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Respiratory infectious diseases impose a heavy burden on global health. Exercise-related interventions have attracted increasing research attention, but the knowledge landscape and emerging trends in this field have not yet been comprehensively mapped. This study aims to address this gap through a bibliometric and visualization analysis of the literature published between 2000 and 2025. A search was conducted in the Web of Science Core Collection and PubMed databases, incorporating relevant English-language literature published between January 1, 2000, and March 31, 2025. After deduplication and screening, 944 articles were ultimately included. Co-occurrence network, clustering, and emergence analyses were conducted using CiteSpace 6.4.R1 software. Descriptive statistical analyses of publication volume and country, institutional, and author distribution were performed using Microsoft Excel. Publication output in this field has increased significantly since 2020, peaking in 2022, a trend highly consistent with the progression of the coronavirus disease 2019 (COVID-19) outbreak. Arena Ross, the University of London (United Kingdom), and the United States emerged as the most prolific author, institution, and country, respectively. Frequent keywords include "Physical activity," "Pulmonary rehabilitation," "Exercise," "COVID-19," "Coronavirus disease," "Rehabilitation," and "Quality of life." Keywords exhibiting high burst strength include "COVID-19 (30.04)," "Coronavirus disease (10.19)," and "respiratory tract infections (7.95)." Emerging research hotspots concentrate primarily on 3 domains: "respiratory function," "Telerehabilitation," and "dyspnea." Research on physical activity interventions for respiratory infectious diseases has shown sustained growth over the past 25 years, undergoing significant structural shifts during the COVID-19 pandemic. This study provides a broad overview of the knowledge landscape and developmental trajectory in this field.

The article "Identification of LGR5 and TFF2 as Biomarkers in High-Risk Chronic Atrophic Gastritis: From Multi-Omics Mining to Clinical Validation" [Digestion. 2026; https://doi.org/10.1159/000549887] by Qingqing Zhang, Di Wu, Fengyun Guo, Shengnan Yang, Lijing Bao, Ruiying Zhang and Ping Wang has been retracted by the Publisher and the Editor.Post-publication concerns were raised regarding the integrity of the clinical cohort data reported in the article. The data presented in Table 1 shares the same subgroup size, gender distributions and H. pylori infection rates across all three subgroups to those reported in a previously published article by the same research group [1]. Additionally, the images in Figure 4b and d of this article are published as Figure 2a and b in [1]. The previous publication was not cited in this article.When asked about the similarities between the cohorts, the authors stated that they were two independent cohorts and that the similarities were coincidental. The Editors did not find the authors' explanation sufficient to resolve their concerns, and as a result have lost confidence in the reliability and originality of the reported cohort data.The authors did not respond to our correspondence about the retraction of this article within the timeframe specified.

Transforming growth factor-β1 (TGF-β1) is involved in airway remodeling in asthma and chronic obstructive pulmonary disease (COPD) through extracellular matrix deposition, pro-fibrotic signal transduction and structural changes. This study used bibliometric methods to draw the development context and current research trends of TGF-β1-related airway remodeling research. On July 18, 2024, we queried the Web of Science Core Collection (WoSCC) to retrieve relevant records. Subsequent bibliometric analyses were performed using VOSviewer, CiteSpace, and R package "bibliometrix" to map collaborative networks, keyword co-occurrences, and emerging research frontiers. A total of 920 articles published from 1994 to 2024 were included, involving 5398 authors from 2652 institutions in 215 countries/regions. China had the highest global productivity with 290 publications. The University of California System was the leading institution with 65 publications. At the level of the individual author, Gosens Reinoud was the most productive author (with 17 publications). At the journal level, articles were mostly published in the American Journal of Respiratory Cell and Molecular Biology. Keyword analysis identified "expression," "inflammation," "asthma," and "growth-factor-beta" as frequent terms. Finally, burst detection illustrated "epithelial-mesenchymal transition (EMT)" and "oxidative stress" as important topics that have emerged recently. This bibliometric analysis maps the main contributors, cooperation networks, and evolving research topics of TGF-β1-related airway remodeling. This field has been centered on cellular mechanisms and inflammatory pathways, while recent studies have increasingly focused on oxidative stress and epithelial-mesenchymal transition. These findings may help guide the prioritization of future airway remodeling research.

Bipolar disorder (BD) is a chronic psychiatric illness. Thyroid hormones play a crucial role in maintaining normal brain function and have a significant impact on mood regulation and neuroendocrine activity. Increasing evidence suggests that thyroid dysfunction is closely related to the onset, progression, and severity of BD. A systematic bibliometric analysis of this field is important for understanding its research trajectory and identifying emerging hotspots. Literature on BD and thyroid hormones published between 1998 and 2022 was retrieved from the Web of Science Core Collection. Data were analyzed and visualized using VOSviewer and CiteSpace software to explore publication trends, major contributing countries and institutions, authors, journals, and keyword characteristics. A total of 452 relevant publications were identified, covering 229 journals, 2318 authors, 1443 institutions, and 188 countries. The United States, China, and Germany were the most active countries in this field. Major contributing institutions included the University of California, Los Angeles, the University of Toronto, and the Technical University of Dresden. Leading scholars were Bauer M, Whybrow PC, and Rybakowski JK. The Journal of Affective Disorders published the most relevant papers. Keyword analysis revealed that research hotspots mainly focused on BD, thyroid function, and depression, particularly around themes such as "risk," "affective illness," and "bipolar affective disorder." The relationship between thyroid hormones and BD has become an important research focus in recent years, providing new directions for future studies in this field. This study systematically reveals the research landscape and developmental trends from 1998 to 2022, offering valuable references and guidance for future research and clinical practice.

Diabetes is a major health concern in Malaysia, yet no comprehensive review has assessed the quality of care for these patients. This study aims to systematically review published evidence on type 2 diabetes mellitus (T2DM) management in Malaysian primary health care (PHC), focusing on the achievement of glycated haemoglobin (HbA1c), blood pressure (BP), and LDL-cholesterol (LDL-C) targets (ABC control). A scoping review was conducted, involving a comprehensive search of four databases (PubMed, Embase, Scopus, and MyMedR) and grey literature for publications up to December 2024. Studies were included if they reported on at least one ABC indicator among the general adult T2DM population in Malaysian PHC settings. The scoping review followed the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines. EndNote was used for deduplication, and Rayyan was utilised for the screening process. Data were extracted and synthesised narratively. A total of 109 publications were included. Publications increased post-2010 but remained geographically concentrated in urban states. Large-scale studies heavily relied on the National Diabetes Registry. HbA1c was the most reported indicator. Findings revealed no evidence of improvement in HbA1c and BP control over two decades; achievement rates were 30-45% for HbA1c (<7.0%) and 20-50% for combined BP target (<130/80 mmHg). Conversely, LDL-C control (&#x2264;2.6 mmol/L) showed a modest improvement, with achievement rates rising from approximately 30% to 50% over a decade. Despite a substantial increase in research, the HbA1c and BP control for T2DM in Malaysian PHC has remained static and suboptimal, highlighting a persistent gap between clinical guidelines and real-world outcomes. The modest improvement in LDL-C suggests that progress is achievable. These findings underscore the need for a balanced policy focus on all three ABC indicators, strategies to overcome systemic barriers, and continued investment in the national registry to guide evidence-based improvements in diabetes care.

Aim: To analyze the development and implementation of the new framework for assessing the functional status of disability in Ukraine, and to evaluate the results of the first year of the new system's operation. Materials and Methods: Sociological method was used. The Ministry of Health has published an analytical report on the results of the first year of work by the expert teams assessing a person's daily functioning from January 1, 2025. Before the reform, the system was based on 328 commissions and 1267 doctors. In contrast, after the reform, more than 7000 physicians were involved in all regions of Ukraine. More than 1,300 expert teams have been formed, making more than 554000 decisions in a yearStatistical analysis included descriptive statistics of indicators. Statistical processing and graphical visualisation of the data were performed using Microsoft Excel (Microsoft Excel for Microsoft 365 MSO, version 2603, build 16.0.19822.20086, 64-bit). Results: A new system focused on assessing functioning has been introduced into clinical practice. A comprehensive legal framework was developed, and the Center for Assessment of the Functional State of a Person was established in 2025. The system includes over 1300 expert teams and approximately 7000 doctors, operates nationwide, and is highly digitized via the Diia platform. Initial results show increased transparency, accessibility, and user satisfaction. Conclusions: The reform aligns with international standards and represents a systemic step toward rights-based disability assessment. However, further improvements are needed in regulatory support, institutional capacity, digital infrastructure, and consistent law enforcement.

Cognitive impairment and cerebral dysfunction are common among patients with end-stage kidney disease undergoing maintenance hemodialysis. Repeated intradialytic hemodynamic stress, including reductions in cerebral blood flow and episodes of intradialytic hypotension, has been associated with adverse neurological outcomes. Quantitative electroencephalography (qEEG) offers a noninvasive approach for continuous assessment of cerebral activity; however, its potential role in dialysis monitoring remains unclear because of methodological heterogeneity and implementation challenges. This scoping review aimed to synthesize current evidence regarding qEEG alterations across the hemodialysis cycle and to evaluate the technical requirements for translating qEEG-derived features into future dialysis-related cerebral monitoring systems. A structured literature search was conducted in PubMed/MEDLINE, Embase, and IEEE Xplore for studies published between January 2005 and February 2026. After removal of duplicates, 554 records were screened, and 70 full-text articles were assessed for eligibility. Sixty-two studies met the inclusion criteria and were included in the qualitative synthesis. Evidence was organized according to the 3 temporal domains of the hemodialysis cycle: predialysis baseline, intradialytic exposure, and postdialysis recovery. In addition to clinical findings, engineering-related evidence concerning electroencephalography hardware, electrode systems, signal processing pipelines, artifact mitigation, multimodal synchronization, edge computing, and digital biomarker validation was reviewed. Patients receiving maintenance hemodialysis consistently demonstrated baseline spectral slowing characterized by increased delta and theta activity, and reduced alpha power. During dialysis, multimodal imaging studies reported cerebral blood flow reductions of approximately 10% to 15%, accompanied by dynamic qEEG changes, including alterations in the alpha-delta ratio and slow wave activity. Connectivity and complexity measures provided complementary information regarding network-level and recovery-related responses but showed substantial variability across acquisition conditions and analytical pipelines. Major implementation challenges included electrical interference, motion artifacts, electrode instability, asynchronous physiological data streams, and limited standardization of preprocessing methods. Comparative analysis indicated that acquisition quality, artifact rejection performance, synchronization accuracy, and individualized baseline modeling are critical determinants of translational feasibility. Current evidence indicates that qEEG-derived measures have been reported in association with both chronic and intradialytic neurophysiological changes in patients undergoing hemodialysis. However, available evidence remains heterogeneous and insufficient to support routine clinical deployment. Future implementation will require standardized acquisition protocols, robust artifact mitigation, synchronized multimodal monitoring, and prospective validation studies. At present, qEEG-derived features should be regarded as candidate digital biomarkers and components of a proposed translational monitoring framework rather than clinically validated monitoring tools.

Physical inactivity among children and adolescents remains a major global public health concern, yet the ways in which behavioral theory is applied to inform physical activity (PA) interventions are often insufficiently described. The Behavior Change Wheel (BCW) model provides a systematic framework for linking behavioral determinants to intervention content, but its application in PA promotion for this population has not been comprehensively mapped. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported following the PRISMA-ScR guideline. Seven electronic databases were searched for studies published since 2011 that explicitly applied the BCW to promote PA among children and adolescents. Data were charted on study characteristics, targeted components of the Capability, Opportunity, and Motivation-Behavior (COM-B) model, BCW intervention functions, behavior change techniques, and implementation outcomes. Fifteen studies met the inclusion criteria. Most applications focused on intervention development, co-design, or feasibility rather than effectiveness evaluation. Psychological capability and reflective motivation were the most frequently targeted COM-B components, and education, training, and enablement were the dominant intervention functions. Commonly used behavior change techniques included goal setting, action planning, self-monitoring, feedback, and social support. Functions involving coercion or restriction were rarely used. Reporting of implementation outcomes was inconsistent, with limited attention to reach, penetration, and sustainability. In studies using the BCW framework, PA interventions for children and adolescents predominantly emphasize individual-level self-regulation strategies, with less focus on opportunity-level change and implementation sustainability. Greater transparency in theoretical mapping and stronger integration of implementation considerations are needed to enhance the translation of theory-based interventions into practice.

Sepsis-associated myocardial injury (SICM) is one of the most common and severe complications of sepsis. The present study aimed to analyze research trends, collaborative networks, and knowledge dissemination in SICM over the past decade using bibliometric methods, thereby providing a reference for future research directions. Relevant literature published between 2015 and 2025 was retrieved from the Web of Science Core Collection (WOSCC) database. A bibliometric cross-sectional analysis was performed using software tools, including VOSviewer and CiteSpace, with corresponding evaluation metrics extracted or calculated. Publications were categorized by country, institution, author, journal, highly cited papers, and keywords; these variables were compared with respect to publication output and academic impact, followed by bibliometric and visual analyses. Over the past decade (2015-2025), remarkable advances have been achieved in sepsis research related to SICM. A total of 2927 papers were included in this study. China, the United States, and England constituted the primary sources of publications in this field; among the top 20 contributing institutions, 15 were from China, 4 from the United States, and one from Australia, with Yang Yang identified as the core contributing author. Shock ranked first in the number of publications, while Critical Care topped the list in terms of citation frequency. The most frequently used keywords were sepsis, mortality, and septic shock. Analysis of keyword bursts revealed that precision regulation based on molecular mechanisms and the exploration of intervention targets represent the current research hotspots. Research on sepsis-associated SICM is flourishing. The present study clarifies the research hotspots in this field, provides a comprehensive overview of relevant research trends, and offers a reference for potential collaborations and future research directions.

&#xa0;The nasal mucosa is the primary defense mechanism of the upper respiratory tract. Its functionality relies heavily on the intricate balance of mucociliary clearance (MCC), mucosal hydration, epithelial tight junction integrity, and local immunological responses. While the detrimental physiological effects of low humidity and cold temperatures on nasal function are extensively documented in the literature, the physiological and pathological impacts of chronic exposure to high relative humidity (RH) and high temperatures-the defining characteristics of tropical and equatorial climates-remain significantly underrepresented and poorly synthesised. Given that approximately 40% of the global population lives in these climate zones, understanding these mechanisms is of paramount importance to global health. This evidence gap is particularly critical for sub-Saharan Africa, where sinonasal disorders constitute a significant and underappreciated component of the otolaryngological disease burden, yet region-specific clinical guidelines remain largely absent. Compounding this, rapid urbanisation across African and Asian tropical cities is accelerating the adoption of air-conditioning, creating novel patterns of indoor-outdoor micro-climatic exposure that may be fundamentally altering the epidemiology of chronic rhinitis.&#xa0;This systematic review aims to comprehensively evaluate the correlation between high ambient humidity in tropical climates and nasal mucosal function. The primary endpoints include mucociliary clearance times, ciliary beat frequency (CBF), mucus rheology (viscoelasticity), epithelial barrier integrity, and the epidemiological prevalence of specific sinonasal disorders such as tropical allergic rhinitis and non-allergic vasomotor rhinitis.&#xa0;A rigorous systematic literature search was conducted in strict adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search spanned PubMed, Scopus, Web of Science, and the Cochrane Library for peer-reviewed articles published between January 1, 2000, and January 1, 2025. Inclusion criteria mandated studies evaluating human nasal mucosal physiology, MCC time, CBF, and humidity levels exceeding 70%. Risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for randomised trials.&#xa0;Out of 1,420 initially identified records, 45 studies met the stringent inclusion criteria for qualitative synthesis. The aggregated data indicate a complex, non-linear, U-shaped relationship between ambient RH and MCC efficiency: optimal MCC occurs between 40% and 60% RH, while chronic exposure to tropical humidity (>70% RH) combined with high ambient temperatures (>28&#xb0;C) is associated with mucosal engorgement, altered mucus rheology characterised by decreased viscosity and elasticity, and a paradoxical slowing of ciliary beat frequency (CBF). Furthermore, the modern tropical lifestyle involves frequent, abrupt transitions between highly humid outdoor environments and cold, desiccating air-conditioned indoor spaces. This 'micro-climatic shock' may contribute to reactive turbinate hypertrophy, disrupted osmotic gradients, and increased susceptibility to perennial aeroallergens such as house dust mites and fungal spores.&#xa0;High ambient humidity in tropical climates is associated with altered nasal mucosal function, including impaired MCC and changes in mucus rheology. These findings highlight the need for climate-specific approaches to the management of sinonasal disorders. Keywords: Nasal mucosa; humidity; tropical climate; mucociliary clearance; rhinitis; air-conditioning.

Approximately 39.9 million people are living with HIV worldwide, most in sub-Saharan Africa. Effective antiretroviral therapy has shifted attention to metabolic comorbidities, and emerging evidence links integrase inhibitors such as dolutegravir to elevated serum uric acid, yet the global burden of hyperuricemia and gout in this population is unquantified. This protocol describes a systematic review and meta-analysis of observational studies (cross-sectional, cohort, and case-control) published from inception to May 2026. We will search PubMed/MEDLINE, EMBASE, Web of Science, and CINAHL. Studies involving adults (&#x2265;18 years) living with HIV that report the prevalence or incidence of hyperuricemia or gout will be included. Two independent reviewers will screen studies, extract data, and assess risk of bias using the Joanna Briggs Institute Prevalence Critical Appraisal Checklist and the Newcastle-Ottawa Scale (NOS). Primary outcomes are the pooled prevalence of hyperuricemia and gout in PLHIV. Secondary outcomes include risk factors associated with urate dysregulation (ART regimen, Cluster of Differentiation 4 [CD4] count, viral load, metabolic comorbidities, and HIV duration), and gout as an immune reconstitution inflammatory syndrome (IRIS) manifestation. A random-effects meta-analysis using the DerSimonian-Laird method with Freeman-Tukey double-arcsine transformation for prevalence data will be performed in R software. Heterogeneity will be assessed using the I2 statistic and Cochran's Q test. Subgroup analyses will explore variation by ART class (pre-ART, PI, NNRTI, INSTI/dolutegravir era), geographic region, CD4 category, and study quality. CRD420261360734.

As an established driver of hypertension, obstructive sleep apnea (OSA) generates a significant cardiovascular burden when both disorders are present. This intersection not only compromises nocturnal hemodynamics but also hampers long-term clinical management. Yet, current health care delivery rarely integrates the simultaneous and continuous tracking of these dual burdens. While wearable technology provides a noninvasive, pragmatic toolset for synchronized physiological monitoring, research remains largely siloed within single-disease frameworks. Consequently, clinical evidence supporting wearable applications specifically for comorbid populations remains sparse. In this scoping review, we summarized the current applications of wearable technology for comorbid OSA and hypertension. The analysis primarily outlines device categories, monitored physiological indicators, prevalent clinical scenarios, and existing challenges. The search for relevant literature spanned PubMed, Web of Science, Embase, and IEEE Xplore, covering the period from January 2015 to February 2026. Eligible studies included adults and used wearable or portable technologies to objectively track sleep- or respiratory-related indicators and cardiovascular/blood pressure metrics. Study selection, data charting, and evidence synthesis were conducted using a 2-reviewer process and descriptive and narrative approaches. Our initial search yielded 739 records. Following title and abstract screening, we reviewed 54 full texts, ultimately finalizing a cohort of 13 eligible studies. Published between 2015 and 2026 across 9 countries, these articles capture data from 5596 participants. Most were observational studies and device validation studies. Evaluated device types included wrist-worn devices, fingertip contact devices, patch and single-lead devices, and multiparameter portable monitoring systems. The clinical applications mainly focused on screening and risk stratification for comorbid OSA and hypertension, monitoring of abnormal nocturnal blood pressure and hemodynamic changes, and cardiovascular risk assessment and remote longitudinal management. However, research remains sparse, and different devices vary greatly in reference standards, diagnostic thresholds, and validation pathways; therefore, their clinical translational value still requires further validation. Wearable devices may complement traditional assessment by providing continuous nocturnal and longitudinal data. However, at present, they are more suitable as auxiliary monitoring and risk warning tools in comorbidity management and cannot yet replace standard sleep studies or standard blood pressure monitoring. Future research should further shift from feasibility validation to large-sample, prospective, multicenter clinical studies in comorbid populations.

The aging Canadian population has led to an increase in Canada's use of home and community care services. In this context, the healthcare system relies heavily on personal support workers who work in various healthcare settings. A significant proportion of these workers are immigrants, and many live in linguistic minorities. Despite their pivotal role, the experiences and working conditions of these personal support workers are underrepresented in the scientific literature, specifically in intersectional analyses. This scoping review aims to examine the work experiences, health conditions, and well-being of immigrant personal support workers in Canada who work in a minority language setting. Studies addressing the work experiences, health conditions, and well-being of immigrant personal support workers in Canada who work in a minority language setting, and those published in English or French. There will have no restrictions on publication date. This review will follow the JBI recommendations for scoping reviews and incorporate the PRISMA-ScR checklist. We will develop an adapted search strategy for five relevant databases (Medline [Ovide], Web of Science, Embase, CINAHL, and Google Scholar). Two independent reviewers will select full-text articles based on pre-established inclusion criteria and extracted relevant data. The results will be presented in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews) guidelines. This scoping review contributes to expanding knowledge about the professional, health, and social realities of immigrant PSWs in Canada's linguistic minority communities.

Euro-EWING99 study was a large, international, prospective study recruiting patients with Ewing sarcoma (EWS) between 1999 and 2015. It assessed three different clinical questions through randomized trials. We report here the characteristics and outcomes of all patients. Patients younger than 50 years with EWS were included in the study. They received induction chemotherapy (six courses of vincristine [day 1], ifosfamide [day 1-3], doxorubicin [day 1-3], and etoposide [day 1-3; VIDE], administered every 3 weeks), local therapy (surgery/radiotherapy), and different consolidation treatments according to clinical risk group and trial.The objectives of the study were to describe the entire cohort according to the initial staging group, to describe the survival outcomes (overall survival [OS]; progression-free survival [PFS]; and local control), and to evaluate prognostic factors associated with OS and PFS. Three thousand three hundred ninety-five patients were included in the study, including 2,267 with a localized disease, 614 with pleuropulmonary metastases, and 514 with extrapulmonary metastases. Ninety-eight percent of patients received &#x2265;4 neoadjuvant VIDE courses. The modalities of local treatment and consolidation therapy differed among the three staging groups. With a median follow-up of 7.2 years, PFS of the entire cohort was 60.2% and 55.4% at 3 and 5 years, respectively. OS was 72.6% and 64.6% at 3 and 5 years, respectively. In addition to metastatic status at diagnosis, main prognostic factors included patient age, tumor volume, and histologic response both for PFS and OS, independent of metastatic status. To our knowledge, this study is the largest published series of patients with EWS and may serve as a landmark paper for EWS. It confirms the major prognostic value of the complete histologic response after neoadjuvant therapy.

Recent advances in large language models (LLMs) such as GPT-3/4 have spurred the development of artificial intelligence (AI) chatbots and advisory tools in medicine. These systems are posited to assist or augment physician-patient communication, potentially improving empathy, clarity, and responsiveness. However, their actual impact on communication outcomes remains uncertain. This study aimed to systematically review and meta-analyze peer-reviewed studies (2020-2025) evaluating how LLM-based interventions affect physician-patient communication, including empathy, clarity, trust, and patient understanding. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, we searched PubMed/MEDLINE, Embase, Scopus, and Web of Science for studies published from 2020 to 2025 examining LLM or chatbot applications in clinical communication contexts. Eligible designs included randomized, observational, cross-sectional, and qualitative studies. Two reviewers (WHP and SR) independently screened titles or abstracts, assessed full texts, and extracted data on study design, population, LLM type, communication measures, and outcomes. We conducted a qualitative synthesis and random-effects meta-analysis, reporting pooled standardized mean differences or odds ratios with 95% CIs. From 312 records, 10 studies were included, all quantitative and predominantly cross-sectional. Populations ranged from patients with chronic conditions to health care professionals and laypersons. Outcomes assessed included empathy (8 studies), clarity or information quality (6 studies), satisfaction or usefulness (4 studies), and trust perceptions (2 studies). In 6 direct comparisons of AI- versus physician-generated responses, LLMs were rated significantly higher in empathy in 5 studies. One large study found that chatbot replies were judged empathetic in 45.1% of cases versus 4.6% for physician replies (odds ratio approximately 9.8, P<.001). Similarly, ChatGPT-4 answers scored higher in empathy on a 5-point scale than human-written responses (mean 4.18 vs 2.70, P<.001). One neurology study showed higher empathy scores (Consultation and Relational Empathy Scale +1.38, P<.01) for ChatGPT answers. Only 1 study found no significant empathy difference. LLM content was also longer and more information-rich, improving patient-perceived clarity and understanding. On the other hand, GPT-4 simplified pathology reports, increasing patient comprehension scores (7.98 vs 5.23/10, P<.001) and reducing consultation time by 70%. However, AI replies were sometimes less concise or less readable for low-literacy patients. In pooled analyses (k=4 studies; total evaluations N=2604), LLM assistance showed a large positive effect on empathy (standardized mean difference 1.02, 95% CI 0.44-1.60; random-effects model). Patient satisfaction results were mixed. No study directly assessed long-term trust. Current evidence suggests that LLM-based chatbots can enhance physician-patient communication by producing more empathetic, detailed, and understandable responses. These improvements may positively influence patient experience and engagement. However, LLMs may also generate overly lengthy or occasionally inaccurate advice, emphasizing the need for physician oversight. While meta-analytic findings are promising, robust randomized controlled trials, real-world and longitudinal studies are needed to confirm benefits, assess trust outcomes, and define optimal clinical integration strategies.

Journal analyses that capture trends, debates, and dilemmas offer valuable insight into the evolution of a field. Since 1996, the Journal of Deaf Studies and Deaf Education (JDSDE) has been a central journal in the field, demonstrating notable scholarly impact. This study aims to contribute to the understanding of Deaf Education and Deaf Studies by systematically examining 961 full articles published in JDSDE over 30&#xa0;years from a critical perspective. Articles were analyzed with respect to research topics, methods, and collaboration patterns. Eighteen topics were identified within educational, developmental, linguistic, and cultural categories. Literacy, language development, cognitive and social-emotional development, early intervention, and Deaf identity/culture accounted for 67.7% of the topics. Quantitative research dominated (78.8%). Interdisciplinary collaboration was satisfactory (60%). Findings indicate opportunities for greater representation of cultural topics, inclusion, early intervention, Deaf people with disabilities, and qualitative, single-case, action, mixed-methods research, and international collaboration. Future systematic analysis of all scholarly journals is anticipated to offer a more comprehensive and integrated view of Deaf Studies and Deaf Education.

Mild cognitive impairment (MCI) represents a clinically critical and heterogeneous syndrome characterized by cognitive decline exceeding normal aging expectations, yet insufficient to impair daily functioning. As the prodromal stage of dementia, MCI offers a crucial intervention window during which therapeutic strategies can modify disease trajectory. Therefore, accurate and early diagnosis is of paramount importance. Artificial intelligence (AI) systems have demonstrated promising performance across multiple diagnostic modalities, yet their performance relative to that of physicians remains incompletely characterized in the literature. A systematic search of 6 electronic databases (PubMed/MEDLINE, EMBASE, Web of Science, Scopus, PsycINFO, and CINAHL) was conducted, resulting in 1358 records. Following de-duplication, systematic evaluation of abstracts and full text applying prespecified eligibility criteria, and exclusion of systematic reviews and meta-analyses, 71 primary research studies were included for analysis. The included studies comprised 71 primary research studies published between 2008 and 2026. AI systems achieved diagnostic accuracy ranging from 62% to 100%, with neuroimaging-based and multimodal approaches often reporting the strongest performance (85-99%). Only 8 studies directly compared AI with physician diagnostic performance. In these limited and methodologically heterogeneous comparisons, AI systems generally matched or exceeded physician performance, although the available evidence base remains small. An artificial neural network achieved 90.0% sensitivity and 84.78% specificity compared to a panel of physicians collectively 46.66% sensitivity, while GPT-4 outperformed junior neurologists in 1 language-based study (81% vs 41-49%; P&#x2005;<&#x2005;.001). AI assistance improved neurologist diagnostic performance in 1 large study by approximately 26% in area under the receiver operating characteristic curve (AUROC) (P&#x2005;<&#x2005;.05). Most studies used internal validation without external datasets, limiting conclusions about real-world generalisability. AI approaches for early diagnosis of MCI appear promising and may support or enhance physician performance in selected settings, but widespread clinical adoption requires prospective validation, standardized physician benchmarking, and rigorous evaluation in real-world clinical environments.

Corneal sensation testing is essential for diagnosing and monitoring neurotrophic keratopathy, yet the gold-standard Cochet-Bonnet (COBO) aesthesiometer (>&#xa3;1000) is unavailable in most ophthalmology departments. The cotton wisp alternative is qualitative and insensitive to early sensory loss. This study evaluated whether a generic adjustable monofilament corneal aesthesiometer (GAMCA) fabricated from commodity materials could replicate COBO performance. The GAMCA comprised a 0.12&#x2009;mm nylon monofilament of adjustable length on a millimetre-scaled sliding carrier, constructed for &#xa3;10.28. Two independently fabricated devices were validated across 12 lengths (5-60&#x2009;mm, 20 measurements each) against published humidity-corrected COBO reference pressures using precision balance and corneal phantom testing. Agreement was assessed by standard-error weighted log-transformed Bland-Altman analysis with supporting regression and correlation statistics. Both devices produced monotonically increasing pressure-length relationships consistent with beam mechanics. Coefficient of variation ranged from 11.0% to 19.9%. Rank-order correspondence with COBO was near-perfect (Pearson's r&#x2009;=&#x2009;0.998-0.999; Spearman's &#x3c1;&#x2009;=&#x2009;1.00; Lin's concordance correlation coefficient 0.849-0.869). Geometric mean bias was &#xd7;1.22 (95% limits of agreement &#xd7;0.939 to &#xd7;1.576) at 60% humidity and &#xd7;1.41 (&#xd7;1.177 to &#xd7;1.680) at 50% humidity. A corneal aesthesiometer replicating COBO mechanical principles can be constructed for approximately 1% of its cost, with preserved rank-order fidelity and acceptable repeatability across clinically relevant pressures. This device could be suitable for community screening, ward-based settings and resource-scarce environments. Prospective clinical validation of reproducibility and threshold detection in normal and hypoaesthetic corneas are now warranted.

Impulsivity is a defining feature of borderline personality disorder (BPD), yet it remains unclear whether it reflects a stable deficit in inhibitory control or a context-dependent breakdown in behavioural regulation under conditions of emotional arousal. Existing models variably emphasise trait, cognitive or affective mechanisms, with limited integration of contextual influences. This scoping review synthesised empirical evidence examining affective mechanisms, neurobiological and methodological accounts of impulsivity in BPD. Following PRISMA-ScR guidelines, CINAHL, EMBASE, EMCARE, MEDLINE, and PsycINFO were searched for studies published between 1980 to November 2025. Forty-six studies meeting inclusion criteria were synthesised across affective, neurobiological, and methodological domains. Study designs included cross-sectional/correlational investigations (n = 17), experimental or task-based paradigms (n = 13), neuroimaging studies (n = 11), lesion or quasi-experimental designs (n = 3), and randomised controlled trials (n = 2). Impulsive behaviour in BPD was most consistently associated with affective instability, with negative urgency emerging as the most robust correlate. Self-report measures showed consistent elevations, whereas behavioural measures of inhibitory control under neutral conditions yielded heterogeneous findings, with several studies indicating preserved performance. Impairments were more reliably observed under emotionally salient or stress-inducing conditions. Neurobiological findings converged on dysregulation within frontolimbic and salience networks, particularly amygdala-prefrontal circuitry. Convergence across measurement modalities was limited, highlighting substantial heterogeneity. Evidence supports a model in which impulsivity in BPD reflects affect-modulated, context-dependent behavioural dyscontrol rather than a pervasive trait-level deficit. Heightened negative urgency and disrupted amygdala-prefrontal regulation appears central, linking affective instability to impulsive behaviour. These findings support mechanism-informed and context-sensitive approaches to assessment and intervention.