Search Results (833)

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterised by persistent joint inflammation and systemic immune dysregulation. While bone marrow activation has been linked to RA pathogenesis, direct access to bone marrow tissue for progenitor analysis remains limited by ethical and technical constraints. Analysis of progenitor cells in peripheral blood can serve as a surrogate reflecting bone marrow activation. In this study, we analysed peripheral blood cells from 12 RA patients and 9 healthy controls using high-dimensional spectral flow cytometry with a nine-marker panel (CD45, CD31, CD235, CD133, CD34, CD105, CD271, CD90, PDPN). Flow Self-Organizing Map (FlowSOM) clustering identified 20 distinct cell populations. Additionally, a complementary flow cytometry panel was used to assess CD31 expression on immune subsets in peripheral mononuclear cells (PBMCs) from 9 RA and 9 healthy donors of this cohort. RA patients showed increased CD45⁺CD31⁻ immune cells, but not their putative progenitors. Conversely, putative CD45⁺CD31^int progenitors and CD45⁺CD31^int mature cells were reduced, along with CD31 expression on T cells. Levels of CD235a⁺ putative erythroid precursors and CD45⁺CD31⁺ progenitors were significantly increased in RA patients. Three putative stromal cell populations were detected in circulation. Together, these findings reveal expanded erythroid precursor populations and reduced CD31 expression on T cells in RA. Our data underscore broad systemic alterations in cellular homeostasis in RA patients. In conclusion, our results suggest that the loss of CD31 expression on immune cell precursors plays a role in age-associated immune remodelling and immune activation in RA and provides the rationale for further studies on erythroblast differentiation and the functional role of erythroblasts in chronic inflammation. Full article

Autism Spectrum Disorder (ASD) is a lifelong condition marked by challenges in social communication and repetitive behaviors. Current treatments, primarily behavioral therapies, often fail to address the core symptoms. Recent research has explored the potential of psychedelics, such as LSD, psilocybin, and MDMA, as a new therapeutic approach. While these substances primarily modulate the serotonin 5-HT_2A receptor, their therapeutic effects also involve interactions with other serotonergic, dopaminergic, and glutamatergic pathways, collectively promoting neuroplasticity—the brain’s ability to change and adapt. The specific receptors’ activation leads to structural and functional changes in the brain that can enhance social behavior and emotional regulation. Studies show that psychedelics may reduce symptoms of conditions like treatment-resistant depression and PTSD, highlighting their therapeutic potential. For ASD specifically, psychedelics may improve psychological flexibility, reduce distress, and enhance social interaction. While promising, the use of these substances requires careful consideration. Psychedelics can induce intense experiences and altered states of consciousness, necessitating strict monitoring and support during therapy. Ethical guidelines, including informed consent, are crucial, especially for vulnerable populations. In conclusion, psychedelics hold significant promise for treating ASD and other psychiatric disorders by promoting neuroplasticity and modulating complex signaling pathways. Continued research and clinical trials, conducted with strong ethical oversight, are essential to realizing their full therapeutic potential. Full article

Background: Sexual health research with migrant and refugee communities presents unique challenges, shaped by cultural sensitivities, stigma, and the under-representation of these populations in health research. However, lived experiences insights are essential for the development of appropriate and useful research and health initiatives. It is important to learn from researchers’ experiences to expand the representation of migrant and refugee community voices. Method: This paper draws on two qualitative studies conducted in South Australia: one exploring the sexual and reproductive health perspectives of refugee and migrant women, and the other of men. We reflect upon the methodological and ethical considerations in conducting research in this sensitive field and provide recommendations for future researchers and healthcare providers when working with migrant and refugee communities. Results: Both studies encountered difficulties in relation to participant recruitment, cross-cultural communication, and addressing taboos surrounding sexual health. At the same time, they highlighted opportunities for generating meaningful insights through culturally safe, gender-sensitive approaches and collaboration with community stakeholders. Conclusions: By synthesising experiences from both projects, we identify practical strategies for building trust, overcoming linguistic and cultural barriers, and creating supportive environments for discussing sensitive topics. These reflections offer guidance for researchers and clinicians aiming to advance culturally responsive sexual health research and strengthen healthcare provision for migrant and refugee populations. Full article

Brain–Computer Interfaces (BCIs) have increasingly been explored as tools for monitoring and modulating cognitive processes relevant to learning. However, their application to learning disorders, and especially to mathematical learning difficulties such as dyscalculia and ageometria, remains conceptually promising but empirically underdeveloped. The present study offers a scoping review with structured narrative synthesis of recent empirical research on BCI-based interventions in learning disorder populations, with particular attention paid to their possible translational relevance for mathematical learning. Following PRISMA-ScR principles and a Population–Concept–Context framework, studies published between 2020 and 2025 were identified through database searches in Scopus, IEEE Xplore, and PubMed. A total of 30 studies met the inclusion criteria. All eligible studies focused on Attention-Deficit/Hyperactivity Disorder (ADHD), while no eligible BCI intervention studies were found for dyscalculia or ageometria. The reviewed literature was dominated by EEG-based neurofeedback interventions. To move beyond descriptive summary, the included studies were organized using a structured analytical framework based on intervention modality, primary cognitive target, methodological robustness, and translational proximity to mathematical learning disorders. Across the evidence base, the most consistent findings concerned attention regulation and executive function outcomes, whereas academic and mathematics-related outcomes were sparse and methodologically less developed. Although several studies suggested improvements in domain-general cognitive mechanisms relevant to mathematical learning, the absence of direct evidence in dyscalculia and ageometria prevents confirmatory conclusions. The review therefore identifies both the promise and the limits of current BCI applications in learning disorder contexts and argues that future research should prioritize theory-driven, disorder-specific trials targeting numeracy, visuospatial reasoning, and executive processes in mathematical learning disabilities. Although current findings suggest promising cognitive and educational potential, these technologies are not yet ready for routine implementation in standard classroom environments without further validation, teacher training, ethical safeguards, and cost-effective deployment models. Full article

Background/Objectives: In-hospital critical outcome among palliative inpatients remains high, often driven by acute physiological instability rather than chronic comorbidities. Although diabetes mellitus (DM) is common in this population, its independent impact on critical outcome is unclear. This study aimed to determine whether acute metabolic and inflammatory markers—specifically glucose, C-reactive protein (CRP), albumin, and oxygen requirement—better predict short-term outcomes, defined as in-hospital critical outcome or ICU transfer during the same hospitalization period, than DM status alone. Methods: This retrospective study included 200 palliative inpatients admitted to the Internal Medicine Clinic of Kestel State Hospital, Bursa, Turkey, between January 2024 and January 2025. Demographic, clinical, and laboratory data were obtained from electronic records. The primary outcome was in-hospital critical outcome or ICU transfer (“critical outcome”). Logistic regression and receiver-operating characteristic (ROC) analyses identified independent predictors. The study was approved by the Bursa Yüksek İhtisas Training and Research Hospital Ethics Committee (ethics approval: protocol code 2024-TBEK 2025/05-12). Results: The mean age was 77.7 ± 12.3 years, and 47% were male. DM was present in 30.5% but did not independently predict critical outcome (p = 0.904). In contrast, oxygen requirement (OR = 4.08, p = 0.002), mean glucose (OR = 1.01, p = 0.001), and cancer (OR = 3.28, p = 0.016) were significant predictors. ROC analysis identified CRP > 64.1 mg/L and albumin < 25 g/L as optimal thresholds, and these two markers formed the basis of the low-, intermediate-, and high-risk stratification, with critical-outcome rates of 39.0%, 45.1%, and 85.4% (p < 0.001). Conclusions: Acute metabolic and inflammatory disturbances—particularly hyperglycemia, elevated CRP, hypoalbuminemia, and oxygen requirement—are stronger prognostic indicators than DM. A simple bedside model incorporating these parameters may improve prognostic accuracy and communication in palliative care. Full article

Heavy metals including mercury (Hg), lead (Pb), cadmium (Cd), and arsenic (As) remain significant global toxins due to their environmental persistence, widespread anthropogenic release, and serious biological effects. This review consolidates current understanding of their natural and industrial sources, environmental cycling, human exposure routes, and population-level vulnerabilities. It covers their toxicokinetics and toxicodynamics, emphasizing species-specific absorption, distribution, and injury mechanisms, including oxidative stress, thiol binding, mitochondrial dysfunction, endocrine disruption, and cancer risk. Clinical signs range from subtle neurocognitive impairment and kidney damage to severe acute poisoning. The review evaluates evidence-based approaches to risk assessment and biomonitoring, such as blood, urine, hair, and speciation tests, noting issues, including unvalidated provoked testing. Treatment focuses on removing exposure, providing nutritional support, and offering supportive care, with chelation therapy reserved for specific cases. It explains the chemistry, pharmacology, and roles of chelating agents—ALA, DMSA, DMPS, Cys, GSH, and physiologic thiols, comparing their effectiveness, limitations, and costs for various metals. Emerging therapies, precision toxicology, and public health strategies are discussed within a prevention-focused context. Unlike prior reviews focused primarily on toxic mechanisms or isolated clinical management, this review integrates mechanistic toxicology, biomarker interpretation and speciation, evidence-based clinical care, and ethical, cost-conscious decision-making within a single translational framework. This narrative review synthesizes foundational and contemporary literature published through 2025, with particular emphasis on studies published since 2000 that inform toxicokinetics, biomarker interpretation, diagnostics, clinical management, and prevention. Full article

The concept of “Healthocide,” first defined by Abi-Rached and colleagues, describes the deliberate and systematic destruction of health systems as a weapon of war. Nowhere is this phenomenon more extensively documented than in Gaza, where the collapse of healthcare infrastructure since October 2023 has been rapid, wide-ranging, and intentionally sustained. The consequence is not only immediate excess mortality, but also profound, long-term loss of population health measured in life-years, a metric that captures both premature death and reductions in expected lifespan. To address the aftermath of such destruction, we propose the framework of “Healthogenesis,” defined as a Palestinian-led, equity-driven, and rights-anchored approach to health system reconstruction in which international actors serve as enablers rather than agenda-setters. The aim of Healthogenesis is not merely to restore pre-war capacity, but to build a resilient, sovereign, and future-proof health ecosystem. Using available demographic and mortality data, we estimate that more than three million life-years have already been lost in Gaza since October 2023. Projection models suggest that an additional 1.1 to 2.2 million life-years could be lost over the coming decade unless an organized programme of reconstruction begins immediately. Quantifying harm in life-years reframes the discourse from moral outrage to measurable obligation. If Healthocide names the crime, then Healthogenesis outlines the cure: a coherent, data-anchored, ethically grounded roadmap for rebuilding a devastated health system and protecting the health futures of an entire population. Full article

Bioethics education has become established as an essential component for addressing the ethical challenges associated with biomedical development, biotechnology, and decision-making in the healthcare field. Although numerous studies have analyzed the teaching of bioethics among medical students and other health professions, empirical research on bioethics literacy in religious formation contexts remains limited. The objective of this study was to evaluate the level of bioethical knowledge (here operationalized as bioethics literacy) among Catholic seminarians in Colombia and to explore the psychometric properties of a questionnaire designed to measure bioethics literacy in this population. A cross-sectional observational study was conducted through the administration of a structured questionnaire consisting of 32 multiple-choice items with a single correct answer addressing philosophical foundations, personalist bioethics, bioethical principles, clinical bioethics, and issues related to biotechnology. A total of 216 complete questionnaires were analyzed using descriptive statistics and exploratory psychometric analyses, including item difficulty and discrimination, internal consistency, and exploratory factor analysis. The results showed a moderate overall level of bioethics literacy, with better performance in applied domains such as clinical bioethics and bioethical principles, and lower levels of correct responses in philosophical foundations and personalist bioethics. The questionnaire showed moderate internal consistency and a preliminary factorial structure, suggesting its usefulness as an exploratory tool for assessing bioethical knowledge in seminary educational contexts. These results highlight the importance of strengthening the integration between philosophical and theological education and the applied analysis of bioethical problems in seminary educational programs. Full article

Recent findings in nutritional epidemiology report an association between high dietary phosphorus intake and increased cancer risk. Building on the author’s analysis of breast cancer incidence in the Study of Women’s Health Across the Nation (SWAN), this paper presents a theoretical–conceptual model and a hypothesis to guide further population-study replication. To strengthen the initial SWAN analysis signal, a sensitivity analysis increased the number of controls in the nested case–control design from four to five per case. This adjustment modestly raised the relative risk (RR) of breast cancer incidence among middle-aged women consuming >1800 mg/day of dietary phosphorus (compared with 800–1000 mg/day) from RR: 2.30 to 2.38 (95% CI: 0.95–5.95; p = 0.06), improving statistical precision from the original p = 0.07. However, the result remains an exploratory pilot signal, not a confirmed association. Because clinical trials cannot ethically expose participants to potential harm from phosphate toxicity, a confirmed association relies on observational research. As in historical tobacco–cancer investigations, secondary analyses are needed across large cohort studies to examine dietary phosphorus intake and incidence of major cancer types. Relevant cohorts include the Nurses’ Health Study, Women’s Health Initiative, Health Professionals Follow-Up Study, National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-Up Study, European Prospective Investigation into Cancer and Nutrition (EPIC), and the Canadian Study of Diet, Lifestyle and Health. Effect estimates can be synthesized using meta-analytic methods following PRISMA-P 2015 guidelines. Dietary phosphate modification may offer a cancer prevention strategy with substantial public health impact and clinical implications. Full article

Contemporary societies are facing converging crises, including environmental degradation, worsening social inequalities, aging populations, and increasingly costly healthcare systems, prompting sustainable health to be proposed as an integrative conceptual perspective for rethinking health, its determinants, and collective action. This narrative review aims to trace the historical evolution of the concept, clarify the vision it offers for public health, and identify its implications for research, policy, and intervention. A literature search (May 2025) was conducted in PubMed, Google Scholar, and Google, with no restrictions on language, time period, or document type. Of 40 relevant documents, 21 were selected for in-depth analysis by two independent reviewers, with duplicate data extraction. The results show that sustainable health broadens the World Health Organisation (WHO) definition of health by incorporating sustainability, intergenerational justice, ecological limits, and social equity. Close to, but distinct from Planetary Health, One Health, and EcoHealth, sustainable health is based on ecological, social and ethical, economic, behavioral, intergenerational, and systemic/intersectoral dimensions. Sustainable health thus emerges as a systemic and transdisciplinary conceptual approach for transforming health systems, living environments, and public policy, requiring further conceptual clarification, robust interdisciplinary research programs, and intersectoral initiatives involving communities. Full article

The integration of emerging technologies and real-world data is transforming the landscape of hematologic clinical trials. Artificial intelligence (AI) offers remarkable capabilities for predictive modeling, patient stratification, and adaptive trial design, while circulating tumor DNA (ctDNA) provides a minimally invasive biomarker for disease monitoring, the early detection of relapse, and treatment response assessment. Concurrently, real-world evidence (RWE) complements traditional clinical trial data by capturing treatment effectiveness, safety, and patient outcomes in broader, heterogeneous populations. This review examines the synergistic potential of AI, ctDNA, and RWE to optimize trial design and decision-making in hematologic malignancies. We discuss methodological innovations, including AI-driven patient selection, ctDNA-guided adaptive interventions, and the incorporation of RWE for external control arms and post-marketing surveillance. Key challenges, such as data standardization, regulatory considerations, and ethical implications, are also addressed. By integrating these advanced tools, clinical trials in hematology can achieve greater efficiency, precision, and translatability, ultimately accelerating the development of personalized therapies and improving patient outcomes. Full article

The slaughter of pregnant pigs raises legal, ethical, and animal welfare concerns in pig production. Relevant information for this overview was compiled from research identified through searches of PubMed, Web of Science, and Google Scholar using defined combinations of search terms related to pregnancy, slaughter of sows, fetal age, gestational stage, and prevalence. No lower time limit for publication year was predefined; publications published up to 2025 were considered. Regulations vary widely between countries, with some specifying clear restrictions for animals in late gestation, while many provide no stage-specific limits. Reasons for culling include economic pressures, management practices such as unrecognized pregnancies and mixed-sex housing, and health or welfare issues. In Europe, the prevalence of sows being pregnant at slaughter ranges from 1.5% to 13%, with most fetuses being in the first or second trimester and a small proportion in the final trimester. In Africa, prevalence is higher and more variable, ranging from 9% to 36.14%, with a larger share of fetuses in mid to late gestation. Data from America is limited, reporting prevalences between 5.9% and 13.5%. The comparability of prevalence estimates is limited due to high heterogeneity and differences in study design. Fetal age can be assessed using metric or non-metric methods, applied either postmortem or in vivo (for example, ultrasonography). Variations in study design, methodology, and population characteristics restrict direct comparability. For legal enforcement and veterinary inspection, reliable fetal age assessment is important, and updated fetometric reference values could contribute to a more consistent interpretation of fetal age. Full article

Modern healthcare remains structurally and conceptually fragmented, with profound clinical and policy implications. At its root lies an ontological fracture: the prevailing biomedical model reduces patients to discrete biological systems (organs, biomarkers, and symptoms) detached from the psychological, social, and ecological contexts in which health and illness are experienced. This is compounded by epistemological fragmentation, where medical knowledge is compartmentalized into increasingly narrow specialties, limiting holistic understanding. These philosophical divisions manifest in downstream operational, informational, financial, and policy dysfunctions duplicative testing, misaligned incentives, disconnected care pathways, and population health failures. To address these multilevel fractures, we propose a unified architecture grounded in three interlocking components. First, the Precision and Personalized Population Health (P3H) framework offers a principle-based realignment toward care that is integrated, personalized, proactive, and population wide. P3H addresses the conceptual shortcomings of fragmented care by focusing on the full human trajectory across time, systems, and determinants. Second, General Purpose Technologies including artificial intelligence, biosensors, mobile diagnostics, and multimodal data systems enable the operationalization of whole-person care at scale, especially in low-resource settings. Third, the AI-WHOLE policy framework (Alignment, Integration, Workflow, Holism, Outcomes, Learning, and Equity) provides governance principles to guide ethical, equitable, and context-specific implementation. We argue that this triadic blueprint is particularly critical for Global South nations, where the lack of legacy infrastructure offers an opportunity for leapfrogging toward integrated, intelligent systems of care. Early models illustrate how policy-aligned, technology-enabled care rooted in whole-person principles can yield improvements in continuity, cost-efficiency, and chronic disease outcomes. This manuscript offers a systems-level strategy to overcome fragmentation and reimagine healthcare delivery, not only by refining clinical tools, but by redefining what it means to care for the human being in full. Full article

Loss of myelinating oligodendrocytes and myelin impairs motor and cognitive functions. Transplantation of autologous oligodendrocyte precursors (OPCs) holds promise for treatment of such diseases, but a protocol to derive human OPCs from a safe, ethical and accessible cell source with the rapidity required to catch the therapeutic window remains to be found. Although we previously generated myelinating glia from rat bone marrow stromal cells (BMSCs), it remains unknown if clinically sourced human BMSCs (hBMSCs) share the same potential. Moreover, whether the multipotency of BMSCs results from diverse progenitors preexisting in the bone marrow or from a single multipotent progenitor population remains unaddressed. Single-cell RNA sequencing data revealed a CD90^hiEGFR⁺PDGFRA⁺ pre-OPC-like subpopulation within hBMSCs. With a small-molecule-based (virus-free and supporting-cell-free) two-step induction protocol designed to expand this pre-OPC population, we generated functional OPCs with high purity in eight days. These derived OPCs showed phenotypic transcriptomes and immunoprofiles. They were also capable of myelinating naked axons when transplanted into myelin-deficient shiverer mice. Results highlight how targeted enrichment and maturation of specific progenitor subpopulations within hBMSCs allows rapid induction of desired cell types. These results place hBMSCs as a robust source of OPCs, unlocking the possibility for cell transplantation therapy for myelin deficiency in the central nervous system. Full article

The rapid global wild boar (Sus scrofa) population growth, coupled with increasing agricultural crop damage and disease transmission, suggests that current management and control strategies remain inadequate. Therefore, an international systematic review using the Web of Science database (WoS; Clarivate Analytics, Philadepphia, PA, USA), including a quantitative synthesis (119 studies up to 11 November 2025, containing 181 experiments) of population reduction methods was conducted, with an emphasis on evaluating their effectiveness, selectivity, and animal welfare aspects relating to wild boar and feral pigs. The results demonstrate a significant increase in research interest for population control methods in recent years. The highest average effectiveness was observed for aerial shooting (56.2% of the population per month), followed by poison baiting (27.6%) and trapping (6.0%). Aerial shooting appeared highly selective in the reviewed contexts; however, together with poison baiting, it is generally not permitted under current European conditions. Trapping (6.0%) and individual hunting (3.9%) offer moderate effectiveness but are highly context-dependent. From a welfare perspective, the analysis indicated that no significant difference in effectiveness was detected between studies that included welfare or stress assessment and those that did not, indicating that consideration of animal welfare does not reduce control efficiency. The study concluded that the analysis did not identify a single universally applicable solution that combines animal welfare considerations with high effectiveness, highlighting a significant research gap. This underscores the urgent need for an effective and publicly acceptable method of reducing wild boar populations, or for the development of strategies that appropriately integrate multiple approaches. However, the interpretation of results is limited by heterogeneity in study design and variability in reported data. Full article