Search Results (739)

Objectives: To synthesize evidence on structural and functional neuroplasticity in patients after anterior cruciate ligament reconstruction (ACLR) and its clinical implications. Methods: Adhering to the PRISMA guidelines for systematic reviews and meta-analyses, a literature search was conducted using PubMed, Embase, Web of Science, Scopus, and Cochrane CENTRAL (2018–2025) using specific keyword combinations, screening the results based on predetermined inclusion and exclusion criteria. Results: Among the 27 included studies were the following: (1) sensory cortex reorganization with compensatory visual dependence (5 EEG/fMRI studies); (2) reduced motor cortex efficiency evidenced by elevated AMT (TMS, 8 studies) and decreasedγ-CMC (EEG, 3 studies); (3) progressive corticospinal tract degeneration (increased radial diffusivity correlating with postoperative duration); (4) enhanced sensory-visual integration correlated with functional recovery. Conclusions: This review provides a novel synthesis of evidence from transcranial magnetic stimulation (TMS), electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), diffusion tensor imaging (DTI), and functional magnetic resonance imaging (fMRI) studies. It delineates characteristic patterns of post-ACLR structural and functional neural reorganization. Targeting visual–cognitive integration and corticospinal facilitation may optimize rehabilitation. Full article

Background and Objectives: The management of type 2 diabetes (T2D) extends beyond glycemic control, requiring a more global strategy that includes optimization of body composition, even more so in the context of sarcopenia and visceral adiposity, as they contribute to poor outcomes. Past reviews have typically been focused on weight reduction or glycemic effectiveness, with limited inclusion of new therapies’ effects on muscle and fat distribution. In addition, the emergence of incretin-based therapies and dual agonists such as tirzepatide requires an updated synthesis of their impacts on body composition. This review attempts to bridge the gap by taking a systematic approach to how current blood-glucose lowering therapies affect lean body mass, fat mass, and the risk of sarcopenia in T2D patients. Materials and Methods: Between January 2015 and March 2025, we conducted a narrative review by searching the PubMed, Scopus, and Web of Science databases for English-language articles. The keywords were combinations of the following: “type 2 diabetes,” “lean body mass,” “fat mass,” “body composition,” “sarcopenia,” “GLP-1 receptor agonists,” “SGLT2 inhibitors,” “tirzepatide,” and “antidiabetic pharmacotherapy.” Reference lists were searched manually as well. The highest precedence was assigned to studies that aimed at adult type 2 diabetic subjects and reported body composition results. Inclusion criteria for studies were: (1) type 2 diabetic mellitus adult patients and (2) reporting measures of body composition (e.g., lean body mass, fat mass, or muscle function). We prioritized randomized controlled trials and large observational studies and excluded mixed diabetic populations, non-pharmacological interventions only, and poor reporting of body composition. Results: Metformin was widely found to be weight-neutral with minimal effects on muscle mass. Insulin therapy, being an anabolic hormone, often leads to fat mass accumulation and increases the risk of sarcopenic obesity. Incretin-based therapies induced substantial weight loss, mostly from fat mass. Notable results were observed in studies with tirzepatide, demonstrating superior reduction not only in fat mass, but also in visceral fat. Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) promote fat loss but are associated with a small yet significant decrease in lean muscle mass. Conclusions: Blood-glucose lowering therapies demonstrated clinically relevant effects on body composition. Treatment should be personalized, balancing glycemic control, cardiovascular, and renal benefits, together with optimal impact on muscle mass along with glycemic, cardiovascular, and renal benefits. Full article

Background/Objectives: Neurodegenerative proteinopathies, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB), are increasingly prevalent worldwide mainly due to population aging. These conditions are marked by complex etiologies, overlapping pathologies, and progressive clinical decline, with significant consequences for patients, caregivers, and healthcare systems. This review aims to synthesize evidence on the healthcare complexities of major neurodegenerative proteinopathies to highlight current knowledge gaps, and to inform future care models, policies, and research directions. Methods: We conducted a comprehensive literature search in PubMed/MEDLINE using combinations of MeSH terms and keywords related to neurodegenerative diseases, proteinopathies, diagnosis, sex, management, treatment, caregiver burden, and healthcare delivery. Studies were included if they addressed the clinical, pathophysiological, economic, or care-related complexities of aging-related neurodegenerative proteinopathies. Results: Key themes identified include the following: (1) multifactorial and unclear etiologies with frequent co-pathologies; (2) long prodromal phases with emerging biomarkers; (3) lack of effective disease-modifying therapies; (4) progressive nature requiring ongoing and individualized care; (5) high caregiver burden; (6) escalating healthcare and societal costs; and (7) the critical role of multidisciplinary and multi-domain care models involving specialists, primary care, and allied health professionals. Conclusions: The complexity and cost of neurodegenerative proteinopathies highlight the urgent need for prevention-focused strategies, innovative care models, early interventions, and integrated policies that support patients and caregivers. Prevention through the early identification of risk factors and prodromal signs is critical. Investing in research to develop effective disease-modifying therapies and improve early detection will be essential to reducing the long-term burden of these disorders. Full article

Background: Chemotherapy-induced peripheral neuropathy is a common and debilitating side effect of cancer treatment. While exercise has shown promise in alleviating this burden, it remains underutilised in clinical practice due to the lack of accessible, clinician-friendly guidance. Aim: This review aimed to synthesise current evidence on exercise interventions for managing chemotherapy-induced peripheral neuropathy and provide practical insights to support clinicians in integrating these approaches into patient care. Methods: A search was conducted across MEDLINE, CINAHL, and SPORTDiscus using keywords related to exercise and CIPN. Studies were included if they involved adults receiving neurotoxic chemotherapy and exercise-based interventions. Two authors independently screened studies and resolved conflicts with a third author. Study quality was assessed using the JBI Critical Appraisal Tools, and only studies meeting a minimum quality standard were included. A balanced sampling approach was employed. Data on study design, participant characteristics, interventions, and outcomes were extracted. Results: Eleven studies were included, covering various exercise modalities: multimodal (n = 5), yoga (n = 2), aerobic (n = 1), resistance (n = 1), balance (n = 1), and sensorimotor (n = 1). Exercise interventions, particularly multimodal exercise, significantly improved symptom severity, functionality, and quality of life (p < 0.05). The studies had high methodological quality, with randomised controlled trials scoring between 9/13 and 11/13, and quasi-experimental studies scoring 8/9 on JBI tools. Conclusions: This review highlights the significant benefits of exercise, especially multimodal exercise, for managing CIPN and provides guidance for integrating these strategies into clinical practice. Future research is needed to refine exercise prescriptions and develop standardised guidelines. Full article

(1) Background: Chronic myeloid leukemia (CML) is a myeloproliferative disorder driven by the BCR::ABL oncoprotein. During the chronic phase, Philadelphia chromosome-positive hematopoietic stem cells generate proliferative myeloid cells with various stages of maturation. Despite this expansion, leukemic stem cells (LSCs) retain self-renewal capacity via asymmetric cell divisions, sustaining the stem cell pool. Quiescent LSCs are known to be resistant to tyrosine kinase inhibitors (TKIs), potentially through BCR::ABL-independent signaling pathways. We hypothesize that dysregulation of genes governing asymmetric division in LSCs contributes to disease progression, and that their expression pattern may serve as a prognostic marker during the chronic phase of CML. (2) Methods: Genes related to asymmetric cell division in the context of hematopoietic stem cells were extracted from the PubMed database with the keyword “asymmetric hematopoietic stem cell”. The collected relative gene set was tested on two independent bulk transcriptome cohorts and the results were confirmed by single-cell RNA sequencing. (3) Results: The expression of genes involved in asymmetric hematopoietic stem cell division was found to discriminate disease phases during CML progression in the two independent transcriptome cohorts. Concordance between cohorts was observed on asymmetric molecules downregulated during blast crisis (BC) as compared to the chronic phase (CP). This downregulation during the BC phase was confirmed at single-cell level for SELL, CD63, NUMB, HK2, and LAMP2 genes. Single-cell analysis during the CP found that CD63 is associated with a poor prognosis phenotype, with the opposite prediction revealed by HK2 and NUMB expression. The single-cell trajectory reconstitution analysis in CP samples showed CD63 regulation highlighting a trajectory cluster implicating HSPB1, PIM2, ANXA5, LAMTOR1, CFL1, CD52, RAD52, MEIS1, and PDIA3, known to be implicated in hematopoietic malignancies. (4) Conclusion: Regulation of CD63, a tetraspanin involved in the asymmetric division of hematopoietic stem cells, was found to be associated with poor prognosis during CML progression and could be a potential new therapeutic target. Full article

Background: Pharmacy technicians are increasingly involved in immunization services, enhancing vaccine accessibility and reducing pharmacies’ workload. This scoping review aims to (1) provide a comprehensive overview of pharmacy technicians’ involvement in immunization services across various healthcare settings and countries, and (2) conduct a comparative analysis of training curricula for pharmacy technicians on immunization. Methods: A scoping review was conducted following the Arksey and O’Malley framework. A comprehensive search of the PubMed and Scopus databases was performed using keywords and MeSH terms such as “pharmacy technician(s)”, “immunization”, “vaccination”, “role”, and “involvement”. Studies included assessed pharmacy technicians’ roles in vaccine administration, training, and public health outcomes. Descriptive and thematic analyses were used to synthesize the findings. In addition, a supplementary analysis of immunization training curricula was conducted, reviewing programs from different countries to identify similarities, differences, and gaps in course structure, content, and delivery formats. Lastly, a comprehensive toolkit was developed, offering guidelines intended to facilitate the implementation of immunization training programs. Results: A total of 35 articles met the inclusion criteria, primarily from the United States of America (n = 30), Canada (n = 2), Ethiopia (n = 1), Denmark (n = 1) and United Kingdom (n = 1). The findings indicate that pharmacy technicians contribute significantly to vaccine administration, patient education, and workflow optimization, particularly in community pharmacies. The COVID-19 pandemic accelerated their involvement in immunization programs. Key challenges include regulatory barriers, a lack of standardized training, and resistance from other healthcare professionals. Facilitators include legislative support (e.g., the PREP Act), structured training programs, and collaborative pharmacist–technician models. Conclusions: Pharmacy technicians can play a vital role in expanding immunization services, improving vaccine uptake, and reducing pharmacist workload. Addressing regulatory inconsistencies, enhancing training, and fostering interprofessional collaboration are crucial for their effective integration of immunization programs. Since immunization by pharmacy technicians is not yet allowed in many EU countries, this review will provide a foundational basis to address their potential to support the healthcare workforce and improve access to immunization services. Full article

Background: Probiotics can modulate the microbiota and decrease uric acid levels. Objectives: This meta-analysis aimed to assess the effects of probiotics on uric acid levels. Methods: The keywords “probiotics”, “uric acid”, “gout”, “hyperuricemia” were searched in PubMed Medline, EMBASE, Web of Science, and Google Scholar. The search was limited to the English, French, Italian, and Spanish languages, and to the period between 1 January 2000 to 30 August 2024. We included RCTs and observational studies comparing probiotics to placebo. We excluded studies reporting (1) prebiotics, symbiotics, or postbiotics, (2) animal studies, and (3) case reports, commentaries, or reviews. Two independent reviewers performed quality assessment and data extraction. This meta-analysis was performed according to the PRISMA 2020 and AMSTAR 2 guidelines. The main outcome measure was uric acid levels “after–before” probiotic versus placebo interventions. Forest plots summarized the data using a random model. Results: Nine studies included 394 patients, of whom 201 were treated with probiotics and 193 with placebo. There was a statistically significant difference in favor of the probiotic group compared with the control group regarding the main outcome measure. However, substantial heterogeneity was noted, explained (after applying subgroup analysis and meta-regression) by the following moderators: continent, diseased/healthy, male sex, and monostrain probiotics. Conclusions: This meta-analysis demonstrates that probiotics reduced uric acid levels in Asian males who had disease and were treated with monostrain probiotics. Full article

The framing of water infrastructure in the news influences how the public perceives future infrastructure development and associated social-environmental risks. This study examines English-language newspaper coverage of the Ken-Betwa river link, the first component of India’s National River Linking Program (INRLP) to receive approval. Data for this analysis comprised 316 newspaper articles, collected via a keyword search in LexisNexis API, from seven Indian English-language newspapers (Free Press Journal (India), Hindustan Times, Indian Express, The Economic Times, The Hindu, The Times of India (TOI), and Times of India (Electronic Edition)) published between 2004 and 2022. By applying LDA topic modeling, a type of generative probabilistic model, to this dataset, this study examines how evolving media narratives frame water infrastructure in India. Our results identify 23 distinct topics and three dominant frames: (1) a government policy frame, (2) INRLP comparative frame, and (3) environmental conservation frame. We find that these frames evolve, with early coverage emphasizing feasibility and government-led negotiations, and later articles highlighting environmental risks. Our analysis shows how media discourse reflects institutional logic and infrastructure milestones. This study demonstrates the value of computational methods for longitudinal media analysis, has the potential to reveal shifts in public discourse, and highlights power dynamics in environmental reporting. Full article

Handwritten Keyword Spotting (KWS) remains a challenging task, particularly in segmentation-free scenarios where word images must be retrieved and ranked based on their similarity to a query without relying on prior page-level segmentation. Traditional KWS methods primarily focus on visual similarity, often overlooking the underlying semantic relationships between words. In this work, we propose a novel NLP-driven re-ranking approach that refines the initial ranked lists produced by state-of-the-art KWS models. By leveraging semantic embeddings from pre-trained BERT-like Large Language Models (LLMs, e.g., RoBERTa, MPNet, and MiniLM), we introduce a relevance feedback mechanism that improves both verbatim and semantic keyword spotting. Our framework operates in two stages: (1) projecting retrieved word image transcriptions into a semantic space via LLMs and (2) re-ranking the retrieval list using a weighted combination of semantic and exact relevance scores based on pairwise similarities with the query. We evaluate our approach on the widely used George Washington (GW) and IAM collections using two cutting-edge segmentation-free KWS models, which are further integrated into our proposed pipeline. Our results show consistent gains in Mean Average Precision (mAP), with improvements of up to $2.3\%$ (from $94.3\%$ to $96.6\%$) on GW and $3\%$ (from $79.15\%$ to $82.12\%$) on IAM. Even when mAP gains are smaller, qualitative improvements emerge: semantically relevant but inexact matches are retrieved more frequently without compromising exact match recall. We further examine the effect of fine-tuning transformer-based OCR (TrOCR) models on historical GW data to align textual and visual features more effectively. Overall, our findings suggest that semantic feedback can enhance retrieval effectiveness in KWS pipelines, paving the way for lightweight hybrid vision-language approaches in handwritten document analysis. Full article

The increasing demand for plant-based cheese alternatives reflects a shift toward healthier and more sustainable food choices. This study aimed to map technological trends, formulation strategies, and major challenges in the development of plant-based cheese analogues through a systematic review of the scientific literature and patents. Following the PRISMA protocol, searches were conducted in ScienceDirect and Lens.org between December 2024 and January 2025 using keywords related to cheese analogues. A total of 1553 scientific articles and 155 patents were initially retrieved. After applying inclusion and exclusion criteria, 88 articles and 66 patents were selected for detailed analysis. The results show a growing interest in this field since 2020, peaking in 2024. Data from 2025 may be limited due to the search period. Keywords were clustered into three main areas: (1) Formulation and Composition, (2) Texture and Processing, and (3) Food Safety and Consumer Acceptance. The United States leads in patent registrations (59). Valio Company and Cargill were the most active assignees, with nine and eight patents, respectively. This study highlights the importance of integrating food science and technology to improve the quality, sensory attributes, and market competitiveness of plant-based cheese analogues compared to traditional dairy products. Full article

Research on watershed ecological protection and restoration within the framework of territorial spatial planning serves as a critical approach to ensuring national ecological security and plays a vital role in enhancing ecosystem stability. In recent years, scholarly interest in this topic has grown significantly. However, development trends and optimization strategies remain unclear, especially regarding comparative insights between Chinese and English research articles within the territorial spatial planning paradigm. A comprehensive review is therefore needed to bridge this gap. This study utilizes bibliometric analysis with CiteSpace, based on publications from the Web of Science (WOS) and China National Knowledge Infrastructure (CNKI) databases, to visualize and compare Chinese and English research articles on watershed ecological protection and restoration. By combining quantitative and qualitative approaches, this study identified research hotspots and trajectories and provided directions for future research. The main findings are as follows: (1) A quantitative analysis indicates that the number of publications has increased significantly since 1998, with growing interdisciplinary and cross-sector collaboration. (2) The qualitative analysis reveals three fundamental theoretical principles: holistic management, multi-scale interactions, and dynamic coordination. (3) The Chinese Academy of Sciences led in research output, while other institutions showed wider geographic coverage, stronger collaboration networks, and a decentralized, multi-core structure. (4) Keyword clustering highlights three major themes: evaluation methodologies for ecological protection and restoration, spatiotemporal evolution and driving mechanisms, and integrated governance system development. (5) Within the territorial spatial planning paradigm, future researchers should employ big data analytics and monitoring technologies to better diagnose and address ecological challenges. Full article

The building sector holds a significant position in the global energy consumption share, and its environmental impact continues to intensify, making the construction industry a key player in sustainable development. The application of life cycle assessment on buildings (LCA-B) is widely employed to evaluate building energy and environment performance, and thus is of great significance for ensuring the sustainability of the project. This work aims to provide a systematic overview of LCA-B development based on reviewed literature. A three-stage mixed research method is adopted in this study: Firstly, an overall analysis framework is constructed, and 327 papers related to building life cycle assessment published between 2009 and 2025 are screened out by using the bibliometric method; Then, through scientometrics analysis, the journal regions, sources, scholars, and keyword evolution are revealed and analyzed using VOSviewer tool, and the hotspots in the field of LCA-B (e.g., integration of building information modeling (BIM) in LCA-B, multi-dimensional framework of environment–society–culture) are preliminarily explored based on the selected highly cited papers. The research finds that: (1) the performance of low energy buildings is better than that of net zero energy buildings from the perspective of LCA; (2) software compatibility and data exchange are the main obstacles in the integration of BIM-LCA; (3) a multi-dimensional LCA framework covering the social or cultural aspects is expected for a comprehensive assessment of building performance. This study provides a systematic analysis and elaboration of review articles related to LCA-B and thereby provides researchers with in-depth insight into this field. Full article

Background: The aim of this review was to analyze training interventions used and their effectiveness in improving pelvic floor muscle function related to urinary continence in postmenopausal women. We then characterized the recommended pelvic floor muscle training programs used in experimental studies based on four training components: frequency, intensity, duration, and type of pelvic floor muscle exercise. Methods: For this purpose, we conducted a literature review of works published up until the end of 2024, available in the Web of Science, PubMed, MEDLINE, and SPORTDiscus with Full Text databases. We used the keywords “pelvic floor muscle”, “training”, and “postmenopausal women”. Initially, we identified 205 articles published between 1997 and 2024. Then, based on specific criteria, we qualified 15 for analysis. Results: Thirteen studies included only PFMT, while three of them combined PFMT with other physical activity. In two studies, training was conducted in the form of a virtual video game using a pressure platform. We have noted that researchers most often use a 1 h pad test, digital palpation, and surface electromyography to assess the function of pelvic floor muscles. In improving pelvic floor muscle function related to urinary incontinence, 14 out of the 15 analyzed studies showed improvement. In only eight of the fifteen articles, researchers characterized all components of the implemented PFMT that enable full replication of the training intervention. In four of the studies, only one of the required components, namely intensity, was missing. The recommended number of training sessions was 2 to 7 per week, on average 3 ± 2 (M ± SD). Training interventions lasted from 2 to 24 weeks, on average 10 ± 6 weeks. Conclusions: Regardless of the chosen form of training intervention, PFMT is an effective method in improving the function of pelvic floor muscles in postmenopausal women. Full article

Background: In elderly community services, information technology is reshaping the daily lives of older adults in unprecedented ways. It effectively addresses the issue of frailty in the community by strengthening support networks and dynamic risk management. Despite its vast potential, there remains a need to explore further enabling methods in the realm of elderly community services. Objectives: This study aims to provide a significant theoretical and practical foundation for information technology in this field by systematically analyzing the progress and trends of digital transformation facilitated by information technology. Materials and method: To map the advancements and emerging trends in this evolving field, this study conducts a bibliometric analysis of 461 relevant publications from the Web of Science Core Collection (2004–2024). The research employs bibliometric methods and utilizes tools such as CiteSpace and VOSViewer to analyze collaborations, keywords, and citations, as well as to perform data visualization. Results: The findings indicate that current research hotspots mainly focus on “community care”, “access to care”, “technology”, and “older adults”.Potential development trends include (1) further exploration of information technology in elderly care to provide more precise health management solutions; (2) systematically building community elderly service systems to offer more detailed elderly care services; (3) strengthening interdisciplinary information sharing and research collaboration to drive innovation in community elderly care models; and (4) introducing targeted policy and financial support to improve the specific implementation framework of information technology in elderly community services. Conclusions: This study provides empirical support for the development of relevant theories and practices. Furthermore, the research outcomes offer valuable insights into business opportunities for practitioners and provide important recommendations for formulating elderly service policies. Full article

(1) Background: Elemental imaging methods such as XRF, SEM/TEM-EDS, LIBS and LA-ICP-MS are widely used in clinical diagnostics. Based on the results obtained, it is possible to assess the safety of both standard and innovative therapies, diagnose diseases, detect pathogens or determine intracellular processes. In addition to bioimaging, these techniques are used for semi-quantitative and quantitative analyses. Some of them also enable highly valuable speciation of analytes. However, the quality of information about elemental tissue composition depends on a number of different factors. Although the crucial parameters of quantitative analysis are the same for each technique, their impact varies depending on the bioimaging method. Due to the fact that imaging results are often crucial in clinical decision-making, it is important to clearly indicate and describe the parameters affecting the quality of results in each technique. Therefore, the aim of this review is to describe the influence of these crucial parameters on bioimaging results based on the methodology and results of studies published in the last ten years. (2) Methods: In order to collect relevant publications, the Scopus database was searched using the keywords “element AND imaging AND human tissue”. Next, studies were selected in which methodological aspects allowed relevant conclusions to be made regarding the quality of the results obtained. (3) Results: One of the most important parameters for all techniques is measurement selectivity resulting from the complexity of human tissue. Quantitative analyses using bioimaging techniques are difficult due to the lack of suitable calibration materials. For the same reason, it is challenging to assess the accuracy of the results obtained. Particular attention should be paid to the results obtained for trace elements. (4) Conclusions: The discussed bioimaging techniques are a powerful tool in the elemental analysis of human tissues. Nevertheless, in order to obtain reliable results, a number of factors influencing the measurements must be taken into account. Full article