This review examines how metabolic reprogramming drives fibrosis and immune dysregulation in systemic sclerosis (SSc), emphasizing the role of nutrient-sensing and energy pathways in disease progression. SSc is characterized by a shift from catabolic to anabolic metabolism, defined by reduced AMP-activated protein kinase (AMPK) and enhanced mechanistic target of rapamycin complex 1 (mTORC1) signaling. This promotes biosynthetic activity, with upregulated glycolysis supplying substrates for collagen production and supporting pro-inflammatory immune cell polarization. Remodeling of the tricarboxylic acid cycle yields key metabolites with extrametabolic roles. α-ketoglutarate (αKG) supports epigenetic regulation, collagen maturation, and AMPK activation, offering protective effects. In contrast, succinate and fumarate promote inflammation and fibrotic signaling. Despite increased anabolic activity, oxidative phosphorylation remains elevated in SSc fibroblasts, contributing to excess reactive oxygen species (ROS). Metabolomic analyses consistently show disrupted amino acid and lipid metabolism, including glutamine and tryptophan pathways, linked to immune activation and fibrogenesis. Single-cell transcriptomics reveal diverse fibroblast subtypes with distinct metabolic programs correlating with fibrosis severity. SSc is characterized by a metabolic reprogramming that favors anabolic, profibrotic, and proinflammatory states. These interconnected metabolic shifts illustrate how central carbon and nutrient pathways not only sustain energy demands but also actively regulate profibrotic signaling, offering new therapeutic targets for modulating fibrosis.

Background: Surgical procedures and alterations of the gastrointestinal (GI) tract increase the risk of small intestinal bacterial overgrowth (SIBO), which is associated with GI symptoms and complications that compromise postoperative recovery. However, the prevalence and clinical impact of SIBO after various upper GI surgical procedures remain poorly understood. Objective: This study aimed to evaluate the prevalence of SIBO after different types of upper GI surgery and to investigate the associated clinical factors. Methods: We conducted an observational study involving 157 patients with a history of upper GI surgery: Roux-en-Y gastric bypass (RYGB), laparoscopic single-anastomosis gastric bypass (OAGB), subtotal (STG) or total gastrectomy (TG), subtotal (SP)or total pancreatectomy (TP), cephalic duodenopancreatectomy (WR), and small bowel resection for Crohn’s disease. A glucose–hydrogen breath test was performed, and demographic, clinical, and treatment-related data were collected. Statistical analyses included t-tests, non-parametric tests, ANOVA, and correlation analyses using R software. Results: At a median follow-up of 25.7 ± 18.1 months, 31% (48/157) of patients tested positive for SIBO. The highest prevalence was observed after RYGB and OAGB (43%), followed by TG (30%), STG (29%), TP/WR (28%), and Crohn’s disease bowel resection (19%). No cases of SIBO were observed after SP. SIBO positivity was significantly associated with bloating and flatulence (p = 0.002), lactose intolerance (p = 0.047), systemic sclerosis (p = 0.042), T2D (p = 0.002), and exposure to adjuvant chemotherapy (p = 0.001) and radiotherapy (p = 0.027). In addition, the risk of SIBO increased proportionally with the duration of GI resection or exclusion (p = 0.013). Conclusions: In our study, the prevalence of SIBO after upper GI surgery was 31%, with the highest incidence (43%) observed in metabolic surgery patients. Importantly, adjuvant radio/chemotherapy was associated with an increased risk of SIBO, and extensive small bowel resection or exclusion was strongly associated with an increased risk of SIBO. Furthermore, the limitations of current diagnostic methods, which lack sufficient sensitivity and specificity, highlight the importance of early screening and standardization of diagnostic techniques to improve patient management and outcomes.

We present the design and validation of a recirculating loop reactor that enables steady-state kinetic measurements for heterogeneous catalysis. This reactor is particularly suited for thin films and low surface area catalysts, which are not effectively evaluated in traditional flow reactors. Key improvements over previous recirculating reactors, such as direct heating of the sample with a focused IR lamp and temperature measurement in direct contact with the sample, allow for enhanced sensitivity and better kinetic analysis on samples with a low number of active sites or slow reaction rates. The system incorporates a bypass flow cell, to directly compare reactions on related powder catalysts under similar conditions with a standard plug-flow reactor. We demonstrate the reactor's capabilities by conducting CO oxidation experiments on a Pt(111) single crystal and a passivated, graphene-covered, Pt(111) crystal, highlighting the system’s ability to differentiate catalytic activity measurements in these model systems and compare them with high surface area powder catalysts of similar composition.

The rapid growth of the gig economy and digital platforms is challenging traditional gender roles, particularly in developing countries where structural inequalities continue to shape labor and household dynamics. Despite growing global interest in gender equity and digital inclusion, limited research has examined how gig work, digital access, and women’s income contributions interact to influence household gender dynamics within culturally conservative contexts. This study aimed to investigate the multidimensional impacts of women’s participation in gig work on time use redistribution, intra-household decision making, gender ideology, and role reversal within households in Pakistan. Using a cross-sectional survey design, data were collected from a representative sample of married couples engaged in the gig economy across urban and peri-urban areas of Pakistan. A quantitative analysis was conducted employing a combination of an analysis of variance, ordinal logistic regression, hierarchical multiple regression, and structural equation modeling to evaluate the direct and indirect relationships between constructs. The findings revealed that women’s gig work participation significantly predicted enhanced digital access, greater income contributions, and increased intra-household decision-making power. These, in turn, contributed to a measurable shift in gender ideology toward equality norms and a partial reversal of traditional gender roles, particularly in household labor division. The study concludes that the intersection of economic participation and digital empowerment serves as a catalyst for progressive gender restructuring within households. Policy implications include the need for gender-responsive labor policies, investment in digital infrastructure, and targeted interventions to support empowering women in non-traditional work roles.

The effectiveness of the System for Teaching and Assessment using Computer Algebra Kernel (STACK) in undergraduate mathematics education has been investigated in recent decades. However, the literature lacks quantitative studies exploring students’ attitudes toward it from various contextual backgrounds. This research delves into students’ perceptions and experiences in Biotechnology and Civil Engineering courses at the University of Trieste (in Northern Italy), with 161 respondents. Findings indicate no statistically significant differences in usage frequency between the two courses, suggesting a uniform acceptance of STACK as implemented in these courses. Descriptive statistics underscore students’ high satisfaction levels, with positive attitudes towards STACK’s utility in supporting topic understanding and improving exercise-solving skills. While course-specific variations revealed that Biotechnology students reported feeling less confident or more challenged during exercises, overall satisfaction remains notably high. A qualitative analysis of open-ended responses reveals concerns regarding system errors and repetitive tasks, which are attributed to the STACK materials rather than the STACK system itself. Respondents suggest improvements including bug fixes, reduced manual operations, and the integration of artificial intelligence to enhance feedback clarity.

The increasing digitalisation of medical education requires teachers to have a broad range of competences that go beyond basic technical knowledge. This pilot cross-sectional study assessed the self-perceived digital competence of medical faculty members and examined differences by professional role, experience and gender. Of 298 eligible staff, 48 participated (response rate 16.1%), including 19 women (39.6%) and 29 men (60.4%). The data was collected via an online survey using the validated Digital Competence Scale for University Teachers, which comprises four subscales: digital literacy, digital skills, digital interaction and technology integration. The overall median score indicated a generally high level of self-perceived digital competence, with 95% bootstrap confidence intervals confirming this pattern. Assistant professors achieved higher scores in all subscales than associate and full professors. Self-perceived digital competence was positively correlated with participation in structured training, higher interest and frequency of use of digital tools, while age and teaching experience were negatively correlated. The findings suggest unequal levels of self-perceived digital competence across the academic status and highlight the positive association of self-perceived digital competence with participation in targeted, practical and inclusive training programmes.

IntroductionChronic musculoskeletal pain is common among older adults (OAs). This study aimed to identify and describe the characteristics of chronic musculoskeletal pain, pain management, and coping strategies among OAs from Turkey, Croatia, and Romania. The study also aimed to explore cultural differences in pain experience and management.MethodsA total of 337 OAs with chronic pain participated: 100 from Turkey, 131 from Croatia and 106 from Romania. The mean age was 76.3 years in Croatia, 73.1 years in Romania, and 74.0 years in Turkey. The majority of participants in Croatia and Romania were female, while the majority of participants in Turkey were male. A structured questionnaire was used to explore four main topics, including factors influencing pain, coping strategies, management strategies, and health-related quality of life.ResultsSignificant differences in pain-related factors, pain management, and coping strategies were found between the three countries (p≤0.05). Physical activity, relaxation exercises, and warm showers/hot packs were associated with pain reduction. Climbing stairs was a significant pain increasing factor in both Romania and Turkey, with participants in these countries more than 2.5 times more likely to report it as a pain increasing factor compared to Croatia. Sitting had the opposite effect in Romania and Turkey. Significant predictors included higher visual analog scale-VAS scores, which were associated with worse self-rated health. Country of origin also influenced health perceptions, with Romanians less likely to report better health than Croatians.DiscussionThe findings highlight the cultural implications of pain perception and management. They reveal that older adults’ coping strategies and health-related quality of life are shaped not only by physical factors but also by beliefs and health perceptions unique to each country and influenced by culture. Education, including physical activity, medication use, and non-pharmacological methods like physiotherapy and interventions that consider cultural context can enhance pain control and health among older adults.