Search Results (11,570)

Background/Objectives: Methylphenidate is one of the most widely prescribed psychostimulants for attention-deficit/hyperactivity disorder, with increasing global use. Its pharmacological action on dopaminergic pathways raises concerns regarding its addictive potential. This systematic review aims to synthesize current evidence on the addictive properties of methylphenidate, including misuse, abuse, tolerance, craving, and withdrawal symptoms. Methods: This systematic review was conducted in accordance with PRISMA guidelines and registered in the PROSPERO database under registration number CRD420261303803. Literature searches were performed in PubMed, Web of Science, and Google Scholar without time restrictions. Studies assessing behavioral, subjective, or neurobiological indicators of methylphenidate addiction were included. Eligible designs comprised randomized controlled trials, observational studies, neuroimaging studies, case reports, and relevant preclinical models. Study quality was assessed using the EPHPP tool. A total of 35 studies were included in the qualitative synthesis. Results: The evidence demonstrated that methylphenidate produced measurable reinforcing effects and subjective drug liking, which were found to be closely related to craving and to depend on dose, pharmacokinetics, and route of administration. Rapid increases in brain dopamine levels, particularly following non-oral or high-dose administration, were associated with higher abuse potential. Misuse was observed to be more common among individuals without ADHD and was often motivated by cognitive enhancement rather than euphoria. In contrast, appropriately monitored therapeutic use was associated with a low observed risk of substance use disorders. Pharmacodynamic tolerance was identified in a subset of patients, whereas a classical withdrawal syndrome was not consistently observed and was generally limited to symptom recurrence. Conclusions: Methylphenidate exhibits measurable addictive potential. However, its clinical significance is context-dependent. Under therapeutic conditions, the risk of addiction is low, whereas it increases substantially with non-medical use, high doses, and alternative routes of administration. These findings support careful patient selection, preference for extended-release formulations, and monitoring of misuse risk. Full article

Background/Objectives: Translabyrinthine (TL) surgery is established for vestibular schwannomas, but its role in a homogeneous posterior petrous face meningioma (PPFM) cohort remains undefined. We characterized surgical, functional, and oncological outcomes and associations with extension and tumor burden. Methods: We retrospectively reviewed 14 patients undergoing TL-only resection at a single institution (2006–2024). Petrosal zones (anterior, middle, posterior) were modeled independently. Outcomes included extent of resection, Simpson grade, complications, tumor control, House–Brackmann (HB) facial nerve (FN) grade, modified Rankin Scale (mRS), and Glasgow Outcome Scale (GOS). Results: Preoperatively, 10 (71.4%) had non-serviceable or absent hearing, and the median diameter was 33.5 mm. Gross or near-total resection was achieved in 85.7% (median extent, 96.2%). At 1 year, 13 of 14 (92.9%) had HB I–II, including all 12 with favorable preoperative function; all had favorable outcomes (mRS 0–2; GOS 4–5). Over a median 65.5-month follow-up, one recurrence and three regrowths occurred, with five patients (35.7%) receiving adjuvant radiation. In exploratory analyses, anterior involvement was associated with a lower likelihood of Simpson grade 1–2 resection (p = 0.025), but not with volumetric extent; tumor diameter correlated with complication burden (ρ = 0.585; p = 0.028), and tumor volume correlated with operative duration (ρ = 0.607; p = 0.021) and hospital stay (ρ = 0.753; p = 0.002). Conclusions: In this first TL-only PPFM series, FN and functional outcomes were favorable and tumor control was acceptable under multimodal management. These findings describe outcomes achievable through the TL corridor in appropriately selected patients rather than an advantage over alternative approaches. Exploratory associations between anterior extension, tumor burden, and outcome require confirmation in larger cohorts. Full article

Under the vehicle as a service (VaaS) paradigm, intelligent connected vehicles continuously generate large-scale, computation-intensive perception data processing tasks. However, limited onboard computing resources and power supply prevent vehicles from handling these tasks efficiently. Vehicular edge computing (VEC) extends available computing resources through vehicle–infrastructure collaboration. Nevertheless, continuous vehicle mobility causes intermittent communication links between vehicles and roadside units, posing new challenges for VEC task scheduling. Therefore, this paper proposes a reinforcement learning-based VEC task scheduling approach that integrates a fuzzy reward mechanism with multi-agent proximal policy optimization (FRMPPO). First, a system architecture is developed by integrating the directed acyclic graph task model, dynamic communication model, and computation model. The scheduling problem is formulated as a partially observable Markov decision process, with the objective of minimizing task completion latency and vehicle energy consumption. Second, a fuzzy reward mechanism is designed to guide the training of multi-agent proximal policy optimization. It takes edge node load pressure and communication state as inputs to adaptively combine local immediate rewards and the global reward, eventually guiding the agents toward a globally optimized cooperative policy. Finally, real-time scheduling decisions under communication intermittency are enabled through a centralized training and decentralized execution framework and gated recurrent unit-based state encoding. Simulation results demonstrate that FRMPPO effectively solves the VEC task scheduling problem, achieving significantly superior performance over existing algorithms in terms of both task completion latency and vehicle energy consumption. The proposed method thereby satisfies the real-time processing demands of perception tasks in VaaS scenarios. Full article

Efficient parsing of manufacturing process data is a key enabler for the informatization of intelligent manufacturing systems. However, network isolation in aerospace-specific job shops makes large volumes of unstructured shop-floor data, such as handwritten production reports and equipment logs, inaccessible to existing information systems. To tackle this, we propose a comprehensive parsing framework that covers data acquisition, parsing, and structured output. For handwritten report parsing, we devise a collaborative pipeline comprising text detection via the Differentiable Binarization Network (DBNet); text recognition using an enhanced Convolutional Recurrent Neural Network (CRNN) that incorporates Asymmetric Convolution (AC) and a Simple Attention Module (SimAM)-based residual module (SimRes, short for SimAM ResNet), referred to as AC-SimRes-CRNN; and table structure extraction via TableMaster. The predicted table cell coordinates, detected text-region coordinates, and recognized text contents are subsequently aggregated to reconstruct complete tables, which are then exported as Excel files. Experiments on the CASIA-HWDB2x and IAM datasets show that AC-SimRes-CRNN achieves an Accurate Rate (AR) of 91.36% and a Correct Rate (CR) of 93.17% on Chinese handwritten text recognition and a Character Error Rate (CER) of 7.85% and a Word Error Rate (WER) of 26.83% on English handwritten text recognition, demonstrating competitive performance against representative methods. Ablation studies validate the contributions of both AC and SimRes. A case study on an aerospace equipment maintenance report further illustrates the component-level feasibility of the proposed workflow. Full article

Objectives: To compare the extent of meibomian gland loss in pediatric patients with blepharo-keratoconjunctivitis (BKC), allergic conjunctivitis, and healthy controls using non-contact infrared meibography. Methods: This retrospective observational study included 81 patients aged 18 years or younger: 20 with BKC, 29 with allergic conjunctivitis, and 32 healthy controls. Meibomian gland loss in the upper and lower eyelids was quantified on non-contact infrared meibography images. Right and left eyes were analyzed separately, and only eyes with the same laterality were compared among groups. Results: Meibomian gland loss was significantly greater in the BKC group than in the allergic conjunctivitis and control groups in all four eyelids (right, left, upper and lower; all p < 0.001). In contrast, gland loss in allergic conjunctivitis showed intermediate values between BKC and controls and did not differ significantly from controls in some eyelids. Within the BKC group, meibomian gland loss did not differ significantly between eyes with and without overt corneal or conjunctival lesions (p ≥ 0.05). Conclusions: Pediatric patients with BKC demonstrate marked meibomian gland loss compared with allergic conjunctivitis and healthy eyes. These findings suggest that BKC represents a particularly aggressive form of MGD. Importantly, early recognition and appropriate treatment of BKC in pediatric patients may help prevent recurrent inflammation and halt further meibomian gland loss, thereby reducing long-term MGD. Full article

Background/Objectives: Breast/chest wall (B/CW) re-irradiation (reRT) is approached cautiously because of concerns regarding late toxicity and uncertain benefit. Contemporary data on mature toxicity and oncologic outcomes after external beam photon reRT are limited. Methods: This retrospective cohort included 113 consecutive patients who completed reRT after resection of locoregionally recurrent breast cancer between 2010 and 2024. The primary endpoint was cumulative incidence of late grade ≥ 2 CTCAE toxicity, analyzed using competing-risks methods. Secondary endpoints were locoregional recurrence-free survival (LRRFS) and local failure (LF), assessed using Kaplan–Meier, Cox regression, and Fine–Gray modeling. Results: Median age at reRT was 66 years. Most recurrences were early-stage (72.6%) and hormone receptor-positive (68.1%). Median cumulative EQD2 was 94.9 Gy, and 25.7% received IMRT. At 67.1 months’ median follow-up, 5-year cumulative incidences of grade ≥ 2 and grade 3 toxicity were 35.4% (95% CI, 25.6–45.1) and 3.9% (95% CI, 0.1–7.8), respectively. Higher cumulative EQD2 predicted grade ≥ 2 toxicity (SHR, 1.94 per 10 Gy; p < 0.001) and grade 3 toxicity (SHR, 4.32 per 10 Gy; p < 0.001). Longer interval between radiotherapy courses (p = 0.029) and IMRT (SHR, 0.40; p = 0.005) were associated with lower grade ≥ 2 toxicity. Five-year LRRFS was 84.2% (95% CI, 76.7–92.4), and LF was 6.8%. Advanced-stage disease and second or subsequent recurrence predicted inferior LRRFS. Partial B/CW reRT did not compromise disease control in early-stage recurrences. Conclusions: Adjuvant breast and chest wall re-irradiation using external photons achieved durable locoregional control with low rates of severe late toxicity in one of the largest reported cohorts. These findings support individualized curative-intent reRT guided by cumulative dose, technique, and recurrence risk. Full article

Background: Obstructive sleep apnea syndrome (OSA) is a significant disorder characterized by recurrent upper airway obstruction. Cervical vertebral alignment and lordosis angles may influence airway cross-sectional area. This study aimed to investigate the relationship between cervical lordosis angles and disease severity in patients with OSA. Methods: The study included 30 patients with OSA (mild n = 6, moderate n = 11, severe n = 13 based on Apnea–Hypopnea Index [AHI]) and 30 non-OSA controls presenting with mechanical neck pain. C1–C2, C1–C7, and C2–C7 angles were measured using the Cobb method on lateral cervical cephalometric radiographs. Additional soft tissue and airway parameters — prevertebral soft-tissue thickness at C2 (PST-C2) and C4 (PST-C4), posterior airway space (PAS), and mandibular plane–hyoid distance (MP-H)— were measured as anatomical surrogates given the unavailability of BMI data. Multiple linear regression (ANCOVA) models adjusting for age and sex were constructed for each cervical angle. Results: All cervical angles were significantly reduced in patients with OSA compared to controls (C1–C2: 25.51 ± 6.47° vs 33.3 ± 4.44°; C1–C7: 35.0 ± 11.9° vs 51.2 ± 7.34°; C2–C7: 9.19 ± 10.6° vs 19.9 ± 5.05°; all p < 0.001). Within the OSA group, a significant moderate negative correlation was found between AHI and the C2–C7 angle (ρ = − 0.522, p = 0.003), while the C1–C7 angle showed a borderline association (ρ = −0.361, p = 0.050) and C1–C2 did not reach significance (ρ = +0.118, p = 0.534). After adjustment for age and sex, group membership (OSA vs. control) remained a strong, independent predictor of all three cervical angles (all p < 0.001), whereas neither age nor sex was a significant predictor (all p > 0.34). PST-C2 was significantly higher in the OSA group (4.93 ± 1.06 mm vs. 4.30 ± 0.70 mm, p = 0.017), whereas PST-C4, PAS, and MP-H did not differ significantly between groups (all p > 0.05), and none of these parameters correlated significantly with the C2–C7 angle. Conclusions: Significant cervical lordosis loss was observed in patients with OSA compared to non-OSA controls, with the C2–C7 angle showing a significant negative correlation with AHI within the OSA group; this association remained robust after adjustment for age and sex. Supplementary soft tissue and airway measurements showed no significant correlation with cervical alignment or AHI, suggesting the observed association is not simply attributable to regional soft-tissue thickness or airway narrowing; however, without direct BMI data, a confounding role of systemic adiposity cannot be excluded. These findings suggest a potential association between cervical posture and upper airway dynamics; however, larger prospective studies are required to confirm clinical utility. Full article

Background: Platinum resistance remains a major therapeutic challenge in epithelial ovarian cancer (EOC). The tumour–stroma ratio (TSR) has emerged as a potential histopathological marker of tumour biology, but its clinical significance in different clinical settings remains unclear. We evaluated the association between stromal proportion, assessed using the TSR methodology, platinum resistance, and survival outcomes in patients undergoing primary debulking surgery (PDS) or neoadjuvant chemotherapy followed by interval debulking surgery (NACT+IDS). Methods: This retrospective study included 83 patients with epithelial ovarian cancer (EOC) who underwent either primary debulking surgery (PDS) or neoadjuvant chemotherapy followed by interval debulking surgery (NACT+IDS) between 2017 and 2024. Patients were analysed separately according to treatment strategy. Stromal proportion was assessed on primary surgical specimens in the PDS cohort and on pretreatment diagnostic biopsy specimens in the NACT+IDS cohort. For this retrospective analysis, platinum resistance was operationally defined as recurrence within six months after completion of first-line platinum-based chemotherapy. Survival outcomes were analysed using the Kaplan–Meier method, and univariable binary logistic regression was performed separately within the PDS and NACT+IDS cohorts to explore the association between stromal category and platinum resistance. Results: Platinum resistance occurred in 25.3% of patients. In the PDS cohort, stromal category was not associated with clinicopathological characteristics, platinum resistance, disease-free survival (DFS), or overall survival (OS). In the NACT+IDS cohort, patients in the stroma-high group had a numerically higher rate of platinum resistance than those in the stroma-low group (57.9% vs. 22.2%; Fisher’s exact p = 0.114). Based on univariable logistic regression analysis, the stroma-high group had higher estimated odds of platinum resistance (OR 4.81, 95% CI 0.78–29.40), although this finding did not reach statistical significance (p = 0.090). No significant association was observed between stromal category and survival outcomes in either cohort. Conclusions: In the NACT+IDS cohort, patients in the stroma-high group had a numerically higher rate of platinum resistance than those in the stroma-low group; however, this difference did not reach statistical significance. These results should be interpreted with caution due to the retrospective study design and limited sample size; however, they nonetheless support further investigation of pretreatment TSR as a simple and easily applicable histopathological parameter in EOC. Larger prospective multicentre studies are required to determine whether this exploratory signal is reproducible and clinically relevant. Full article

Background/Objectives: Axillary lymph node dissection (ALND) remains common in patients presenting with a high baseline axillary nodal burden despite substantial nodal downstaging after neoadjuvant chemotherapy (NAC). This study evaluated whether post-neoadjuvant radiologic axillary response could support selective axillary de-escalation in patients with clinically staged cN2 breast cancer and pathologically confirmed axillary metastasis. Methods: This retrospective single-center cohort included 166 cases treated between October 2020 and August 2024. All had pathologically confirmed axillary metastasis, completed neoadjuvant systemic therapy, underwent post-treatment axillary ultrasound, and received definitive surgery. Radiologic node-negative status (radN0) was defined by restoration of benign nodal morphology. Surgical management and pathological nodal outcomes were evaluated according to radiologic response. Results: Radiologic nodal clearance occurred in 61/166 cases (36.7%), while axillary pathological complete response [ypN0(i−)] was achieved in 59/166 (35.5%). ypN0(i−) was observed in 53/61 radN0 cases (86.9%) versus 6/105 radN+ cases (5.7%; p < 0.001). Among radN0 cases, 47/61 (77.0%) underwent limited sentinel lymph node biopsy/targeted axillary dissection (SLNB/TAD) without ALND, of whom 43/47 (91.5%) achieved ypN0(i−). Axillary pCR rates varied by molecular subtype, ranging from 20.5% in HR+/HER2− disease to 72.2% in triple-negative disease (p < 0.001). No ipsilateral axillary recurrence occurred in the limited SLNB/TAD group during a median follow-up of 36 months. Conclusions: Post-neoadjuvant radiologic nodal clearance was strongly associated with pathologically node-negative findings and may support consideration of carefully selected responders with cN2 breast cancer for SLNB/TAD-based staging. Radiologic response should complement, rather than replace, surgical staging and multidisciplinary decision-making. Full article

Background: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, with lymph node metastasis (LNM) being a key predictor of recurrence and poor prognosis. Preoperative detection of LNM remains challenging due to the limitations of imaging modalities, leading to inadequate surgical resection in 20–30% of patients. While immune checkpoint molecules have been implicated in PTC progression, the heterogeneity of CD8⁺ T cell exhaustion subsets and their specific association with LNM remain poorly defined. In this study, we aimed to perform an exploratory characterization of the distinct immune landscape of PTC prone to LNM, with a focus on terminal immune exhaustion, in order to generate hypotheses for improved risk stratification and therapeutic strategies. Methods: Fresh PTC tissues from 40 patients (22 LNM-positive and 18 LNM-negative) were analyzed via flow cytometry (FCM) to quantify immune cell subsets, inflammatory cytokines, and chemokines. Immunohistochemistry (IHC) validated CD45⁺ immune cell infiltration. Transcriptomic and clinical data from 448 PTC patients in The Cancer Genome Atlas (TCGA-PTC) cohort were used for bioinformatic analysis consistent with the observed phenotype, including Gene Set Variation Analysis (GSVA) of terminal exhaustion gene signatures. Results: LNM-positive PTC exhibited a unique inflammatory milieu with significantly elevated IL-6, IL-1ra, CCL5, and IL-9 levels (all p < 0.05) in tumor interstitial fluid. FCM analysis revealed that LNM-positive PTC had increased infiltration of total CD45⁺ immune cells, CD3⁺ T cells, and CD3⁺CD8⁺ T cells (all p < 0.05). Critically, terminally exhausted PD-1^hiTIM-3⁺ CD8⁺ T cells were significantly enriched in LNM-positive PTC (p = 0.022) and positively correlated with extrathyroidal extension (p = 0.044). Additionally, LNM risk was associated with increased CD4⁺ regulatory T (Treg) cell frequency (p = 0.023) and elevated CTLA-4 expression on CD4⁺ T cells (p = 0.047). In TCGA-PTC validation, the terminal exhaustion gene signature was predominantly enriched in LNM-positive (p < 0.0001) and advanced-stage PTC (p < 0.001) and strongly correlated with BRAF mutation (predominantly V600E) (p < 0.0001)—the most common oncogenic driver in aggressive PTC. Conclusions: Our findings suggest a terminal immune exhaustion phenotype (characterized by PD-1^hiTIM-3⁺ CD8⁺ T cells and Treg enrichment) as a potential key feature associated with LNM-prone PTC. This phenotype shows consistency across clinical samples and TCGA datasets, linking BRAF mutation (predominantly V600E) to immune suppression and metastatic potential. These insights provide a novel exploratory immune-based biomarker for LNM risk stratification and support the potential of combining anti-PD-1/TIM-3 therapy with BRAF inhibitors for high-risk PTC, which should be confirmed in future studies. Full article

Background: Pharmacists, as healthcare professionals of public trust, operate within a complex legal environment involving multiple forms of professional liability, particularly civil and criminal liability. Although these forms of responsibility are formally regulated by statutory law, the practical distinction between them remains largely dependent on judicial interpretation and case-specific circumstances. Objective: The aim of this study was to assess the scale and nature of judicial proceedings involving pharmacists and to identify the most common factors leading to civil and criminal liability. Additionally, the study sought to highlight the largely under-recognized phenomenon of legal actions involving pharmacists and to determine which areas of pharmacy practice generate the greatest legal risk. Methods: The study employed a mixed-methods design combining qualitative case law analysis with descriptive quantitative assessment. A total of 146 judicial decisions involving pharmacists were reviewed, including 43 civil and 19 criminal cases constituting the principal subject of the analysis. The examined judgments were assessed with regard to factual background, legal qualification, judicial reasoning, applied legal provisions, and type of liability imposed. Cases were additionally categorized according to the nature of the violation and the protected legal interest affected. Results: A total of 146 judicial decisions involving pharmacists were identified and analyzed, including 43 civil cases and 19 criminal cases. The findings demonstrate that legal proceedings involving pharmacists are not isolated events but represent a recurring phenomenon within professional practice. Civil cases were dominated by disputes related to reimbursement claims, prescription processing, and regulatory compliance, accounting for over half of all analyzed civil proceedings. In contrast, criminal cases were less frequent but displayed substantial heterogeneity, including unlawful medicine distribution, reimbursement fraud, breaches of professional duties, and other criminal offences. Importantly, only a minority of cases involved direct patient harm, while the majority arose from administrative, organizational, and regulatory obligations associated with pharmacy practice. The analysis identified prescription reimbursement procedures, medicine dispensing regulations, and pharmacy management responsibilities as the principal sources of legal risk for pharmacists. Conclusions: Published case law demonstrates the recurrent presence and considerable diversity of legal proceedings involving pharmacists. Most cases do not arise from direct patient harm but rather from regulatory, administrative, and organizational obligations associated with pharmacy practice. Civil proceedings are predominantly linked to reimbursement and prescription-related disputes, whereas criminal cases are less common but more diverse in nature. The results highlight the need for greater legal awareness among pharmacists, enhanced risk-management education, and stronger integration of legal competencies into undergraduate and postgraduate pharmacy training. Increased recognition of legal risks may contribute to both professional protection and improved patient safety. Full article

Background/Objectives: Myxofibrosarcoma (MFS) shows infiltrative fascial extensions that complicate margin achievement and drive local recurrence. We evaluated whether intraoperative ultrasound guidance improves negative margin achievement and oncological outcomes compared with conventional excision. Methods: In this retrospective cohort study at a single tertiary referral center, patients with MFS underwent conventional excision (2008–2013; n = 15) or ultrasound-guided excision (2014–2024; n = 50; primary comparative analysis n = 47 after excluding three patients). The primary outcome was negative margin achievement; secondary outcomes were overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS). Exploratory matching-adjusted indirect comparisons (MAICs) were performed against seven published international MFS cohorts. Results: Overall R0 (negative) margin rates did not differ between cohorts (97.9% vs. 93.3%; p = 0.428). Among R0 margins, however, a wide clearance (R0-wide, ≥1 mm) was more frequent in the US-guided cohort, whereas R0-close (<1 mm) margins predominated after conventional excision (R0-wide 83.0% vs. 46.7%; odds ratio 5.38, 95% CI 1.30–23.73; p = 0.014). Median follow-up was 49 months; five-year OS, LRFS, and DMFS were 97.5%, 94.3%, and 83.7%. In the internal historical comparison, LRFS was directionally higher with ultrasound guidance (94.3% vs. 68.2%; HR 0.26; p = 0.059). In MAICs, LRFS favored the US-guided cohort in all five comparisons and OS in two of four. Conclusions: Intraoperative ultrasound guidance was associated with a higher rate of wide (R0-wide, ≥1 mm) negative margins and favorable local disease control in MFS; whether wider microscopic clearance itself improves local control requires prospective multicenter evaluation. Full article

The development of accurate, robust and adaptive methods for monitoring the optical parameters of fiber-optic sensors (FOS) is one of the priority tasks in the field of precision measurements, especially in the context of rapidly growing requirements for intelligent monitoring systems. This paper presents a comprehensive approach to the use of modern deep learning algorithms for analyzing and processing spectral data coming from FOS. The proposed solution is based on the use of convolutional neural networks (CNN) for the automatic extraction of informative features, as well as autoencoders for noise suppression and signal restoration. A hybrid architecture combining CNN and recurrent neural networks (RNN) was developed. The experiments conducted confirmed the effectiveness of the evaluated models. On the independent regression test set, the CNN-only model achieved a macro-averaged R²-based prediction score of 98.2% without added noise and 89.4% under high-noise conditions; on a separate temporal test sequence, the hybrid CNN + RNN model achieved 95.0% compared with 88.0% for CNN alone. The presented approach has high resistance to noise and the ability to scale to various types of FOS. At the conclusion, the prospects for the practical applications of the proposed system are discussed: the structural monitoring of buildings and structures and the automation of processes in industry and energy, with an emphasis on reliability, autonomy and integration with existing platforms. Full article

Background: In recent decades, doctoral education has undergone a profound transformation. As a result, PhD students have become an increasingly vulnerable population, facing greater risk of mental health problems than the general population. A particularly important subgroup comprises PhD students in medicine and health sciences, who often combine doctoral training with clinical work. Their dual roles expose them to additional pressures, with an increased risk of burnout. Given that their context differs considerably from the typical university environment, in this systematic review, we aim to synthesize the current evidence on burnout, impostor syndrome, and research engagement, along with related indicators of psychological distress, among PhD students in medicine and health sciences, as well as identify key risk and protective factors and highlight gaps for future research. Methods: A systematic literature search was conducted in March 2026 across the Web of Science, Scopus, and Ovid MEDLINE databases. Following a screening process based on PRISMA guidelines, 27 studies were included; due to substantial heterogeneity, findings were synthesized narratively. Results: Psychological difficulties appeared to be more strongly associated with institutional factors rather than personal traits. Burnout was highly prevalent and linked to professional isolation and poor relationships with supervisors. Impostor syndrome emerged as a recurrent theme in qualitative accounts, though it was formally assessed with a validated instrument in only one study. Moreover, research engagement did not appear to protect students from burnout. Conclusion: Burnout and psychological distress are widespread among PhD students in medicine and health sciences, and impostor feelings emerged as a recurrent theme, although formally measured in only one study. These findings highlight the need for structural and institutional changes rather than relying solely on individual psychological support. Full article

End-of-Line (EoL) quality inspection of electric motors requires reliable detection of manufacturing faults before products leave the production line. However, conventional supervised deep learning approaches depend on a sufficient number of labeled instances of faulty motors, which are scarce in high-quality manufacturing environments. This limits their applicability to newly introduced products and previously unobserved fault types. This paper presents an unsupervised deep learning framework for anomaly detection in motor acoustic and vibration signals, designed for EoL quality inspection in manufacturing. The proposed method leverages Mel-frequency spectrograms (MFSs) as input features and employs a hybrid neural network combining a convolutional neural network (CNN) and bidirectional gated recurrent units (BiGRUs), effectively capturing both local spectral patterns and temporal dependencies. The method is evaluated on real industrial production data from over 2400 motors, of which approximately 4.3% were faulty, reflecting the highly imbalanced nature of high-quality manufacturing. The model was trained exclusively on healthy motor data and therefore does not require labeled faulty samples during training. Experimental results demonstrate strong discrimination between healthy and faulty motors, indicating that the proposed approach is suitable for automated EoL quality inspection in manufacturing environments where labeled faulty data are scarce. Full article