Search Results (8,802)

Non-communicable diseases (NCDs), including cardiovascular disease, cancer, and chronic respiratory disease, are major causes of death worldwide; addressing NCDs is thus essential. NCDs may contribute to health disparities between rural and urban areas. The COVID-19 pandemic has altered medical and social environments, and NCD management approaches may have changed accordingly. This scoping review aimed to examine themes of reported rural healthcare challenges related to NCD management before and after the COVID-19 pandemic. A literature search of original articles was conducted via PubMed. A thematic analysis was applied to compare the content of studies classified as pre-pandemic and post-pandemic. A total of 23 articles were identified, including 12 studies classified as pre-pandemic and 11 studies classified as post-pandemic. Before the pandemic, commonly reported challenges included low management rates of hypertension and diabetes, instability in pharmaceutical supply, and insufficient training of healthcare personnel. We integrated these into a theme related to “healthcare”. After the pandemic, in addition to the low management rates, studies increasingly addressed mental and nutritional health, multimorbidity, and socioeconomic disparities. We integrated there into a theme related to “society”. Namely, studies classified as pre-pandemic primarily reported healthcare-related aspects, whereas studies classified as post-pandemic more frequently reported broader societal aspects in addition to healthcare-related aspects. These findings may reflect changes in how rural healthcare challenges related to NCDs have been recognized and discussed following the COVID-19 pandemic. Further research is needed to clarify the significance and implications of these reported themes. Full article

Background/Objectives: Substance use disorders (SUDs) remain a major public health challenge, with high relapse rates despite established pharmacological and behavioral treatments. This scoping review maps evidence on structured exercise interventions as therapeutic approaches in SUD treatment, focusing on direct clinical outcomes, substance-specific effects, and implementation strategies. Methods: Following PRISMA-ScR and JBI guidance, searches of PubMed, Scopus, PsycINFO, and SPORTDiscus identified human studies published from 2000 to 31 December 2024 that evaluated supervised exercise interventions in adults with SUDs. Results: Evidence from randomized trials and recent network meta-analyses indicates clinically relevant benefits for abstinence, craving reduction, mood symptoms, cognitive function, treatment retention, and withdrawal management. Moderate-to-vigorous aerobic exercise delivered three to four times weekly for at least 12 weeks, at approximately 180 MET-minutes per week, appears particularly effective, while combined aerobic and muscle-performance protocols may yield broader benefits. Conclusions: Exercise interventions show strong potential as adjuncts to SUD care. Implementation should incorporate individualized prescription, substance-specific safety screening, cardiovascular and psychiatric monitoring, and multidisciplinary coordination. Further long-term randomized trials, mechanistic studies, and cost-effectiveness evaluations are needed. Full article

Ultrafine particles (UFPs; <100 nm) can penetrate biological barriers and trigger inflammation, oxidative stress, and endothelial dysfunction, yet they remain largely unregulated and understudied relative to PM_2.5. This scoping review, conducted following PRISMA-ScR guidelines, systematically searched PubMed and Scopus for epidemiological studies examining ambient UFP exposure and mortality. Of 704 articles screened, 21 studies published between 2007 and 2025 met inclusion criteria. Fourteen assessed short-term exposure (≤1 month) using time-series or case-crossover designs with central-site particle number concentration monitors, and seven assessed long-term exposure using land-use regression, chemical transport, or machine learning models. A majority of both short-term (10 of 14) and long-term (6 of 7) studies reported positive associations between UFP exposure and mortality, particularly for respiratory outcomes. The strongest associations were observed in studies using higher-resolution or source-specific exposure methods, a pattern consistent with reduced misclassification. However, exposure assessment approaches varied widely in spatial resolution, instrument type, and particle size definitions, introducing substantial heterogeneity that limits comparability across studies. These findings underscore the need for standardized UFP measurement protocols, high-resolution exposure assessment, and further investigation of disparities in exposure and health outcomes to inform regulatory consideration. Full article

Background/Objectives: Surgical treatment of colorectal cancer (CRC) is associated with a substantial risk of postoperative complications and delayed recovery of functional capacity, particularly in older patients and those with multiple comorbidities. Preoperative prehabilitation has emerged as a strategy aimed at optimizing patients’ physical, nutritional, and psychological status prior to surgery; however, its clinical effectiveness and feasibility of implementation remain subjects of ongoing debate. The aim of this narrative review was to provide a clinically oriented synthesis of current evidence regarding multimodal prehabilitation in patients undergoing CRC surgery, with particular emphasis on perioperative outcomes, functional recovery, nutritional optimization, and implementation-related considerations. Methods: A targeted narrative review of the peer-reviewed literature indexed in PubMed (2015–2025) was conducted to identify contemporary review-type publications, including narrative reviews, systematic reviews, scoping reviews, and meta-analyses, addressing prehabilitation in CRC surgery. The findings were synthesized narratively and interpreted with emphasis on clinical applicability and translational relevance. Results: Twenty contemporary review publications were included in the analysis. Across the included publications, the most frequently reported favorable effects were observed for multimodal prehabilitation, incorporating physical exercise, nutritional support, and a psychological component. These interventions were associated with improvements in functional capacity and, in some meta-analyses, with a reduction in postoperative complication rates and shorter length of hospital stay, particularly in high-risk patients. Prehabilitation was assessed as safe and well tolerated. Conclusions: The current body of evidence indicates that multimodal prehabilitation may constitute a beneficial adjunct, particularly in improving functional capacity, while its impact on hard postoperative outcomes remains closely dependent on intervention quality, appropriate patient selection, and seamless integration with established perioperative care pathways. Future meta-analyses should address underexplored components of prehabilitation, including preparation for stoma formation and targeted educational and psychological support related to sexual health. Full article

The COVID-19 pandemic affected maternal mental health in the UK, increasing postpartum emotional distress. This scoping review identified forms of postpartum emotional distress (PPED) examined during the pandemic, the methodologies and assessment tools used, analytical approaches, reported limitations, future research directions, and overall findings. This review followed Arksey and O’Malley’s framework and the Joanna Briggs Institute scoping review guidelines. A comprehensive, keyword-based search strategy was applied across electronic databases, initially on 28 January 2023, and updated on 20 July 2023, and 3 September 2025. Strict inclusion criteria were used, and data from eligible studies were charted and synthesised. This review of 35 UK studies on postpartum emotional distress (PPED) during COVID-19 found a dominant focus on depression and anxiety, with other PPED forms largely neglected. Quantitative designs overwhelmingly outnumbered qualitative and mixed-method approaches. Common limitations included low sample diversity, reliance on online self-report surveys, cross-sectional designs, convenience sampling, and social-media-based recruitment. This review is the first to map research approaches used to explore postpartum emotional distress (PPED) during COVID-19 in the UK. The limitations and future research directions identified in this review highlight an urgent need for more diverse sampling, longitudinal study designs, qualitative research exploring women’s lived experience narratives of different forms of postpartum emotional distress, greater consideration of biopsychosocial factors, and evidence-based interventions. Full article

Immune checkpoint inhibitors (ICIs) have translated the scope of cancer therapy, but their immune-restorative mechanism can lead to immune-related adverse events (irAEs), which can affect several organs with varying severity. Early identification of patients at risk of irAEs is prudent to inform clinical decisions in precision oncology and remains a challenge as current clinical and biomarker methods still lack predictive accuracy. Artificial Intelligence (AI) presents a promising strategy for improving early detection, risk stratification as well as monitoring of irAEs. This narrative review summarizes the current AI modalities for detecting and predicting irAEs risk occurring with ICI therapy, including clinical Machine Learning models, radiomics-based approaches, natural language processing (NLP) systems and the integration of modalities with multimodal AI frameworks. Clinical Machine Learning models demonstrate moderate predictive performance whereas radiomics-derived modeling appears promising for pneumonitis. NLP and language models have achieved higher accuracy for retrospective irAEs detection. Multimodal AI applications offer theoretical potential through diverse data integration that captures the complex biology of irAEs; however, current evidence is limited. All these modalities face limitations of inadequate sample sizes, retrospective design, heterogeneous outcome definitions, class imbalance, and insufficient external validation. AI-based models have significant potential for personalized immunotherapy monitoring but require prospective multicenter validation, standardized datasets and clinically interpretable frameworks prior to implementation. Future advances in multimodal modeling can also enable precise prediction and early detection of irAEs, ultimately improving the safety and effectiveness of cancer immunotherapy. Full article

Background and Objectives: Traumatic brain injury (TBI) is one of the leading causes of long-term disability among adults, with consequences for balance, postural stability, and quality of life. Addressing balance disorders in TBI patients requires a tailored and continuous care approach; the existing literature underlines a general framework for physiotherapy treatments, but no clear profile of technique, dosage and timing of intervention emerges. The present scoping review, therefore, aimed at mapping physiotherapy approaches to balance in TBI population, highlighting their potential effects and role through care pathways. Materials and Methods: A scoping review was conducted, according to PRISMA Extension for Scoping Reviews, with the aim of mapping physical therapy approaches to treat balance disorders in adult patients with TBI. A specific search string for each database was formulated through a PCC (Population, Concept, Context) framework. The search, limited to articles in English and published between 2015 and 2025, was conducted across five databases (PubMed, PEDro, Scopus, Embase, and Web of Science), including experimental studies, observational designs, and `case reports. Results: From the initial selection of 1052 records, six studies were included: five randomized controlled trials and a case report, published between 2016 and 2022. Results presented high heterogeneity of physiotherapy programs and outcome variations; interventions identified included virtual reality, video game therapy, adapted physical exercise, ballistic training, rapid-resistance elliptical training, and rhythmic auditory stimulation. These studies reported variable improvements in balance and mobility, not even with significant inter-group differences. Conclusions: Several techniques showed preliminary evidence in pre/post improvements of balance for TBI patients, including strength exercise, aerobic training and virtual-mediated approaches such as video game therapy and virtual reality. Rhythmic auditory stimulation has unclear effects. Future studies are needed to define the impact of each balance recovery strategy according to the baseline characteristics of the patient. Full article

Background/Objectives: Sinonasal inverted papilloma is a rare Schneiderian epithelial tumor, histologically benign in most cases, but characterized by locally aggressive behavior, a high recurrence rate and a recognized potential for malignant transformation, most frequently into sinonasal squamous cell carcinoma. The present article is a scoping review that maps and critically synthesizes the available evidence on epithelial, immunohistochemical and selected molecular markers in malignant-transformed sinonasal inverted papilloma, rather than a quantitative systematic review or meta-analysis. Methods: The literature search was performed according to PRISMA-ScR principles in PubMed/MEDLINE, Embase, Scopus/Web of Science and Google Scholar, using the search keywords sinonasal inverted papilloma, malignant transformation, markers, HPV, p63, p40, p16 and Ki-67, as well as complementary markers of the cell cycle and of the EGFR/CDKN2A/TP53 pathways. Results: Based on the available data, p40 and p63 have diagnostic value for defining and mapping the squamous phenotype, including invasive carcinomatous nests, but they are not standalone predictive markers of malignant transformation. p16 cannot be automatically used as a surrogate for active HPV infection in inverted papilloma, while the results regarding HPV remain inconclusive in relation to malignant transformation of sinonasal inverted papilloma. Ki-67, especially when interpreted topographically and in relation to dysplasia and invasion, may suggest proliferative acceleration, but prognostic thresholds have not yet been validated. Conclusions: The conclusion of our study is that the risk of malignant transformation cannot be reduced to a single marker; it must be interpreted through an integrative clinical, imaging, histopathological, immunohistochemical and molecular model, which requires prospective multicenter validation. Full article

Bibliometric analysis is widely used to map scientific fields, identify influential publications, and visualize thematic structures, but maps, rankings, and network clusters cannot by themselves produce a scientifically critical review. This article proposes the Bibliometric-Assisted Critical Review (BACR) framework as a writing-oriented conceptual and pedagogical model for authors, doctoral researchers, supervisors, and reviewers working with large and heterogeneous literatures. BACR is presented as a methodological framework and authoring heuristic, not as an empirical study, a new reporting standard, or a substitute for systematic reviews, scoping reviews, meta-analyses, or conventional bibliometric reviews. The framework distinguishes a broad bibliometric corpus from a narrower critical reading corpus and explains how bibliometric signals can be translated into reading decisions, appraisal questions, synthesis moves, and transparent reporting practices. Its practical outputs include a nine-phase writing process, a bibliometric-to-critical translation matrix, a critical appraisal template, a worked mini-example, a recommended manuscript architecture, a preliminary checklist, and a table of common errors. BACR is intended to help authors use science mapping to strengthen, rather than replace, close reading and critical synthesis. The framework is still preliminary and needs to be adapted to specific fields, tested through pilot applications, and validated. Full article

Background: Native nephrectomy is frequently required in autosomal-dominant polycystic kidney disease (ADPKD) before or during transplantation, but the optimal minimally invasive approach is unsettled, and it is unclear whether the pattern of post-operative complications tracks with operative technique. We report a retrospective single-centre experience of hand-assisted laparoscopic (HAL) native nephrectomy and, alongside it, a technique-stratified scoping review of complications. Methods: We retrospectively reviewed all consecutive adults undergoing HAL native nephrectomy—with an infra-umbilical midline hand-port and free intraperitoneal cyst rupture—in preparation for transplantation in the period between December 2019 and December 2025. In parallel, we performed a PRISMA-ScR-compliant scoping review (MEDLINE, Embase, Scopus) of minimally invasive ADPKD nephrectomy, with duplicate independent screening and extraction, stratifying complications by operative approach and cyst-decompression method. No quantitative pooling was undertaken. Results: Twenty-three patients (mean age 52.8 ± 9.9 years; 87% dialysis-dependent; 78% for transplant preparation) were included. Median operative time was 102 min (IQR 90–122) with minimal blood loss, one transfusion (4%), and no open conversion. Complications occurred in 8/23 (35%) and were bowel-predominant: one small-bowel perforation, two obstructions, and one ileus—three of Clavien–Dindo grade IIIb, all in right-sided nephrectomies and independent of specimen weight. Peri-operative mortality was 1/23 (4%), from a non-technique-related mycotic aortic dissection. Of 481 records screened, 19 studies met inclusion; the cyst-decompression method was reported in only 7 (37%). Bowel events clustered in series using free intraperitoneal cyst rupture or puncture and were largely absent where decompression was contained, a pattern crossing platform boundaries and that is mechanistically consistent with intraperitoneal spillage of cyst contents. Conclusions: HAL native nephrectomy is a rapid and feasible means of removing massively enlarged polycystic kidneys before transplantation but, in our experience, carries a bowel-predominant morbidity that clustered in right-sided procedures and was independent of specimen weight. The sparse literature is consistent with—but cannot confirm—a relationship to intraperitoneal cyst spillage rather than to the hand-assisted approach itself. Whether contained cyst decompression can preserve operative efficiency while reducing bowel morbidity is a hypothesis warranting prospective study. Full article

Background/Objectives: As population ageing accelerates, integrated care has become an important strategy for addressing the complex care needs of older adults. Although gerontological nurse specialists (GNSs) are expected to contribute to integrated care, their roles remain inconsistently defined and insufficiently synthesized across healthcare systems and professional role titles. This scoping review aims to systematically map the roles of GNSs in supporting integrated care for older adults within hospital-based settings. Methods: This scoping review protocol will follow the JBI methodology for scoping reviews and will be reported in accordance with the PRISMA-ScR guidelines. Searches will be conducted in PubMed, CINAHL, Web of Science, China National Knowledge Infrastructure, and Ichushi-Web, with no date restrictions. Studies published in English, Chinese, and Japanese will be included. The review will consider studies involving nurses with recognized specialist or advanced nursing practice competence in gerontological or older-adult care and will focus on their roles in supporting integrated care for older adults within hospital-based settings and hospital-linked transitional care services. Two independent reviewers will conduct study selection and data extraction. The findings will be synthesized descriptively and presented using tabular, narrative, and diagrammatic formats. Conclusions: This review is expected to contribute to a clearer understanding of the roles of GNSs in integrated care for older adults and provide evidence to inform future nursing practice, workforce development, education, and research in gerontological integrated care. Registration: This protocol was registered within the OSF database on 19 May 2026. Full article

While green bonds are increasingly used to channel capital towards environmentally responsible projects, their effectiveness depends not only on market growth, but also on the credibility of the institutional frameworks that support the green label. Through focused bibliometric positioning, scoping synthesis and comparative document analysis, the paper examines how seven major green-bond frameworks organise credibility: the EU European Green Bond Standard, the ICMA Green Bond Principles, the Japan Green Bond Guidelines, the ASEAN Green Bond Standards, China’s catalogue-plus-principles framework, India’s Sovereign Green Bond Framework and China’s Sovereign Green Bond Framework 2025. The findings show that frameworks converge in product grammar, including project selection, management of proceeds, reporting and external review, but diverge substantially in credibility architecture, especially regarding external review, supervision, refinancing governance and environmental additionality. Current frameworks generally make green-bond labels more transparent, comparable and verifiable, but not necessarily more additional in environmental terms. Important challenges therefore remain: fragmented standards, greenwashing risks, information asymmetries, weak impact-reporting comparability and limited safeguards against refinancing existing assets. The paper argues that the contribution of green bonds to the green transition depends on how credibility is institutionally organised. Full article

The release of ChatGPT in November 2022 transformed second language (L2) writing instruction and led to rapid growth in research on large language model (LLM)-generated feedback; however, no synthesis has mapped this literature in terms of feedback quality, learner uptake, and pedagogical integration. This scoping review examines 185 empirical studies published between November 2022 and March 2026 that were identified through a Scopus search (n = 283 screened) and analysed using a systematic keyword-based charting framework applied to full abstracts, with full-text analysis of 35 studies. The review identifies four major patterns: (1) comparative AI–human feedback research dominates the literature (27.6%); (2) content-level feedback remains underexplored (13.5% of studies); (3) learner uptake is rarely measured as a primary outcome; and (4) LLM feedback is broadly comparable to teacher feedback for surface-level errors but weaker for content and argumentation, while learner perceptions often exceed demonstrated performance outcomes. Hybrid AI–teacher models show promising but underexamined potential, accounting for only 12.4% of the literature. The field shows a focus on perceptions rather than learning outcomes, an apparent tendency toward positive-results reporting, and no clear teaching models. This study proposes a typology of LLM feedback functions and outlines a research agenda focused on uptake, longitudinal outcomes, and hybrid AI–teacher integration. Full article

The article provides a wide-range review of issues concerning the evolving of infrastructure for the purpose of transport system decarbonization, which is one of the crucial directions on the path to achieving carbon neutrality. Transport systems contribute, according to various statistics, between 20 and 25% of global carbon dioxide emissions, making the development of sustainable infrastructure one of the crucial issues for achieving net-zero goals. By synthesizing 135 studies published between (2022) and (2026), the paper investigates research on following key fields: (1) low-emission conveyances, infrastructure for their refueling, and its availability; (2) policy and strategies for transport decarbonization and plans concerning technologies for low-carbon means of transport, (3) management systems for organization of transportation, including Intelligent Transport Systems and smart mobility; (4) crisis management in green transport systems—investigations and solutions connected to ensuring the systems’ continuity in critical situations; and (5) research on the costs of transportation decarbonization, economic analysis and optimization of costs associated with the development of low-emission transport. The analyzed literature shows the extraordinary importance of the transport decarbonization problem and presents a wide range of conducted studies and applications being implemented. The findings indicate fields, for which the complexity and completeness of works seem to be satisfactory, but also show sectors within which certain research gaps do still exist. The outcomes of the work indicate policy and technological pathways that can lead to improving the sustainability of infrastructure for decarbonized transport systems, together with some proposals of the scope of research directions that should be carried out. Full article

Background: Palatal orthodontic mini-implants are increasingly used for sagittal, vertical, and transverse mechanics, including molar distalization, mesialization, posterior intrusion, impacted tooth traction, and miniscrew-assisted rapid palatal expansion. Yet site selection is often discussed as if anatomical bone availability were the dominant determinant of performance. Objective: This scoping review maps direct palatal evidence and supporting mechanistic evidence on how palatal substrate, miniscrew design, insertion protocol, digital planning, biomaterial surface, and biomechanical loading interact to determine primary stability, loaded stability, survival, and failure risk. Methods: Records were searched in PubMed/MEDLINE, Scopus and Web of Science Core Collection and organized into two evidence streams, as follows: P1 direct palatal evidence and P2 supporting mechanistic/biomaterials evidence. Data were charted using a Bone–Screw–Force framework. Results: The evidence indicates that anterior palatal and anterior paramedian sites are usually favorable for routine anchorage, but posterior sites, PPSAIS, and MARPE locations may warrant patient-specific three-dimensional assessment when clinical and conventional radiographic evaluation is insufficient. Primary stability emerges from cortical thickness, trabecular quality, effective intraosseous length, miniscrew diameter, thread design, insertion angle, pilot-hole protocol, torque, force magnitude, and biological response. Digital workflows are best interpreted as trajectory-control technologies rather than as convenience tools. Biomaterial and surface evidence remains promising but insufficiently connected to palatal-specific outcomes. Conclusions: Palatal miniscrew performance should be reframed as an interface problem rather than a site-only problem. A Bone–Screw–Force framework can support biomechanically driven site selection while identifying where quantitative evidence remains insufficient. Full article