Cardiomyocyte mechanical contraction sensitivity-enhanced biosensing for precise drug evaluation.

Multi-source straw used as a resource can reduce environmental and economic burdens

Multifunctional bilayered nanofibrous scaffold of chitosan/poly(caprolactone) enriched with simvastatin and thymoquinone for accelerated diabetic wound healing.

Attention-deficit/hyperactivity disorder (ADHD) persists into adulthood in up to 60% of cases, affecting 2.5-6.8% of adults worldwide, with high comorbidity rates of mood, anxiety, and substance use disorders, and significant functional impairments, such as reduced quality of life, increased mortality, and economic burden. This review synthesizes etiological factors, including neuroimaging evidence of fronto-striatal and default mode network disruptions, high heritability up to 70-80% driven by common, polygenic and rare variants, and environmental risk factors. Treatment emphasizes multimodal approaches, with stimulants as first-line pharmacotherapy due to their superior efficacy over non-stimulants like atomoxetine and viloxazine. Novel agents in development, such as centanafadine triple reuptake inhibitor and solriamfetol target core symptoms and comorbidities, showing promising phase III results. Despite the high effect sizes of pharmacological treatment for ADHD, obstacles such as acceptance and adherence remain challenging. Neuromodulatory interventions, including transcranial direct current stimulation (tDCS) and neurofeedback, demonstrate moderate effects on inattention and executive function. Psychotherapeutic options, particularly cognitive-behavioral therapy (CBT)-based interventions, improve symptom management and emotional regulation, often as adjuncts to medication. The review highlights the need for personalized strategies addressing adherence, comorbidity, and long-term outcomes, emphasizing integrated care to mitigate ADHD's lifelong impact.

To estimate and compare the economic burden of obesity across three Integrated Care Boards in England, with a specific focus on the contribution of Type 2 diabetes and related complications. An adapted burden of obesity model integrating estimated national health costs data with local population metrics was applied to the integrated care boards to estimate health care, social care, productivity and economic and quality of life associated costs. Data were stratified by sector, age, sex, BMI and prevalence of obesity-related complications. Across the regions, 599,248 adults were living with obesity. Total economic burden reflected obesity prevalence, with the highest costs in Leicester, Leicestershire and Rutland, followed by Bedfordshire, Luton and Milton Keynes and then Northamptonshire. Despite this, Bedfordshire, Luton and Milton Keynes had the highest per-patient costs across all cost categories. Social care and productivity losses each contributed approximately 30% of total costs, with informal care comprising 96% of social care expenditure. Per-patient healthcare costs increased with BMI. Type 2 diabetes and hypertension were among the most prevalent and costly complications, while stroke and coronary heart disease had the highest per-patient costs. Coexisting coronary heart disease with Type 2 diabetes significantly increased treatment costs. Obesity was more prevalent among working-age adults, with males incurring higher per-patient complication costs across all conditions and integrated care boards. This study demonstrates the significant and variable local economic burden of obesity. Disparities in per-patient costs, sex and complication profiles highlight the need for stratified, data-driven commissioning. Targeted prevention in high-burden areas can help ICBs reduce system pressures and guide effective local strategies.

School greenspace and myopia incidence and burden in Chinese children and adolescents: The Guangzhou children and adolescents cohort study.

Dual-responsive PDA-HP hydrogel enables mitochondria-targeted mild photothermal therapy for spinal cord repair.

Homoplantaginin ameliorates osteoarthritis by activating Sirt3/PINK1/Parkin signaling to promote mitophagy and attenuate inflammation in chondrocytes.

Dieckol, a phlorotannin from Ecklonia cava, alleviates stress hormone-induced depressive-like behaviors through glucocorticoid receptor antagonism.

Single-vesicle profiling of multiple biomarkers on serum EVs via EV-CATCH and nano-flow cytometry for clinical stratification of Alzheimer's disease.

Heart failure (HF) is a major public health challenge, contributing to high morbidity, mortality, and significant economic burden worldwide. Early diagnosis and accurate risk stratification are critical for improving patient outcomes and guiding clinical decisions. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a well-established blood biomarker of ventricular overload, widely used for diagnosing HF and assessing its severity. Beyond diagnosis, NT-proBNP provides valuable prognostic insights into treatment response and can predict adverse cardiovascular events, such as HF-related hospitalizations and mortality, thus playing a key role in personalized care and therapeutic management. Despite its clinical significance, current CE/FDA-certified methods for NT-proBNP measurement face critical limitations, particularly in point-of-care settings and for ongoing, minimally or non-invasive monitoring. These constraints hinder the ability to perform remote (e.g. community medical clinic) monitoring-a crucial capability for revolutionizing heart failure management. To address this challenge, we report the development and proof-of-concept validation of an ultrasensitive (compared to gold standard enzyme-linked immunosorbent assays), miniaturized electrochemical biosensor for fast and minute sample detection of NT-proBNP in tears from a well-characterized cohort of heart failure patients. Correlation analysis of NT-proBNP concentrations in tear fluid and blood plasma/serum, together with key clinical parameters, demonstrates that tear fluid is a promising non-invasive matrix for heart failure diagnosis and continuous monitoring in point-of-care settings. This approach provides a transformative pathway to advance heart failure management by enabling remote, point-of-care diagnostic monitoring outside of centralized hospitals and laboratories.

Empowering active surveillance of Carbapenem-resistant Enterobacterales: Insights from one year of genomic surveillance.

A causal attention network with time frequency channel feature fusion for epileptic seizure prediction.

Sickle cell disease (SCD) is a major individual and public health challenge in sub-Saharan Africa, where over 5 million affected individuals live and where access to disease-modifying treatment is limited. Despite established safety and efficacy of hydroxyurea, its use is limited across the region due to inconsistent healthcare infrastructure, high medication and laboratory costs, inadequate clinician training, and persistent disease stigma. Practical hydroxyurea dosing strategies, integration into national health plans, and a stronger supply chain are necessary to improve access to this life-saving medication. Newly approved medications, such as L-glutamine and crizanlizumab, may provide additional benefits to select patients, but are expensive and unavailable. The increased mortality observed in people on voxelotor in Africa highlights the need to ensure the safety of any new medication in varied settings through high-quality research conducted on the continent. Overall, holistic strategies are needed to improve SCD care in Africa, such as universal screening with connection to comprehensive care that includes disease-modifying treatment, community and healthcare worker education, centers of excellence, and capacity building. SCD management in Africa can be transformed by addressing systemic barriers and leveraging collaborative partnerships, leading to reduced mortality and alleviation of the individual and economic burdens of the disease. It is a moral and economic imperative to prioritize access to SCD treatment in Africa, the region with the greatest disease burden globally.

The role of AI-driven communication in delirium prevention, detection, and care for critically ill ICU patients: A systematic review with inductive thematic synthesis.

Introduction: The increased prevalence of Chronic Obstructive Pulmonary Disease (COPD) worldwide, and particularly in India, is of major concern as it causes a high economic burden. It also leads to disability, impairs the quality of life, loss of productivity, increased hospital admissions, and premature death. Therefore, understanding the true burden of COPD to plan healthcare policies and provide disease-specific strategies for prevention and management, an accurate estimate of the prevalence of COPD in India is critical for healthcare planning. Aim: To estimate the pooled prevalence of COPD in India (2012- 2025) and to examine patterns by region and population type. Materials and Methods: This systematic review and metaanalysis followed the PRISMA 2020 guidelines. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and local journals for studies published between 2012 and 2025, using relevant MeSH terms and Boolean operators. Eligible studies included populationbased, spirometry-confirmed, or questionnaire-based prevalence reports. Hospital-based studies, disease-specific cohorts, reviews, conference abstracts, and those without complete prevalence data were excluded. Data extraction and Joanna Briggs Institute (JBI) risk-of-bias assessment were performed independently by two reviewers. A meta-analysis was performed to estimate the pooled prevalence of COPD across Indian studies using a random-effects model with 95% confidence intervals. Subgroup analyses were conducted by region, age group, gender, population setting, exposure type (biomass fuel use, smoking, occupational dust), and diagnostic criteria (post-bronchodilator spirometry versus symptom-based diagnosis). Statistical heterogeneity was assessed using the I² statistic, and potential publication bias was evaluated through funnel plot inspection and Egger’s regression test. Results: Out of 1,462 records identified, 26 studies met the inclusion criteria and were included in both the qualitative synthesis and meta-analysis. The pooled prevalence of COPD was estimated to be 11.3% (95% CI 9.4-13.4%), with the highest estimates in northern and eastern regions of India. Subgroup analyses revealed a higher prevalence among the elderly, smokers, and households exposed to biomass fuel. Conclusion: Early diagnosis of COPD at the primary healthcare level is essential to initiate timely management and reduce disease burden. Reliable estimate of the true prevalence of COPD in India is required, for which a nationwide populationbased survey for screening of COPD with adequate training and resources.

This decade, type 2 diabetes and its complications present a major global public health crisis and a significant economic burden, even though it is chronic and often asymptomatic. The global prevalence of diabetes continues to increase at an alarming rate. The International Diabetes Federation estimated that 588.7 million adults aged 20-79 years were living with diabetes worldwide in 2024, with projections reaching 852.5 million by 2050 [1]. The consequences of this issue can lead to serious complications such as amputations, blindness, cardiovascular diseases, heart attacks, cognitive decline, and Alzheimer's disease, all of which place a significant strain on health and social security systems. Therefore, prevention is the key to avoiding this substantial health and economic pressure. In the prevention and overall management of type 2 diabetes, phytotherapy can be highly effective. The current challenge is to identify practical and safe products that contain plant extracts. Our goal is to develop a dietary supplement aimed at preventing Type 2 Diabetes (T2D), particularly during the prediabetes phase, which currently lacks effective therapies. Therefore, the creation of nutraceutical products to support patient care is essential. In this context, we conducted a study presenting original research on the green optimization of polyphenol extraction from Salvia officinalis and Olea europaea for an adjuvant dietary supplement, with a focus on the treatment of type 2 diabetes. The present study aimed to optimize the green ultrasound-assisted extraction (UAE) process to maximize the recovery of bioactive polyphenols from Salvia officinalis and Olea europaea leaves, two Mediterranean plants used in traditional care for diabetic patients in northern Algeria, with well-documented antioxidant and antidiabetic properties. A Box-Behnken response surface methodology (RSM) was employed to evaluate the effects of glycerol concentration (10-90% v/v), temperature (20-80°C), and sonication time (5-15min) on total polyphenol content (TPC, mg GAE g-1). The polynomial model was statistically significant, with a p-value of 0.0029 and a coefficient of determination (R²) of 0.9292, indicating high predictive accuracy. Among the variables analyzed, glycerol concentration had the most significant effect (p < 0.001), whereas sonication temperature had a moderate effect. The optimal extraction conditions were determined to be 50% glycerol, 50°C, and 10 minutes of sonication. Under these conditions, the maximum total phenolic content (TPC) achieved was 185 mg GAE per gram. This result is comparable to that obtained with ethanol-based extraction but was achieved under milder and safer conditions. A comparative analysis showed that glycerol-based ultrasound-assisted extraction yielded polyphenol levels and antioxidant activity similar to those achieved with ethanol extraction. However, glycerol offers additional benefits such as biodegradability, energy efficiency, and safety suitable for drug use. The extract demonstrated strong DPPH scavenging and α-glucosidase inhibitory activities, highlighting its potential as a functional ingredient for the management of type 2 diabetes mellitus (T2DM). This study presents a validated framework for green extraction to produce high-value phytochemical extracts. By integrating sustainable solvents with optimized processes, we establish a strong foundation for developing nutraceutical formulations that balance environmental responsibility with therapeutic effectiveness. Specifically, the use of Salvia officinalis and Olea europaea offers the opportunity to supply high-quality raw materials in sufficient quantities to support future enhancements in the pharmaceutical and agri-food sectors.

The abnormal dilatation of the spermatic veins, or varicocele, affects 14%-20% of teenagers, a proportion similar to that of adults, which peaks in late adolescence (15-19 years old). It is more common in metropolitan and developed areas, possibly due to increased access to medical attention and diagnostic resources. Treatment myths and beliefs about adolescent varicocele (AV) persist, making it a highly disputable condition to address. Concerns include whether surgical intervention is necessary for teenage varicocele and whether it enhances seminal parameters after varicocelectomy. Inadequate or delayed management may contribute to future infertility, imposing a significant public health and economic burden due to the costs associated with assisted reproductive technologies and psychosocial impacts. This minireview addresses common misconceptions about teenage varicocele and clarifies the clinical assessment, treatment, and long-term effects of varicocele in adolescents. This minireview examines and provides information on essential topics, including etiopathogenesis, evaluation, and groups of patients at risk of infertility, emphasizing the importance of testicular volume asymmetry (greater than 20%) and semen parameters in predicting future subfertility. Principles of management, indications, and choice of intervention (follow-up, surgical, and adjunctive treatment) are explored, along with treatment outcomes, to address this challenging situation. A balance between intervention and cautious follow-up is emphasized in the evidence-based suggestions for treatment strategies, which depend on the clinical examination, scrotal Doppler, and semen parameter findings. Based on testicular asymmetry, semen parameters, and symptomatology, management strategies range from conservative surveillance to surgical varicocelectomy and minimally invasive procedures like embolization. AV is a complex condition. If untreated, it can cause oligospermia, infertility, and irreparable testicular damage. Timely intervention, such as subinguinal microsurgical varicocelectomy, is essential after an early diagnosis is made by clinical examination supported by Doppler ultrasound and semen analysis for symptomatic, bilateral palpable, or asymptomatic unilateral varicoceles with testicular asymmetry greater than 20% and abnormal semen parameters in Tanner V boys. Long-term data indicate that patients who have had surgery have better testicular growth and semen characteristics; nevertheless, the effect on future fertility is still being studied, indicating the need for individualized treatment plans. Testicular health, with preserved reproductive potential, is maintained through proactive evaluation and care. AV can affect quality of life in addition to causing physical discomfort; worries about fertility, body image, and social stigma call for comprehensive, patient-centered care.

ABSTRACT Air pollution is widely recognized as a major public health concern, and emerging evidence suggests an association with dementia. Establishing a causal relationship, however, is difficult. Economic cycles affect both dementia prevalence and pollution levels: during economic booms, financial resources for treatment rise, but so do air pollution and work-related stress. In South Korea, air quality has generally improved, even as Alzheimer’s cases have increased with population aging, indicating a time-series relationship that biases regression results. Air pollution and vascular dementia also temporarily declined during COVID-19, reflecting omitted variable bias. To address these endogeneity concerns, we use wind speed and direction as instruments for air pollution in South Korea. Our estimates show that higher concentrations of PM10, PM2.5, and NO2 significantly increase dementia cases, with instrumental variable results substantially larger than ordinary least squares, underscoring the importance of correcting for bias. These findings carry important policy implications. Because air pollution is a negative externality, its health consequences—including dementia—extend beyond individual responsibility and represent broader social costs. Reducing pollution could therefore not only improve health outcomes but also ease the considerable economic burden of dementia care. As air pollution disproportionately affects vulnerable groups—individuals with dementia who are unable to sustain employment or income—targeted social support is also essential to address their combined medical and financial challenges. Implications: We underscore the importance of addressing endogeneity issues when evaluating the relationship between air pollution and dementia. Conventional approaches may produce biased estimates due to spurious time-series-correlations and omitted variables. By using wind speed and direction as instruments, we identify LATE-based causal effects of air pollution on the number of dementia patients. Our findings suggest important policy implications: reducing air pollution can lower the substantial social and economic costs associated with dementia. Improved administrative data linking clinical records with environmental exposures would support effective monitoring and policy evaluation. Furthermore, international cooperation is needed to address transboundary nature of air pollution.

Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity of adolescence and disproportionately affects females, with outcomes strongly dependent on curve magnitude and timing of detection. Increasing evidence demonstrates that structural and systemic factors influence multiple stages of the AIS care continuum and may be the primary drivers of disparities in care amongst this population. This narrative review synthesizes contemporary evidence on sex- and race-based inequities in AIS, emphasizing structural drivers rather than biologic explanations for these disparities and highlighting priorities for future research. Studies examining presentation severity show heterogeneous results, but intersectional analyses consistently identify compounded disadvantage among Black adolescents with public insurance. Delayed detection and loss to follow-up emerge as central mechanisms linking social context to higher surgical rates and greater economic burden. In contrast, disparities in short-term postoperative complications appear attenuated after adjustment in many cohorts. However, differences in length of stay, hospital charges, and the geographic distribution of care persist, primarily related to patient race and insurance coverage. Most variation in findings across settings reflects differences in screening policies, insurance structures, and the socioeconomic indices used to characterize disadvantage, as well as limitations inherent to administrative databases and registry attrition. The available evidence indicates that structural and systemic factors, rather than biological factors, have a direct impact on disparate care in AIS. This impact is most noticeable at the initial stages of care, such as screening and diagnosis, where sociocultural and socioeconomic differences can affect patients' access to timely non-operative care. However, it seems once the decision to treat with surgery has been made, the previously existing disparities do not affect surgical outcomes but can affect long-term follow-up.