Developments in fusion imaging (FI) software have facilitated easy use of three-dimensional (3D) roadmaps based on preregistered computed tomography (CT) or magnetic resonance imaging (MRI) datasets for guidance of cardiac catheterizations. The aim of this study was to report the initial results from the first international prospective registry of cardiac catheterizations guided with fusion of CT and MRI datasets. A multi-center prospective registry was set up to evaluate fusion of fluoroscopic two-dimensional (2D) images and the CT- or MRI-derived 3D roadmaps for guidance of cardiac catheterizations in congenital heart disease. Fusion imaging was applied in 205 patients for guidance (n = 182) or planning (n = 23) of cardiac catheterization. Successful fusion of CT or MRI images was achieved in all cases. In 176 (96.7%) patients, 2D-3D registration was performed. In the remaining 6 patients, 3D-3D registration was utilized. Accurate initial 3D roadmap alignment was achieved in 142 (78%) patients. Seventeen (9.3%) patients required intra-procedural readjustment of the 3D roadmap due to distortion of the anatomy. Interventional procedures were performed in 137 (75.3%) patients. In 37 (20.3%) patients, catheterization was performed using only 3D guidance without additional angiography. Overall, 3D guidance with FI was deemed at least useful in 98.3% of patients and not useful or misleading in 3 (1.7%) patients. Direct 2D-3D registration of pre-catheterization CT or MRI is a safe and effective method of guidance of cardiac catheterization in selected congenital heart disease cases. In selected patients, FI facilitates percutaneous interventions without contrast angiography.
Recurrence of acute myocarditis (AM) is challenging. The management and natural history of patients who experience a recurrence of AM (Re-AM) remain poorly characterized. The aim of this study is to investigate clinical characteristics and outcomes of patients with Re-AM. In this international multicenter study, 141 consecutive patients with biopsy-proven or cardiac magnetic resonance-proven Re-AM (35 [26-45] years, 77% male, median left ventricular ejection fraction 55%) were investigated and compared with 372 consecutive patients with single acute myocarditis (S-AM). The primary outcome was a composite of all-cause mortality, heart transplant and major ventricular arrhythmias. Patients with Re-AM had more frequently a family history of cardiomyopathy (19% in Re-AM versus 2.8% in S-AM, P<0.001) and a diffuse late gadolinium enhancement compared with patients with S-AM (46% in Re-AM versus 34% in S-AM, P=0.019). The extent of late gadolinium enhancement also increased between the first and the second AM episode in patients with Re-AM (P=0.001). During a median follow-up of 33 months (interquartile range, 23-52) patients with Re-AM had a higher risk of primary outcome (P=0.001) compared with patients with S-AM, as well as a significantly elevated competing risk of major ventricular arrhythmias (P<0.001), which remained independently associated even after adjustment (hazard ratio, 2.15 [95% CI, 1.15-4.04], P=0.017). A family history of cardiomyopathy, autoimmune diseases, and ring-like late gadolinium enhancement was independently associated with a higher risk of recurrent AM. Re-AM is a distinct clinical subgroup of AM associated with generally worse prognosis and a specific increased arrhythmic risk compared with S-AM.
The aim of this study was to report clinical and hemodynamic results from a real-world registry of aortic valve replacement (AVR) with the Perceval sutureless bioprosthesis, comparing mini-sternotomy (MS) versus mini-thoracotomy (MT) approach. This prospective international registry enrolled 1,652 patients across 55 institutions between 2011 and 2021. Patients undergoing isolated AVR by minimally invasive cardiac surgery approaches were analyzed. Preoperative covariates were adjusted using 1:1 propensity score matching, reaching a final cohort of 261 patients for each approach. Isolated AVR via minimally invasive approaches was performed in 710 patients-406 in MS and 304 in MT. After matching, the baseline characteristics were similar between the two groups, except for the preoperative NYHA class distribution. MT was associated with shorter intensive care unit and hospital stays (p = <0.001 and p = 0.050, respectively), but with higher cross-clamp and cardiopulmonary bypass times compared to MS (<0.001). Within 30 days, one cardiovascular death occurred in the MS group, while 4 (1.5%) reinterventions were reported in the MT group. Pacemaker implantation was required in 5 (1.9%) patients in the MS group and 14 (5.4%) patients in the MT group, with no statistically significant difference. In the matched cohort, survival probability for late events showed no difference between surgical approaches. Mean pressure gradients remained stable during follow-up, with no difference between the groups. Our propensity-matched analysis demonstrates that the use of Perceval in minimally invasive approaches is associated with low perioperative complication rates. Sutureless implanted in MT has lower intensive care and in-hospital stay without significant differences in long-term clinical and echocardiographic outcomes.
International medical graduates (IMGs) hold a growing number of positions in the physical medicine and rehabilitation (PM&R) workforce; however, many IMGs continue to encounter notable challenges in navigating the United States residency application process. Accordingly, this study organized a one-hour, program director (PD)-led webinar to evaluate the impact of this educational event on attendees' self-perceived knowledge and confidence of seven key domains, including: (i) their baseline understanding of the PM&R residency program, (ii) writing a personal statement, (iii) building a curriculum vitae and arranging geographic preferences, (iv) communication for letters of recommendation and standard letters of evaluation, (v) utilization of program signaling, (vi) Interview and post-interview communication, and (vii) Other IMG-specific considerations. By comparing pre- and post-session questionnaire results, this retrospective study found statistically significant improvements in IMGs' self-perceived knowledge and confidence across all seven domains after attending this PD-led panel. Moreover, the overall satisfaction was high, and attendees reported that the panel was well-structured, relevant, and engaging. Accordingly, these findings highlight the importance of direct PD engagement in IMG-focused PMR education and the need for continued research into the specific challenges encountered by IMGs pursuing a PM&R residency application in the United States.
MicroRNAs (miRNAs) serve as crucial regulators of gene expression and are involved in many fundamental biological processes, including cell growth, differentiation, and programmed cell death. In recent years, a growing body of evidence has highlighted the vital role of miRNAs in the pathogenesis, prognosis, and therapeutic response of glioma tumors. Given the significant increase in research in this field over the past two decades, a comprehensive bibliometric analysis is essential to evaluate scientific trends, identify key researchers, assess international collaborations, and uncover emerging topics. Such an analysis can provide a clear overview of scientific advancements and existing knowledge gaps. This study presents a systematic bibliometric review, with data collected from the Scopus database. The search strategy combined the keywords "microRNA," "Glioma," "Research Trends," and "Brain Tumor" in article titles, abstracts, and keywords. The timeframe for this review was from 2007 to 2025, and only peer-reviewed articles published in English were considered. The extracted data were analyzed based on several metrics, including the number of annual publications, research growth trends, prominent authors, national and international scientific collaborations, and keyword co-occurrence frequency. Data visualization and analysis were performed using VOSviewer software to map co-occurrence networks. The analysis of publication trends revealed that research on microRNAs in glioma showed a consistent growth from 2010 onwards, peaking in 2020 with approximately 280 published articles, but has followed a downward trend since 2021. The co-authorship analysis by country identified China and the United States as the main hubs for scientific output and international collaboration in this domain. Among authors, Galina Gabriely (Center of Neurologic Diseases, Brigham and Women's Hospital, USA), Li Gang (Department of Neurosurgery, Huashan Hospital, Fudan University, China), Wang Y (Department of Neurosurgery, Capital Medical University, China), and You Yongping (Department of Neurosurgery, Nanjing Medical University, China) were recognized as the most prolific and influential researchers based on publication volume and centrality in the co-authorship network (Gabriely et al., 2008, Li et al., 2013, Wang et al., 2025). The use of full names and institutional affiliations facilitates accurate identification of these researchers in international databases such as PubMed. The author co-authorship map revealed several active and focused research clusters. In the keyword co-occurrence analysis, terms with the highest frequency and centrality were "glioma" (n = 653), "microRNA" (n = 589), "glioblastoma" (n = 413), "mir-21" (n = 201), "migration" (n = 180), "biomarker" (n = 164), "prognosis" (n = 139), and "therapy" (n = 132), establishing them as the core concepts of the studies. Four distinct conceptual clusters were extracted: molecular and cellular mechanisms, clinical applications, signaling pathways, and comparative studies between gliomas and other cancers.To provide readers with a clearer and more comprehensive perspective of these thematic clusters, representative signature publications within each domain are highlighted. In the molecular and cellular mechanisms cluster, studies such as Chen et al. (2021) and Beylerli et al., 2022b, Beylerli et al., 2022a have elucidated how specific microRNAs regulate glioma cell proliferation, migration, invasion, and apoptosis. Within the clinical applications cluster, Tluli et al., 2023a, Tluli et al., 2023 and Mafi et al. (2022) have emphasized the diagnostic, prognostic, and therapeutic potential of microRNA signatures in glioma patients. Regarding signaling pathways, Ahmed et al. (2021) and Makowska et al. (2023) have detailed the involvement of miRNA-mediated modulation of pathways such as PI3K/AKT, p53, and Wnt/β-catenin in glioblastoma progression. Finally, in the comparative oncology cluster, studies examining shared microRNA regulatory patterns across glioma and other malignanciesincluding hepatocellular carcinoma and osteosarcoma have been reported by Faramin Lashkarian et al. (2023) and related works, illustrating the broader oncogenic and tumor-suppressive roles of microRNAs across cancer types. The inclusion of these representative publications strengthens the conceptual interpretation of the bibliometric clusters and situates the findings within the broader scientific literature. The findings of this bibliometric study indicate that research in the field of microRNAs and glioma has experienced significant growth over the last two decades, with several key countries, institutions, and authors playing a prominent role in its advancement. Emerging topics such as diagnostic biomarkers, therapeutic targets, and miRNA-related signaling pathways in glioma tumors are central to recent research. This analysis can assist researchers and scientific policymakers in identifying knowledge gaps, strengthening international collaborations, and directing future research efforts.
Inborn errors of immunity (IEIs) are an expanding group of genetically defined disorders associated with infections, autoimmunity, and malignancy. Advances in high- throughput genomics and updates to international classifications have reformed the field, shifting from phenotype-based descriptions to molecular frameworks. Bibliometric analysis offers a structured approach to mapping research growth, collaboration, and thematic evolution. We analyzed global IEI research from 1995 to 2025 using bibliometric methods, focusing on publication trends, collaboration networks, leading contributors, and thematic shifts. Publications were retrieved from Web of Science Core Collection and PubMed. After screening, 840 original articles were analyzed with Biblioshiny and VOSviewer to assess citation patterns, coauthorship, thematic clusters, and keyword evolution. IEI research (n = 840; 333 journals; 7,466 authors) increased at 4.5% annually, with a marked rise after 2018 after next-generation sequencing and International Union of Immunologic Societies classification updates. The United States produced the largest output, while European countries had a higher citation impact per article. Collaboration was strongest between North America and Europe, with other regions remaining more domestically focused. Thematic mapping revealed a transition from clinical phenotypes to genetic, multiomic, and precision frameworks, alongside growing focuses on autoinflammation, immune dysregulation, and rare disease subgroups. Over 3 decades, IEI research has expanded substantially, reflecting a paradigm shift toward molecular discovery and international collaboration. Persistent regional disparities highlight the need for inclusive genomic studies and equitable partnerships, providing strategic insights to advance clinical immunology and enhance care for patients with rare immune disorders.
Chronic spontaneous urticaria (CSU) is a mast cell-mediated condition that can cause significant impairment in quality of life. Second-generation H1-antihistamines are recommended as first-line treatment, but a proportion of patients do not achieve adequate control and require add-on therapy. Omalizumab is the preferred biologic for CSU that is unresponsive to high-dose H1-antihistamines. Our aim was to assess the efficacy and safety of omalizumab in patients with CSU refractory to high-dose second-generation H1-antihistamines within a Middle Eastern tertiary care health care setting and to then relate the findings to current international urticaria guideline recommendations. A retrospective observational study was undertaken at a tertiary allergy clinic from September 2015 to September 2018. A total of 75 adults with CSU of more than 6 months' duration and unresponsive to 4-fold doses of H1-antihistamines received omalizumab and were followed in the clinic. The primary outcome was change in Urticaria Control Test score before and after treatment. Additional data included responder classification, comorbidities, laboratory findings, treatment intervals, and adverse events. There was a significant improvement in Urticaria Control Test score following omalizumab treatment (mean change -7.56; P < .001), with no association between outcome and baseline IgE levels. The response rates were 84% complete, 13% partial, and 3% poor. Most complete responders achieved control after 1 or 2 doses. Vitamin D deficiency and raised IgE level were frequent but did not predict response. Adverse events were infrequent and mild. Omalizumab is effective and well tolerated in CSU that is refractory to high-dose H1-antihistamines, providing rapid and sustained symptom control in most patients. Current international guidelines continue to recommend omalizumab as the first-choice add-on therapy in this setting, with other biologics remaining under investigation.
Women bear the brunt of human rights violations faced by persons with albinism, especially in sub-Saharan Africa. In addition to insufficient access to skin and eye care, increased rates of skin cancer, stigma and discrimination, and threats of mutilation and murder as they are reportedly trafficked for economic gain, they face heightened gender-based violence linked to misbeliefs about albinism. This study explored through a human rights lens the resilience of mothers affected by albinism, at the intersection of gender, colorism, and religion in Tanzania and South Africa. The critical ethnography involved participant observation, interviews, and sharing circles with 97 participants, including mothers and key informants such as albinism advocates, health and social workers, community leaders, and policy makers. In Tanzania, we conducted fieldwork in Mwanza and Dar es Salaam; in South Africa, in the provinces of Northern Cape and Gauteng. We present a comparative analysis of the two countries. The study shows that critical resilience comes about through social relationships, collective practices, and identities present in communities (local and national). We identified six promising practices that created conditions to strengthen gender equity: In Tanzania, peer support groups build capacity as human rights defenders; international non-governmental organizations (NGOs) fill gaps and advocate; and faith leaders act as advocates. In South Africa, progressive health system and policy frameworks, genetic counseling and health education equip families, and traditional healers act as advocates. The promising practices distilled from the Tanzanian and South African cases should be considered for broader uptake, importantly with local adaptations.
Cholera has re-emerged as a major global public health threat. Orally administered attenuated or inactivated vaccines offer protection against enteric pathogens such as Vibrio cholerae, and several World Health Organization-prequalified oral cholera vaccines are used globally as part of international cholera prevention and control measures. However, vaccine effectiveness, particularly in young children in low- and middle-income countries, is often lower than in adults, leaving this vulnerable age group at greater risk of cholera. The heat-labile toxin (LT) of enterotoxigenic Escherichia coli (ETEC) has strong mucosal adjuvant properties, and in detoxified form (double-mutant LT), it has been shown to safely improve immune responses to protein and somatic lipopolysaccharide antigens in children in Bangladesh who received the oral inactivated whole-cell enterotoxigenic ETEC vaccine ETVAX. Subsequent field trials of ETVAX in children in Zambia and The Gambia have also further demonstrated safety and immunogenicity in this difficult-to-immunize age group. Current concerns about reduced effectiveness of oral cholera vaccines in children led us to re-examine data from an earlier unpublished study conducted to discern for the first time, the adjuvant effects of LT on an orally administered vaccine in humans. The study showed that native LT improved immune responses to a cholera vaccine in adult volunteers. More recent work with double-mutant LT administered with the ETEC whole-cell vaccine ETVAX supports the findings reported here with the oral cholera vaccine Dukoral. These data suggest that modern attenuated versions of native LT, such as double-mutant LT, should be evaluated for improving immune responses to cholera vaccines.
Erectile dysfunction (ED) is a prevalent condition, with vasculogenic ED being the most common subtype, primarily related to endothelial dysfunction and cardiovascular risk factors. Low-intensity extracorporeal shock wave therapy (Li-ESWT) has emerged as a promising non-invasive treatment option. However, predictors of treatment response remain poorly defined. To identify clinical and vascular predictors of treatment success following Li-ESWT in patients with vasculogenic ED and to develop a novel, practical, and non-invasive scoring system to predict therapeutic response. This prospective study included 219 men aged 18-80 years with vasculogenic ED between January 2024 and January 2025. All patients underwent Li-ESWT (18 000 pulses over 3 weeks). Clinical and vascular parameters, including age, ED duration, body mass index, presence of cardiovascular risk factors, diabetes mellitus (DM), carotid intima-media thickness (cIMT), flow-mediated dilation rate (FMD), and prior phosphodiesterase type 5 inhibitor (PDE5i) response, were recorded. Treatment success at 6 months was defined as an increase of ≥1 point in the erection hardness score or ≥5 points in the International Index of Erectile Function-5 EF. The primary outcome was treatment success at 6 months after Li-ESWT. Secondary outcomes included the development and validation of a predictive scoring system. Treatment success rate was 66.2% (145/219). Independent predictors of treatment success were absence of DM (odds ratio [OR] = 2.67, P = .012), ED duration <36 months (OR = 2.23, P = .026), cIMT <0.8 mm (OR = 2.04, P = .042), prior PDE5i benefit (OR = 2.47, P = .016), FMD ≥5% (OR = 2.57, P = .012), age <65 years (OR = 2.28, P = .032), and presence of cardiovascular risk factors (OR = 2.23, P = .036). A scoring system incorporating these 7 variables achieved an area under the curve of 0.819 (95% confidence interval [CI] 0.762-0.877). Using a cut-off of 4.5 points, the sensitivity was 73% and the specificity was 77% (P < .001). This scoring system may help clinicians identify patients most likely to benefit from Li-ESWT, optimize patient selection, and improve individualized treatment strategies in vasculogenic ED. The study is strengthened by its prospective design, relatively large sample size, and inclusion of vascular function parameters (FMD, cIMT). Limitations include the lack of external validation and the absence of penile Doppler ultrasound confirmation in all patients. This study identified key demographic and vascular predictors of Li-ESWT response and introduces a novel, non-invasive clinical scoring system with strong predictive accuracy. This tool may enhance treatment personalization and support clinical decision-making in the management of ED.
Heart failure (HF) is a major cause of morbidity and mortality worldwide and is frequently associated with dysfunction of other organs, including the liver. Hepatic congestion and impaired perfusion from cardiac dysfunction may lead to liver injury, described as cardiohepatic syndrome. Studies suggest that liver dysfunction markers, such as the Model for End-Stage Liver Disease (MELD) and MELD excluding international normalized ratio (MELD-XI) scores, may serve as prognostic indicators in HF patients. This systematic review and meta-analysis evaluated the relationship between liver dysfunction markers and mortality outcomes in HF patients. A systematic literature search was conducted. Studies evaluating the association between liver dysfunction markers (MELD or MELD-XI scores) and mortality outcomes in adult HF patients were included. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using the generic inverse variance method with a random-effects model in Review Manager (RevMan) version 5.4 (The Cochrane Collaboration, Copenhagen, Denmark). Subgroup analyses were performed by liver dysfunction marker type and HF phenotype. The primary outcome was all-cause mortality. Nine studies comprising over 32,000 HF patients were included. Elevated liver dysfunction markers were significantly associated with increased mortality risk (pooled HR = 1.12, 95% CI 1.06-1.18). Substantial heterogeneity was observed (I² = 91%). Subgroup analysis showed significant associations for both MELD-XI (HR = 1.09, 95% CI 1.04-1.14) and MELD scores (HR = 1.10, 95% CI 1.06-1.14). Analysis by HF type revealed significant associations in acute HF (HR = 1.07), chronic HF (HR = 1.23), and advanced HF (HR = 1.05). Sensitivity analyses confirmed the findings, with no substantial publication bias observed. Elevated liver dysfunction markers significantly correlate with increased mortality in HF patients. Both MELD and MELD-XI scores provide prognostic information across HF populations. These findings emphasize the importance of considering hepatic dysfunction in HF assessment and suggest liver dysfunction markers may aid risk stratification. Further prospective studies are needed to determine the role of these markers in clinical decision-making.
Epididymitis is a common urogenital infection in adult men caused by sexually transmitted pathogens, urinary tract infections, trauma, or autoimmune mechanisms, with etiologies varying by age. In addition to severe pain and reduced quality of life, it may result in complications such as abscess formation, testicular atrophy, and infertility. Despite its clinical significance, comprehensive analyses of research trends remain limited. Bibliometric and knowledge-mapping approaches can provide quantitative insights into the field's development and hotspots. Using the Web of Science Core Collection and the PubMed Database, we retrieved literature related to epididymitis published from January 1, 2014, to September 10, 2025. Bibliometric analyses of publication volume, journals, authors, institutions, countries, and keywords were conducted using the Bibliometrix R package (v5.1.1), VOSviewer (v1.6.20), and CiteSpace (v6.4. R2). Scientific knowledge maps were generated to identify research hotspots and developmental trends in epididymitis. A total of 497 publications from 2,887 authors across 955 institutions in 67 countries were analyzed. Annual output remained stable at 30-50 articles since 2014. Andrologia was the most influential journal, and Pilatz Adrian was the leading author. China produced the most publications, the United States had the highest total citations, and Germany showed the highest average citation impact and strongest international collaboration. Justus Liebig University Giessen ranked first among institutions. Research trends have shifted from clinical diagnosis toward pathogenic and immunological mechanisms. Human studies focus on clinical features and treatment outcomes, whereas animal studies emphasize immunoinflammatory mechanisms and reproductive impacts. Research on epididymitis is advancing from clinical observation toward molecular immunology and precision therapy. Future studies should further focus on sexually transmitted pathogens, the immunopathological mechanisms of epididymitis, and the relationship between chronic inflammation and male infertility.
To compare the average time between the registration of a biological drug and its recommendation for incorporation for rheumatoid arthritis (RA) and cancer (CA) at national and international levels. This retrospective, comparative study analyzed the time taken to incorporate biological drugs recommended by National Commission for the Incorporation of Technologies (CONITEC) in the Brazilian Unified Health System(SUS) for RA and CA from January 1, 2012, to March 28, 2024. The incorporation time in Brazil was compared to that of regulatory bodies in England and Australia for the same treatments. Kaplan-Meier curves and the Log rank test were used to estimate time differences between countries. In Brazil, biological drugs for RA took an average of 2,019 days from the National Health Surveillance Agency (ANVISA) approval to CONITEC's incorporation recommendation. In England, the averages were 1,242 days for RA and 1,683 for CA, while in Australia, it was 744 days for RA and 1,315 for CA. Australia incorporated drugs faster than both England and Brazil. The lengthy process in Brazil for incorporating biological technologies for RA and CA may hinder access, delaying treatment for many patients. This barrier is particularly significant for low-income individuals who rely exclusively on the SUS.
For single-isocentre multi-target (SIMT) stereotactic radiosurgery (SRS), benchmarking, auditing and inter-institutional standardisation of dose verification remain challenging as they require specialized equipment and expertise. This work aims to develop and validate an electronic portal imaging device (EPID)-based technique to determine 3D dose in a virtual spherical phantom which is applicable across institutions for SIMT SRS dose verification. Small-field output factors from 11 international centres were measured in-water for the TrueBeam linear accelerator, including jaw-defined and high-definition multi-leaf collimator (MLC) fields from 0.5 × 0.5 to 20 × 20 cm2 and depths from 1.5-20 cm. Matching EPID images were collected at each centre. Utilising the average-centre data, jaw-derived and MLC-derived models were created to convert EPID images to three-dimensional dose in a virtual spherical phantom. Models were validated by comparing EPID-derived dose with film in a three-dimensional-printed spherical phantom for 11 non-coplanar SIMT SRS plans. Output factors estimated from EPID-to-dose models were within 1.8% (jaw-derived) and 1.0% (MLC-derived) of measured factors at 10 cm depth. For SIMT SRS plans, target dose differences were -0.3 ± 2.4% (mean ± standard deviation) and gamma pass rates were 99.6 ± 1.7% (5%/1.5 mm) for the jaw-derived model compared to film. For the MLC-derived model, -0.2 ± 2.1% dose differences and 99.7 ± 1.2% pass rates (5%/1.5 mm) were achieved. The EPID-based three-dimensional dose reconstruction method was modelled using multi-institutional data and validated for static and SIMT SRS deliveries. This method requires no specialised equipment and can be applied across institutions for benchmarking, auditing and standardised patient-specific quality assurance for SRS.
Curiosity is a fundamental human drive to explore, the desire to know. In particular, epistemic curiosity is the central construct in individual differences in curiosity. Epistemic curiosity represents a manifestation of exploratory behavior within the intellectual and cognitive domains. Japanese studies in epistemic curiosity have developed independently, based on Hatano and Inagaki's theory. Studies have been conducted on the role of learning and education for the two types of epistemic curiosity, diversive and specific curiosity. The Japan version of the Epistemic Curiosity (J-EC) scale, which measures these two types as a personality trait, has been developed based upon empirical studies using the J-EC scale. We thought it was necessary to develop an English version of the J-EC scale, in order to be able to make international comparisons of levels of curiosity among Japanese people. In this study, we translated the J-EC scale into English and assessed its factor structure, reliability, and validity. Results of factor analysis and correlation analysis validated the factor structure of diversive and specific curiosity, and the reliability and validity of diversive and specific curiosity subscales almost perfectly in accordance with our hypotheses.
Advancements in synthetic biology (SynBio) and other emerging and converging technologies, such as artificial intelligence (AI) additive manufacturing (3D printing), and nanotechnology are driving progress at an unprecedented pace. However, these promising and groundbreaking advances could also lead to novel biological risks, including the potential development of SynBio-enabled bioweapons (BW). Conducting a Delphi process, we consulted 13 experts from diverse relevant sectors. The multi-stage process included insights from literature reviews, expert interviews, two rounds of expert surveys, and two workshops. We identified consistent biological threat prioritizations and established consensus-driven policy recommendations. Based on this, we developed a novel hybrid governance framework. Our key proposal includes a multifaceted and integrative approach involving four sequential, iterative components: raising awareness; establishing robust training and monitoring systems to improve biosecurity measures; developing and implementing agile governance frameworks; and strengthening international treaties, such as the Biological Weapons Convention (BWC). We consider these integral, interconnected components to be interdependent and equally important. In an era of SynBio, AI-driven bioengineering, and democratization of biotechnology, implementing these recommendations will better safeguard against the potential misuse of these advancements in the context of the development and proliferation of BW.
This study provides a comprehensive mapping of the global research landscape on algae, microalgae, and seaweed in food-related applications over the period 1989-2024, with particular emphasis on food additives, nutraceuticals, functional foods, and bioactive compounds. Based on 929 records retrieved from the Web of Science Core Collection, a tailored bibliometric framework is employed that integrates performance analysis, science mapping, thematic evolution, and reference-year analysis, thereby linking publication dynamics with the intellectual and conceptual structure of the field. The findings indicate a pronounced and sustained growth in algae-based food research, characterized by extensive international collaboration and a rising emphasis on functional ingredients and health-promoting compounds. Thematic and conceptual analyses delineate algal extracts, bioactive compounds, polysaccharides, proteins, and lipids as the principal knowledge clusters. The evolutionary trajectory of the field reveals a progression from primarily biochemical characterization toward more application-oriented research in food, nutraceutical, and functional health domains. Collectively, these results provide a systematic evidence base to support researchers, industry stakeholders, and policymakers in understanding current research priorities and in identifying emerging directions in algae-based food innovation.
Bulbar urethral strictures are a common cause of lower urinary tract symptoms (LUTSs) in men and frequently recur after standard endoscopic treatments. There is growing interest in identifying less invasive techniques that provide durable outcomes compared to conventional endoscopic methods. Optilume has shown favorable outcomes in prospective trials, but real-world evidence, especially including treatment-naïve patients, remains limited. We performed a retrospective study in two German urology practices, including 40 men with symptomatic bulbar urethral strictures. Symptoms were assessed using the International Prostate Symptom Score (IPSS) and IPSS-derived quality-of-life (QoL) score at baseline and at follow-up. The primary endpoints were changes in IPSS and QoL; secondary endpoints included reintervention and safety. Nonparametric paired testing (Wilcoxon) and correlation analysis (Pearson) were applied. Median follow-up was 29.5 months. IPSS improved from a median of 19.5 (2-35) to 6.0 (0-26), and QoL improved from 5.0 (0-6) to 1.0 (0-5) (p < 0.000001). The median absolute change was ΔIPSS -10.5 overall; ΔIPSS was -16.5 in treatment-naïve patients and -9.5 in previously treated patients. Median ΔQoL was -4.0 overall (-3.5 treatment-naïve; -4.0 previously treated). One patient (2.5%) was scheduled for reintervention due to subjective dissatisfaction despite IPSS improvement. Treatment-naïve patients showed a trend toward better outcomes. Optilume demonstrated excellent mid-term outcomes (median follow-up: 29.5 months) in the treatment of bulbar urethral strictures, with significant improvements in symptom burden and QoL and a low reintervention rate (2.5%) in a real-world two-center cohort with a nonsignificant trend toward greater symptomatic improvement in treatment-naïve individuals. These findings support Optilume as a viable minimally invasive option. Larger prospective studies incorporating stricture-specific patient-reported outcome measures and comparative designs are needed to confirm long-term effectiveness, cost considerations, and optimal patient selection.
Automatic segmentation of gliomas on amino acid PET is essential for quantitative tumor assessment, a pillar in monitoring gliomas under treatment. This study aimed to develop a deep learning model for the automated extraction of PET RANO criteria from [18F]FDOPA PET, with external validation. A total of 635 static [18F]FDOPA PET scans from three European centers were retrospectively included for glioma diagnosis, recurrence assessment, or treatment monitoring. The training cohort comprised 530 scans from Nancy Hospital, with external validation and test sets from Pitié-Salpêtrière Hospital (n = 66) and Turin Hospital (n = 39). Ground truth segmentations followed international guidelines. A 3D U-Net was trained to segment tumor and healthy brain volumes. Performance was evaluated using the Dice coefficient using the whole tumor volume. Quantitative agreement for PET RANO criteria 1.0 parameters, tumor-to-background ratios (TBRmean, TBRmax) and metabolic tumor volume (MTV), was assessed at the lesion-level. Tumor segmentation achieved Dice of 0.925 [0.841; 0.970] in training, 0.885 [0.829; 0.925] in validation, and 0.851 [0.733; 0.911] in the test set. At lesion level, agreement with expert quantification was high, with low bias and strong reliability for MTV (2.293 [-4.734; 9.321] mL), TBRmax (0.056 [-0.189; 0.301]), and TBRmean (-0.139 [-0.424; 0.146]) and intra-class correlation coefficients superior to 0.93. Measurable lesions were correctly identified in more than 97% of cases. Our [18F]FDOPA PET deep learning model (available at https://github.com/IADI-Nancy/FDOPA-PET-GliomaSeg) demonstrates robust multicenter performance and enables fully automated, reproducible quantification, supporting broader clinical adoption of amino-acid PET in neuro-oncology. This study presents an automated method to measure glioma burden on brain imaging routinely used in clinical practice. Using a large multicenter dataset, we trained and validated a deep learning model that reliably identifies tumor tissue and produces quantitative measurements that closely match expert assessments. These measurements are central to evaluating treatment response and guiding clinical decision making. By reducing the variability and workload associated with contouring, this approach has the potential to streamline follow-up, improve consistency across centers, and support more robust response assessment in both routine care and clinical trials for patients with glioma.
Female sex is associated with lower incidence of myocardial infarction, especially at younger ages. However, sex differences in mortality and coronary artery disease patterns among young patients with ST-segment-elevation myocardial infarction are not well established. This study evaluated sex differences in in-hospital and 1-year all-cause death and in the extent of coronary artery disease in patients aged ≤45 years with ST-segment-elevation myocardial infarction. A systematic review (December 9, 2025) was conducted using PubMed, Cochrane, Embase, major cardiology conference proceedings, and ClinicalTrials.gov. Studies comparing sexes for outcomes were included. Non-English publications, abstracts without full text, and studies published before 2010 were excluded. A random-effects meta-analysis was performed, with results presented as relative risks (RR) and 95% CIs. Heterogeneity was assessed using τ and I2, risk of bias using the Risk of Bias in Nonrandomized Studies of Interventions tool. The study was registered on the International Prospective Register of Systematic Reviews. Eleven studies including 738 029 patients with ST-segment-elevation myocardial infarction (22% women) were analyzed. Female sex was associated with higher unadjusted in-hospital (RR, 1.56 [95% CI, 1.40-1.74]; τ=0.04; I2=0%) and 1-year mortality rate (RR, 1.78 [95% CI, 1.50-2.12]; τ=0.00; I2=0%). Women more frequently had single-vessel disease (73% versus 60%; RR, 1.13 [95% CI, 1.03-1.23]; τ=0.07; I2=67%), while men had 2-vessel (23% versus 18%; RR, 0.76 [95% CI, 0.68-0.85]; τ=0.00; I2=0%;) and 3-vessel disease (16% versus 9%; RR, 0.49 [95% CI, 0.27-0.86]; τ=0.41; I2=33%). In young patients with ST-segment-elevation myocardial infarction, female sex is associated with higher unadjusted in-hospital and 1-year death despite less extensive CAD. Further studies adjusting for comorbidities and standardizing CAD definitions are needed.