Search Results (7,366)

The integration of exosomes into professional cosmetics marks a significant paradigm shift from traditional passive formulations to advanced regenerative esthetics. Rather than being defined solely by their nanometric dimensions or classical association with endosomal biogenesis, these vesicles function as highly targeted intercellular messengers capable of delivering complex bioactive payloads to modulate tissue repair and collagen synthesis. While robust preclinical and clinical trials validate their remarkable potential in skin rejuvenation, hair restoration, and hyperpigmentation management, significant translational barriers remain. A critical analysis of the current literature reveals that successful clinical outcomes frequently rely on physical penetration enhancers, such as microneedling or fractional lasers, making it challenging to isolate the autonomous efficacy of topical vesicles from the trauma-induced regenerative response. Furthermore, commercial viability is dictated by stringent regulatory frameworks. In the European Union, Regulation (EC) No 1223/2009 strictly prohibits human-derived biologicals, while the US Food and Drug Administration (FDA) aggressively monitors the unsubstantiated marketing of cellular therapies. To navigate these biosafety and legal constraints, the aesthetic industry is increasingly pivoting toward non-human and legally compliant alternatives. Consequently, Plant-Derived Extracellular Vesicles (PDEVs), microbiome-derived exosomes (such as those obtained from bacterial fermentation), and bioengineered synthetic analogues have become the focal point of market innovation. A practical evaluation of the MCCM Medical Cosmetics portfolio illustrates this strategic shift, demonstrating the clinical versatility of botanical sources. To secure the long-term credibility of exosome technology, the industry must overcome current manufacturing heterogeneity by aligning with international standardization frameworks, such as the MISEV2023 guidelines, thereby ensuring reliable delivery systems, batch-to-batch consistency, and uncompromised consumer safety. This review provides a comprehensive overview of the biological mechanisms, clinical efficacy, and translational challenges associated with exosome-based cosmetics. Full article

Radiation detection technology is critical in medical diagnosis, high-energy physics experiments, nuclear environmental monitoring, and radiation safety protection. Its technological iteration stems from innovations in high-performance radiation detection materials. Traditional materials often have narrow dose–response intervals, insufficient high-precision measurement capability, low spatial resolution, and poor stability, failing to meet high-precision detection requirements. Ag-doped phosphate glass (Ag-PG), based on radio-photoluminescence (RPL), effectively addresses these limitations with its comprehensive advantages: high radiation sensitivity, a wide linear dose–response range, submicron spatial resolution for radiation imaging, write-erase-rewrite capability, and visualized dose monitoring potential, and it also boasts significant fundamental research value and engineering application prospects. Specifically, while existing RPL reviews mainly provide a comprehensive analysis from the perspective of RPL and present typical RPL material systems, this paper systematically analyzes the structural characteristics of the Ag-PG matrix and the coordination configuration and site occupation of Ag ions. It clarifies RPL luminescence properties, dose–response mechanisms, and the evolution of luminescence centers, while reviewing advancements in applications such as radiation dose detection and high-resolution X-ray imaging. By summarizing the current research status, technical advantages and existing challenges of Ag-PG, this study provides theoretical references and conceptual insights to promote breakthroughs in its fundamental research and practical applications in high-precision radiation dose detection, advanced medical imaging, micro-nano-scale radiation detection, and nuclear industry non-destructive testing. Full article

Medical workers are frequently exposed to high-stress environments, highlighting the need for non-invasive stress monitoring strategies based on autonomic nervous system activity. Ammonia emitted from the human skin surface has been reported to increase under physical and psychological stress; however, its relationship with autonomic nervous system (ANS) dynamics remains unclear. In this study, we performed simultaneous, time-resolved measurements of dermal ammonia emission and heart rate variability (HRV) in 11 medical workers during 3 h of routine work. Dermal ammonia emission flux was continuously monitored using a passive flux sampler (PFS) coupled with ion chromatography, while autonomic nervous system activity was assessed by Holter electrocardiography. The temporal profiles of ammonia emission were analyzed in relation to HRV indices, including high frequency (HF) and the low-frequency-to-high-frequency ratio (LF/HF). Dermal ammonia emission increased under conditions characterized by lower HF and/or higher LF/HF, whereas elevated HF was associated with reduced ammonia emission (r = −0.47, p < 0.001). Furthermore, temporal fluctuations in ammonia emission were associated with sympathetic–parasympathetic switching. These findings suggest that dermal ammonia emission may be associated with HRV-related physiological responses under real-world working conditions and may have potential as a non-invasive indicator for stress-related physiological monitoring. Full article

How older adults psychologically appraise their health while managing multiple chronic conditions is a behavioral-science question as much as a clinical one. This study estimated the weighted prevalence of favorable mental-health self-appraisal, identified its behavioral, social, and functional correlates, and compared the relative salience of diagnosed-condition burden and functional limitation among U.S. adults aged ≥ 50 years with multimorbidity. This retrospective cross-sectional secondary analysis used the 2023 Medical Expenditure Panel Survey (MEPS) Full Year Consolidated Data File (HC-251). Multimorbidity was defined as at least two diagnosed chronic priority conditions. The primary outcome represents favorable mental-health self-appraisal, derived from MNHLTH53 (excellent/very good/good vs. fair/poor). Covariates were organized using Andersen’s Behavioral Model and health-psychology concepts of adaptation, resources, and lived functional burden. Weighted prevalence estimates and survey-weighted logistic regression models were fitted using PERWT23F, VARSTR, and VARPSU. Robustness checks examined a stricter outcome threshold, proxy adjustment/non-proxy restriction, and a physical-health extension model. The analytic sample included 5523 respondents, representing approximately 77.9 million U.S. adults aged ≥ 50 years with multimorbidity. The weighted prevalence of favorable perceived mental-health self-appraisal was 86.6% (95% CI 85.4–87.7). In the fully adjusted core model (complete-case n = 5330), age 65–74 years (aOR 1.52, 95% CI 1.17–1.98) and age ≥ 75 years (aOR 1.79, 95% CI 1.36–2.36) were associated with higher odds of favorable appraisal. Lower odds were observed for Hispanic respondents, non-Hispanic Asian respondents, lower educational attainment, lower income, non-employment, ≥4 diagnosed conditions, and any functional limitation. The strongest inverse association was limitation status (aOR 0.32, 95% CI 0.27–0.39). Sensitivity analyses were directionally consistent. Favorable mental-health self-appraisal remained common in this medically complex older population, but it was socially and functionally patterned. Functional limitation appeared more behaviorally salient than diagnosis count alone. Because the analysis was cross-sectional and based on household-interview reported measures, these results should be interpreted as associations rather than causal effects. Full article

In the framework of mean-field approximation, the influence of social contacts on the spread of an epidemic in a population of constant size is discussed. The key feature of the proposed model is that it includes two infection–transmission mechanisms depending on the physical nature of the contact between people. We separate the transfer mechanism related directly to the movement of people (the so-called transport processes) from the one occurring when the relative velocity between individuals is negligible (the so-called social contacts). Based on the developed physicochemical analogy, this approach allows us to derive, in a unified manner, expressions for the rate constants of infection–transmission of different nature. The resulting transmission rate constants are used to modify the SEIS model to examine the influence of social activity on the formation of an endemic equilibrium in the population under consideration. The frequency of social contacts is estimated using Dunbar’s approach and a direct statistical calculation based on the binomial distribution. These relations are then used to discuss the formation of quasi-stationary states, which can be interpreted as endemic equilibria. A qualitative analysis of the resulting dynamical regimes is carried out. The necessary conditions for the existence of this equilibrium, depending on both social and medical–biological factors, are also derived. The analytical results are illustrated by numerical simulations. The present results should be interpreted as a necessary step to establish a link between purely transport and social mechanisms of epidemic development. Full article

Exposure to blast waves without kinetic, penetrating, thermal, or toxic components causes a distinct form of traumatic brain injury, termed primary blast-induced TBI (pbTBI). Clinical manifestations of pbTBI span a wide spectrum, ranging from life-threatening intracranial hemorrhage, hyperemia, and delayed cerebral edema to mild and transient neurological symptoms without detectable structural abnormalities on routine imaging. At the mild end of the spectrum, symptoms after a single exposure may resolve quickly, yet repeated exposures—even at very low levels, termed “subconcussive”—can develop into post-concussive syndrome (PCS) or persistent post-concussive symptoms (PPCS) in a subset of individuals. Despite extensive studies, the molecular pathobiology linking primary blast exposure to delayed and sometimes chronic neurobehavioral deficits remains incompletely understood. A mechanistic framework connecting blast-wave physics to biomechanics to biological vulnerability may therefore help define exposure hazards, interpret clinical symptomatology, and guide diagnostic and therapeutic development. This review summarizes the physics of primary blast waves, the resulting biomechanical responses, and candidate biological substrates, emphasizing structures and interfaces with distinct acoustic impedances across anatomical, tissue, cellular, and molecular scales. We synthesize evidence supporting the hypothesis that the cerebral vasculature and endothelial cells represent critically vulnerable substrates of primary blast-wave injury, in part because the vascular tree constitutes the brain’s largest and most widely distributed interface between compartments with different acoustic impedances. Across experimental and human studies, endothelial stress, vascular injury, and downstream neuroinflammation emerge as convergent molecular responses to primary blast exposure. Temporal dynamics are central to understanding pbTBI because many blast-induced processes unfold in sequential phases. These observations support conceptualizing pbTBI as a condition characterized by prominent cerebrovascular injury of varying severity with secondary consequences for neuronal signaling, network function, and behavior. Within this framework, cerebrovascular and neurovascular unit (NVU) dysfunction provides a parsimonious bridge between primary blast-wave exposure and chronic symptom trajectories, where vascular pathology may offer more accessible therapeutic targets than neuronal injury. Key knowledge gaps include identifying which physical component(s) of the blast are most injurious, establishing biologically meaningful dose–response relationships at molecular and physiological levels, and defining windows of vulnerability during recovery that are relevant to repeated exposures. Addressing these gaps is essential for refining safety protocols, improving diagnostic specificity through mechanism-informed biomarkers, and developing evidence-based molecular and vascular therapeutic targets for pbTBI-associated conditions. Progress will require integrating waveform-aware dosimetry with longitudinal physiological and molecular monitoring across both preclinical and human cohorts. Such integration offers a practical path toward translating blast physics into actionable medical guidance for prevention, triage, and recovery management. Full article

Prostate cancer (PCa) is one of the most common malignancies in men and remains a major cause of cancer-related death worldwide. Radiotherapy is a well-established treatment modality for PCa, offering clinical outcomes comparable to surgical approaches. In recent years, stereotactic body radiotherapy (SBRT), characterized by the delivery of high radiation doses in a limited number of fractions, has been increasingly adopted as a standard approach in the treatment of prostate cancer, due to its favorable efficacy and toxicity profile. CyberKnife (CK) is one of the most commonly used hypofractionated radiotherapy techniques. This preliminary study aimed to evaluate and compare the radiation dose delivery and treatment time of CK-based SBRT using two different collimation systems: the multileaf collimator (MLC) and the IRIS variable aperture collimator, a dynamic device that adjusts its opening to simulate different circular field sizes. A total of 19 patients with low-to-intermediate-risk PCa were selected and treated at the Radiation Oncology Department of the National Cancer Institute IRCCS Fondazione G. Pascale in Naples between January 2024 and January 2025. For each patient, two treatment plans were generated—one with the IRIS collimator and one with the MLC. The results demonstrated that the use of the MLC significantly reduced treatment time while maintaining dosimetric quality comparable to IRIS-based plans. These findings support the clinical benefit of MLC implementation in prostate SBRT with the CK system. Full article

Background/Objectives: Survival rates after pediatric liver transplantation have improved substantially over recent decades, yet the psychiatric consequences for recipients remain a concern that warrants closer attention. We sought to map the psychiatric symptom burden across multiple domains in this population and to determine which symptom clusters carry the greatest impact on health-related quality of life (HRQOL). Materials and Methods: Fifty liver transplant recipients between the ages of 8 and 18 were enrolled at a single center. Children and their parents completed four psychiatric measures—the CBCL, CDI, SCARED, and CRIES-13—alongside the parent-proxy PedsQL to capture HRQOL across physical, emotional, social, and school functioning domains. Correlations between instruments were calculated, and linear regression was used to determine which psychiatric variables independently predicted PedsQL Total scores. Results: Across all psychiatric measures, higher symptom scores were associated with lower HRQOL, with school functioning recording the lowest absolute PedsQL domain score, while emotional functioning demonstrated the strongest and most consistent inverse correlations with all psychiatric symptom measures across instruments. CBCL Total (r = −0.607), SCARED Total (r = −0.557), and CRIES-13 Total (r = −0.548) scores all correlated meaningfully with overall HRQOL. When entered into multivariable analysis, anxiety symptoms measured by the SCARED (β = −0.295, p = 0.032) and post-traumatic stress symptoms measured by the CRIES-13 (β = −0.400, p = 0.004) stood out as the two independent predictors of worse PedsQL Total scores. Conclusions: Even in medically stable recipients, anxiety and post-traumatic stress symptoms were independently associated with lower daily functioning scores and overall quality of life. These findings suggest that routine psychosocial screening and trauma-informed approaches may warrant integration into post-transplant care protocols, and that prospective, adequately powered studies are needed to confirm and extend these associations. Full article

Background: Infertility affects millions of people causing grave societal and health consequences (poor physical and mental wellbeing). Aims: To translate and validate the COMPI scale in Serbian and examine associations of infertility-related stress, coping strategies and evaluation of care with medically assisted reproduction (MAR) outcomes in female Serbian infertility patients. Methods: The study included patients undergoing MAR for four months. Participants completed a socio-demographic and gynecologic questionnaire, the Serbian-translated COMPI scale, Beck Anxiety Inventory (BAI) and Zung Self-Rating Depression scale (ZDS). Serbian COMPI was validated in the classic manner. Associations between COMPI scores and pregnancy outcomes were analyzed by Spearman’s correlation and multivariable regression. Results: A total of 107 women participated and 24.3% achieved pregnancy. The Serbian COMPI demonstrated high internal consistency (Cronbach alpha = 0.838). Compared with reference COMPI data, personal, social and marital stress scores were higher, while meaning-based coping and marital benefit scores were lower. Regression analysis showed that higher marital stress, partner communication difficulties and meaning-based coping were associated with higher pregnancy likelihood. Conclusions: Serbian patients undergoing MAR reported high infertility-related stress and predominantly used active coping strategies. Patients who applied meaning-based coping were more likely to achieve pregnancy. Full article

Background: Chronic low back pain (CLBP) is a leading cause of disability worldwide, with exercise endorsed as first-line treatment and non-steroidal anti-inflammatory drugs (NSAIDs) among the most used pharmacologic options. These interventions are frequently combined in clinical practice, yet their synergistic effects remain unclear. To evaluate whether NSAID use modifies the association between physical activity (PA) and CLBP using nationally representative data from NHANES 2009–2010. Methods: We analyzed 988 adults aged ≥20 years with complete data on chronic low back pain, physical activity, medication use, and modeled covariates. Results: Among participants not using NSAIDs, moderate recreational physical activity was associated with lower odds of CLBP (adjusted OR = 0.47, 95% CI 0.25–0.91; p = 0.029). Active transport showed a similar direction but was not statistically significant (OR = 0.38, 95% CI 0.13–1.12; p = 0.074). In interaction models, active transport x aspirin was associated with higher odds of CLBP (OR = 2.24, 95% CI 1.02–4.90; p = 0.044), and moderate recreational PA x any NSAID use was also associated with higher odds of CLBP (OR = 2.26, 95% CI 1.01–5.06; p = 0.047). Subgroup analyses were exploratory and heterogeneous, including a significant potential protective interaction (OR ≈ 0.19, 95% CI 0.06–0.69; p = 0.015). Conclusions: In a nationally representative sample, NSAID use appeared to modify the association between physical activity and chronic low back pain. These findings are exploratory and hypothesis-generating. Therefore, longitudinal studies are needed to clarify the temporal and causal relationships and the potential influence of NSAIDs. Full article

Mistreatment is a pervasive and normalized feature of medical culture. In medical residencies, it functions as a structural rite of passage that shapes professional socialization. While the prevalence of mistreatment is documented, there is a lack of qualitative research exploring its role as a mechanism of identity construction. The aim of this study was to understand the experiences of mistreatment among internal medicine residents in Medellín, Colombia, through the lens of ritual theory and symbolic violence. A particularistic ethnographic study was conducted with 12 residents selected via theoretical sampling. Data were collected through semi-structured interviews and a reflexive field journal. Rigor was ensured using investigator triangulation and analytical bracketing to manage researchers’ biases. The training process follows a three-stage rite. (1) Separation: Symbolic violence and social pressure to specialize frame general medicine as “mediocre,” turning admission into a “battlefield” where self-worth is tied to success. (2) Marginalization (Liminality): Residents endure systemic mistreatment, including sleep deprivation (3.5 h rest cycles), public ridicule (“pimping”), and physical/verbal abuse (e.g., being hit with stethoscopes or called “testicles/jerks”). This stage is governed by a “purificatory logic” where suffering is internalized as a meritocratic requirement. This leads to high morbidity, with clinical diagnoses of anxiety and depression. (3) Integration (Postliminality): Professional autonomy and financial stability act as a “redemption” that justifies past suffering. Mistreatment is not an isolated interpersonal issue but a structurally embedded ritual and a core element of the hidden curriculum. It reinforces toxic hierarchies and a “tyranny of merit” that obscures structural barriers. These findings offer analytically transferable insights for global medical education, calling for a deconstruction of ritualized violence to foster more humanistic training environments. Full article

Micro/nanorobotics is emerging as a promising biomedical technology because of its precision, minimal invasiveness, multifunctionality, and potential to mitigate systemic adverse effects. At these ultraminiaturized scales, unique physical constraints necessitate design principles and actuation strategies distinct from those of conventional robotic systems, making material choice, structural design, propulsion mechanisms, and fabrication methods central to overall performance. In this review, we examine recent trends in micro/nanorobot development, with particular emphasis on the advantages of employing hydrogels and the current technical limitations associated with their use. Magnetic, chemical, acoustic, optical, and biohybrid propulsion strategies are comparatively analyzed, together with the material requirements and biological compatibility associated with each approach. Representative applications in drug delivery, tissue regeneration, and cancer therapy are further discussed to highlight the broad medical potential of these systems. Finally, remaining challenges related to material limitations, actuation efficiency, biocompatibility, and manufacturing scalability are identified, and future directions toward clinical translation and practical deployment are outlined. Overall, this review provides an integrated perspective on how hydrogel properties, actuation physics, fabrication strategies, and translational considerations collectively shape the development of more adaptive, biocompatible, and clinically relevant microrobotic systems. Full article

Background/Aim: While improvements in oral health can sometimes lead to improvements in systemic diseases, certain systemic diseases such as heart disease require consideration during dental treatment. In clinical pediatric dentistry, dental professionals may encounter the pediatric patient with systemic diseases, and should consult with physicians regarding the overall health status of their patients with systemic diseases before dental procedures. Materials and Methods: We reviewed the responses to letters of inquiry made to external medical institutions regarding the overall physical condition of patients during a 5-year period (2021–2025). The survey items were the gender, age, aim of letter, systemic disease, and physician responses and instructions. Result: A total of 48 letters of inquiry were found, of which 34 were initial confirmations and 14 were reconfirmations. In children aged ≤5 years, the common aim was oral management or caries treatment, and the proportion of surgical procedures increased with age. Among the systemic diseases involved, the diseases of the circulatory system such as congenital heart disease were the most common, with 70% of initial confirmations leading to premedication with antibiotics prior to invasive dental procedures. Although many responses remained unchanged upon reconfirmation, the responses for some patients changed. Conclusions: This study shows the importance of dental professionals consulting with physicians regarding the health condition of patients with systemic diseases before oral management. Furthermore, a single confirmation is insufficient, and the information must be regularly updated. Full article

The Therapeutic Shoe Benefit (TSB) allows Medicare insurance beneficiaries to reduce their diabetic foot ulcer risk by providing offloading shoes. Anecdotal evidence suggests that the process is cumbersome and that not all providers are aware of this benefit. This study evaluated TSB awareness across multiple healthcare disciplines and documented barriers to utilization. An online study surveyed healthcare providers practicing in the United States to determine familiarity with TSB and barriers to prescribing therapeutic shoes. The project was IRB-reviewed and received exempt status. The survey was sent to a wide variety of healthcare practitioners including: podiatrists, primary care providers, physical therapists, orthotist/prosthetists, specialty providers, and diabetes educators. This was done through targeted emails from professional organizations, word-of-mouth messaging through private practice groups, and marketing on LinkedIn. The survey was administered via Qualtrics with embedded branching logic used to gather data from the TSB’s three classifications of healthcare specialists: certifying physicians, prescribing practitioners, and suppliers. A total of 580 valid completions of the survey were analyzed. Irrespective of the TSB, podiatric physicians and medical professionals providing direct patient care recommend supportive shoes for patients with diabetes 98.2% (336/342) of the time. When asked about knowledge of the TSB, 522 or 90% of respondents indicated awareness of this Medicare benefit. Knowledge by specialty was hard to differentiate due to low responses by some specialties; however, prescribing podiatrists and prosthetic providers both responded with a familiarity rate above 92%. Common obstacles to providers prescribing shoes were: complexity of documentation (67.8%), challenges communicating with other providers (55.0%), and financial reasons/labor-to-reimbursement ratio (38.4%). TSB has the potential to reduce amputations and wound care costs. However, therapeutic shoes are underutilized with less than 20% of potential beneficiaries accessing this benefit. This research strengthens the argument that streamlining the process may increase access to therapeutic shoes. Full article

The dental pulp–dentin complex is a dynamic tissue system whose structure and biological functions evolve over time under physiological, molecular, and environmental influences. This study aimed to characterize age-related alterations in apoptotic, inflammatory, and autophagy-associated signaling pathways, alongside nanoscale mechanical changes, and to evaluate their potential impact on pulp tissue homeostasis and cellular adaptive capacity. Materials and Methods: Human teeth (n = 90) were divided into three age groups: young (≤17 years), mature (18–50 years), and old (>51 years). Immunohistochemistry was performed to assess the expression of CD34, BID, Caspase-8, NFκB, STAT3, JAK1, COX-2, LAMP2, and MAP LC3II. Nanoindentation and atomic force microscopy (AFM) were used to measure dentin hardness and modulus of elasticity. Results: BID expression increased with age, whereas Caspase-8 showed a relative decrease (p < 0.05). Anterior teeth exhibited higher marker positivity than molars for BID (p = 0.029), Caspase-8 (p = 0.004), STAT3 (p = 0.001), and JAK1 (p = 0.026). Mechanical analysis revealed the lowest modulus of elasticity in young root dentin and the highest in old coronal dentin, reflecting progressive age-dependent structural changes. Conclusions: Aging of the dentin–pulp complex involves coordinated modulation of apoptotic, autophagic, and inflammatory pathways, closely linked to altered mechanical properties. This interplay likely influences pulp vitality and adaptive cellular responses, highlighting potential targets for age-adapted dental therapeutic strategies. Full article