Search Results (2,289)

Background/Objectives: Mycoplasma pneumoniae (MP) is a frequent cause of community-acquired pneumonia, but it is increasingly recognized for extrapulmonary complications, specifically Mycoplasma pneumoniae-induced rash and mucositis (MIRM). This systematic review aims to comprehensively assess the frequency of clinical features, diagnostic criteria and outcomes of oral mucositis in patients with confirmed MP infection. Methods: A systematic review was conducted following PRISMA guidelines across PubMed, Web of Science and Scopus, covering the period 2015–2025. Inclusion criteria encompassed in vivo studies, case reports, and case series in English focusing on MP-associated mucositis. Methodological quality was assessed using JBI checklists for case-based evidence and the Newcastle–Ottawa Scale for cohort studies. Two clinical cases were reported. Results: Out of 242 identified records, 42 studies were included, involving 140 patients with a notable male predominance (62%). Oral involvement was reported in 92.9% of cases, often characterized by severe ulcerations, hemorrhagic crusting, and debilitating pain. Intensive Care Unit admission was required in 21.5% of cases due to severe systemic or mucosal disease, with 14.3% necessitating parenteral nutrition. Quality assessment indicated moderate-to-high methodological rigor across most included studies. Conclusions: MIRM represents a significant clinical entity where oral mucositis is a dominant feature, often preceding or overshadowing respiratory symptoms. Early recognition by oral health professionals is crucial to avoid misdiagnosis, ensure appropriate multidisciplinary care, and implement supportive or immunomodulatory therapies that reduce morbidity and hospitalization length. Full article

An encephalocele is a rare congenital or acquired cranial defect characterized by herniation of intracranial tissue through a defect in the skull base. In human and veterinary medicine, these lesions are frequently associated with abnormalities in neural tube development or structural weakness of the cranial bones, resulting in the protrusion of brain tissue and meninges through anatomical openings such as the cribriform plate. Although this condition has been extensively described in human neurosurgical research, reports on dogs remain limited, and the clinical significance of surgical intervention in cases with communication to the nasal cavity remains unclear. In this case, a young American Cocker Spaniel presented with seizures, prompting advanced diagnostic evaluation. Magnetic resonance imaging revealed a protrusion of the intracranial tissue through a defect in the cribriform plate extending into the nasal cavity. Surgical resection of the protruding tissue was performed, followed by skull base reconstruction. Histopathological examination demonstrated nervous tissue with chronic inflammatory changes without evidence of neoplasia. The patient recovered uneventfully after surgery and remained free of seizure recurrence during follow-up. Surgical management may represent a viable treatment option for seizure disorders in young dogs, particularly when persistent cranio-nasal communication is present, and provides a clinically relevant comparative model for similar cranial base defects described in human pathology. Full article

The increasing deployment of resource-constrained Internet of Things (IoT) devices requires security mechanisms that preserve confidentiality without compromising energy efficiency or responsiveness. Although Transport Layer Security (TLS) provides standardized protection for MQTT-based communication, its computational overhead may significantly affect embedded architectures. This study presents a controlled experimental evaluation of three communication configurations implemented on ESP32-based nodes: unencrypted Message Queuing Telemetry Transport (MQTT), MQTT over TLS 1.2, and an application-layer hybrid scheme combining Elliptic Curve Diffie–Hellman key exchange with AES-128 encryption. Second-level measurements of instantaneous current, accumulated energy, end-to-end latency, and memory footprint were collected across repeated experimental runs. Time-series diagnostics were performed to assess autocorrelation and stationarity, and block bootstrap resampling was applied to ensure dependence-aware statistical inference. The results indicate that TLS introduces the highest cumulative energy growth and latency dispersion, while the hybrid ECC–AES configuration demonstrates intermediate behavior with reduced overhead relative to TLS. Pareto frontier analysis shows that TLS is dominated in the joint energy–latency space, whereas the hybrid scheme represents a non-dominated compromise between security and efficiency. These findings provide a stability-aware and statistically robust framework for evaluating security–performance trade-offs in embedded IoT systems. Full article

This study aimed to establish the first national diagnostic reference levels (DRLs) for coronary angiography (CAG) and interventional cardiology procedures in Korea, based on a nationwide patient-dose survey conducted in 2024. Radiation dose data were collected from 20 cardiovascular centers between April and December 2024 using a dedicated server system for radiation dose-structured reports, namely, Digital Imaging and Communications in Medicine. We classified 1980 procedures into the following seven procedural groups: CAG, CAG with percutaneous coronary intervention (CAG + PCI), CAG with percutaneous transluminal coronary angioplasty (CAG + PTCA), coronary spasm provocation, acute myocardial infarction (AMI), chronic total occlusion (CTO), and PCI alone. The DRLs were defined as the 75th percentile of the cumulative kerma–area product (KAP) and fluoroscopy time (FT). The established DRLs for KAP (Gy·cm²) were: CAG, 18.68; CAG + PCI, 63.40; AMI, 58.52; and CTO, 106.83. The corresponding DRLs for FT (s) were: CAG, 440.00; CAG + PCI, 1201.50; AMI, 947.64; and CTO, 2819.00. This study established the first official national DRLs for CAG and interventional cardiology procedures in Korea, using real-world clinical data. These reference levels provide a practical framework for institutions to benchmark radiation exposure, evaluate practice patterns, and optimize patient radiation safety. Full article

Background/Objectives: Artificial intelligence (AI) shows promise in supporting mammography interpretation and triaging referrals, potentially enhancing breast screening. However, successful AI integration depends on patient acceptance and trust. This study explores patient and public perceptions of AI in breast imaging and clinical decision-making to identify knowledge gaps and guide communication strategies. Methods: Paper surveys were distributed to women attending the Breast Care Unit at Queen’s Hospital, Burton, and the London Breast Institute between August and December 2025. Demographic data, levels of trust and comfort with AI, and concerns about AI were collected. Responses were analysed using descriptive statistics, Pearson’s Chi-square tests with Cramér’s V and thematic analysis. Results: One hundred and twenty participants completed the survey. Fifty percent would accept AI alongside clinicians for interpretation of mammograms or ultrasound scans, significantly associated with no previous breast cancer diagnosis (p = 0.02; Cramér’s V = 0.22, 2 degrees of freedom (df)) and technological comfort (p < 0.001; Cramér’s V = 0.42, 1 df). Lower acceptance was found among those with prior diagnosis and low comfort with technology. Acceptance of AI-assisted triage (44.5%) was also significantly associated with technological comfort (p = 0.008; Cramér’s V = 0.30, 1 df). Eighty percent reported no knowledge of AI use in breast clinics, and only 37% would trust AI findings. Qualitative analysis identified three themes: (1) clinician oversight as indispensable, (2) the knowledge gap as a barrier to acceptance, and (3) concerns about operational risks and accountability. Conclusions: Although patients were generally receptive to AI, acceptance was conditional on clinician supervision. Limited awareness and concerns about diagnostic accuracy remain barriers to implementation. Educational initiatives should precede widespread adoption to support informed and confident patient acceptance of AI-assisted imaging and decision-making. Full article

Dry eye disease, a multifactorial and symptomatic disease characterized by tear film instability and ocular surface dysfunction, has emerged as an increasingly pressing global health concern—particularly against the backdrop of increasing digital device usage and the widespread application of virtual learning. Traditional pharmacotherapies, such as artificial tears, yield only transient symptomatic relief. Compared with pharmacological agents, surgical treatments are further restricted in clinical application, primarily because of their invasiveness, technical complexity, postoperative complications, and high costs. Consequently, the development of novel therapeutic strategies has emerged as imperative. This review summarizes advances in pharmacotherapy, including nanomedicine and biological agents, as well as emerging physiotherapies, such as photobiomodulation, thermal pulsation, and neurostimulation. These innovative therapeutic approaches address the partial limitations of conventional treatments through three main molecular mechanisms: improved drug delivery, multitargeted pharmacology, and enhanced biocompatibility. Nevertheless, the clinical translation of many innovative therapies requires large-scale clinical trials to validate clinical efficacy, optimize dosage regimens, and assess long-term safety profiles. In the future, integrating lifestyle modifications, effective clinician–patient communication, and patient-centric diagnostic approaches will facilitate the establishment of therapeutic alliances and support the success of precision medicine. Full article

Odontogenic sinusitis (ODS) is a common cause of unilateral maxillary sinusitis arising from periapical lesions (PALs) or other dental sources. The infection is typically polymicrobial and dominated by anaerobic bacteria, which are often under detected by routine culture. Molecular approaches such as quantitative polymerase chain reaction (QPCR) and next-generation sequencing (NGS) may provide improved characterization of the microbial burden and community structure. This study aimed to compare culture-based methods, targeted quantitative PCR, and 16S rRNA sequencing in paired samples to characterize microbial composition of ODS and evaluate diagnostic performance. Paired sinus mucosal biopsy (SIN) and periapical lesion (PAL) samples were collected from 28 patients with clinically confirmed ODS. Bacterial detection was performed using conventional culture and targeted QPCR assays for ten clinically relevant taxa. In three randomly selected patients, paired samples were additionally analyzed by 16S rRNA gene amplicon sequencing. Microbial load, taxa richness, and similarity between the two anatomically connected sites were assessed using Wilcoxon signed-rank, McNemar, Jaccard distance, and Bray–Curtis dissimilarity analyses. Results: Culture showed low sensitivity, identifying a limited number of pathogens, primarily Staphylococcus aureus, Streptococcus anginosus, and Fusobacterium nucleatum, in a minority of samples. In contrast, QPCR demonstrated substantially higher detection rates, particularly in PAL samples. Porphyromonas gingivalis (96.8%), Fusobacterium spp. (100.0%), and the S. anginosus group (90.3%) were highly prevalent in PAL specimens, with overlapping but lower detection in SIN samples. PAL samples exhibited significantly higher bacterial loads and taxa richness than paired SIN samples (Wilcoxon p = 0.0004). 16S rRNA sequencing confirmed polymicrobial communities at both sites and identified additional taxa not included in the QPCR panel. Similarity analyses revealed pronounced interindividual variability, ranging from near-identical to highly divergent paired microbiota. Periapical lesions act as reservoirs of predominantly anaerobic bacteria that may seed the maxillary sinus in ODS. Although microbial overlap exists, sinus communities display lower burden and site-specific compositional shifts. Culture-based diagnostics underestimate ODS microbial complexity, whereas combined molecular approaches provide a more comprehensive and clinically informative assessment. Full article

Extracellular vesicles (EVs) are nanoscale membrane-bound particles that mediate intercellular communication by transferring proteins, nucleic acids, lipids, and metabolites. Increasing evidence implicates EVs in Alzheimer’s disease (AD) pathogenesis through the propagation of amyloid-β, tau, and neuroinflammatory signals across neural and glial networks. In parallel, EVs isolated from biofluids have emerged as promising sources of disease-associated biomarkers and potential therapeutic carriers. This review aims to synthesize current evidence on EV-mediated mechanisms in AD, evaluate the diagnostic value of EV-associated biomarkers, and discuss emerging EV-based and bioengineered therapeutic strategies. We summarize how EVs derived from neurons, astrocytes, microglia, and peripheral cells contribute to amyloid-β and tau spread, neuroinflammation, synaptic dysfunction, and metabolic stress in AD. Disease-associated alterations in EV cargo from blood, cerebrospinal fluid, and urine are critically assessed for biomarker applications. We further highlight advances in EV bioengineering, including cargo loading, surface modification, targeting strategies, and modulation of EV biogenesis. Finally, key translational challenges—such as EV heterogeneity, biodistribution, immune clearance, and standardization—are discussed to define future directions for leveraging EVs as diagnostic and therapeutic platforms in AD. Full article

Background: This paper describes the development of speech materials in the Romani language intended for audiological and comprehension assessment of Romani-speaking children and adults living in Slovakia. The work responds to the documented lack of linguistic resources and test stimuli in Romani, which limits the accuracy of speech perception and comprehension testing. Method: The existing state of communication-assessment tests used in Slovakia was reviewed, and new Romani-language materials for audiology and comprehension testing were created. The work focused on developing word lists, matrix-based sentence tests, and comprehension sentences that were linguistically verified by native Romani speakers. Results: A set of Romani speech stimuli was developed, including a ten-word screening list, a 50-word illustrated set for pediatric audiometry, an adaptive matrix sentence test for advanced assessment, and a collection of comprehension sentences targeting various linguistic structures. Conclusions: The newly created Romani-language test materials address the absence of suitable diagnostic tools in Slovakia and provide culturally and linguistically appropriate resources for more accurate audiological and comprehension assessment. Full article

Complex psychosis is a clinically relevant rehabilitation construct rather than a formal diagnostic category and refers to psychotic illness associated with treatment-resistant symptoms, functional impairment, and additional cognitive, psychiatric, neurodevelopmental, or physical health complexity. In this clinician-oriented narrative review, we synthesised current evidence on rehabilitation interventions for adults with complex psychosis, integrating direct evidence from specialist rehabilitation settings with indirect evidence from schizophrenia-spectrum studies when clinically informative. We searched major clinical databases, prioritised guidelines, systematic reviews, meta-analyses, and controlled studies, and organised the synthesis by functional domain and pathway relevance. Evidence was strongest for cognitive remediation, particularly when combined with broader psychiatric rehabilitation or vocational support, for family interventions in relapse prevention, and for individual placement and support in competitive employment. Social–cognitive and metacognitive interventions appear clinically valuable, although transfer to real-world functioning is more variable. Community-based rehabilitation, supported accommodation, illness self-management, and ecological adaptation strategies remain central to functional recovery when embedded within multidisciplinary pathways. Digital and virtual interventions are promising adjuncts, but their efficacy remains heterogeneous and implementation challenges include engagement, privacy, and service integration. Overall, rehabilitation in complex psychosis is most convincing when it is personalised, measurement-based, and delivered through integrated service models linking assessment, intervention selection, supported living, and recovery-oriented care. Full article

The inflammatory response possesses a central role in human pathophysiology, regulating the tissue microenvironment and cell signaling. Inflammation occurs either as a symptom of homeostasis disturbance or as a driver for determining cell fate. In this context, cells recruit secreted cytokines, chemokines and intracellular mediators, in cooperation with their surrounding cellular components, to integrate inflammatory stimuli. The extracellular matrix (ECM) acts as a scaffold for shaping tissue structure and simultaneously undergoes continuous remodeling to provide a dynamic network for intercellular communication. Serglycin (SRGN) is the only known intracellular and extracellular proteoglycan, implicated in the formation of secretory vesicles and ECM reorganization. The regulatory roles of SRGN in the bioavailability of secreted factors, as well as SRGN pleiotropic interactions within the ECM, as well as with cell surface receptors, have emerged to beessential for inflammatory diseases and tumor progression. Its overexpression and excessive secretion, alongside its contribution to cell signaling, highlight the potential diagnostic and therapeutic aspects of SRGN in human diseases. Full article

Explainable Artificial Intelligence (XAI) has become a critical requirement in medical image analysis, where transparency and interpretability are essential for clinical trust and decision support. Melanoma is recognized as one of the most deadly types of skin cancer, with its occurrence exhibiting an increasing pattern in recent times. However, detecting this cancer in its initial stages greatly increases patients’ chances of long-term survival. Various computer-based techniques have recently been proposed to diagnose skin lesions at their early stages. Even though the machine learning community has achieved a certain degree of success, there is still an unresolved research challenge regarding high error margins and the limited interpretability of automated systems. This study focuses on addressing both segmentation and classification tasks, with particular emphasis on two key concepts: (1) improving image quality to maximize distinguishability between foreground and background regions, thereby enhancing visual interpretability and segmentation accuracy and (2) eliminating redundant and cluttered feature information to generate the most discriminative and compact feature representations. The input images are initially processed using a novel metaheuristic contrast-stretching method to estimate image-specific key parameters, thereby enhancing lesion boundary clarity in a clinically interpretable manner. Following this, the improved images are fed into selected pre-trained deep models, including DenseNet-201, Inception-ResNet v2, and NASNet-Mobile. The extracted features from all pre-trained models are fused to produce resultant vectors, which are then refined using a bio-inspired feature selection method, termed entropy-controlled whale optimization, to retain only the most informative attributes. The selected discriminative feature set is subsequently classified using multiple classifiers. The results indicate that the proposed framework achieves superior performance compared to existing methods in terms of accuracy, sensitivity, specificity, and F1-score. Additionally, it facilitates a more explainable, transparent, and structured diagnostic pipeline appropriate for medical applications. Full article

The human virome, comprising eukaryotic viruses, bacteriophages, and viral genetic material, is a dynamic component of the microbiome with growing relevance in infectious diseases. This narrative review is structured to: (i) summarize the general composition of the human virome and methodological challenges, including the fraction of unclassified viral “dark matter”; (ii) describe virome alterations in chronic infections; and (iii) explore site-specific virome dynamics across respiratory, intestinal, and genito-urinary tracts in both chronic and acute infections. In chronic viral infections such as HIV, HBV, HCV, and HPV, a recurrent feature is the expansion of Anelloviridae—particularly torque teno virus—reflecting impaired immune surveillance rather than direct pathogenicity, suggesting their potential as surrogate biomarkers of immune competence. Evidence on virome changes in chronic bacterial and parasitic infections remains limited, highlighting a critical knowledge gap. Acute infections are associated with compartment-specific shifts in eukaryotic viruses and bacteriophage communities, often paralleling changes in bacterial populations and inflammatory responses, with implications for disease severity. Despite advances in metagenomic approaches, a substantial proportion of viral sequences remains unclassified, limiting functional interpretation. Nevertheless, virome profiling provides an ecosystem-level perspective, offering insights beyond single-pathogen detection and supporting emerging applications in diagnostics, immune monitoring, prognosis, and infectious disease surveillance. Full article

Debates around corporate greenwashing increase consumer skepticism toward environmental claims and heighten reputational risks in sustainability communication. Consequently, some corporations strategically limit the visibility of their environmental practices, making it more difficult for stakeholders to interpret sustainability communication. This study develops and validates a multidimensional scale to measure consumer attitudes toward greenhushing. An initial pool of 35 items was refined through evaluation by 12 experts, followed by sequential exploratory and confirmatory factor analyses using pilot (n = 94) and main study (n = 401) data. The resulting 16-item, three-dimensional scale comprising greenhushing approval, price-based trust, and greenwashing skepticism was supported by convergent and discriminant validity tests alongside internal consistency measures. Rather than directly measuring sustainability communication performance, the scale offers a stakeholder-level diagnostic indicator of how limited sustainability communication is perceived by consumers, providing a quantitative foundation for empirical research and managerial decision-making. Full article

Ultrafast fiber lasers operating near 2 μm have emerged as a critical platform for advancing mid-infrared photonics due to their narrow pulse durations, high peak powers, and broad tunability. These sources exploit the rich energy-level structures of Tm³⁺ and Ho³⁺ doped fibers and reside within an atmospheric transmission window, enabling applications spanning nonlinear microscopy, precision micromachining, optical frequency metrology, biophotonics, and free-space optical communication. Recent progress in low-loss fiber fabrication, dispersion-engineered cavity design, and mode-locking technologies has significantly expanded the performance boundaries of 2 μm ultrafast fiber lasers. This review systematically examines the underlying pulse-formation mechanisms and categorizes state-of-the-art mode-locking approaches. Representative laser architectures are compared with respect to pulse duration, energy scalability, repetition-rate enhancement, spectral characteristics, and environmental stability. Key application pathways in high-resolution spectroscopy, biomedical diagnostics, and mid-IR supercontinuum generation are highlighted. Finally, the remaining challenges and prospective research directions are discussed to inform the development of next-generation ultrafast photonic sources in the 2 μm band. Full article