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22 pages, 1473 KB  
Systematic Review
High-Intensity Laser Therapy Versus Extracorporeal Shockwave Therapy for Plantar Fasciitis: A Systematic Review and Meta-Analysis
by Pei-Ching Wu, Dung-Huan Liu, Yang-Shao Cheng, Chih-Sheng Lin and Fu-An Yang
Bioengineering 2026, 13(1), 90; https://doi.org/10.3390/bioengineering13010090 - 13 Jan 2026
Abstract
Background: Plantar fasciitis is a prevalent musculoskeletal disease characterized by heel pain and functional impairment. Both high-intensity laser therapy (HILT) and extracorporeal shockwave therapy (ESWT) have demonstrated efficacy in managing plantar fasciitis; however, their relative effectiveness remains unclear. Purpose: This systematic review and [...] Read more.
Background: Plantar fasciitis is a prevalent musculoskeletal disease characterized by heel pain and functional impairment. Both high-intensity laser therapy (HILT) and extracorporeal shockwave therapy (ESWT) have demonstrated efficacy in managing plantar fasciitis; however, their relative effectiveness remains unclear. Purpose: This systematic review and meta-analysis aimed to compare the effects of HILT and ESWT for treating plantar fasciitis. Methods: A comprehensive literature search of PubMed, the Cochrane Library, EMBASE, and Scopus was conducted from inception to 13 July 2025 to identify randomized controlled trials (RCTs) investigating both interventions. Two reviewers independently extracted data and assessed the methodological quality of the trials using the Physiotherapy Evidence Database (PEDro) scale. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The primary outcomes of this study were pain intensity and foot function. The visual analog scale (VAS) was used for pain assessment. Foot function was evaluated by the total scores of the Foot Function Index (FFI) and American Orthopedic Foot & Ankle Society Scale (AOFAS) and the activities of daily living (ADL) subscale scores of the Foot and Ankle Ability Measure (FAAM). Outcomes were assessed at the end of treatment and during short-, medium-, and long-term follow-ups. The meta-analysis utilized standardized mean differences (SMDs), assessed heterogeneity using the I2 test, applied the inverse variance method for pooling continuous variables, and employed a random-effects model because of the variable study methods used across the included articles. Results with p < 0.05 were considered statistically significant. The I2 test was used to objectively measure statistical heterogeneity, with I2 ≥ 50% indicating significant heterogeneity. Results: Five RCTs met the inclusion criteria, with methodological quality scores ranging from 6 to 7 on the 10-point PEDro scale. In total, 120 participants received HILT and 116 received ESWT. Regarding pain intensity (VAS), no statistically significant differences were detected between HILT and ESWT at any time point, including short-term morning pain (SMD = −0.11, 95% CI −0.42 to 0.19, p = 0.40), resting pain (SMD = 0.01, 95% CI −0.48 to 0.49, p = 0.05), and activity pain (SMD = −0.08, 95% CI −0.41 to 0.26, p = 0.89), as well as medium-term morning, resting, and activity pain (all p > 0.05). For foot function (FFI), the pooled analysis of all studies showed no significant short-term difference (SMD = 0.37, 95% CI −0.22 to 0.95, p = 0.01; I2 = 73%); however, a subsequent sensitivity analysis, which excluded one studyreduced heterogeneity to 0% and revealed a significant short-term advantage of ESWT (SMD = 0.64, 95% CI 0.32 to 0.95, p < 0.01). Medium-term FFI also favored ESWT (SMD = 0.53, 95% CI 0.14 to 0.92, p < 0.01). Overall, the certainty of evidence ranged from moderate to low, mainly due to risk of bias and heterogeneity, as assessed by the GRADE approach. Conclusions: While the pooled results suggested a trend toward greater functional improvement with ESWT than with HILT in the short- and medium-term, the effect sizes were small. No significant between-group differences were observed in pain-related outcomes. Given the limited number of available trials and variability in treatment protocols, current evidence remains insufficient to draw definitive conclusions about the comparative efficacy of ESWT and HILT. Further high-quality, large-scale randomized controlled trials with standardized methodologies are needed to better inform clinical decision-making. Full article
(This article belongs to the Section Biomechanics and Sports Medicine)
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21 pages, 2605 KB  
Article
In Vitro Accuracy Analysis of Intraoral Scanning Strategies: A Comparison of Two Contemporary IOS Systems
by Sabina-Ana Răuță, Vlad Gabriel Vasilescu, Lucian Toma Ciocan, Alexandra Popa, Ana-Maria Cristina Țâncu, Florin Octavian Froimovici, Bogdan Dimitriu, Silviu-Mirel Pițuru and Marina Imre
Dent. J. 2026, 14(1), 52; https://doi.org/10.3390/dj14010052 - 13 Jan 2026
Abstract
Background: Digital intraoral scanning has become an essential component of modern restorative dentistry, offering enhanced accuracy, workflow efficiency, and patient comfort compared to conventional impression techniques. Despite these advantages, the accuracy of intraoral scanners (IOS) can be affected by multiple parameters, among [...] Read more.
Background: Digital intraoral scanning has become an essential component of modern restorative dentistry, offering enhanced accuracy, workflow efficiency, and patient comfort compared to conventional impression techniques. Despite these advantages, the accuracy of intraoral scanners (IOS) can be affected by multiple parameters, among which scanning strategy and device design are particularly influential. Purpose: This study aimed to investigate the effect of different scanning strategies on scan accuracy and precision, focusing on two widely used intraoral scanners (Medit i700 and Trios 5) in a controlled in vitro environment. Materials and Methods: A standardized digital test object was created according to ISO 20896-1 specifications to ensure uniformity and comparability. The object was printed using a high-precision 3D printer and scanned multiple times with both IOS systems, employing distinct scanning strategies under identical environmental conditions. Data analysis was performed using descriptive and comparative statistics, including Mean, Median, Mean Absolute Deviation (MAD), Root Mean Square Error (RMSE), Standard Deviation (SD), and Variance, to evaluate trueness and precision. Results: The Medit i700 consistently exhibited lower deviation values and greater precision compared with the Trios 5, reflecting higher trueness and precision. Scanning strategy influenced scan outcomes; structured, systematic scanning paths produced more stable and accurate datasets. The Trios 5 demonstrated higher variability, suggesting increased sensitivity to operator motion and scanning trajectory. Conclusions: Both the scanner type and scanning strategy substantially affect intraoral scan accuracy. The superior performance of the Medit i700 indicates greater robustness and operator-independent stability. Clinically, these results underscore the importance of standardized scanning protocols, as operator consistency may be a key determinant of digital impression accuracy and, consequently, of clinical outcomes. Full article
(This article belongs to the Special Issue Feature Papers in Digital Dentistry)
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20 pages, 1213 KB  
Review
What Is the Role of Diabetic Alert Dogs in Glycemic Monitoring for Individuals with Type 1 Diabetes? A Scoping Review
by Nathalia Marçallo Peixoto Souza, Paula Rothbarth Silva, Christiane Mayrhofer Grocoske de Lima, Mateus Santana Lopes, Patricia Sthefani Calixto, Bruna Mariza Zampier Bilek, Luana Mota Ferreira, Marciane Welter, Fabiane Gomes de Moraes Rego and Marcel Henrique Marcondes Sari
Med. Sci. 2026, 14(1), 39; https://doi.org/10.3390/medsci14010039 - 13 Jan 2026
Abstract
Background/Objectives: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition that requires continuous glycemic monitoring to prevent acute and long-term complications. In recent years, Diabetic Alert Dogs (DADs) have been increasingly used as an adjunctive strategy to assist individuals with T1DM [...] Read more.
Background/Objectives: Type 1 diabetes mellitus (T1DM) is a chronic autoimmune condition that requires continuous glycemic monitoring to prevent acute and long-term complications. In recent years, Diabetic Alert Dogs (DADs) have been increasingly used as an adjunctive strategy to assist individuals with T1DM by alerting glycemic fluctuations through olfactory detection of physiological changes. Despite growing interest, the available evidence remains heterogeneous and fragmented. Methods: Therefore, this scoping review was conducted to address the following research question: “What evidence is available regarding the relationship between Diabetic Alert Dogs (DADs) and glycemic monitoring in individuals with T1DM?”, conducted in accordance with the Joanna Briggs Institute methodology and reported following the PRISMA Extension for Scoping Reviews. Results: Searches were performed in PubMed, Scopus, and Web of Science without time restrictions. After duplicate removal (n = 485), 2379 records were screened, of which 24 articles underwent full-text assessment and 10 studies met the predefined inclusion criteria. Regarding glycemic alteration detection, most studies (7/10) reported that DADs could identify both hypoglycemic and hyperglycemic episodes, while the remaining studies focused exclusively on hypoglycemia detection. Sensitivity values were consistently higher for hypoglycemia than for hyperglycemia, and none reported false alert rates exceeding 20%. In addition to glycemic alert performance, improvements in perceived safety, independence, and quality of life were described in half of the included studies (5/10). Conclusions: By systematically mapping the characteristics, outcomes, and methodological approaches of studies involving DADs, this scoping review provides an overview of current evidence and identifies key knowledge gaps in training protocols, outcome standardization, and performance reporting. Full article
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13 pages, 541 KB  
Review
Occupational Radiation Risk Stratification and Protection in Fluoroscopy-Guided Surgeons and Interventionalists: A Multispecialty Structured Narrative Review
by Nana Kwadwo Okraku-Yirenkyi, Sri Snehita Reddy Bonthu, Hanisha Bhakta, Oluwatoyin O. Duyile and Michael Bernas
J. Pers. Med. 2026, 16(1), 50; https://doi.org/10.3390/jpm16010050 - 13 Jan 2026
Abstract
Background/Objectives: Fluoroscopy-guided procedures are widely used across surgical and interventional specialties but expose operators to ionizing radiation with associated stochastic and deterministic effects. The aim is to characterize occupational radiation exposure, evaluate the effectiveness of shielding strategies, assess long-term cancer risks, and identify [...] Read more.
Background/Objectives: Fluoroscopy-guided procedures are widely used across surgical and interventional specialties but expose operators to ionizing radiation with associated stochastic and deterministic effects. The aim is to characterize occupational radiation exposure, evaluate the effectiveness of shielding strategies, assess long-term cancer risks, and identify compliance patterns. Methods: This structured narrative review summarizes evidence on operator dose, shielding effectiveness, compliance with protective practices, and long-term cancer risk. A search of PubMed, Scopus, Embase, and Web of Science (limited to January 2000–March 2024) identified 62 records; 27 full texts were reviewed, and 16 studies met the inclusion criteria. Results: Across studies, unshielded chest exposure averaged 0.08–0.11 mSv per procedure, and eye exposure averaged 0.04–0.05 mSv. Lead aprons reduced exposure by about 90% at 0.25 mm and 99% at 0.5 mm, thyroid collars reduced neck dose by 60–70%, and lead glasses reduced ocular dose 2.5–4.5-fold. Compliance with aprons and thyroid collars was high, whereas lead glasses and lower-body shielding were inconsistently used. Limited epidemiologic data suggested a higher cancer burden in exposed surgeons, and Biologic Effects of Ionizing Radiation (BEIR) VII–based modeling projected increased lifetime risks of solid cancers in chronically exposed operators. Conclusions: Protective equipment substantially reduces operator dose, but exposure variability and inconsistent shielding practices persist and justify standardized monitoring, stronger enforcement of radiation safety protocols, and longitudinal studies. Full article
(This article belongs to the Special Issue Review Special Issue: Recent Advances in Personalized Medicine)
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11 pages, 454 KB  
Review
Irisin as a Neuroprotective Agent in Parkinson’s Disease: The Role of Physical Exercise in Modulating Dopaminergic Neurons
by José Garcia de Brito-Neto, Paulo Leonardo de Góis Morais, José Rodolfo Lopes de Paiva Cavalcanti, Francisco Irochima Pinheiro, Fausto Pierdoná Guzen and Ricardo Ney Cobucci
Pharmacy 2026, 14(1), 9; https://doi.org/10.3390/pharmacy14010009 - 13 Jan 2026
Abstract
Exercise-induced myokines have emerged as crucial mediators of the beneficial effects of physical activity on neurodegenerative diseases through complex molecular mechanisms involving oxidative stress reduction, neuroinflammation suppression, and synaptic plasticity enhancement. Among these myokines, irisin, encoded by the FNDC5 gene, has gained significant [...] Read more.
Exercise-induced myokines have emerged as crucial mediators of the beneficial effects of physical activity on neurodegenerative diseases through complex molecular mechanisms involving oxidative stress reduction, neuroinflammation suppression, and synaptic plasticity enhancement. Among these myokines, irisin, encoded by the FNDC5 gene, has gained significant attention as a potential therapeutic target in neurodegenerative conditions due to its ability to cross the blood–brain barrier and exert pleiotropic neuroprotective effects. This review synthesizes current evidence from both preclinical and clinical studies examining the role of exercise-induced irisin in neurodegeneration, with particular emphasis on translational potential and therapeutic applications. A comprehensive search was conducted across PubMed, Web of Science, Scopus, and EMBASE databases (spanning January 2015 to December 2024) to identify peer-reviewed articles investigating irisin’s neuroprotective mechanisms in neurodegenerative diseases. Ten studies met the inclusion criteria (five rodent/primate model studies and five human clinical investigations), which were analyzed for methodological rigor, intervention protocols, biomarker quantification methods, and reported outcomes. Reviewed studies consistently demonstrated that exercise-induced endogenous irisin elevation correlates with improved cognitive function, reduced neuroinflammatory markers, enhanced synaptic plasticity, and modulation of neurodegenerative pathways, with exogenous irisin administration reproducing several neuroprotective benefits observed with exercise training in animal models. However, substantial heterogeneity exists regarding exercise prescription parameters (intensity, duration, frequency, modality), training-induced irisin quantification methodologies (ELISA versus mass spectrometry), and study designs (ranging from uncontrolled human observations to randomized controlled trials in animal models). Critical appraisal reveals that human studies lack adequate control for confounding variables including baseline physical fitness, comorbidities, concurrent medications, and potential sources of bias, while biochemical studies indicate distinct pharmacokinetics between endogenous training-induced irisin and exogenous bolus dosing, necessitating careful interpretation of therapeutic applicability. The translational potential of irisin as a therapeutic agent or drug target depends on resolving methodological standardization in biomarker measurement, conducting well-designed clinical trials with rigorous control for confounders, and integrating findings from molecular/biochemical studies to elucidate mechanisms linking irisin to disease modification. Future research should prioritize establishing clinical trial frameworks that harmonize exercise prescriptions, employ robust biomarker quantification (mass spectrometry), and stratify participants based on disease stage, comorbidities, and genetic predisposition to clarify irisin’s role as a potential therapeutic intervention in neurodegenerative disease management. Full article
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11 pages, 471 KB  
Review
Autopsy-Proven Snakebite Envenoming Deaths: A Review of Forensic and Pathological Evidence
by Matteo Antonio Sacco, Saverio Gualtieri, Aurora Princi and Isabella Aquila
Forensic Sci. 2026, 6(1), 2; https://doi.org/10.3390/forensicsci6010002 - 13 Jan 2026
Abstract
Background/Objectives: Snakebite envenoming remains a critical yet frequently under-recognized cause of mortality in many parts of the world, particularly in tropical and rural areas where access to timely medical care and accurate post-mortem investigation is limited. While clinical and epidemiological data on snakebites [...] Read more.
Background/Objectives: Snakebite envenoming remains a critical yet frequently under-recognized cause of mortality in many parts of the world, particularly in tropical and rural areas where access to timely medical care and accurate post-mortem investigation is limited. While clinical and epidemiological data on snakebites have been extensively studied, the forensic characterization of fatal envenomations remains fragmentary and inconsistently documented. This review aims to synthesize the existing literature on autopsy-confirmed snakebite deaths, focusing on the pathological and toxicological evidence that supports cause-of-death determinations in forensic settings. Methods: A comprehensive search of the PubMed NCBI databases identified nine relevant studies, including case reports, retrospective analyses, and systematic reviews. Results: Across these reports, a range of lethal mechanisms were identified, including venom-induced consumption coagulopathy (VICC), acute renal failure (frequently in the setting of rhabdomyolysis and acute tubular necrosis), neurotoxic respiratory arrest, multi-organ necrosis, and myocardial infarction. Histological findings frequently revealed glomerular and tubular necrosis, pulmonary edema and/or hemorrhage, pituitary and adrenal hemorrhage, and cerebral ischemic changes. Toxicological confirmation was achieved in several cases using ELISA and liquid chromatography–mass spectrometry (LC–MS/MS), underscoring the importance of biochemical validation in post-mortem diagnosis and the value of analytical tools beyond ELISA (e.g., immunoaffinity LC–MS/MS, venom-specific immunohistochemistry, zymography for SVMP activity). Conclusions: Our findings highlight the variability in venom effects across snake families—particularly Viperidae, Elapidae, and Lamprophiidae/Atractaspididae—and emphasize the indispensable role of forensic autopsy in distinguishing snakebite envenoming from other causes of sudden or unexplained death. However, significant limitations persist, including inconsistent autopsy protocols, lack of species-specific venom assays, and poor integration of toxicological methods in routine forensic practice. Addressing these gaps through standardized forensic guidelines and improved access to diagnostic tools is essential for enhancing the accuracy of death investigations in envenoming-endemic regions. Full article
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13 pages, 407 KB  
Article
Does Regional Anesthesia Improve Recovery After vNOTES Hysterectomy? A Comparative Observational Study
by Kevser Arkan, Kubra Cakar Yilmaz, Ali Deniz Erkmen, Sedat Akgol, Gul Cavusoglu Colak, Mesut Ali Haliscelik, Fatma Acil and Behzat Can
Medicina 2026, 62(1), 154; https://doi.org/10.3390/medicina62010154 - 13 Jan 2026
Abstract
Background and Objectives: Vaginal natural orifice transluminal endoscopic surgery, vNOTES, has become an increasingly preferred minimally invasive option for benign hysterectomy. General anesthesia is still the routine choice, yet regional methods such as combined spinal epidural anesthesia may support a smoother postoperative [...] Read more.
Background and Objectives: Vaginal natural orifice transluminal endoscopic surgery, vNOTES, has become an increasingly preferred minimally invasive option for benign hysterectomy. General anesthesia is still the routine choice, yet regional methods such as combined spinal epidural anesthesia may support a smoother postoperative course. Although the use of vNOTES is expanding, comparative information on anesthetic approaches remains limited, and its unique physiologic setting requires dedicated evaluation. To compare combined spinal epidural anesthesia with general anesthesia for benign vNOTES hysterectomy, focusing on postoperative nausea and vomiting, recovery quality, and intraoperative physiologic safety. Materials and Methods: This retrospective cohort study was conducted in a single center and identified women who underwent benign vNOTES hysterectomy between March 2024 and August 2025 from electronic medical records. Participants received either combined spinal epidural anesthesia or general anesthesia according to routine clinical practice. All patients were managed within an enhanced recovery pathway that incorporated standardized analgesia and prophylaxis for postoperative nausea and vomiting. The primary outcome was the incidence of postoperative nausea and vomiting during the first day after surgery. Secondary outcomes included time to discharge from the recovery unit, pain scores at set postoperative intervals, early functional recovery, patient satisfaction and physiologic parameters extracted from intraoperative monitoring records. Analyses were performed according to the anesthesia group documented in the medical files. Results: One hundred forty patients met inclusion criteria and were included in the analysis. Combined spinal epidural anesthesia was linked to a lower incidence of postoperative nausea and vomiting, a shorter stay in the post-anesthesia care unit, and reduced pain scores in the first 24 h (adjusted odds ratio 0.32, ninety five percent confidence interval 0.15 to 0.68). Early ambulation and oral intake were reached sooner in the combined spinal epidural group, with higher overall satisfaction also noted. Adherence to ERAS elements was similar between groups, with no meaningful differences in early feeding, mobilization, analgesia protocols or PONV prophylaxis. During the procedure, combined spinal epidural anesthesia produced more episodes of hypotension and bradycardia, while general anesthesia was linked to higher airway pressures and lower oxygen saturation. Complication rates within the first month were low in both groups. Conclusions: In this observational cohort study, combined spinal epidural anesthesia was associated with lower postoperative nausea, earlier recovery milestones and greater patient comfort compared with general anesthesia. Hemodynamic instability occurred more often with neuraxial anesthesia but was transient and manageable. While these findings point to potential recovery benefits for some patients, the observational nature of the study and the modest scale of the differences necessitate a cautious interpretation. They should be considered exploratory rather than definitive. The choice of anesthesia should therefore be individualized, weighing potential recovery benefits against the risk of transient hemodynamic effects. Larger and more diverse studies are needed to better define patient selection and clarify the overall risk benefit balance. These findings should be interpreted cautiously and viewed as hypothesis-generating rather than definitive evidence supporting one anesthetic strategy over another. Full article
(This article belongs to the Section Obstetrics and Gynecology)
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15 pages, 324 KB  
Review
Late Oral Complications in Childhood Cancer Survivors: Implications for Pediatric Dentistry and Survivorship Care
by Lucija Ruzman, Ana Zulijani, Tomislav Skrinjaric, Domagoj Buljan, Jasminka Stepan Giljevic, Iva Bilic Cace and Ana Milardovic
Children 2026, 13(1), 114; https://doi.org/10.3390/children13010114 - 13 Jan 2026
Abstract
Survival rates for children treated for malignant diseases continue to improve, yet many survivors face persistent late oral complications that affect function, aesthetics, and quality of life. Oncological therapy, especially at a young age and following head and neck radiotherapy or intensive chemotherapy, [...] Read more.
Survival rates for children treated for malignant diseases continue to improve, yet many survivors face persistent late oral complications that affect function, aesthetics, and quality of life. Oncological therapy, especially at a young age and following head and neck radiotherapy or intensive chemotherapy, can disrupt dental and craniofacial development, resulting in dental developmental disorders, enamel defects, salivary gland dysfunction, caries susceptibility, periodontal problems, trismus, and osteoradionecrosis of the jaw. Although these effects are partially known, they are frequently underrecognized in routine practice, and many children do not receive adequate long-term dental follow-up. A key challenge highlighted in the recent literature is the absence of structured, evidence-based guidelines for monitoring and managing late oral effects. The article emphasizes the need for clearer recommendations, better communication of oncological treatment histories, and stronger integration of dental professionals within survivorship care. Developing standardized follow-up protocols will be essential to ensure timely detection, consistent management, and improved oral health outcomes for childhood cancer survivors. This article is intended as a narrative review, synthesizing available evidence from key publications to highlight clinically relevant late oral complications and gaps in current survivorship care. Full article
13 pages, 460 KB  
Review
Right Ventricular–Pulmonary Artery Coupling as a Prognostic Marker in Cardiac Amyloidosis: A Comprehensive Review
by Nikolaos Tsiamis, Dimitrios Afendoulis, Christos Tountas, Fotios Toulgaridis, Flora Tsakirian, Sotirios Tsalamandris, Maria Drakopoulou, Kostas Tsioufis, Anastasia Kitsiou and Konstantinos Toutouzas
Life 2026, 16(1), 109; https://doi.org/10.3390/life16010109 - 12 Jan 2026
Abstract
Background: Cardiac amyloidosis (CA) is characterized by progressive myocardial infiltration leading to restrictive cardiomyopathy and heart failure. While left ventricular assessment has traditionally dominated prognostic evaluation, right ventricular (RV) dysfunction and RV–pulmonary artery (PA) coupling have emerged as critical determinants of outcomes. Objectives: [...] Read more.
Background: Cardiac amyloidosis (CA) is characterized by progressive myocardial infiltration leading to restrictive cardiomyopathy and heart failure. While left ventricular assessment has traditionally dominated prognostic evaluation, right ventricular (RV) dysfunction and RV–pulmonary artery (PA) coupling have emerged as critical determinants of outcomes. Objectives: This review synthesizes current evidence on RV–PA coupling as a prognostic marker in cardiac amyloidosis, examining measurement methodologies, prognostic significance, pathophysiological mechanisms, and clinical applications. Methods: We comprehensively reviewed the recent literature on RV–PA coupling in CA, focusing on studies published from 2020 to 2025, including both AL and ATTR subtypes. We analyzed data from multicenter cohorts, prospective registries, and validation studies examining the relationship between RV–PA coupling indices and clinical outcomes. Results: RV–PA coupling, most commonly assessed using the tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP) ratio, consistently demonstrates strong independent prognostic value for mortality and heart failure outcomes in CA patients. Impaired coupling (TAPSE/PASP < 0.45 mm/mmHg) identifies high-risk patients with hazard ratios ranging from 1.98 to 4.17 for adverse outcomes. In a multicenter cohort of 283 patients, TAPSE/PASP < 0.45 mm/mmHg was independently associated with death or heart failure hospitalization (HR 1.98, 95% CI 1.32–2.96, p = 0.001) and significantly improved risk reclassification (NRI 0.46–0.49). In ATTR-specific populations receiving disease-modifying therapy, impaired coupling (TAPSE/PASP ≤ 0.382 mm/mmHg) predicted three-year mortality with an adjusted HR of 2.99. The coupling index provides incremental value over individual RV parameters by accounting for afterload conditions and demonstrates consistent prognostic performance across both AL and ATTR subtypes. Conclusions: RV–PA coupling represents a robust, easily obtainable prognostic marker that should be routinely assessed in CA patients for risk stratification and clinical decision-making. The TAPSE/PASP ratio can be calculated from standard echocardiographic examinations without additional cost or time, making it practical for widespread implementation. Future research should focus on standardizing measurement protocols, establishing disease-specific thresholds, evaluating coupling trajectories with novel therapies, and integrating coupling assessment into staging systems and management algorithms. The strong prognostic signal, pathophysiological relevance, and ease of measurement position RV–PA coupling as an essential component of comprehensive cardiac amyloidosis evaluation. Full article
(This article belongs to the Special Issue Innovation and Translation in Cardiovascular Interventions)
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22 pages, 650 KB  
Review
Euthanasia Methods in Invertebrates: A Critical Narrative Review of Methodological and Welfare Standards
by Jaco Bakker, Melissa A. de la Garza, Margot Morel, Anne H. Outwater, John Chipangura, Job B. G. Stumpel, Francis Vercammen, Gregory A. Lewbart and Remco A. Nederlof
Animals 2026, 16(2), 222; https://doi.org/10.3390/ani16020222 - 12 Jan 2026
Abstract
Invertebrates are increasingly consumed and kept as pets, research models, and in zoological exhibits, creating a growing need to better understand their clinical management and welfare. However, the knowledge regarding nociception, pain perception, and euthanasia in invertebrates remains limited, and standardized protocols are [...] Read more.
Invertebrates are increasingly consumed and kept as pets, research models, and in zoological exhibits, creating a growing need to better understand their clinical management and welfare. However, the knowledge regarding nociception, pain perception, and euthanasia in invertebrates remains limited, and standardized protocols are largely absent. Current guidelines are incomplete, often anecdotal, and omit several major invertebrate phyla. To address this gap, we conducted a narrative review of the literature, aiming to critically evaluate existing euthanasia methods, associated welfare implications, and opportunities for refinement. The amount of peer-reviewed species-specific literature is limited and scattered. In addition, most described methods are insufficiently studied and/or do not align with our definition of euthanasia. Based on the available literature, and to provide practical guidance despite these limitations, we propose a two-step approach to invertebrate euthanasia. The first step consists of inducing anesthesia to achieve loss of responsiveness, followed by a second step; a terminal procedure involving physical or chemical destruction of the brain or major ganglia. Our review focuses on the application of this two-step approach. The effectiveness and humaneness of euthanasia techniques vary considerably across taxa and life stages. Substantial further research is required to validate and optimize humane end-of-life procedures for diverse invertebrate species. Full article
(This article belongs to the Section Animal Welfare)
18 pages, 901 KB  
Systematic Review
Laser-Based Photobiomodulation in Postoperative Tissue Healing in Oral and Maxillofacial Surgery: Systematic Review of RCTs
by Iwona Niedzielska, Grzegorz Dawiec, Rafał Wiench, Małgorzata Pihut, Dariusz Skaba and Josep Arnabat-Dominguez
J. Clin. Med. 2026, 15(2), 613; https://doi.org/10.3390/jcm15020613 - 12 Jan 2026
Abstract
Background: Postoperative bone healing can be impaired by systemic factors and surgical trauma, leading to delayed recovery. Photobiomodulation therapy (PBMT) has been proposed as a non-invasive method to enhance osteogenesis, but variability in protocols and outcomes limits its clinical use. Aim: [...] Read more.
Background: Postoperative bone healing can be impaired by systemic factors and surgical trauma, leading to delayed recovery. Photobiomodulation therapy (PBMT) has been proposed as a non-invasive method to enhance osteogenesis, but variability in protocols and outcomes limits its clinical use. Aim: To systematically review and synthesize evidence from randomized controlled trials (RCTs) evaluating PBMT’s effectiveness in promoting postoperative osteogenesis. Methods: A systematic search of PubMed, Embase, Scopus, and Cochrane Library was conducted following the PRISMA 2020 guidelines. Only RCTs comparing PBMT with sham treatment or standard care were included. Data on laser parameters, surgical indications, and outcomes such as bone regeneration, healing time, and implant stability were extracted. The risk of bias of the included randomized studies was evaluated using the Cochrane Risk of Bias 2 (RoB version 2) tool. Results: Twelve RCTs were included. PBMT consistently improved early soft tissue healing and reduced postoperative inflammation and edema. Some studies showed accelerated bone maturation, especially in grafted sockets and distraction osteogenesis, while others reported no significant long-term effects on implant stability or chronic lesion healing. Heterogeneity in laser parameters limited comparability. Conclusions: PBMT is a safe adjunct that reliably enhances early postoperative healing and may promote bone remodeling in selected cases. Standardized protocols and larger, high-quality RCTs are needed to confirm long-term benefits and optimize treatment parameters. Full article
(This article belongs to the Section Dentistry, Oral Surgery and Oral Medicine)
27 pages, 6082 KB  
Article
AGSM–CPA: Reliability-Aware Robustness for Rotation-Invariant Point Cloud Learning
by Mengyuan Ge, Shuocheng Wang, Yong Yang and Junfeng Yao
Mathematics 2026, 14(2), 278; https://doi.org/10.3390/math14020278 - 12 Jan 2026
Abstract
Rotation-invariant (RI) point cloud models aim to reduce sensitivity to viewpoint changes, but their performance still drops noticeably in real-world settings when local geometry is degraded by noise, occlusion, and uneven sampling. Once these disturbances propagate through deeper layers, they can lead to [...] Read more.
Rotation-invariant (RI) point cloud models aim to reduce sensitivity to viewpoint changes, but their performance still drops noticeably in real-world settings when local geometry is degraded by noise, occlusion, and uneven sampling. Once these disturbances propagate through deeper layers, they can lead to significant robustness degradation, especially for high-capacity RI backbones. To address this problem, we propose AGSM-CPA (Adaptive Geometric Signal Modulation with Cross-Perturbation Alignment), a lightweight and plug-and-play framework that enhances the robustness of RI models without altering their core convolutional operators. It integrates two complementary modules: the Geometric Signal-to-Noise Ratio (G-SNR) modulation mechanism, which adaptively suppresses unreliable neighborhoods based on local coordinate variance, and the Cross-Perturbation Semantic Consistency Alignment (CP-SCL) module, which enforces prediction consistency between weakly augmented inputs and strongly corrupted ones. We evaluate AGSM-CPA on ModelNet40, ScanObjectNN, and ShapeNetPart. Across standard corruption protocols, AGSM-CPA consistently improves robustness while maintaining competitive clean accuracy with negligible computational overhead. These results indicate that AGSM-CPA offers a practical, reliability-aware adapter for robust rotation-invariant point cloud learning. Full article
(This article belongs to the Section E1: Mathematics and Computer Science)
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24 pages, 1445 KB  
Review
Usefulness of Transanal Irrigation and Colon Hydrotherapy in the Treatment of Chronic Constipation and Beyond: A Review with New Perspectives for Bio-Integrated Medicine
by Raffaele Borghini, Francesco Borghini, Alessia Spagnuolo, Agnese Borghini and Giovanni Borghini
Gastrointest. Disord. 2026, 8(1), 6; https://doi.org/10.3390/gidisord8010006 - 12 Jan 2026
Abstract
Transanal Irrigation (TAI) and Colon Hydrotherapy (CHT) represent emerging therapeutic options that may complement first-line interventions or serve as rescue treatments for chronic constipation and fecal incontinence. Their clinical utility depends on patient characteristics, specific therapeutic goals, device features, and probe type, as [...] Read more.
Transanal Irrigation (TAI) and Colon Hydrotherapy (CHT) represent emerging therapeutic options that may complement first-line interventions or serve as rescue treatments for chronic constipation and fecal incontinence. Their clinical utility depends on patient characteristics, specific therapeutic goals, device features, and probe type, as well as the procedural setting. This review presents the various pathophysiological contexts in which these techniques can be applied, analyzing their specific characteristics and potential pros and cons. Moreover, these interventions are also considered within a Psycho-Neuro-Endocrino-Immunological (PNEI) framework, given the potential influence of intestinal function and microbiota modulation on the bidirectional communication pathways linking the enteric nervous system, neuroendocrine regulation, immune activity, and global patient well-being. Since there is not yet enough scientific data on this topic, future research should prioritize randomized controlled trials comparing these techniques with other standard treatments (e.g., laxatives or dietary fiber) in defined patient populations. Longitudinal studies will also be essential to clarify long-term safety, potential effects on microbiota, and both risks and benefits. Standardization of technical procedures also remains a critical need, especially regarding professional competencies, operating parameters (e.g., instilled volumes and pressure ranges), and reproducible protocols. Moreover, future investigations should incorporate objective outcome measures, as colonic transit time, stool form and frequency, indices of inflammation or intestinal wall integrity, and changes to microbiome composition. In conclusion, TAI and CHT have the potential to serve as important interventions for the treatment and prevention of chronic constipation and intestinal dysbiosis, as well as their broader systemic correlates, in the setting of bio-integrated medicine. Full article
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10 pages, 951 KB  
Case Report
Direct Pulp Capping of Dental Pulp with Two Different Autologous Platelet Concentrates A-PRF+ and H-PRF—A Report on Two Cases
by Janet Kirilova and Dimitar Yovchev
Dent. J. 2026, 14(1), 48; https://doi.org/10.3390/dj14010048 - 12 Jan 2026
Abstract
Background: Autologous platelet concentrates, including platelet-rich fibrin (PRF) matrices, have been proposed as biologically active scaffolds for vital pulp therapy. Evidence on the clinical use of different solid PRF matrices for direct pulp capping remains limited. Objective: The aim of this [...] Read more.
Background: Autologous platelet concentrates, including platelet-rich fibrin (PRF) matrices, have been proposed as biologically active scaffolds for vital pulp therapy. Evidence on the clinical use of different solid PRF matrices for direct pulp capping remains limited. Objective: The aim of this study is to describe and monitor two clinical cases of reversible pulpitis treated with direct pulp capping using two PRF membranes prepared by different centrifugation approaches, namely advanced platelet-rich fibrin plus (A-PRF+) and horizontal platelet-rich fibrin plus (H-PRF). Methods: In Case 1, A-PRF+ was prepared using a fixed-angle centrifugation protocol; in Case 2, H-PRF was prepared using a horizontal centrifugation protocol. In both cases, deep carious lesions with small carious pulp exposures (<1.5 mm) were managed by caries removal, ozone-assisted dentin disinfection, and direct pulp capping with the respective PRF membrane, followed by temporary calcium-silicate cement definitive coronal restoration. Clinical and radiographic follow-up, including cone-beam computed tomography, was performed for up to 12 months. Results: In Case 1 (A-PRF+), reparative dentin bridge formation was confirmed at 90 days, with a thickness of 0.2 mm. In Case 2 (H-PRF), reparative dentin was observed within 46 days, with a thickness of 0.28 mm. In both cases, pulp vitality was maintained, and no clinical symptoms or periapical changes were detected during the 12-month follow-up. Conclusions: These two cases suggest that direct pulp capping using PRF membranes (A-PRF+ or H-PRF), combined with ozone-assisted dentin disinfection and adequate coronal sealing, may be associated with maintained pulp vitality and hard-tissue repair after carious pulp exposure diagnosed as reversible pulpitis. Due to the descriptive two-case design and major confounding factors (including age and lesion characteristics), no comparative conclusions can be drawn. Prospective controlled clinical studies with standardized protocols are warranted. Full article
(This article belongs to the Special Issue Regenerative Dentistry: Innovations and Clinical Applications)
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11 pages, 1149 KB  
Article
Time- and Cost-Efficient, Minimally Invasive Comparative Assessment of Implant Stability: Reliability and Inter-Examiner Agreement of IST Versus ISQ Across Different Bone Quality Models
by Sung-Joon Kim and Se Hoon Kahm
Bioengineering 2026, 13(1), 86; https://doi.org/10.3390/bioengineering13010086 - 12 Jan 2026
Abstract
This study evaluated the reliability and inter-examiner agreement of the Implant Stability Test (IST) by Anycheck compared to the established Implant Stability Quotient (ISQ) by Osstell across different bone quality types. Seven dental hygienists with varying experience levels performed stability measurements using both [...] Read more.
This study evaluated the reliability and inter-examiner agreement of the Implant Stability Test (IST) by Anycheck compared to the established Implant Stability Quotient (ISQ) by Osstell across different bone quality types. Seven dental hygienists with varying experience levels performed stability measurements using both devices on standardized implant models representing hard, normal, and soft bone qualities. Both IST and ISQ demonstrated excellent inter-examiner reliability (ICC > 0.90) across all bone quality types, with strong positive correlations (r > 0.85) between measurements regardless of bone density. No significant differences were found in measurement consistency between examiners with different experience levels for either device. The results demonstrate that IST provides comparable reliability to ISQ for implant stability assessment, with excellent inter-examiner agreement and accessibility for practitioners with varying experience levels. The IST system offers practical advantages including elimination of SmartPeg requirements, reduced abutment manipulation, and simplified measurement protocols, supporting its potential as a reliable and cost-effective alternative to traditional ISQ measurements under standardized experimental conditions. Full article
(This article belongs to the Special Issue Advanced Restorative Dental Materials and Implant Technologies)
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