Search Results (372)

The utilisation of edible insects for human nutrition is a long-standing practice in many parts of the globe, and is being gradually introduced into countries without an entomophagic tradition as well. These unconventional sources of protein of animal origin have arisen as a sustainable alternative to other animal protein sources, such as meat. This review intends to present the compilation of data in the scientific literature on the chemical composition and nutritional value of the bee brood of A. mellifera species and subspecies as edible foods. For this, a comprehensive search of the scientific literature was carried out using the databases ScienceDirect, Scopus, Pub-Med, BOn, and SciELO. Appropriate keywords were used for the search to reach the research works that addressed the topics of the review. The results showed that bee brood has considerable quantities of protein, fat and carbohydrates. The most abundant amino acids are leucine and lysine (these two being essential amino acids) and aspartic acid, glutamic acid, and proline (these three being non-essential amino acids). As for the fatty acids, bee broods contain approximately equal fractions of saturated and monounsaturated fatty acids, while the polyunsaturated fatty acids are negligible. The dietary minerals present in higher quantities are potassium, phosphorus, and magnesium, and the most abundant vitamins are vitamin C and niacin; choline is also present, although it is not a true vitamin. Although bee brood from A. mellifera has potential for human consumption as a nutrient-rich food, there are still many aspects that need to be further studied in the future, such as safety and hazards linked to possible regular consumption. Full article

Male-factor infertility accounts for approxiamately half of all infertility cases globally, yet therapeutic options remain limited for individuals with no retrievable spermatozoa, such as those with non-obstructive azoospermia (NOA). In recent years, artificial gametogenesis has emerged as a promising avenue for fertility restoration, driven by advances in two complementary strategies: organotypic in vitro spermatogenesis (IVS), which aims to complete spermatogenesis ex vivo using native testicular tissue, and in vitro gametogenesis (IVG), which seeks to generate male gametes de novo from pluripotent or reprogrammed somatic stem cells. To evaluate the current landscape and future potential of these approaches, a narrative, semi-systematic literature search was conducted in PubMed and Scopus for the period January 2010 to February 2025. Additionally, landmark studies published prior to 2010 that contributed foundational knowledge in spermatogenesis and testicular tissue modeling were reviewed to provide historical context. This narrative review synthesizes multidisciplinary evidence from cell biology, tissue engineering, and translational medicine to benchmark IVS and IVG technologies against species-specific developmental milestones, ranging from rodent models to non-human primates and emerging human systems. Key challenges—such as the reconstitution of the blood–testis barrier, stage-specific endocrine signaling, and epigenetic reprogramming—are discussed alongside critical performance metrics of various platforms, including air–liquid interface slice cultures, three-dimensional organoids, microfluidic “testis-on-chip” devices, and stem cell-derived gametogenic protocols. Particular attention is given to clinical applicability in contexts such as NOA, oncofertility preservation in prepubertal patients, genetic syndromes, and reprocutive scenarios involving same-sex or unpartnered individuals. Safety, regulatory, and ethical considerations are critically appraised, and a translational framework is outlined that emphasizes biomimetic scaffold design, multi-omics-guided media optimization, and rigorous genomic and epigenomic quality control. While the generation of functionally mature sperm in vitro remains unachieved, converging progress in animal models and early human systems suggests that clinically revelant IVS and IVG applications are approaching feasibility, offering a paradigm shift in reproductive medicine. Full article

High-intensity interval training (HIIT) has emerged as a promising non-pharmacological intervention for improving cardiometabolic health. In populations with diabetes, cardiovascular disease, obesity, or metabolic dysfunction, redox imbalance—characterized by elevated oxidative stress and impaired antioxidant defense—is a key contributor to disease progression. This narrative review synthesizes current evidence on the effects of HIIT on oxidative stress and antioxidant capacity across diverse cardiometabolic disease cohorts. While findings are heterogeneous, the majority of studies demonstrate that HIIT intervention can reduce levels of oxidative stress markers and enhance antioxidant enzyme expression. These redox adaptations may underpin improvements in vascular endothelial function, inflammation, and metabolic regulation. Importantly, variations in intensity, duration, and health status influence these responses, highlighting the need for individualized exercise prescriptions. Safety considerations are emphasized, including the necessity for medical clearance, gradual progression, and individualized training prescriptions in higher-risk individuals. In conclusion, HIIT shows potential as a targeted strategy to restore redox homeostasis and improve cardiometabolic outcomes, although further research is needed to clarify optimal protocols and the underlying mechanisms. Full article

Hypertrophic cardiomyopathy (HCM) is a prevalent and often underdiagnosed genetic cardiac disorder characterized by left ventricular hypertrophy and, in many cases, dynamic left ventricular outflow tract obstruction (LVOTO). The development of cardiac myosin inhibitors (CMIs) represents an emerging therapeutic approach in the pharmacological management of obstructive HCM (oHCM). This review offers an integrated and up-to-date synthesis of the cardiac myosin inhibitor class, with a focus on mavacamten, aficamten, and the broader landscape of emerging agents. It also highlights recent clinical trial outcomes, pharmacokinetic and pharmacogenetic considerations, and potential future directions in therapy. Furthermore, we incorporate the most recent data up to May 2025, including late-breaking trial results and real-world safety findings, aiming to provide clinicians with a practical and comprehensive perspective on this evolving drug class. A narrative review was conducted by systematically searching PubMed, Scopus, Google Scholar, and ClinicalTrials.gov for English-language articles and trials published between January 2016 and May 2025. Keywords included “cardiac myosin inhibitor”, mavacamten”, “aficamten”, “MYK-224”, and “hypertrophic cardiomyopathy.” Inclusion criteria encompassed clinical trials and comprehensive reviews specifically addressing CMIs in cardiac applications. CMIs such as mavacamten and aficamten have demonstrated significant clinical benefits in reducing LVOT gradients, improving exercise capacity, and alleviating symptoms in patients with oHCM. Mavacamten is currently approved for clinical use, while aficamten is in advanced regulatory review. Comparative data suggest potential advantages of aficamten in the onset of action, pharmacokinetic profile, and tolerability. Emerging evidence supports the exploration of CMIs in pediatric populations, heart failure with preserved ejection fraction (HFpEF), and non-obstructive HCM (nHCM), although results are still preliminary. Cardiac myosin inhibitors offer a novel, pathophysiology-targeted approach to managing oHCM. While mavacamten has established efficacy, next-generation agents like aficamten may offer improved safety and versatility. Further long-term studies are needed to clarify their role across broader patient populations. Full article

Although intracranial hypertension (ICH) has traditionally been framed as simply a numerical escalation of intracranial pressure (ICP) and usually dealt with in its clinical form and not in terms of its complex underlying pathophysiology, an emerging body of evidence indicates that ICH is not simply an elevated ICP process but a complex process of molecular dysregulation, glymphatic dysfunction, and neurovascular insufficiency. Our aim in this paper is to provide a complete synthesis of all the new thinking that is occurring in this space, primarily on the intersection of glymphatic dysfunction and cerebral vein physiology. The aspiration is to review how glymphatic dysfunction, largely secondary to aquaporin-4 (AQP4) dysfunction, can lead to delayed cerebrospinal fluid (CSF) clearance and thus the accumulation of extravascular fluid resulting in elevated ICP. A range of other factors such as oxidative stress, endothelin-1, and neuroinflammation seem to significantly impair cerebral autoregulation, making ICH challenging to manage. Combining recent studies, we intend to provide a revised conceptualization of ICH that recognizes the nuance and complexity of ICH that is understated by previous models. We wish to also address novel diagnostics aimed at better capturing the dynamic nature of ICH. Recent advances in non-invasive imaging (i.e., 4D flow MRI and dynamic contrast-enhanced MRI; DCE-MRI) allow for better visualization of dynamic changes to the glymphatic and cerebral blood flow (CBF) system. Finally, wearable ICP monitors and AI-assisted diagnostics will create opportunities for these continuous and real-time assessments, especially in limited resource settings. Our goal is to provide examples of opportunities that exist that might augment early recognition and improve personalized care while ensuring we realize practical challenges and limitations. We also consider what may be therapeutically possible now and in the future. Therapeutic opportunities discussed include CRISPR-based gene editing aimed at restoring AQP4 function, nano-robotics aimed at drug targeting, and bioelectronic devices purposed for ICP modulation. Certainly, these proposals are innovative in nature but will require ethically responsible confirmation of long-term safety and availability, particularly to low- and middle-income countries (LMICs), where the burdens of secondary ICH remain preeminent. Throughout the review, we will be restrained to a balanced pursuit of innovative ideas and ethical considerations to attain global health equity. It is not our intent to provide unequivocal answers, but instead to encourage informed discussions at the intersections of research, clinical practice, and the public health field. We hope this review may stimulate further discussion about ICH and highlight research opportunities to conduct translational research in modern neuroscience with real, approachable, and patient-centered care. Full article

Pruritus is a common and distressing symptom in palliative care, often resulting from complex underlying conditions such as cancer, chronic kidney disease, and liver failure. Conventional pharmacological treatments frequently offer limited relief and may produce undesirable side effects in this medically fragile population. Despite the high prevalence and impact of pruritus in palliative care, there is a lack of consolidated evidence on integrative non-pharmacological approaches. This narrative review explores the potential role of essential oils as a complementary approach to managing pruritus in palliative settings. A review of the literature was conducted to examine the mechanisms of action, safety considerations, and clinical outcomes associated with the use of essential oils, with a particular focus on their anti-inflammatory, neuromodulatory, and soothing properties. Evidence suggests that essential oils may provide symptom relief and enhance quality of life when integrated into multidisciplinary care; however, small sample sizes, heterogeneity, and methodological weaknesses often limit the findings of these studies. Furthermore, the long-term safety and antigenotoxic potential of essential oils remain underexplored. This narrative review concludes that while essential oils appear promising as adjunct therapies for pruritus, further rigorous research, particularly well-designed clinical trials and toxicological assessments, is needed to support their safe and effective use in palliative care. Full article

The evolution of electrical power systems into smart grids has brought about significant advancements in electricity generation, transmission, and utilization. These cutting-edge grids have shown potential as an effective way to maximize energy efficiency, manage resources effectively, and enhance overall reliability and sustainability. However, with the integration of complex technologies and interconnected systems inherent to smart grids comes a new set of safety and security challenges that must be addressed. First, this paper provides an in-depth review of the key considerations surrounding safety and security in smart grid environments, identifying potential risks, vulnerabilities, and challenges associated with deploying smart grid infrastructure within the context of the Internet of Things (IoT). In response, we explore both cryptographic and non-cryptographic countermeasures, emphasizing the need for adaptive, lightweight, and proactive security mechanisms. As a key contribution, we introduce a layered classification framework that maps smart grid attacks to affected components and defense types, providing a clearer structure for analyzing the impact of threats and responses. In addition, we identify current gaps in the literature, particularly in real-time anomaly detection, interoperability, and post-quantum cryptographic protocols, thus offering forward-looking recommendations to guide future research. Finally, we present the Multi-Layer Threat-Defense Alignment Framework, a unique addition that provides a methodical and strategic approach to cybersecurity planning by aligning smart grid threats and defenses across architectural layers. Full article

Background: Ibuprofen is one of the most accessible non-steroidal anti-inflammatory drugs (NSADs), exhibiting non-selective reversible inhibition on COX-1 and COX-2. A series of common adverse reactions have been mentioned through the years: gastrointestinal (gastritis, ulceration, hemorrhage, or perforation), renal, hematologic, and cardiovascular. Objective: The aim of this study was to assess the real-world impact of ibuprofen regarding cardiovascular safety, utilizing an established pharmacovigilance database. Methods: Descriptive and disproportionality-based methods were used. Forty specific descriptors of cardiovascular effects were selected. Eight other NSADs and the combination of ibuprofen and pseudoephedrine were used as comparators. Results: A total of 58,760 cases were identified as being associated with ibuprofen in EudraVigilance. Stroke was reported for ibuprofen with a lower probability compared with etoricoxib (ROR: 0.34; 95% CI: 0.21–0.55), celecoxib (ROR: 0.07; 95% CI: 0.06–0.10), meloxicam (ROR: 0.25; 95% CI: 0.14–0.43), acetylsalicylic acid (ROR: 0.07; 95% CI: 0.05–0.09), and ibuprofen/pseudoephedrine (ROR: 0.11; 95% CI: 0.05–0.25). Thrombosis was reported for ibuprofen with a higher probability only relative to ketoprofen (ROR: 2.95; 95% CI: 1.71–5.09). Hypertension was reported for ibuprofen as being more probable than for acetylsalicylic acid (ROR: 1.58; 95% CI: 1.43–1.76). Myocardial infarction was reported as being more probable for ibuprofen than ketoprofen (ROR: 2.31; 95% CI: 1.57–3.40) or nimesulide (ROR: 2.43; 95% CI: 1.25–4.73). Conclusions: Overall, according to our study, the probability of reported cardiovascular adverse reactions is lower than those determined for the rest of the NSAIDs; however, taking into consideration the inherent limitations of the study, further clinical investigations would contribute to a better understanding of the cardiovascular safety of ibuprofen. Full article

Background: Intracerebral hemorrhage management presents clinicians with a significant therapeutic challenge. Maintaining antiplatelet therapy potentially increases the risk of recurrent bleeding, while discontinuation heightens susceptibility to ischemic stroke, particularly during the critical first month after hemorrhage. In contemporary practice, physicians demonstrate considerable hesitancy regarding early antiplatelet reinitiation, complicated by the absence of clear evidence-based treatment guidelines. Aim: This meta-analysis assesses the safety of early antiplatelet resumption following ICH. Methods: We conducted a systematic review by searching Web of Science, Scopus, PubMed, and Cochrane Library from inception to April 2025. Articles were independently screened and data extracted by two reviewers who also assessed study quality. The inclusion criteria are enrollment of adults (≥18 years) with imaging-confirmed intracerebral hemorrhage surviving >24 h, comparing early vs. delayed or withheld antiplatelet therapy. Randomized trials underwent separate evaluation using Cochrane’s Risk of Bias. Statistical analysis was performed using R software (version 4.4.2), with categorical outcomes pooled as risk ratios (RRs) with 95% confidence intervals. Statistical significance was established at p < 0.05. The evidence is limited by the availability of few RCTs, variable antiplatelet regiments, male predominance, and other confounding factors. The review was registered in SFO. Results: Our meta-analysis included 10 studies (8 observational, 2 RCTs) with 5554 patients. Early antiplatelet therapy significantly reduced recurrent intracerebral hemorrhage by 46% (RR 0.54, 95% CI 0.37–0.78, p = 0.001). All-cause mortality showed a non-significant difference (RR 0.81, 95% CI 0.65–1.01, p = 0.06). No significant differences were found for ischemic stroke (RR 0.99, 95% CI 0.60–1.63, p = 0.96), major hemorrhagic events (RR 0.75, 95% CI 0.49–1.13, p = 0.17), or ischemic vascular outcomes (RR 0.71, 95% CI 0.49–1.02, p = 0.60). Conclusions: Our meta-analysis reveals that early antiplatelet therapy following intracerebral hemorrhage significantly reduces recurrent hemorrhagic events (46% reduction) without increasing major ischemic or hemorrhagic complications. Full article

The off-the-track Thoroughbred’s (OTTTB’s) suitability for equestrian retraining and rehoming should always be subject to behavioral considerations. Certain attributes may be advantageous to a horse’s racing performance but unfavorable to their prospects off the track. It is important to gain a non-biased understanding of how Thoroughbreds (TBs) in equestrian disciplines compare with other horses behaviorally, to minimize risks of poor welfare and safety outcomes. The current study used owner-reported information (n = 1633) from the Equine Behavior Assessment and Research Questionnaire (E-BARQ) global database to compare the behaviors of OTTTBs with those of other ridden horses. Boldness, compliance, rideability, trainability, and responsiveness to acceleration and deceleration signals were evaluated in the context of 27 E-BARQ items, as determined by exploratory factor analysis (EFA). In this study, OTTTBs demonstrated more boldness (t = 3.793; p < 0.001) and lower compliance and responsiveness to deceleration signals (t = 3.448; p < 0.001) than non-OTTTBs. Trainability, rideability, and responsiveness to acceleration signals did not differ significantly between OTTTBs and non-OTTTBs. These findings provide direction for future research into causal factors and improvement opportunities regarding the training and management of Thoroughbreds, on- and off-the-track. Full article

Autonomous Parking Systems (APSs) are rapidly evolving, promising enhanced convenience, safety, and efficiency. This review critically examines the current strategies in perception, path planning, and vehicle control, alongside system-level aspects like integration, validation, and security. While significant progress has been made, particularly with the advent of deep learning and sophisticated sensor fusion, formidable challenges persist. This paper delves into the inherent trade-offs, such as balancing computational cost with real-time performance demands; unresolved foundational issues, including the verification of non-deterministic AI components; and the profound difficulty of ensuring robust real-world deployment across diverse and unpredictable conditions, ranging from cluttered urban canyons to poorly lit, ambiguously marked parking structures. We also explore the limitations of current technologies, the complexities of safety assurance in dynamic environments, the pervasive impact of cost considerations on system capabilities, and the critical, often underestimated, need for genuine user trust. Future research must address not only these technological gaps with innovative solutions but also the intricate socio-technical dimensions to realize the full potential of APS. Full article

Human Factors and Ergonomics (HF/E) play an essential role in the development of sustainable manufacturing systems. By prioritizing worker wellbeing through the mitigation of occupational hazards and the enhancement of workplace health, HF/E contributes significantly to improved system performance. In accordance with the principles of Industry 5.0 and Society 5.0, which emphasize human-centered design and wellbeing, organizations that effectively integrate HF/E principles can achieve a competitive advantage on the market. Based on a globally recognized ranking system utilized by investors in making informed decisions, the study focuses on manufacturing companies ranked by their occupational health and safety (OHS) scores, a key criterion for assessing the social dimension of company performance. This research aims to identify and analyze top-ranked companies that explicitly highlight HF/E-related benefits within their public documents and sustainability reports. The paper investigates aspects related to the integration of AI and digital technologies to enhance safety and health in manufacturing systems, with a specific focus on human presence detection in hazardous zones, improvements in machines and equipment design, occupational risk assessments, and initiatives for enhancing worker wellbeing. The findings are expected to provide compelling evidence for companies to prioritize HF/E consideration during the design and redesign phases of sustainable manufacturing systems. The paper provides significant value to non-indexed companies by offering a dual approach for improving OHS performance, based on an empirical evaluation assessment method and practical strategies for effective OHS implementation in different manufacturing industries and countries. Full article

Carotid stenosis is a common pathology in clinical practice and unfortunately carries a high risk of serious cerebrovascular events. The early recognition of carotid plaque and, consequently, a careful analysis by means of multimodal imaging are the necessary steps to undertake a correct management pathway, aimed at preventing or, if not possible, reducing the risk of atherogenic phenomena responsible for cerebral infarction. In particular, the presence or absence of clinical symptoms, understood as the occurrence of events such as TIAs in the last 6 months, non-disabling strokes or repeated episodes of amaurosis fugax, and the degree of carotid stenosis, are certainly the most studied parameters, and as reported by several international guidelines, can lead to the best therapeutic strategy: whether to rely on conservative medical therapy or to resort to mechanical revascularization of the carotid stenosis. According to the recommendations of the European Society of Vascular Surgery, mechanical revascularization is recommended for stenosis > 50% in symptomatic patients and stenosis > 60% in asymptomatic patients. In contrast, the latest findings on plaque vulnerability have focused attention on individual patient characteristics and clinical comorbidities that may be responsible for plaque inflammation and should therefore be taken into consideration to decide if revascularization treatment is needed even in those subjects who present stenosis with less degree than reported as critical value. Moreover, further radiological investigations are fundamental to finding the presence of entities such as plaque ulceration, plaque neo-vascularization, fibrous caps, and intraplaque lipid core that are responsible for increased vulnerability. Medical therapy involves interventions aimed at eliminating cardiovascular risk factors by administering drugs that control the comorbidities responsible for worsening carotid stenosis. Recent studies are also evaluating the effectiveness of new plaque-modifying drugs or targeted anti-inflammatory agents in reducing the risk of plaque development and complications. Revascularization therapies, on the other hand, include surgery (CEA), the endovascular technique (CAS), and a new hybrid technique (TCAR): they are all valid alternatives for the treatment of carotid stenosis, each with specific technical difficulties, but on the whole with comparable safety profiles and risk rates of postoperative complications, although some recent emergencies have focused attention on possible short- and long-term gender-dependent outcome differences. The aim of this manuscript is to present the state of the art in the management of patients with carotid stenosis and to take a closer look at revascularization options. In our opinion, the choice of one strategy over another should therefore depend on gender, anatomical features of the patient, preoperative comorbidities, and last but not least, the experience of the center and the multidisciplinary team involved in the management of the patient. Full article

Coronary artery disease is the most common cause of mortality worldwide. Percutaneous coronary intervention represents an important method of treatment. Over time, the methods have been refined to improve safety and efficacy. With the development of drug-eluting stents, in-stent restenosis has importantly decreased, but it remains a relevant concern in terms of the need for additional revascularization procedures or recurrent coronary events. Different platforms, polymers, and anti-proliferative agents have been tested, mostly demonstrating non-inferiority when compared. Additional devices, such as drug-coated balloons, bioresorbable scaffold systems, gene-eluting stents and bioadaptor implants have been developed. As none of the aforementioned methods demonstrated considerable superiority over the others, the search for the ideal treatment method continues. Based on currently available data, the ideal treatment method could be a personalized approach combining different revascularization methods. Additional research with subpopulation group studies, different associated diseases or vessels affected, and longer follow-up are required to determine better subgroups of patients that would benefit most from specific treatment methods. Full article

Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs), which were originally developed for managing type 2 diabetes by enhancing insulin secretion and reducing appetite, have emerged as promising candidates in alcohol use disorder (AUD). These medications offer a dual mechanism of action that aligns with the multifaceted nature of addiction by targeting both peripheral metabolic and central reward pathways. This review focused on the current clinical trials and real-world evidence regarding the effects of GLP-1RAs as novel therapeutics for AUD. We also discussed early but encouraging results from clinical trials in AUD, observational and real-world evidence, safety profiles, psychiatric considerations, and future directions leading beyond GLP-1RAs. Methods: A comprehensive English-language literature search was conducted per PRISMA guidelines across PubMed, Medline, Google Scholar, Web of Science, and trial registries. Using targeted keywords, we identified relevant clinical and observational studies on GLP-1RAs for alcohol use disorder, excluding off-topic or non-English works and assessing all studies for eligibility. Results: Out of 1080 records identified, seven studies met the inclusion criteria. The findings from recent clinical trials, large-scale observational studies, and real-world evidence suggest that GLP-1RAs may significantly reduce alcohol consumption, cravings, and alcohol-related hospitalizations. Their central effect on reward processing, coupled with a generally favorable safety profile, supports their potential therapeutic role beyond metabolic disorders. Conclusions: Emerging evidence positions GLP-1RAs as a promising new pharmacologic approach for managing AUD. Ongoing and future research should prioritize larger, longer-duration randomized controlled trials that include diverse populations, with specific attention to treatment motivation, co-occurring psychiatric conditions, and long-term outcomes. Full article