Search Results (1,128)

Background: Non-suicidal self-injury (NSSI) is highly prevalent during adolescence and is associated with a range of emotional, cognitive, and interpersonal vulnerabilities. Although prior research has identified key correlates such as emotion dysregulation, hopelessness, interpersonal distress, and attachment insecurity, these factors have largely been examined in isolation, limiting understanding of how they jointly contribute to NSSI. Methods: The present study examined the network structure of NSSI and associated vulnerability processes in a community sample of 2067 Spanish adolescents (M age = 14.62, SD = 1.80). A regularized partial correlation network (EBICglasso) was estimated, including NSSI frequency and functions, emotion dysregulation, hopelessness, perceived burdensomeness, thwarted belongingness, and attachment representations. Centrality and network stability were evaluated using standard indices and bootstrapping procedures. Results: The network revealed a differentiated structure of associations. Perceived burdensomeness and intrapersonal NSSI functions emerged as the most influential nodes, whereas emotion dysregulation occupied a key bridging position connecting attachment-related experiences, interpersonal vulnerability, and NSSI processes. In contrast, NSSI frequency and interpersonal functions showed a more peripheral role. Attachment security was negatively associated with core risk variables, consistent with a protective role within the network. Conclusions: Findings suggest that NSSI in adolescence is embedded within a system of interacting emotional and interpersonal processes, structured around the functional meaning of the behavior and key interpersonal appraisals. Emotion dysregulation emerged as a highly connected node linking multiple domains, while attachment was associated with several key variables within the network. These findings suggest potential targets for early identification and intervention, particularly focusing on emotion regulation, perceived burdensomeness, and intrapersonal functions of NSSI. Full article

Background: The glucocorticoid receptor NR3C1 exhibits antiepileptic properties, but the mechanisms governing its stability during epileptogenesis remain elusive. This study investigated whether the E3 ubiquitin ligase TRIM8 regulates neuronal hyperexcitability and epileptic activity by modulating NR3C1. Methods: We established an in vivo epilepsy model via intrahippocampal kainic acid (KA) injection and an in vitro epileptiform model using Mg²⁺-free artificial cerebrospinal fluid in primary hippocampal neurons. The roles of TRIM8 and NR3C1 were assessed using in vivo and in vitro gain- and loss-of-function approaches, alongside co-immunoprecipitation, Western blotting, immunofluorescence and whole-cell patch-clamp recording. Results: TRIM8 is significantly upregulated in hippocampal and temporal lobe neurons in epileptic mice. TRIM8 was markedly upregulated in the hippocampal neurons of epileptic mice, inversely correlating with NR3C1 levels. Mechanistically, TRIM8 interacted with NR3C1, promoting its polyubiquitination and proteasomal degradation. This TRIM8-mediated NR3C1 reduction enhanced the phosphorylation of AMPA receptor (AMPAR) subunits GluR1 (Ser831) and GluR2 (Ser880) without affecting total receptor expression. In vitro, TRIM8 overexpression exacerbated calcium dysregulation, neuronal injury, and AMPAR phosphorylation; crucially, concurrent NR3C1 overexpression rescued these effects. In vivo, knockdown of TRIM8 significantly reduced seizure frequency, prolonged the latency to the first Stage III seizure, shortened average seizure duration, and decreased total seizure burden in KA-induced epileptic mice. Electrophysiologically, TRIM8 overexpression significantly increased the frequency of spontaneous action potentials and amplitudes of spontaneous excitatory postsynaptic currents under Mg²⁺-free conditions. Furthermore, in vivo knockdown of TRIM8 attenuated KA-induced seizure severity, restored NR3C1 protein stability, and suppressed aberrant AMPAR phosphorylation in the hippocampus. Triple immunofluorescence staining showed that KA-induced epilepsy increased TRIM8 but decreased NR3C1 immunoreactivity in NeuN⁺ hippocampal neurons, and TRIM8 knockdown reversed these changes. Conclusions: TRIM8 acts as a critical driver of epileptiform activity by targeting NR3C1 for degradation, thereby disinhibiting AMPAR phosphorylation and enhancing network hyperexcitability. The TRIM8-NR3C1-AMPAR axis emerges as a previously unrecognized molecular pathway in epileptogenesis, highlighting its potential as a promising therapeutic target for epilepsy. Full article

Background/Objectives: Rehospitalization after traumatic spinal cord injury (SCI) is common, but binary or count summaries may obscure heterogeneity in timing, recurrence, frequency, and duration. We aimed to identify clinically interpretable rehospitalization burden profiles in the SCIMS 2021ARPublic dataset and examine descriptive associations with clinical correlates and participation outcomes. Methods: We analyzed Form I, Form II, and Record Status public-use files. Among 29,310 individuals with at least one non-lost follow-up interview, 28,745 with at least one non-missing rehospitalization indicator entered latent class analysis. Four prespecified indicators captured early, recurrent, frequent, and prolonged rehospitalization. Candidate two- through six-class models were compared using AIC, BIC, entropy, class size, posterior probabilities, and interpretability. Pairwise adjusted logistic models examined candidate clinical correlates in 10,407 participants with complete 2016+ follow-up data. Adjusted linear models examined CHART participation domains in 20,766–20,949 participants. Results: A four-profile solution was retained: low rehospitalization burden (59.8%), early/prolonged rehospitalization (18.9%), frequent/prolonged rehospitalization (7.7%), and high recurrent/frequent/prolonged burden (13.6%). UTI and pressure ulcer history showed the most consistent associations with burdened profiles. Severe pain and frequent sleep problems were associated with selected heavier-burden profiles, while depressive symptoms showed smaller and less precise associations. Sensitivity analyses supported structural stability while highlighting observation-time bias and classification uncertainty inherent to wave-based public-use data. Compared with the low-burden profile, burden profiles showed lower CHART scores, especially for mobility and occupation. Conclusions: Rehospitalization after traumatic SCI is heterogeneous. These utilization burden profiles summarize distinct observed patterns but require prospective validation before use in risk stratification or follow-up planning. Full article

Pituitary apoplexy is an uncommon but clinically urgent complication that often involves intrasellar hemorrhage and tissue necrosis. The mechanisms linking acute tissue injury to the inflammatory tumor microenvironment remain incompletely defined. Here, we characterized the apoplexy-associated microenvironment and examined whether macrophage mechanosensitive signaling contributes to inflammatory amplification and tissue damage in pituitary neuroendocrine tumors (PitNETs). We combined single-cell RNA sequencing (scRNA-seq), histological validation, clinical stratification, and in vitro functional assays using apoplectic and non-apoplectic human PitNET specimens. Macrophage state transitions, intercellular communication, and transcriptional regulatory programs were analyzed, followed by an experimental assessment of the PIEZO1–Ca²⁺ axis and macrophage-conditioned medium-induced tumor cell death. Histological validation confirmed macrophage accumulation in apoplectic PitNETs, including a 1.67-fold increase in IBA-1-positive cells (p < 0.001). CellChat-inferred interaction metrics increased descriptively in apoplectic samples. Apoplectic tissues showed higher TNF-α expression (3.00-fold; p < 0.0001) and higher PIEZO1 fluorescence in IBA-1-positive regions (1.39-fold; p = 0.001). Yoda1 increased Calcium 520 fluorescence in macrophages (1.72-fold; p = 0.002), whereas Piezo1 knockdown reduced the Yoda1-associated response (p = 0.003). Conditioned medium from activated macrophages increased total Annexin V/PI-positive death in AtT-20 cells (0.53 ± 0.53% to 32.48 ± 1.14%; p < 0.001) and GH3 cells (0.82 ± 0.50% to 30.92 ± 1.11%; p < 0.001); Piezo1 knockdown or TNF-α neutralization attenuated this effect. Clinically, pathological necrosis was associated with higher symptom frequencies and a greater adjusted likelihood of two or more clinical symptoms. Together, these findings indicate that PIEZO1-related macrophage signaling may participate in TNF-α-associated tumor cell necroptosis in pituitary apoplexy. Pathological necrosis was linked to greater acute symptom burden and perioperative hormonal abnormalities, suggesting that it may identify a clinically severe apoplexy subtype. Full article

Objective: Hemispherotomy is an effective treatment for select forms of drug-resistant hemispheric epilepsy, including perinatal stroke, Rasmussen’s encephalitis, and Sturge–Weber syndrome. Post-traumatic epilepsy (PTE) has been reported to occur in ~10% of children following traumatic brain injury (TBI). TBI has not been extensively evaluated as an indication for hemispherotomy, as its effects are rarely unilateral. Here, we report the results from five pediatric cases of hemispherotomy for drug-resistant hemispheric PTE. Methods: A retrospective review was performed of all pediatric patients with drug-resistant PTE secondary to TBI who underwent hemispherotomy between 2018 and 2022 at the Children’s Hospital of Philadelphia (n = 5). All patients initially underwent craniectomy and subsequent cranioplasty due to TBI; criteria for hemispherotomy were met in the following years, leading to a recommendation for hemispherotomy at the epilepsy surgery conference. Clinical characteristics, seizure and functional outcomes, and postoperative complications were reviewed. Seizure outcomes were classified according to the Engel criteria. Results: Five children (median age: 8.3 years, range: 5.0–10.3 years) with drug-resistant PTE underwent lateral trans-sylvian hemispherotomy. TBI etiology included non-accidental trauma (n = 3) and motor vehicle accidents (n = 2). All patients exhibited Engel Class Ia seizure outcomes (median follow-up: 15 months, range: 5–39 months), with a reduction in anti-seizure medications from a median of five preoperatively to one postoperatively. No patient experienced re-operation. Neuropsychological outcomes were patient-specific, with most exhibiting a mix of gains and challenges after surgery. Conclusion: We demonstrate the use of hemispherotomy to treat drug-resistant, hemispheric PTE in five children, with excellent reduction in seizure frequency and mixed or improved neuropsychological outcomes. Full article

Background/Objectives: Recurrent acute otitis media (AOM) in children is known to cause cumulative cochlear and vestibular injury. Whether a single fulminant episode severe enough to require surgical intervention produces an analogous long-term audiovestibular signature, and whether infection severity contributes to outcome independently of cumulative episode count, is unclear. The present study addressed this gap. Methods: In this single-centre retrospective cohort study, 65 paediatric patients who had undergone surgical treatment for acute mastoiditis—the fulminant form of AOM—between July 2001 and March 2021 were assessed a median of 11.5 years after surgery. Of these, 35 had undergone mastoidectomy with tympanostomy and 30 had undergone tympanostomy alone because their episode had not been severe enough to require mastoidectomy. Thirty-two age-matched healthy volunteers (one ear each) formed the control group, yielding 97 ears in three groups (Group TM, 35 ears; Group T, 30 ears; Group C, 32 ears). Extended high-frequency pure-tone audiometry (125–20 kHz), distortion-product otoacoustic emissions (DPOAEs), single-frequency and wideband tympanometry, ipsilateral acoustic reflex thresholds, and lateral-canal vestibulo-ocular reflex gain were measured. Results: Both operated groups showed significantly elevated audiometric thresholds in the high- and extended high-frequency ranges compared with controls (HTA: χ² = 24.25, p < 0.001), with corresponding reductions in DPOAE amplitudes (HTA: χ² = 25.04, p < 0.001). Group TM did not differ significantly from Group T at any frequency band, indicating a negligible additional contribution of mastoidectomy itself. Acoustic reflex thresholds were elevated in Group TM. Vestibulo-ocular reflex gain was within reference ranges in all groups. Conclusions: A single fulminant episode of acute middle-ear infection in childhood—whether severe enough to require mastoidectomy or treated by tympanostomy alone—was associated, more than a decade later, with significantly elevated audiometric thresholds closely resembling those reported after multiple recurrent infections, supporting an effect of infection severity independent of cumulative episode count. Long-term audiological follow-up with extended high-frequency audiometry and otoacoustic emission testing is warranted, irrespective of whether mastoidectomy was required. Full article

Background/Objectives: The Al Haouz earthquake that struck Morocco on 8 September 2023, resulted in substantial material, human, and psychological impacts. Children are at increased risk of psychological disorders, notably post-traumatic stress disorder (PTSD). This study aims to assess probable PTSD and its associated factors among children exposed to the Al Haouz earthquake. Methods: This cross-sectional study, conducted between December 2024 and January 2025, included 536 children from the affected areas. Probable PTSD was assessed using the 20 item Child and Adolescent Trauma Screen (CATS). Sociodemographic and exposure-related data, including post-earthquake conditions, were collected using a structured questionnaire. Data analysis was performed using SPSS software, version 25. Results: Analysis revealed that 47.6% of the children presented with probable PTSD. Multivariable analysis identified several factors independently associated with probable PTSD among children exposed to the earthquake, including age between 11 and 15 years (AOR = 2.02; p < 0.001), female gender (AOR = 1.82; p = 0.001), advanced level of education (AOR = 1.87; p = 0.006), housing damage (AOR = 2.08; p = 0.015), physical injury (AOR = 1.86; p = 0.012), proximity to the epicenter (AOR = 2.22; p = 0.006), temporary shelter in tents (AOR = 1.75; p = 0.02), difficulty of evacuation (OR = 1.97; p = 0.01), and loss of a family member (AOR = 1.98; p = 0.013). Conclusions: This study revealed a high frequency of probable PTSD in children exposed to the Al Haouz earthquake and identifies several associated factors, highlighting the need to targeted, multidimensional interventions. Full article

Background: Effective root canal disinfection is essential for successful nonsurgical root canal treatment (RCT). Although sodium hypochlorite (NaOCl) remains the standard irrigant, it carries a risk of chemical tissue injury if extruded beyond the root canal system and may have limited penetration into anatomically complex regions. Underwater discharge plasma (UDP) generates reactive oxygen and nitrogen species (RONS) through high-frequency, high-voltage electrical discharge in aqueous media, and preclinical and in vitro studies have reported broad-spectrum antimicrobial activity. This study evaluated the clinical and radiographic outcomes of nonsurgical RCT performed using physiological saline-based UDP irrigation without NaOCl in a heterogeneous real-world clinical cohort. Methods: This single-center retrospective cohort study included 186 teeth from 134 patients treated with the PLAZEN RCT^® UDP device and physiological saline irrigation, without NaOCl. The median follow-up period was 16 months. Radiographic outcomes were assessed using the Periapical Index (PAI) system, and treatment success was evaluated according to prespecified Strict and Loose criteria incorporating both radiographic and clinical findings. Stratified analysis was performed according to preoperative PAI score: Group A (PAI 1–2) and Group B (PAI 3–5). UDP-related adverse events, defined as thermal tissue injury caused by discharge heat, were ascertained through retrospective review of clinical records, operative notes, and serial periapical radiographs. Results: Among the 186 treated teeth, radiographic outcomes were classified as Healed (85.5%), Healing (3.8%), and Unhealed (10.8%). Overall Strict and Loose success rates were 79.6% and 82.3%, respectively. Initial treatment showed numerically higher success rates than retreatment. In the stratified analysis, Group A showed an 84.1% success rate with 100% tooth survival, whereas Group B demonstrated Strict and Loose success rates of 68.5% and 83.3%, respectively. Exploratory multivariable analysis showed that periodontal pocket depth > 3 mm was the most consistent factor associated with lower odds of treatment success, whereas associations involving canal obliteration and higher preoperative PAI score were less stable across sensitivity analyses and should be interpreted with caution. No UDP-related adverse events were recorded during follow-up. Attrition sensitivity analyses were performed, and the outcome estimates should be interpreted with caution, given the retrospective design and substantial loss to follow-up. Conclusions: In this preliminary observational cohort, physiological saline-based UDP irrigation without NaOCl was associated with favorable observed periapical healing outcomes and no recorded UDP-related adverse events over a median follow-up of 16 months. However, loss to follow-up was substantial; when all 116 teeth lost to follow-up were classified as treatment failures, the worst-case Strict success rate decreased to 49.0%. Therefore, these findings should be interpreted as preliminary descriptive evidence of clinical feasibility rather than as evidence of comparative efficacy or definitive clinical safety. Adequately powered randomized controlled trials with concurrent NaOCl control arms and long-term follow-up are warranted to evaluate the comparative effectiveness, safety, and reproducibility of physiological saline-based UDP irrigation protocols. Full article

Background: In Chuckwagon racing, teams of four Thoroughbreds with two lead horses in front and two wheel horses directly behind pull a 600 kg wagon around a racetrack. Our study focuses on stride parameters that have previously retrospectively predicted impending injuries. We hypothesize that in aid of the initiation of the tight figure-of-eight turn at the start of the race, the more agile lead horses gallop with higher stride frequency (SF) and reduced stride length (SL), and that differences are exacerbated in the initial accelerative race segments. Methods: Speed, SF, and SL were quantified with global navigation satellite system (GNSS) loggers over consecutive 100 m segments over 5 furlongs in sixty horses competing in Chuckwagon racing. Mixed models for SF and SL (p < 0.05, Bonferroni correction) investigated the effect of speed (fixed covariate), race segment (100 m to 1000 m), and position (lead or wheel horse) as fixed factors and their two-way interactions. Results: SF and SL were significantly affected by all two-way interactions (all p ≤ 0.025). At the average speed of 55.5 km/h, SF was 2.333 and 2.293 Hz, SL was 6.624 and 6.735 m for lead and wheel horses, respectively. Larger SF and SL differences between lead and wheel horses were found at the start and the end of the race. Conclusions: Particularly at the start and end of a Chuckwagon race, there are distinct differences in stride parameters between lead and wheel horses. Specific speed–SF–SL models for Chuckwagon lead and wheel horses might benefit from incorporating race phase. Full article

This study aimed to characterize cortical dysfunction and frequency-specific network reorganization following optic nerve injury using spin-exchange relaxation-free magnetoencephalography (SERF-MEG), and to assess the potential of MEG-derived multiscale features as sensitive functional biomarkers for clinical evaluation. In this prospective case–control study, SERF-MEG recordings were acquired during a pattern-reversal visual stimulation paradigm. Time-domain evoked components (M100/M135), global electrophysiological indices, energy-based metrics, and alpha- and beta-band phase-based functional connectivity were extracted. Network topology was quantified using graph-theoretical measures, including global and local efficiency, clustering coefficient, and assortativity. Group-level differences between patients and healthy controls were statistically analyzed. Patients showed significantly reduced M100/M135 amplitudes, prolonged M100 latency, and a lower early-component energy ratio. Functional connectivity was significantly decreased in the alpha and beta bands, accompanied by reduced global and local efficiency, mean strength, and clustering coefficient. Seed-based analyses revealed reduced connectivity predominantly in occipito-parietal and occipito-temporal pathways. SERF-MEG provides sensitive identification of cortical- and network-level functional impairments following optic nerve damage. MEG has significant clinical potential for disease diagnosis and therapy monitoring, providing a novel objective assessment tool for neuro-ophthalmological disorders. Full article

Background: Severe knee trauma and chronic cruciate ligament insufficiency are commonly accompanied by marked quadriceps femoris (QF) atrophy and weakness. High-load strengthening is often poorly tolerated by patients with compromised joint stability; therefore, low-load blood flow restriction resistance training (LL-BFRT) may serve as an effective alternative. Case presentation: A 38-year-old male presented 27 months after motorcycle-related polytrauma with right knee pain, instability, complete anterior and posterior cruciate ligament ruptures, and partial QF denervation after femoral nerve injury. Before surgery, he completed a supervised 5-week LL-BFRT prehabilitation program (13 sessions). Results: Lean thigh circumference increased by 5.9% proximally and 17.7% distally. Voluntary activation increased from 87.2% to 92.5%, and maximal QF EMG median frequency decreased by 7.4%. Knee extensor isometric and concentric (60°/s) peak torque increased by 52.4% and 36.9%, respectively. QF isometric endurance time increased from 48.5 to 61.8 s. Stair-climbing time decreased from 18.9 to 10.6 s, repetitions in the step-down test increased from 10 to 17, and the Y-balance test composite score increased from 77.7% to 99.4%. Conclusions: Substantial physiological and clinical improvements in QF voluntary activation, maximal strength, endurance, and lower limb function were observed following a short-term LL-BFRT program in a patient with multiple ligament injuries. Changes in lean thigh circumference were consistent with possible improvements in muscle size; however, muscle hypertrophy was not directly assessed. Full article

Background and Objectives: Trauma-associated auditory dysfunction, encompassing tinnitus and hearing loss, represents a frequent yet underrecognized sequela of acoustic overexposure, blast injury, and head trauma. Despite increasing clinical awareness, the published literature exhibits substantial heterogeneity in reported prevalence estimates and recovery outcomes across different injury mechanisms. This narrative review aims to synthesize available evidence on the prevalence, clinical characteristics, recovery patterns, and prognostic factors of tinnitus and hearing loss following traumatic injury, with a particular focus on comparing outcomes across distinct trauma mechanisms and evaluating the impact of early intervention. Materials and Methods: A comprehensive literature search was conducted in PubMed, Embase, Scopus, and Web of Science for studies published between January 2010 and December 2025. The search strategy combined terms related to traumatic injury (e.g., “acoustic trauma,” “blast injury,” “traumatic brain injury,” “head trauma”) with terms related to auditory dysfunction (e.g., “tinnitus,” “hearing loss,” “auditory dysfunction”). Eligible studies included observational studies (cohort, cross-sectional, case–control) reporting original data on tinnitus and/or hearing loss prevalence, recovery outcomes, or prognostic factors in adult or mixed populations exposed to traumatic injury. A narrative synthesis was organized thematically around the key research questions. Results: The available evidence consistently indicates that tinnitus and hearing loss are frequent consequences of blast injury, acute acoustic trauma, and traumatic brain injury, although reported prevalence estimates vary considerably across studies due to differences in populations, injury mechanisms, and diagnostic criteria. Blast injury is associated with mixed hearing loss (conductive and sensorineural components), while acute acoustic trauma typically causes sensorineural hearing loss, often with a characteristic high-frequency notch. Traumatic brain injury can lead to central auditory processing deficits even when pure-tone thresholds are normal. Recovery is variable and often incomplete; tympanic membrane perforations frequently heal spontaneously, but sensorineural components often persist. Early treatment (within days to two weeks) is associated with better recovery outcomes. Conclusions: Trauma-associated tinnitus and hearing loss are highly prevalent and frequently result in persistent disability. The strong association between early treatment and improved recovery outcomes supports the implementation of prompt audiological evaluation and intervention following traumatic injury. These findings underscore the need for routine audiological screening in at-risk populations and for continued research into preventive strategies, standardised assessment protocols, and optimised treatment regimens. Full article

Objective: Traumatic brain injury (TBI) is disproportionately prevalent in incarcerated populations, yet the potential impact on cognitive functioning remains underexplored. This study examined the relationship between TBI history and cognitive performance in a male prison population. Method: Sixty-three participants from Tongariro Prison completed a comprehensive neuropsychological assessment including measures of executive function, memory, processing speed, and perceptual reasoning, with embedded performance validity metrics. TBI history was assessed using the Ohio State University TBI Identification Method (OSU-TBI ID), premorbid function was assessed using the Speed and Capacity of Language Processing (SCOLP) Spot-the-Word task, mood was assessed using the Depression, Anxiety and Stress Scales (DASS-21), and alcohol and substance use were measured using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Regression analyses explored the relationship between TBI history and cognitive functioning, controlling for premorbid function, mood, alcohol and substance use, and ethnicity. Results: Contrary to hypotheses, TBI frequency and severity were not associated with poorer cognitive performance in this population. However, a self-reported history of pervasive TBI—defined as repeated head impacts over a narrow time frame—was significantly associated with reduced performance on the Color–Word Interference Test (CWIT) inhibition task, indicating links to greater cognitive disinhibition. Conclusions: Findings suggest that experiencing at least one period of pervasive TBI may be associated with an impact on inhibition (but not other aspects of executive functioning) in men in prison. These results underscore the importance of nuanced TBI history assessment and highlight inhibition as a potential target for rehabilitation in incarcerated individuals exposed to repetitive head trauma. Full article

Exposure to electromagnetic fields (EMFs) at different frequencies has been reported to induce apoptotic changes in brain tissue. Apoptosis is commonly evaluated using the TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling) method; however, conventional semi-quantitative scoring is subjective and may vary between observers. Therefore, this study aimed to evaluate the feasibility of transfer learning-based convolutional neural network (CNN) models for the objective and automated classification of apoptotic damage in TUNEL-stained brain sections. A total of 92 light microscopy images of TUNEL-stained rat brain tissue, obtained from experimental groups, were analyzed. Apoptotic damage was categorized into three classes (0: no, +1: slight, +2: moderate) based on semi-quantitative scoring. Pre-trained convolutional neural network models, including AlexNet, SqueezeNet, GoogLeNet, Inception-v3, and ResNet-101, were applied for image classification. All models were able to classify apoptotic damage levels, defined by the extent of TUNEL staining, from images with varying performance. The best-performing model achieved high classification accuracy and demonstrated strong agreement with manual scoring, as determined by visual assessments by experts. The models successfully distinguished between different levels of apoptotic damage observed across experimental groups. The findings suggest that transfer learning-based CNN models may provide an objective and reproducible approach for the classification of apoptotic damage in TUNEL-stained histopathological images, thereby reducing observer-dependent variability. This approach may also support histopathological evaluation in experimental models, including studies investigating EMF-induced brain injury. Full article

Necrotizing enterocolitis (NEC) remains one of the most serious gastrointestinal emergencies in preterm infants, and imaging plays a central role in diagnosis and clinical management. Historically, evaluation has relied primarily on abdominal radiography, which remains widely available and embedded in established diagnostic frameworks. However, the hallmark radiographic signs of NEC (i.e., pneumatosis intestinalis, portal venous gas, and free air) reflect relatively advanced manifestations of intestinal injury that indicate established mucosal disruption or transmural necrosis. Bowel ultrasound has increasingly complemented radiography by enabling real-time assessment of bowel wall integrity, perfusion, motility, and intra-abdominal fluid, providing physiologic information that may refine clinical interpretation and monitoring of disease progression. Expanding use of neonatologist-performed bowel ultrasound may further improve access to bedside intestinal imaging and facilitate more timely evaluation in neonatal intensive care settings. In parallel, emerging imaging technologies seek to extend the capabilities of conventional imaging by interrogating biologic processes that underlie intestinal injury. Modalities such as contrast-enhanced ultrasound, ultra-high-frequency ultrasound, and photoacoustic imaging offer the potential to characterize bowel microvascular perfusion, tissue oxygenation, and microstructural changes that may precede overt radiographic abnormalities. Complementary physiologic monitoring approaches are also being explored to identify infants at risk before clinical disease develops. Techniques including superior mesenteric artery Doppler, near-infrared spectroscopy, bowel acoustic monitoring, and electrogastrography aim to detect early alterations in intestinal perfusion, oxygenation, and motility. In addition, artificial intelligence applied to imaging and physiologic data may enhance pattern recognition, risk stratification, and clinical decision support. Together, these advances suggest that NEC evaluation is evolving from a paradigm focused on detecting late structural injury toward integrated approaches capable of identifying intestinal vulnerability earlier and monitoring disease more precisely. Full article