Search Results (1,019)

In light of the growing interest in the bidirectional relationship between epilepsy and dementia, this review aims to provide an overview of the role of hyperphosphorylated tau (pTau) in cognition in human epilepsy. A literature search identified five relevant studies. All of them examined pTau burden in surgical biopsy specimens from patients with temporal lobe epilepsy. The prevalence of pTau reported across the five studies, encompassing a total of 142 patients, ranged from 3.5% to 95%. Findings also varied regarding the location of pTau in the hippocampus and/or temporal cortex. Two of five studies (40%) demonstrated an inverse relationship between pTau burden and cognitive performance, one study with regard to executive functions and the other with regard to naming and verbal short-term memory. The only longitudinal study found a significant link between pTau and cognitive decline in verbal learning and memory, and in part also in naming, from the pre- to the postoperative assessment and from three to 12 months postoperatively. Given the heterogeneity of the study cohorts and the neuropsychological and neuropathological methodologies and findings, no clear picture emerges regarding the association between pTau and cognition in temporal lobe epilepsy. Added to this is the multifactorial etiology of cognitive impairment in epilepsy, including the active epilepsy, the underlying and sometimes dynamic pathology, and anti-seizure medication. Some of these factors may affect pTau expression. Further research should aim to investigate pTau longitudinally and noninvasively on a whole-brain level, using targeted neuropsychological outcome measures and controlling for age and other factors potentially influencing cognitive trajectories in epilepsy. Full article

Sarcopenia, an age-related decline in skeletal muscle mass, strength, and function, is increasingly recognized as a significant condition in the aging population, particularly among those with cardiovascular diseases (CVD). This review provides a comprehensive synthesis of the interplay between sarcopenia and cardiogeriatrics, emphasizing shared mechanisms such as chronic low-grade inflammation (inflammaging), hormonal dysregulation, oxidative stress, and physical inactivity. Despite advancements in diagnostic frameworks, such as the EWGSOP2 and AWGS definitions, variability in criteria and assessment methods continues to challenge standardization. Key diagnostic tools include dual-energy X-ray absorptiometry (DXA) and bioimpedance analysis (BIA) for muscle mass, alongside functional measures such as grip strength and gait speed. The review highlights the bidirectional relationship between sarcopenia and cardiovascular conditions such as heart failure, aortic stenosis, and atherosclerotic cardiovascular disease, which exacerbate each other through complex pathophysiological mechanisms. Emerging therapeutic strategies targeting the mTOR pathway, NAD+ metabolism, and senescence-related processes offer promise in mitigating sarcopenia’s progression. Additionally, integrated interventions combining resistance training, nutritional optimization, and novel anti-aging therapies hold significant potential for improving outcomes. This paper underscores critical gaps in the evidence, including the need for longitudinal studies to establish causality and the validation of advanced therapeutic approaches in clinical settings. Future research should leverage multi-omics technologies and machine learning to identify biomarkers and personalize interventions. Addressing these challenges is essential to reducing sarcopenia’s burden and enhancing the quality of life for elderly individuals with comorbid cardiovascular conditions. This synthesis aims to guide future research and promote effective, individualized management strategies. Full article

Obesity often coexists with thyroid diseases, and the prevalence of these disorders has been on the rise for years. While hypothyroidism can contribute to excess fat tissue, the relationship between Body Mass Index (BMI) and thyroid function hormones is bidirectional. Research confirms that fat tissue reduction can positively impact thyroid function. Thus, delaying the initiation of therapies beyond substitution treatment to achieve optimal weight reduction in individuals with thyroid dysfunction seems unwarranted. The authors summarize current knowledge on this topic in the article. Full article

In an era where fake news detection has become a pressing issue due to its profound impacts on public opinion, democracy, and social trust, accurately identifying and classifying false information is a critical challenge. In this study, the effectiveness is investigated of advanced machine learning models—convolutional neural networks (CNNs), bidirectional encoder representations from transformers (BERT), and generative pre-trained transformers (GPTs)—for robust fake news classification. Each model brings unique strengths to the task, from CNNs’ pattern recognition capabilities to BERT and GPTs’ contextual understanding in the embedding space. Our results demonstrate that the fine-tuned GPT-4 Omni models achieve 98.6% accuracy, significantly outperforming traditional models like CNNs, which achieved only 58.6%. Notably, the smaller GPT-4o mini model performed comparably to its larger counterpart, highlighting the cost-effectiveness of smaller models for specialized tasks. These findings emphasize the importance of fine-tuning large language models (LLMs) to optimize the performance for complex tasks such as fake news classifier development, where capturing subtle contextual relationships in text is crucial. However, challenges such as computational costs and suboptimal outcomes in zero-shot classification persist, particularly when distinguishing fake content from legitimate information. By highlighting the practical application of fine-tuned LLMs and exploring the potential of few-shot learning for fake news detection, this research provides valuable insights for news organizations seeking to implement scalable and accurate solutions. Ultimately, this work contributes to fostering transparency and integrity in journalism through innovative AI-driven methods for fake news classification and automated fake news classifier systems. Full article

This paper examines the dynamic relationships between speculative activities, commodity returns, and macroeconomic conditions across five sectors compassing 29 commodities. Using weekly data spanning from January 2000 to July 2023, we construct comprehensive measures of commodity market speculation across five sectors and examine their sector-specific impact on returns through advanced econometric methods, including dynamic conditional correlation models, quantile regressions, Markov-switching models, and time-varying Granger causality tests. Our results reveal that the impact of speculative activities on commodity futures returns is conditional on the commodity sector and prevailing macroeconomic conditions. Moreover, the relationship between macroeconomic factors, speculative activities, and commodity futures returns is time varying. Among the macroeconomic variables, the financial stress indicator, as measured by the St. Louis Fed Financial Stress Index, shows a significant ability to predict commodity futures returns. The relationship between speculation and commodity returns is bi-directional across all sectors. Full article

This review explores the emerging relationship between obstructive sleep apnea (OSA) and periodontal disease (PD), emphasizing shared inflammatory pathways, overlapping risk factors, and potential systemic health implications. Both conditions are characterized by chronic inflammation and oxidative stress, which independently contribute to cardiovascular disease, diabetes, and other systemic disorders. Evidence suggests a bidirectional relationship, with OSA-related hypoxia exacerbating periodontal tissue breakdown and PD-induced inflammation potentially influencing OSA severity. However, the causative nature of the relationship between OSA and PD remains uncertain, largely due to inconsistencies in diagnostic criteria, methodological variability, and study heterogeneity. This review highlights the essential role of systematic reviews (SRs) in synthesizing current evidence, identifying research gaps, and guiding future studies. To maximize their impact, SRs should adhere to rigorous methodological quality standards, improve transparency in data reporting, and address the heterogeneity of included studies. Future research should focus on longitudinal and interventional designs, standardize diagnostic protocols, and investigate biomarkers, oral microbiome profiles, and inflammatory mediators to elucidate the mechanisms linking OSA and PD. Multidisciplinary collaboration between dental and sleep specialists is crucial to advancing evidence-based strategies that improve patient outcomes and address the broader health implications of these often coexisting conditions. Full article

Background/Objectives: Sustaining the human brain’s hippocampus from atrophy throughout ageing is critical. Exercise is proven to be effective in promoting adaptive hippocampal plasticity, and the hippocampus has a bidirectional relationship with the physical environment. Therefore, this systematic review explores the effects of walking, a simple physical activity in the environment, on hippocampal formation volume changes for lifelong brain and cognitive health. Method: PubMed, Scopus, and Web of Science were searched for studies on humans published up to November 2022 examining hippocampal volume changes and walking. Twelve studies met the inclusion criteria. Study quality was assessed using the PEDro scale and ROBINS-I tool. A narrative synthesis explored walking factors associated with total, subregional, and hemisphere-specific hippocampal volume changes. Results: Overall, walking had positive effects on hippocampal volumes. Several studies found benefits of higher-intensity and greater amounts of walking for total hippocampal volume. The subiculum increased after low-intensity walking and nature exposure, while the parahippocampal gyrus benefited from vigorous intensity. The right hippocampus increased with spatial navigation during walking. No studies examined the effect of walking on the dentate gyrus. Conclusions: This systematic review highlights walking as a multifaceted variable that can lead to manifold adaptive hippocampal volume changes. These findings support the promotion of walking as a simple, effective strategy to enhance brain health and prevent cognitive decline, suggesting the design of physical environments with natural and biophilic characteristics and layouts with greater walkability and cognitive stimulation. Future research is encouraged to explore the hippocampal subregional changes instead of focusing on total hippocampal volume, since the hippocampal formation is multicompartmental and subfields respond differently to different walking-related variables. Full article

The development of electricity spot markets necessitates more refined and accurate load forecasting capabilities to enable precise dispatch control and the creation of new trading products. Accurate load forecasting relies on high-quality historical load data, with complete load data serving as the cornerstone for both forecasting and transactions in electricity spot markets. However, historical load data at the distribution network or user level often suffers from anomalies and missing values. Data-driven methods have been widely adopted for anomaly detection due to their independence from prior expert knowledge and precise physical models. Nevertheless, single network architectures struggle to adapt to the diverse load characteristics of distribution networks or users, hindering the effective capture of anomaly patterns. This paper proposes a PLS-VAE-BiLSTM-based method for anomaly identification and correction in load data by combining the strengths of Variational Autoencoders (VAE) and Bidirectional Long Short-Term Memory Networks (BiLSTM). This method begins with data preprocessing, including normalization and preliminary missing value imputation based on Partial Least Squares (PLS). Subsequently, a hybrid VAE-BiLSTM model is constructed and trained on a loaded dataset incorporating influencing factors to learn the relationships between different data features. Anomalies are identified and corrected by calculating the deviation between the model’s reconstructed values and the actual values. Finally, validation on both public and private datasets demonstrates that the PLS-VAE-BiLSTM model achieves average performance metrics of 98.44% precision, 94% recall rate, and 96.05% F1 score. Compared with VAE-LSTM, PSO-PFCM, and WTRR models, the proposed method exhibits superior overall anomaly detection performance. Full article

The connections between sarcopenia and various chronic conditions, including type 2 diabetes (T2DM), metabolic syndrome (MetS), and liver disease have been highlighted recently. There is also a high occurrence of sarcopenia in metabolic dysfunction-associated steatotic liver disease (MASLD) patients, who are often disregarded. Both experimental and clinical findings suggest a complex, bidirectional relationship between MASLD and sarcopenia. While vitamin D, testosterone, and specific drug therapies show promise in mitigating sarcopenia, consensus on effective treatments is lacking. Recent focus on lifestyle interventions emphasizes dietary therapy and exercise for sarcopenic obesity in MASLD. Challenges arise as weight loss, a primary MASLD treatment, may lead to muscle mass reduction. The therapeutic approach to sarcopenia in morbidly obese MASLD patients also includes bariatric surgery (BS). BS induces weight loss and stabilizes metabolic imbalances, but its impact on sarcopenia is nuanced, underscoring the need for further research. Our aim is to provide a comprehensive review of the interplay between sarcopenia and MASLD and offer insight into the most recent therapeutic challenges and discoveries, as sarcopenia is often overlooked or unrecognized and poses significant challenges for managing these patients. Full article

Background/Objectives: Diabetes mellitus and periodontitis share a significant, bidirectional relationship. Diabetes raises the risk of periodontitis and influences its severity, impacting tissue repair and bone metabolism. Conversely, periodontal inflammation can disrupt glycemic control, further complicating this interlinked relationship. This systematic review aimed to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) as an adjunct to subgingival instrumentation (SI) in the treatment of periodontal pockets with a probing pocket depth (PPD) ≥ 5 mm in individuals with type 2 diabetes mellitus (DM2) and periodontitis. Methods: Using the PICOS framework, this review addressed the following question: “How does aPDT as an adjunct to SI compare to SI alone in treating periodontal pockets with PPD ≥ 5 mm in individuals with DM2 and periodontitis?” Databases searched included PubMed, Scopus, and Web of Science up to December 2024. Randomized clinical trials evaluating periodontal status and HbA1c levels in patients with DM2 undergoing periodontal therapy and experiencing SI were included. Patients who received adjunctive aPDT were compared to a control group that received SI alone. A meta-analysis was conducted illustrating treatment effects across groups. Results: After screening 117 studies based on titles and abstracts, three and four studies met the eligibility criteria for quantitative and qualitative analyses, respectively. The principal periodontal parameters assessed included PPD, clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP). Forest plots for PD, BOP, PI, and CAL at baseline, three months, and six months revealed no statistically significant differences between the SI+aPDT group and the SI-only group. Glycated hemoglobin across treatment groups was not different. Conclusions: The combination of aPDT with SI provides limited clinical benefits in treating periodontal pockets with a PPD ≥ 5 mm in diabetic patients with periodontitis. Full article

The first part of this review highlighted the evolving landscape of atherosclerosis, noting emerging cardiometabolic risk factors, the growing impact of exposomes, and social determinants of health. The prominent role of atherosclerosis in the bidirectional relationship between cardiovascular disease and cancer was also discussed. In this second part, we examine the complex interplay between multimorbid cardio-oncologic patients, cardiometabolic risk factors, and the harmful environments that lend a “syndemic” nature to these chronic diseases. We summarize management strategies targeting disordered cardiometabolic factors to mitigate cardiovascular disease and explore molecular mechanisms enabling more tailored therapies. Importantly, we emphasize the early interception of atherosclerosis through multifactorial interventions that detect subclinical signs (via biomarkers and imaging) to treat modifiable risk factors and prevent clinical events. A concerted preventive effort—referred to by some as a “preventome”—is essential to reduce the burden of atherosclerosis-driven chronic diseases, shifting from mere chronic disease management to the proactive promotion of “chronic health”. Full article

Background: Globally, the progressive increase in the aging population has led to social and health problems associated with age-related chronic diseases, such as type 2 diabetes mellitus (T2DM) and sarcopenia. Recent studies have highlighted that sarcopenia and diabetes have a bidirectional relationship. Nutritional therapy is a key element in the treatment of both sarcopenia and diabetes. To date, there are no nutritional guidelines for the management of sarcopenia in T2DM. The aim of this study was to evaluate the efficacy of a muscle-targeted nutritional intervention in older people with sarcopenia and type 2 diabetes based on the Italian nutrition guidelines. Methods: A total of 211 subjects (117 M and 94 F) affected by T2DM with a mean age of 74 ± 6.0 years were screened for sarcopenia, using EWGSOP2 diagnosis criteria, and enrolled to receive personalized dietary plans with two main targets: a daily energy intake of 25–30 kcal/kg body weight and a daily protein intake of at least 1.1–1.2 g/kg body weight. Results: In total, 34 subjects (24 M and 10 F) were sarcopenic with a prevalence of 16%, which was higher in men. After six months of treatment, handgrip strength increased by 0.83 kg (19.57 ± 5.70 kg vs. 20.40 ± 6.10 kg, p = 0.649), protein intake improved (0.91 ± 0.28 g/kg body weight vs. 1.03 ± 0.40 g/kg body weight, p = 0.115), and the glycated hemoglobin decreased (7.39 ± 0.49% to 6.82 ± 0.98%, p = 0.010). Seven younger subjects had an improvement of sarcopenia with a decrease in HbA1c (7.50 ± 0.59% vs. 6.91 ± 0.79, p = 0.19). The difference over time in the consumption of saturated fatty acids (OR 0.6, 95% CI 0.33–1.09, p = 0.096) and simple sugars (OR 0.91, 95% CI 0.80–1.01, p = 0.090) appeared to be associated with an improvement of sarcopenia status. A total of 177 subjects did not meet the criteria for a diagnosis of sarcopenia, and 148 subjects were assessed. The handgrip strength (26.22 ± 9.36 vs. 26.18 ± 9.24 kg, p0.974) and the glycated hemoglobin (7.21 ± 1.07 vs. 7.27 ± 0.98%, p = 0.735) remained stable over time, while protein intake at six months increased (0.81 ± 0.29 vs. 0.91 ± 0.29 g/kg body weight, p = 0.024). Four people were diagnosed with sarcopenia at follow-up, with a lower handgrip strength test result. These subjects were older and had worse glycemic control (HbA1c + 0.5%). Conclusions: Lifestyle modification is important to prevent or reverse the development of the disease. Nutritional therapy in this population is therefore aimed at meeting all nutritional needs and promoting better glycemic control, in terms of glycated hemoglobin, in order to reduce the development of sarcopenia. Although promising, the intervention requires validation in larger studies with control groups. Full article

This study aimed to determine the impact of economic policy uncertainty and geopolitical risk on environmental quality in 17 selected countries. In addition, it also aimed to test the environmental Kuznets curve hypothesis (EKC) within the scope of the determined variables and model. In this context, analyses were carried out with annual data for the period 1997–2022, based on the country group for which the economic policy uncertainty index was calculated, subject to data limitations. In this study, a Quantile Regression of Panel Data (QRPD) analysis, OLS (Ordinary Least Squares), and a panel causality test were used. As a result of the estimation with the Quantile Regression of Panel Data (QRPD), it was found that the increase in economic policy uncertainty had a positive effect on environmental quality in most of the quantiles, while geopolitical risk had significant and negative effects on environmental quality in the medium and high quantiles. The validity of the EKC hypothesis was also proved in the analysis. According to the results of the panel causality test, there was a bidirectional causality relationship between environmental quality and all the independent variables, except the square of economic growth. In order to make a comparison with the new-generation estimation method, QRPD, it was observed that the estimation results with the classical regression method, OLS, were similar. In light of these findings, it is recommended that policy makers pursue strategies that balance economic growth and environmental quality, reduce the environmental impacts of geopolitical risks, and favor a renewable energy transition. Moreover, long-term and stable environmental policies have a crucial role in the success of these strategies. Full article

Polycystic ovary syndrome (PCOS) is the most common endocrine metabolic disorder found in women of reproductive age and is characterized by both metabolic and reproductive dysfunction. Women with PCOS commonly have insulin resistance, increased susceptibility to type 2 diabetes mellitus, dyslipidemia, hyperinsulinemia, increased cardiovascular risk, hepatic steatosis, infertility, and an overall reduction in physical and psychological well-being. Several previous studies have shown a causal association between PCOS and hepatic disorders, such as chronic liver disease (CLD) and nonalcoholic fatty liver disease (NAFLD), where PCOS was identified as contributing to the hepatic features. Whilst it is recognized that PCOS may contribute to hepatic dysfunction, there is also evidence that the liver may contribute to the features of PCOS. The purpose of this review is to discuss the current understanding regarding hepatic involvement in PCOS pathophysiology, the inflammatory markers and hepatokines involved in the development of PCOS, and the role of genetics in the occurrence of PCOS. This review illustrates that PCOS and NAFLD are both common disorders and that there is both genetic and metabolic linkage between the disorders. As such, whilst PCOS may contribute to NAFLD development, the converse may also be the case, with a potential bidirectional relationship between PCOS and liver disease. Full article

Dry eye disease (DED) is a multifactorial, chronic, and often relapsing condition with a significant impact on patient quality of life (QoL). Symptoms such as ocular discomfort and visual disturbances are diverse and frequently misaligned with objective clinical signs, complicating diagnosis and management. DED not only interferes with daily activities like reading, driving, and computer use but also imposes a substantial economic burden due to direct healthcare costs and reduced work productivity. Beyond its ocular manifestations, DED has been associated with higher prevalence rates of depression and anxiety, with a complex bidirectional relationship. Patients with DED may experience psychological distress that exacerbates symptoms, leading to a vicious cycle that further impairs QoL. This underscores the importance of integrating mental health screening into the management of DED, particularly for high-risk populations. Optimizing the care of DED patients requires empathy, effective communication, and the establishment of a therapeutic alliance that acknowledges patient experiences and involves them in personalized treatment plans. Such an approach can improve patient satisfaction, enhance treatment adherence, and address both ocular and psychological dimensions of the disease. This paper highlights current evidence on the impact of DED symptoms and its association with mental health and recommends strategies to improve clinical management through a patient-centered approach. Full article