Literature Review Research Articles

Integrating DNA Barcoding Within an Orthogonal Approach for Herbal Product Authentication: A Narrative Review.

Existing methods for morphological, organoleptic, and chemical authentication may not adequately ensure the accurate identification of plant species or guarantee safety. Herbal raw material authentication remains a major challenge in herbal medicine. Over the past decade, DNA barcoding, combined with an orthogonal approach integrating various testing methods for quality assurance, has emerged as a new trend in plant authentication. The review evaluates DNA barcoding and common alternative testing in plant-related sectors to enhance quality assurance and accurate authentication. Studies were selected based on their relevance to the identification, quality assurance, and safety of herbal products. Inclusion criteria were peer-reviewed articles, systematic reviews, and relevant case studies from the last two decades focused on DNA barcoding, identification methods, and their applications. Exclusion criteria involved studies lacking empirical data, those not peer-reviewed, or those unrelated to the main focus. This ensured the inclusion of high-quality, pertinent sources while excluding less relevant studies. An orthogonal approach refers to the use of multiple, independent methods that provide complementary information for more accurate plant identification and quality assurance. This reduces false positives or negatives by confirming results through different techniques, combining DNA barcoding with morphological analysis or chemical profiling. It enhances confidence in results, particularly in cases of potential adulteration or misidentification of plant materials. This study highlights the persistent challenges in assuring the quality, purity, and safety of plant materials. Additionally, it stresses the importance of incorporating DNA-based authentication alongside traditional methods, to enhance plant material identification.

The Role of Dopamine in Impulsivity and Substance Abuse: A Narrative Review

Substance use disorder (SUD), based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is defined by symptoms caused by utilizing a substance that a person continues taking despite its negative effects. Impulsive decision making is commonly defined as a reduced ability to choose a delayed large reward instead of a small immediate reward. Dopamine has been implicated as a prominent neurotransmitter implicated in the development and pattern of addiction and impulsivity, especially in regard to substance use disorder. Discovery as a key player in the development of addiction dates to the 1950s, with a study performed by Olds and Milner on rats placed in a Skinner box. Their original discovery is part of the beginning of what would become the search into the main mechanistic source of addiction, and how exactly it works at a cellular, physiological, and psychological level. The dopaminergic pathways of our brains are well-studied. It is well established that most of the dopaminergic neurons of the brain are located in the ventral mid-brain and consists of four main pathways: mesocortical, mesolimbic, nigrostriatal, and tuberoinfundibular pathways. Dopamine acts various receptors, with dopamine (D) receptors 1, 2, and 3 playing a major role in motor function and receptors D1 and D2 playing a major role in reward. There are additional studies warranted, especially finding ways to manipulate the dopaminergic system to treat addiction disorders of all varieties. The focus of the present investigation is to delve into the current literature regarding dopamine and its clinical implications in substance use disorder and impulsive behavior.

Phenolic Components And Biological Activity Of Pomegranate.

Pomegranate (Punica granatum L.) have been subject of extensive studies for its abundance of phytochemicals and numerous biological and medicinal properties. It is a fruit-bearing tree, which is widely consumed as a nutraceutical source as well as functional food for putative health benefits. The phenolic components are the characteristic bioactive constitutes of pomegranate, including hydrolysable tannins, flavonoids, and phenolic acids. The whole plant of this tree has many medicinal folkloric uses and good therapeutic effect, such as anticancer, antioxidant, antibacterial, antiviral, hypoglycemic, lipid-lowering, cardioprotection and digestive system protection. Through comprehensive search of available literature, this narrative review can provide an up-to-date overview of the current knowledge of characteristic bioactive constituents's structure and potential health benefits of Pomegranate, which can be used as reference for the future clinical and basic research, and also helpful for the development of pomegranate into functional food and nutraceuticals.

Towards the year 2049: The next 25 years of occupational health and safety research.

In this discussion paper, we close our 2024 series reflecting on the successes, failures, and promises of occupational health and safety research in celebration of the 50th anniversary of the Scandinavian Journal of Work, Environment & Health (SJWEH). This paper aims to elaborate on the future of our research field. We conducted a narrative review of lessons learned in the series, examining insights gained and key takeaways. Additionally, we explored the current and anticipated agendas of major institutions, including the World Health Organization and the European Union, on occupational health and safety, as well as potential developments in the academic publishing industry. Occupational health and safety research has significantly evolved over the last 50 years, emphasizing longitudinal study designs, enriching observational data with registry-based information, and expanding the scope of hazardous determinants impacting workers` health. Novel statistical approaches have further enabled researchers to address complex associations, such as mediation effects, and to strengthen causal inference in observational studies. At the same time, the publishing business is changing rapidly, with artificial intelligence poised to reshape both research practices and the landscape of academic publishing. In the changing landscape of research and academic publishing, our goal is for SJWEH to continue to be a leading source of high-quality research dedicated to protecting and improving workers' health. We are curious and excited to see where all these current and anticipated changes will lead in the years to come.

E -cigarettes and kidney health: current knowledge and future perspectives.

Chronic conventional cigarette smoking has been closely linked to incident chronic kidney disease (CKD) in the general population. It is associated with the acceleration of pre-existing CKD and failure of kidney allograft function. Cessation of conventional cigarette smoking is effective in reducing the increased risk of smoking induced kidney damage. This narrative review summarizes current knowledge and future study perspectives of the impact of e-cigarettes (e-cigs) use on kidney health. The past decade has seen a dramatic increase in the use of electronic nicotine delivering systems, also called e-cigs. Compared to conventional cigarette smoking, little is known concerning the effects of e-cigs use on kidney health. A few cross-sectional studies suggest an association between vaping and kidney damage (albuminuria, reduction in estimated glomerular filtration rate) in adolescents and young adults. Furthermore, limited animal experiments indicate that e-cigs constituents/aerosols may lead to structural and functional kidney damage. The renal health effects of e-cigs remain largely uncertain and make it difficult to draw definitive conclusions about e-cigs use and kidney health. The relatively new popularity of e-cigs, the wide variability in device design and e-liquid formulations, and the lack of standardized methods to measure daily or life-long e-cigs exposure make it challenging to conduct comprehensive long-term studies. Nephrologists should actively address smoking habits in their patients and urge cessation of conventional cigarette smoking as well as e-cigs use to prevent CKD progression and improve overall health.

Management of Sacrocolpopexy Mesh Complications-A Narrative Review and Clinical Experience from a Large-Volume Center.

Despite the reputation of sacrocolpopexy as a highly durable reconstructive surgery for pelvic organ prolapse, mesh-related complications remain a significant deterrent for patients. This review discusses the incidence, presentation, diagnosis, management and prevention of sacrocolpopexy mesh complications. We reviewed the literature on sacrocolpopexy focusing on long-term mesh complications and their management. As the literature is not specifically robust, we also give our recommendations based on experience from a large-volume center. Intraoperative videos and images are provided to illustrate findings and management techniques. Sacrocolpopexy mesh complications include vaginal mesh exposure; bladder or bowel erosions; inflammatory and infectious conditions including spondylodiscitis; and mesh-related pain. Presentation ranges from overt symptoms such as mesh palpated in the vagina to insidious-like spondylodiscitis manifesting as back pain and malaise. Diagnosis relies on methodical history taking, review of operative reports, and a physical examination, with office-based endoscopy studies and imaging as indicated. Various management options have been described in the literature. We recommend an expectant approach for asymptomatic patients; For symptomatic vaginal exposure, we encourage removal of entire mesh arm(s) via an abdominal approach; however, many prefer to utilize a transvaginal or partial excisional approach first. Spondylodiscitis is managed with long-term antibiotics and often requires mesh removal. Prevention strategies include using a lightweight polypropylene mesh attached to well- vascularized vaginal walls, avoiding direct placement on any sutured vaginotomy or cystotomy. Delayed absorbable monofilament suture is non-inferior to permanent suture. Sacrocolpopexy mesh complications can be challenging to diagnose and manage. Symptomatic cases often require a proactive approach; listening to patients when they describe persistent symptoms with postoperative onset; a low threshold for further evaluation; and upfront discussion of management options.

Introducing the ProInterest model

This study introduces the ProInterest model, a novel framework designed to foster long-term student engagement in mathematics. ProInterest model identifies features that trigger initial interest and subsequently sustain student interest towards mathematics activities. We explore the interplay between these features based on a focused narrative review and demonstrate their application through a case analysis of two mathematics tasks that look different on the surface, yet can be identified to share common features fostering interest when looked through the lense of the ProInterest model. We also apply the model to tasks generated by experts and AI. We show that applying the model to identify features that can trigger and maintain student interest towards a task, one can reveal shortcomings in typical mathematics tasks: humour and creativity are typically missing, and even tasks aimed to be tailored to appeal to students may utilise unimaginative layout and structure. This research bridges a critical gap in the knowledge of interest promoting mathematics tasks by providing a practical tool for educators and instructional designers to create engaging mathematics experiences.

Factors Contributing to Early Recovery of Urinary Continence Following Radical Prostatectomy: A Narrative Review

Stress urinary incontinence (SUI) is a common condition in patients following radical prostatectomy (RP), which has a significant impact on all aspects of quality of life and is associated with significant social stigma. The factors that improve urinary incontinence in patients following surgery remain controversial. The aim of our narrative review was to identify and synthesise the latest evidence on pre-, intra- and post-operative factors and predictors that contribute to early continence recovery after RP. In this narrative review, primary resources were identified by searching PubMed, EMBASE and Medline, and secondary resources were collected by cross-referencing citations in the relevant articles. We started our review by searching for systematic reviews of factors and predictors that contribute to early recovery of urinary continence after RP. We then reviewed societal guidelines such as the American Urological Association and European Urological Association guidelines on male urinary incontinence. This review focuses on the pre-, intra and postoperative factors that influence postoperative SUI after RP, as well as highlighting modifications in surgical techniques that lead to early continence recovery. Increasing age, higher BMI, shorter membranous urethral length (MUL), and larger PV are independent prognostic factors for SUI within 3 months after RP. Factors such as modified surgical technique preservation of anatomical structure lead to influence postoperative early continence recovery. SUI after RP is influenced by various factors. These factors include not only anatomical landmarks and patient-related factors such as age, BMI, length of MUL and prostate volume, but also prior transurethral resection or laser enucleation of the prostate, the surgeon’s expertise, the surgical approach and NS technique.

Revolutionizing Cytology and Cytopathology with Natural Language Processing and Chatbot Technologies: A Narrative Review on Current Trends and Future Directions

The application of chatbots and Natural Language Processing (NLP) in cytology and cytopathology is an emerging field, which is currently characterized by a limited but growing body of research. Here, a narrative review has been proposed utilizing a standardized checklist and quality control procedure for including scientific papers. This narrative review explores the early developments and potential future impact of these technologies in medical diagnostics. The current literature, comprising 11 studies (after excluding comments, letters, and editorials) suggests that chatbots and NLP offer significant opportunities to enhance diagnostic accuracy, streamline clinical workflows, and improve patient engagement. By automating the extraction and classification of medical information, these technologies can reduce human error and increase precision. They also promise to make patient information more accessible and facilitate complex decision-making processes, thereby fostering greater patient involvement in healthcare. Despite these promising prospects, several challenges need to be addressed for the full potential of these technologies to be realized. These include the need for data standardization, mitigation of biases in Artificial Intelligence (AI) systems, and comprehensive clinical validation. Furthermore, ethical, privacy, and legal considerations must be navigated carefully to ensure responsible AI deployment. Compared to the more established fields of histology, histopathology, and especially radiology, the integration of digital tools in cytology and cytopathology is still in its infancy. Building on the advancements in related fields, especially radiology’s experience with digital integration, where these technologies already offer promising solutions in mentoring, second opinions, and education, we can leverage this knowledge to further develop chatbots and natural language processing in cytology and cytopathology. Overall, this review underscores the transformative potential of these technologies while outlining the critical areas for future research and development.

Relevance of Competency Based Education for Architectural Education in India

Background A holistic architectural education is the culmination of learning knowledge, skills, attitudes, and values, which eventually reflects in the quality of graduates. Even though different schools of thought have made various kinds of qualitative contributions towards the evolution of architectural education in India, it has largely been dominated by the quantitative and technical aspects of its regulating framework. Architects engage with the demanding contradictions between responsibilities of an ethical nature, the dynamic challenges of practice, and the intricacies of architectural imagination. The aesthetical and imaginative foundations of the field make it incumbent upon the architects to possess a balance of ecumenical proficiencies for accountability and personalization. The purpose of the study is to identify relevant attributes of Competency Based Education (CBE) that can be adopted for architectural education in India. Methods This research follows a narrative review approach and a descriptive-analytic method to broadly understand the attributes of CBE and its potential relevance to architectural education in India. 323 articles were searched on various search strings based on their relevance to the inquiry. 76 documents written in English language were included and appraised through the Scale of the Assessment for Narrative Review Articles (SANRA) tool to avoid any risk of bias. The PRISMA 2020 checklist and flow diagram has been used to report the findings of this narrative review. Result The study identifies eight critical parameters of CBE with respect to its definitions, origins, transitions, regulatory environment, characteristics, approaches and implications on teaching-learning, frameworks and models of assessment; and challenges, which makes a case for the relevance of CBE for architectural education in India, which hasn’t been explored yet. Conclusion The broader expectations of ‘being competent’ can be addressed through a conscious adoption of strategies of relevant attributes of CBE which can encourage building attitudes and temperament for life-long learning.

Effects of substance exposure on gametes and pre-implantation embryos: a narrative review.

Substance use refers to the consumption of drugs that have varying degrees of impact on a persons' physical, mental and emotional well-being. While the adverse health effects of drugs have been extensively documented, further research is needed to understand their impact on fertility. Studies have indicated that substance use affects both the male and female reproductive systems. As substance use is more prevalent among young adults compared with the elderly, it appears that individuals of reproductive age are particularly vulnerable to the reproductive impairments associated with substance use. Although numerous studies have reported detrimental effects of substance use on pregnant women and their foetus during the post-implantation stages, there are limited studies on critical pre-implantation period and gamete stages. In this narrative review, we aimed to focus on the most significant evidence regarding the impact of substances on gametes and pre-implantation embryos.

Predictors of poor outcomes in juvenile dermatomyositis: what do we know? A narrative review.

Juvenile dermatomyositis (JDM) is a rare chronic systemic inflammatory disorder with a highly variable clinical course. It is important to identify the patients at risk of developing more severe disease. However, based on the existing literature, there is a lack of data regarding predictors of poor outcomes. Obtaining knowledge about clinical and laboratory risk factors for disease progression and severity at an earlier stage of the disease could potentially lead to a better long-term prognosis for patients with JDM. A narrative review with the aim of identifying risk factors for poor outcomes in patients with JDM, such as death, severe disease, refractory disease, and functional impairment, was conducted. A total of 27 articles was included. Certain clinical manifestations and immunology features appear to worsen the prognosis in children with JDM. The recognition of these risk factors is essential for all pediatric rheumatologists as it allows the earlier identification of patients with potentially worse outcomes. These patients should receive closer follow-up and aggressive and individualized therapy in order to reduce their morbimortality. Additional research is needed not only to identify more predictors of worse outcomes but also to identify more effective treatment approaches targeted toward these patients.

Molecular characterization of Ebola virus, immune response, and therapeutic challenges: a narrative review

AbstractThe Ebola virus (EBOV) remains a major public health challenge due to its complex structure and the lack of appropriate and effective vaccines and therapies. This review characterizes the Ebola virus, its immune response, and its therapeutic challenges. Structural EBOV proteins include the envelope glycoprotein, nucleoprotein, RNA polymerase L, and viral proteins VP30, VP24, VP35, and VP40. The proteins play a role in the virus’s pathogenesis by evading the host's immune response. The immune system evasion mechanisms of EBOV are critical in its pathogenesis. Some vaccines, such as the recombinant vesicular stomatitis virus-Zaire Ebola virus (RVSV-ZEBOV), have proven to be very effective and have been approved by the Food and Drug Administration (FDA) additionally, four other vaccines have been approved including Gam Evac-Combi (licensed in Russia), ad5-EBOV (approved in China), Zabdeno and Mvabea (approved in Europe). However, some challenges remain in developing effective vaccines, such as the selection of immunogens, cross-protecting immunity, long-term protection, mechanism of protection, and rapid response vaccination. Despite the progress made, there is still a need for an effective vaccine that offers durable and broad protection against multiple strains of the Ebola virus. This will be achieved through the collaboration of various organizations and government and Non-Governmental Organization (NGO) agencies.

Utilization of Single-Pulse Transcranial-Evoked Potentials in Neurological and Psychiatric Clinical Practice: A Narrative Review

Background: The utility of single-pulse TMS (transcranial magnetic stimulation)-evoked EEG (electroencephalograph) potentials (TEPs) has been extensively studied in the past three decades. TEPs have been shown to provide insights into features of cortical excitability and connectivity, reflecting mechanisms of excitatory/inhibitory balance, in various neurological and psychiatric conditions. In the present study, we sought to review and summarize the most studied neurological and psychiatric clinical indications utilizing single-pulse TEP and describe its promise as an informative novel tool for the evaluation of brain physiology. Methods: A thorough search of PubMed, Embase, and Google Scholar for original research utilizing single-pulse TMS-EEG and the measurement of TEP was conducted. Our review focused on the indications and outcomes most clinically relevant, commonly studied, and well-supported scientifically. Results: We included a total of 55 publications and summarized them by clinical application. We categorized these publications into seven sub-sections: healthy aging, Alzheimer’s disease (AD), disorders of consciousness (DOCs), stroke rehabilitation and recovery, major depressive disorder (MDD), Parkinson’s disease (PD), as well as prediction and monitoring of treatment response. Conclusions: TEP is a useful measurement of mechanisms underlying neuronal networks. It may be utilized in several clinical applications. Its most prominent uses include monitoring of consciousness levels in DOCs, monitoring and prediction of treatment response in MDD, and diagnosis of AD. Additional applications including the monitoring of stroke rehabilitation and recovery, as well as a diagnostic aid for PD, have also shown encouraging results but require further evidence from randomized controlled trials (RCTs).

Challenges and Considerations in Diagnosing and Managing p16+-Related Oropharyngeal Squamous Cell Carcinoma (OPSCC) with Neck Metastasis: Implications of p16 Positivity, Tobacco Exposure, and De-Escalation Strategies

Background: The incidence of patients showing neck metastasis and no obvious primary tumor at the initial diagnostic evaluation or neck cancer of unknown primary (NCUP) is rising. It is estimated that a relevant part of these tumors arises in the tonsillar crypts or base of the tongue and are p16+-related. However, today, the detection rate of the primary tumor is suboptimal. Identifying the primary tumor and its biomolecular characterization is essential since it influences the treatment administered, possibly reducing radiation fields and providing de-escalation to primary surgical management. However, p16 IHC (immunohistochemistry) might not be sufficient to diagnose HPV-related OPSCC. The other subset of patients discussed are the HPV-positive patients who have a history of tobacco exposure and/or p53 mutations. Possible factors that could negatively influence the outcomes of these patients are investigated and discussed below. So, this paper aims to analyze the diagnostic, bio-molecular, clinico-radiological, morphological, prognostic and therapeutical aspects of p16-positive OPSCC, highlighting the possible bias that can occur during the diagnostic and prognostic process. Methods: A narrative review was conducted to investigate the biases in the diagnostic and therapeutic process of two groups of patients: those who are p16-positive but HPV-negative patients, and those who are p16-positive and HPV-positive with exposure to traditional risk factors and/or p53 mutations. The keywords used for the literature research included the following: NCUP, OPSCC, p16IHC, HPV testing, p16 positive HPV negative OPSCC, p16 positive HPV positive OPSCC, tonsillectomy, tobacco exposure, p53 mutations, cystic neck metastasis, extranodal extension (ENE), radiotherapy, de-escalation and neck neck dissection. Results: HPV-positive OPSCC has specific clinico-radiological features. Bilateral tonsillectomy should be considered for the identification of the primary tumor. P16 IHC alone is not sufficient for diagnosing HPV-related OPSCC; additional detection methods are required. The role of tobacco exposure and p53 mutations should be investigated especially in cases of HPV-positive tumors. Extranodal extension (ENE) must be taken into consideration in the prognostic staging of HPV-positive tumors. Surgical primary treatment involving neck dissection (ND) and bilateral tonsillectomy followed by adjuvant radiation may represent the most appropriate approach for N3 cases. Diagnosis, prognosis and therapeutical implications must be addressed considering clinical, biomolecular and morphological aspects. At least today, the numerous biases that are still present influencing the diagnostic and prognostic process do not permit considering de-escalation protocols. Conclusions: A precise and accurate diagnosis is required in order to adequately stage and manage p16+ OPSCC, particularly with neck metastasis. The role of tobacco exposure and/or p53 mutations must be considered not only in p16+ OPSCC but especially in HPV-positive OPSCC. Until a more accurate diagnosis is possible, ENE should be considered even in p16+HPV+ OPSCC. Primary surgery with unilateral ND and bilateral tonsillectomy might be the treatment of choice given the numerous diagnostic and prognostic pitfalls. Therefore, it is inappropriate and risky to propose de-escalation protocols in routine clinical practice due to the risk of undertreatment.

A comprehensive narrative review on psychotherapies for patients with autism spectrum disorders

Autism spectrum disorders (ASD) are complex neurodevelopmental conditions characterized by challenges in social interaction, communication, and repetitive behaviors. Psychotherapeutic interventions must tailor to meet the specific needs of individuals with ASD, given their diverse presentation of symptoms and functioning levels. This narrative review explores the range of psychotherapies available for individuals with ASD, examining their methodologies, effectiveness, and suitability. By using targeted search terms such as “autism,” “autistic disorder,” “autism spectrum disorders,” “psychotherapy,” “psychological intervention,” and “psychosocial intervention,” an extensive review of publications in English from 2000 to 2024 was conducted. This review covered several databases, including Embase, PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar. The review identified ten major psychological interventions for the treatment of individuals with ASD: behavioral therapies, developmental therapies, cognitive behavioral therapy, social skills training, speech-language therapy, occupational therapy, family therapy, mindfulness-based interventions, parent-mediated interventions, and dance movement psychotherapy. The main text elaborates on the effects of each intervention on various aspects of ASD. By providing this comprehensive overview, clinicians can select appropriate therapeutic strategies that cater to the individual profiles of those with ASD, ultimately enhancing therapeutic outcomes and quality of life for this population.

Unveiling the power of artificial intelligence for image-based diagnosis and treatment in endodontics: An ally or adversary?

Artificial intelligence (AI), a field within computer science, uses algorithms to replicate human intelligence tasks such as pattern recognition, decision-making and problem-solving through complex datasets. In endodontics, AI is transforming diagnosis and treatment by applying deep learning algorithms, notably convolutional neural networks, which mimic human brain function to analyse two-dimensional (2D) and three-dimensional (3D) data. This article provides an overview of AI applications in endodontics, evaluating its use in 2D and 3D imaging and examining its role as a beneficial tool or potential challenge. Through a narrative review, the article explores AI's use in 2D and 3D imaging modalities, discusses their limitations and examines future directions in the field. AI significantly enhances endodontic practice by improving diagnostic accuracy, workflow efficiency, and treatment planning. In 2D imaging, AI excels at detecting periapical lesions on both periapical and panoramic radiographs, surpassing expert radiologists in accuracy, sensitivity and specificity. AI also accurately detects and classifies radiolucent lesions, such as radicular cysts and periapical granulomas, matching the precision of histopathology analysis. In 3D imaging, AI automates the segmentation of fine structures such as pulp chambers and root canals on cone-beam computed tomography scans, thereby supporting personalized treatment planning. However, a significant limitation highlighted in some studies is the reliance on in vitro or ex vivo datasets for training AI models. These datasets do not replicate the complexities of clinical environments, potentially compromising the reliability of AI applications in endodontics. Despite advancements, challenges remain in dataset variability, algorithm generalization, and ethical considerations such as data security and privacy. Addressing these is essential for integrating AI effectively into clinical practice and unlocking its transformative potential in endodontic care. Integrating radiomics with AI shows promise for enhancing diagnostic accuracy and predictive analytics, potentially enabling automated decision support systems to enhance treatment outcomes and patient care. Although AI enhances endodontic capabilities through advanced imaging analyses, addressing current limitations and fostering collaboration between AI developers and dental professionals are essential. These efforts will unlock AI's potential to achieve more predictable and personalized treatment outcomes in endodontics, ultimately benefiting both clinicians and patients alike.

Overview of hepatocarcinogenesis focusing on cellular origins of liver cancer stem cells: a narrative review.

Hepatocellular carcinoma (HCC) accounts for 85% to 90% of primary liver cancers and generally has a poor prognosis. The hierarchical model, which posits that HCC originates from liver cancer stem cells (CSCs), is now widely accepted, as it is for other cancer types. As CSCs typically reside in the G0 phase of the cell cycle, they are resistant to conventional chemotherapy. Therefore, to effectively treat HCC, developing therapeutic strategies that target liver CSCs is essential. Clinically, HCCs exhibit a broad spectrum of pathological and clinical characteristics, ranging from well-differentiated to poorly differentiated forms, and from slow-growing tumors to aggressive ones with significant metastatic potential. Some patients with HCC also show features of cholangiocarcinoma. This HCC heterogeneity may arise from the diverse cellular origins of liver CSCs. This review explores the normal physiology of liver regeneration and provides a comprehensive overview of hepatocarcinogenesis, including cancer initiation, isolation of liver CSCs, molecular signaling pathways, and microRNAs. Additionally, the cellular origins of liver CSCs are reviewed, emphasizing hematopoietic and mesenchymal stem cells, along with the well-known hepatocytes and hepatic progenitor cells.

Zambia's battle against cholera outbreaks and the path to public health resilience: a narrative review

ABSTRACT In Zambia, cholera has been a persistent public health concern for decades, mainly attributed to inadequate sanitation and restricted access to clean water in some parts of the country. The literature was collected from PubMed, Google Scholar, and public health organization websites, focusing on cholera outbreaks in Zambia since 2000. Key search terms included ‘cholera prevention’ and ‘Zambia outbreaks.’ A total of 30 articles were analyzed to assess public health strategies and identify gaps for future planning. Periodic outbreaks of cholera have characterized Zambia's history by significant fluctuations in case numbers and fatalities since 1977. Notably, the years 1993, 1999, 2003/2004, 2005/2006, 2010, 2017/2018, and the most recent outbreak from October 2023 to February 2024 have marked significant episodes in the country's struggle against this waterborne disease. This narrative review examines the recurrent outbreaks of cholera in Zambia to understand the recent outbreak's extraordinary spread and severity in the context of public health resilience. The most recent outbreak with staggering 19,719 cases and 682 deaths, underscores the unprecedented scale and severity of the current public health emergency. The findings highlight the need for a holistic public health approach that prioritizes resilience in disease prevention.

Sodium Chloride Cotransporter in Hypertension

The sodium chloride cotransporter (NCC) is essential for electrolyte balance, blood pressure regulation, and pathophysiology of hypertension as it mediates the reabsorption of ultrafiltered sodium in the renal distal convoluted tubule. Given its pivotal role in the maintenance of extracellular fluid volume, the NCC is regulated by a complex network of cellular pathways, which eventually results in either its phosphorylation, enhancing sodium and chloride ion absorption from urines, or dephosphorylation and ubiquitination, which conversely decrease NCC activity. Several factors could influence NCC function, including genetic alterations, hormonal stimuli, and pharmacological treatments. The NCC’s central role is also highlighted by several abnormalities resulting from genetic mutations in its gene and consequently in its structure, leading to dysregulation of blood pressure control. In the last decade, among other improvements, the acquisition of knowledge on the NCC and other renal ion channels has been favored by studies on extracellular vesicles (EVs). Dietary sodium and potassium intake are also implicated in the tuning of NCC activity. In this narrative review, we present the main cornerstones and recent evidence related to NCC control, focusing on the context of blood pressure pathophysiology, and promising new therapeutical approaches.