Search Results (9,226)

Pregnancy involves major cardiovascular adaptations, yet its long-term impact on maternal brain health remains poorly understood. The American Heart Association’s Life’s Simple 7 (LS7) and Life’s Essential 8 (LE8) are validated tools to assess cardiovascular and brain health, but their use in obstetric populations is limited. Following PRISMA-ScR guidelines, we searched three databases (2010–2024) for studies assessing ≥ 1 LS7/LE8 component during pregnancy with mid- or later-life cognitive or dementia outcomes; narrative synthesis and meta-analyses were conducted where feasible. Of 3940 screened abstracts, 30 studies met the inclusion criteria. Most examined hypertensive disorders of pregnancy (HDP), few assessed diabetes independently, and none evaluated the full LS7/LE8 construct. Meta-analyses showed that HDP was associated with increased risk of all-cause dementia (HR 1.34; 95% CI 1.11–1.62) and vascular dementia (HR 1.76; 95% CI 1.03–3.00; n = 3 studies), but not Alzheimer’s disease (HR 1.22; 95% CI 0.96–1.56). Although LS7/LE8 are established frameworks for cardiovascular and brain health, their application during pregnancy remains limited. Integrating LE8 into obstetric care may enable earlier identification of individuals at risk for later-life cognitive decline and inform strategies to promote maternal brain health across the lifespan. Full article

Professional competency frameworks are important for aligning educational outcomes with workforce needs. While multiple frameworks exist across sectors, the underlying research-informed design principles guiding their development remain fragmented. This systematic review synthesizes methodological approaches and proposes research-informed design principles used in developing professional competency frameworks across diverse professions, identifying common patterns and informing future framework design. A systematic review was conducted following PRISMA 2020 and SWiM guidelines. Searches across major academic databases yielded 3656 records. After screening, 47 studies met inclusion criteria. Data extraction focused on methodological processes and development activities. Thematic analysis was used to generate a set of initial design principles: (1) Foundational Inquiry and Evidence Gathering; (2) Consensus-Building and Collaborative Validation; and (3) Framework Development and Iterative Refinement. The development of competency frameworks is inherently cyclical, interdisciplinary, and iterative, blending empirical inquiry with collaborative validation. The identified research-informed design principles offer a transferable blueprint applicable across sectors, from healthcare to education and other industries. Thus, it is strongly recommended that future studies use these initial research-informed design principles to inform competency development. The systematic review has been registered to Open Science Framework (OSF). Full article

Background/Objectives: Acute otitis media (AOM) remains a leading cause of pediatric morbidity and a primary indication for antibiotic prescription worldwide. Given the potential for serious complications and the evolving landscape of antimicrobial resistance, up-to-date epidemiological data on causative bacteria are essential. This study aimed to assess the global prevalence of major bacterial pathogens in pediatric AOM and evaluate variations across geographic regions and temporal periods (pre-2000 vs. post-2000). Methods: A systematic search of PubMed, Embase, and Web of Science (1980–2025) was conducted to identify studies reporting middle ear fluid culture results in children (0–18 years) with AOM. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 45 studies encompassing 16,305 AOM episodes were included. Data were synthesized from North America, Europe, the Middle East, Asia, Oceania, and Africa. Pooled prevalence estimates and 95% confidence intervals (CIs) were calculated using a random-effects model, and heterogeneity was assessed via the I² statistic. Results: The overall pooled culture-positive rate was 66.6% (95% CI, 62.2–70.8%). Regional pooled estimates ranged from 56.1% in the Middle East (95% CI, 40.3–70.6%; underlying counts, 3776/10,652) to 77.5% in North America (95% CI, 68.2–84.7%; underlying counts, 1567/2125). Streptococcus pneumoniae was the most prevalent pathogen, with a pooled proportion of 29.0% (95% CI, 26.3–31.8%), followed by Haemophilus influenzae (22.3%; 95% CI, 19.3–25.6%) and Moraxella catarrhalis (4.6%; 95% CI, 3.4–6.1%). While S. pneumoniae remained the leading pathogen in most regions, H. influenzae showed marked geographic variability, peaking in the Middle East at 27.5% (95% CI, 17.0–41.2%; underlying counts, 2280/10,652) and reaching its lowest level in Asia at 13.5% (95% CI, 7.8–22.4%; underlying counts, 336/1854). The pooled culture-positive rate declined from 72.5% before 2000 (95% CI, 67.6–76.9%; underlying counts, 5769/8199) to 59.4% in 2000 and later (95% CI, 52.1–66.3%; underlying counts, 6661/15,707), although S. pneumoniae remained the predominant isolate in both periods. Conclusions: S. pneumoniae remains the primary bacterial driver of pediatric AOM globally. However, the observed geographic disparities and the temporal shift in pathogen prevalence following pneumococcal conjugate vaccine (PCV) introduction underscore the necessity for region-specific empirical antibiotic selection. These findings highlight the critical need for sustained microbiological surveillance to inform future vaccination and treatment strategies. Full article

Aiming at the problems of uneven population initialization distribution, easy trapping in local optima, unbalanced exploration and exploitation capabilities, insufficient optimization accuracy and convergence speed of the original Greater Cane Rat Algorithm (GCRA), this paper proposes a Chaos-Integrated Difference-Enhanced Greater Cane Rat Algorithm (CEGCRA). Firstly, the algorithm adopts the piecewise chaotic map to generate the initial population, which effectively improves the uniformity and diversity of the population and reduces the risk of premature convergence. Secondly, an accumulated difference foraging strategy is designed to integrate the position and fitness difference information between individuals and the optimal individual, dynamically adjust the search direction and step size, and realize the adaptive balance between global exploration and local exploitation capabilities. Finally, the dynamic switching mechanism between the exploration and exploitation stages of the algorithm is improved, and the boundary constraint handling strategy is optimized to further enhance the algorithm stability. To verify the performance of the CEGCRA, comparative experiments were carried out on the CEC2014 and CEC2020 benchmark test suites. The results show that compared with the original GCRA, the optimal fitness value of the CEGCRA is reduced by an average of 35.3%, the standard deviation is reduced by an average of 22.7%, and the convergence speed is increased by an average of 28.9%. In two typical engineering constrained optimization problems, namely, welded beam design and cantilever beam design, the cost of the welded beam solved by the CEGCRA is 12.5% lower than that of the original GCRA and 8.7% lower than that of the PSO algorithm; the weight of the cantilever beam is 0.012% lower than that of the original GCRA and 0.008% lower than that of the GA, with a constraint satisfaction rate of 100%. The experimental results fully prove that the CEGCRA is superior to the original GCRA and seven comparison algorithms such as PSO, DE and SSA in terms of optimization accuracy, convergence speed, robustness and constraint handling ability and can effectively solve complex engineering optimization problems with high dimensionality, nonlinearity and multiple constraints. Full article

Student well-being, encompassing mental, social, cognitive, and behavioral domains, is increasingly compromised by academic stress, social isolation, and sedentary lifestyles. Horticulture-based interventions (HBIs), involving plant-based activities, have shown potential in promoting holistic health across populations. Nevertheless, no systematic review has synthesized global evidence for its effects on students. This systematic review aimed to evaluate HBI’s impact on students’ well-being, synthesizing global evidence to inform educational and therapeutic practices. This systematic review was registered in PROSPERO (CRD420251250712). Following PRISMA guidelines, we searched PubMed, Web of Science, MEDLINE, EMBASE, and APA PsycInfo from inception to 30 June 2025. Keywords were used to search for related articles. Fifteen studies (n > 2000 students, aged 5–18 years) from South Korea (n = 8), Taiwan (n = 3), Chinese Mainland (n = 1), Hong Kong, China (n = 1), Italy (n = 1), and the United States (n = 1) were included for analysis. Results showed that HBI has the potential to enhance emotional/psychological well-being (e.g., stress reduction, mood improvement), social well-being (e.g., peer relations, social skills), cognitive and education benefits (e.g., attention, academic attitudes), and physical and overall health benefits (e.g., physical activity, quality of life). HBI may contribute to multifaceted student well-being, particularly emotional and social domains. This systematic review provides a reference for educators to integrate horticultural programs into the curriculum. Government and school policies may consider funding school gardens. Future randomized controlled trials with diverse populations are needed to address limitations like small samples and geographic bias. Full article

Background/Objectives: Silver’s ability to kill pathogenic bacteria is being widely researched in environment, consumer, and health-related applications. One topic of voluminous research is the antimicrobial properties of silver and silver in wound dressings. This research literature has been reviewed in articles using qualitative analyses, meta-analyses, systematic reviews, bibliometric analyses, and other grounded methods. We present a new strategy for the analysis of the population of articles on the subject based on an ontology of this topic. Methods: A search of the Scopus database for all peer-reviewed articles on silver in wound dressings yielded a population of 4711 relevant ones. The ontology is a logical deconstruction of the problem: “use of silver species on nanosupports deposited on a matrix with antimicrobial effectiveness assayed by methods to promote wound healing of chronic wounds as determined by recovery”. Each bolded term denotes a dimension of the ontology, and each dimension denotes a taxonomy of constituent elements. A Convolutional Neural Network (CNN) was trained using a manually mapped subset of articles. The CNN was then used to map the population of articles. Results: Out of the 4711 articles, 3079 dealt with silver and wound dressings; the others involved silver, but were not related to wound dressings and were not considered. Overall analysis shows that three classes of silver encompass the entire field: silver nanoparticles (AgNP) (78% of papers), inorganic silver-ion-containing species (7%) and silver associated with organic molecules (15%). AgNP papers have grown exponentially beginning in the early 2000s; there is no clear trend regarding inorganic silver-containing-species papers; whereas with the silver-organics species papers, there has been growth in the past decades, but now the number of publications is stabilizing. Research on the AgNPs has primarily focused on in vitro testing (54%), with very limited animal testing (17%) and human testing (3%). On the other hand, with silver-organics, animal (30%) and human testing (38%) are prominent. Inorganic silver ion species also have been human-tested extensively (43%). Thus, in clinical applications of silver wound dressings, AgNP lags considerably as compared to the other silver species, though academic research in AgNP is robust. Conclusions: From detailed temporal visualizations of the ontological mapping, the antecedents and consequences of silver in wound dressings are presented. This first ontological analysis is a novel way of visualizing an entire research field and the temporal characteristics of the various dimensions of the ontology provide information on the current state of research as well as where the field is headed. Full article

Background: Open banking (OB) is rapidly transforming financial ecosystems by enabling controlled data sharing among multiple actors through application programming interfaces (APIs). While this transformation promises innovation and competition, it also introduces complex security challenges that extend beyond purely technical considerations. Despite growing attention in academic and professional domains, existing reviews provide limited integration of security concerns with global adoption patterns and cross regional variation. Methods: This systematic review analyses empirical and conceptual research on security in OB published between 1999 and 2025, capturing early digital banking studies that later informed the development of OB. The literature is structured into three distinct phases: foundational digital banking developments, regulatory formalisation of OB frameworks, and post-implementation expansion of OB ecosystems. A comprehensive search was conducted across major academic databases and scholarly portals, complemented by relevant regulatory and policy sources. Following duplicate removal, title and abstract screening, full-text eligibility assessment, and methodological quality appraisal, 117 studies were retained for qualitative synthesis. Results: The findings reveal recurring security challenges arising from the interaction between technological infrastructures, regulatory frameworks, and user behaviour within OB ecosystems. Technical safeguards such as APIs, strong customer authentication, and encryption are necessary but insufficient when they are misaligned with regulatory implementation and user behaviour. Behavioural factors, including trust, consent understanding, and security-related decision making, play a central role in shaping ecosystem resilience. Based on this synthesis, the study develops a tri-dimensional security framework integrating technological, regulatory, and behavioural dimensions. The bibliometric analysis of 117 studies reveals that technological security dominates the literature (58%), followed by regulatory governance (44%) and behavioural dimensions (42%). However, only 17.9% of studies integrate all three dimensions simultaneously. APIs and authentication mechanisms represent the most frequent technological terms, while PSD2 and GDPR dominate regulatory discourse. Trust and decision-making are the most recurrent behavioural constructs. The relatively low proportion of fully integrated studies confirms a structural fragmentation within OB security research, thereby empirically justifying the proposed tri-dimensional framework. Chronologically, early studies (1999–2015) predominantly focused on technical security mechanisms and regulatory compliance, whereas more recent research (2020–2025) increasingly highlights the interplay between regulatory frameworks and user behaviour, suggesting a shift towards a more holistic understanding of security within OB adoption. Conclusions: This systematic review concludes that integrating technological, regulatory, and behavioural perspectives advances a more comprehensive understanding of security in OB ecosystems. The proposed tri-dimensional security framework provides a structured foundation for future research and supports policy-relevant and practice-oriented security design. Full article

Reliable navigation is critical for UAVs operating in GNSS-denied environments, where conventional Inertial Navigation System/Global Navigation Satellite System (INS/GNSS) integrated navigation struggles to meet the requirements of high-reliability and long-endurance missions. As a passive and autonomous approach, terrain-aided navigation (TAN) offers strong concealment and a high degree of autonomy. However, most existing TAN methods rely on handcrafted features, which limit their ability to fully exploit multi-level terrain information, while sensitivity to elevation noise and attitude variations further degrades matching accuracy and robustness. To address these issues, this paper proposes a GNSS-denied UAV terrain matching navigation method based on an autoencoder network with contrastive learning. A Global–Local Dual-branch Feature Extraction Network (GL-DualNet) is designed to combine the local detail extraction capability of CNNs with the global dependency modeling ability of the Swin Transformer, enabling effective multi-scale terrain representation. In addition, an Autoencoder Contrastive Learning Model (ACLM) is developed to jointly optimize reconstruction and contrastive objectives, enabling unsupervised learning of terrain features with improved discriminability and robustness against noise and rotational disturbances. Experiments on a public terrain dataset show that the proposed method outperforms conventional terrain matching approaches under different noise levels, rotational disturbances, and search ranges, demonstrating its effectiveness and robustness for UAV navigation in complex GNSS-denied environments. Full article

A common challenge when modeling social–ecological systems (SESs) is defining the spatial extent of the system. Boundaries that do not adequately capture both social and ecological processes and their interactions can lead to mischaracterization of the system, while expanding boundaries too widely can impact model complexity and required resources. Socially, boundaries can invoke and influence identity, culture, power, and sense of place. Boundary decisions benefit from flexible, iterative approaches and the expertise of local communities. Here, we use a structured database search supplemented with citation searching to identify and review the literature that addresses choosing or defining spatial boundaries in SESs mapping or modeling and, when applicable, how participatory methods were used in the research process. In a review of the resulting 79 studies, we discovered that pre-existing social or ecological boundaries were used most frequently (36 and 18 publications, respectively). Twenty-one publications combined social and ecological boundaries or data to create custom boundaries, and four studies used an alternative approach to conventional boundaries. Informed by the literature review, we present a general framework for defining boundaries at the outset of SES research. We then connect the framework to a specific case study based on a collaborative project with Tribal, university, and federal scientists to develop a social–ecological climate adaptation plan. We present guiding questions alongside candidate boundaries for our study system and explore the tradeoffs of these boundary options, which can function as a useful template for other social–ecological research collaborations. Full article

Cardiometabolic disease is increasingly shaped by the overlap among obesity, type 2 diabetes, chronic kidney disease, heart failure, and atherosclerotic cardiovascular disease, underscoring the need for prevention strategies that extend beyond glucose-centered care. This narrative review critically examines the mechanistic rationale, clinical evidence, guideline evolution, and practical implementation of sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) and glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) within the cardiorenal–metabolic continuum. A structured literature search was conducted in PubMed, Scopus, and Web of Science, focusing primarily on publications from January 2019 to March 2026, with selected landmark studies from earlier years included for context. Priority was given to randomized controlled trials, major cardiovascular and kidney outcome trials, meta-analyses, clinical practice guidelines, scientific statements, and expert consensus documents. The reviewed evidence indicates that SGLT-2 inhibitors show the most consistent benefits in reducing heart failure events, slowing chronic kidney disease progression, and lowering cardiorenal risk, whereas GLP-1 receptor agonists are more strongly associated with reductions in major adverse cardiovascular events, residual atherosclerotic risk, and body weight. Emerging data also support extension of this therapeutic paradigm beyond diabetes, particularly in obesity-associated cardiovascular risk. Contemporary care is increasingly moving toward phenotype-informed treatment selection, earlier organ-protective intervention, and multidisciplinary management, although cost, access, tolerability, and implementation barriers remain important limitations. SGLT-2 inhibitors and GLP-1 receptor agonists are therefore central to modern cardiovascular prevention across the cardiovascular–kidney–metabolic spectrum. In this context, the proposed Cardiometabolic 2.0 framework may serve as a clinically oriented model for integrating these therapies within contemporary organ-protective care. Full article

Brucellosis remains one of the most widespread zoonotic infections worldwide, causing serious veterinary, medical, and socio-economic consequences. The disease, caused by bacteria of the genus Brucella, affects a wide range of domestic and wild animals as well as humans, with global incidence potentially reaching 1.6–2.1 million new cases annually. The most effective approach to combating brucellosis is specific prevention through vaccination. Therefore, we conducted this review to summarize data from existing studies on modern strategies for brucellosis vaccination, types of vaccine platforms, their efficacy, safety, and applicability in veterinary and human medicine. We searched databases including PubMed, Scopus, and Web of Science to identify relevant scientific articles in English published from 1990 to 2025. The aim of this work is to conduct a systematic analysis of modern brucellosis vaccination strategies in livestock and humans, as well as to evaluate the prospects of new vaccine platforms. The review examines live attenuated, inactivated, subunit, vector, and DNA vaccines, as well as their immunological mechanisms of action, advantages, and limitations of application. This information allows for a better understanding of the mechanisms of protective immunity formation and challenges related to DIVA diagnostics (Differentiating Infected from Vaccinated Animals). The “One Health” concept demonstrated the interconnection between human, animal, and environmental factors, emphasizing the need for an interdisciplinary approach to brucellosis monitoring, prevention, and control. Vector vaccines based on influenza virus (Flu-BA), developed in Kazakhstan, have shown high promise, combining immunogenicity, protective efficacy, and a favorable safety profile. Promising directions remain mRNA vaccines, nanoparticles, CRISPR/Cas9 technologies, and mucosal vaccines. Full article

Background/Objectives: Nowadays, social media is increasingly utilized in the field of orthodontics for information sharing and promotion, yet its influence on patients’ willingness to initiate orthodontic treatment remains insufficiently defined. This systematic review aims to synthesize the available evidence on the impact of orthodontic-related social media content on patients’ willingness to seek orthodontic treatment. Methods: An extensive literature search was performed across five electronic databases up to August 2025, complemented by manual screening of reference lists. Randomized and non-randomized studies evaluating orthodontic-related social media exposure and reported treatment-related willingness or motivation outcomes were considered for inclusion. Results: A total of 1243 records were identified, and eight studies met the inclusion criteria, including six cross-sectional studies, one randomized controlled trial, and one qualitative study. Given the diversity of study designs and assessment methods, the results were synthesized narratively. Visually oriented orthodontic-related social media posts, particularly outcome-focused imagery such as before–after photographs, were more frequently associated with increased willingness to seek orthodontic treatment compared with technical content. Gender-related differences were reported, with female participants appearing more responsive to orthodontic-related social media exposure. Across the included studies, Instagram was identified as the platform exerting the strongest influence. Conclusions: The findings of this systematic review indicate that visually oriented orthodontic-related social media content, particularly outcome-focused imagery such as before–after photographs, shows more consistent associations with willingness to seek orthodontic treatment, alongside gender-related differences and platform-specific effects. Full article

The black-winged kite algorithm (BKA) integrates the Cauchy mutation strategy and the leader selection strategy to simulate high-altitude circling exploration, fixed-point diving attack, and group cooperative migration of the black-winged kites to approximate the global optimal solution. The BKA exhibits deficiencies in ponderous convergence efficacy, inefficient calculation precision, and insufficient population diversity. To strengthen the convergence property and computational practicability, an enhanced BKA with multiple strategies (MSBKA) is advocated to accommodate global optimization and constrained engineering applications. The objective is to systematically verify its advancement and competitiveness and accurately actualize the global optimal solution. The ranking-based differential mutation can strengthen population information interaction, accelerate convergence efficiency, restrain premature convergence, diminish homogenization competition, promote exploration and exploitation, intensify elite individual guidance, downscale ineffective iterations, and materialize orderly population renewal. The simplex method can execute the local refinement operations of reflection, expansion, compression and contraction, strengthen local mining efficiency, ameliorate solution accuracy, abate parameter sensitivity, eschew local optimal traps, accelerate accurate convergence, and preserve the optimal individual potential. The elite opposition-based learning strategy can fabricate reverse solutions, expand the monolithic detection space, shorten the convergence process, elevate the quality of initial and iterative solutions, boost population diversity, guide intelligent search direction, and relieve premature convergence. The MSBKA utilizes deficiency orientation, strategy adaptation, and collaborative search to accomplish the realistic demands of high-precision, high-efficiency and strong constraint adaptation, surmount the static trade-off dilemma, endow a strong directional abscond mechanism to replace random perturbation, and actualize the inertia of directional exploration and the blind spots of solution exploitation. Twenty-three benchmark functions and six real-world engineering designs are employed to authenticate theoretical superiority and engineering practicability. The experimental results demonstrate that the MSBKA incorporates strong practicability and reliability to strengthen information interaction, restrain search stagnation, diminish convergence oscillation and fluctuation, facilitate globalized discovery and localized extraction, expedite convergence efficacy, ameliorate solution precision, and consolidate stability and robustness. Full article

With the rapid development of robot technology, the multi-robot cooperation system has been widely used in rescue, monitoring, logistics, and other fields. Aiming at the key problems in multi-robot cooperative localization and target search, considering the search time, search mileage, and search risk, a cooperative localization and search algorithm based on ant colony optimization (ACO-CLS) is proposed based on the analysis of the target weight factor, the sensitivity of the number of robots, the adaptability of robot formation, and the sensitivity of robot speed. Firstly, a multi-sensor fusion localization algorithm based on IMU and UWB sensors is designed, and the error-state Kalman filter (ESKF) is used to achieve high-precision position estimation. Secondly, a dynamic grouping strategy based on weight is proposed to realize intelligent grouping based on target priority and robot position. Then, the ant colony algorithm is introduced to make path decisions, and the robot search is guided by pheromone updates and heuristic information. Finally, an intelligent reallocation mechanism after target discovery is designed to realize the dynamic optimization of resource allocation. The simulation results show that the proposed algorithm is superior to the traditional methods in terms of location accuracy, search efficiency, and system robustness, and has important theoretical value and application prospects. Full article

Background/Objectives: A non-surgical orthodontic treatment strategy for transverse maxillary deficiencies, especially in late adolescents and young adults, is microscrew-assisted rapid palatal expansion (MARPE). The literature indicates several concerns regarding its long-term efficacy and potential complications. Recent studies have provided valuable insights into the MARPE technique, particularly focusing on its efficacy, potential complications, and treatment failures. The present scoping review aims to synthesize and critically appraise clinical evidence on MARPE in post-pubertal patients, with a specific focus on treatment outcomes, mechanisms of failure, and local and systemic adverse effects to inform risk–benefit assessment and clinical decision-making. Methods: A systematic search was conducted across four electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) to identify English-language clinical trials, observational studies, and systematic reviews published between January 2015 and December 2025. The search strategy employed controlled vocabulary (MeSH terms) and Boolean operators targeting MARPE, treatment failure, and adverse effects in patients aged ≥ 16 years. After title/abstract screening and full-text assessment using predetermined inclusion criteria, 15 studies (3 systematic reviews with meta-analysis, 2 umbrella reviews, 4 systematic/scoping reviews, 2 randomized controlled trials, and 4 observational studies) were selected for qualitative synthesis. Results: Fifteen studies were finally included, which demonstrated significant heterogeneity in methodological design, sample characteristics, outcome measurement protocols, and MARPE device specifications. Mean success rates of 92.5% for maxillary transverse expansion were reported, with mean expansion duration ranging between 20 and 126 days. Key adverse effects comprised dentoalveolar tipping (buccal inclination of maxillary molars and premolars), periodontal complications (buccal bone resorption of 0.6–0.9 mm, gingival recession, papilla recession in 18% of cases), root resorption, miniscrew loosening, midpalatine/circummaxillary sutures, and potential but minimally documented intracranial effects. Conclusions: MARPE appears to be a valid non-surgical option for selected post-pubertal patients, but its success depends on careful case selection and monitoring for dentoalveolar, periodontal, sutural, and rare intracranial adverse effects. Full article