Search Results (377)

The advancement of artificial intelligence (AI), deep learning, and radiomics has introduced novel methodologies for the detection, classification, prognosis, and treatment evaluation of pancreatic ductal adenocarcinoma (PDAC). As the integration of AI into medical imaging continues to evolve, its potential to enhance early detection, refine diagnostic precision, and optimize treatment strategies becomes increasingly evident. However, despite significant progress, various challenges remain, particularly in terms of clinical applicability, generalizability, interpretability, and integration into routine practice. Understanding the current state of research is crucial for identifying gaps in the literature and exploring opportunities for future advancements. This literature review aims to provide a comprehensive overview of the existing studies on AI applications in PDAC, with a focus on disease detection, classification, survival prediction, treatment response assessment, and radiogenomics. By analyzing the methodologies, findings, and limitations of these studies, we aim to highlight the strengths of AI-driven approaches while addressing critical gaps that hinder their clinical translation. Furthermore, this review aims to discuss future directions in the field, emphasizing the need for multi-institutional collaborations, explainable AI models, and the integration of multi-modal data to advance the role of AI in personalized medicine for PDAC. Full article

Background: Transfection is vital for gene therapy, mRNA treatments, CAR-T cell therapy, and regenerative medicine. While viral vectors are effective, non-viral systems like lipid nanoparticles (LNPs) offer safer, more flexible alternatives. This work explores emerging non-viral transfection technologies to improve delivery efficiency and therapeutic outcomes. Methods: This review synthesizes the current literature and recent advancements in non-viral transfection technologies. It focuses on the mechanisms, advantages, and limitations of various delivery systems, including lipid nanoparticles, biodegradable polymers, electroporation, peptide-based carriers, and microfluidic platforms. Comparative analysis was conducted to evaluate their performance in terms of transfection efficiency, cellular uptake, biocompatibility, and potential for clinical translation. Several academic search engines and online resources were utilized for data collection, including Science Direct, PubMed, Google Scholar Scopus, the National Cancer Institute’s online portal, and other reputable online databases. Results: Non-viral systems demonstrated superior performance in delivering mRNA, siRNA, and antisense oligonucleotides, particularly in clinical applications. Biodegradable polymers and peptide-based systems showed promise in enhancing biocompatibility and targeted delivery. Electroporation and microfluidic systems offered precise control over transfection parameters, improving reproducibility and scalability. Collectively, these innovations address key challenges in gene delivery, such as stability, immune response, and cell-type specificity. Conclusions: The continuous evolution of transfection technologies is pivotal for advancing gene and cell-based therapies. Non-viral delivery systems, particularly LNPs and emerging platforms like microfluidics and biodegradable polymers, offer safer and more adaptable alternatives to viral vectors. These innovations are critical for optimizing therapeutic efficacy and enabling personalized medicine, immunotherapy, and regenerative treatments. Future research should focus on integrating these technologies to develop next-generation transfection platforms with enhanced precision and clinical applicability. Full article

Water governance in Europe faces mounting challenges from climate change, demographic pressures, and aging infrastructure—especially in Southern regions increasingly affected by drought and institutional fragmentation. In contrast, Nordic countries such as Denmark and Sweden exhibit coherent, integrated governance systems with strong regulatory oversight. This study introduces the Water Governance Maturity Index (WGMI), a document-based assessment tool designed to evaluate national water governance across five dimensions: institutional capacity, operational effectiveness, environmental ambition, equity, and climate adaptation. Applying the WGMI to eight EU countries—four Nordic and four Southern—reveals a persistent North–South divide in governance maturity. Nordic countries consistently score in the “advanced” or “model” range, while Southern countries face systemic gaps in implementation, climate integration, and territorial inclusion. Based on these findings, the study offers actionable policy recommendations, including the establishment of independent regulators, strengthening of river basin coordination, mainstreaming of climate-water strategies, and expansion of affordability and participation mechanisms. By translating complex governance principles into measurable indicators, the WGMI provides a practical tool for benchmarking reform progress and supporting the EU’s broader agenda for just resilience and climate adaptation. Unlike broader frameworks like SDG 6.5.1, the WGMI’s document-based, dimension-specific approach provides granular, actionable insights for governance reform, enhancing its utility for EU and global policymakers. Full article

Today, ‘social sustainability’ is a key feature of many organisations’ environmental, social, and governance strategies, as well as underpinning sustainable development goals. The term refers to the implementation of targets such as reduced societal inequalities, the promotion of social well-being, and the practice of positive community relations. Building a meaningful, accountable, and quantifiable evidence-base from which to translate these high-level concepts into tangible and achievable goals is, however, challenging. The complexities of measuring social capital—often described as a building block of social sustainability—have been documented. The challenge lies in measuring the person, group, or collective in interaction with the context under investigation, whether that be a climate goal, an institution, or a national policy. Social identity theory is a social psychological approach that articulates the processes through which an individual internalises the values, norms, and behaviours of their contexts. Levels of social identification—a concept capturing the state of internalisation—have been shown to be predictive of outcomes as diverse as communication and cognition, trust and citizenship, leadership and compliance, and health and well-being. Applying this perspective to the articulation and measurement of social sustainability provides an opportunity to build an empirical approach with which to reliably translate this high-level concept into achievable outcomes. Full article

How do regulatory policies, funding structures, and cross-sector coordination shape knowledge flows and institutional transformation? Focusing on the smart medical device sector in Taiwan, this study explores how governance dynamics accelerate system transformation and foster demand for adaptive and integrative innovation systems. Building on the National Biotechnology Innovation System framework and qualitative system dynamics modeling, the study analyzes institutional interactions through 28 semi-structured interviews and 18 policy documents. Findings identify systemic bottlenecks, including translational gaps, coordination challenges, and barriers for traditional manufacturers. These gaps have enabled tech firms to emerge as system leaders by bridging these institutional gaps. This study extends innovation systems theory by conceptualizing an emergent governance function that addresses institutional gaps. At the policy level, the study highlights the importance of enabling institutional change in governance to address structural fragmentation and support system-wide transformation. Full article

The convergence of artificial intelligence (AI) and nanomedicine has transformed cancer vaccine development, particularly in optimizing RNA-loaded lipid nanoparticles (LNPs). Stability and targeted delivery are major obstacles to the clinical translation of promising RNA-LNP vaccines for cancer immunotherapy. This systematic review analyzes the AI’s impact on LNP engineering through machine learning-driven predictive models, generative adversarial networks (GANs) for novel lipid design, and neural network-enhanced biodistribution prediction. AI reduces the therapeutic development timeline through accelerated virtual screening of millions of lipid combinations, compared to conventional high-throughput screening. Furthermore, AI-optimized LNPs demonstrate improved tumor targeting. GAN-generated lipids show structural novelty while maintaining higher encapsulation efficiency; graph neural networks predict RNA-LNP binding affinity with high accuracy vs. experimental data; digital twins reduce lyophilization optimization from years to months; and federated learning models enable multi-institutional data sharing. We propose a framework to address key technical challenges: training data quality (min. 15,000 lipid structures), model interpretability (SHAP > 0.65), and regulatory compliance (21CFR Part 11). AI integration reduces manufacturing costs and makes personalized cancer vaccine affordable. Future directions need to prioritize quantum machine learning for stability prediction and edge computing for real-time formulation modifications. Full article

Background/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a major global health challenge characterized by complex adipose–liver interactions mediated by adipokines and hepatokines. Despite rapid field evolution, a comprehensive understanding of research trends and translational advances remains fragmented. This study systematically maps the scientific landscape through bibliometric analysis, identifying emerging domains and future clinical translation directions. Methods: A comprehensive bibliometric analysis of 1002 publications from 2004 to 2025 was performed using thematic mapping, temporal trend evaluation, and network analysis. Analysis included geographical and institutional distributions, thematic cluster identification, and research paradigm evolution assessment, focusing specifically on adipokine–hepatokine signaling mechanisms and clinical implications. Results: The United States and China are at the forefront of research output, whereas European institutions significantly contribute to mechanistic discoveries. The thematic map analysis reveals the motor/basic themes residing at the heart of the field, such as insulin resistance, fatty liver, metabolic syndrome, steatosis, fetuin-A, and other related factors that drive innovation. Basic clusters include metabolic foundations (obesity, adipose tissue, FGF21) and adipokine-centered subjects (adiponectin, leptin, NASH). New themes focus on inflammation, oxidative stress, gut microbiota, lipid metabolism, and hepatic stellate cells. Niche areas show targeted fronts such as exercise therapies, pediatric/novel adipokines (chemerin, vaspin, omentin-1), and advanced molecular processes that focus on AMPK and endoplasmic-reticulum stress. Temporal analysis shows a shift from single liver studies to whole models that include the gut microbiota, mitochondrial dysfunction, and interactions between other metabolic systems. The network analysis identifies nine major clusters: cardiovascular–metabolic links, adipokine–inflammatory pathways, hepatokine control, and new therapeutic domains such as microbiome interventions and cellular stress responses. Conclusions: In summary, this study delineates current trends and emerging areas within the field and elucidates connections between mechanistic research and clinical translation to provide guidance for future research and development in this rapidly evolving area. Full article

This study examines the contributions of renewable energy transition (RET) and environmental innovation (EI) to environmental performance in G7 countries from 2003 to 2021, with a focus on the transmission channels of green finance and environmental governance. Using the Augmented Mean Group (AMG) estimator and confirming robustness through the Dynamic Common Correlated Effects Mean Group (DCCE-MG) method, the study explores both direct and indirect effects of RET and EI on two key environmental indicators: the Environmental Performance Index and the Load Capacity Factor. The results reveal that both RET and EI have a significant impact on environmental performance. Moreover, green finance and environmental governance serve as crucial channels through which RET and EI exert their influence. These findings underscore the importance of developing effective financial instruments and robust regulatory frameworks to translate energy and innovation policies into tangible environmental benefits. By highlighting the interplay between technological advancement, financial capacity, and institutional quality, this study provides novel insights into the environmental policy landscape of advanced economies and offers guidance for designing integrated strategies to achieve long-term sustainability goals. Full article

Background/Objectives: Next-generation-sequencing-based genomic profiling (GP) of advanced breast cancer (BC) has been increasingly integrated into clinical practice. The growing number of biomarker-based therapies in BC increasingly complicates treatment decisions. As a result, molecular tumor boards (MTBs) have become pivotal. However, real-world data on the utility of MTBs in advanced BC remain limited. This study evaluates the translation of molecular findings in BC patients into MTB recommendations and examines their implementation and outcomes in real-world clinical practice. Methods: This retrospective, single-center study included 103 BC patients who received GP between January 2018 and December 2023. Patients were discussed at the weekly multidisciplinary MTB of our institution. Data retrieved included patient characteristics, GP results, and MTB recommendations, which were consecutively matched with treatment outcomes, namely the proportion of patients receiving an MTB treatment recommendation, proportion of patients receiving molecularly matched targeted therapy (MTT), and best treatment response. Results: The MTB reviewed 94 patients and provided 155 recommendations to 68 patients (72.3%), including systemic anti-cancer treatment (n = 123), clinical study participation (n = 4), genetic counseling (n = 12), and additional molecular testing (n = 16) recommendations. Treatment recommendations were provided to 63 patients (67%), of whom 38 (60.3%) received MTT. Of the 35 patients eligible for response assessment, 16 (45.7%) demonstrated clinical benefit: three achieved a complete response, six a partial response, and ten a stable disease > 6 months. Conclusions: GP and MTBs expand biomarker-matched treatment options to BC patients beyond the standard of care. Around half of the patients who receive MTT experience a clinical benefit. The standardization of procedures, the development of multi-biomarker-based prediction, and the enhancement in MTT delivery to patients are key challenges, which should be addressed in future initiatives. Full article

Educators must understand current practices and gaps in knowledge regarding environmental sustainability in simulation education to reduce the environmental impact of plastic waste while still maintaining fidelity in simulation education. Therefore, a scoping review was conducted to answer the PICO question, “In healthcare institutions and hospitals, what are the environmentally sustainable practices that can be translated into simulation labs as best practice?” Fourteen studies were identified through a search of seven databases, critically appraised, and analyzed. Three key themes emerged: (1) the 5 R’s, (2) getting people motivated, and (3) larger external collaboration. These themes highlight practical strategies and motivational factors for sustainable practices. An expanded 5 R’s framework (reduce, reuse, recycle, research, and rethink) was introduced to guide a holistic approach. The literature highlights the importance of education, stakeholder engagement, and clearly defined standards as key drivers for motivating individuals and teams to engage in sustainable behaviors. These efforts are most effective when supported by interdisciplinary collaboration, regulatory frameworks, national policies, and technological innovation. Sustainability initiatives should extend beyond individual institutions to foster broader systemic change. Full article

As global urbanization accelerates amidst compounding risks, comprehensive urban resilience assessment has emerged as a pivotal issue in optimizing risk governance pathways. Grounded in the Pressure–State–Response (PSR) theoretical framework, this study constructs a multidimensional evaluation system for comprehensive urban resilience. Through the integration of a combined weighting method and the TOPSIS model, we systematically measure resilience levels across 13 prefecture-level cities in Jiangsu Province, with the obstacle degree model employed to identify critical resilience constraints. The findings reveal significant spatial heterogeneity in regional resilience patterns. High-resilience cities establish positive feedback mechanisms through economic foundations, innovation-driven strategies, and institutional coordination. Conversely, low-resilience cities face multidimensional constraints, including industrial structure imbalance, inadequate social security systems, and infrastructure deficiencies. The resilience disparity stems from the coupling effects of systemic multidimensional elements, with three core obstacles identified: energy consumption and population pressure in the Pressure dimension, medical resource scarcity and innovation deficit in the State dimension, and fiscal expenditure inefficiency in the Response dimension. The study proposes strategic interventions, including fiscal structure optimization, cross-regional resource coordination enhancement, and innovation–translation mechanism improvement, to facilitate urban systems’ transformation from passive resistance to proactive adaptation. This research provides novel perspectives for analyzing complex system resilience evolution and offers scientific grounds for urban agglomeration risk prevention and sustainable development. Full article

Entrepreneurship development strategies are crucial for translating academic potential into economic and societal value. To achieve this, educational institutions must understand the factors influencing students’ entrepreneurial intentions. While research on academic entrepreneurship exists, comparative studies that explore these factors across different national contexts are scarce. This study addresses this gap through a comparative analysis of student entrepreneurship in Bulgaria, Malta, and Turkey, investigating key factors, such as attitudes toward entrepreneurship (ATE), the role of entrepreneurship education (EEdu), and entrepreneurial inspirations. Based on 415 survey responses collected between April and June 2024, hypothesized relationships were tested using appropriate bivariate statistical analyses. The results indicate that a positive evaluation of running one’s own business significantly increases entrepreneurial intentions, particularly when the business is perceived as safe, realistic, pleasant, and strong. The university’s role is pivotal: students largely relied on institutional support for their business initiatives; showed a strong preference for practical, hands-on educational methods; and identified a lack of entrepreneurship education as a key obstacle. A family background with entrepreneurial parents also positively influenced students’ preference for running their own businesses. Interestingly, the findings challenge a simple dichotomy between employment and entrepreneurship. A preference for full-time employment did not diminish entrepreneurial intentions, suggesting students may view these career paths as complementary or sequential. Conversely, preferences for part-time or self-employment did not have a significant positive impact on entrepreneurial initiatives. These findings underscore the need for universities to provide tailored, practical support and to recognize the complex and non-linear career trajectories envisioned by modern students. Full article

Background: Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder that continues into adulthood and is linked to significant academic, occupational, and psychological challenges. Medical students may be at heightened risk due to the cognitive and emotional demands of their training. However, regional data on adult ADHD symptoms in this population, particularly in northern Saudi Arabia, remain limited. Objective: to estimate the prevalence of probable adult ADHD symptoms among medical students at the University of Tabuk and to examine the associated sociodemographic, academic, and health-related factors. Methods: A cross-sectional, web-based survey was conducted between 15 May and 5 June 2025 among randomly selected Saudi medical students (years 2–6) at the University of Tabuk. The validated Arabic version of the WHO Adult ADHD Self-Report Scale (ASRS-v1.1) was used to screen for probable ADHD. A positive screen was defined as ≥4 flagged items. Descriptive and bivariate analyses were performed using SPSS v29. Results: Of the 219 respondents (60.3% male; mean age: 21.6 years), 23.3% screened positive for probable adult ADHD. Symptom frequency peaked in the third (40.0%) and fourth (35.6%) academic years and was lowest among sixth-year students (11.4%) (p = 0.012). A strong association was observed between positive ADHD screening and self-reported psychiatric disorders (p < 0.001). No statistically significant associations were found for gender, income, GPA, marital status, or academic phase. Conclusions: Nearly one in four medical students at the University of Tabuk exhibited symptoms suggestive of adult ADHD, a prevalence markedly higher than global estimates and consistent with regional trends. The association with psychiatric morbidity and the mid-programme peak suggests a need for proactive screening, mental health support, and academic accommodations. Universities can translate these findings into practice by instituting routine ADHD screening, offering flexible assessment accommodations, embedding peer-mentoring programmes, and strengthening on-campus mental-health referral pathways. Full article

Background/Objectives: The global population is rapidly aging, raising interest in dietary practices for promoting the healthspan. This study aimed to comprehensively investigate the state of diet and longevity research over the past decade, addressing the lack of bibliometric synthesis within the field. Methods: A bibliometric analysis was performed using the keywords “diet” and “longevity” on English-language articles from the Web of Science database that were published from 2015 to 2024. Data were analyzed using Web of Science tools, InCites, and VOSviewer to identify trends in publication output, citation metrics, coauthorship networks, institutional contributions, and keyword co-occurrence patterns. Results: Overall, 2203 articles meeting the inclusion criteria were included in the analysis. Publication volume and citation counts gradually increased, peaking in 2021. Countries, including the United Kingdom, and organizations, such as the National Institutes of Health and Harvard University, had significant citation impact, and the United States and China led productivity. Molecular processes (oxidative stress and autophagy), dietary models (Mediterranean diet and calorie restriction), and public health issues (obesity and mortality) were the main thematic clusters. Model species, including Caenorhabditis elegans and Drosophila melanogaster, were frequently used. Regional disparities in research production and notable terminology variability were noted. Conclusions: This study emphasizes the development and diversity of nutrition and longevity research while highlighting novel molecular and translational topics. More international cooperation, uniform language, and multidisciplinary frameworks are warranted to promote equal scientific advancement worldwide and connect mechanistic discoveries with therapeutic outcomes. Full article

Glioblastoma is a highly aggressive, infiltrative brain tumor of the central nervous system (CNS). Its extensive molecular and biochemical heterogenicity hinders the identification of reliable biomarkers and therapeutic targets, thereby making prognosis and existing therapy ineffective. In recent years, breakthroughs in the use of proteomics on a range of biological samples, such as plasma, cerebrospinal fluid (CSF), tissues, brain cells, and exosomes, represent a potential improvement to GBM investigations. Mass spectrometry-based approaches represent an important technique in the characterization of the tumoral proteome, for the identification of differentially expressed proteins, and for studying altered molecular pathways involved in tumor stages. Proteomics studies advance our knowledge about GBM pathogenesis, the discovery of reliable diagnostic and prognostic markers, and therapeutic approaches, also. In this context, for the effective application of proteomics on GBM, it is mandatory to develop a translational network by integrating hospitals, biobanks, and research institutions into a single network, to enable a collaborative approach across disciplines, thereby enabling rapid translation to clinical application of new proteomic insights. Today, high-quality biobanks play a key role in enabling collaborative, ethically compliant research, supporting the effective application of proteomics in glioblastoma studies and the translation of discoveries into clinical practice. This review explores current trends in proteomics and GBM research, highlighting how leveraging biobank infrastructure and fostering institutional cooperation can drive the development of targeted pilot projects to enhance the impact and effectiveness of glioblastoma research. Full article