Search Results (1,049)

Thoracic aortic atresia in adults represents a rare and extreme manifestation of aortic coarctation, marked by complete luminal occlusion and frequently compensated by extensive collateral circulation. This narrative review critically evaluates existing literature and institutional experience concerning surgical and endovascular repair strategies for aortic atresia, synthesizing evidence from related aortic arch pathologies due to the absence of direct comparative studies. Both treatment modalities—open surgical repair and catheter-based recanalization with stenting—have evolved significantly, presenting distinct advantages and limitations influenced by patient anatomy, age, and comorbidities. While surgical repair remains the standard for neonates, infants, and complex cases due to superior long-term durability and blood pressure control, endovascular procedures using chronic total occlusion technique and covered stents offer less invasive alternatives with rapid recovery, particularly in adults with suitable anatomic characteristics. The review highlights procedural considerations, including technical approaches, stent selection, and potential complications such as restenosis, hypertension, and vascular injury. Individualized, multidisciplinary decision-making remains essential, with shared consensus guiding therapy in the absence of randomized trials. The article identifies critical gaps in knowledge, emphasizing the need for multicenter, long-term studies and technological advances—including hybrid and personalized strategies for optimal management and for improving outcomes in this challenging congenital condition. Full article

Non-small cell lung cancer (NSCLC) is a severe disease with a very poor prognosis. Some 30–80% of patients with NSCLC die within five years of cancer diagnosis. The main factors contributing to this condition are the lack of effective markers for diagnosing cancer at an early stage, as well as the complexity of the biological processes involved in tumorigenesis and progression. The development of knowledge regarding all aspects of NSCLC has provided information used in the detection, systemic anticancer therapy and monitoring of NSCLC, which has a significant impact on prognosis and quality of life. NSCLCs release various biological substances into the bloodstream. Liquid biopsies allow for the analysis of tumor components in body fluids, and the usefulness of these biopsy tests as a substitute for tumor tissue is increasing. In this article, we critically review the available literature on microRNAs, circulating cell-free DNA (cfDNA), tumor-educated platelets (TEPs), circulating tumor cells (CTCs), circulating extracellular vesicles (EVs), and metabolomic and proteomic markers in the diagnosis and monitoring of NSCLC. However, the usefulness of these new markers in clinical practice has significant limitations. Full article

Bovine viral diarrhea virus (BVDV) is a pathogen of worldwide economic importance. In Uruguay, BVDV is endemic, with seroprevalence >80% at the farm level. This study analyzed 912 samples collected from January 2018 to October 2024 by reverse transcription PCR and sequencing, from calves with diarrhea, aborted fetuses, heifers with a history of abortions, and animals exhibiting symptoms of Mucosal Disease. This work summarizes ten years (2014–2024) of molecular epidemiology and evolution of BVDV. Analysis of the BVDV 5′UTR/N^pro genomic region revealed that the BVDV-1a, 1e, 1i, and 2b subtypes circulate in Uruguay. BVDV-1a remains the most prevalent subtype, followed by BVDV-2b, whose prevalence has been increasing. Our previous studies revealed that BVDV-1a showed geographical diversification in Uruguay. In this work, evolutionary studies conducted with N^pro genomic region showed that BVDV-2b is evolving at a substitution rate of 6.09 × 10⁻⁴ substitutions/site/year and has been introduced from Brazil in six separate events between 1870 and 1928, showing no geographical diversification. This work demonstrates that BVDV-1a and BVDV-2b are evolving differently in Uruguay. This evolutionary divergence is notable when comparing patterns observed in other countries where these subtypes circulate. Our findings provide crucial knowledge that should be considered for developing effective BVDV control measures in Uruguay. Full article

Maternal overweight and obesity have reached global epidemic levels, altering metabolic adaptations during pregnancy and lactation. Beyond their well-known impact on gestational outcomes, elevated BMI profoundly influences the secretion of adipokines—hormones derived from adipose tissue that circulate in maternal blood and are secreted into breast milk—thereby directly linking maternal metabolism to offspring development. In this state-of-the-art narrative review, we synthesize current evidence on how maternal overweight and obesity shape concentrations of key adipokines (leptin, adiponectin, ghrelin, obestatin, and resistin) in serum, cord blood and breast milk. Excess maternal weight robustly increases leptin, while effects on adiponectin, ghrelin, obestatin, and resistin remain uncertain. To our knowledge, this is the first review to focus specifically on the impact of maternal overweight and obesity on adipokine alterations across both pregnancy and lactation. Future studies should apply standardized sampling and analytical protocols and use longitudinal designs including body composition assessments to clarify their role in maternal and child metabolic health. Full article

Rotavirus remains a leading cause of acute gastroenteritis worldwide, particularly in young children, despite widespread vaccination efforts. This study aims to evaluate rotavirus circulation at the population level through wastewater-based epidemiology (WBE), offering a non-invasive, complementary approach to clinical surveillance. Between 2024 and 2025, a total of 172 composite 24 h samples were collected from eight urban wastewater treatment plants across Northern, Central, and Southern Italy. Viral RNA was concentrated by PEG precipitation and quantified using digital RT-PCR, while genotypes were determined via nested PCR targeting VP7 and VP4 genes. Rotavirus RNA was detected in 143 out of 172 samples (83.1%), with viral loads ranging between 4.2 × 10² to 7.3 × 10⁵ genome copies per liter (g.c./L). Genotyping revealed G3 as the predominant VP7 type, followed by G1, G2, G6, and G9. All VP4-positive samples were classified as P8. This investigation expands current knowledge of rotavirus epidemiology in Italy using molecular surveillance of urban wastewater. By combining digital RT-PCR and genotyping, it offers a robust framework for integrating WBE into rotavirus monitoring programs, especially in settings where clinical surveillance is limited. Full article

Metastases are responsible for the majority of cancer-related deaths and remain one of the most complex and therapeutically challenging hallmarks of cancer. The metastatic cascade involves a multistep process by which cancer cells invade local tissue, enter and survive in circulation, extravasate, and ultimately colonize distant organs. Increasingly, the tumor microenvironment (TME), particularly the extracellular matrix (ECM), has emerged as a central regulator of these steps. Far from being a passive scaffold, the ECM actively influences cancer progression through its biochemical signals, structural properties, and dynamic remodeling. Among ECM components, collagens play a particularly pivotal role by mediating tumor cell adhesion, migration, invasion, survival, immune evasion, and therapeutic resistance. This narrative review synthesizes current knowledge of the dual roles of collagen in the metastatic process, with a focus on the cellular and molecular mechanisms. We highlight how altered ECM architecture and signaling contribute to metastatic niche formation and explore the potential of targeting ECM components as a strategy to enhance cancer therapy and improve patient outcomes. Full article

Heart failure (HF) is a complex clinical syndrome characterized by impaired cardiac function and maladaptive neurohormonal activation, representing one of the leading causes of morbidity, hospitalization, and mortality worldwide. Both its incidence and prevalence continue to rise, largely as a consequence of population aging and the increasing burden of cardiovascular risk factors. The pathogenesis of HF is multifactorial, involving a dynamic interplay between inflammation and neurohormonal activation, ultimately leading to cardiac remodeling, diastolic dysfunction, and impaired cardiac output. In this context, numerous biomarkers have been investigated for diagnosis and prognosis utility in patients with HF. According to their underlying pathophysiological mechanisms, biomarkers in HF can be broadly categorized as indicators of inflammation, oxidative stress, cardiac remodeling, myocardial stress, neurohormonal activation, and cardiomyocyte injury. This review summarizes current knowledge on the pathophysiological basis of HF and highlights the diagnostic and prognostic relevance of circulating biomarkers, emphasizing their role in linking disease mechanisms with clinical management. Full article

Upper tract urothelial carcinoma (UTUC) is a rare malignancy that accounts for a small minority of all urothelial cancers. Historically, treatment recommendations for UTUC have been extrapolated from bladder cancer trials due to limited high-quality, UTUC-specific evidence. However, emerging data has shown how UTUC exhibits distinct biological, molecular, and clinical features compared to bladder cancer. In this piece, we provide an analysis of the current evidence supporting adjuvant chemotherapy and immunotherapy for UTUC. We discuss landmark trials such as the POUT trial for adjuvant chemotherapy, as well as pivotal trials such as CheckMate 274, IMvigor 010 and AMBASSADOR that examine the role of adjuvant immunotherapy for UTUC. Additionally, we briefly highlight advances in cancer genetics and the emerging use of circulating tumor DNA as a potential biomarker. While there has been significant progress made in adjuvant treatments for UTUC, substantial knowledge gaps remain. Clinical trials using UTUC-specific populations will be critical in improving outcomes and personalizing care for this patient population. Full article

Research on Mesoscale Convective Systems (MCSs) in Ecuador has focused on regional studies. However, it lacks a thorough and general examination of their relationship with the nation’s diverse orography and large-scale phenomena. This study conducts a climatological analysis of MCS occurrence throughout Ecuador’s natural regions. We perform this study using Sen’s Slope and the Mann–Kendall test. Teleconnections from the Pacific and Atlantic Oceans are studied through wavelet decomposition between time series and Pacific and Atlantic oceanic indices. The main factors that control MCS formation depend on the region. The Intertropical Convergence Zone (ITCZ) at the large scale affects the entire territory. In western Ecuador, MCS formation is mostly related to the El Niño current and the Chocó Low-Level Jet (CLLJ). The Orinoco Low-Level Jet (OLLJ) and evapotranspiration and nocturnal convection display the largest roles in the east. A progressive intensification of activity from Highlands-North in SON is detected (0.143 MCSs per year). MCSs contribute 26% of total precipitation on average, with regional variations from Coast-South (16.41%) to Amazon-North (44.13%). The research confirms existing knowledge about El Niño’s strong relationship (ρ = 0.7) with MCS occurrence in coastal areas while uncovering new complex patterns. The Trans-Nino Index (TNI) functions as a critical two-sided modulator that conventional analysis methods fail to detect. It produces null correlations over conventional time series of MCS occurrence yet emerges as a primary driver of low-frequency variability in the proposed six natural zones of Ecuador. Wavelet decomposition reveals contrasting TNI responses: Amazon-North shows positive correlation (0.73) while Amazon-South exhibits negative correlation (−0.70) at low frequencies. This affects Walker circulations dynamics over the Pacific Ocean. This research establishes fundamental knowledge about MCSs in Ecuador. It builds on a database with strong methodology as a backbone. The research provides essential information about the factors leading to convection in the country. This will help improve seasonal forecast accuracy and risk management effectiveness. Full article

The widespread circulation of digital misinformation exposes a critical shortcoming in prevailing detection strategies, namely, the absence of robust mechanisms to confirm the origin and authenticity of online content. This study addresses this by introducing VeriTrust, a conceptual and provenance-centric framework designed to establish content-level trust by integrating Self-Sovereign Identity (SSI), blockchain-based anchoring, and AI-assisted decentralized verification. The proposed system is designed to operate through three key components: (1) issuing Decentralized Identifiers (DIDs) and Verifiable Credentials (VCs) through Hyperledger Aries and Indy; (2) anchoring cryptographic hashes of content metadata to an Ethereum-compatible blockchain using Merkle trees and smart contracts; and (3) enabling a community-led verification model enhanced by federated learning with future extensibility toward zero-knowledge proof techniques. Theoretical projections, derived from established performance benchmarks, suggest the framework offers low latency and high scalability for content anchoring and minimal on-chain transaction fees. It also prioritizes user privacy by ensuring no on-chain exposure of personal data. VeriTrust redefines misinformation mitigation by shifting from reactive content-based classification to proactive provenance-based verification, forming a verifiable link between digital content and its creator. VeriTrust, while currently at the conceptual and theoretical validation stage, holds promise for enhancing transparency, accountability, and resilience against misinformation attacks across journalism, academia, and online platforms. Full article

Background/Objectives: Omentin, also known as intelectin-1, is a secreted adipokine with anti-inflammatory, insulin-sensitizing, and immune-modulatory functions, primarily expressed in visceral adipose tissue. While omentin has been associated with favorable metabolic outcomes, its role in cancer pathogenesis appears context-dependent and remains poorly understood. This review investigates the biological functions, expression patterns, and clinical relevance of omentin across gastrointestinal malignancies. Methods: A comprehensive review of the literature was conducted using PubMed, Scopus, and Web of Science up to August 2025 to evaluate the role of omentin in gastrointestinal cancers. Both preclinical and clinical studies evaluating omentin, its analogues and omentin-enhancing agents in gastric, colorectal, hepatic, pancreatic, and esophageal cancers were included. Results: Omentin exhibits anti-proliferative, anti-inflammatory, and anti-angiogenic effects within the tumor microenvironment in several GI malignancies. However, evidence also indicates a dual role. High intratumoral omentin expression correlates with improved prognosis in colorectal, gastric, and hepatic cancers; in contrast, elevated circulating levels–particularly in colorectal and pancreatic cancers–have been paradoxically associated with increased cancer risk and poor outcomes. Mechanistically, omentin modulates PI3K/Akt, NF-κB, AMPK, and oxidative stress pathways, and interacts with TMEM207. However, most available studies are small-scale and heterogeneous, with methodological inconsistencies and limited multi-omics integration, leaving major knowledge gaps. Conclusions: This review highlights omentin’s distinct systemic and local roles across GI cancers, underscoring its translational implications. Omentin emerges as a promising but context-dependent biomarker and therapeutic target, with future research needed to address heterogeneity, standardize assays, and validate its clinical utility in large-scale prospective studies. Full article

Vitamin D, long recognized for its essential role in calcium–phosphate balance and bone health, has increasingly been identified as a pleiotropic regulator of metabolic, cardiovascular, and renal function. Deficiency of vitamin D is widespread worldwide and has been linked to a higher risk of insulin resistance, type 2 diabetes, atherosclerosis, hypertension, and chronic kidney disease. Meta-analyses suggest that each 10 nmol/L (≈4 ng/mL) increase in serum 25-hydroxyvitamin D [25(OH)D] is associated with about a 4% lower risk of type 2 diabetes, whereas other analyses indicate an approximately 10% reduction in cardiovascular event risk per 10 ng/mL (≈25 nmol/L) increment in circulating 25(OH)D concentration. Clinical and epidemiological studies suggest that optimal 25(OH)D concentrations may protect against cardiometabolic and renal complications, though supplementation trials show heterogeneous outcomes depending on baseline vitamin D status, genetic background, and dosage. By synthesizing current knowledge, this work highlights vitamin D status as a potentially modifiable determinant of global disease burden and a target for preventive and therapeutic strategies. Full article

The development and function of the heart are governed by a highly coordinated network of regulatory mechanisms, among which miRNAs play a central role. These small, non-coding molecules modulate gene expression predominantly through mRNA degradation. This narrative review aims to summarize current knowledge about biogenesis, its impact on heart development and function, and its clinical implications in pediatric cardiology. We discuss how specific miRNAs contribute to shaping the normal heart and influencing the pathogenesis of congenital malformations. Furthermore, we review disease-specific miRNA signatures identified in the most common congenital heart defects and some acquired diseases, including hypoplastic left heart syndrome (HLHS), tetralogy of Fallot (TOF), bicuspid aortic valve (BAV), septation defects, cardiomyopathies, arrhythmias, and myocarditis. Many studies indicate that circulating and tissue miRNAs can become non-invasive biomarkers for early diagnosis and disease monitoring. Experimental data suggest their potential use in treatment despite many delivery and safety challenges. However, further research is necessary to fully exploit the potential of miRNAs and effectively translate these findings into clinical practice in pediatric cardiology. Full article

The development of hepatic steatosis in geese is a complex, multistage process involving genes related to lipid synthesis, transport, storage, and metabolism. Key genes activated during this process include ME1 (malic enzyme 1), SCD1 (stearoyl-CoA desaturase), ACSL1 (acyl-CoA synthetase long-chain family member 1), and ELOVL6 (elongation of very-long-chain fatty acids protein 6). The expression of these genes varies depending on the tissue, breed, and metabolic context. Geese possess a unique ability to develop hepatic steatosis (fatty liver) without accompanying inflammation or liver damage. This condition typically arises from overfeeding, either through carbohydrates or fats, leading to significant triglyceride accumulation in hepatocytes. Importantly, this state remains reversible and is considered non-pathological. The physiological and molecular changes observed in overfed geese, particularly regarding liver lipid accumulation and serum enzyme activity, closely resemble those found in human non-alcoholic fatty liver disease (NAFLD). This similarity makes geese an excellent biomedical model for studying NAFLD. Overfeeding initiates a cascade of enzymatic reactions that regulate lipid metabolism at the genetic level. These reactions decrease circulating free fatty acids and glucose while promoting triglyceride storage in the liver. The aim of this study is to synthesize current knowledge on the genetic regulation of fatty acid metabolism in geese, highlighting how these genes coordinate the processes of activation, desaturation, synthesis, and elongation during induced steatosis. Moreover, the summarized effects of different diet supplements will enhance goose feeding strategies for foie gras production. Full article

This study examines the global mobility of researchers in the smart city domain from 2000 to 2020, using inter-country and intercity affiliation data from the Web of Science. Employing network analysis and spatial econometric models, the paper maps the structural reconfiguration of scientific labor circulation. The results show that the international mobility network is dense yet asymmetric, dominated by a small set of high-frequency corridors such as China–United States, which intensified markedly over the two decades. While early networks were fragmented and polycentric, the later period reveals a multipolar configuration with significant growth in South–South and intra-European exchanges. At the city level, Beijing, Shanghai, Wuhan, and Nanjing emerged as central nodes, reflecting the consolidation of East Asian hubs within the global knowledge system. Mesoscale community detection highlights the coexistence of territorially embedded ecosystems and transregional corridors sustained by thematic and reputational affinities. Growth decomposition indicates that high-income countries benefit from both talent retention and international inflows, while upper-middle-income countries rely heavily on inbound mobility. Spatial regression and quantile models confirm that economic growth and baseline scientific visibility remain robust drivers of urban smart city performance. In contrast, mobility effects are context-dependent and heterogeneous across city positions. Together, these findings demonstrate that researcher mobility is not only a vector of knowledge exchange but also a mechanism that reinforces spatial hierarchies and reshapes the geography of global smart city innovation. Full article