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Article
Chemistry and Materials Science
Organic Chemistry

Marco A. Obregón-Mendoza

,

Rosario Tavera-Henández

,

Rubén Sánchez-Obregón

,

Carolina Escobedo-Martínez

,

Rubén A. Toscano

,

Raúl G. Enríquez

Abstract: Herein, Diacetylcurcumin (DAC), a derivative of curcumin, was synthesised, and two new polymorphs (monoclinic and triclinic) are reported in addition to the previously known polymorph (P21). Solid-state NMR (CP-MAS) and X-ray studies allowed the unambiguous authentication of the elusive polymorph 2 (canoe-shaped, P21/n) and the concomitant polymorph 3 (elliptical-shaped, P-1). We demonstrate that morphological crystal analysis under a microscope, in conjunction with ATR-IR, is a rapid and inexpensive technique for exploring the polymorphic landscape of curcuminoids. This discovery highlights the ongoing progress in curcumin derivative research and should inspire fellow chemists and materials scientists to further explore it.

Article
Physical Sciences
Thermodynamics

Jordan Barton

Abstract: This paper assumes that a thermodynamic system can be composed purely of coherence and information, and constructs a working model on that basis. We derive operational parameters for such systems using definitions of the Certainty Equation, semantic entropy, semantic temperature, and formulate five laws and three modes of coherence and information systems. This analysis is then compared to the features of black holes.

Article
Engineering
Aerospace Engineering

Yingrui Bing

,

Yanan Wang

,

Jiali Xu

,

Changqing Cao

Abstract: To address the challenges of unauthorised drone flights in campus low‑altitude security—where traditional detection equipment is costly and ineffective at night—this paper designs a lightweight, all‑weather drone detection and early‑warning system based on a Raspberry Pi edge computing platform and visible/infrared dual‑spectrum fusion. The system uses an IMX219‑77IR infrared camera that automatically switches imaging modes according to ambient brightness, achieving day‑and‑night continuous perception. A YOLOv8n model is compressed to 10 MB via channel pruning and knowledge distillation, reaching an inference speed of 85.2 ms/frame on the Raspberry Pi. A self‑built campus drone dataset of 2,000 images (1,600 open‑source + 400 self‑collected) yields 97.16% precision, 93.79% recall, and 97.27% mAP50. A Flask backend and web map interface provide real‑time alerts by polling every 2 seconds. Total hardware cost is below 1,500 yuan, more than 70% lower than traditional systems. Field tests (5–50 m) show daytime confidence >0.9, nighttime infrared confidence ≈0.88, false negative rate <8%, false positive rate <5%, and stable continuous operation. The project has won a university‑level competition second prize and its software copyright application is under review, demonstrating strong practical value and promotion potential.

Article
Medicine and Pharmacology
Orthopedics and Sports Medicine

Luis Garcia-Bordes

,

Lorenzo Escutia-Marí

,

Silvia Vizcaino-Navarro

,

Patricia Laiz-Boada

,

Roberto Seijas-Vázquez

,

Pedro Álvarez-Díaz

,

Xavier Cuscó-Segarra

,

David Barastegui-Fernández

,

Miguel Vázquez-Gómez

,

Iker Ayestarán-Calero

+3 authors

Abstract: Background/Objectives: The anticoagulant used for blood collection is a fundamental but underexplored variable in platelet-rich plasma (PRP) preparation. Ethylenediaminetetraacetic acid (EDTA) and sodium citrate act on platelets through distinct calcium chelation mechanisms with potentially different consequences for PRP quality. Our group has previously demonstrated that biological and demographic variables independently modulate platelet composition in PRP; the present study extends this analysis to the pre-analytical anticoagulant variable. No prospective paired clinical study has systematically compared the effects of EDTA and sodium citrate on platelet morphological parameters in a real clinical setting. This study aimed to characterise these differences and evaluate their implications for orthobiologic therapy. Methods: A prospective within-subject paired-sample study was conducted at Instituto Cugat – Quirónsalud Barcelona (November 2025–April 2026). Twenty-six consecutive adult patients undergoing routine blood extraction prior to orthopaedic procedures had blood drawn simultaneously into K₂-EDTA and sodium citrate (3.2%) tubes. Full haematological analysis was performed on a Sysmex XN automated analyser within 30 minutes. Primary outcomes were mean platelet volume (MPV), platelet distribution width (PDW), large platelet ratio (P-LCR), large platelet cell count (P-LCC), and plateletcrit (PCT). Statistical comparisons used the paired t-test or Wilcoxon signed-rank test; effect sizes were quantified as Cohen's d. Results: Seven of eight platelet-related parameters differed significantly between anticoagulants (all p<0.001). Compared to sodium citrate, EDTA produced systematically higher MPV (+10.1%, d=2.81), P-LCR (+25.8%, d=2.41), P-LCC (+24.3%, d=1.70), PDW (+13.5%, d=1.33), PCT (+7.3%, d=0.78), RDW-CV (+2.0%, d=0.83), and RDW-SD (+2.6%, d=0.80). MPV was higher with EDTA in all 26/26 paired samples without exception. Total platelet count did not differ significantly (p=0.135). Effect sizes for all morphological parameters were large (d≥0.78). Conclusions: EDTA induces large, reproducible, and universal platelet morphological changes consistent with calcium chelation-induced swelling, not genuine platelet hypertrophy. These artefactual changes systematically overestimate platelet size and large platelet indices by up to 26%, with direct implications for PRP quality assessment in orthobiologic medicine. Sodium citrate should remain the anticoagulant of choice for PRP preparation. Clinicians using EDTA must recognise that morphological parameters do not reflect functional platelet capacity.

Review
Medicine and Pharmacology
Orthopedics and Sports Medicine

Flynn McGuire

,

Emma Hughes

,

Travis Maak

,

Daniel M. Cushman

Abstract: Thymosin beta-4 (TB4) and the related compound commonly referred to as TB-500 are widely discussed in tissue healing and musculoskeletal medicine, but the scope and nature of the supporting literature remain unclear. We conducted a scoping review to map the evidence on TB4 and TB-500 in tissue healing, regeneration, and musculoskeletal repair. PubMed, Europe PMC, and ClinicalTrials.gov were searched through March 2026. English-language in vitro, animal, human, and registered clinical trial sources directly evaluating TB4, TB-500, or included derivatives in repair-related contexts were eligible. Of 1772 records identified, 80 studies were included. The evidence base was weighted toward mixed and in vitro designs, and most studies evaluated TB4 rather than TB-500. The most common tissue categories were wound/skin/soft tissue, vascular/endothelial, ocular/cornea, and bone. Direct musculoskeletal tissue categories such as tendon, ligament, muscle, cartilage, and spine/intervertebral disc were comparatively sparse. Human evidence was concentrated in ocular/cornea and wound/skin/soft tissue settings, whereas direct TB-500 evidence was limited to a single included study. Overall, the mapped literature supports the popular interest in several repair-related pathways but remains unevenly distributed and largely preclinical, with limited human evidence directly relevant to musculoskeletal applications.

Review
Medicine and Pharmacology
Endocrinology and Metabolism

Weili Wei

,

Rui Liu

,

Dan Su

,

Yuhui Ping

,

Yonggui Song

,

Zhifu Ai

Abstract: Major depressive disorder (MDD) is increasingly understood as a disorder of integrated immune, endocrine, metabolic, neurovascular and synaptic regulation rather than a disease reducible to a single neurotransmitter deficit. Lipidomic studies have repeatedly identified glycerophospholipid abnormalities in MDD, but their mechanistic meaning remains unresolved because changes in bulk lipid abundance do not explain how a metabolic disturbance becomes a receptor-level neural signal. This review argues that the lysophosphatidylcholine (LPC)-autotaxin (ATX)-lysophosphatidic acid (LPA)-LPA receptor (LPAR) axis offers a chemically and biologically coherent route for addressing that gap. LPC is not merely a readout of phospholipid remodeling; it is the direct ATX substrate from which receptor-active LPA can be generated. LPA receptors, in turn, regulate neural excitability, synaptic balance, hippocampal plasticity and stress-related behavior. Human studies report lower serum and cerebrospinal-fluid ATX in MDD, lower CSF LPA 22:6 in MDD and schizophrenia, and negative total-LPA findings that caution against biomarker oversimplification. Experimental studies show that ATX/LPA/LPAR perturbation alters hippocampal function, emotional behavior, stress resilience and synaptic physiology. These findings do not establish a completed depression pathway. They support a more specific hypothesis: depression-relevant ATX-LPA biology may be molecular-species resolved, compartment dependent, regionally organized and shaped by local production-inactivation balance. Reproductive endocrine transitions provide a biologically informative setting for testing this hypothesis because mood vulnerability, systemic lipid remodeling and steroid-sensitive regulation of pathway-adjacent nodes converge in the same clinical context. The decisive unresolved issue is spatial and biochemical: no depression-relevant study has yet demonstrated that defined brain-accessible LPC species, catalytically active ATX, locally generated LPA, local LPA inactivation capacity and receptor-specific circuit output coexist within a single mood-relevant CNS microenvironment. Future work should therefore move from fluid-level association toward pathway closure through targeted and spatial lipidomics, anatomical ATX activity mapping, LPA inactivation assays, BBB/interface analysis, LPAR perturbation and matched circuit or behavioral readouts.

Article
Medicine and Pharmacology
Medicine and Pharmacology

Awal Prasetyo

,

Dora Maftikhati

,

Levina Athaya Anarizta

,

Nazhira Ghina Setyawan

,

Anindha Waradita Putri Yuwono

,

Maria Meutia Saleha

,

Farahdita Ramadhanti

,

Hermawan Istiadi

,

Udadi Sadhana

,

Fathur Nur Kholis

Abstract: This study investigates the comparative effects of traditional cigarettes and e-cigarettes on lung health in male Rattus norvegicus over 8 and 12 weeks. Following ARRIVE 2.0 guidelines, 30 rats were divided into six groups to evaluate the impact of nicotine and ascorbic acid aerosols on tracheal and alveolar structures, as well as systemic inflammatory markers (IL-6, TNF-α, SOD-3, MDA). Results indicate that long-term cigarette exposure (12 weeks) and nicotine vaping (8 weeks) significantly stunted weight gain, whereas ascorbic acid vaping caused less growth inhibition. Histological analysis revealed that 8-week cigarette exposure (K3) increased tracheal mucosal thickness and antioxidant activity (SOD-3), while cigarette smoke generally decreased goblet cell counts and induced early emphysema. In contrast, long-term exposure significantly elevated IL-6 and caused severe alveolar wall damage. Notably, vaping ascorbic acid (K6) offered protective benefits, preserving the basement membrane and reducing septal thickening compared to nicotine groups. The findings conclude that while short-term smoking triggers immediate tracheal damage, long-term exposure escalates systemic inflammation and permanent alveolar destruction. Phytochemical-based aerosols, such as ascorbic acid, reduce pulmonary injury compared with nicotine-based products.

Review
Public Health and Healthcare
Nursing

Elena Andina-Díaz

,

Bárbara Santamarta-Fernández

,

Elena Fernández-Martínez

Abstract: Background: Community-based mental health and social interventions focusing on housing stability, integrated care and psychosocial support are increasingly recognised as essential for improving the mental health and wellbeing of people experiencing homelessness. This review synthesizes how these interventions address mental health and social determinants of health. Methods: Following PRISMA 2020 guidelines, a search of six electronic databases (2019–2025) was conducted (PROSPERO: CRD420250653260). The review included 29 quantitative, qualitative, and mixed-methods studies examining community-based interventions for people experiencing homelessness and mental health conditions. Results: Community-based interventions, particularly Housing First models, were consistently associated with improved housing stability, mental health outcomes, and programme retention. Integrated multidisciplinary services and outreach promote psychosocial wellbeing, continuity of care and reducing emergency service use. Peer-led programs support social integration, although evidence for technology-based tools remains mixed. Conclusions: Addressing social determinants of health through structured community-based interventions is essential to tackle mental health inequalities. The findings highlight the importance of multidisciplinary and mental health nursing approaches that support continuity of care, psychosocial wellbeing, and social inclusion within vulnerable populations.

Article
Biology and Life Sciences
Toxicology

Chun-lai Yu

,

Xiang-yu Ou

,

Yuxing Ma

,

Hai-hua Wang

,

Xu-ming Qi

,

Ji-liang Zhang

Abstract: 2,2′,4,4′-Tetrabromodiphenyl ether (BDE-47) is a persistent organic pollutant detected in coastal environments. The effects of BDE-47 on mangrove plants at the molecular and histological levels remain elusive. In this study, seedlings of the man-grove species Avicennia marina were exposed to BDE-47 at concentrations of 0, 1 and 10 ng L-1 for 20 days under hydroponic conditions. Leaf growth parameters, anatomical structures, and transcriptomic profiles were examined. At 1 ng L-1 BDE-47, no signif-icant changes were observed in leaf growth or vascular tissue morphology. However, transcriptome analysis showed significant enrichment of differentially expressed genes in the linoleic acid metabolism pathway, indicating that A. marina initiates early stress perception via enhanced stress perception and signal transduction, trigger adaptive defense responses to low-level BDE-47 exposure, and circumvent growth inhibition. At 10 ng L-1 BDE-47, leaf area, width, length, and fresh weight were all reduced. In addi-tion, histological examination revealed vascular bundle sheath atrophy, impaired xy-lem and phloem development, reduced parenchyma cell diameter, and a decreased proportion of intercellular space. Transcriptomic analysis at 10 ng L-1 exposure identi-fied significant enrichment of differentially expressed genes in the circadian rhythm and spliceosome pathways, indicating that the pollutant's toxicity has progressed from local metabolic disruption to perturbation of the plant's core regulatory network. Overall, our findings reveal distinct response patterns of A. marina leaves to BDE-47 exposure at environmentally relevant concentrations, initially elucidate the adaptive defense mechanism and underlying molecular basis of toxic effects in mangrove plants under low-concentration BDE-47 exposure, and provide critical scientific support for the ecological risk assessment and conservation of coastal mangrove wetlands.

Article
Computer Science and Mathematics
Geometry and Topology

Mancho Manev

,

Victoria Kuncheva

Abstract: The study of the so-called Π-manifolds has continued. This is a short name for almost paracontact almost paracomplex manifolds with a pair of metrics — Riemannian and pseudo-Riemannian — that are mutually related and compatible with the structure of the manifold. The well-known classification of these manifolds with respect to the Riemannian metric has been used to derive an alternative classification of the same manifolds with respect to the pseudo-Riemannian metric. The interrelations between the two classifications and the corresponding classification tensors are investigated. Finally, a three-dimensional explicit example on a Lie group is given, which illustrates the most interesting case of the transition from one classification to the other.

Article
Arts and Humanities
Other

Pirapong Wongsaensee

,

Pintusorn Onpium

,

Chakkrapong Kuensaen

,

Nantawan Muangyai

Abstract: Social media platforms and user-generated content (UGC) have become central to how travelers discover and evaluate cultural destinations. Yet lesser-known second-tier heritage sites remain substantially underrepresented in digital tourism research. This study investigates how Chinese tourists perceive and engage with the intangible cultural heritage (ICH) of Lamphun, Thailand, through UGC collected from three major Chinese social media platforms (WeChat, Douyin, and Rednote) spanning the period from 2019 to 2023. A total of 642 relevant posts were analyzed using a mixed-methods analytical framework comprising VADER-based sentiment analysis, machine learning classification of tourism intention, and TF-IDF-driven thematic clustering. Results indicate an overall predominance of positive sentiment, particularly toward social rituals, festive events, and traditional craftsmanship, with positive sentiment emerging as the strongest predictor of travel intention. Digital engagement metrics, notably likes and favorites, further amplified the impact of intention-bearing content, while thematic clustering revealed four distinct experiential dimensions, with festival and ritual-centered narratives generating the highest sentiment and tourism intention scores. These findings demonstrate the strategic value of integrating advanced UGC analytics into destination marketing frameworks, offering actionable insights for promoting underrepresented cultural heritage destinations within the increasingly competitive global digital tourism landscape.

Article
Public Health and Healthcare
Public Health and Health Services

Thomas Fotas

,

Ioannis Giantsis

,

Menelaos Lefkaditis

,

Ioannis S. Pappas

,

Mathis A. B. Christodoulopoulos

,

Efterpi Zafiriou

,

Electra Nicolaidou

,

Alexander C. Katoulis

,

Georgios Christodoulopoulos

Abstract: (1) Background: Tungiasis is a cutaneous ectoparasitosis caused by the penetration of gravid female Tunga penetrans fleas into the epidermis. Although endemic in tropical and subtropical regions, it remains rare in Europe, where most cases are travel-associated and secondary household transmission is seldom documented. This study describes imported tungiasis in Greece and investigates possible secondary household transmission in a non-endemic setting. (2) Methods: Seven Greek men residing in Attica developed tungiasis following occupational exposure in Tanzania, together with one secondary case in a non-travelling household contact who had never travelled outside Greece. Diagnosis was based on clinical and dermoscopic findings and confirmed by amplification and sequencing of the mitochondrial cytochrome oxidase I (COI) gene. Household investigations were also performed. (3) Results: Eight male patients presented with painful plantar and/or subungual nodular lesions. Sequence analysis of COI demonstrated 657/662 bp (99%) identity with the Tunga penetrans reference sequence, and identical sequences were identified in all samples. All patients exhibited mild-to-moderate elevations of hepatocellular and cholestatic liver enzymes, which resolved within two weeks following treatment. Only one secondary household case was identified, and no infestation was detected among additional cohabitants or companion animals. (4) Conclusions: This report documents imported tungiasis with probable secondary household transmission in Greece and highlights the importance of clinical awareness and environmental assessment in non-endemic settings.

Hypothesis
Medicine and Pharmacology
Immunology and Allergy

Alexandre C. M. Amato

Abstract: Lipedema affects an estimated 11–12% of women worldwide and is characterized by bilateral, symmetric adipose deposition in the lower extremities, disproportionate pressure pain, spontaneous bruising, and resistance to conventional dietary interventions. Despite its prevalence, lipedema lacks a unifying mechanistic framework. Current descriptions treat it as a fat storage disorder with secondary vascular and inflammatory features, leaving critical observations mechanistically unexplained: a highly characteristic quantitative sensory testing (QST) pattern with no published alternative mechanistic explanation, a paradoxical immunological profile, a 35–40% comorbidity with fibromyalgia, a 1.42 relative risk for ADHD, estrogen-dependent onset, and asymmetric expression in the presence of local vascular triggers.We propose the gfWAT-IIT2 framework, which posits that lipedema is fundamentally a syndrome of polarization of the gluteofemoral white adipose tissue (gfWAT) microenvironment toward innate type 2 immunity (IIT2), amplified by estrogen via mast cell estrogen receptors, and generating neuropathic pain through selective histaminergic sensitization of Aδ/C fibers (H1/H4 receptors, PPT↓) and inhibition of Aβ fibers (H3 receptor, VDT↑), with thermal thresholds remaining normal: a triad that is mechanistically explained by histaminergic peripheral sensitization.The gfWAT-IIT2 framework integrates reported clinical, sensory, immunological, and depot-specific observations into a testable mechanistic cascade, generates fourteen falsifiable predictions, and repositions the therapeutic target from adipocyte to mast cell. The framework further proposes that asymmetric lipedema (where one limb expresses the disease more severely due to an identifiable local trigger) constitutes a natural controlled experiment suggesting that local trigger removal may be disease-modifying in selected patients with documented triggers.

Review
Engineering
Mechanical Engineering

Amal Alliyankal Vijayakumar

,

Francesca Lionetto

,

Alfonso Maffezzoli

Abstract: Polymer-based sandwich structures are widely used for their lightweight and tailorable properties, but interfacial failure phenomena often govern their performance. Among these, Mode I skin/core debonding is a critical mechanism that limits structural reliability. This review provides a unified and critical assessment of experimental methodologies for Mode I fracture characterisation, focusing on the ASTM D8637/D8637M standard and alternative setups, including Double Cantilever Beam (DCB), Single Cantilever Beam (SCB), and Climbing Drum Peel (CDP) tests. Alongside, the influence of geometrical factors, processing conditions, and intrinsic polymer properties on Mode I characterisation is detailed.Conventional DCB setups are shown to introduce mixed-mode effects due to asymmetric loading. In contrast, the modified DCB-UBM setup achieves near-pure Mode I conditions at the expense of increased complexity. Comparative analysis indicates that SCB with roller base outperforms the standardised flexible-rod setup, particularly for specimens with non-linear responses. The geometric constraints imposed by ASTM D8637/D8637M are also revisited, demonstrating that reduced-dimension specimens can yield comparable fracture toughness, thereby enabling greater design flexibility. Additionally, while the standard prescribes Modified Beam Theory (MBT) and Area Method (AM) for initiation and propagation, both methods provide comparable propagation toughness under linear conditions. For non-linear systems, alternative data reductions based on CDP concepts, with the SCB-roller base setup, are effective. Mode I characterisation is strongly influenced by polymer properties, as well as processing-induced polymer and interfacial behaviour, requiring interpretation within a structure–property–processing framework. Based on this assessment, key challenges and potential improvements are identified, guiding the development of more accurate and reliable testing methodologies for polymer sandwich structures.

Article
Engineering
Control and Systems Engineering

Guy André Boy

Abstract: Context is at the heart of systemic cognition. We cannot discuss a sociotechnical system (STS) without considering the contexts in which it is designed, developed, validated, operated, maintained, and ultimately dismantled. More specifically, this is why we need a clearer understanding of what we mean by “context” in STS design and operations. The central assumption of the systemic cognition approach is that we gradually become familiar with the complexity of an STS through the creation and refinement of conceptual models in context. This process is incremental and integrative (i.e., anytime emerging behaviors, phenomena, and properties are discovered from experience, they are integrated into the STS at work). Concept models in context (CMC) are not only limited to providing a situated framework for operations people, but they also guide engineering people in human systems integration (HSI). Therefore, how can we figure out relevant contexts? How can we model them? How do we integrate them into the systemic cognition framework as CMCs to support HSI? More specifically, how are systemic cognition resources (SCRs) framed and articulated by context? This article proposes a constructivist approach for building CMCs that encompass the entire life cycle of an STS and are useful for tangibility testing and traceability. Documenting CMCs is helpful throughout the life cycle of an STS (i.e., from design to operations to dismantling). Several examples are used to support the CMCs being developed.

Article
Medicine and Pharmacology
Orthopedics and Sports Medicine

Guillermo Cortés-Roco

,

Verónica Low-Barría

,

Rodrigo Yáñez-Sepúlveda

,

Jorge Pérez-Contreras

,

Yeny Concha-Cisternas

,

Juan Hurtado-Almonacid

,

Exal Garcia-Carrillo

Abstract: Background: Plyometric training has been proposed as an effective strategy for improving neuromuscular performance in climbing. However, its specific effects on upper-body explosive capacity and rate of force development (RFD) in advanced boulder climbers remain unclear. The objective was to determine the effect of a 10-week plyometric training program on neuromuscular performance in advanced boulder climbers. Methods: Eighteen male climbers participated, divided into a plyometric training group (n = 9; 31.33 ± 5.63 years) and a control group (n = 9; 29.67 ± 4.50 years). Maximal strength and rate of force development (RFD) of the finger flexor muscles were assessed, and RFD was analyzed in time intervals from 0 to 200 ms and in a relative range of 20–80% of maximal strength. Maximal pulling strength (isometric pull-ups) was assessed using a load cell in a standardized pull-up position. Lower-body power was assessed using the counter-movement jump (CMJ) test, and upper-body specific power using the Power Slap test on a campus board. The plyometric training program was conducted over ten weeks (two sessions of 45 to 60 minutes each). Results: Significant differences were observed between groups in pull-ups (Δ difference = +3.89 repetitions; 95% CI:-7.48,0,30, p=0.036; η²p=0.248), push-up power (Δ difference = +174.5 W; 95% CI: 5.05,–343. 46, p=0.044; η²p=0.128) and isometric pull-up RFD at 200 ms (Δ difference = +107.85 kg/s; 95% CI: 27.54, -188.16; p=0.012; η²p=0.336), and in the 20–80% range (Δ difference = +261.78 kg/s; 95% CI: 23.09–500.47; p=0.034; η²p=0.194). No differences were observed between groups in Power Slap (p=0.409) or in CMJ height (p=0.122). Conclusion: A 10-week plyometric training program produced specific neuromuscular adaptations in advanced boulder climbers, improving pull-up performance, upper body explosive power, and isometric pull-up RFD. The absence of transfer to finger strength, Power Slap, and CMJ confirms the high specify of neuromuscular adaptations to the trainer movement pattern.

Technical Note
Computer Science and Mathematics
Data Structures, Algorithms and Complexity

Justice Yaw Effah

,

Brandon Ortiz

Abstract: Fragmentation of data is common in the U.S. healthcare system, which leads to substandard patient safety, excess administration waste, and impediments to public health monitoring. This paper proposes a relational database design, the Centralized-Decentralized Health Management System (CDHMS) that achieves a balance between conflicting requirements of local autonomy and federated access to data. The system is based on 15 normalized relations that are organized in 6 functional layers: core clinical infrastructure, Master Patient Index, Interoperability Mapping layer, Audit and Break-Glass logging subsystem, Patient consent and access-control framework, and a Role Based plus Attribute Based Access Control (RBAC+ABAC) model with 6 different user roles. The schema is deployed in MySQL Workbench 8.0 CE, with some sample mock data, and tested using 12 test queries. Results show the architecture enables no duplicate patient identities, reconciliation of incompatible coding vocabularies, granular patient consent management, and a tamper evident audit trail of all patient data access, including emergency overrides.

Article
Medicine and Pharmacology
Otolaryngology

Mauro Gufoni

,

Giampiero Neri

Abstract: The study considers the hypothesis (supported by a compatible theory) that the vibratory test (SVIN) corresponds to unilateral weakness (UW) in caloric tests and that the head-shaking test (HST) is directly proportional to directional preponderance (DP). A group of 76 patients with vestibular deficits at various stages of compensation, confirmed by bithermal tests using the Fitzgerald-Hallpike technique and evaluated with Jongkees' formulas, was studied and compared with SVIN and HST results. The statistical study shows a marked correlation between SVIN and UW and between HST and DP. At the same time, the cross-correlations between SVIN and DP, and between HST and UW, are significantly weaker, confirming the hypothesis. It is concluded that, in cases where caloric testing is not considered necessary, these two bedside functional tests can give a precise idea of the results of caloric testing and that this interpretation can highlight the great clinical potential of SVIN and HST performed in combination.

Review
Public Health and Healthcare
Public Health and Health Services

Erwin Hernando Hernandez Rincón

,

María Alejandra Rodriguez Martínez

,

Maria Jose Rodriguez

,

Maria Fernanda Polo

Abstract: (1)Background: Burn injuries lead to long-term physical, psychological, and functional sequelae, with socioeconomic, clinical, and health system factors contributing to inequities in outcomes. Chronic neuropathic pain, fragmented care, and limited access to rehabilitation remain persistent challenges, particularly among vulnerable populations. (2) Methods: A scoping review was conducted following PRISMA-ScR guidelines, searching PubMed, Scopus, Web of Science, and ScienceDirect for studies published between 2010 and 2026 in English, Spanish, or Portuguese. Thirty-one studies were included, encompassing quantitative, qualitative, mixed-methods research, literature reviews, guidelines, and reports addressing continuity of care and follow-up after skin grafting in burn patients of any cause or age. Data were extracted independently and synthesized using descriptive and narrative approaches. (3) Results: The incidence of chronic neuropathic pain was 6%, often refractory and associated with smoking and substance use, with gabapentin and ascorbic acid showing significant pain reduction. Structured follow-up programs improved quality of life and psychosocial outcomes but did not reduce readmissions. Indigenous populations experienced greater severity and complications, while approximately half of the patients were at risk of post-traumatic stress disorder linked to body image dissatisfaction. Telemedicine reduced access barriers, yet delays in specialized care contributed to contractures and pathological scarring. Early rehabilitation mitigated functional disability, though gaps persist in pain management, psychosocial support, and continuity of care. (4) Conclusions: Post-burn recovery is a multidimensional process requiring structured follow-up, early rehabilitation, telemedicine, and culturally adapted interventions to promote equity and patient-centered outcomes. Keywords: Burns; Chronic neuropathic pain; Postoperative follow-up; Rehabilitation; Health inequities; Pa-tient-centered outcomes.

Review
Biology and Life Sciences
Aging

Md. M. N. Azim

,

Sujay Kumar Bhajan

,

Mithun Chandra Banik

,

Md Shihab Hussain

,

Md. Sohel Rana

,

Sanjit Biswas

,

Tasnim Elin Islam

,

SM Abu Sama Al Faruqee

,

Md Ataur Rahman

,

Maroua Jalouli

+6 authors

Abstract: Aging causes exhaustion of stem cells (SCs), loss of regenerative potential, and thereby makes them susceptible to age-related diseases (ARDs), known as cellular senescence. Senescent stem cells (SenSCs) secrete Senescence-Associated Secretory Phenotypes (SASPs) that synergistically exacerbate inflammation. Alongside this, they secrete Senescence-Derived extracellular vesicles (SenEVs) that carry a diverse array of molecules that transmit senescence-inducing signals to distant cells and tissues throughout the body, intensifying the detrimental effects of ageing and fostering a pro-tumorigenic microenvironment (PTME). In this review, we comprehensively assess these EVs, their distinct microRNA (miRNA) landscape, protein cargo, including extracellular matrix (ECM) remodeling enzymes and inflammatory cytokines, lipid profiles, and metabolomic signatures. Critically, we elucidate how SenEVs drive systemic ageing through paracrine transmission of senescence, impairing tissue regeneration by propagating oxidative stress, disrupting stem cell niches, and contributing to organ-specific ageing. Furthermore, we discussed their role as pro-cancer factors by remodeling the tumor microenvironment (TME), as they carry oncogenic miR-21 and miR-34a, which promote immune evasion and facilitate metastatic spread. Given their pervasive influence, SenEVs offer significant therapeutic opportunities, ranging from biomarkers of biological ageing to strategies to block harmful EVs and to engineer therapeutic EVs for targeted delivery. Future directions on SenEV research should focus on standardization, single-cell EV biology, organ-specific EV mapping, multi-omics integration, and AI-driven research. This integrated perspective underscores the profound clinical and global relevance of SenEVs as innovative targets for combating cancer and ARDs.

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