Search Results (32,020)

Background/Objectives: The integration of artificial intelligence (AI) into obstetric care poses significant potential to enhance clinical decision-making and optimize maternal and neonatal outcomes. Traditional prediction methods in maternal-foetal medicine often rely on subjective clinical judgment and limited statistical models, which may not fully capture complex patient data. By integrating computational innovation with mechanistic biology and rigorous clinical validation, AI can finally fulfil the promise of precision obstetrics by transforming pregnancy complications into a preventable, personalised continuum of care. This study aims to map the current landscape of AI applications across the continuous spectrum of maternal–foetal health, identify the types of models used, and compare clinical targets and performance, potential pitfalls, and strategies to translate innovation into clinical impact. Methods: A literature search of peer-reviewed studies that employ AI for prediction, diagnosis, or decision support in Obstetrics was conducted. AI algorithms were categorised by application area: foetal monitoring, prediction of preterm birth, prediction of pregnancy complications, and/or labour and delivery. Results: AI-driven models consistently demonstrate superior performance to traditional approaches. Nevertheless, their widespread clinical adoption is hindered by limited dataset diversity, “black-box” algorithms, and inconsistent reporting standards. Conclusions: AI holds transformative potential to improve maternal and neonatal outcomes through earlier diagnosis, personalised risk assessment, and automated monitoring. To fulfil this promise, the field must prioritize the creation of large, diverse, open-access datasets, mandate transparent, explainable model architectures, and establish robust ethical and regulatory frameworks. By addressing these challenges, AI can become an integral, equitable, and trustworthy component of Obstetric care worldwide. Full article

Background: Post-traumatic joint contracture (PTJC) remains one of the most prevalent and challenging complications arising from musculoskeletal trauma or surgical intervention. Conventional treatment modalities are largely reactive and address symptoms after onset, yet provide limited efficacy once contracture has developed. In contrast, pharmacological strategies targeting the underlying inflammatory and fibrotic pathways offer a promising strategy for preventing the development of PTJC altogether. Methods: A total of 26 male Sprague Dawley rats underwent standardized knee trauma followed by immobilization for a duration of two weeks. Rats were randomized into two groups. The experimental group (n = 13) received bosentan at a dosage of 50 mg/kg twice daily throughout the immobilization period. The control group (n = 13) received a placebo instead. Joint mobility was quantitatively assessed by measuring the contracture angle (CA) and resistance to extension. In addition, posterior joint capsule tissues were harvested for histological analysis and subjected to quantitative PCR (qPCR) to quantify the expression of profibrotic genes, including α-Sma, Il-6, Tgf-β1, Nfκ-b, Ctgf. Results: Bosentan had no relevant effect on the biomechanics of the contracture compared to the placebo group. The contracture angle was comparable between the groups (86.8° ± 14.1°, 84.8° ± 11.1°). Similarly, the force required to achieve knee joint extension was comparable between the groups. Gene expression analysis also provided no evidence of reduced expression of pro-inflammatory or profibrotic genes. Histological assessments revealed no change in the absolute or relative number of myofibroblasts, or in the number of vessels, in the posterior joint capsules of the rats treated with bosentan. Compared to the control group, the number of myofibroblasts significantly increased in both the bosentan and control groups (p < 0.001, one-way ANOVA). Conclusion: Bosentan’s purported antifibrotic properties do not appear to confer a preventative effect on the development of PTJC. These findings suggest that, despite its potential in modulating fibrosis, bosentan does not mitigate the progression of the fibrotic condition. Furthermore, the involvement of endothelin-1 (ET-1) in the pathophysiology of PTJC remains yet to be fully understood, warranting further investigation. Full article

In modern power systems, distributed generation (DG) clusters such as wind and solar resources are increasingly being integrated into active distribution networks through DG cluster control, which enhances the economic efficiency and adaptability of the DGs. However, cyber attacks on cyber–physical systems (CPS) may disable control links within the DG cluster, leading to the loss of control over slave DGs and resulting in power deficits, thereby threatening system stability. Existing CPS security assessment methods have limited capacity to capture cross-domain propagation effects caused by cyber attacks and lack a comprehensive evaluation framework from the attacker’s perspective. This paper establishes a CPS system model and control–communication framework and then analyzes the cyber–physical interaction characteristics under DG cluster control. A logical model of cyber attack strategies targeting DG cluster inverters is proposed. Based on the control topology and master–slave logic, a probabilistic failure model for DG cluster control is developed. By considering power deficits at cluster point of common coupling (PCC) and results in internal network of the DG cluster, a physical consequence quantification method is introduced. Finally, a cyber risk assessment method is proposed for DG cluster control under cyber attacks. Simulation results validate the effectiveness of the proposed method. Full article

The consumption of dietary supplements is increasing worldwide, yet national data from Saudi Arabia remain limited. This study examined the prevalence, patterns, and predictors of dietary supplement use, with emphasis on vitamin intake. A cross-sectional survey was conducted among 477 adults meeting inclusion criteria. Self-reported data included demographics, supplement use in the past 12 months, types and forms consumed, frequency, motivations, and information sources. Descriptive statistics and logistic regression were applied. Overall, 58% reported using at least one supplement in the past year, with vitamins comprising 81% of use. Pills and capsules were preferred, and daily intake was most common (58%). Female gender (AOR = 2.04; 95% CI: 1.26–3.31) and higher education (AOR = 4.04; 95% CI: 1.88–8.64) significantly predicted vitamin use. Common motivations included health promotion (19%), symptom relief (24%), and physical appearance (10%), with gender differences in reasons related to general health and immunity. Nearly three-quarters of participants relied on informal sources for supplement intake. Dietary supplement use is prevalent, particularly among women and the highly educated. Targeted education and regulatory measures are needed to promote safe, informed use, aligning with the national health strategies under Saudi Vision 2030. Full article

Next-generation cancer immunotherapy increasingly combines tumor-targeting antibodies or antibody–drug conjugates (ADCs) with immune effector cells to enhance therapeutic precision. However, many existing approaches rely on genetic modification or complex manufacturing, limiting their clinical scalability and rapid deployment. To address this issue, we developed an antibody capture protein (ACP)-based surface engineering platform that enables the rapid, reversible, and non-genetic functionalization of NK cells with therapeutic antibodies or ADCs. This approach uses a DMPE-PEG-lipid conjugate to anchor thiolated protein A (ACP) to the NK cell membrane via hydrophobic insertion, thereby stably and selectively binding to the Fc region of IgG molecules. Using this strategy, we developed ACP-modified NK cells (AC-NKs) that can selectively capture therapeutic antibodies (trastuzumab (TZ), trastuzumab-emtansine (T-DM1), and sacituzumab (SZ)) pre-bound to each target antigen on tumor cells and induce antigen-specific cytotoxic responses. The resulting AC-NKs exhibited enhanced tumor recognition and cytotoxicity against HER2-positive and Trop-2-positive cancer cells in vitro. Compared with conventional combination therapies, AC-NKs enhanced immune activation, as demonstrated by effective delivery of cytotoxic agents, enhanced cancer cell engagement, and upregulation of CD107a expression. Notably, the system supports multiple antigen targeting and tunable antibody loading, enabling adaptation to tumor heterogeneity and resistant phenotypes. This platform might also provide a simple, scalable, and safe method for rapidly developing programmable immune cell therapies without genetic modification. Its versatility supports multi-antigen targeting and broad applicability across NK and T cell therapies, offering a promising path toward personalized, off-the-shelf chemoimmunotherapy. Full article

Background/Objectives: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Iron metabolism and chronic inflammation are two interrelated processes that significantly influence the initiation and progression of CRC. Iron is essential for cell proliferation, but its excess promotes oxidative stress and DNA damage, while inflammation driven by cytokine-regulated pathways accelerates tumourigenesis. We therefore conducted this narrative review to collate the available evidence on the link between iron homeostasis and inflammatory signalling in CRC and highlight potential diagnostic and therapeutic applications. Methods: This narrative review of preclinical and clinical studies explores the molecular and cellular pathways that connect iron regulation and inflammation to CRC. Key regulatory molecules, such as the transferrin receptor (TFRC), ferroportin (SLC40A1), ferritin (FTH/FTL), hepcidin, and IL-6, were reviewed. Additionally, we summarised the findings of transcriptomic, epigenomic, and proteomic studies. Relevant therapeutic approaches, including iron chelation, ferroptosis induction, and anti-inflammatory strategies, were also discussed. Results: Evidence suggests that CRC cells exhibit altered iron metabolism, marked by the upregulation of transferrin receptor (TFRC), downregulation of ferroportin, and dysregulated expression of ferritin. Inflammatory mediators such as IL-6 activate hepcidin and STAT3 signalling, which reinforce intracellular iron retention and oxidative stress. Increased immune evasion, epithelial proliferation, and genomic instability appear to be linked to the interaction between inflammation and iron metabolism. Other promising biomarkers include ferritin, hepcidin, and composite gene expression signatures; however, their clinical application remains limited. Although several preclinical studies support the use of targeted iron therapies and combination approaches with anti-inflammatory agents or immunotherapy, there is a lack of comprehensive clinical validation confirming their efficacy and safety in humans. Conclusion: Although preclinical studies suggest that iron metabolism and inflammatory signalling form an interconnected axis closely linked to CRC, translating this pathway into reliable clinical biomarkers and effective therapeutic strategies remains a significant challenge. Future biomarker-guided clinical trials are essential to determine the clinical relevance and to establish precision medicine strategies targeting the iron–inflammation crosstalk in CRC. Full article

Background: C3 glomerulopathies (C3G), including dense deposit disease (DDD) and C3 glomerulonephritis (C3GN), are rare kidney disorders driven by dysregulation of the alternative complement pathway. Eculizumab, a terminal complement inhibitor targeting C5, has emerged as a potential therapeutic option in these conditions. This systematic review evaluated the efficacy and safety of eculizumab in patients with C3G or DDD. Methods: Literature searches in PubMed and Cochrane databases identified case reports and case series reporting eculizumab use. Results: Only eight studies involving ten patients met the inclusion criteria. Eculizumab stabilized renal function and reduced proteinuria in most cases, especially when C5b-9 deposition was present. Histopathological improvements were variable, and recurrence after discontinuation occurred in some patients. Responses were limited in cases with alternative mechanisms of C5 activation. Conclusions: Eculizumab offers clinical benefit in select C3G and DDD patients but does not address the underlying cause of complement dysregulation. The need for long-term therapy, incomplete histologic resolution, and risk of relapse underscore the necessity of larger trials and the development of personalized treatment strategies. Full article

Traumatic brain injury (TBI) results in a cascade of neuropathological events, which can significantly disrupt synaptic integrity. This review explores the acute, subacute and chronic phases of synaptic dysfunction and loss in trauma which commence post-TBI, and their contribution to the subsequent neurological sequelae. Central to these disruptions is the loss of dendritic spines and impaired synaptic plasticity, which compromise neuronal connectivity and signal transmission. During the acute phase of TBI, mechanical injury triggers presynaptic glutamate secretion and Ca²⁺ ion-mediated excitotoxic injury, accompanied by cerebral edema, mitochondrial dysfunction and the loss of the mushroom-shaped architecture of the dendritic spines. The subacute phase is marked by continued glutamate excitotoxicity and GABAergic disruption, along with neuroinflammatory pathology and autophagy. In the chronic phase, long-term structural remodeling and reduced synaptic densities are evident. These chronic alterations underlie persistent cognitive and memory deficits, mood disturbances and the development of post-traumatic epilepsy. Understanding the phase-specific progression of TBI-related synaptic dysfunction is essential for targeted interventions. Novel therapeutic strategies primarily focus on how to effectively counter acute excitotoxicity and neuroinflammatory cascades. Future approaches may benefit from boosting synaptic repair and modulating neurotransmitter systems in a phase-specific manner, thereby mitigating the long-term impact of TBI on neuronal function. Full article

Smartphone addiction has emerged as a significant public health concern, particularly among adolescents and young adults. This narrative review, conducted in line with the ANDJ checklist, synthesizes evidence from 25 systematic reviews and meta-analyses, complemented by randomized controlled trials and clinical studies, to provide a structured overview of the field. The study selection flow and publication trends reveal a rapidly expanding research landscape, with most evidence produced in the last decade, reflecting both the ubiquity of smartphones and increasing awareness of their health impacts. The synthesis highlights converging findings across reviews: excessive smartphone use is consistently associated with psychosocial, behavioral, and academic challenges, alongside sleep disturbances and mental health symptoms. Common messages include the recognition of smartphone addiction as a multidimensional phenomenon, while emerging themes point to heterogeneity in definitions, tools, and methodological approaches. Comparative analysis of reviews underscores both shared risk factors—such as emotional dysregulation and social isolation—and differences in study designs and target populations. Importantly, this review identifies critical gaps, including the lack of standardized definitions, limited longitudinal evidence, and scarce cross-cultural validation. At the same time, promising opportunities are noted, from lifestyle-based interventions (e.g., physical activity) to educational and policy-level strategies fostering digital literacy and self-regulation. The post-pandemic context further emphasizes the need for sustained monitoring and adaptive responses. Overall, this review calls for youth-centered, multi-sector interventions aligned with WHO recommendations, supporting coordinated, evidence-based action across health, education, and policy domains. Full article

Background/Objectives: Headache disorders, including migraine and tension-type headache (TTH), are among the most prevalent and disabling neurological conditions globally. This study aimed to evaluate temporal changes, demographic disparities, and socio-geographic variation in the burden of headache disorders across European countries. Methods: We analyzed data from the Global Burden of Disease Study 2021, covering 45 European countries grouped into Western, Central, and Eastern regions. We examined age-standardized prevalence, incidence, and disability-adjusted life year (DALY) rates for headache disorders between 1990 and 2021. Analyses were stratified by sex, age group, region, and country-level socio-demographic index (SDI). All estimates were reported with 95 percent uncertainty intervals where relevant. Spearman correlation was used to assess associations between disease burden and SDI. Results: Between 1990 and 2021, the number of individuals with headache disorders in Europe rose from 345.0 to 370.6 million, although age-standardized prevalence remained stable. The burden of migraine slightly increased, with age-standardized DALY rates rising from 648.35 to 657.27 per 100,000 population. Conversely, TTH showed a minor decline in both prevalence and DALY rates. Women and individuals aged 30 to 44 years consistently exhibited the highest burden, particularly for migraine. Higher SDI scores were positively correlated with DALY rates for migraine (rho = 0.392, p = 0.008) but negatively correlated for TTH (rho = −0.466, p = 0.001). Conclusions: Headache disorders continue to pose a major and largely unmitigated health burden across Europe. Regionally targeted strategies are essential to reduce disability and improve outcomes across diverse European populations. Full article

Background/Objectives: In view of demographic change and the increase in chronic illnesses, home care poses a considerable challenge. Telemedical technologies offer considerable potential for improving the quality of care and relieving the burden on family caregivers. With this study, we aim to develop appropriate training strategies for the use of telemedical applications in home care, focusing on the specific requirements of patients with dementia, heart failure, diabetes mellitus, chronic obstructive pulmonary disease, and stroke. Methods: A comprehensive survey was conducted among 31 family caregivers to record their experience with digital technologies and to analyze caregiver acceptance of these technologies and barriers to their use. The survey comprised 29 questions, including a mix of multiple-choice, Likert scale, and open-ended questions. The internal consistency of the questionnaire was high (Cronbach’s alpha = 0.8876). Results: The results show that although 32% of respondents already use digital technologies, there is a significant need for training and support. Key barriers identified include a lack of technical skills (cited by 45% of respondents), limited access to suitable devices (38%), and privacy concerns (35%). In addition, 90% of respondents expressed a willingness to participate in training programs. Conclusions: Based on the survey results, evidence-based recommendations are provided for the design of training programs tailored to the individual needs of family caregivers. Through a targeted combination of e-learning modules, webinars, and practical exercises, family caregivers can be empowered to take full advantage of telemedical technologies and thus significantly improve the quality of care at home. The results underscore the importance of overcoming technical barriers and providing comprehensive training to ensure the effective use of telemedicine in home care. Full article

Non-small cell lung carcinoma (NSCLC) is a prominent type, with an 85–90% incidence in all lung cancer cases. The evidence for a particular therapy strategy for people with NSCLC is still inadequate. This review evaluates NSCLC therapies that have passed phase IV trials, emphasizing their efficiency and adverse effects. Crucial therapeutic approaches, including dacomitinib, lorlatinib, durvalumab, osimertinib, and rivaroxban, are discussed, highlighting their mechanisms of action, uses, and adverse effects. Immune checkpoint medications are recommended because of their specific activity and minimal adverse reactions. The review also investigates cooperation therapies, such as targeting immune checkpoint inhibitors and hemostasis, alongside chemotherapy, as they offer potential for future therapies. However, further research is needed to improve the safety and efficacy of current treatments, and to explore novel ways to achieve better long-term outcomes. Full article

Goose astrovirus (GAstV) infection has emerged as a prevalent cause of urate deposition and viral gout in major goose farming across China, leading to high mortality and substantial economic losses. However, the molecular mechanisms linking GAstV to gout pathogenesis remain elusive. Here, a total of 10 five-day-old Jiangnan white goslings were selected, and tissue damage and kidney gene expression profiles were investigated. The results showed multi-organ damage in GAstV-infected gosling, including kidney, liver, spleen, and lung. Also, 342 differentially expressed genes were identified in infected kidney tissues after 10 days post-infection using transcriptomic sequencing, including 185 upregulated and 157 downregulated genes. In addition, gene set enrichment analysis revealed significant positive correlations between GAstV infection and bile acid metabolism and fatty acid metabolism pathways. Notably, bile acid metabolism was implicated in uric acid regulation and gout progression. Protein–protein interaction network analysis identified AGXT as a central hub gene within the bile acid metabolic pathway, with key upregulated interactors including PIPOX, ALDH1A1, and CAT. AGXT, a critical enzyme in glyoxylate detoxification, directly modulates uric acid biosynthesis. Our findings propose that GAstV-induced activation of bile acid metabolism, particularly AGXT upregulation, drives hyperuricemia and subsequent gout pathology. This study elucidates a novel mechanism of GAstV-associated metabolic dysregulation and provides actionable genetic targets for antiviral breeding strategies in waterfowl. Full article

Aptamers have many advantages, including facile synthesis and a high affinity and good selectivity toward their targets. Therefore, aptamer-based biosensors have become increasingly popular for the detection of different bioanalytical substances. Microchip-based analytical detection platforms offer significant advantages for the detection of different analytes, including their ease of operation, high throughput, cost-effectiveness, and high sensitivity. Aptamer-based signal amplification techniques have been combined with microchips to sensitively detect bioanalytical substances due to their stable reactions, easy operation, and specificity in biomedical science and environmental fields. This review summarizes representative articles about aptamer signal amplification strategies on microchips for the detection of bioanalytical substances, as well as their advantages and challenges for specific applications. We highlight the accomplishments and shortcomings of aptamer signal amplification strategies on microchips and discuss the direction of development and prospects of aptamer signal amplification strategies on microchips. Full article

This study investigates the economic role of wine tourism in Nemea, Greece, a prominent Protected Designation of Origin (PDO) wine-producing region. Employing a mixed-methods approach, the research combines interviews with local stakeholders and a structured post-wine-tasting visitor survey to assess wine tourism’s contribution to local development. A two-step multivariate analysis, incorporating Multiple Correspondence Analysis and Hierarchical Cluster Analysis, reveals five distinct visitor profiles differing in spending behaviour, familiarity with the destination, and engagement patterns. While high-spending visitors support winery revenues, their limited local integration reduces their broader developmental impact. Conversely, younger and repeat domestic visitors offer more dispersed economic benefits through overnight stays, gastronomy, and cultural participation. In addition, local stakeholders highlight the region’s viticultural identity and growing tourism interest as strengths but also note persistent weaknesses such as inadequate infrastructure, limited coordination, and underdeveloped visitor services. The study concludes that visitor segmentation offers actionable insights for enhancing wine tourism’s developmental role. Targeted strategies tailored to specific visitor types are essential for improving integration with the local economy. These findings contribute to ongoing discussions on how wine tourism can act as a lever for inclusive, sustainable rural development in traditional wine regions. Full article