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PubMed2026

Positive psychology interventions during pregnancy: A systematic review.

Positive psychology interventions (PPI) have been applied and demonstrated evidence in various population groups. The present systematic review focused on the types and influence of PPI on the physical and psychological health of pregnant women. Studies that matched the selection criteria were identified on EBSCOhost, PsychINFO, Web of Science, PubMed, Scopus and four positive psychology journals. From the 2528 records identified, finally eight studies were included in the review. PPI in this review were delivered utilising various positive psychology components such as hope, gratitude and optimism based on existing theories, for example, the strengths theory, broaden-and-build theory, and hope theory. Most interventions were conducted from 14 gestational weeks onwards and were delivered via virtual platforms or mobile applications. As a result of this systematic review, it was identified that PPIs for maternal well-being were aimed at improving (1) physical health, including labour pain, nausea and vomiting; (2) psychological health, including stress, emotions, anxiety and depression; and (3) subjective health, including life satisfaction, perceived social support and quality of life. Most of the selected studies provided significant evidence towards improvement of well-being outcomes from administering PPI. For future studies, in-depth PPI integrated coping and support approaches should be further evidenced among diverse pregnant populations.

Humans↗

PubMed2026

Understanding specificity in immune-brain pathways: A systematic review of differential associations between individual cytokines and brain structure and function measured through magnetic resonance imaging in humans.

Research shows that cytokines are associated with psychiatric disorders, including major depression, and multiple aspects of brain structure and function. Accumulating data suggest that different cytokines may have unique profiles of biological activity, particularly in their neuromodulatory roles, but it is currently unclear whether they have unique associations with specific neural circuits in humans. In this paper, we systematically review magnetic resonance imaging studies conducted with depressed or healthy control human participants under age 65 that examine associations between peripheral cytokines and brain structure and function, with the goal of evaluating evidence for the specificity of these cytokine-brain associations. We find that across multiple measures of brain structure and function, the majority of studies reviewed reported unique associations between individual cytokines and brain outcomes. A synthesis of findings across studies also suggests a preliminary hypothesis of specific associations of interleukin-6 levels in circulation with the default mode network and tumor necrosis factor-alpha with the salience network, which could be tested in future research. We conclude the review with future directions for research that can strengthen understanding of these associations.

Humans↗

PubMed2026

Genetic diversity and recombination of NA-PRRSV field strains in Vietnam: Implications for vaccine efficacy.

Porcine reproductive and respiratory syndrome (PRRS) causes severe reproductive losses in pregnant sows and piglets, resulting in substantial economic impact on the swine industry worldwide. However, due to the significant genetic diversity and rapid evolutionary changes of the pathogen, continuous surveillance and detailed genetic analysis of circulating strains are essential. The current study aimed to evaluate the genetic diversity of the hypervariable (HV) region of non-structural protein 2 (nsp2) among North American PRRSV strains isolated from swine farms in Vietnam. Phylogenetic analysis and multiple sequence alignment were conducted to determine subtype classification and assess genetic variability. A total of 48 field isolates were obtained, of which 12.5% belonged to classical NA-PRRSV, 16.6% to NADC30-like and 70.9% to HP-PRRSV, primarily distributed across sublineages 1.4, 5.1, 8.7 and 8.9. Amino acid comparisons found multiple insertions, deletions and substitutions at various positions within the hypervariable region of nsp2. The study revealed substantial genetic variation in the HV region of nsp2 among NA-PRRSV field strains, largely associated with recombination and immune escape. These findings highlight epidemiological risks to vaccine efficacy and underscore the need for continuous molecular surveillance to support effective PRRSV control in Vietnam.

PRRSV↗

PubMed2026

Recent advances in electrode materials for electrochemical detection of zearalenone.

Zearalenone (ZEN) is an estrogenic mycotoxin commonly found in cereals, animal feed, and processed foods, making it an important concern for food safety and public health. Conventional chromatographic and immunological methods can detect ZEN; however, they often require expensive instruments, lengthy sample preparation, and skilled personnel, which restrict their use for rapid and on-site testing. Electrochemical sensors have attracted enormous interest of the scientific community because of their high sensitivity, rapid response, low cost, miniaturization potential, and compatibility with portable systems. The analytical performance of the electrochemical sensors is strongly influenced by electrode materials, morphology, conductivity, porosity, surface functionality, and the efficiency of bioreceptor immobilization. Despite several reviews on mycotoxin detection, a systematic assessment connecting electrode-material design, modification strategies, sensing mechanisms, and electroanalytical performance specifically for ZEN sensing remain limited. This review critically evaluates recent advances in metal oxides, carbon-based materials, metal-organic- and covalent organic frameworks, MXenes, polymers, and hybrid composites for electrochemical ZEN detection. Particular attention has been given to their roles in electron transfer, analyte enrichment, selectivity, and real-sample analysis. The review also compares the major limitations of current sensing systems, including complex fabrication, matrix interference, insufficient long-term stability, poor inter-electrode reproducibility, and limited scalability. Finally, future directions for developing robust, cost-effective, portable, and commercially viable ZEN sensors are discussed.

Journal Article↗

PubMed2026

Socket motility assessment of anophthalmic sockets: a systematic review.

PURPOSE: Systematically review and categorize the methods used to assess socket and prosthetic motility in anophthalmic patients following enucleation or evisceration. METHODS: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, Web of Science, and Scopus were searched from inception through September 2024. Studies reporting qualitative or quantitative assessments of motility in anophthalmic sockets or ocular prostheses were included. Motility assessment methods were categorized as qualitative (descriptive or graded clinical evaluation) or quantitative (numerical measurements in millimeters, degrees, or objective tracking systems). RESULTS: Thirty-five studies encompassing 1,819 patients met inclusion criteria. Nineteen studies used qualitative assessment methods, including subjective observation, graded scales based on cardinal gaze positions, or comparison with the contralateral eye. Sixteen studies employed quantitative techniques, such as the Kestenbaum limbus test, Lister perimeter measurements, conjunctival or limbal markings, photographic image analysis, infrared eye-tracking systems, and magnetic search-coil technology. Considerable heterogeneity was observed in measurement techniques, reporting standards, timing of assessment, and distinction between socket and prosthetic motility. CONCLUSIONS: Substantial variability exists in the methods used to assess motility in anophthalmic sockets, limiting comparability across studies. Establishing standardized, feasible, and reproducible assessment approaches may improve outcome reporting and facilitate meaningful comparisons in future oculoplastic research.

Humans↗

PubMed2026

Association of media use with sleep of children and adolescents: an umbrella review.

Adequate sleep is essential for child and adolescent development, driving extensive research across scientific disciplines. This umbrella review provides a comprehensive overview of existing evidence on media consumption and sleep and thereby lays the foundation for identifying key concepts and gaps. An inclusive systematic search for reviews reporting literature searches was conducted in 02/2021 and updated last in 09/2024. Methodological quality of the included reviews was assessed using AMSTAR-2. We included 84 reviews reporting on the association between media use and sleep in individuals aged 0-18 years. The field is dominated by reviews of low methodological quality, mainly including original cross-sectional studies with subjective measures in older children and adolescents. A total of 475 original articles were covered by the reviews; only 10 of them appeared in at least seven and at most nine reviews. Screen time generally had a negative impact on sleep, though evidence varied from very low to strong. Evidence for effects of conventional books on sleep remains inconclusive. High quality systematic reviews are needed to evaluate robust studies using objective measures of sleep and contemporary media use across all age groups up to adolescence and to explore the impact of non-digital media use on sleep, considering age and gender differences.

Humans↗

PubMed2026

Hormonal contraceptives and women's sleep health: A systematic review.

Sex hormones and hormonal contraceptives influence the regulation of sleep-wake behavior. However, there are very few large-scale studies to date that have comprehensively evaluated how hormonal contraceptives influence women's sleep health. The purpose of this systematic review was to synthesize the existing research on hormonal contraceptive use and sleep in women ages 18-50. The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement checklist. Nineteen studies were included in this review. Data were extracted and evaluated for risk of bias and heterogeneity. The included studies demonstrated high heterogeneity in terms of objective and/or subjective sleep-related measures and non-sleep primary study outcomes and demonstrated significant risks of bias, underscoring the need for methodological consistency in assessing women's sleep health. Several clinical considerations may be gleaned from this existing research in terms of the behavioral assessment and treatment of sleep difficulties in women using hormonal contraceptives. Additional investigation is needed to identify standardized research and clinical methodology guidelines for assessing and treating women's sleep health.

Humans↗

PubMed2026

Functional characterization of the MdFLZ2 gene in drought and salt stress tolerance in apple.

Drought and salt stress are significant environmental limitations that severely constrain plant growth and productivity, therefore, enhancing stress tolerance is a key goal in crop improvement. The plant-specific FCS-like zinc finger (FLZ) proteins have been identified as important regulators of stress adaptation. In this study, we conducted a genome-wide characterization of the FLZ gene family in apple and functionally characterized MdFLZ2. qRT-PCR analysis revealed that MdFLZ2 was differentially expressed across various tissues and transcriptionally induced by both drought and salt stress. Subcellular localization assays demonstrated that the MdFLZ2 protein is localized to both the nucleus and the cytoplasm. The overexpression of MdFLZ2 in apple calli, Arabidopsis and tomato conferred increased resistance to drought and salt stress. In addition, yeast two-hybrid (Y2H) assays confirmed that MdFLZ2 interacted with MdSnRK1.1, and similar interactions were also detected between other MdFLZ family members and MdSnRK1.1. Collectively, our findings suggest MdFLZ2 as a positive regulator of drought and salt tolerance and highlight its potential to serve as a genetic resource for abiotic stress improvement.

Malus↗

PubMed2026

A Critical Assessment of Evidence-Based Design's Knowledge Base and Inspiration: A Systematic Review.

PurposeThis study examines Evidence-Based Design (EBD) as an epistemological framework for guiding design research and practice, with a particular focus on its reliance on Evidence-Based Medicine (EBM) as a source of methodological inspiration.BackgroundOver the past two decades, EBD has been promoted as a way to strengthen design processes through the systematic use of scientific evidence. Its relationship to EBM, however, remains conceptually ambiguous: EBD draws legitimacy from EBM's hierarchical conception of "best evidence" while at the same time acknowledging the specificities of design practice, which do not easily fit such a model.MethodologyA systematic review was conducted on 31 publications in the design research literature that explicitly address the tension surrounding EBD's conception of "best evidence." The criticisms raised were coded and analyzed by main topics and subtopics.ResultsThe review highlights several reasons why EBM's hierarchical view of "best evidence" is an unsuitable epistemological foundation for EBD. It imposes scientifically inappropriate and practically ineffective methodological standards, devalues important sources of design knowledge, and fails to address central epistemic challenges intrinsic to design processes.ConclusionsBy bringing together critical yet fragmented insights from the literature, this study argues for the development of an updated epistemological framework for EBD. Constructing this framework will require sustained interdisciplinary dialogue between design research and philosophy of science.

Humans↗

PubMed2026

The Neurological Impact of Metabolic and Bariatric Surgery: A Systematic Review of Post-Operative Neuropathic and Non-Neuropathic Complications.

Metabolic and bariatric surgery achieves durable weight loss and meaningful improvement in obesity-related comorbidities yet carries a risk of neurological complications that remains under-recognised in routine clinical practice. This systematic review, registered with PROSPERO (CRD42024591611) and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, searched MEDLINE, Embase, Emcare, CINAHL and Cochrane databases through September 2023 to evaluate the incidence, spectrum, timing, pathophysiology and management of post-operative neurological complications. Twelve studies comprising over 5000 patients were included. Reported incidence ranged from 1.4% to 16%, with peripheral neuropathy the most frequent manifestation. Mononeuropathies, particularly carpal tunnel syndrome, were prominent in several cohorts, while central complications including Wernicke encephalopathy occurred less commonly but with considerably greater severity. Thiamine deficiency was the predominant aetiological factor. Onset varied from days to several years postoperatively, with early presentations typically compression-related and later ones nutritionally mediated. Outcomes were generally favourable with early intervention, though severe or delayed cases were associated with persistent neurological deficits and occasional mortality. Neurological complications after bariatric surgery are heterogeneous and largely preventable, and structured post-operative follow-up with consistent adherence to nutritional supplementation remains central to reducing long-term harm.

Humans↗

PubMed2026

Longitudinal associations between family factors and the neurodevelopmental and psychosocial outcomes of children with congenital heart disease: A systematic review.

Family factors have been gaining increased attention in understanding adverse neurodevelopmental and psychosocial outcomes for children with congenital heart disease (CHD). To clarify relevance, we undertook a systematic review of only longitudinal studies which assessed such associations. Comparisons with the contribution of disease/surgical factors were also made where included studies considered such. We included longitudinal studies which assessed dynamic family factors (e.g. parent mental health, attachment, family functioning) and later child outcomes. Searches were conducted across CINAHL, Medline-Pubmed, PsychInfo and SCOPUS Web of Science. The NIH Quality Assessment Tool was used to evaluate study quality and risk of bias. Eighteen studies, utilizing data from 11 study samples and 2109 participants, met inclusion criteria. These studies included samples from infancy, with follow-up periods stretching into young adulthood, and with various degrees of CHD severity. The quality of studies was "good" to "fair", with key limitations of attrition and limited sociocultural diversity in samples. Findings suggested that family factors predicted later child psychosocial outcomes and more consistently than severity of disease indicators. This contrasted with a much smaller number of studies examining family factors and child neurodevelopmental outcomes, where no reliable conclusions could be reached. Findings highlight the importance of screening and family focused interventions for this population.

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PubMed2026

Virtual, Augmented, and Mixed Reality Technologies in Neurosurgical Training: Enhancing Skills and Surgical Outcomes: A Systematic Review.

OBJECTIVE: To systematically review the role of virtual reality (VR), augmented reality (AR), and mixed reality (MR) in neurosurgical education and training. DESIGN: Systematic review conducted in accordance with the PRISMA guidelines. SETTING: A comprehensive search was performed across PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar for English-language studies published between 1 January 2020 and 30 April 2026. PARTICIPANTS: Studies involving neurosurgeons, fellows, residents, and medical students (maximum sample size: n = 48) were included. RESULTS: Of 7,204 initially identified studies, 25 met the inclusion criteria. VR was primarily used for surgical simulation (100% of VR studies) and anatomical education (62.5%). AR demonstrated broader applications, including preoperative planning (40%) and intraoperative support (30%). MR was evenly distributed across simulation, planning, and intraoperative support (40% each). The most frequently improved outcomes were training effectiveness (52%) and technical proficiency (44%). Methodological quality scores, assessed using the Modified Medical Education Research Study Quality Instrument (MMERSQI), ranged from 39.5 to 84.5, indicating varied rigor. CONCLUSION: VR, AR, and MR technologies show potential to enhance surgical precision, technical skills, and educational outcomes in neurosurgical training. However, standardization of methodologies and cost-effective solutions remain essential. Future research should focus on long-term clinical impact and integration of AI-driven training models.

Virtual Reality↗

PubMed2026

A transcription factor-focused CRISPR screen identifies SKI as a BCL11A-independent repressor of ζ-globin.

The regulation of α-like globin genes, particularly the embryonic ζ-globin gene (HBZ), remains incompletely understood. To identify transcriptional regulators of HBZ, we establish a GFP reporter system based on the HBZ-P2A-GFP allele in erythroid cell lines and conduct a CRISPR/Cas9 screen targeting 1639 transcription factors. This screen identifies SKI as a potent HBZ repressor. Functional validation shows that SKI loss increases HBZ expression without impairing erythropoiesis, whereas SKI overexpression suppresses HBZ. Tet-on-inducible SKI overexpression and auxin-inducible SKI degradation indicate that SKI rapidly represses HBZ transcription. Transcriptome profiling further reveals that SKI deletion activates HBZ while minimally affecting other erythroid genes. Mechanistically, genome-wide occupancy analyses show that SKI binds the distal enhancers HS-10 and HS-40, with partial co-occupancy by BCL11A. Despite this overlap, dual knockout of SKI and BCL11A synergistically increases HBZ expression, as does base editing of the SKI-binding site within HS-10. We also identify a naturally occurring variant (chr16:193207G>A) within this enhancer in α-thalassemia patients with elevated ζ-globin levels. Together, these findings establish SKI as a direct, BCL11A-independent transcriptional repressor of ζ-globin. This work advances our understanding of globin gene regulation and suggests targeted ζ-globin reactivation as a potential therapeutic strategy for α-thalassemia.

Enhancer↗

PubMed2026

A systematic review of sleep hygiene interventions in physically and operationally demanding occupations.

Workers in physically and operationally demanding (POD) occupations (e.g. military personnel, emergency responders, law enforcement) experience disrupted sleep due to irregular schedules and high-stress work environments. Given the importance of sleep for physical and cognitive performance, interventions to improve sleep in POD occupations are crucial yet remain under-researched. To investigate the effectiveness of sleep hygiene interventions in improving sleep quality and quantity outcomes for POD occupations, a systematic review was conducted across five databases (PubMed, CINAHL, SPORTDiscus, PsycINFO, Web of Science) in September 2024. Eligible studies involved workers in POD occupations where a sleep hygiene intervention was compared against a waitlist or passive control. Ten studies were included, eight randomised controlled trials (RCTs) and two non-randomised controlled trials (NRCTs). Narrative synthesis identified Structured Training Programs (n = 7), Phone Assistance Programs (n = 2), and Single Lecture Interventions (n = 1). Evidence certainty ranged from Very Low to Moderate, converging towards Low quality due to imprecision, risk of bias, and indirectness. Structured Training Programs showed moderate improvements in sleep quality and small-to-moderate effects on sleep duration. Phone Assistance Programs had minimal effects, and Single Lecture Interventions had negligible impact. Higher-quality research is urgently needed to assess sleep hygiene interventions in POD occupations.

Humans↗

PubMed2026

Orbital involvement in sickle cell disease: A systematic review.

Orbital involvement in sickle cell disease (SCD) is rare but potentially vision-threatening and is often misdiagnosed due to overlap with infectious orbital disease. We conducted a systematic review of case reports and series describing orbital complications in patients with confirmed SCD, following PRISMA and MOOSE guidelines. Across 53 studies, 76 cases were identified. Patients were predominantly male (77.6%), with an average age of 13.2 years. Orbital disease was the initial SCD manifestation in 6.6%. Presentations included periorbital edema in all, proptosis in 64.1%, restricted ocular motility in 56.5%, reduced visual acuity in 28.1%, and bilateral involvement in 38.2%. Laboratory findings commonly included leukocytosis (73%) and raised inflammatory markers (86.7%). Radiologically, orbital subperiosteal hematoma were observed in 70%, combined orbital bone infarction and hematoma in 38.2%, and orbital bone infarction alone in 19.7%. Magnetic resonance imaging is critical for accurate diagnosis. Intracranial hemorrhage was present in 9.2%. Less frequent manifestations included orbital apex syndrome, lacrimal gland disease, and nonspecific soft tissue swelling. Management was primarily conservative (82.9%), and surgery was reserved for vision-threatening or intracranial complications. Complete recovery was achieved in 93.1% of cases. While severe vision-threatening complications are uncommon, early recognition remains critical to optimising outcomes in sickle cell orbitopathy.

Humans↗

PubMed2026

A full review of online education resources available on antifungal stewardship.

BACKGROUND AND OBJECTIVES: Antifungal resistance represents an increasing global threat, driven by the rising burden of fungal disease. Antifungal stewardship (AFS) is a critical component of broader antimicrobial resistance (AMR) efforts, but education in this area remains less established than antibacterial stewardship initiatives. The scope and characteristics of the current landscape of online AFS resources have not yet been systematically described. To identify and evaluate online educational resources focused on fungal disease management and AFS, and assess their accessibility, format, educational design and implementation focus. METHODS: A structured search of internet search engines, distribution platforms and organizational websites was conducted to identify English-language web-based resources related to fungal disease management and stewardship. Resources were evaluated using predefined criteria including access model, format, length, educational design, interactivity and AFS content. An overall educational value score (1-10) was assigned. RESULTS: Twenty-three educational resources were identified. Most were delivered as online unfacilitated courses (11, 48%) and were short (<4 h) (12, 52%). Most focused on guidelines and syndromic management (18, 78%) and targeted doctors and/or nurses/midwives (22, 96%). Limited interactivity was reported in nine (39%) courses. Five courses (22%) had either a substantial or comprehensive focus on AFS. CONCLUSIONS: Online AFS educational resources are available and support awareness and knowledge development. However, they remain relatively few in number. Greater emphasis on implementation-focused learning, behaviour change components and broader global representation may enhance their impact.

Journal Article↗

PubMed2026

Implicit and explicit statistical learning in reading: Evidence from a randomized controlled-learning study and computational modeling.

A key challenge in reading acquisition is understanding how learners extract the complex probabilistic mappings between print, meaning, and sound. Statistical learning (SL) theory offers a mechanistic account of how such mappings are acquired, whether implicitly through exposure or explicitly through instruction. We conducted a randomized controlled-learning study in Chinese, a writing system characterized by multiple sub-lexical regularities linking orthography, semantics, and phonology. Ninety-five 2nd-3rd graders with or at risk for dyslexia were randomly assigned to one of three groups: an implicit-SL training group exposed to repeated lexical and sublexical orthography-semantics-phonology associations, an explicit-SL training group receiving the same input plus explicit instruction on the sublexical print-sound mapping, and a no-SL control group. Both SL groups outperformed controls on the characters they were trained on, as well as on untrained characters that required generalization. However, only the explicit group demonstrated abstraction of print-sound mapping to novel items. Neural network simulations further revealed distinct mechanisms supporting implicit and explicit SL, consistent with a dual-system account of reading acquisition. Together, these findings (1) clarify how implicit and explicit learning distinctly support the discovery of statistical structure in written language and (2) underscore the implicit-explicit dual learning mechanism underlying reading acquisition.

Humans↗

PubMed2026

A profile of deaths in children at the Diepkloof Forensic Pathology Services mortuary in Gauteng, South Africa from 1 January 2019 to 31 December 2020.

This retrospective study was conducted to address the scarcity of knowledge regarding unnatural child deaths in South Africa. This was done by analysing cases admitted to the Diepkloof Forensic Pathology Services mortuary between 1 January 2019 and 31 December 2020. Data from FPS death registers and FPS case files were used to profile: (1) the incidence, causes and manner of death, circumstances of death, and ancillary investigations performed at autopsy; and (2) to assess the impact of the COVID-19 pandemic on trauma-related child deaths. Of 4 704 decedents, 535 (11.4%) were children, predominantly male (55.5%) and Black (94.8%). Accidental deaths were the most common manner of death (42.6%), primarily due to road traffic accidents, burns, and aspiration. Homicides accounted for 6.5% of all deaths in children, most frequently involving sharp force or gunshot injuries. Cranio-cerebral injuries predominated in trauma-related deaths. In 2020, compared to preceding years, with the implementation of the COVID-19 restrictions, there was a decrease in trauma-related child fatalities. These findings suggest that many child deaths are potentially preventable through government implementation of improved safety interventions and community education.

Humans↗