Search Results (2,479)

Background: Emotion processing is critical in the neuropathology of major depressive disorder (MDD), while its relationship with clinical treatment remains unclear. This study aims to indicate the associations between emotion processing and treatment effects following a sequential dual-site accelerated repetitive transcranial magnetic stimulation (rTMS) protocol. Methods: MDD patients were recruited to receive rTMS treatment with four sessions per day for four consecutive days, with stimulation sequentially delivered to the left dorsolateral prefrontal cortex (dlPFC) and the dorsomedial prefrontal cortex (dmPFC). Symptoms were assessed at baseline, end of treatment, and week 4 using the Montgomery–Åsberg Depression Rating Scale (MADRS), Snaith-Hamilton Pleasure Scale (SHAPS), and Fatigue Severity Scale (FSS). Emotional valence and arousal were evaluated with the Affect Rating Task (ART). Results: A total of 51 participants completed the clinical assessments and ART, with two excluded due to missing baseline data in the SHAPS and FSS. The linear mixed-effects models revealed significant improvement in depressive (p < 0.001, d = −0.343) and fatigue symptoms (p = 0.010, d = −0.572) following rTMS treatment. Neutral valence was correlated with MADRS scores at baseline (R² = 0.096, p = 0.027). In addition, changes in arousal for positive images (p = 0.047, adjusted R² = 0.097) and neutral images (p = 0.019, adjusted R² = 0.160) at treatment end were significantly correlated with MADRS improvement at week 4. Conclusions: Our study highlights the association between changes in emotional arousal and improvement in MDD following accelerated dlPFC-dmPFC dual-site rTMS treatment. Full article

Microplastics (MPs) can serve as bearers of microorganisms and additional contaminants. However, the functional composition and assembly processes of plastisphere bacteria in co-contaminated soil–plant systems are not yet well understood. Using a pot experiment, we examined the effects of both individual and combined cadmium (Cd) and polypropylene (PP) MP contamination on the development of the bioenergy plant sorghum. The bacterial community, co-occurrence networks, and assembly processes in the rhizosphere soil and PP plastisphere were investigated using high-throughput sequencing. Compared with contamination by a single compound, combined contamination with Cd and PP had a more potent inhibitory effect on the development of sorghum. PCoA and diversity indices indicate that the bacterial community on PP plastics is structurally simpler than that in rhizosphere soil. The PP plastisphere could recruit bacteria from the genera Sphingomonas, Rhizobium, and Bacillus. The bacterial communities in the soil and the PP plastisphere were mostly formed by stochastic processes, with diffusion limitation playing a greater role in the bacterial community in the PP plastisphere. Co-occurrence network analysis revealed differences between the bacterial communities in the soil and in the PP plastisphere, with the network in the PP plastisphere showing lower complexity and connectivity. Functional prediction revealed that the prevalence of nitrogen cycling genes was greater in the PP plastisphere than in the dirt and that the PP plastisphere presented greater metabolic activity. The relative prevalence of metabolic pathways associated with human diseases was markedly elevated in the PP plastisphere, which may be correlated with the dissemination of pathogenic microorganisms. These findings indicate that the PP plastisphere, as a distinct microbial niche, might attract certain bacteria, consequently affecting the functional characteristics of cocontaminated soil–plant systems. Full article

Background: Type 2 diabetes mellitus (T2DM) and periodontitis are highly prevalent immune-inflammatory diseases that interact bidirectionally. However, how early-onset T2DM, periodontitis, and adverse lifestyle behaviors collectively remodel the gingival plaque microbiome at the ecological network level remains poorly understood in Indian populations. Methods: A cross-sectional 16S rRNA gene (V3–V4) sequencing study was conducted on supragingival and subgingival plaque from 60 adults (30–40 years) recruited in Mumbai. Participants were categorized as healthy (H, n = 10), periodontitis (P, n = 10), T2DM (n = 20), and T2DM with periodontitis (T2DM_P, n = 20). Comprehensive demographic, anthropometric, metabolic, periodontal, dietary, lifestyle, and oral hygiene data were collected. Sequence data were processed using QIIME2–DADA2, followed by diversity, differential abundance, and genus-level co-occurrence network analyses (Spearman |r| ≥ 0.6, FDR < 0.05; core prevalence ≥ 70%). Results: α-diversity showed no marked depletion across groups, whereas Bray–Curtis β-diversity revealed significant global separation, with maximal dissimilarity between H and T2DM_P. Healthy individuals with favorable lifestyle behaviors harbored scaffold-forming taxa such as Corynebacterium matruchotii, Lautropia mirabilis, and Capnocytophaga spp. In contrast, P and T2DM_P groups showed enrichment of proteolytic, inflammation-adapted genera including Porphyromonas, Tannerella, Treponema, Fretibacterium, Peptostreptococcus, and Selenomonas. Network analysis revealed a shift from commensal-rich modular networks to densely connected, keystone-centered disease modules. Conclusion: Early-onset T2DM and periodontitis, particularly under adverse lifestyle behaviors, reorganize plaque microbial composition and interaction architecture rather than depleting diversity, highlighting plaque-based keystone taxa and networks as targets for microbiome-informed risk stratification and integrated medical–dental–lifestyle interventions. Full article

Objectives: This study aims to explore the facilitators and barriers in the process of using AI agents for disease management in older COPD patients. Methods: Based on the normalization process theory, a descriptive qualitative study was used to conduct semi-structured interviews with 28 older patients with COPD recruited from June to August 2025 in a Class A tertiary hospital in Wuxi, Jiangsu Province. Results: A total of 28 interviews were conducted. Four themes (Coherence, Cognitive Participation, Collective Action, Reflexive Monitoring), nine subthemes (recognition of intelligent technology;supported by policy discourse and the background of national-level projects; the creation of a family atmosphere; recommendations from HCPs; relief and social connection; new “doctor”–patient relationship and communication; eliminate the burden and return to life; benefit and value perception; right self-decision by AI) in facilitators and nine subthemes (privacy conflicts and trust deficiency; blurred boundaries of human–machine responsibility and authority; non-high-quality services are chosen reluctantly; technical anxiety; lack of motivation for continued engagement; extra burden; limitations of the physical environment; human–machine dialogue frustration; a sense of uncertainty about the future of AI) in barriers were extracted. Conclusions: This study identified key factors influencing the use of AI agents in chronic disease management in older patients with COPD. The results provide directions for improving the implementation and sustainable use of AI health technologies. Full article

Introduction: Timely access to healthcare is essential for improving population health and reducing inequities. Immigrants often experience unique cultural, linguistic, and systemic barriers that delay care-seeking and service utilization. Despite the rapid growth of the Nepalese community in Canada, there is limited empirical evidence examining their healthcare access. This study aimed to assess the prevalence and determinants of delays in accessing healthcare among Nepalese immigrants. Methods: A community-based participatory research (CBPR) framework guided a cross-sectional survey conducted between January and June 2019. The research process was co-led by academic investigators, community scholars, and local Nepalese organizations to ensure cultural and contextual relevance. A snowball sampling strategy was used to recruit 401 Nepalese adults. Data were analyzed using descriptive statistics and multivariable logistic regression to examine sociodemographic and health-related factors associated with delayed healthcare access. Results: Of the 401 respondents, 66.3% (n = 266) reported experiencing a delay in accessing healthcare within the preceding 12 months. Delays were more common among participants aged 26–45 years, those who were married, employed, or had an undergraduate degree or lower. After adjusting for covariates, older age, lower education, having a family doctor, higher income (≥$26,000), and one or more chronic conditions were associated with increased odds of delay. Family size and the number of years living in Canada have had little effect on care delay. Conclusions: Delays in accessing healthcare are common among Nepalese immigrants in Calgary, reflecting the intersection of individual, cultural, and systemic determinants. These findings underscore the importance of community-engaged, culturally responsive strategies to address barriers and promote equitable healthcare access for immigrant populations. Strengthening partnerships between health systems and immigrant communities may enhance trust, navigation, and continuity of care. Full article

Arteriogenesis, the growth of pre-existing arterioles into functional collateral arteries, represents a key adaptive response to severe arterial stenosis. This process is driven by hemodynamic forces and a tightly coordinated inflammatory cascade. Here, we investigated the effects of pharmacological stimulation of the nitric oxide-cyclic guanosine monophosphate (NO-cGMP) signaling pathway using the phosphodiesterase-5 (PDE5) inhibitor Sildenafil on collateral vessel growth in a murine model of femoral artery ligation (FAL). Flow cytometric analyses revealed that Sildenafil treatment significantly enhanced platelet–leukocyte aggregate formation, a prerequisite for the subsequent initiation of a localized perivascular inflammation. Histological and immunofluorescence analyses further demonstrated a marked increase in mast cell recruitment and degranulation at early time points (days 1 and 3 post-FAL). In addition, Sildenafil promoted perivascular macrophage accumulation on days 3 and 7, with a pronounced shift toward an M2-like pro-regenerative polarization state, ultimately resulting in the enhanced proliferation of vascular cells and the enlargement of collateral diameters. Together, these findings identify Sildenafil as a potent enhancer of arteriogenesis through coordinated immune cell activation, stimulating vascular cell proliferation along with positive collateral outward remodeling. Thus, Sildenafil emerges as a promising therapeutic candidate to promote collateral artery growth in cardiovascular occlusive diseases. Full article

Technical job interviews have become a vulnerable environment for social engineering attacks, particularly when they involve direct interaction with malicious code. In this context, the present manuscript investigates an exploratory case study, aiming to provide an in-depth analysis of a single incident rather than seeking to generalize statistical evidence. The study examines a real-world covert attack conducted through a simulated interview, identifying the technical and psychological elements that contribute to its effectiveness, assessing the performance of artificial intelligence (AI) assistants in early detection and proposing mitigation strategies. To this end, a methodology was implemented that combines discursive reconstruction of the attack, code exploitation and forensic analysis. The experimental phase, primarily focused on evaluating 10 large language models (LLMs) against a fragment of obfuscated code, reveals that the malware initially evaded detection by 62 antivirus engines, while assistants such as GPT 5.1, Grok 4.1 and Claude Sonnet 4.5 successfully identified malicious patterns and suggested operational countermeasures. The discussion highlights how the apparent legitimacy of platforms like LinkedIn, Calendly and Bitbucket, along with time pressure and technical familiarity, act as catalysts for deception. Based on these findings, the study suggests that LLMs may play a role in the early detection of threats, offering a potentially valuable avenue to enhance security in technical recruitment processes by enabling the timely identification of malicious behavior. To the best of available knowledge, this represents the first academically documented case of its kind analyzed from an interdisciplinary perspective. Full article

Liver cancer, also known as hepatocellular carcinoma (HCC), remains a major global health concern, with high mortality driven by late-stage diagnosis, limited treatment efficacy, and frequent therapeutic resistance. Matrix metalloproteinases (MMPs), a large family of zinc-dependent endopeptidases, are central to the biological processes that drive liver tumor initiation and progression. By degrading and reorganizing extracellular matrix components, MMPs facilitate tumor expansion, tissue invasion, and metastatic dissemination. In addition, these enzymes regulate the availability of growth factors, cytokines, and chemokines, thereby influencing angiogenesis, inflammation, immune cell recruitment, and the development of an immunosuppressive tumor microenvironment. Aberrant expression or activity of multiple MMP family members is consistently associated with aggressive clinicopathologic features, including vascular invasion, increased metastatic potential, and reduced patient survival, highlighting their promise as prognostic markers and actionable therapeutic targets. Past attempts to modulate MMP activity were hindered by broad inhibition profiles and dose-limiting toxicities, underscoring the need for improved specificity and delivery strategies. Recent advances in molecular design, biologics engineering, and nanotechnology have revitalized interest in MMP targeting by enabling more selective, context-dependent modulation of proteolytic activity. Preclinical studies demonstrate that carefully tuned MMP inhibition can limit tumor invasion, enhance anti-angiogenic responses, and potentially improve the efficacy of existing systemic therapies, including immuno-oncology agents. This review synthesizes current knowledge on the multifaceted roles of MMPs in HCC pathobiology and evaluates emerging therapeutic strategies that may finally unlock the clinical potential of targeting these proteases. Full article

Objective: To better define potential executive function difficulties in individuals living with HIV but not clinically identified as having HAND, with and without mild to moderate cocaine dependence (CD), our cross-sectional study examined executive function performance on the Stroop Color-Word Test (Stroop) and the Trail Making Test (TMT) in four groups stratified by HIV and CD status. Method: We recruited 101 participants (26 HIV+/CD+; 18 HIV+/CD−; 30 HIV−/CD+; 27 HIV−/CD−). We utilized a 2 (HIV: yes/no) × 2 (Cocaine: yes/no) MANCOVA while controlling for age and premorbid intelligence on the Stroop trials (i.e., color-naming, word-reading, interference), and TMT-A and TMT-B z-scores, number of errors, and the B/A ratio. Results: HIV was associated with significantly slower performance on the Stroop Interference (p = 0.012, η² = 0.064). CD showed a trend towards slower performance on interference trials (p = 0.061, η² = 0.037) and was associated with significantly more errors on the Stroop Word-Reading (p = 0.028, η² = 0.050) and Interference trials (p = 0.046, η² = 0.041), suggestive of difficulties with inhibitory control and written language processing. There were no significant HIV × Cocaine interactions. Conclusions: Our results suggest HIV without clinically identified cognitive impairment and CD are associated with distinct and potentially overlapping executive functioning deficits, particularly for measures of inhibitory control. Notably, CD showed trend-level slowing on Stroop Interference performance, suggesting partial overlap with HIV effects. Clarifying the specific cognitive processes impacted by HIV and CD can help guide tailored interventions to improve functional outcomes in these populations. Full article

Background: Organ transplant offers patients a second chance at life, yet chronic rejection remains a formidable barrier to long-term success. Unlike the instantaneous storm of acute rejection, chronic rejection is a slow, unremitting process that silently remodels vessels, scars tissues, and diminishes graft function. At the center of this process are macrophages, immune “shapeshifters” that can heal or harm depending on their cues. Methods: This manuscript systematically reviews and synthesizes the current evidence from experimental studies and clinical observations, as well as molecular insights, to unravel how macrophages orchestrate chronic rejection. It travels over macrophage origins alongside their dynamic polarization into pro-inflammatory (M1) or pro-repair yet fibrotic (M2) states. The discussion integrates mechanisms of recruitment, antigen presentation, vascular injury, and fibrosis, while highlighting the molecular pathways (NF-κB, inflammasomes, STAT signaling, metabolic rewiring) that shape macrophage fate. Results: Macrophages play a central role in chronic rejection. Resident macrophages, once tissue peacekeepers, amplify inflammation, while recruited monocyte-derived macrophages fuel acute injury or dysfunctional repair. Together, they initiate transplant vasculopathy through cytokines, growth factors, and matrix metalloproteinases, slowly narrowing vessels and starving grafts. Donor-derived macrophages, often overlooked, act as early sentinels and long-term architects of fibrosis, blurring the line between donor and host immunity. At the molecular level, macrophages lock into destructive programs, perpetuating a cycle of inflammation, vascular remodeling, and scarring. Conclusions: Macrophages are not passive bystanders but pivotal decision makers in chronic rejection. Their plasticity, while a source of pathology, also opens therapeutic opportunities. Emerging strategies like macrophage-targeted drugs, immune tolerance approaches, gene and exosome therapies currently offer ways to reprogram these cells and preserve graft function. By shifting the macrophage narrative from saboteurs to guardians, transplantation medicine may transform chronic rejection from an inevitability into a preventable complication, extending graft survival from fleeting years into enduring decades. Full article

DNA double-strand breaks (DSBs) can be induced by cellular byproducts or genotoxic agents. Improper processing of these lesions leads to increased genome instability, which constitutes a hallmark of pathological conditions and fuels carcinogenesis. DSBs are primarily repaired by homologous recombination (HR) and non-homologous end joining (NHEJ) and the proper balance between these two pathways is finely modulated by specific molecular events. Here, we report that the histone chaperone DAXX plays a fundamental role in the response to DSBs. Indeed, in human cells, DSBs induce ATM/ATR-dependent phosphorylation of DAXX on serine 424 and 712 and promote its binding to chromatin and the deposition of the histone variant H3.3 in proximity to DNA breaks. Enrichment of H3.3 at DSBs promotes 53BP1 recruitment to these lesions and the repair of DNA breaks by HR pathways. Moreover, H3.3-specific post translational modifications, particularly K36 tri-methylation, play a key role in these processes. Altogether, these findings indicate that DAXX and H3.3 mutations may contribute to tumorigenesis-enhancing genome instability. Full article

Root exudates are key mediators of plant–soil–microbe interactions, shaping rhizosphere dynamics and influencing agroecosystem resilience. Comprising diverse primary and secondary metabolites, these compounds are actively secreted through specific transport pathways and are modulated by intrinsic plant traits and environmental conditions. Root exudates serve as chemical signals that recruit and structure microbial communities, facilitating nutrient mobilization, microbial feedbacks, and the regulation of plant growth and stress responses. By modulating soil chemical, physical, and biological properties, exudates contribute to carbon cycling, soil health, and the maintenance of ecosystem services. Moreover, they play multifunctional roles in enhancing plant tolerance to abiotic and biotic stresses, while also mediating interactions with neighboring plants. This review provides a holistic perspective on root exudation, encompassing their mechanisms and drivers, roles in rhizosphere ecology and plant stress adaptation, and methodological advances, while highlighting opportunities to harness these processes for resilient, productive, and sustainable agroecosystems. Full article

Background and Objectives: Telemedicine has become an essential component of chronic Inflammatory Bowel Disease (IBD) care, yet the factors that shape patient satisfaction with remote consultations remain only partially understood. This study aimed to assess satisfaction with institutional telemedicine services among Italian patients with ulcerative colitis (UC) and Crohn’s disease (CD), and to identify sociodemographic, clinical and organisational predictors to inform more person-centred telehealth models. Materials and Methods: We conducted a prospective, multi-centre, cross-sectional study in three IBD units in northern, central and southern Italy between June and October 2024. Consecutive adult patients who had completed a scheduled, non-emergency telemedicine visit were invited within 24–48 h to complete an online questionnaire including the Italian Telemedicine Satisfaction Questionnaire (I-TSQ), sociodemographic items, IBD-related variables, and telemedicine process indicators (accessibility, technology usability, technical support, time saved). Data were analysed descriptively and with multivariable linear regression to determine independent predictors of satisfaction, adjusting for recruiting centre. Results: A total of 705 patients participated (54.9% UC; 55.3% disease duration > 10 years). Overall, telemedicine satisfaction was high (mean I-TSQ total 57.5 ± 4.9; range 35–70), and all respondents reported reduced indirect costs compared with in-person visits. Greater ease of technology use, more frequent contact with the care team, male sex, older age, and employment were independently associated with higher satisfaction scores. Conversely, first-ever teleconsultations, CD, subcutaneous therapies, more difficult platform access, and the need for technical support were linked to lower satisfaction. Model fit was modest (R² up to 0.20), suggesting the presence of additional unmeasured relational and contextual factors. Conclusions: Telemedicine for IBD is widely accepted in Italy, but satisfaction is strongly conditioned by digital usability, previous experience, and clinical complexity. Tailored telehealth pathways that incorporate user-friendly platforms, proactive technical support, and attention to vulnerable subgroups are needed to translate high satisfaction into sustained, equitable remote care. Full article

Vista landscapes of historic cities embody unique spatial order and cultural memory, and the scientific quantification of their visual quality presents a common challenge for both heritage conservation and urban renewal. Focusing on the Beijing Central Axis, this study integrates VR panoramic technology with the SBE-SD evaluation method to develop a visual quality assessment framework suitable for vista landscapes of historic cities, systematically evaluating sectional differences in scenic beauty and identifying their key influencing factors. Thirteen typical viewing places and 17 assessment points were selected, and panoramic images were captured at each point. The evaluation framework comprising 3 first-level factors, 11 secondary factors, and 24 third-level factors was established, and a corresponding scoring table was designed through which students from related disciplines were recruited to conduct the evaluation. After obtaining valid data, scenic beauty values and landscape factor scores were analyzed, followed by correlation tests and backward stepwise regression. The results show the following: (1) The scenic beauty of the vista landscapes along the Central Axis shows sectional differentiation, with the middle section achieving the highest scenic beauty value, followed by the northern section, with the southern section scoring the lowest; specifically, Wanchunting Pavilion South scored the highest, while Tianqiao Bridge scored the lowest. (2) In terms of landscape factor scores, within spatial form, color scored the highest, followed by texture and scale, with volume scoring the lowest; within marginal profile, integrity scored higher than visual dominance; within visual structure, visual organization scored the highest, followed by visual patches, with visual hierarchy scoring the lowest. (3) Regression analysis identified six key influencing factors, ranked in descending order of significance as follows: color coordination degree of traditional buildings, spatial openness, spatial symmetry, hierarchy sense of buildings, texture regularity of traditional buildings, and visual dominance of historical landmark buildings. This study establishes a quantitative assessment pathway that connects subjective perception and objective environment with a replicable process, providing methodological support for the refined conservation and optimization of vista landscapes in historic cities while demonstrating the application potential of VR panoramic technology in urban landscape evaluation. Full article

Objectives: The aim of the present study was to adapt the Sharenting Evaluation Scale to Turkish and to test its reliability and validity. Methods: Through an online data collection platform, we recruited 391 parents (M_age = 42.2, SD_age = 5.6, 76% female). They have at least one child under 18 years of age and actively engage with social media. Sharenting Evaluation Scale consists of 17 items rated on a 6-point Likert scale. Its Turkish adaptation underwent a two-phase process: exploratory and confirmatory factor analyses, along with testing for construct validity. Results: The exploratory factor analysis revealed that the 17 items in the questionnaire were loaded onto two factors (Social Behavior and Implications). The confirmatory factor analysis indicated that the two-factor model fitted the current sample well. To evaluate the construct validity of the Sharenting Evaluation Scale, we compared groups at the extreme ends of the scoring spectrum. A t-test was conducted to compare the scores of both groups across subscales, revealing a significant difference. We observed positive correlations between sharenting and parental self-regulation, authoritative parenting, permissive parenting, and digital media literacy which indicate the criterion validity. Conclusions: In conclusion, the current study demonstrates that the Turkish version of the Sharenting Evaluation Scale is a reliable and valid tool. Full article