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23 pages, 2193 KiB  
Article
A Virome Scanning of Saffron (Crocus sativus L.) at the National Scale in Iran Using High-Throughput Sequencing Technologies
by Hajar Valouzi, Akbar Dizadji, Alireza Golnaraghi, Seyed Alireza Salami, Nuria Fontdevila Pareta, Serkan Önder, Ilhem Selmi, Johan Rollin, Chadi Berhal, Lucie Tamisier, François Maclot, Long Wang, Rui Zhang, Habibullah Bahlolzada, Pierre Lefeuvre and Sébastien Massart
Viruses 2025, 17(8), 1079; https://doi.org/10.3390/v17081079 - 4 Aug 2025
Abstract
Saffron (Crocus sativus L.) is a vegetatively propagated crop of high economic and cultural value, potentially affected by viral infections that may impact its productivity. Despite Iran’s dominance in global saffron production, knowledge of its virome remains limited. In this study, we [...] Read more.
Saffron (Crocus sativus L.) is a vegetatively propagated crop of high economic and cultural value, potentially affected by viral infections that may impact its productivity. Despite Iran’s dominance in global saffron production, knowledge of its virome remains limited. In this study, we conducted the first nationwide virome survey of saffron in Iran employing a high-throughput sequencing (HTS) approach on pooled samples obtained from eleven provinces in Iran and one location in Afghanistan. Members of three virus families were detected—Potyviridae (Potyvirus), Solemoviridae (Polerovirus), and Geminiviridae (Mastrevirus)—as well as one satellite from the family Alphasatellitidae (Clecrusatellite). A novel Potyvirus, tentatively named saffron Iran virus (SaIRV) and detected in three provinces, shares less than 68% nucleotide identity with known Potyvirus species, thus meeting the ICTV criteria for designation as a new species. Genetic diversity analyses revealed substantial intrapopulation SNP variation but no clear geographical clustering. Among the two wild Crocus species sampled, only Crocus speciosus harbored turnip mosaic virus. Virome network and phylogenetic analyses confirmed widespread viral circulation likely driven by corm-mediated propagation. Our findings highlight the need for targeted certification programs and biological characterization of key viruses to mitigate potential impacts on saffron yield and quality. Full article
(This article belongs to the Special Issue Emerging and Reemerging Plant Viruses in a Changing World)
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18 pages, 7965 KiB  
Article
Identification of Environmental Noise Traces in Seismic Recordings Using Vision Transformer and Mel-Spectrogram
by Qianlong Ding, Shuangquan Chen, Jinsong Shen and Borui Wang
Appl. Sci. 2025, 15(15), 8586; https://doi.org/10.3390/app15158586 (registering DOI) - 1 Aug 2025
Viewed by 195
Abstract
Environmental noise is inevitable during seismic data acquisition, with major sources including heavy machinery, rivers, wind, and other environmental factors. During field data acquisition, it is important to assess the impact of environmental noise and evaluate data quality. In subsequent seismic data processing, [...] Read more.
Environmental noise is inevitable during seismic data acquisition, with major sources including heavy machinery, rivers, wind, and other environmental factors. During field data acquisition, it is important to assess the impact of environmental noise and evaluate data quality. In subsequent seismic data processing, these noise components also need to be eliminated. Accurate identification of noise traces facilitates rapid quality control (QC) during fieldwork and provides a reliable basis for targeted noise attenuation. Conventional environmental noise identification primarily relies on amplitude differences. However, in seismic data, high-amplitude signals are not necessarily caused by environmental noise. For example, surface waves or traces near the shot point may also exhibit high amplitudes. Therefore, relying solely on amplitude-based criteria has certain limitations. To improve noise identification accuracy, we use the Mel-spectrogram to extract features from seismic data and construct the dataset. Compared to raw time-series signals, the Mel-spectrogram more clearly reveals energy variations and frequency differences, helping to identify noise traces more accurately. We then employ a Vision Transformer (ViT) network to train a model for identifying noise in seismic data. Tests on synthetic and field data show that the proposed method performs well in identifying noise. Moreover, a denoising case based on synthetic data further confirms its general applicability, making it a promising tool in seismic data QC and processing workflows. Full article
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27 pages, 6443 KiB  
Article
The Effects of the Choice of Liquefaction Criteria on Liquefaction in Soils with Plastic Fines
by Carmine Polito
J 2025, 8(3), 27; https://doi.org/10.3390/j8030027 - 1 Aug 2025
Viewed by 87
Abstract
Cyclic triaxial tests are widely used in laboratory studies to assess the liquefaction susceptibility of soils. Although standardized procedures exist for conducting these tests, there is no universally accepted criterion for defining liquefaction. The choice of a liquefaction criterion significantly influences the interpretation [...] Read more.
Cyclic triaxial tests are widely used in laboratory studies to assess the liquefaction susceptibility of soils. Although standardized procedures exist for conducting these tests, there is no universally accepted criterion for defining liquefaction. The choice of a liquefaction criterion significantly influences the interpretation of test results and subsequent engineering analyses. This study evaluates the impact of different liquefaction criteria by analyzing 42 cyclic triaxial tests performed on soil mixtures containing plastic fines. Both stress-based and strain-based liquefaction criteria were applied to assess their influence on test outcomes. The analyses focused on two key parameters: the number of loading cycles required to initiate liquefaction and the normalized dissipated energy per unit volume needed for liquefaction to occur. Results indicate that for soils susceptible to liquefaction failures, these parameters remain relatively consistent across different failure criteria. However, for soils prone to cyclic mobility failures, the number of loading cycles and the dissipated energy required for liquefaction vary significantly depending on the selected failure criterion. These findings highlight the importance of carefully selecting a liquefaction criterion, as it directly affects the assessment of soil behavior under cyclic loading. A better understanding of these variations can improve the accuracy of liquefaction susceptibility evaluations and inform geotechnical design and hazard mitigation strategies. Full article
(This article belongs to the Section Engineering)
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22 pages, 626 KiB  
Systematic Review
Exercise as Modulator of Brain-Derived Neurotrophic Factor in Adolescents: A Systematic Review of Randomized Controlled Trials
by Markel Rico-González, Daniel González-Devesa, Carlos D. Gómez-Carmona and Adrián Moreno-Villanueva
Sports 2025, 13(8), 253; https://doi.org/10.3390/sports13080253 - 1 Aug 2025
Viewed by 237
Abstract
Adolescence represents a critical period of neurodevelopment during which brain-derived neurotrophic factor (BDNF) plays a fundamental role in neuronal survival and synaptic plasticity. While exercise-BDNF relationships are well-documented in adults, evidence in adolescents remains limited and inconsistent. This systematic review examined the effects [...] Read more.
Adolescence represents a critical period of neurodevelopment during which brain-derived neurotrophic factor (BDNF) plays a fundamental role in neuronal survival and synaptic plasticity. While exercise-BDNF relationships are well-documented in adults, evidence in adolescents remains limited and inconsistent. This systematic review examined the effects of exercise modalities on circulating BDNF concentrations in adolescent populations. A systematic search was conducted following PRISMA guidelines across multiple databases (FECYT, PubMed, SPORTDiscus, ProQuest Central, SCOPUS, Cochrane Library) through June 2025. Inclusion criteria comprised adolescents, exercise interventions, BDNF outcomes, and randomized controlled trial design. Methodological quality was assessed using the PEDro scale. From 130 initially identified articles, 8 randomized controlled trials were included, with 4 rated as excellent and the other 4 as good quality. Exercise modalities included aerobic, resistance, concurrent, high-intensity interval training, Taekwondo, and whole-body vibration, with durations ranging 6–24 weeks. Four studies demonstrated statistically significant BDNF increases following exercise interventions, four showed no significant changes, and one reported transient reduction. Positive outcomes occurred primarily with vigorous-intensity protocols implemented for a minimum of six weeks. Meta-analysis was not feasible due to high heterogeneity in populations, interventions, and control conditions. Moreover, variation in post-exercise sampling timing further limited comparability of BDNF results. Future research should standardize protocols and examine longer interventions to clarify exercise-BDNF relationships in adolescents. Full article
(This article belongs to the Special Issue Neuromechanical Adaptations to Exercise and Sports Training)
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11 pages, 1914 KiB  
Case Report
Case Report of Nephrogenic Diabetes Insipidus with a Novel Mutation in the AQP2 Gene
by Alejandro Padilla-Guzmán, Vanessa Amparo Ochoa-Jiménez, Jessica María Forero-Delgadillo, Karen Apraez-Murillo, Harry Pachajoa and Jaime M. Restrepo
Int. J. Mol. Sci. 2025, 26(15), 7415; https://doi.org/10.3390/ijms26157415 (registering DOI) - 1 Aug 2025
Viewed by 113
Abstract
Nephrogenic diabetes insipidus (NDI) is a rare hereditary disorder characterized by renal resistance to arginine vasopressin (AVP), resulting in the kidneys’ inability to concentrate urine. Approximately 90% of NDI cases follow an X-linked inheritance pattern and are associated with pathogenic variants in the [...] Read more.
Nephrogenic diabetes insipidus (NDI) is a rare hereditary disorder characterized by renal resistance to arginine vasopressin (AVP), resulting in the kidneys’ inability to concentrate urine. Approximately 90% of NDI cases follow an X-linked inheritance pattern and are associated with pathogenic variants in the AVPR2 gene, which encodes the vasopressin receptor type 2. The remaining 10% are attributed to mutations in the AQP2 gene, which encodes aquaporin-2, and may follow either autosomal dominant or recessive inheritance patterns. We present the case of a male infant, younger than nine months of age, who was clinically diagnosed with NDI at six months. The patient presented recurrent episodes of polydipsia, polyuria, dehydration, hypernatremia, and persistently low urine osmolality. Despite adjustments in pharmacologic treatment and strict monitoring of urinary output, the clinical response remained suboptimal. Given the lack of improvement and the radiological finding of an absent posterior pituitary (neurohypophysis), the possibility of coexistent central diabetes insipidus (CDI) was raised, prompting a therapeutic trial with desmopressin. Nevertheless, in the absence of clinical improvement, desmopressin was discontinued. The patient’s management was continued with hydrochlorothiazide, ibuprofen, and a high-calorie diet restricted in sodium and protein, resulting in progressive clinical stabilization. Whole-exome sequencing identified a novel homozygous missense variant in the AQP2 gene (c.398T > A; p.Val133Glu), classified as likely pathogenic according to the American College of Medical Genetics and Genomics (ACMG) criteria: PM2 (absent from population databases), PP2 (missense variant in a gene with a low rate of benign missense variation), and PP3 (multiple lines of computational evidence supporting a deleterious effect)]. NDI is typically diagnosed during early infancy due to the early onset of symptoms and the potential for severe complications if left untreated. In this case, although initial clinical suspicion included concomitant CDI, the timely initiation of supportive management and the subsequent incorporation of molecular diagnostics facilitated a definitive diagnosis. The identification of a previously unreported homozygous variant in AQP2 contributed to diagnostic confirmation and therapeutic decision-making. The diagnosis and comprehensive management of NDI within the context of polyuria-polydipsia syndrome necessitates a multidisciplinary approach, integrating clinical evaluation with advanced molecular diagnostics. The novel AQP2 c.398T > A (p.Val133Glu) variant described herein was associated with early and severe clinical manifestations, underscoring the importance of genetic testing in atypical or treatment-refractory presentations of diabetes insipidus. Full article
(This article belongs to the Special Issue A Molecular Perspective on the Genetics of Kidney Diseases)
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16 pages, 3072 KiB  
Article
Process Development to Repair Aluminum Components, Using EHLA and Laser-Powder DED Techniques
by Adrienn Matis, Min-Uh Ko, Richard Kraft and Nicolae Balc
J. Manuf. Mater. Process. 2025, 9(8), 255; https://doi.org/10.3390/jmmp9080255 - 31 Jul 2025
Viewed by 194
Abstract
The article presents a new AM (Additive Manufacturing) process development, necessary to repair parts made from Aluminum 6061 material, with T6 treatment. The laser Directed Energy Deposition (DED) and Extreme High-Speed Directed Energy Deposition (EHLA) capabilities are evaluated for repairing Al large components. [...] Read more.
The article presents a new AM (Additive Manufacturing) process development, necessary to repair parts made from Aluminum 6061 material, with T6 treatment. The laser Directed Energy Deposition (DED) and Extreme High-Speed Directed Energy Deposition (EHLA) capabilities are evaluated for repairing Al large components. To optimize the process parameters, single-track depositions were analyzed for both laser-powder DED (feed rate of 2 m/min) and EHLA (feed rate 20 m/min) for AlSi10Mg and Al6061 powders. The cross-sections of single tracks revealed the bonding characteristics and provided laser-powder DED, a suitable parameter selection for the repair. Three damage types were identified on the Al component to define the specification of the repair process and to highlight the capabilities of laser-powder DED and EHLA in repairing intricate surface scratches and dents. Our research is based on variation of the powder mass flow and beam power, studying the influence of these parameters on the weld bead geometry and bonding quality. The evaluation criteria include bonding defects, crack formation, porosity, and dilution zone depth. The bidirectional path planning strategy was applied with a fly-in and fly-out path for the hatching adjustment and acceleration distance. Samples were etched for a qualitative microstructure analysis, and the HV hardness was tested. The novelty of the paper is the new process parameters for laser-powder DED and EHLA deposition strategies to repair large Al components (6061 T6), using AlSi10Mg and Al6061 powder. Our experimental research tested the defect-free deposition and the compatibility of AlSi10Mg on the Al6061 substrate. The readers could replicate the method presented in this article to repair by laser-powder DED/EHLA large Al parts and avoid the replacement of Al components with new ones. Full article
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35 pages, 887 KiB  
Review
Prognostic Factors in Colorectal Liver Metastases: An Exhaustive Review of the Literature and Future Prospectives
by Maria Conticchio, Emilie Uldry, Martin Hübner, Antonia Digklia, Montserrat Fraga, Christine Sempoux, Jean Louis Raisaro and David Fuks
Cancers 2025, 17(15), 2539; https://doi.org/10.3390/cancers17152539 - 31 Jul 2025
Viewed by 137
Abstract
Background: Colorectal liver metastasis (CRLM) represents a major clinical challenge in oncology, affecting 25–50% of colorectal cancer patients and significantly impacting survival. While multimodal therapies—including surgical resection, systemic chemotherapy, and local ablative techniques—have improved outcomes, prognosis remains heterogeneous due to variations in [...] Read more.
Background: Colorectal liver metastasis (CRLM) represents a major clinical challenge in oncology, affecting 25–50% of colorectal cancer patients and significantly impacting survival. While multimodal therapies—including surgical resection, systemic chemotherapy, and local ablative techniques—have improved outcomes, prognosis remains heterogeneous due to variations in tumor biology, patient factors, and institutional practices. Methods: This review synthesizes current evidence on prognostic factors influencing CRLM management, encompassing clinical (e.g., tumor burden, anatomic distribution, timing of metastases), biological (e.g., CEA levels, inflammatory markers), and molecular (e.g., RAS/BRAF mutations, MSI status, HER2 alterations) determinants. Results: Key findings highlight the critical role of molecular profiling in guiding therapeutic decisions, with RAS/BRAF mutations predicting resistance to anti-EGFR therapies and MSI-H status indicating potential responsiveness to immunotherapy. Emerging tools like circulating tumor DNA (ctDNA) and radiomics offer promise for dynamic risk stratification and early recurrence detection, while the gut microbiome is increasingly recognized as a modulator of treatment response. Conclusions: Despite advancements, challenges persist in standardizing resectability criteria and integrating multidisciplinary approaches. Current guidelines (NCCN, ESMO, ASCO) emphasize personalized strategies but lack granularity in terms of incorporating novel biomarkers. This exhaustive review underscores the imperative for the development of a unified, biomarker-integrated framework to refine CRLM management and improve long-term outcomes. Full article
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17 pages, 1486 KiB  
Article
Occurrence and Reasons for On-Farm Emergency Slaughter (OFES) in Northern Italian Cattle
by Francesca Fusi, Camilla Allegri, Alessandra Gregori, Claudio Monaci, Sara Gabriele, Tiziano Bernardo, Valentina Lorenzi, Claudia Romeo, Federico Scali, Lucia Scuri, Giorgio Bontempi, Maria Nobile, Luigi Bertocchi, Giovanni Loris Alborali, Adriana Ianieri and Sergio Ghidini
Animals 2025, 15(15), 2239; https://doi.org/10.3390/ani15152239 - 30 Jul 2025
Viewed by 118
Abstract
On-farm emergency slaughter (OFES) is employed when cattle are unfit for transport but still suitable for human consumption, thereby ensuring animal welfare and reducing food waste. This study analysed OFES patterns in Northern Italy, where a large cattle population is housed but information [...] Read more.
On-farm emergency slaughter (OFES) is employed when cattle are unfit for transport but still suitable for human consumption, thereby ensuring animal welfare and reducing food waste. This study analysed OFES patterns in Northern Italy, where a large cattle population is housed but information on the practice is rarely analysed. A total of 12,052 OFES cases from 2021 to 2023 were analysed. Most involved female cattle (94%) from dairy farms (79%). Locomotor disorders were the leading reason (70%), particularly trauma and fractures, followed by recumbency (13%) and calving-related issues (10%). Post-mortem findings showed limbs and joints as the most frequent condemnation sites (36%), often linked to trauma. A significant reduction in OFES cases occurred over time, mainly due to fewer recumbency and calving issues, likely reflecting stricter eligibility criteria introduced in 2022. Weekly variations, with peaks on Mondays and lows on Saturdays, suggest that logistical constraints may sometimes influence OFES promptness. These findings suggest that on-farm management and animal handling could be improved further to reduce welfare risks and carcass waste. Due to the lack of standardised data collection and regulatory harmonisation, a multi-country investigation could improve our understanding of this topic and inform best practice. Full article
(This article belongs to the Special Issue Ruminant Welfare Assessment—Second Edition)
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20 pages, 1220 KiB  
Systematic Review
The Evolving Role of Stem Cells in Oral Health and Regeneration: A Systematic Review
by Gianna Dipalma, Grazia Marinelli, Arianna Fiore, Liviana Balestriere, Claudio Carone, Silvio Buongiorno, Francesco Inchingolo, Giuseppe Minervini, Andrea Palermo, Angelo Michele Inchingolo and Alessio Danilo Inchingolo
Surgeries 2025, 6(3), 65; https://doi.org/10.3390/surgeries6030065 - 30 Jul 2025
Viewed by 278
Abstract
Background: Mesenchymal stem cells (MSCs), multipotent and immune-regulatory cells derived from tissues such as bone marrow, dental pulp, and periodontal ligament, emerged as promising agents in regenerative dentistry. Their clinical applications include endodontic tissue regeneration, periodontal healing, and alveolar bone repair, addressing [...] Read more.
Background: Mesenchymal stem cells (MSCs), multipotent and immune-regulatory cells derived from tissues such as bone marrow, dental pulp, and periodontal ligament, emerged as promising agents in regenerative dentistry. Their clinical applications include endodontic tissue regeneration, periodontal healing, and alveolar bone repair, addressing critical challenges in dental tissue restoration. Methods: A systematic review was conducted following PRISMA guidelines and registered in PROSPERO. We searched PubMed, Scopus, and Web of Science databases for open-access, English-language clinical trials and observational studies published from 2015 to 2025. Studies focusing on the application of MSCs in dental tissue regeneration were included based on predefined eligibility criteria. Results: Out of 2400 initial records, 13 studies met the inclusion criteria after screening and eligibility assessment. Most studies investigated MSCs derived from dental pulp and periodontal ligament for regenerating periodontal tissues and alveolar bone defects. The majority reported improved clinical outcomes; however, variations in MSC sources, delivery methods, sample sizes, and follow-up periods introduced methodological heterogeneity. Conclusions: MSCs show significant potential in enhancing bone and periodontal regeneration in dental practice. Nonetheless, the current evidence is limited by small sample sizes, short follow-up, and inconsistent methodologies. Future large-scale, standardized clinical trials are required to validate MSC-based regenerative therapies and optimize treatment protocols. Full article
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20 pages, 4256 KiB  
Article
Design Strategies for Stack-Based Piezoelectric Energy Harvesters near Bridge Bearings
by Philipp Mattauch, Oliver Schneider and Gerhard Fischerauer
Sensors 2025, 25(15), 4692; https://doi.org/10.3390/s25154692 - 29 Jul 2025
Viewed by 171
Abstract
Energy harvesting systems (EHSs) are widely used to power wireless sensors. Piezoelectric harvesters have the advantage of producing an electric signal directly related to the exciting force and can thus be used to power condition monitoring sensors in dynamically loaded structures such as [...] Read more.
Energy harvesting systems (EHSs) are widely used to power wireless sensors. Piezoelectric harvesters have the advantage of producing an electric signal directly related to the exciting force and can thus be used to power condition monitoring sensors in dynamically loaded structures such as bridges. The need for such monitoring is exemplified by the fact that the condition of close to 25% of public roadway bridges in, e.g., Germany is not satisfactory. Stack-based piezoelectric energy harvesting systems (pEHSs) installed near bridge bearings could provide information about the traffic and dynamic loads on the one hand and condition-dependent changes in the bridge characteristics on the other. This paper presents an approach to co-optimizing the design of the mechanical and electrical components using a nonlinear solver. Such an approach has not been described in the open literature to the best of the authors’ knowledge. The mechanical excitation is estimated through a finite element simulation, and the electric circuitry is modeled in Simulink to account for the nonlinear characteristics of rectifying diodes. We use real traffic data to create statistical randomized scenarios for the optimization and statistical variation. A main result of this work is that it reveals the strong dependence of the energy output on the interaction between bridge, harvester, and traffic details. A second result is that the methodology yields design criteria for the harvester such that the energy output is maximized. Through the case study of an actual middle-sized bridge in Germany, we demonstrate the feasibility of harvesting a time-averaged power of several milliwatts throughout the day. Comparing the total amount of harvested energy for 1000 randomized traffic scenarios, we demonstrate the suitability of pEHS to power wireless sensor nodes. In addition, we show the potential sensory usability for traffic observation (vehicle frequency, vehicle weight, axle load, etc.). Full article
(This article belongs to the Special Issue Energy Harvesting Technologies for Wireless Sensors)
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19 pages, 848 KiB  
Review
The Role of Sex in the Impact of Sleep Restriction on Appetite- and Weight-Regulating Hormones in Healthy Adults: A Systematic Review of Human Studies
by Mira Alfikany, Khaula Sakhr, Stef Kremers, Sami El Khatib, Tanja Adam and Ree Meertens
Clocks & Sleep 2025, 7(3), 39; https://doi.org/10.3390/clockssleep7030039 - 29 Jul 2025
Viewed by 205
Abstract
Short sleep has been linked to overweight, possibly via alterations in appetite-regulating hormones, but findings are inconsistent. Sex differences may contribute to this variability. This systematic review examines whether sex modifies the hormonal response to sleep curtailment. PubMed, Embase, Cochrane, CINAHL, and PsycINFO [...] Read more.
Short sleep has been linked to overweight, possibly via alterations in appetite-regulating hormones, but findings are inconsistent. Sex differences may contribute to this variability. This systematic review examines whether sex modifies the hormonal response to sleep curtailment. PubMed, Embase, Cochrane, CINAHL, and PsycINFO were searched for English-language experimental studies published before December 2024. Included studies assessed at least one appetite-regulating hormone and presented sex-specific analyses. Studies involving health conditions affecting sleep, circadian misalignment, or additional interventions were excluded. Risk of bias was assessed using the Revised Cochrane Risk-of-Bias tool (RoB 2). Eight studies (n = 302 participants) met inclusion criteria. A narrative synthesis of the findings was conducted for each hormone separately to explore potential differences in their response to sleep restriction. Some sex-related variations in hormonal response to sleep restriction have been observed for leptin (four studies, n = 232), insulin (three studies, n = 56), glucagon-like peptide-1 (one study, n = 27), ghrelin (three studies, n = 87), adiponectin (two studies, n = 71) and thyroxine (two studies, n = 41). However, findings were inconsistent with no clear patterns. No sex-related differences were found for glucagon or PYY, though data were limited. Findings suggest sex may influence hormonal responses to sleep restriction, but inconsistencies highlight the need to consider factors such as BMI and energy balance. Well-controlled, adequately powered studies are needed to clarify these effects. Full article
(This article belongs to the Section Human Basic Research & Neuroimaging)
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11 pages, 205 KiB  
Article
Toward Standardized Massive Transfusion Protocols: A Multicenter Evaluation of Practice Variability Within a National Trauma System
by Dongmin Seo, Junsik Kwon, Inhae Heo, Younghwan Kim, Jae Hun Kim, Taegyun Kim, Hangjoo Cho and Kyoungwon Jung
Healthcare 2025, 13(15), 1848; https://doi.org/10.3390/healthcare13151848 - 29 Jul 2025
Viewed by 274
Abstract
Background/Objectives: Hemorrhage remains a leading cause of early mortality in trauma patients, and timely transfusion guided by a structured massive transfusion protocol (MTP) is critical for improving outcomes. Although regional trauma centers have been established, standardized MTPs remain insufficiently developed in many [...] Read more.
Background/Objectives: Hemorrhage remains a leading cause of early mortality in trauma patients, and timely transfusion guided by a structured massive transfusion protocol (MTP) is critical for improving outcomes. Although regional trauma centers have been established, standardized MTPs remain insufficiently developed in many settings. This study aimed to evaluate current MTP practices across five major trauma centers within a national trauma care system. Methods: Participating institutions provided written protocols and completed a structured survey addressing key domains, including activation criteria, transfusion strategies, laboratory monitoring, adjunct therapies, termination processes, and performance improvement measures. Findings were analyzed and compared against established international recommendations. Results: All centers had implemented MTPs and were capable of delivering initial blood products within 15 min. However, considerable variation was observed in activation triggers, transfusion ratios, and laboratory monitoring protocols. None of these centers maintained thawed plasma or whole blood in immediate readiness. Only one of five centers had a formal performance improvement monitoring system. Tranexamic acid was included in all institutional protocols. Conclusions: This review highlights significant variability and critical gaps in MTP implementation across trauma centers. Inconsistent activation criteria, the absence of essential components, and limited quality monitoring may compromise the efficacy of current practices. To improve patient outcomes, a standardized, evidence-based MTP framework should be developed and implemented nationwide. Full article
20 pages, 1780 KiB  
Systematic Review
Morphological Variations of the Anterior Cerebral Artery: A Systematic Review with Meta-Analysis of 85,316 Patients
by George Triantafyllou, Ioannis Paschopoulos, Katerina Kamoutsis, Panagiotis Papadopoulos-Manolarakis, Juan Jose Valenzuela-Fuenzalida, Juan Sanchis-Gimeno, Alejandro Bruna-Mejias, Andres Riveros-Valdés, Nikolaos-Achilleas Arkoudis, Alexandros Samolis, George Tsakotos and Maria Piagkou
Diagnostics 2025, 15(15), 1893; https://doi.org/10.3390/diagnostics15151893 - 28 Jul 2025
Viewed by 281
Abstract
Background: The anterior cerebral artery (ACA), a critical component of the cerebral arterial circle, exhibits substantial morphological variability. While previous studies have explored ACA morphology using cadaveric and imaging methods, a comprehensive meta-analysis incorporating the latest evidence is lacking. Methods: Following [...] Read more.
Background: The anterior cerebral artery (ACA), a critical component of the cerebral arterial circle, exhibits substantial morphological variability. While previous studies have explored ACA morphology using cadaveric and imaging methods, a comprehensive meta-analysis incorporating the latest evidence is lacking. Methods: Following current guidelines, a systematic review and meta-analysis were performed across four major databases, supplemented by the gray literature and targeted journal searches. Ninety-nine studies, encompassing 85,316 patients, met the inclusion criteria. Statistical analyses were conducted using R, applying random effects models to estimate pooled prevalence and morphometric parameters. Results: The pooled prevalence of typical ACA morphology was 93.75%, whereas variants were noted in 6.25% of cases. The predominant variation identified was the accessory ACA (aACA) (1.99%), followed by unilateral absence of the A1 segment (1.78%), with the latter being more frequently recognized in imaging studies (p < 0.0001). Rare variants encompassed azygos ACA (azACA) (0.22%), fenestrated ACA (fACA) (0.02%), and bihemispheric ACA (bACA) (0.02%). The mean diameter and length of the A1 segment were measured at 2.10 mm and 14.24 mm, respectively. Hypoplasia of the A1 segment (<1 mm diameter) was recorded in 3.15% of cases. The influences of imaging modality, laterality, and population distribution on prevalence estimates were minimal. No significant publication bias was detected. Conclusions: Although infrequent, variants of the ACA possess significant clinical importance attributable to their correlation with aneurysm formation and the impairment of collateral circulation. The aACA and the absence of the A1 segment emerged as the most common variations. This meta-analysis presents an updated and high-quality synthesis of ACA morphology, serving as a valuable reference for clinicians and anatomists. Full article
(This article belongs to the Special Issue Advances in Anatomy—Third Edition)
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15 pages, 319 KiB  
Systematic Review
Vitamin D Deficiency and Risk of Gestational Diabetes Mellitus in Western Countries: A Scoping Review
by Paola Correa, Hirukshi Bennett, Nancy Jemutai and Fahad Hanna
Nutrients 2025, 17(15), 2429; https://doi.org/10.3390/nu17152429 - 25 Jul 2025
Viewed by 363
Abstract
Background: Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication globally. Maternal vitamin D deficiency has been linked to the risk of GDM. The aim of this study was to explore and synthesise current evidence on the association between vitamin D deficiency and [...] Read more.
Background: Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication globally. Maternal vitamin D deficiency has been linked to the risk of GDM. The aim of this study was to explore and synthesise current evidence on the association between vitamin D deficiency and the development of gestational diabetes in Western countries. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodological framework. Relevant studies were identified through a comprehensive search across seven databases: ProQuest Public Health, Google Scholar, PubMed, ScienceDirect, The Lancet, BMC Public Health, the International Journal of Women’s Health, and Scopus. Studies were included based on predefined inclusion and exclusion criteria relevant to the research question. The review followed the JBI protocol, and the PRISMA flowchart was used to guide and visualise the study selection process. Results: Nineteen studies were included in the final analysis, comprising research predominantly from Australia (5), the United States (5), and Canada (4). The findings indicate a notable association between vitamin D deficiency and GDM risk, moderated by factors such as maternal age, ethnicity, seasonal variation, and body mass index (BMI). Older maternal age and higher BMI were linked with lower vitamin D levels and a higher incidence of GDM. Ethnic groups with darker skin tones showed higher rates of vitamin D deficiency, increasing vulnerability to GDM. Seasonal patterns revealed lower vitamin D levels during winter months, correlating with greater GDM risk. These patterns underscore the need for targeted preventive strategies, including the potential role of vitamin D supplementation. Conclusions: This review supports an observed association between maternal vitamin D deficiency and increased GDM risk, influenced by demographic and environmental factors. While the evidence points to a potential preventative role for vitamin D, further high-quality research, including systematic reviews and meta-analyses, is essential to establish causality and inform clinical guidelines. The review identifies knowledge gaps and suggests directions for future research and clinical practice. Full article
(This article belongs to the Section Nutrition and Diabetes)
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Systematic Review
Effects of Different Types of High-Intensity Interval Training (HIIT) on Physical Performance in Female Basketball Players—A Systematic Review
by Ilma Čaprić, Mima Stanković, Ivana Bojić, Borko Katanić, Igor Jelaska, Luka Pezelj, Bojan Masanovic, Valentina Stefanica and Karuppasamy Govindasamy
Life 2025, 15(8), 1180; https://doi.org/10.3390/life15081180 - 25 Jul 2025
Viewed by 484
Abstract
The aim of this systematic review was to examine the effects of high-intensity interval training (HIIT) on physical performance and body composition in female basketball players. The review followed PRISMA guidelines, and the protocol was registered in the PROSPERO database (registration number: CRD420251006285). [...] Read more.
The aim of this systematic review was to examine the effects of high-intensity interval training (HIIT) on physical performance and body composition in female basketball players. The review followed PRISMA guidelines, and the protocol was registered in the PROSPERO database (registration number: CRD420251006285). A comprehensive search was conducted across PubMed, Scopus, Web of Science, and Google Scholar. Nine studies that met the inclusion criteria were analyzed, with intervention durations ranging from 4 to 12 weeks. Despite differences in protocols, a majority of studies reported improvements in VO2max (6/9), explosive strength (7/9), agility (5/6), and speed (5/6) and reductions in body mass and fat percentage (3/3). These findings highlight HIIT as an effective method for enhancing both aerobic and anaerobic capacities, as well as optimizing body composition. Despite variations in study protocols, HIIT consistently offers improvements in performance, irrespective of training level. The results underscore the importance of HIIT in preparing athletes, not only during the preseason but also throughout the competition period. Coaches should consider integrating HIIT into training programs, adjusting intensity and volume based on the season to optimize performance and prevent overtraining. Full article
(This article belongs to the Special Issue Effects of Exercise Training on Muscle Function)
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