Search Results (101)

In 1988, two seminal studies were published almost simultaneously in the same scientific journal. Both spurred the field of brain energy metabolism research in new directions, culminating in a long-lasting debate that appeared to split its practitioners into two factions that seem unwilling to agree on what metabolic processes are fueling the active brain with adenosine triphosphate (ATP). The first study used rat hippocampal slices to demonstrate the ability of lactate to support neuronal function as the sole oxidative mitochondrial substrate. The second study demonstrated that upon brain stimulation, glucose consumption is not accompanied by respective oxygen consumption, but a non-oxidative glucose utilization or what has become known as “aerobic glycolysis”. Consequently, for almost four decades, researchers in this field have been divided between those who profess that brain activity is supported by oxidative lactate metabolism and those who insist that non-oxidative glucose metabolism supports it. Hypotheses for both concepts were offered, “The Astrocyte Neuron Lactate Shuttle Hypothesis” and “The Efficiency Tradeoff Hypothesis,” respectively. To bridge the gap between the two groups, a recent editorial, authored by over twenty leading investigators, was published. The editorial received two separate responses from investigators who supported the non-oxidative glucose consumption as the main process supporting neural activity, signaling that the gap between the two groups remained. The present perspective highlights the principal disagreements that divide this utmost important field of research. It argues that the main reason for these disagreements is rooted in the assumption that pyruvate is the end-product of aerobic glycolysis, even when many among those who adhere to this assumption accept that in the active brain glycolysis is the main provider of the necessary ATP and the end-product is lactate under aerobic conditions. The consideration of a paradigm shift, according to which lactate is the real end-product of glycolysis, independent of the presence or absence of oxygen, could bridge the great divide between those who separate glycolysis into two outcomes and those who profess that there is only one, prefix-less glycolytic pathway that always ends with the production of lactate. Full article

Background/Objectives: The initial systematic review of “Concurrent Disorder Management Guidelines. Systematic Review” assessed the quality of the concurrent disorders’ clinical management guidelines in 2020, including the guidelines in the field from 2000 to 2020. Twenty-four guidelines were identified and assessed with AGREE II (Appraisal of Guidelines for Research and Evaluation). As dual disorder needs increased specifically among the younger population, requiring significant healthcare resources, more efficient approaches targeting complex concurrent disorders are essential. Since 2020, multiple new guidelines have been developed in response to new developments in the field of substance use disorder management. This systematic review update aimed to identify and appraise all new available concurrent disorder management guidelines to strategize the management of concurrent disorders, support better outcomes and further research directions. Methods: The review was registered, and protocol is available in the international register—PROSPERO. Literature searches were performed by two independent authors in electronic databases and the gray literature. The inclusion criteria were English language clinical management guidelines for adult concurrent disorders between 2020 and 2025. Sources that were not formal clinical guidelines, not addressed to physicians for adult age group, addressed to intellectual/developmental disability, or written in languages other than English were excluded. Results: The initial search resulted in 5003 records. A total of eight new guidelines were identified and assessed with AGREE II, highlighting the consistent gap in the evidence-based management recommendations. Conclusions: The appraised guidelines had similar quality to the 2020 findings, supporting dual or combined treatment; however, all guidelines had multiple domains not developed rigorously and with methodological limitations. Levels of complexity and staging of treatment were not considered in recommendations. Average domain scores were very low, with the lowest being applicability and editorial independence. Development of high-quality, rigorously developed, evidence-based guidelines, addressing staging, resource implications, and patient involvement is recommended as the evidence base remains underdeveloped. Full article

Background: Airway mucus plugging is a key but long-overlooked mechanism of persistent airflow obstruction in both asthma and chronic obstructive pulmonary disease (COPD). Type 2 (T2) cytokines, particularly interleukin (IL)-4 and IL-13, drive goblet cell metaplasia, MUC5AC overexpression, and impaired mucociliary clearance, while eosinophil-derived products increase mucus viscosity and promote plug persistence. Methods: A comprehensive narrative review was conducted by searching PubMed and ClinicalTrials.gov databases from inception to February 2026. Search terms included “mucus plugs,” “mucus plugging,” “biologics,” “dupilumab,” “tezepelumab,” “mepolizumab,” “benralizumab,” “IL-4,” “IL-13,” “MUC5AC,” “quantitative CT,” “functional respiratory imaging,” “asthma,” and “COPD.” Studies were included if they reported original data or systematic evidence on mucus plug quantification, biologic-mediated changes in mucus plug scores, or imaging modalities for mucus assessment in asthma or COPD. Editorials, case reports with fewer than three patients, and studies not available in English were excluded. Two authors (P.-V.M. and A.C.) independently screened titles and abstracts; discrepancies were resolved by consensus. Randomized controlled trials, observational studies, and preclinical studies evaluating mucus plug outcomes and T2-targeted therapies were included. Reference lists of retrieved articles were hand-searched for additional relevant publications. Results: A recent systematic review identified multiple randomized controlled trials and observational studies that showed CT-assessed mucus plug scores go down with biologic therapies targeting the T2 pathway in asthma. Observational data extend this evidence to anti-IL-5/IL-5Rα agents. The VESTIGE trial provided the first functional respiratory imaging evidence of mucus plug resolution with dupilumab. In COPD, the BOREAS/NOTUS and MATINEE trials established the efficacy of dupilumab and mepolizumab in eosinophilic phenotypes; however, differences in inclusion criteria—particularly regarding FeNO thresholds and prior exacerbation burden—may explain divergent effects on lung function endpoints. Mucus plug outcomes have not been evaluated in COPD biologic trials. Quantitative imaging modalities, including HRCT mucus plug scoring, functional respiratory imaging, and hyperpolarized gas MRI, now enable objective assessment of mucus burden. Conclusions: Mucus plugging meets the definition of a treatable trait: it can be measured with CT scoring, it matters clinically, and it responds to T2 cytokine blockade. Adding mucus plug assessment to routine clinical evaluation, together with mucolytic strategies where needed, could move treatment decisions from empirical to biology-based across the asthma–COPD spectrum. Further studies are needed to confirm that mucus plug scoring works as a biomarker of treatment response in COPD and to test whether combining biologics with mucolytics improves outcomes. Full article

The rapid integration of generative artificial intelligence into scientific publishing is reshaping how academic text can be produced, revised, and scaled. While transparent and limited use of AI for language support may be acceptable, a new structural vulnerability may be emerging in medical publishing: the large-scale production of short, plausible, and weakly individualized correspondence across multiple specialties. In this viewpoint, we describe and conceptualize a pattern that may be termed synthetic authorship, defined not as undisclosed AI use alone, but as a reproducible mode of scholarly output structurally facilitated by automation. We focus particularly on letters to the editor, a format that combines brevity, rapid editorial handling, and formal indexation, and may therefore be especially exposed to this phenomenon. Based on recurring patterns observed in PubMed-indexed literature, including unusually high publication velocity, abrupt thematic dispersion, and stylistic uniformity across unrelated domains, we argue that such outputs may challenge the authenticity, epistemic value, and editorial function of scientific correspondence. We do not present empirical proof of misconduct, but rather outline a conceptual framework for understanding this emerging risk and propose proportionate editorial safeguards, including cross-domain pattern detection and contextual assessment of authorship coherence. As AI lowers the threshold for generating domain-plausible commentary at scale, scientific publishing must adapt its integrity frameworks accordingly. In this context, vigilance toward synthetic authorship may become an essential component of editorial responsibility and post-publication quality control. Full article

The consolidation of artificial intelligence (AI) is transforming the journalistic sector, to the point that its ethical dimension is being altered. However, the mission and values of the media in the face of the current emergence of generative artificial intelligence (GenAI) have barely been explored. Bearing this in mind, it is important to understand not only how journalists perceive AI, but also to examine the role that the media assign to themselves and the audience’s participation in this context. This research explores the roles defined by a sample of leading media outlets (n = 21) in seven countries in Western Europe and North America: France, Germany, Italy, Spain, the United Kingdom, Canada, and the United States. To this end, a discursive content analysis is applied to three newspapers (printed or digital) per country. The findings reflect differences between countries and media outlets, within a common trend of prioritizing responsibility as the primary editorial value, followed by truthfulness. We also found scant direct references to AI regulation, alongside the development of participatory interactivity within readership established by the media outlet. Furthermore, greater participation of audiences was observed in publicly funded publications, granting audiences a deliberative role. Full article

Peer review is the cornerstone of scholarly publishing and, in medicine, the ultimate guarantor of the reliability of clinical evidence that informs guidelines, therapeutic strategies, and patient care. However, the current peer review system is increasingly strained by bias, abuse, and reviewer overload. Favoritism toward prominent authors, editorial “nepotism,” coercive citation practices, superficial evaluations, and even documented cases of idea theft from confidential manuscripts undermine the trustworthiness of the scientific literature upon which clinical decisions depend. In this paper, we argue that artificial intelligence (AI) and large language models (LLMs) offer a transformative opportunity to strengthen the integrity and efficiency of medical peer review. AI-driven tools can perform rapid consistency checks, detect statistical errors or plagiarism, and enforce compliance with ethical and methodological standards across thousands of manuscripts. Early implementations of AI-guided review platforms, plagiarism detectors, and citation-anomaly algorithms demonstrate that machine assistance can make reviews more thorough, objective, and reproducible. At the same time, we acknowledge the limitations of AI, including hallucinations, a lack of human judgment, and risks to confidentiality if misused. To address these concerns, we propose a hybrid model in which AI handles routine screening and technical tasks under strict safeguards, while human experts retain final responsibility for scientific evaluation. This human–AI partnership may represent an essential step toward improving the quality, fairness, and reliability of the clinical evidence base. Full article

Background: Medication-related osteonecrosis of the jaw (MRONJ) remains a challenging complication associated with antiresorptive and antiangiogenic therapies, characterized by impaired bone healing, infection, and compromised vascularization. Advanced biomaterials capable of promoting bone regeneration and modulating the local microenvironment are being investigated as potential therapeutic strategies. Graphene-based biomaterials have recently emerged as promising candidates due to their unique physicochemical properties and multifunctional biological effects. Objective: This systematic review aimed to analyze and synthesize current evidence on graphene-based 3D scaffolds and related graphene-based biomaterials for bone regeneration, with particular attention to their potential relevance in MRONJ treatment and prevention. Data Sources: A systematic literature search was conducted in PubMed and Scopus databases, complemented by manual screening of reference lists from relevant publications. Eligibility Criteria: Studies investigating graphene-based scaffolds, composites, or graphene-derived biomaterials for bone regeneration were considered. Experimental in vitro and in vivo studies, as well as translational studies addressing osteogenesis, angiogenesis, antimicrobial activity, immunomodulation, or drug-delivery properties relevant to bone healing and MRONJ, were included. Editorials, conference abstracts, and non-English publications were excluded. Methods: Titles and abstracts were independently screened by the authors, followed by full-text assessment for eligibility. Data regarding scaffold composition, graphene derivatives, biological mechanisms, and regenerative outcomes were qualitatively synthesized due to heterogeneity in study designs and outcome measures. Results: The identified literature highlights the multifaceted role of graphene-based biomaterials in bone regeneration. Graphene and its derivatives enhance osteogenic differentiation, promote angiogenesis, modulate immune responses, and exhibit intrinsic antimicrobial properties. In addition, graphene-based scaffolds provide versatile platforms for drug delivery and photothermal or photodynamic therapeutic strategies. These multifunctional properties may address key pathophysiological mechanisms involved in MRONJ, including impaired bone remodeling, infection control, and tissue regeneration. Limitations: The available evidence is predominantly derived from preclinical studies, with limited direct investigation in MRONJ-specific models and considerable heterogeneity in scaffold design and experimental methodologies. Conclusions: Graphene-based 3D scaffolds represent a promising and versatile platform for bone regenerative strategies potentially applicable to MRONJ management. Further translational research and well-designed preclinical and clinical studies are required to clarify their safety, efficacy, and therapeutic applicability. Registration: This review was conducted according to PRISMA 2020 guidelines. The review protocol was not registered. Full article

The emergence of artificial intelligence tools in scientific production is generating significant challenges for scientific integrity and editorial governance, prompting journals and publishers to develop normative guidelines for their use. This study analyzes the current state of guideline implementation among Latin American journals indexed in Scopus and classified according to the Scimago Journal Rank (SJR). A quantitative approach was adopted, complemented by a descriptive documentary analysis based on a detailed review of the websites of 1119 journals from 17 Latin American countries. The collected data were systematized using Excel and analyzed through descriptive and inferential statistical techniques. The results indicate that only 27.2% of journals have explicit guidelines on the use of artificial intelligence, with a predominantly regulatory rather than punitive orientation that prioritizes technical support while restricting practices that compromise human intellectual control. Additionally, statistically significant differences were identified according to quality indicators, showing that journals with higher quality levels are more likely to have such guidelines. Overall, the findings reveal an incipient and heterogeneous regulatory development, underscoring the need to strengthen and harmonize editorial guidelines on artificial intelligence in order to safeguard transparency, clarify the responsibilities of the actors involved in the production and publication process, and protect the integrity of scientific communication. Full article

This contribution examines the key aspects of the aggiornamento of Ignatian spirituality promoted by French Jesuits through the journal Christus between 1954 and 1967. The founding of the journal can be understood as a response to a sense of identity crisis among French Jesuits, likely provoked by the Fourvière crisis and the abrupt end of the worker-priest movement, which was eventually prohibited by Rome. In this context, the call to reconnect with Ignatian sources became imperative to foster theological and spiritual reflection capable of shedding light on the tensions of the present. The generation led by Maurice Giuliani, Michel de Certeau, and François Roustang—who spearheaded this editorial project—distanced itself from the hermeneutics of their predecessors, particularly Joseph de Guibert, as regards the spiritual history of the Society of Jesus. Instead, they emphasized a mysticism of action, the necessary integration of spirituality and apostolic works, the ecclesial implications of Ignatian service, and a bold, increasingly open dialogue between Ignatian tradition and the human sciences. Full article

This systematic review examines how emotional well-being in journalism has been de-fined, experienced, and supported between 2010 and 2025. It draws on 15 peer-reviewed empirical studies identified in Web of Science and Scopus and evaluated using PRISMA 2020 and the MMAT. The review addresses three main gaps in the field: unclear definitions, limited synthesis of risk and protective factors, and scarce assessment of support interventions. Across studies, emotional distress emerges from structural pressures, such as overwork, trauma exposure, online harassment, job precarity, and the erosion of collegial networks. These pressures, rather than inherent traits of journalistic work, shape vulnerability. Protective factors include social support, editorial autonomy, professional experience, purpose-driven motivation, and practices like mindfulness or digital disconnection. Yet their impact is often limited by weak organizational infrastructures. Vulnerability is higher among women, freelancers, and early career journalists, although intersectional analyses remain rare. Sectoral and organizational responses—peer networks, resilience programs, trauma-informed training, and emerging digital safety policies—show promise but remain fragmented. The review concludes that emotional well-being should be framed as an ethical and structural responsibility within journalism, and that sustainable progress requires systemic measures that foster psychological safety and professional dignity. Full article

Background/Objectives: Postoperative pulmonary complications (PPCs) remain frequent and increase morbidity, mortality, and resource use. Preoperative risk scores (ARISCAT, NSQIP-derived calculators) use mostly static variables and may miss the dynamic perioperative host response preceding respiratory deterioration or infection. We address the gap in clinically interpretable syntheses of perioperative blood biomarker trajectories that distinguish infectious from non-infectious PPCs and clarify bedside-ready versus exploratory markers. Methods: We conducted a narrative review with a structured Medline search (inception to 1 November 2025) plus reference screening. We included English-language adult surgical studies (observational or interventional) evaluating perioperative blood biomarkers in relation to PPCs or postoperative pulmonary infection; case reports, editorials, and reviews were excluded. No formal risk-of-bias assessment or quantitative meta-analysis was performed. Results: Across 298 cited publications, serial patterns of routinely available biomarkers (C-reactive protein, procalcitonin, lactate, albumin, and leukocyte-derived indices) were most consistently associated with PPC risk and helped separate expected postoperative inflammation from evolving infection when interpreted longitudinally rather than as single values. Mechanistic biomarkers (cytokines/immune-function assays, endothelial injury and coagulation/fibrinolysis markers, oxidative stress indicators) add biological insight but are limited by assay availability, heterogeneous sampling windows, and absent standardized cut-offs. Omics signatures and machine learning models combining biomarker kinetics with clinical variables are promising but require prospective, transportable validation. Conclusions: Key barriers to implementation include biological variability, non-specificity across postoperative syndromes, heterogeneous sampling windows, and lack of standardized cut-offs. Integrating multimarker panels into validated, dynamic predictive frameworks represents a promising direction for perioperative precision medicine. Full article

Background/Objectives: Radiomics, the high-throughput extraction of quantitative features from medical imaging, offers a promising method for identifying laryngeal cancer imaging biomarkers. We aim to systematically review the literature on radiomics in laryngeal squamous cell carcinoma, assessing applications in tumour staging, prognosis, recurrence prediction, and treatment response evaluation. PROSPERO ID: CRD420251117983. Methods: MEDLINE and EMBASE databases were searched in May 2025. Inclusion criteria: studies published between 1 January 2010 and 31 January 2024, extracted radiomic features from CT, PET/CT, or MRI, and analysed outcomes related to diagnosis, staging, survival, recurrence, or treatment response in laryngeal cancer. Exclusion criteria: case reports, abstracts, editorials, reviews, or conference proceedings, exclusive focus on preclinical or animal models, lack of a clear radiomics methodology, or did not include imaging-based feature extraction. Results were synthesised narratively by modelling objective, alongside formal assessment of methodological quality using the Radiomics Quality Score (RQS). Results: Twenty studies met the inclusion criteria, with most using CT-based radiomics. Seven incorporated PET/CT. Radiomic models demonstrated moderate-to-high accuracy across tasks including T-staging, thyroid cartilage invasion, survival prediction, and local failure. Key predictive features included first-order entropy, skewness, and texture metrics such as size zone non-uniformity and GLCM correlation. Methodological variability, limited external validation, and small samples were frequent limitations. Conclusions: Radiomics holds strong promise as a non-invasive biomarker for laryngeal cancer. However, methodological heterogeneity identified through formal quality assessment indicates that improved standardisation, reproducibility, and multicentre validation are required before widespread clinical implementation. Full article

Researchers are increasingly engaged in studies to determine and correct negative welfare consequences of animal husbandry and behaviour modification procedures, not least in response to industries’ growing need to maintain their social licence through demonstrable welfare standards that address public expectations. To ensure that welfare recommendations are scientifically credible, the studies must be rigorously designed and conducted, and the data produced must be interpreted with full regard to conceptual, methodological, and experimental design limitations. This commentary provides guidance on these matters. In addition to, and complementary with, the ARRIVE guidelines that deal with animal studies in general, there is a need for additional specific advice on the design of studies directed at procedures that alter behaviour, whether through training, handling, or restraint. The COMPASS Guidelines offer clear direction for conducting welfare-focused behaviour modification research. They stand for the following: Controls and Calibration, emphasising rigorous design, baseline measures, equipment calibration, and replicability; Objectivity and Open data, ensuring transparency, validated tools, and data accessibility; Motivation and Methods, with a focus on learning theory, behavioural science, and evidence-based application of positive reinforcers and aversive stimuli; Precautions and Protocols, embedding the precautionary principle, minimising welfare harms, listing stop criteria, and using real-time monitoring; Animal-centred Assessment, with multimodal welfare evaluation, using physiological, behavioural, functional, and objective indicators; Study ethics and Standards, noting the 3Rs (replacement, reduction, and refinement), welfare endpoints, long-term effects, industry independence, and risk–benefit analysis; and Species-relevance and Scientific rigour, facilitating cross-species applicability with real-world relevance and robust methodology. To describe these guidelines, the current article is organised into seven major sections that outline detailed, point-by-point considerations for ethical and scientifically rigorous design. It concludes with a call for continuous improvement and collaboration. A major purpose is to assist animal ethics committees when considering the design of experiments. It is also anticipated that these Guidelines will assist reviewers and editorial teams in triaging manuscripts that report studies in this context. Full article