Search Results (8,850)

A systematic review was conducted to identify ergonomic risk factors associated with musculoskeletal disorders in the limbs of mining workers, the assessment methods used, and their relationships. Following PRISMA 2020 guidelines, 53 studies from Scopus, ScienceDirect, Web of Science, MDPI, and IEEE Xplore (January 2015–May 2026) were included. Eleven risk factors were identified, with vibration (18 studies) and working hours (12 studies) being the most frequently reported. Five individual assessment methods (ISO/IEC 2631-1, REBA, OWAS, NIOSH, Risk Score), one symptom questionnaire (Nordic Questionnaire), and five hybrid/advanced methods (Bayesian Network + REBA, RULA + Nordic, SEM + Participatory Ergonomics, DMQ + Logistic Regression, RULA + Fuzzy Logic) were identified. Fifteen limb segments were evaluated, with the back (15 studies), shoulders (12 studies), and neck (12 studies) being the most studied, while wrists and elbows were notably absent. Hybrid methods demonstrated superior accuracy compared to individual approaches. Underground mining studies (58%) predominated over open-pit operations (42%). The findings provide an integrated framework connecting risk factors, affected limbs, and assessment tools. Critical gaps were identified, including the lack of wrist/elbow evaluation, underrepresentation of female miners, and absence of AI-based assessment systems. Four key challenges are proposed for future research, including developing deep learning-based ergonomic assessment tools and implementing real-time monitoring systems. Full article

Background/Objectives: Occupational Contact Dermatitis (OCD) is one of the most common occupational diseases and represents a substantial clinical and socioeconomic burden. Despite its high prevalence, OCD is frequently underrecognised and underreported, limiting the effectiveness of occupational health surveillance and preventive strategies. This study aimed to investigate the extent of OCD underreporting in Italy by comparing official reporting data with incidence estimates derived from epidemiological data available in the scientific literature. Methods: Official data on dermatitis and eczema cases reported to the Italian National Institute for Insurance against Accidents at Work (INAIL) between 2020 and 2024 were analysed and compared with incidence estimates obtained through a systematic literature search of epidemiological studies, surveillance systems, and cohort studies conducted in high-risk occupational groups with available specific incidence data in the scientific literature, such as healthcare workers, construction workers, and hairdressers. Results: INAIL data showed an average of approximately 182 reported OCD cases per year during the study period. However, the estimates we calculated suggested a substantially higher disease burden, with an annual estimate ranging from 1439 cases to 21,412 cases. This implies that, depending on the incidence source used, only 0.8% to 12.7% of the expected cases are notified. Conclusions: OCD appears to be substantially underreported in Italy. Underrecognition of its occupational origin, the low severity often attributed to symptoms, and the limits of current surveillance systems likely contribute. Better occupational health surveillance, greater awareness among clinicians and workers, and simpler reporting procedures would improve case recognition and help prevent progression to chronic disease. Full article

IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory disorder that can affect multiple organs, while sinonasal involvement remains uncommon and poorly characterized. Its clinical and radiological resemblance to malignancy may delay diagnosis. We report the case of a 41-year-old man presenting with unilateral left exophthalmos, facial pain, ptosis and paraesthesia. Imaging revealed a destructive maxillary sinus mass extending into the pterygopalatine fossa and orbit, raising strong suspicion of malignancy. Endoscopic biopsy demonstrated dense lymphoplasmacytic infiltration, storiform fibrosis, obliterative phlebitis and numerous IgG4-positive plasma cells, suggestive of IgG4-associated chronic rhinosinusitis. Although the lesion fulfilled key histopathological features of IgG4-RD, its isolated maxillary sinus location potentially represents an atypical site of the disease, not included in the current ACR/EULAR classification criteria. Following surgery and corticosteroid therapy, symptoms initially resolved; however, possible local recurrence was detected four months later on PET imaging. Haematological evaluation subsequently recommended clinical surveillance without systemic immunosuppressive therapy. This case highlights the diagnostic challenges of unilateral rhinosinusitis presenting as an isolated tumour-like lesion and displaying dense IgG4 plasma cell infiltrate. IgG4-RD should be considered in the differential diagnosis of destructive sinonasal masses, even without involvement of typical organs. Histopathological evaluation is essential to guide diagnosis and management and avoid unnecessary aggressive surgery. Full article

Extraparenchymal neurocysticercosis, caused by Taenia solium, is an uncommon form of neurocysticercosis involving the subarachnoid space and ventricular system. Clinical manifestations are heterogeneous, including seizures, meningitis, and intracranial hypertension, and are often associated with worse outcomes. Diagnosis remains challenging, as cysts may be difficult to detect on conventional imaging due to signal characteristics similar to cerebrospinal fluid, frequently leading to inconclusive results. We describe a patient presenting with a six-month history of focal seizures in whom the diagnosis was established following surgical excision of a cystic lesion, with definitive confirmation provided by positive PCR detection of T. solium nuclear ribosomal DNA in the excised tissue. The patient received 14 days of dual antiparasitic therapy and remained free of neurological symptoms during 12 months of follow-up. This case highlights the potential limitations of noninvasive diagnostic modalities and the challenges that physicians might encounter when evaluating infectious diseases that are not endemic to their country of practice. It also underscores the value of a structured diagnostic approach, as recommended by several international health bodies, complemented by advanced molecular techniques such as PCR. Overall, it provides a clinically relevant illustration of key diagnostic challenges and decision-making steps in the evaluation of this complex condition. Full article

Glaucoma requires continuous surveillance, sustained treatment adherence, and timely recognition of postoperative or treatment-related complications. Conventional outpatient follow-up provides structured clinical assessment but offers limited visibility of symptoms between appointments. This study describes TeleGlaukos, a clinician-led adaptive telemonitoring platform designed for hybrid perioperative and therapeutic glaucoma care. Its principal innovation is a configurable protocol engine that transforms static symptom forms into patient-specific workflows through conditional questions, symptom-triggered branching, medication reminders, rule-based alerts, and bidirectional clinician–patient communication. The platform was implemented as a Progressive Web App connected to a modular Django backend through RESTful APIs and WebSocket-enabled communication. The clinical pilot cohort comprised 30 glaucoma patients followed between May 2025 and April 2026. The wider platform environment contained 95 registered accounts: 30 glaucoma patients, 10 ophthalmologists, 10 research or administrative users, 20 development and testing accounts, and 25 non-pilot registered users. Across the platform, 737 engaged sessions, 1329 events, 30 bidirectional messages, and 186 questionnaire responses were recorded. Structured monitoring identified suspected treatment-related adverse reactions in two patients, prompting earlier clinical reassessment and treatment adjustment. Usability was assessed in 22 respondents (18 patients and 4 ophthalmologists), yielding a mean System Usability Scale score of 79.43 ± 17.98 (95% CI: 71.46–87.40), corresponding to a Good adjective rating and an Acceptable usability range; internal consistency was high (Cronbach’s alpha = 0.882). The artificial intelligence-assisted module remained exploratory and was not evaluated as an autonomous clinical component. TeleGlaukos demonstrated technical feasibility, favourable perceived usability, and the capacity of adaptive symptom workflows to surface clinically relevant signals between visits. Larger multicentre studies are required to evaluate effectiveness, safety, adherence, workflow burden, and cost-effectiveness. Full article

Background and Objectives: Cameron lesions are linear gastric erosions or ulcers that develop at the level of the diaphragmatic constriction within a hiatal hernia. They represent an underrecognized cause of chronic iron-deficiency anemia and upper gastrointestinal bleeding. This study aimed to characterize the demographic, clinical, endoscopic, and therapeutic features of Cameron lesions diagnosed at a tertiary referral digestive endoscopy center in the Republic of Moldova. Methods: This was a retrospective single-center study from Republic of Moldova conducted over a 9-year period (2017–2026). Forty-three consecutive patients with endoscopically confirmed Cameron lesions were included. All examinations were performed by a single experienced endoscopist using high-definition endoscopy systems (Olympus EVIS Exera III and Olympus EVIS X1). Demographic characteristics, hiatal hernia type and size, clinical presentation, endoscopic findings, bleeding stigmata, Helicobacter pylori status, and postoperative outcomes were analyzed. Results: The mean age of the patients was 60.4 years (range, 31–83 years), with a female predominance (65.1%; 28 women and 15 men). The distribution of hiatal hernia types was as follows: type I (axial/sliding), 32.6% (n = 14); type II (paraesophageal/rolling), 34.8% (n = 15); and type III (mixed), 32.6% (n = 14). Cameron lesions developed after failed fundoplication in three patients (6.9%) and were identified in fixed (39.5%), completely reducible (16.3%), and partially reducible (mixed) hernias (44.2%). The main indications for upper gastrointestinal endoscopy were GERD symptoms (53.4%), iron-deficiency anemia (20.9%), prophylactic or postoperative surveillance (18.6%), and overt upper gastrointestinal bleeding (7.0%). Active Cameron lesions were identified in 55.8% of patients, whereas cicatricial and mixed lesions accounted for 30.2% and 13.9%, respectively. Bleeding stigmata were classified according to Forrest as Ia (2.3%), Ib (18.6%), IIa (4.65%), IIb (11.6%), IIc (7.0%), and III (55.81%). Nine patients (20.9%) were identified with active bleeding. Importantly, Cameron lesions were also identified in small hiatal hernias (<3 cm) and in patients with recurrent hiatal hernia after failed fundoplication. Helicobacter pylori infection was detected in 25.6% (n = 11) of patients. Conclusions: This study confirms the well-established association between Cameron lesions, female sex, hiatal hernias, and gastrointestinal bleeding while providing several novel observations, including their occurrence in small hiatal hernias, diagnosis in relatively young adults, and recurrence following failed fundoplication. The findings also highlight the potential contribution of the reducible component of hiatal hernias to lesion development and emphasize the importance of meticulous inspection of the hernia sac during every upper gastrointestinal endoscopic examination. Full article

Progressive neurodegenerative diseases are often associated with motor symptoms, among which tremor is one of the most debilitating manifestations, significantly compromising daily activities and quality of life. Continuous, non-invasive monitoring of tremor characteristics helps to assess disease progression and optimize treatment strategies. For this reason, wearable measurement systems can provide an objective and non-invasive means for the quantitative characterization and monitoring of tremor-related movements. This study addresses the development of a compact, low-power wearable board for real-time tremor monitoring based on the Nicla Sense ME embedded system. The proposed device performs on-board processing to extract spectral features of movement and wirelessly sends them via Bluetooth Low Energy to a remote host, enabling on-demand visualization or storage of tremor data. The measurement system was technically validated through a comparative experimental protocol based on the simultaneous acquisition of tremor signals using the proposed device and a commercial Shimmer3 IMU as the reference system. The comparison considered both the similarity of the measured spectrograms and the agreement in dominant-frequency estimation. Spectrogram correlation coefficients reached 0.85, with amplitude MAE and RMSE values as low as 0.07 m/s² and 0.14 m/s², respectively. For dominant-frequency estimation, Pearson correlation coefficients reached 0.99, with MAE and RMSE values as low as 0.17 Hz and 0.20 Hz. These results support the feasibility of the proposed architecture as a practical wearable solution for quantitative hand tremor monitoring. Full article

Methylmalonic and propionic acidemias are inherited disorders of propionyl-CoA catabolism characterized by deficient activity of L-methylmalonyl-CoA mutase and propionyl-CoA carboxylase, respectively. They lead to metabolite accumulation in tissues and biological fluids, including methylmalonic, propionic, 3-hydroxypropionic, 2-methylcitric and maleic acids. Affected patients develop multi-systemic symptoms, with predominant neurological manifestations. Although current therapy based on dietary protein restriction significantly decreases mortality and morbidity, it is still insufficient to prevent long-term complications in most patients. The pathogenesis of methylmalonic and propionic acidemias has been investigated in recent decades using chemically induced in vivo models, genetic animal models, in vitro models and tissues and biological fluids from patients. Although the precise mechanisms responsible for the clinical manifestations in these disorders remain under debate, biomarkers of mitochondrial dysfunction and oxidative stress have been consistently described in tissues from affected patients and genetic murine models. Notably, growing evidence indicates that the organic acids accumulating in these disorders, which are formed within mitochondria, compromise mitochondrial functions through multiple mechanisms, disrupting bioenergetics, quality control, calcium homeostasis and redox balance, ultimately leading to cell death. This review discusses pathomechanisms of mitotoxicity caused by the major organic acids accumulating in methylmalonic and propionic acidemias from observations taken from patients and animal models. Full article

Background: Artificial intelligence (AI) is increasingly being used in interventions among individuals with neurodevelopmental and cognitive disorders, offering personalized and adaptive approaches that advance traditional therapeutic practices. Although previous reviews have focused on symptom detection or alleviation, less attention has been paid to the impact of AI in fostering the acquisition of higher-order skills essential for being functional and independent. This review uniquely addresses this gap by synthesizing evidence from randomized controlled trials on AI-driven skill acquisition across multiple domains. Objectives: The objective of this systematic review is to synthesize evidence from randomized controlled trials evaluating the effectiveness of AI-driven interventions in promoting skillfulness. More specifically, it investigates the acquisition of neurocognitive, self-regulation, and adaptive and related skills among individuals with neurodevelopmental and cognitive disorders, including attention deficit and hyperactivity disorder, autism spectrum disorder, dyslexia, dyscalculia, and cognitive impairment. Methods: A systematic search, according to the PRISMA 2020 guidelines, was conducted, selecting randomized controlled trials published between 2019 and 2026. Eligible technologies included conversational agents, intelligent tutoring systems, adaptive training platforms, and machine learning-based interventions. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Results: Twenty-four randomized controlled trials met the inclusion criteria. The findings demonstrated improvements in a wide range of skills, such as attention, working memory, mental flexibility, metacognitive control, emotional regulation, inhibition control, and social and communication skills. Generative AI showed efficacy for language and communication skills, while machine learning-based systems demonstrated positive effects on attention regulation and self-regulation. Conclusions: This review concludes that artificial intelligence can effectively assist conventional interventions for individuals with neurodevelopmental and cognitive disorders. However, the heterogeneity in intervention designs, outcome measures, and participant populations limits generalizability and highlights the need for standardized assessment frameworks, larger-scale longitudinal trials, and mechanistic investigations to translate these preliminary gains into long-term functional improvements across diverse clinical and cultural contexts. Full article

Background: Helicobacter pylori colonizes the human gastric mucosa through outer membrane proteins (OMPs), particularly the adhesins BabA and BabB, which recognize host blood group antigens and mediate bacterial attachment and persistent colonization; importantly, structural and genetic studies have confirmed substantial polymorphisms in these adhesins that may affect their functional properties and contribute to differences in the clinical outcomes of infection. Therefore, the present study aimed to investigate the prevalence and genetic diversity of babA/babB variants in H. pylori isolates obtained from Jordanian patients and to evaluate their association with different gastric pathological conditions. Methods: A total of 106 gastric mucosal biopsies were collected from patients with gastric symptoms at two major hospitals in Jordan. Specimens underwent endoscopic evaluation, rapid urease testing (RUT), and histopathological examination according to the Sydney classification system. H. pylori detection was performed using real-time PCR targeting 16S rRNA and universal bab genes using novel primers designed to amplify both babA and babB variants. Conventional PCR was used for specific BabA and BabB gene amplification, followed by sequencing analysis of BabB variants. Results: A total of 106 patients were enrolled, with a mean age of 40.2 ± 15.9 years. H. pylori was detected in 76 (71.7%), 83 (78.3%), and 79 (74.5%) cases by the Rapid Urease Test (RUT), histopathology, and 16S rRNA qPCR, respectively. Using histopathology as the reference method, 16S rRNA qPCR demonstrated a sensitivity of 95.2%, compared with 91.6% for RUT. Among the 83 histopathology-positive cases, the universal bab gene was detected in 72 (86.7%), of which 53/72 (73.6%) were positive according to babB-specific PCR. Among patients with chronic gastritis, universal bab positivity increased progressively from 82.5% in mild to 88.5% in moderate and 93.3% in severe gastritis, whereas babB positivity increased from 50.0% to 76.9% and 80.0%, respectively. Sequencing of 40 babB-positive samples identified 27 distinct babB sequence profiles, with CHI-023 and LIM-008 being the most frequently identified reference sequence matches (10.0% each), highlighting substantial genetic diversity within the analyzed babB region. Conclusions: The findings demonstrate high diagnostic performance of 16S rRNA qPCR and RUT relative to histopathology, together with substantial genetic diversity within the analyzed babB region. Full article

Gray mold (Botrytis cinerea Pers.) is a primary yield-limiting disease in European viticulture. Here we report a field evaluation of two chitosan oligomer (COS)-based nanocarrier (NC) systems loaded with Rubia tinctorum (NC-Rt) and Uncaria tomentosa (NC-Ut) extracts for B. cinerea management in ‘Tempranillo’ vineyards (D.O.P. Ribera del Duero, 2024 season). In vitro, nanoencapsulation reduced the effective extract concentration required for complete inhibition of B. cinerea mycelial growth by 1.8–6.7-fold relative to free extracts. Ex situ, both NC formulations at MIC×3 significantly reduced gray mold severity on inoculated ‘Tempranillo’ bunches at days 5 and 7, but not on ‘Verdejo’ bunches. In a field trial under commercial-vineyard conditions, NC-Ut and NC-Rt reduced mean gray mold severity from 80% in the untreated control to 18–25%, compared with 35–40% for the free extracts and commercial chitosan, an effectiveness of 69–78%. No visual symptoms of acute phytotoxicity were observed during the trial, and cluster weight and cluster number did not differ significantly among treatments. A preliminary, exploratory sensory screening of the wines produced from the treated grapevines detected no significant treatment-related differences in off-flavor or Botrytis-related defect scores. These single-season results support further evaluation of COS-based NCs as delivery systems for plant-derived antifungals in viticulture. Full article

Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system (CNS) characterized by the destruction of the myelin sheath around nerve cells. The prevalence and serious consequences of MS highlight the shortcomings of existing treatments and the importance of developing innovative therapeutic approaches. Based on successful pilot studies in patients and an experimental autoimmune encephalomyelitis (EAE) mouse model, CAR-T cells offer a novel therapeutic mechanism by directly targeting and eliminating B cells, overcoming the shortcomings of antibody-mediated B cell depletion, which is unable to penetrate deep into the CNS. Recent discoveries have also revealed an important role for the gut microbiota in maintaining immune homeostasis. In a state of homeostasis, there is a symbiotic relationship between host factors and the microbiota that helps to maintain a healthy state. However, alterations in the composition and function of the gut microbiota, known as gut dysbiosis, can disrupt this homeostasis. The microbiota, through its metabolites, can influence not only internal processes in the gut but also the CNS in MS. Therapeutic interventions that help restore the balance of the gut microbiota may be a promising additional treatment to existing therapies to alleviate symptoms and promote remission in patients with MS. Full article

Gamma-aminobutyric acid (GABA), a non-protein amino acid widely present in plant-based foods, has gained considerable attention for its diverse physiological effects and underlying mechanisms. As a functional dietary component, GABA has been reported to exhibit antihypertensive activity in preclinical and preliminary human studies, with proposed mechanisms including angiotensin-converting enzyme (ACE) inhibition and modulation of sympathetic outflow. In nematode models, GABA has been observed to alleviate aging-related oxidative stress by enhancing antioxidant enzymes (e.g., SOD, CAT) and reducing lipofuscin accumulation. It may also alleviate certain menopausal symptoms based on limited human trial data, potentially through regulation of autonomic nervous system balance and reduction in vasomotor disturbances. Its anxiolytic and sleep-promoting effects are linked to GABAergic neurotransmission via GABAA/B receptors, which suppresses hypothalamic–pituitary–adrenal (HPA) axis hyperactivity. GABA also shows anticancer potential in cell-based assays by disrupting tumor cell cycles and metastasis pathways, while its antidiabetic role in preclinical models involves pancreatic β-cell protection and glucose homeostasis regulation. Despite the wide range of proposed physiological benefits, safety assessments indicate that GABA is generally well-tolerated at typical dietary supplement doses (≤300 mg/day), with higher intakes (up to 3000 mg/day) permitted in some regulatory frameworks, supporting its use in functional foods. Future research should focus on optimizing GABA-enriched food production and elucidating dose-related mechanisms for personalized nutrition. Full article

Background and Clinical Significance: Intimal sarcoma is a rare, aggressive malignancy of the large arteries that grows within the vessel lumen and frequently mimics thromboembolic disease, leading to diagnostic delay. Flow restoration and tissue biopsy are both difficult if the tumour occupies a technically demanding arterial segment, which is further aggravated if conventional large-bore arterial access is precluded by peripheral arterial disease. Case Presentation: A 66-year-old woman with multiple cardiovascular risk factors presented with subacute left upper-limb ischaemia and painless digital cyanosis (embolic phenomena) that had progressed despite therapeutic anticoagulation. Computed tomography angiography demonstrated a sub-occlusive filling defect extending from the origin of the left subclavian artery towards the aortic arch, initially interpreted as thrombus. There were no clear signs of malignant disease, despite differential screenings. Multiple on- and off-site surgical consultations were done, but the patient was repeatedly rejected for operation due to disease characteristics and high surgical risk. Severe iliofemoral peripheral arterial disease precluded usual transfemoral arterial delivery of a large-bore system, so the subclavian mass was aspirated using a 22/26-French sheath and extracorporeal aspiration system (AngioVac System (AngioDynamics)) delivered through percutaneous transcaval (caval–aortic) access, under cerebral embolic protection. Repeated aspiration runs with mechanical snare augmentation achieved substantial debulking, angiographic normalisation of flow and abolition of the invasive pressure gradient, without injury to the target artery. The caval–aortic tract was eventually closed with an occluder device. Histopathology of the aspirate revealed a malignant spindle-cell mesenchymal neoplasm consistent with intimal sarcoma. Staging subsequently demonstrated metastatic disease, and the patient proceeded to covered-stent maintenance of subclavian patency and first-line systemic chemotherapy. The patient is undergoing chemotherapy at 7-month follow-up, but palliation is being considered due to disease progression. Conclusions: Transcaval delivery of a large-bore aspiration system (AngioVac) is a feasible strategy to achieve both flow restoration and diagnostic tissue sampling when conventional arterial access is unavailable. Intimal sarcoma should be considered when arterial “thrombus” fails to respond to anticoagulation, particularly alongside constitutional symptoms. Full article

Pelvic floor disorders, particularly pelvic organ prolapse (POP) with or without stress urinary incontinence (SUI), are among the most prevalent benign conditions affecting women and are associated with substantial burdens. This study aimed to evaluate tissue extracellular matrix remodelling in women with POP with or without SUI by integrating clinical and phenotypic characteristics, and tissue and plasma specimens, and to determine whether the dominant biological signal is observed at the systemic or local tissue level in pelvic floor failure. Case–control analysis consisted of 121 women with POP with or without SUI and a control group (POP and SUI-free). Plasma and tissue concentrations of collagen type I, collagen type III, elastin, MMP-1, MMP-2, MMP-3, and MMP-9 were quantified (60 POP with or without SUI, 61 controls). Clinical and demographic characteristics were compared between groups, and secondary correlations between tissue biomarkers, pelvic floor symptom scores, and POP-Q parameters were evaluated within the POP group. The results of the present study reveal that the studied women were older, had higher BMI, parity, and vaginal delivery burden, and had markedly higher symptom scores. Plasma biomarkers showed limited differences between groups, whereas tissue biomarkers showed strong separation: COL1 and ELN were lower, while COL3, MMP1, MMP2, MMP3, and MMP9 were higher in POP. The strongest individual discriminatory markers were found to be MMP2 (AUC 0.958) and MMP9 (AUC 0.977). In adjusted models controlling age, BMI, and parity, parameters such as COL1, COL3, ELN, MMP2, MMP3, and MMP9 remained independently associated with POP. In this cohort, pelvic organ prolapse is associated with a robust extracellular matrix remodelling signature in vaginal-wall tissue, characterised by reduced structural components and increased MMP levels. Tissue biomarkers, particularly MMP-2 and MMP-9, may represent markers of the POP-associated tissue phenotype and warrant further validation in larger cohorts. Full article