Search Results (13,179)

Objectives: To synthesize current evidence regarding advances in periodontal diagnosis and therapy, with emphasis on molecular biomarkers, omics technologies, microbiome profiling, digital imaging, and artificial intelligence-based analytical models that support the transition toward precision periodontology. Methods: This narrative review examines contemporary evidence on emerging molecular, microbiological, and digital technologies applied to periodontal diagnosis, prognostic assessment, and therapeutic planning. The review includes studies addressing salivary and gingival crevicular fluid biomarkers, microbiome characterization, omics approaches, cone-beam computed tomography, three-dimensional imaging, machine-learning algorithms, and personalized periodontal therapies. Relevant literature was identified through searches in major biomedical databases, including PubMed/MEDLINE, Scopus, and Web of Science, focusing on studies published on periodontal diagnostics, biomarkers, digital technologies, artificial intelligence, and precision medicine approaches in periodontology. Results: Peer-reviewed articles addressing innovative diagnostic and therapeutic approaches in periodontology were considered. Priority was given to studies evaluating clinical applicability, diagnostic performance, prognostic utility, and personalized treatment strategies integrating molecular and digital technologies. Conclusions: Emerging molecular and digital technologies are reshaping periodontal diagnosis and therapy by improving disease detection, risk prediction, and individualized treatment planning. Biomarkers, omics technologies, microbiome profiling, and artificial intelligence-assisted imaging may enhance diagnostic precision and clinical decision-making. These developments support the implementation of precision periodontology; however, challenges related to biomarker validation, algorithm standardization, cost, and accessibility remain barriers to routine clinical adoption. Further research is necessary to validate these approaches and facilitate their integration into periodontal practice. The integration of biomarkers, omics technologies, advanced imaging, and artificial intelligence may improve early periodontal diagnosis, prognostic assessment, and personalized treatment planning. These innovations support the transition toward precision periodontology and have the potential to enhance clinical decision-making, treatment outcomes, and long-term periodontal health in routine dental practice. Full article

Mesenchymal stromal cells (MSCs) have emerged as a promising therapeutic platform for central nervous system disorders, including neurodegenerative diseases and lysosomal storage disorders (LSDs). This review examines MSC mechanisms of action—paracrine activity, immunomodulation, antioxidant effects, TFEB-mediated autophagy regulation, and enzymatic cross-correction in LSDs—while critically assessing translational challenges. We provide a comparative analysis of MSC sources, administration routes, dosing regimens, and safety profiles, with emphasis on hemocompatibility and thrombotic risks. The evidence base for MSC efficacy in amyotrophic lateral sclerosis, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and LSDs is systematically reviewed, highlighting both promising signals and limitations. MSC-derived extracellular vesicles are discussed as a cell-free alternative with improved safety and potential blood–brain barrier interaction. We propose an individualized monitoring framework integrating clinical scales, biomarkers, and neuroimaging. Despite preclinical promise, the field faces major hurdles: product standardization, optimal dosing, and the need for large, randomized controlled trials. The most rational path forward lies in combination strategies—MSCs as adjuncts to gene or enzyme replacement therapy—and engineered platforms for sustained delivery. This review provides a roadmap for translational decision-making and identifies critical gaps that must be addressed before MSC-based therapies can be integrated into routine neurological practice. Full article

Background: Age-related macular degeneration (AMD) represents a leading cause of irreversible vision loss worldwide, driven by intricate interactions among oxidative stress, low-degree chronic inflammation, and macular pigment depletion in aging retinas. Lutein, a component of the macular pigment, has attracted significant attention in AMD management for its antioxidant and blue-light filtering properties. Its oral supplementation, however, although showing potential in slowing AMD progression, requires daily intake and results in variable macular absorption. Trans-scleral iontophoresis (TSI) is a non-invasive technique using low-intensity electric currents to deliver charged molecules into biological tissues and represents an innovative method to deliver lutein into the retina. Methods: The present narrative review synthesizes and discusses the results of lutein supplementation in AMD patients; the ocular iontophoresis basal principles, efficacy, safety and limitations in treating different ophthalmic pathologies; and the evolving clinical evidence supporting lutein TSI in the AMD management. Results: Ex-vivo studies have shown that lutein TSI may provide efficient, localized, rapid, and sustained retinal supplementation of macular pigment, overcoming oral intake limitations. Recent preliminary clinical studies have demonstrated that this technique is well-tolerated and effective in enhancing macular pigment optical density and improving some visual functions in AMD patients. Conclusions: Ex-vivo and pilot clinical studies highlight the capacity of TSI to deliver lutein inside the retina, overcoming physiological barriers that may limit the efficacy of lutein oral administration. The demonstration of the efficacy of the procedure in preserving/improving visual functions and delaying disease progression in AMD patients requires further long-term randomized controlled clinical studies. Full article

Skin aging is characterized by various changes, including epidermal thinning, barrier dysfunction, dermis alteration, and dermal–epidermal junction flattening. These changes lead to wrinkles and loss of skin radiance. This study investigates the potential of a supercritical CO₂ extract derived from Helichrysum italicum distillation co-products (CO₂SC extract) to serve as a botanical anti-aging product, targeting epidermal renewal, barrier reinforcement, dermal–epidermal junction organization, and engagement of retinoid-related gene networks. CO₂SC extract’s effects were examined at 0.005% in aged-human-skin equivalents via histology, immunohistology, and transcriptomics. Furthermore, CO₂SC extract was investigated at 0.1% in human skin explants using label-free proteomics in comparison with retinol (ROL) at 0.1% and 0.3%. The clinical effectiveness and tolerability of 0.1% CO₂SC extract were determined by conducting a randomized, intra-individual comparison with a 0.1% ROL formulation. In aged-human-skin equivalents, CO₂SC extract at 0.005% increased epidermal thickness, enhanced expression of differentiation- and barrier-related genes, and stimulated dermal remodeling by increasing type I and III collagens while promoting type VII collagen at the dermal–epidermal junction. Transcriptomic analysis revealed upregulation of genes involved in ROL metabolism and retinoic-acid-responsive signaling. Proteomic profiling further highlighted treatment-associated molecular signatures in comparison with ROL. Clinically, 0.1% CO₂SC extract significantly improved wrinkles by day 28, with improvements of comparable magnitude to those observed with the 0.1% ROL arm under the tested conditions and good tolerability, with no signs of irritation reported, including in sensitive-skin participants. CO₂SC extract displays anti-aging activity at the molecular, histological, and clinical levels under the tested conditions, modulating gene networks related to ROL metabolism and retinoid signaling while reinforcing barrier integrity and dermal regeneration. Together with its favorable tolerability profile, these findings suggest that this CO₂SC extract triggers retinoid-associated programs while maintaining a molecular profile distinct from that of ROL, supporting further evaluation as a botanical anti-aging ingredient agent. Full article

Microplastics and nanoplastics (MNPs) have emerged as widespread environmental contaminants, with increasing evidence suggesting that chronic exposure may adversely affect human health. Experimental and emerging human studies indicate that MNPs can interact with multiple biological systems and trigger a range of mechanisms, including oxidative stress, mitochondrial dysfunction, cellular injury, barrier disruption, and immune and inflammatory responses. These effects may involve direct interactions with tissues and cells as well as indirect pathways, including alterations in gut microbial and intestinal homeostasis. In turn, persistent inflammatory and metabolic disturbances may contribute to tissue dysfunction and the development or progression of chronic diseases. This narrative review summarizes current evidence on the biological effects of MNP exposure, focusing on the mechanisms linking environmental exposure to chronic inflammation and disease. We discuss their potential involvement in cardiovascular, liver, kidney, respiratory, and neurological diseases, while highlighting the emerging role of the gut microbiota and intestinal barrier as potential modulators of these effects. Given the limitations of current human evidence and the heterogeneity of experimental models, we also discuss major knowledge gaps and the need for further mechanistic and epidemiological studies to clarify the clinical relevance of chronic MNPs exposure. Full article

Hepatocellular carcinoma (HCC) remains difficult to control because recurrence, impaired hepatic reserve, and treatment resistance limit durable benefit. Natural products and traditional Chinese medicine (TCM) provide resources that range from drug-lead discovery to adjunctive multicomponent therapy. This review integrates pharmacological and clinical evidence for purified compounds, semisynthetic derivatives, extracts, formulas, and delivery systems. It focuses on metabolic reprogramming and redox homeostasis, stress responses and regulated cell death, tumor cell plasticity and vascular remodeling, and the immune microenvironment and host response. Recent studies have strengthened selected mechanistic claims through chemical probes, functional perturbation, and resistance models. Clinical research has concentrated on recurrence control after surgery or minimally invasive treatment and on combinations with transarterial chemoembolization, targeted agents, and immunotherapy. Randomized trials and prospective cohorts suggest potential benefit in specific settings, although product standardization, external validation, and long-term follow-up remain limited. Major translational barriers include uncertain active constituents, inadequate batch comparability, missing tumor-exposure data, and sparse herb–drug interaction studies. Future development should match target validation, pharmacokinetics, safety assessment, and clinical endpoints to each product class and clarify whether a candidate is best positioned as a drug lead, adjunctive therapy, or supportive intervention. Full article

Highly pathogenic avian influenza H5N1 virus (H5N1 HPAIV) has long circulated in wild waterfowl and poultry and continues to cross species barriers, posing sustained threats to livestock productivity and public health. The 2024 outbreak of H5N1 HPAIV in dairy cattle across multiple U.S. states represents the first recognized large-scale transmission event of this virus in ruminants, reshaping our understanding of its host range and transmission ecology. This review summarizes recent advances in the epidemiology, virological characteristics, transmission, pathogenesis, surveillance, and control of dairy cattle-associated H5N1. The initial multistate outbreak was dominated by clade 2.3.4.4b genotype B3.13, whereas subsequent independent introductions of genotype D1.1 demonstrated that repeated avian-to-cattle spillover also contributes to the evolving outbreak ecology. A defining feature is efficient replication in bovine mammary epithelial cells, resulting in high viral titers in milk, supporting milk-associated exposure and milking-related contamination as plausible components of transmission, although the relative contribution of different routes remains unresolved. Infected cattle typically show reduced feed intake, a marked decline in milk production, abnormal milk, and mild systemic signs, whereas severe respiratory disease and mortality are uncommon. Mutations such as PB2-M631L, PA-K497R, and changes in NP and NS1 may promote replication and immune evasion in bovine cells, while genotype-specific PB2 adaptations highlight the potential for further mammalian adaptation. Human infections reported to date have been predominantly mild and associated with occupational exposure, with no evidence of sustained human-to-human transmission. Experimental vaccine studies have begun to demonstrate immunogenicity in cattle, although protection against mammary infection, viral shedding, and transmission remains to be established. Future priorities include clarifying mammary tropism and transmission dynamics, while strengthening diagnostics, farm biosecurity, vaccination, evaluating cattle vaccination strategies, and integrated One Health surveillance. Full article

Vision impairment affects approximately 2.2 billion people worldwide, with glaucoma, age-related macular degeneration, fungal keratitis, and diabetic retinopathy among the leading causes of preventable blindness. Effective pharmacotherapy remains severely constrained by the eye’s multilayered barrier architecture. Tear film, the corneal epithelium, the blood–aqueous barrier, and the blood–retinal barrier collectively restrict conventional topical drug bioavailability to less than 5% of the administered dose. Liposomal drug delivery systems have emerged as a clinically translatable platform capable of overcoming these barriers through targeted surface modification. This review provides a brief introduction to ocular barriers to drug delivery and transport and critically examines numerous surface-modification strategies applied to liposomal carriers to enhance corneal permeation and ocular bioavailability of drugs. It highlights the advantages and disadvantages of each modification strategy, as well as the convergent mechanism of liposomal surface modification in overcoming ocular barriers, and provides a comparative analysis of different surface-modification strategies of liposomes in terms of safety, efficacy and corneal retention. Additionally, it describes challenges associated with liposomal ophthalmic formulations in industrial scaling up. The review also sheds light on some FDA-approved liposomal ophthalmic products, active clinical trials on liposomal formulations, and relevant patents, demonstrating the potential benefits of liposomal drug delivery in the treatment of ocular disorders. Full article

The digital divide in developing economies persists as a multidimensional challenge encompassing infrastructure access, digital skills, usage patterns, and social inequality. This paper presents a structured literature review of 63 peer-reviewed articles (2018–2025) examining how intelligent connectivity, the convergence of fifth-generation (5G) mobile networks, artificial intelligence (AI), and the Internet of Things (IoT), can contribute to bridging this divide. The findings reveal that intelligent connectivity offers transformative potential across agriculture, healthcare, education, and financial services. However, its impact is contingent upon enabling governance, institutional capacity, and digital skills. Three contributions emerge: (1) a conceptual framework specifying directional pathways from enabling conditions to intelligent connectivity deployment and inclusive outcomes; (2) a comparative regional analysis (Sub-Saharan Africa, Southeast Asia, and Latin America) identifying context-specific barriers and opportunities; and (3) a socio-technical model positioning intelligent connectivity as an integrated system rather than a purely technological solution. A key limitation is acknowledged: only 16% of the reviewed corpus addresses developing economies, necessitating triangulation with institutional reports from the International Telecommunication Union (ITU), Organization for Economic Co-operation and Development (OECD), and Global System for Mobile Communications Association (GSMA). The paper concludes with open research challenges and policy recommendations for inclusive digital transformation. Full article

Fracturing flowback fluid poses significant pollution risks and potential threats to the surrounding ecological environment, especially soil and groundwater systems. This study innovatively combined the dielectric barrier discharge (DBD) low-temperature plasma technology with the Fenton oxidation process to construct a synergistic degradation system. Systematic investigation of key operational parameters, including discharge voltage, H₂O₂ and Fe²⁺ dosages, and initial pH, was conducted to evaluate their effects on process performance. Under the optimal process parameters, the system achieves over 90% in both COD removal rate and guar gum degradation efficiency, outperforming traditional treatment technologies. Mechanistic analysis suggests that the efficient degradation of HPG may result from the combined action of plasma-generated reactive species and Fenton-derived oxidizing species. However, further identification of transformation products and toxicity evaluation are still required. This research provides a green and efficient new solution for the fracturing flowback fluid treatment, which has significant engineering application value. Full article

Pork is highly perishable during storage, leading to enormous economic losses and potential food safety hazards. Anthocyanins (ANTs) possess excellent antioxidant and antibacterial activities, but their poor stability in practical applications limits their industrial application. To address these issues, a novel composite preservation film was prepared by the four-sided applicator solution casting method, using polylactic acid (PLA) and polybutylene adipate-co-terephthalate (PBAT) as matrix materials and ANTs@ZIF-8 as functional filler. Zeolitic imidazolate framework-8 (ZIF-8) encapsulated ANTs to enhance its stability and achieve sustained release, while the PLA/PBAT was selected for its good biodegradability, mechanical and barrier properties. The structure and properties of the PLA/PBAT/ANTs@ZIF-8 composite films were investigated, and the results showed that ANTs@ZIF-8 nanoparticles had stable dispersibility in the matrix, which effectively improved the compatibility between nanoparticles and the film matrix. The prepared composite films exhibited excellent tensile strength (TS), elongation at break (EAB) and water vapor transmission rate (WVTR), as well as good antibacterial activity against E. coli and S. aureus. Furthermore, the practical pork preservation performance of the films was investigated, and the results demonstrated that the composite films could effectively reduce the pH value, water loss, color difference, total volatile basic nitrogen (TVB-N) content and malondialdehyde (MDA) content of fresh pork during storage, successfully extending the shelf life of pork to 12 days. This study develops a multifunctional, biosafe, and biodegradable PLA/PBAT composite film incorporated with ANTs@ZIF-8, providing a feasible strategy and scientific reference for the design and development of high-performance active biodegradable packaging materials. Full article

Background: The dynamic advancement of pediatric hemato-oncology and intensified therapeutic protocols have significantly increased survival rates while simultaneously highlighting the challenge of long-term treatment complications. Within the cohort of adolescent and young adult (AYA) survivors, delayed neurocognitive deficits, often manifesting as the chemobrain phenotype, and psychosocial disorders constitute a particularly substantial burden. Contemporary neurogastroenterological evidence indicates a fundamental role of persistent dysbiosis and gut–brain axis dysfunction in the pathogenesis of these alterations. This review aims to critically synthesize translational evidence elucidating the impact of iatrogenic gut microbiota damage and modifiable dietary patterns on the development of long-term neurocognitive sequelae in survivors of early childhood cancer. Methods: A systematized narrative review was conducted in accordance with the SANRA guidelines by integrating data from in vivo models and observational studies. A comprehensive literature search across the PubMed, Embase, Cochrane Central, Scopus, and Web of Science databases up to June 2026 was performed utilizing the Population, Exposure, and Outcomes (PEO) framework. Results: Oncological therapies, including myeloablative conditioning and broad-spectrum antibiotic therapy, induce a microbial scar phenomenon characterized by the depletion of commensal Firmicutes in favor of resistant pathobionts. The subsequent decline in the synthesis of neuroprotective short-chain fatty acids (SCFAs) alongside the pathological activation of the kynurenine pathway disrupts central nervous system homeostasis. Translocation of lipopolysaccharides (LPSs) across the compromised intestinal barrier generates systemic inflammation recognized as inflammaging, which, in turn, stimulates neurotoxic microglial hyperreactivity. This pathophysiological cascade is accelerated by a pro-inflammatory Western diet, whereas anti-inflammatory interventions such as the MIND diet and postbiotics demonstrate measurable restorative potential. Conclusions: The pathophysiology of delayed neurotoxicity is largely a consequence of systemic neuroinflammation driven by intestinal dysbiosis. Implementing individualized dietary and microbiome-targeted strategies into survivorship care protocols constitutes a crucial direction for clinical prophylaxis. Validating their clinical efficacy in the AYA population necessitates prospective randomized controlled trials integrated with shotgun metagenomic sequencing. Full article

Copper and lead contamination in loess areas poses a potential threat to soil environmental quality and sustainable land use, while the low permeability, high clay content, and strong buffering capacity of loess often limit the efficiency of conventional electrokinetic (EK) remediation. In this study, a modified activated carbon–carbon fiber (MAC–CF) composite reactive barrier was introduced into an EK remediation system to enhance the soil-phase depletion of Cu and Pb from contaminated loess. The effects of ordinary activated carbon (AC), MAC, CF, and different MAC–CF mixing ratios on current, cumulative electroosmotic flow (EOF), soil pH, electrical conductivity (EC), and potentially toxic metal (PTM) removal were systematically investigated. The conventional AC barrier increased system resistance and inhibited current transmission and EOF. The MAC barrier exhibited enhanced OH⁻ adsorption and buffering capacity, decreasing the cathode-adjacent pH from approximately 9.8 to 8.8. CF incorporation improved barrier conductivity, increasing the peak current from 1.6 A for MAC (100%) to 4.0 A for MAC (25%) + CF (75%), while cumulative EOF increased from approximately 380 to 950 mL. The MAC (25%) + CF(75%) barrier provided the best balance between conductivity enhancement and cathodic alkalization regulation. Sectional Cu removal reached approximately 90% near the anode, whereas Pb removal ranged from approximately 18% to 29%, with a section-weighted mean of about 24.8%. The corresponding residual Pb concentrations (approximately 355–410 mg kg⁻¹) indicate that the system is more effective for Cu and would require additional treatment to meet a conservative agricultural-soil target for Pb. The results support complementary functions of CF in maintaining conductive pathways and MAC in regulating cathodic alkalization. Because Cu and Pb in the spent barrier and electrolyte chambers were not quantified, the proposed precipitation-suppression and migration mechanisms are interpreted from the combined electrochemical, pH, EC, adsorption, and soil-residual evidence rather than from a complete metal mass balance. Full article

Congenital diaphragmatic hernia (CDH) is increasingly recognized as a dynamic cardiopulmonary disease in which pulmonary hypoplasia, pulmonary hypertension, and cardiac dysfunction interact to shape clinical instability, therapeutic response, and outcomes. Hemodynamic phenotyping has emerged as a strategy to move beyond binary classification of pulmonary hypertension and toward physiology-directed care. Early single-center experiences suggest potential clinical utility of echocardiography-guided, phenotype-directed management; however, external validation remains limited. Further important challenges remain, including technical and institutional barriers to timely echocardiography, limitations of static single-time-point assessments, uncertainty regarding what exactly defines each phenotype, and incomplete understanding of the impact of time and therapies on phenotype presentations. In this perspective, we summarize the evolution of heart-focused care in CDH, describe current hemodynamic phenotyping approaches, examine unresolved questions in phenotype classification and implementation, and outline future research priorities needed to advance dynamic, mechanism-based precision cardiopulmonary care for infants with CDH. Full article

(1) Background: Preconception care (PCC) is an important component of preventive reproductive healthcare and public health because modifiable risk factors affecting maternal, neonatal, and longer-term health may be present before conception. Despite broad recognition of its potential value, substantial uncertainty remains regarding how PCC should be organised, financed, and implemented across different healthcare systems. (2) Methods: This structured narrative review synthesised evidence on healthcare- provider models, financing, affordability, willingness to pay (WTP), and barriers and facilitators affecting PCC implementation. A structured search of PubMed, Scopus, and Web of Science Core Collection covered publications from January 2010 to March 2026 and was updated on 14 July 2026. Original research studies, systematic and scoping reviews, narrative reviews, clinical guidelines, policy reports, and relevant methodological or health-economic publications were considered. A structured qualitative appraisal was used to interpret evidence according to study design or evidence type, directness to PCC, healthcare-system context, methodological limitations, and consistency across sources. A total of 61 publications were retained in the structured evidence synthesis. (3) Results: No single PCC delivery model was consistently supported as universally applicable. Across heterogeneous settings, the evidence more consistently supported broad principles including accessibility, continuity of care, multidisciplinary coordination, clear professional roles, financial accessibility, and integration with existing healthcare pathways. Implementation was constrained by insufficient training, consultation-time limitations, unclear professional responsibilities, fragmented service organisation, inadequate reimbursement, and socioeconomic inequalities. Evidence on WTP, specific financing arrangements, and digital delivery models was more limited and context-dependent. (4) Conclusions: The available evidence supports PCC as an important preventive reproductive-health strategy, but the optimal organisational and financing models remain uncertain and are likely to depend on healthcare-system context. Integrated and multidisciplinary approaches appear promising, although specific provider configurations, financing mechanisms, and digital interventions require further comparative and longitudinal evaluation. The author-developed hypothetical conceptual model proposed in this review should therefore be interpreted as a hypothesis-generating synthesis of the available evidence rather than as an empirically validated clinical pathway or causal model. Full article