Search Results (38,128)

Background/Objectives: Nutritional support is a key component in the management of chronically ventilated patients, who are at high risk of malnutrition due to prolonged illness and metabolic stress. Enteral nutrition, particularly high-protein formulas (HPFs) and high-density formulas (HDFs), is commonly used to improve clinical outcomes; however, their effects on anthropometric and biochemical parameters remain incompletely understood. Our objective was to evaluate the association of HPFs and HDFs with changes in anthropometric and biochemical parameters in chronically ventilated patients receiving enteral nutrition. Methods: This retrospective study evaluated chronically ventilated patients receiving long-term enteral nutrition. Patients were categorized into four groups based on feeding strategy: continuous HPF, transition to HPF, transition from HPF and transition to HDF. Body weight, serum albumin and total protein were assessed at baseline and follow-up (up to 6 months). Within-group changes were analyzed using paired statistical tests. Results: Within-group analyses demonstrated changes in body weight, body mass index and serum albumin levels over time. Body weight increased significantly across all groups. The greatest increase was observed in patients transitioning to an HPF (70.82–75.35 kg, p = 0.00019), with a significant increase also following HDF administration (59.51–62.57 kg, p = 0.0389). Serum albumin increased significantly only in the transition-to-HPF group. HDF administration showed a non-significant increase in albumin and a near-significant rise in total protein. Conclusions: Enteral nutrition strategies were associated with changes in anthropometric and biochemical parameters in chronically ventilated patients. HPFs and HDFs were associated with improved body weight, with biochemical improvements most evident after HPF initiation and favorable trends observed with HDF administration. Future prospective studies with standardized protocols and objective nutritional markers are warranted. Full article

Background/Objectives: Chronic primary pain (CPP) is a new diagnostic category including chronic pain conditions lacking clinical signs or a clear etiopathogenetic origin. These disorders may share a common neural mechanism known as central sensitization, where nociceptive neurons become hyper-responsive to standard or subthreshold pain stimuli, resulting in pain hyper-sensitivity. In this context, non-invasive brain stimulation (NIBS) appears to be a promising tool for improving CPP symptoms by targeting maladaptive brain activity and connectivity. To date, the effects of NIBS on CPP symptoms remain unexplored. To fill this gap, we conducted a meta-analysis, investigating the effect of NIBS in improving the three core symptoms of CPP, namely pain intensity, emotional distress, and functional disability. Methods: Following PRISMA guidelines, we screened four databases up to February 2025 for English-language, peer-reviewed randomized clinical trials that included CPP patients treated with NIBS and reported pre/post or follow-up scores on validated measures of at least one core symptom. Quality of life was examined as an additional outcome. Results: Fifty-four studies were included, with 1371 participants receiving real stimulation and 1103 sham. Findings highlighted that real stimulation improved CPP symptoms immediately after treatment and at one-month follow-up. Meta-regressions showed that longer CPP duration reduced short-term effects on emotional distress and diminished all outcomes at one-month follow-up. Conclusions: Further research is needed to establish standardized NIBS protocols for CPP management, to investigate the effectiveness at longer follow-up periods, and to test whether combining NIBS with other interventions enhances treatment effectiveness and durability. Full article

Background/Objectives: Managing bone diseases demands novel, natural compounds to bypass the heavy side effects of current therapies. Honey is well-known for its therapeutic traits, yet we know very little about how specific floral varieties impact bone tissue. This study confronts this gap by comparing how acacia, chestnut, and coriander honeys drive human osteoblast behavior in vitro. Methods: After mapping the phenolic/flavonoid profiles and antioxidant capacities of these honeys, we tested them on hFOB 1.19 human osteoblasts. We tracked cell migration via scratch assays and validated osteogenic maturation through Alkaline Phosphatase (ALP) activity and Alizarin Red (AR) mineralization over 7 days. Confocal time-lapse imaging with pharmacological inhibitors monitored intracellular calcium dynamics, while gene shifts were analyzed via qRT-PCR. Results: Coriander honey (CH) packed the highest polyphenol levels and antioxidant power. Biologically, while all honeys accelerated scratch closure, CH drove cell motility most potently. Remarkably, a 7-day treatment with these honeys sparked a significant and robust increase in ALP activity and mineralization, surpassing the osteogenic induction observed with standard osteoinductive media. Mechanistically, CH triggered a sharp [Ca²⁺] spike, relying on external calcium entry and IP3-dependent internal release via PLC activation. qRT-PCR confirmed this anabolic shift via OPG and OPN upregulation. Conclusions: Honey exerts pronounced multi-level osteopromotive effects at both the functional and transcriptional levels, tightly linked to its botanical source. Among the variants, coriander honey stands out for its exceptional ability to fast-track osteoblast migration, differentiation, and early mineral deposition. Therefore coriander honey represents a promising in vitro candidate that warrants further preclinical evaluation for bone repair applications. Full article

Background: Obesity among Saudi adolescents has risen sharply, yet whether school athletic participation is associated with students showing improved dietary habits and better anthropometric profiles compared to those of their non-athlete peers remains unclear. This study compared anthropometric indices and dietary habits between school athletes and non-athletes in Riyadh. Methods: A cross-sectional study was conducted with 124 male secondary school students (70 athletes and 54 non-athletes aged 16–17 years) in Riyadh, Saudi Arabia. Athletes were defined as students who reported engaging in vigorous-intensity sport for ≥3 days/week for ≥60 min/session. BMI, body weight, and waist circumference were measured objectively. Dietary habit frequencies across ten food categories were assessed using the validated Arab Teens Lifestyle Study (ATLS) questionnaire. Independent samples t-tests and chi-square tests were used; effect sizes were calculated as Cohen’s d. A Bonferroni-corrected threshold (p < 0.005) was applied for multiple dietary comparisons. Results: Athletes had significantly lower BMI (23.64 ± 5.39 vs. 30.28 ± 7.25 kg/m²; p < 0.001, d = 1.06), body weight (p < 0.001, d = 0.93), and waist circumference (85.46 ± 12.61 vs. 95.50 ± 17.89 cm; p < 0.001, d = 0.66). Obesity prevalence was 15.7% among athletes versus 51.9% among non-athletes. Of ten dietary variables, only fresh fruit consumption showed a between-group difference (62.9% vs. 40.7% high-frequency; p = 0.010), which did not survive Bonferroni correction. Conclusions: School athletes demonstrated substantially better anthropometric profiles than their non-athlete peers, but dietary habit frequencies were largely similar across both groups. The high obesity prevalence among non-athletes underscores the need for school-based programs that combine structured physical activity with targeted nutrition education. Full article

Background/Objectives: Impacted maxillary canines are frequently associated with variations in maxillary arch morphology; however, the relationship between impaction position and three-dimensional arch characteristics remains unclear. This study aimed to evaluate the association between buccally and palatally impacted maxillary canines and maxillary arch morphology using CBCT and three-dimensional digital model analysis. Methods: This retrospective cross-sectional study included CBCT images and three-dimensional dental models of 86 individuals with unilateral impacted maxillary canines (mean age: 16.1 ± 0.72 years). Impacted canines were classified as buccal or palatal according to CBCT findings. Maxillary arch morphology was assessed using digital model analysis. Statistical comparisons between groups were performed using independent-samples t-tests (p < 0.05). Results: The buccally impacted group demonstrated significantly greater arch length, higher arch length-to-arch width ratios, greater mesiodistal width of the four maxillary incisors and increased tooth–arch discrepancy (p < 0.05). In contrast, intermolar width and available arch space were significantly greater in the palatally impacted group (p < 0.05). No significant differences were identified in arch width or palatal depth measurements between groups (p > 0.05). Intra-examiner reliability demonstrated excellent agreement (ICC > 0.90). Conclusions: Maxillary dental arch morphology differed according to the position of impacted maxillary canines. Buccal impaction was associated with sagittal arch elongation and increased tooth–arch discrepancy. In contrast, palatal impaction was not consistently associated with reduced transverse dental arch dimensions within the measurements evaluated in this study. These findings contribute to a better understanding of the association between impacted canine position and maxillary dental arch morphology and may assist clinicians in the morphological assessment of patients with impacted maxillary canines. Full article

Background: Early identification of balance impairments is critical for detecting the fall risk in older adults. Force plates are the standard for measuring postural sway, but are restricted in practice because they are cumbersome and expensive. The Balance Mat is a portable device that requires comprehensive validation against force plates and clinical benchmarks in older adult populations. Objective: The objective of this study was to evaluate the technical validity and clinical discriminative ability of the Balance Mat against a laboratory-grade force plate, clinical tests, and the fall history in an older adult cohort. Methods: Fifty-six community-dwelling older adults performed static balance assessments across six stance conditions. Postural sway data were recorded simultaneously using the Balance Mat and a force plate. The technical validity was assessed using Spearman’s rank correlation and intraclass correlation coefficients. Linear regression models were applied to calibrate the Balance Mat outputs against the force plate. The diagnostic accuracy for classifying the fall risk against the timed up and go test, the Falls Efficacy Scale-International, and the retrospective fall history was evaluated using an area-under-the-curve analysis. Results: The Balance Mat demonstrated strong associations with force plate measurements, particularly for the sway path/velocity, variance and Area95 ($r>0.80$). Following calibration, the absolute agreement for the sway path/velocity reached excellent levels ($ICC=0.93$) and good levels for Area95 and RMS ($ICC>0.75$), whereas the mean sway demonstrated a poor agreement and was excluded. For fall-risk classification, the calibrated Balance Mat achieved a fair accuracy for the retrospective fall history and a high Falls Efficacy Scale-International concern (area under the curve, 0.76-0.78), and a fair accuracy for the timed up and go thresholds (area under the curve, 0.70). Conclusions: The calibrated Balance Mat provided valid measurements of postural sway that aligned with the force plate parameters, particularly for the sway path/velocity and Area95. The within-stance agreement for the sway path/velocity ranged from ICC= 0.44 to 0.88, and the pooled value should not be interpreted as the uniform performance across all stance conditions. Given its fair diagnostic accuracy, the device is best utilised as a portable screening tool in combination with standard clinical assessments and the fall history rather than as a standalone diagnostic test. Full article

Fast radio bursts (FRBs) are millisecond-duration radio transients of extragalactic origin, while ultra-high-energy cosmic rays (UHECRs; $E\gtrsim {10}^{18}$ eV) remain among the most important unresolved problems in astroparticle physics. This review examines the viability of FRBs and their central engines as sources of UHECRs within a comprehensive multi-messenger framework. We summarize the observational constraints on UHECR source populations imposed by the energy spectrum, nuclear composition, anisotropy measurements, diffuse $\gamma$-ray background, and high-energy neutrino observations, which, together, favor source classes capable of accelerating heavy nuclei with hard injection spectra, modest cosmological evolution, and sufficiently high source densities. We then review the current landscape of FRB progenitor and engine models, including magnetars, supramassive neutron stars, compact-object mergers, and accretion-powered systems, emphasizing their energetics, environments, and particle-acceleration capabilities through relativistic shocks, magnetic reconnection, magnetar wind nebulae, and direct electromagnetic acceleration by ultra-relativistic FRB pulses. We discuss how these scenarios are constrained by neutrino and $\gamma$-ray observations from IceCube, KM3NeT, and Fermi-LAT, as well as by large-scale UHECR anisotropy measurements from the Pierre Auger Observatory and Telescope Array. Finally, we examine the observational tests that will become possible in the coming decade through large samples of localized FRBs, composition-resolved UHECR measurements, next-generation neutrino observatories, and wide-field $\gamma$-ray facilities. We emphasize that FRB dispersion and rotation measures provide unique probes of the baryonic and magnetic environments relevant for UHECR acceleration and propagation, enabling a new form of multi-messenger tomography of cosmic-ray source environments and allowing the FRB–UHECR connection to become a quantitatively testable astrophysical framework. Full article

Background/Objectives: Adenomyosis is a common estrogen-dependent gynecological condition with a largely undefined genetic architecture. Ciliary dysfunction has been implicated in its pathogenesis, positioning genes governing ciliary structure and motility as biologically plausible candidates for investigation. The DNAH5 gene encodes a critical component of the outer dynein arms within the ciliary axoneme, and pathogenic variants are among the most common causes of primary ciliary dyskinesia. This study aimed to systematically determine the frequency of a novel synonymous DNAH5 variant, NM_001369.3:c.9258C>T, p.(Leu3086=), in a large, histopathologically confirmed sporadic adenomyosis cohort from Turkiye, and to evaluate its occurrence relative to population-level reference data. Methods: A total of 121 women with histopathologically confirmed adenomyosis following hysterectomy were enrolled. Sanger sequencing was performed under stringent quality control conditions, including primer specificity verification by NCBI BLAST and UCSC In Silico PCR. Variant frequency was compared against gnomAD v4.0 and an in-house Turkish exome database (NGS Cloud; ~30,000 sequences) using Fisher’s exact test. In silico splice site analysis was performed using SpliceAI, and variant classification followed ACMG/AMP guidelines. Results: The variant was detected in 63 of 121 patients (52.1%; 95% CI: 43.1–61.0%), exclusively in the heterozygous state; no homozygous carriers were identified. The variant was absent from both gnomAD v4.0 across all populations and the NGS Cloud Turkish exome database (MAF: 0.0000), yielding a frequency difference (p < 2.2 × 10⁻¹⁶). SpliceAI analysis predicted no significant splice site impact (all delta scores < 0.1). The variant was classified as a variant of uncertain significance (VUS; BP7, PM2_supporting). Conclusions: This study identifies a difference in the frequency of a novel synonymous DNAH5 variant between a histopathologically confirmed adenomyosis cohort from Turkiye and population-level reference datasets, in which the variant was absent. Given the unphenotyped nature of the reference dataset, these findings are hypothesis-generating and do not establish a causal genetic association. Replication in independent cohorts and functional studies are warranted to elucidate the biological significance of this variant in adenomyosis susceptibility. Full article

Background/Objectives: Chronic stress contributes to anxiety disorders and cognitive impairment, while effective multi-target therapeutic strategies remain limited. This study investigated the effects of a standardized extract prepared from the aerial parts of Bacopa monnieri (L.) Wettst. (Brahmi) extract and an anthocyanin-rich mixed Thai berry extract, administered individually and in combination, in a chronic unpredictable mild stress (CUMS) rat model. Methods: Extracts derived from Morus alba L. (mulberry), Antidesma ghaesembilla Gaertn. (mamao), and Syzygium nervosum DC. (ma-kiang) were characterized for anthocyanin and phenolic contents, antioxidant activities, and cyanidin-3-O-glucoside levels using HPLC. Male Sprague Dawley rats were subjected to a 14-day CUMS protocol and treated with Brahmi extract, mixed Thai berry extract, or their combinations. Behavioral assessments included the open-field test, elevated plus maze, and novel object recognition test. Histopathological evaluation of the prefrontal cortex and hippocampus was also performed. Results: Brahmi extract and mixed Thai berry extract attenuated selected anxiety-related behaviors and improved recognition memory-related parameters in CUMS-exposed rats. The low-dose berry extract produced the most consistent behavioral improvements, whereas combination-treated groups showed greater histological preservation. Histopathological analysis revealed reduced neuronal degeneration and improved tissue organization in the prefrontal cortex and hippocampus of treated animals. Conclusions: These findings support the potential therapeutic relevance of Bacopa monnieri and anthocyanin-rich Thai berry extracts under chronic stress conditions, with differential effects observed between individual and combination treatments. Full article

Background/Objectives: Immune surveillance is increasingly recognized as a modifier of myeloproliferative neoplasm (MPN) initiation and evolution, yet the contribution of the NKG2D receptor and its ligands MICA/MICB to CALR-mutated disease remains unclear. Methods: We performed high-resolution next-generation sequencing genotyping of MICA and MICB in 43 patients with CALR-mutated MPN (WHO 2022 criteria) and compared the allele and haplotype distributions with those of 156 healthy Bulgarian controls and 85 patients with JAK2 V617F-positive MPN. Associations were tested using age- and sex-adjusted additive generalized linear models; bi-locus haplotypes were evaluated using haplotype score methods. In a genotyped subgroup (35 CALR-mutated MPN patients and 105 controls), functional KLRK1 (NKG2D) polymorphisms were analyzed for haplotype-level associations. We also performed 700 ns molecular dynamics simulations of selected MICA variants in complex with NKG2D and reanalyzed publicly available single-cell RNA-sequencing data (GSE117826) and RNA-sequencing data from CRISPR/Cas9-edited CALR-mutant iPSC-derived megakaryocytes to evaluate MICA/MICB expression. Results: MICA*004:001 was significantly associated with CALR-mutated MPN versus controls (p = 0.004; Bonferroni-adjusted p = 0.047), while MICB*008:001 showed only nominal association. Exploratory haplotype analyses identified a MICA*009:01-MICB*004:001 haplotype associated with CALR-mutated status (p = 0.008) and a KLRK1 G-A-G-T haplotype (rs1049174-rs2617160-rs2246809-rs2617170) associated with increased CALR-mutated MPN risk (OR = 3.61; p = 0.029). Transcriptomic reanalysis indicated a higher fraction of CALR-mutant stem and progenitor cells expressing detectable MICA/MICB transcripts, and heterozygous CALR-mutant megakaryocytes exhibited higher MICA expression than the wild type. Conclusions: Together, these data support an exploratory immunogenetic and transcriptomic link between the NKG2D-MICA/MICB axis and CALR-mutated MPN, but direct protein-level and functional studies are required before mechanistic or therapeutic conclusions can be drawn. Full article

Background/Objectives: Non-specific low back pain (NSLBP) is the leading cause of disability worldwide. Artificial intelligence (AI) technologies are increasingly being integrated into healthcare interventions for NSLBP, yet their effectiveness remains uncertain. This systematic review and meta-analysis aimed to evaluate the effectiveness of AI-based Physical therapy (PT) interventions on pain intensity and disability outcomes in patients with NSLBP. Methods: We conducted a comprehensive search across six electronic databases. Randomised controlled trials (RCTs) evaluating AI-based interventions for NSLBP were only included. Mean differences (MD) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed using I² statistics and Cochran’s Q test. Results: Five RCTs (n = 1939) met the inclusion criteria for systematic review. Three RCTs (n = 594 participants) provided data for meta-analysis. AI-based interventions significantly reduced pain (pooled MD −0.721, 95% CI −1.047 to −0.395; z = −4.34, p < 0.001; I² = 9.5%). Disability also significantly improved (pooled MD −1.031, 95% CI −2.020 to −0.042; t(2) = −4.48, p = 0.046; I² = 0%). Neither effect reached the minimal clinically important difference (1.0 for pain, 2–4 for disability). No serious adverse events were reported. Conclusions: AI-based PT interventions produce statistically significant but clinically small improvements in pain and disability for NSLBP. Certainty of evidence is low due to risk of bias and imprecision. Larger, blinded RCTs with standardised outcomes are needed. Full article

Background/Objectives: Oral cancer is one of the most common types of cancer, with high mortality rates if not detected early. Traditional diagnostic methods based on clinical examination rely on experience, leading to delays in early and reliable diagnosis. In recent years, medical imaging and AI-based computer-aided diagnostic systems have shown promising results in the automated identification of oral cancer. In particular, the efficient management of high-dimensional feature spaces in machine learning and deep learning approaches directly impacts classification performance. In this context, metaheuristic-based feature selection technics is a critical component because of eliminating redundant and irrelevant features. To address these challenges, this study proposes a metaheuristic-based feature selection method to reduce feature dimensionality and enhance the classification performance of oral cancer detection. Methods: This study proposes an improved Honey Badger Algorithm-based feature selection approach for the automated detection of oral cancer. In the proposed method, the distance vector used in the HBA method has been redefined to improve the balance between exploration and exploitation. Additionally, a new Cauchy mutation-based migration strategy was integrated into the proposed method to increase diversity in the search space and avoid getting stuck in local minima. The continuous-valued iHBA method was discretized with a modified sin–cos transfer function for feature selection. Oral cancer images were filtered using the CLAHE method, and after extracting deep features with the ResNet50 architecture, the proposed metaheuristic-based method was used to select discriminative features. Results: The proposed method was first tested for reliability and limitations through repeated runs on problems with different characteristics, such as unimodal and multimodal classical test functions. Then, the method was applied to extract significant features for oral cancer detection using a Histopathological Imaging Database containing 1224 histopathological oral tissue images at 100× and 400× magnification levels from 230 patients. The proposed approach was assessed in terms of accuracy, precision, recall, F1-score, and convergence curves in comparison with various classical feature selection techniques, such as wrapper-based, filter-based, and embedded-based methods, as well as other metaheuristic-based methods. The experimental results demonstrated that the suggested strategy outperformed both traditional feature selection techniques and alternative metaheuristic approaches. Conclusions: The effectiveness of the proposed method in improving diagnostic accuracy was evaluated through comprehensive experimental analyses. The obtained findings show that the proposed iHBA-based feature selection approach can reduce feature dimensionality, eliminate redundant and irrelevant features, and improve the classification performance of oral cancer detection. Therefore, the proposed method provides an effective and competitive computer-aided diagnostic framework for the automated classification of histopathological oral cancer images. Full article

Social media studies often rely on one platform while drawing conclusions about online publics more generally. This study tests that inferential move through an event-centered comparison of El Niño discourse across X/Twitter, YouTube, Facebook, Reddit, TikTok, and LinkedIn. The observation window ran from 9 May through 17 May 2026, several days before and after the May 14 El Niño Watch issued by the National Oceanic and Atmospheric Administration (NOAA), which reported an 82 percent probability of El Niño emerging during May to July 2026 and a 96 percent probability of continuation through the 2026 to 2027 Northern Hemisphere winter. The corpus contains 8145 items classified as highly or moderately related to El Niño after platform-specific collection and common annotation. X/Twitter supplies 7075 items, YouTube 864, Facebook 66, Reddit 59, TikTok 50, and LinkedIn 31. Texts were annotated with a shared structured schema covering relevance, sentiment, emotion, topic, stance, likely misinformation, personal experience, humor, calls to action, language, engagement, and length. The results show that platform choice changes the empirical object. X/Twitter appears multilingual, fast-moving, and weather-heavy. YouTube is more negative, humorous, and personally experiential. Facebook is long-form and media/news oriented, with the highest model-flagged likely misinformation rate. Reddit is concentrated around weather concern. TikTok is short, playful, and personal. LinkedIn is small, professional, and mostly informational. These differences caution against generalizing from one platform to social media as a whole unless a study explicitly defines its scope, accounts for platform and genre differences, and recognizes that visible discourse may include organizational, algorithmically amplified, automated, or otherwise inauthentic activity alongside genuine human expression. Full article

Size-exclusion chromatography (SEC) or gel-permeation chromatography (GPC) is an essential tool for determining the molecular weight and polydispersity of water-soluble polymers, including biopolymers used in hydrogels, sealants, bioinks, and other biomedical materials. However, aqueous SEC of polyelectrolytes, i.e., charged polymers, is often complicated by non-size interactions among polymer chains, porous column beads, pore surfaces, frits, tubing, and mobile phase. Salt addition to eluent is commonly used to screen these interactions, but the minimum salt concentration required to restore reliable SEC behavior remains poorly defined, and excessive salt may introduce tailing, refractive-index artifacts, deposits, or instrument concerns. In this study, aqueous SEC with refractive index (RI) and right-angle light scattering (RALS) detection was used to evaluate the effect of salt ($\mathrm{N}{\mathrm{a}}_2\mathrm{S}{\mathrm{O}}_4$) concentration on poly(ethylene oxide) (PEO), a nominally neutral reference standard polymer, and sodium alginate as a model anionic biopolymer. PEO retained a single bell-shaped peak across the tested salt range, but its elution volume and SEC/RALS-derived molecular weights varied slightly with salt concentration, showing that even a nominally neutral reference polymer is affected by mobile-phase conditions. Alginate showed much stronger salt dependence: eluent at very low salt concentration produced broad, noisy, and convoluted chromatograms, whereas increasing salt concentration progressively narrowed the main peak. The first condition that produced a clear, approximately symmetric RI/RALS main peak was $6.25\times {10}^{-3} \mathrm{M}$ $\mathrm{N}{\mathrm{a}}_2\mathrm{S}{\mathrm{O}}_4$, identifying it as the minimum effective salt concentration for this alginate/column/instrument system. To rigorously validate these observations, we propose a set of both qualitative and quantitative peak analyses that objectively confirm the optimal mobile-phase conditions. Ultimately, these results provide a practical workflow for identifying the minimum effective salt concentration required for reliable SEC analysis of water-soluble polymers. Full article

Background/Objectives: Invasive coronary physiology has evolved from a tool for assessing intermediate stenoses to a comprehensive framework for guiding diagnosis and treatment across the spectrum of coronary artery disease (CAD). This review aims to provide an updated, catheterization laboratory-centered overview of contemporary invasive coronary physiology, emphasizing its role in optimizing percutaneous coronary intervention (PCI) and in evaluating patients with angina and non-obstructive coronary arteries (ANOCA/INOCA). Methods: A narrative review of contemporary evidence, including randomized trials, consensus documents, and guideline recommendations, was conducted. Key physiological indices—fractional flow reserve (FFR), non-hyperemic pressure ratios (NHPRs), coronary flow reserve (CFR), and index of microcirculatory resistance (IMR)—were examined alongside emerging tools such as longitudinal vessel analysis and the pullback pressure gradient (PPG). Applications in pre- and post-PCI assessment, physiology–imaging integration, and comprehensive functional testing in ANOCA/INOCA were evaluated. Results: Physiology-guided PCI improves clinical outcomes and resource utilization compared with angiography-guided strategies. Longitudinal vessel assessment and PPG enable characterization of focal versus diffuse CAD, improving procedural planning and prediction of post-PCI physiological results. Post-PCI physiological assessment identifies residual ischemia and guides optimization strategies. In patients without obstructive CAD, combined assessment of microvascular function and vasomotor reactivity allows identification of distinct pathophysiological endotypes, supporting mechanism-based, individualized therapy. Integration with intracoronary imaging further enhances procedural precision. Conclusions: Contemporary invasive coronary physiology provides a multidimensional approach integrating epicardial, microvascular, and vasomotor domains. This framework supports personalized decision-making, optimizes revascularization, and reduces unnecessary interventions, representing a cornerstone of modern coronary care. Full article