBCD ingestion before exercise and at half-time promoted greater late-exercise CHO utilization without increasing cardiovascular or gastrointestinal strain. Co-ingestion of whey protein with HBCD provided ergogenic benefits over Placebo by improving fatigue-limited endurance performance, supporting isocaloric CHOP co-ingestion as a practical nutritional strategy for prolonged soccer-specific intermittent exercise. Full article

Background: Accurate assessment of extubation readiness in mechanically ventilated children remains difficult because successful sustained breathing depends on the interaction of respiratory, metabolic, inflammatory, neurological, and cardiovascular factors. This study developed and internally validated machine-learning models for predicting 48 h extubation success using routinely available pre-extubation data. Methods: Of 1097 total PICU admissions, 341 mechanically ventilated children treated between 2021 and 2026 constituted the final analytic cohort. The primary outcome was survival without reintubation during the first 48 h after planned extubation. Demographic, clinical, laboratory, blood gas, illness severity, and ventilator variables were evaluated. Logistic Regression, Random Forest, Gradient Boosting, and Support Vector Machine models were assessed using stratified 5-fold cross-validation. Unsupervised k-means clustering was performed to identify physiological phenotypes. Results: Extubation was successful in 298 children (87.4%) and failed in 43 (12.6%). Failure was associated with higher oxygenation index, lactate, procalcitonin, C-reactive protein, PaCO₂, pSOFA, PEEP, and rapid shallow breathing index, together with lower arterial pH, bicarbonate, ionized calcium, hemoglobin, albumin, sodium, and Glasgow Coma Scale scores. Random Forest yielded the numerically highest discrimination, with an AUC of 0.983 (95% CI, 0.971–0.993), a sensitivity of 0.980, a specificity of 0.814, an accuracy of 0.959, and a Brier score of 0.032. Arterial pH, the oxygenation index, bicarbonate, ionized calcium, procalcitonin, lactate, and PaCO₂ showed the highest Random Forest Gini importance scores. Clustering identified a low-severity phenotype (n = 302; 97% success; 0% mortality) and a high-severity phenotype (n = 39; 10% success; 100% mortality). Conclusions: Multidimensional machine-learning models predicted 48 h pediatric extubation success with strong internal discrimination. Prospective multicenter external validation is required before clinical implementation. Full article

Background/Objectives: The ankle–brachial index (ABI) is a low-cost, non-invasive screening tool for peripheral artery disease (PAD) and an independent predictor of cardiovascular events, which makes it suitable for primary care. Peripheral haemodynamic data across body mass index (BMI) gradients remain scarce, and BMI and diabetes are seldom modelled together despite their frequent co-occurrence. We investigated their associations with peripheral haemodynamic parameters. Methods: We performed a cross-sectional study in 147 primary care users, twenty-seven of whom had a self-reported diagnosis of diabetes mellitus (DM). Systolic pressure was obtained by auscultation, with Doppler being unavailable. The ABI was calculated per leg from unrounded pressure, and the lower index was adopted and classified according to American Heart Association thresholds (abnormal: ≤0.90; borderline: 0.91–0.99; normal: 1.00–1.40; elevated: >1.40). Nested linear models with robust standard errors estimated the adjusted association of DM with each outcome. Results: The DM group was older (62 vs. 44 years; p < 0.001), with greater rates of excess weight (77.8% vs. 54.2%), hypertension (59.3% vs. 25.8%), dyslipidaemia (48.1% vs. 11.7%), and smoking (30.8% vs. 10.1%). Crude upper-limb systolic pressure was 10.1 mmHg higher in the DM group (95% confidence interval [CI]: −0.5 to 20.6) but fell to 1.3 mmHg upon adjustment for age (p = 0.82 fully adjusted). The ABI did not differ between the groups (mean difference of 0.02, 95%CI: −0.06 to 0.11; p = 0.59) and showed no gradient across BMI. An abnormal ABI was present in 14.4% of participants and a borderline ABI in 18.5%, so that 32.9% had an ABI below 1.00. Conclusions: The crude blood pressure difference was attenuated after adjustment, chiefly for age, and DM was not independently associated with any outcome; residual confounding cannot be excluded. No ABI difference was detected, but power reached 80% only for a difference of about 0.12 units. The fact that one-third of participants had an ABI below 1.00 warrants further investigation of risk-based vascular peripheral assessment in primary care. Full article

Background/Objectives: Elevated brachial–ankle pulse wave velocity (baPWV) predicts adverse outcomes after percutaneous coronary intervention, but its relation to the quantitative angiographic outcomes of drug-eluting stent (DES) implantation is unknown. We examined baPWV against acute gain and late lumen loss. Methods: In a retrospective single-center cohort, 242 lesions in 141 patients with paired quantitative coronary angiography (QCA) were analyzed. baPWV was modeled per 1 SD with patient-level clustering (linear mixed model for acute gain; cluster-robust ordinary least squares for late lumen loss), with a Bonferroni-corrected α = 0.025 for the co-primary outcomes. Generalizability was assessed against registry patients without QCA. Results: An unadjusted inverse association with acute gain (β = −0.093 mm per 1 SD; p = 0.013) was fully attenuated after adjustment (β = −0.019; 95% CI −0.106 to +0.068; p = 0.67). baPWV was not associated with late lumen loss (adjusted β = −0.021; 95% CI −0.091 to +0.050; p = 0.57). Conclusions: Pre-procedural baPWV showed no independent association with acute gain or late lumen loss after DES implantation, consistent with a marker of systemic cardiovascular risk rather than independent local angiographic information. These data do not support using baPWV to guide procedural decisions. Full article

Background/Objectives: Respiratory syncytial virus (RSV) causes morbidity in older adults with cardiovascular disease, in whom infection may precipitate severe lower respiratory tract disease, hospitalization, functional decline, and cardiovascular destabilization. We evaluate the evidence for RSV vaccination in cardiovascular disease and propose a jurisdiction-adaptable framework for integrating vaccination into cardiovascular care. Methods: Observational studies, randomized trials, pragmatic and test-negative studies, prespecified cardiovascular analyses of DAN-RSV, and eligibility recommendations were narratively synthesized and translated into a pathway encompassing patient identification, eligibility and risk assessment, vaccine delivery and co-administration, documentation, and follow-up. Results: Acute cardiac events are frequent during RSV hospitalization, and cardiovascular risk may persist after infection. Randomized trials establish protection against RSV-associated lower respiratory tract disease and respiratory illness, while real-world studies support effectiveness against RSV-related hospitalization. DAN-RSV reduced all-cause cardiorespiratory hospitalization but did not demonstrate significant reductions in cardiovascular hospitalization, myocardial infarction, heart failure (HF) hospitalization, atrial fibrillation, stroke, cardiovascular death, or major adverse cardiovascular events; observational associations with lower post-vaccination cardiovascular-event rates remain hypothesis-generating. The framework prioritizes adults aged ≥75 years and those aged 50–74 years with high-risk cardiovascular conditions where consistent with national recommendations, embeds vaccination assessment across cardiology, HF, primary care, pharmacy, and long-term care, and incorporates co-administration, documentation, and outcome surveillance. Conclusions: The principal contribution is a pathway for moving RSV vaccination from recommendation to routine preventive care for adults with cardiovascular disease. It anchors implementation in established RSV and cardiorespiratory benefits while treating cardiovascular-event reduction as a research priority rather than a demonstrated indication. Full article

Endothelial dysfunction is a key mechanism linking obesity, metabolic disturbances, and cardiovascular disease, contributing to the development and progression of atherosclerosis and other vascular complications. This review provides a comprehensive overview of the molecular mechanisms underlying endothelial dysfunction in obesity and discusses current diagnostic approaches and therapeutic strategies aimed at restoring vascular homeostasis. The available evidence indicates that chronic inflammation, oxidative stress, insulin resistance, reduced nitric oxide bioavailability, increased reactive oxygen species production, and dysregulated adipokine signaling play central roles in endothelial impairment. Recent advances in functional vascular assessment, circulating biomarkers, and imaging techniques have improved the early identification of endothelial dysfunction and cardiovascular risk. Current therapeutic strategies include pharmacological agents, such as glucagon-like peptide-1 receptor agonists, sodium-glucose co-transporter 2 inhibitors, metformin, and dipeptidyl peptidase-4 inhibitors, together with lifestyle interventions based on healthy dietary patterns and regular aerobic and resistance exercise. These approaches improve glycemic control, reduce inflammation and oxidative stress, enhance endothelial function, and contribute to cardiovascular protection. Overall, the evidence supports an integrated and personalized management strategy targeting both metabolic and vascular abnormalities to reduce cardiovascular risk and improve long-term clinical outcomes in individuals with obesity. Full article

Background: Multisystem inflammatory syndrome in children (MIS-C) was recognized in 2020 as a post-infectious hyperinflammatory condition occurring 2–6 weeks after SARS-CoV-2 infection. While large studies from Europe and North America have described its clinical spectrum and outcomes, evidence from the Middle East remains limited. MIS-C shares features with Kawasaki disease (KD), including persistent fever, mucocutaneous manifestations, and cardiac involvement, but differs in age distribution, gastrointestinal involvement, and patterns of cardiac injury. Objective: To map the reported Middle Eastern evidence on the clinical and laboratory phenotype, Kawasaki-like manifestations, cardiovascular involvement, management, short-term outcomes, and evidence gaps in children with MIS-C. Methods: A scoping review was conducted using the Arksey and O’Malley framework, guided by Joanna Briggs Institute methodology and reported according to PRISMA-ScR. PubMed/MEDLINE, Scopus, Web of Science, and the WHO COVID-19 database were searched for studies published from 1 December 2020 through 30 September 2025. Two reviewers independently screened records in Rayyan and charted data using standardized forms. Findings were synthesized descriptively; numerical ranges reflect values reported across selected contributing studies and are not pooled regional estimates. Results: Twenty-seven original clinical studies met the eligibility criteria, including case reports, case series, and observational cohorts from the UAE, Saudi Arabia, Qatar, Jordan, and multinational Middle Eastern collaborations. Across the included reports, affected children were generally older than the typical classic Kawasaki disease population. Gastrointestinal symptoms were commonly reported, and myocardial dysfunction was reported more frequently than coronary artery abnormalities. Most patients received intravenous immunoglobulin, often combined with corticosteroids. Short-term outcomes were generally favorable, but the evidence was heterogeneous and follow-up was limited. No meta-analysis was performed. Conclusions: The available Middle Eastern literature suggests that MIS-C commonly presents in school-aged children with gastrointestinal, mucocutaneous, and myocardial involvement. These patterns are descriptive rather than definitive because the evidence is predominantly retrospective, geographically uneven, and methodologically heterogeneous. The principal contribution of this review is to map the regional literature and identify priorities for prospective, standardized, multicenter studies and long-term follow-up. Full article

Background/Objectives: Dietary inflammation may influence cardiometabolic health, yet the gut mycobiome and bacterial–fungal interactions remain unclear. Building upon our earlier findings and data from the TALENTs trial (Targeting Aging and Longevity with Exogenous Nucleotides) baseline data, we explored gut fungal profiles and bacterial–fungal co-occurrence patterns in relation to the Dietary Inflammatory Index (DII) and Life’s Essential 8 (LE8) in older adults. Methods: We enrolled 301 community residents aged 60–70 years, with 285 providing qualified fungal internal transcribed spacer (ITS) sequencing data. DII scores were derived from 3-day dietary records to reflect dietary inflammatory risk, and LE8 (integrating health behaviors including physical activity and metabolic health factors including BMI, blood lipids, blood pressure, and blood glucose) was used to assess cardiovascular health; LE8_non-diet was applied as a sensitivity measure. Fungal diversity, genus-level taxa, ecological guilds, and bacterial–fungal associations were analyzed using diversity indices, ZINB/Hurdle models, bootstrap, E-values, DIABLO analysis, and network construction. Results: DII showed an inverse correlation with LE8_non-diet (r = −0.130, p = 0.024). Fungal alpha and beta diversity did not differ significantly across DII-defined groups. Conversely, better cardiovascular status was linked to higher fungal richness, with significantly elevated Chao1 and ACE indices in the high-CVH group (both p < 0.05). Additionally, integrated ZINB, Hurdle, and stability analyses jointly pinpointed four candidate fungal genera that correlated with both DII and LE8. Both ZINB and DIABLO analyses consistently indicated that antagonistic interactions dominated gut bacterial–fungal associations (89.9% vs. 63.8% of negative associations, respectively), with DIABLO further revealing synchronized community-level co-variation between the two kingdoms (r = 0.325, p < 0.01). FUNGuild prediction further revealed saprotrophic guilds enriched in the high-CVH group and host-associated guilds in the low-CVH group, with similar patterns across DII-defined groups. Conclusions: This cross-sectional study reveals gut mycobiome profiles and potential bacterial–fungal co-occurrence patterns among older adults stratified by dietary inflammatory potential and cardiovascular health status, generating testable hypotheses for subsequent nutritional and metabolic research integrating lifestyle behaviors and functional health outcomes. Full article

Background/Objectives: Duloxetine is a serotonin–norepinephrine reuptake inhibitor used for psychiatric and chronic pain conditions. It enhances serotonergic and noradrenergic neurotransmission by inhibiting the reuptake of serotonin and norepinephrine. Acute poisoning, most commonly resulting from intentional oral ingestion, may frequently present with neurological and cardiovascular manifestations. Although duloxetine is widely prescribed, evidence regarding acute overdose remains limited, and no validated toxic duloxetine concentration threshold reliably predicts the severity of duloxetine toxicity. This systematic review aimed to synthesize published cases of duloxetine poisoning and characterize clinical manifestations, management strategies, and outcomes. Methods: We searched PubMed and Google Scholar for case reports and case series describing cases of duloxetine poisoning. We included cases of acute duloxetine poisoning with a clearly toxic ingested dose and/or analytically confirmed toxic duloxetine concentrations. Results: A total of 18 publications describing 23 patients were included in this systematic review. Duloxetine intoxication was classified as suicidal in 17 cases (73.9%), accidental in 5 cases (21.7%), and not specified in one case (4.3%). In most cases (78.3%), duloxetine overdoses involved co-ingestion of other central nervous system depressants. The most common clinical manifestation was altered mental status, ranging from somnolence, confusion, disorientation, and drowsiness to impaired consciousness, coma, or unresponsiveness in severe cases. Nearly half of the included duloxetine poisoning cases (47.8%) were fatal. Conclusions: In conclusion, acute duloxetine intoxication is most frequently associated with the co-ingestion of other central nervous system depressants, and early recognition with prompt supportive management is essential to minimize the risk of fatal outcomes. Full article

Brain aging exhibits substantial interindividual heterogeneity, yet separating aging-related neuroanatomical variation from pathological influences remains methodologically challenging. To address this issue, we constructed a Clinically Defined Aging Reference (CDAR) cohort from the UK Biobank by excluding individuals with overt clinical pathology and applied the Surreal-GAN framework to characterize latent patterns of age-associated structural variations. A total of 26,251 participants were included. The model identified two co-occurring dimensions of brain aging, referred to as R₁ and R₂, that were stable across subsamples (R₁: r = 0.873, R₂: r = 0.953) and remained consistent when refitted separately in males and females (female: r = 0.792, male: r = 0.818). R₁ was characterized by widespread gray matter reduction involving cortical, subcortical, and cerebellar regions and was associated with broadly poorer cognitive performance, adverse lifestyle profiles, metabolic and inflammatory alterations, and age-related diseases. R₂ exhibited relative preservation of subcortical structures together with widespread preservation of cortical surface area and more selective differences in cortical thickness. Compared with R₁, R₂ showed weaker associations with cognition and peripheral physiological measures but retained associations with cardiovascular-related outcomes. These findings suggest that brain aging within a clinically defined aging reference cohort may involve multiple partially dissociable neuroanatomical dimensions rather than a single pattern, providing an operational reference for studying aging-related structural heterogeneity under reduced clinical confounding. Full article

Background/Objectives: Self-management intervention strategies are recommended to address the needs of breast cancer survivors (BCSs) who have cardiovascular diseases (CVDs). Despite the benefits, these strategies are often suboptimally implemented, resulting in inadequate cardiovascular management among BCS with CVDs. The project aims to develop a nurse-led and GP-supported self-management (NGPS) intervention to reduce cardiovascular risks in BCS with CVDs and evaluate its feasibility and potential effects in primary care settings using the double diamond co-design process and the Medical Research Council (MRC) Framework for Developing and Evaluating Complex Interventions. Methods: The study will be conducted in two phases. In phase I, an evidence-based and co-designed NGPS protocol with end-users will be preliminarily developed based on the identified research evidence, relevant theories, practice guidelines and the current practice standards in Australia. The co-design workshop(s) will involve healthcare professionals and BCSs with CVDs to further refine and validate the developed preliminary protocol. In phase II, a one-group pre-post pilot study will evaluate the feasibility of the intervention and study procedures, such as recruitment, retention, adherence, acceptability, and safety as primary outcomes. The study will also preliminarily explore the effectiveness of the intervention such as physiological measures as secondary outcomes to inform a future large-scale trial. Phase II also involves follow-up qualitative interviews to explore participants’ experiences of the pre-post pilot study. The participants will be recruited from primary medical centres in Victoria. Conclusions: The findings will provide a co-designed evidence-based intervention for primary care nurses and General Practitioners (GPs) to promote long-term health outcomes for patients with both breast cancer (BC) and CVDs. Clinical registration: ClinicalTrial.gov (registration No. NCTO7313397). Full article

Background: Persistent cardiovascular and multisystem manifestations remain an important concern following hospitalization for coronavirus disease 2019 (COVID-19). However, the spectrum of newly identified conditions during follow-up and their relationship with acute disease severity remain incompletely characterized. This study aimed to describe cardiovascular and multisystem diagnoses, identified during short-term and long-term follow-up and to evaluate the association between acute-phase clinical characteristics, biomarkers, and subsequent outcomes. Methods: We conducted a retrospective observational cohort study including 762 adults hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between January 2021 and December 2022. Follow-up data were obtained from patients who re-presented to the same hospital during short-term follow-up (mean 4.33 months; n = 130) or long-term follow-up (mean 2.06 years; n = 186). Newly documented cardiovascular and non-cardiovascular diagnoses recorded during routine clinical care were analyzed separately for each follow-up cohort. Multivariable logistic regression was used to identify predictors of in-hospital mortality and cardiovascular outcomes. Results: At least one newly documented diagnosis was identified in 120/130 patients (92.3%) during short-term follow-up and in 175/186 patients (94.1%) during long-term follow-up. Cardiovascular diagnoses were identified in 32.3% and 45.2% of patients attending short-term and long-term follow-up, respectively. Hypertension and atherosclerosis were the most frequent cardiovascular diagnoses during short-term follow-up, whereas heart failure and ischemic heart disease predominated among patients attending long-term follow-up. Pulmonary fibrosis was the most common non-cardiovascular diagnosis at both follow-up periods. Elevated D-dimer and fibrinogen levels during acute COVID-19 were independently associated with in-hospital mortality, whereas acute-phase NT-proBNP was not independently associated with cardiovascular diagnoses identified during follow-up. Conclusions: Patients who re-presented for clinical evaluation after hospitalization for COVID-19 exhibited a substantial burden of newly documented cardiovascular and multisystem diagnoses. Given the retrospective design, independent follow-up cohorts, and absence of a non-COVID control group, these findings should be interpreted as observational post-hospitalization data rather than evidence of causal or progressive post-COVID-19 disease. Prospective controlled longitudinal studies are needed to better define the long-term health consequences of SARS-CoV-2 infection. Full article

Background/Objectives: Clostridioides difficile infection (CDI) is an increasingly recognised nosocomial complication in patients hospitalised with coronavirus disease 2019 (COVID-19), driven by broad-spectrum antibiotic exposure, corticosteroid use, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related intestinal dysbiosis. The contribution of underlying cardiovascular comorbidities, particularly heart failure, to CDI susceptibility in hospitalised COVID-19 patients remains insufficiently characterised. We aimed to evaluate the prevalence, risk factors, and clinical impact of CDI in hospitalised COVID-19 patients at a tertiary Romanian infectious diseases centre, with a specific focus on cardiovascular disease and modifiable antimicrobial-prescribing factors. Methods: This single-centre retrospective observational cohort study enrolled 395 consecutive adult patients hospitalised with SARS-CoV-2 infection confirmed by reverse transcription polymerase chain reaction (RT-PCR) at the “Victor Babeș” Clinical Hospital for Infectious Diseases and Pneumophthisiology, Timișoara, Romania, between 1 March 2020 and 31 December 2024. Patients were stratified into a CDI group (n = 24) and a non-CDI group (n = 371) on the basis of hospital-onset CDI. Demographic, clinical, laboratory, therapeutic, and outcome variables were extracted from electronic medical records. Continuous variables were compared using Student’s independent-samples t-test, categorical variables using Fisher’s exact test; odds ratios (ORs) with exact 95% confidence intervals (CIs) were computed for all binary comparisons, and a parsimonious multivariable logistic regression was used to adjust the antibiotic-exposure effect for age. Temporal relationships between CDI onset and sepsis documentation were also analysed. A two-sided p-value < 0.05 was considered statistically significant. Results: CDI was identified in 24 patients (prevalence 6.1%). The CDI and non-CDI groups were comparable in age (71.1 ± 10.2 vs. 71.7 ± 11.4 years; p = 0.817), sex distribution (50.0% vs. 45.8% female; p = 0.833), and vaccination status (p = 0.383). Heart failure prevalence did not differ between groups (29.2% vs. 26.7%; OR 1.13, 95% CI 0.46–2.81; p = 0.813). Any antibiotic therapy was strongly associated with CDI (95.8% vs. 70.6%; OR 9.57, 95% CI 1.28–71.74; p = 0.004), as was longer duration of antibiotic therapy (8.1 ± 2.2 vs. 5.2 ± 3.7 days; p < 0.001). In the multivariable model, each additional day of antibiotic therapy was independently associated with a 13.6% increase in the odds of CDI (adjusted OR 1.14 per day, 95% CI 1.03–1.26; p = 0.013) after adjustment for age. Piperacillin/tazobactam accounted for 65.2% (15/23) of the recorded pre-CDI broad-spectrum antibiotic regimens among antibiotic-exposed CDI patients. Documented sepsis was substantially more frequent in CDI patients (95.8% vs. 15.4%; p < 0.001) and length of hospitalisation was prolonged (15.6 ± 8.2 vs. 12.0 ± 8.1 days; p = 0.038). In-hospital mortality did not differ significantly (4.2% vs. 7.5%; p = 1.000). Conclusions: Hospital-onset CDI complicated 6.1% of hospitalised COVID-19 admissions and was independently associated with the cumulative duration of antibiotic therapy. Heart failure was not significantly associated with CDI in this cohort; however, given the limited number of CDI events, this should be interpreted as absence of evidence rather than evidence of absence. CDI was also associated with prolonged hospitalisation and high co-occurrence of documented sepsis, although causality cannot be inferred from the retrospective design. These findings support strengthened antibiotic stewardship and targeted CDI surveillance in COVID-19 inpatient wards. Full article

Population ageing has increased the need for safe, accessible, and sustainable exercise strategies that support functional capacity, independence, and healthy ageing. Nordic walking has been examined across physiological, functional, clinical, and health-related contexts; however, previous research syntheses have generally focused on specific intervention effects, populations, or outcome categories, leaving the relationships among these research strands insufficiently understood. This study combined CiteSpace-based bibliometric analysis with Latent Dirichlet Allocation (LDA) topic modeling to examine the knowledge structure and thematic development of Nordic walking research in ageing-related populations from 2006 to 2025. A total of 263 publications indexed in the Web of Science Core Collection were included in the final analysis. The results showed that research activity was geographically concentrated, whereas institutional connections were relatively dispersed. Co-citation patterns linked the field with exercise science, rehabilitation, gerontology, gait analysis, and clinical health research. Keyword and temporal analyses indicated that research attention expanded from the physiological and biomechanical characterization of Nordic walking toward functional rehabilitation, chronic disease-related applications, and broader health outcomes. The seven LDA-derived topics reflected health-outcome evaluation, metabolic and cardiovascular indicators, functional rehabilitation, exercise physiology, cognitive health, body composition and muscle function, and gait-related rehabilitation. Rather than representing isolated research domains, these topics reveal an interconnected knowledge structure linking exercise-related mechanisms, functional and clinical outcomes, and broader ageing-related health concerns. Future research should improve intervention reporting, adopt population-specific outcome selection, and strengthen the linkage between exercise mechanisms and functional or health-related outcomes to support more comparable and cumulative evidence. Full article

Background/Objectives: Psilocibin (PSY), a serotonergic hallucinogen, has attracted increasing scientific interest due to its therapeutic potential, particularly in treatment-resistant depression. In parallel with its growing clinical and research relevance, important questions have emerged regarding its safety profile, including potential effects on the liver, kidneys, cardiovascular system, and immune function. The aim of this narrative review was to systematically collect, critically appraise, and organize the dispersed evidence regarding potential multi-organ safety signals associated with PSY exposure. Methods: A narrative review was conducted including preclinical studies, pharmacological investigations, available clinical data, and published case reports, including reports of mushroom-related intoxications involving PSY-containing species. All available sources addressing potential toxicological outcomes associated with PSY were considered, regardless of exposure context, in order to reflect the current state of evidence. Results: The available evidence base is limited and heterogeneous, consisting primarily of case reports, observational data, and mechanistic preclinical studies. Reported adverse events are rare and frequently confounded by polysubstance use, uncertainty of dose, co-ingestion of other compounds, and lack of exposure standardization. Despite these limitations, biologically plausible mechanisms related to serotonergic receptor activation provide a rationale for further investigation of potential organ-specific effects. However, current controlled clinical data do not provide consistent evidence supporting intrinsic multi-organ toxicity of PSY. Conclusions: Current evidence does not confirm clinically meaningful intrinsic multi-organ toxicity of PSY under controlled conditions. Nevertheless, the available literature suggests the presence of potential safety signals that warrant further systematic evaluation. In the context of growing clinical interest in PSY, this review provides a structured synthesis of current knowledge and highlights critical gaps in understanding its organ-specific safety profile. Full article