Search Results (1,933)

As an essential component of the built environment, outdoor artificial lighting at night, has a profound impact on visitors’ experience quality. Research on the light environment extends beyond visual effects to encompass broader psychophysiological impacts, such as perception, emotion, and public health. Shooting tree lights (STLs) are a distinctive type of outdoor lighting, commonly installed in landscape environments. This study aims to investigate the effects of different colors (yellow, red, green, and blue) of STL on alertness at night. Sixty participants took part in an experimental design assessing the impact of four different colors on electroencephalogram (EEG) and self-reported alertness. Our results indicate that STL color is a significant factor influencing physiological alertness levels. Exposure to yellow light reduced beta power, diminished alertness, and enhanced relaxation and comfort compared to red, blue, and green light. The study also identified variations in alertness based on age and gender. With respect to age, younger individuals exhibited greater alertness, while women were more alert than men. This study suggests that yellow light is generally more favorable than other colors in enhancing subjective light comfort. These findings underscore the importance of prioritizing yellow-colored STLs in landscape planning and design to promote relaxation and comfort for nighttime visitors. Full article

Heart failure with preserved ejection fraction (HFpEF) represents a growing global public health challenge, now accounting for approximately half of all heart failure cases and often linked to a systemic pathophysiological process in older adults with multiple comorbidities. Despite increasing recognition of the vascular contributions to HFpEF, the precise molecular mechanisms, particularly the role of noncoding Ribonucleic Acids (ncRNAs) in mediating vascular aging and subsequent cardiac dysfunction, remain incompletely understood. This review provides a comprehensive overview of the mechanistic link between vascular aging and HFpEF, with a specific focus on the pivotal roles of ncRNAs in this complex interplay. We delineate the classification of vascular aging, its cellular hallmarks, including endothelial senescence, vascular smooth muscle cell phenotypic switching, and extracellular matrix remodeling, and its systemic implications, such as inflammaging, oxidative stress, and reduced nitric oxide bioavailability. We then detail how these vascular alterations, including increased ventricular afterload and impaired myocardial perfusion due to coronary microvascular dysfunction, contribute to HFpEF pathophysiology. The review extensively discusses recent findings on how diverse classes of ncRNAs, notably microRNAs, long noncoding RNAs, and circular RNAs, along with emerging evidence for PIWI-interacting RNAs, small nuclear RNAs, small nucleolar RNAs, and tRNA-derived small RNAs, regulate these vascular aging processes and serve as molecular bridges connecting vascular dysfunction to heart failure. In conclusion, understanding the regulatory landscape of ncRNAs in vascular aging may reveal novel biomarkers and therapeutic avenues, offering new strategies for precision medicine in HFpEF. Full article

Urban landscapes have given rise to novel ecosystems (e.g., green areas), which differ in design and ecological quality depending on local planning strategies. Europe has the goal to increase conservation through increasing greenspace; however, urban wildlife health impacts, particularly on birds, are poorly studied. This study investigates associations between haemosporidians and intestinal coccidia in the Eurasian Tree Sparrow (Passer montanus), as well as their body condition and immunological status, from five urban green areas in Madrid, Spain, from 2019 to 2022. These green areas differ in green infrastructure, and because these birds are adapted to urban environments, they are a good model to evaluate how green area infrastructure may affect the birds’ health. We detected a 29% prevalence of haemosporidians (Haemoproteus being the most common, followed by Leucocytozoon and Plasmodium) and a 4% prevalence of intestinal coccidia. We found that haemosporidian prevalence was significantly higher in green areas with untreated stagnant water surrounded by muddy areas, ideal conditions for vector reproduction. Therefore, effective management strategies, especially related to water treatment, are essential for protecting urban wildlife and human health. This study provides valuable information for researchers and urban wildlife managers to incorporate appropriate management strategies into urban green area planning to preserve urban biodiversity and protect public health. Full article

Background/Objectives: While the integration of artificial intelligence (AI) into clinical research is rapidly accelerating, a comprehensive analysis of the global AI clinical trial landscape has been limited. This study presents the first systematic characterization of AI-related clinical trials registered in the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). It aims to map global trends, identify patterns of concentration, and analyze the structure of international collaboration. Methods: A search of the WHO ICTRP was conducted on 20 June 2025. Following a two-stage screening process, the dataset was analyzed for temporal trends, geographic distribution, disease and technology categories, and international collaboration patterns using descriptive statistics and network analysis. Results: We identified 596 AI clinical trials across 62 countries, with registrations growing exponentially since 2020. The landscape is defined by extreme geographic concentration, with China accounting for the largest share of trial participations (35.6%), followed by the USA (8.5%). Research is thematically concentrated in Gastroenterology (22.8%) and Oncology (20.1%), with Diagnostic Support (45.6%) being the most common technology application. Formal international collaboration is critically low, with only 8.7% of trials involving multiple countries, revealing a fragmented collaboration landscape. Conclusions: The global AI clinical trial landscape is characterized by rapid but deeply imbalanced growth. This concentration and minimal international collaboration undermine global health equity and the generalizability of AI technologies. Our findings underscore the urgent need for a fundamental shift toward more inclusive, transparent, and collaborative research models to ensure the benefits of AI are realized equitably for all of humanity. Full article

Introduction: Ecological networks (ENs) are critical frameworks designed to protect biodiversity, enhance habitat connectivity, and provide ecosystem services in fragmented landscapes. Urban ecological networks (UENs) adapt this concept to address the challenges posed by urbanization, habitat fragmentation, and climate change. Methods: This systematic review follows the PRISMA methodology, with the search strategy applied across PubMed, Scopus, and Web of Science. Articles published until 29 July 2025, were evaluated based on their alignment with One Health domains: human, animal, and ecosystem health. The included studies underwent independent review and quality assessment using the Newcastle–Ottawa Scale. Results: Only nine of the 228 articles that were found satisfied the requirements for inclusion. These studies examined UENs’ effects on biodiversity, species migration, and climate resilience but lacked direct evaluation of human health impacts. Key findings highlighted the role of ecological corridors in improving habitat connectivity, promoting biodiversity, and mitigating climate-related fragmentation. Conclusions: While UENs show significant potential to enhance biodiversity and urban resilience, their direct impacts on human health remain underexplored. Future interdisciplinary research should focus on quantifying these links and integrating UENs into urban planning to address ecological and Public Health challenges under a One Health framework. Full article

Background and Rationale: Visceral disorders, both functional and organic, significantly impact health-related quality of life and pose a challenge for healthcare systems. Osteopathy offers manual, systemic, and patient-centered approaches for their management, yet these remain controversial due to limited scientific support and methodological inconsistencies. In the evolving landscape of healthcare regulation in Europe, and particularly in Italy, exploring clinical reasoning and operational models in visceral osteopathy is essential. This study aimed to explore the beliefs, clinical reasoning, and management strategies of experienced Italian osteopaths in the treatment of visceral disorders using a Constructivist Grounded Theory approach. Methods: This qualitative study applied a Constructivist Grounded Theory approach to explore the beliefs and clinical practices of 10 experienced Italian osteopaths. Semi-structured interviews were transcribed, coded, and thematically analyzed, integrating literature comparisons to support theory generation. Results: Four core themes emerged: (1) education and professional development, (2) definition and identification of visceral disorders, (3) clinical management strategies, and (4) multidisciplinary collaboration. The findings reveal marked heterogeneity in diagnostic frameworks and treatment rationales, often driven by tradition and subjective interpretation rather than empirical evidence. Palpatory assessments were frequently prioritized over patient-reported outcomes. Conclusion: The study highlights substantial fragmentation in Italian visceral osteopathic practice, echoing challenges across Europe. Promoting a shift towards critical thinking, evidence-based models, shared terminology, and interprofessional integration is essential for contextualising osteopathic contributions to the care of individuals presenting with visceral-related problems. These findings provide insights into the fragmented clinical practices of Italian osteopaths and may contribute to shaping a more critical and evidence-informed approach within Italian osteopathic practice and professional development, which is now more relevant than ever, given the recent integration of osteopathy into the Italian higher education system. Full article

Constructing an ecological security pattern (ESP) represents an effective strategy for alleviating regional landscape fragmentation, which is crucial for maintaining regional ecological health. This study focuses on the Jinan metropolitan area as a case study, employing morphological spatial pattern analysis (MSPA), ecosystem services evaluation, and circuit theory to construct the ecological network (EN). This study optimizes the EN by considering connectivity and spatial distribution, with reference to priority areas and ecological protection red lines (EPRLs). Additionally, the robustness of the EN was evaluated, and the ESP for the Jinan metropolitan area was constructed. The results show the following: (1) The initial EN of the study area comprises 40 ecological sources (ESs) and 84 ecological corridors (ECs). Four types of priority areas were identified. There is a noticeable imbalance in the spatial distribution of ESs and ECs across the Jinan metropolitan area. (2) During the optimization process, 10 new ESs were extracted based on priority areas, which weakened the obstacle effect of problem areas in ECs, and 7 new ESs were extracted based on EPRL, which solved the problem of uneven distribution of ESs to a certain extent. (3) The optimized EN consists of 57 ESs and 124 ECs. Robustness analysis reveals that this multi-perspective optimization method enhances the connectivity and stability of the EN. An ESP of “One Belt, Two Axes, Two Zones, and Five Cores” has been established for the Jinan metropolitan area. This study provides a valuable reference for sustainable development in the Jinan metropolitan area and offers a scientific basis for similar metropolitan areas. Full article

Neuroendocrine neoplasms (NENs) of the lung are a biologically and clinically diverse group of tumors that includes well-differentiated typical and atypical carcinoids (LNETs), as well as poorly differentiated large-cell neuroendocrine carcinoma and small-cell lung cancer. Despite their relative rarity, the incidence of LNETs is increasing, primarily due to advancements in diagnostic techniques and heightened clinical awareness. While the current World Health Organization (WHO) classification offers a morphological basis for diagnosis and prognosis, particularly for extrapulmonary neuroendocrine neoplasms (ep-NENs), it has limitations in predicting the clinical behavior of pulmonary carcinoids. Recent evidence highlights the inadequacy of traditional criteria in fully capturing the biological complexity and clinical heterogeneity of these tumors. This review explores the evolving landscape of LNETs, focusing on well-differentiated forms and analyzing current classification systems, clinicopathological features, and the emerging role of novel prognostic and predictive biomarkers. Advances in histopathology and molecular profiling have begun to elucidate distinct molecular subsets within carcinoids, offering potential avenues for improved risk stratification and therapeutic decision-making. Although there are limited treatment options for advanced disease, new insights into tumor biology could facilitate the development of personalized therapeutic strategies and pave the way for future innovations in LNET management. Full article

Metabolic diseases are increasing in relevance both in health and the economy in most countries. In this direction, if gold-standard technologies are based on blood analysis, non-invasive glucose monitoring is a relevant and great challenge that has not yet been fully resolved. Sweat represents a more suitable medium for the non-invasive sensing and monitoring of glucose than other bodily fluids, such as saliva, tears, or urine. However, the measurement of glucose levels requires the use of highly precise and sensitive sensors, given the low glucose concentration in sweat. This paper provides an overview of the patent landscape related to wearable biosensors for the monitoring of glucose levels in sweat. Full article

Background/Objectives: We analyzed recent changes in the incidence of glaucoma and associated visual impairment (VI) in Korea over a 16-year period. Methods: We utilized nationwide, longitudinal cohort data from the Korea National Health Insurance System (KNHIS) National Health Screening Cohort from 2004 to 2019 to evaluate the age-standardized incidence rate (SIR) of glaucoma and glaucoma-related VI. VI was determined based on KNHIS health examinations and the National Registry for Visual Disability. The incidence rates were estimated per 100,000 person-years. Joinpoint regression analysis was applied to assess significant changes in incidence trends, and subgroup analyses were conducted by age and sex. Results: The age-SIR of glaucoma increased from 864.1 per 100,000 in 2004 to a peak of 1101.1 in 2016, followed by a decline to 978.9 in 2019. Joinpoint regression identified a significant rise from 2007 to 2015 (annual percent change [APC]: +3.92%), with a subsequent decline (APC: –3.30%). The incidence of glaucoma-related severe VI decreased from 26.23 per 100,000 in 2004 to 8.76 in 2012, remaining stable thereafter at 12.49 in 2019. The VI-to-incidence ratio also declined from 0.030 in 2004 to 0.009 in 2012, which remained stable thereafter at 0.013 in 2019. Females consistently exhibited higher glaucoma incidence but lower VI rates than males. Conclusions: These recent trends highlight the evolving landscape of glaucoma epidemiology in Korea and underscore the need for sustained early detection efforts and optimized patient management. Full article

The built environment, technology, human health and well-being, and sustainable development are closely related, and human-centered therapeutic design in environmental, architectural, spatial, and landscape domains demonstrates human health promotion potential. This study examines health promotion design measurement indices and develops a scale for sub-healthy tourists in a hot spring tourism destination. Recent research mainly emphasized the development and utilization of hot spring resources and their economic benefits. It rarely provided a systematic discussion on the health-promoting impact of environmental design and evaluation criteria. Thus, this study employs the literature review method and the Delphi expert method to construct an index system and measurement scale that comprises 20 evaluation indices of physical, mental, and social health. Moreover, this study conducts a questionnaire survey to measure the physical, mental, and social health of sub-healthy tourists and non-sub-healthy tourists (observation and control groups) and the sub-healthy tourists before and after their visit to the hot spring tourism destination (pre-test group and post-test group). The scale demonstrates satisfactory reliability and validity, and the health–healing design measurement indices for the sub-healthy tourists consist of three subscales: physical, mental, and social health. The evaluation index system and measurement scale can comprehensively and effectively measure the effects of healing and therapeutic design (HTD) and can be used as reliable tools for sub-healthy tourists in hot spring tourism. Full article

The increasing global health crisis of neurodegenerative diseases such as Alzheimer’s, Parkinson’s, amyotrophic lateral sclerosis, and Huntington’s disease is worsening because of a rapidly increasing aging population. Disease-modifying therapies continue to face development challenges due to the blood–brain barrier (BBB), which prevents more than 98% of small molecules and all biologics from entering the central nervous system. The therapeutic landscape for neurodegenerative diseases has recently undergone transformation through advances in targeted drug delivery that include ligand-decorated nanoparticles, bispecific antibody shuttles, focused ultrasound-mediated BBB modulation, intranasal exosomes, and mRNA lipid nanoparticles. This review provides an analysis of the molecular pathways that cause major neurodegenerative diseases, discusses the physiological and physicochemical barriers to drug delivery to the brain, and reviews the most recent drug targeting strategies including receptor-mediated transcytosis, cell-based “Trojan horse” approaches, gene-editing vectors, and spatiotemporally controlled physical methods. The review also critically evaluates the limitations such as immunogenicity, scalability, and clinical translation challenges, proposing potential solutions to enhance therapeutic efficacy. The recent clinical trials are assessed in detail, and current and future trends are discussed, including artificial intelligence (AI)-based carrier engineering, combination therapy, and precision neuro-nanomedicine. The successful translation of these innovations into effective treatments for patients with neurodegenerative diseases will require essential interdisciplinary collaboration between neuroscientists, pharmaceutics experts, clinicians, and regulators. Full article

Spatial environments influence users’ behavioral patterns and psychological perceptions, affecting health outcomes—a professional consensus in architecture, particularly within healthy buildings. Growing attention to spatial design’s health benefits has rapidly increased quantitative research. Relationships between spatial elements (e.g., green spaces, water features, facilities) and health indicators (e.g., emotional state, mental health, physical activity) are increasingly clear. Due to collective behavior patterns on campuses, the space–health relationship is particularly pronounced. This paper examines campus open spaces via meta-analysis to explore spatial elements’ relative influence on health outcomes. After a chronological review of qualitative research, it cross-sectionally extracts quantitative data. The independent variable (“campus open space”) is categorized into natural landscapes, service facilities, and built environment (design organization). The dependent variable (“health”) is subdivided into physical health, mental health, and positive social adaptation. The main conclusions of the study are as follows: Campus open spaces significantly impact student health, with the built environment exerting the strongest influence. Combining landscape/facility elements with spatial guidance yields more significant results. Furthermore, based on the calculated impact factor data for each element, this study has developed an evaluation scale that could serve as an empirical foundation for future assessments of campus health benefits, thereby guiding health-oriented campus spatial design. Full article

The treatment landscape for EGFR-mutated metastatic non-small cell lung cancer (mNSCLC) has evolved significantly with multiple combination regimens demonstrating superiority over single agent Osimertinib over the past two years. Recent trials such as FLAURA2 and MARIPOSA have explored intensified front-line regimens, with FLAURA2 demonstrating improvement in PFS with the addition of chemotherapy to Osimertinib and MARIPOSA, showing both a PFS and OS benefit with a novel combination regimen of Amivantamab and Lazertinib. However, these regimens are associated with significantly higher toxicity to patients and pose a huge financial and logistical burden to the health care system; therefore, treatment selection must therefore be individualized, considering disease biology, patient fitness, and toxicity burden. Post-progression strategies remain challenging due to resistance mechanisms like EGFR C797S mutations and MET amplification and the lack of data post-progression on novel first-line combinations. Ongoing trials are investigating fourth-generation EGFR TKIs, MET inhibitors, antibody–drug conjugates, and bispecific antibodies in subsequent lines. While regimens like Amivantamab-Lazertinib show promise even in second-line settings, toxicity, cost, and access remain barriers. As therapeutic options expand, biomarker-driven sequencing and personalized care will be critical to optimizing long-term outcomes in EGFR-mutated mNSCLC. Full article

Physical activity plays a vital role in promoting public health. Among its various forms, outdoor exercise offers combined physical and mental health benefits. However, the spatial patterns and underlying drivers of outdoor exercise remain underexplored in rapidly urbanizing areas. Based on 15,880 app-tracked trajectories from 723 individuals, this study investigates running, walking, and cycling patterns across 130 communities in Southern Dongguan. Results reveal three key findings. First, different types of outdoor exercise show distinct spatial patterns: running is common in urban centers, walking is concentrated around natural landscapes, and cycling follows cross-regional networks. Second, natural and built environmental features shape outdoor exercise behavior. Waterfront continuity promotes participation, while residential areas support walking. In contrast, manufacturing zones inhibit participation due to environmental degradation. Socioeconomic factors also influence participation by enhancing the grassroots governance capacity. Third, spatial spillover effects significantly shape cycling patterns, and traditional models that ignore spatial dependence underestimate environmental impacts. These findings provide new insights into how the combined influence of artificial and natural environments shapes outdoor exercise in rapidly urbanizing cities. They also reveal the distinctive role of grassroots governance with state support in China, offering valuable lessons for other fast-growing urban regions worldwide. Full article