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ARTIFICIAL INTELLIGENCE IN ULTRASONOGRAPHIC DIAGNOSIS OF THYROID NODULES: ENHANCING RISK STRATIFICATION AND CLINICAL DECISON-MAKING
No full textThyroid nodules are common clinical findings, increasingly detected due to the widespread use of high-resolution ultrasound imaging. While the majority of these nodules are benign, a minority may be malignant, necessitating accurate and efficient risk stratification. Traditional ultrasonographic evaluation relies heavily on the operator’s expertise and subjective interpretation, which introduces diagnostic variability.
This narrative review explores the evolving role of artificial intelligence in the ultrasonographic diagnosis of thyroid nodules. The principal objective of this review is to critically evaluate the diagnostic performance, clinical utility, and integration potential of artificial intelligence (AI)-based methodologies—including machine learning (ML) and deep learning (DL)—in the ultrasonographic assessment of thyroid nodules. Particular attention is devoted to the enhancement of existing risk stratification frameworks, and to identifying barriers to implementation in routine clinical. The review evaluates AI-integrated diagnostic systems in relation to existing classification frameworks, such as the thyroid imaging reporting and data system, and highlights innovations in elastography, 3D imaging, and automated segmentation. Evidence suggests that AI can enhance diagnostic accuracy, reduce interobserver variability, and improve the standardization of thyroid nodule assessment. Some algorithms demonstrate performance comparable to that of experienced clinicians, particularly in differentiating benign from suspicious nodules.
Despite promising results, limitations such as model generalizability, the need for large annotated datasets, and clinical validation remain challenges. The findings support the integration of artificial intelligence as a complementary tool to assist healthcare professionals in making more objective, consistent, and timely decisions regarding the evaluation and management of thyroid nodules
Methodology: A comprehensive narrative review of peer-reviewed literature was undertaken, encompassing both classical and AI-augmented ultrasonographic techniques, with a specific focus on diagnostic criteria, algorithmic accuracy, and classification consistency across TI-RADS variants (ACR-TIRADS, EU-TIRADS, K-TIRADS). Additionally, the role of emerging modalities such as ultrasound elastography was examined in the context of evaluating cytologically indeterminate nodules. Literature published between 2009 and 2025 was examined to assess how machine learning and deep learning algorithms contribute to image interpretation, classification, and malignancy prediction.
Abbreviated Description of The State Of Knowledge: Thyroid nodules are detected in up to 60% of the general adult population via ultrasonography. Although the malignancy rate remains relatively low (~5%), the clinical imperative is the accurate differentiation of malignant from benign lesions. Risk stratification relies on the assessment of sonographic features, including echogenicity, shape, margins, calcifications, and vascularity. Several standardized scoring systems—most notably TI-RADS—are employed to systematize malignancy risk and guide indications for fine-needle aspiration biopsy (FNAB). Despite its utility, ultrasonography remains inherently operator-dependent and subject to interpretive variability. AI-powered diagnostic systems have demonstrated promising potential in mitigating interobserver discrepancies, augmenting risk classification fidelity, and improving diagnostic throughput. Adjunctive techniques such as elastography provide additional biomechanical data, although limitations in methodological standardization currently preclude widespread adoption
THE ROLE OF SPORT-RELATED NASAL BONE FRACTURE IN DEVELOPMENT OF SLEEP APNOEA IN CHILDREN
No full textSport-related injuries have been reported as one of the top three causes of nasal bone fractures in the paediatric population regardless of the region. The most common sport disciplines responsible for nasal bone fractures are ball games like football, basketball and baseball. The diagnosis of nasal bone fracture is especially difficult in children consequential to a different anatomical structure of their nose than that of an adult’s. Masked by edema etc it is frequent for a paediatric fracture to be omitted on first examination, therefore it is crucial for physicians to take history and examine the young patients very carefully despite the child’s potential non-cooperative spirit. Paediatric nasal fractures are most commonly managed with closed reduction as surgical treatment is often delayed until the nose's development is complete, which occurs around adolescence, in order to avoid interfering with the growth centre. This approach may result in various post-traumatic complications, typically requiring frequent follow-up visits and secondary surgical treatment. As a result, it is critical to pay close attention to the underlying structural nasal structure during the initial diagnosis and treatment to avoid complications such as septal hematoma, septal deviation, and nasal obstruction. This review aims to outline the most frequent and severe long-term complications, stress the significance of early diagnosis and treatment, and provide strategies for preventing nasal bone fractures both re-injury and re-injury in children. Additionally, we would like to explore the likelihood that children will experience post-traumatic nasal obstruction, which can subsequently result in sleep apnea, reduced quality of life, and impaired athletic performance
ECONOMIC IMPACTS OF ROBOTICS TECHNOLOGY IN REMOTE GREENHOUSE FARMING: EVIDENCE FROM NORTHWEST INDIANA
No full textThis study examines the economic impacts of robotics adoption in greenhouse farming, focusing on Northwest Indiana (NWI) as part of the U.S. Economic Development Administration’s Project TRAVERSE. The research aims to quantify how robotics and automation enhance productivity, reduce labor dependence, and generate regional economic benefits. Employing an input–output (I–O) modeling framework using IMPLAN 2022 data, the study estimates the direct, indirect, and induced impacts of investments in greenhouse and robotics sectors. Findings indicate that robotics adoption yields higher multipliers for output, employment, labor income, and value added compared to traditional greenhouse farming. These results highlight stronger regional linkages, increased efficiency, and sustainable employment opportunities. The analysis demonstrates that technological innovation in agriculture not only boosts productivity but also contributes to broader regional resilience and economic diversification. The paper concludes that systematic economic impact assessment is vital for guiding public investments, workforce development, and policy decisions. Future research should track long-term adoption trends, evaluate policy incentives, and integrate sustainability metrics to inform climate-resilient and inclusive agricultural innovation
DETECTABLE IN-BLOOD BRCA1 METHYLATION AS A BIOMARKER OF BREAST CANCER PREDISPOSITION
No full textGermline BRCA1 mutations are a well-established risk factor for the development of breast cancer. Nevertheless, many patients who present with a clinical phenotype typical of BRCA1-associated tumors do not carry pathogenic BRCA1 mutations. Current risk models are inadequate, highlighting the need for new biomarkers. In this context, blood-based epigenetic markers such as DNA methylation are being explored. Many studies have examined BRCA1 promoter methylation in blood DNA as a BC risk marker. Retrospective analyses report that BRCA1 methylation in blood correlates with higher risk in triple-negative tumors. However, findings remain inconsistent due to numerous technical issues, including methodological variability, assay limitations, and differences in targeted CpG sites. This review highlights the risk of developing breast cancer in women with a methylated BRCA1 promoter in peripheral blood-derived DNA, as well as the potential drawbacks and challenges in this area.
Methodology: Relevant studies were identified through a targeted search of the PubMed database using keywords such as “BRCA1,” “methylation,” “breast cancer,” and “blood DNA.” Inclusion criteria comprised studies evaluating BRCA1 promoter methylation in blood-derived DNA in relation to breast cancer risk. Studies analyzing BRCA1 promoter methylation exclusively in tumor tissue or other non-blood specimens were excluded
DIAGNOSIS, TREATMENT AND SOMATIC MANIFESTATION OF ENDOMETRIOSIS: AN UPDATED REVIEW
No full textEndometriosis is a chronic gynecological condition affecting millions of women worldwide. It involves the growth of endometrial-like tissue outside the uterine cavity, which leads to significant symptoms and a marked decline in quality of life.
The aim of the Study: The purpose of this work is to present the most recent knowledge on the diagnosis, treatment methods, and somatic symptoms of endometriosis. The analysis covers publications from 2020 to 2025 and focuses on evaluating current medical approaches as well as identifying areas that require further development to improve prognosis and the daily functioning of patients.
Materials and Methods: A structured search of publications from 2020–2025 was conducted in the PubMed and Google Scholar databases using keywords related to diagnostic methods, therapeutic options, and the somatic and psychosomatic symptoms of endometriosis.
Results: Our review highlights that while invasive laparoscopy remains the diagnostic gold standard for endometriosis, advanced imaging techniques like transvaginal ultrasound and MRI are increasingly crucial, particularly for deep infiltrative disease. Despite these tools, significant diagnostic delays persist due to non-specific symptoms and the lack of sensitive non-invasive biomarkers. Current treatments involve hormonal therapies and surgical removal of lesions, but these approaches face challenges such as side effects, recurrence risks, and complications. Crucially, endometriosis is recognized as a multisystem disorder with diverse somatic manifestations including gastrointestinal, urinary, and systemic symptoms like chronic fatigue, alongside significant mental health impacts and increased risks for conditions such as cardiovascular disease and certain cancers
Conclusions: The collected data indicate that endometriosis is a multisystem disorder, and its effective management requires collaboration among specialists from various fields. Such an approach enables better tailoring of therapy and improved symptom control. A major challenge remains the long diagnostic delay, which still ranges from several to more than ten years. Advances in modern imaging techniques and the development of sensitive biomarkers may substantially shorten this period and allow earlier intervention
EFFECTS OF BLUE LIGHT EXPOSURE ON RAPID EYE MOVEMENT SLEEP DURATION AND MELATONIN LEVELS IN CHILDREN: A COMPREHENSIVE LITERATURE REVIEW
No full textBlue light exposure from electronic devices has emerged as a significant environmental factor affecting children's sleep architecture and circadian physiology. This comprehensive literature review synthesizes empirical evidence from 2020-2025 examining the effects of blue light exposure on rapid eye movement (REM) sleep duration and melatonin levels in pediatric populations. A systematic search of PubMed, Web of Science, and related databases identified studies employing objective measurement methods, including polysomnography (PSG) and actigraphy validated against PSG, with melatonin measurement via salivary DLMO. The current evidence demonstrates that blue light exposure, particularly from electronic devices in the evening hours, significantly suppresses melatonin production in children even at very low illuminance levels (5-40 lux), producing melatonin suppression of 70-99% depending on light intensity and spectral composition. Blue light predominantly affects melatonin suppression and REM sleep through intrinsically photosensitive retinal ganglion cells (ipRGCs) expressing melanopsin with peak sensitivity at approximately 480 nm. Studies indicate that evening blue light exposure reduces REM sleep duration, increases REM fragmentation with elevated microarousals, increases sleep onset latency, and impairs sleep efficiency in children. The magnitude of effects on REM sleep and melatonin suppression demonstrates circadian timing dependency, with exposure during 21:00-22:30 hours producing maximum sleep disruption. Evening screen use, particularly interactive forms, is associated with delayed sleep onset and reduced total sleep duration in children measured via objective actigraphy. Interventions restricting blue light exposure before bedtime through screen abstinence and blue light-blocking glasses show slight improvements in sleep timing and circadian phase advancement. This review concludes that evidence-based guidelines recommending screen restriction in the 1-2 hours before bedtime are justified based on documented physiological mechanisms and objective sleep disruption in children
THE IMPACT OF POLYPHARMACY ON FALL RISK IN PATIENTS WITH PARKINSON’S DISEASE
No full textBackground: Falls are frequent and disabling in Parkinson’s disease (PD), and polypharmacy may heighten risk through adverse effects such as orthostatic hypotension, sedation, and cognitive decline. However, the specific contribution of multiple medications to fall risk in PD remains underexplored.
Aim: This study examined whether polypharmacy increases fall risk in PD and identified medication classes and patient factors influencing this relationship.
Methods: In a 12-month prospective cohort, adults with idiopathic PD were evaluated for demographics, PD severity, cognition, comorbidities, orthostatic blood pressure, medication use, and prior falls. Polypharmacy was defined as ≥5 medications and hyper-polypharmacy as ≥10. Falls were tracked monthly. Logistic regression and secondary moderation/mediation analyses assessed predictors of falls.
Results: Polypharmacy affected 40–63% of participants and was associated with a higher fall incidence (72.8% vs. 44.8%). It independently increased fall risk (OR = 2.49), with hyper-polypharmacy showing greater impact (OR = 3.11). Benzodiazepines, antipsychotics, antidepressants, and anticholinergics were the strongest medication-related contributors. Older age moderated, and cognitive impairment partly mediated the relationship.
Conclusion: Polypharmacy significantly elevates fall risk in PD, particularly when involving CNS-active or anticholinergic drugs. Routine medication review and deprescribing may help reduce falls and improve safety in this population
THE SIGNIFICANCE OF SLEEP IN GLUCOSE METABOLISM REGULATION – THE ROLE OF CIRCADIAN RHYTHM DISRUPTIONS IN TYPE 2 DIABETES DEVELOPMENT: A NARRATIVE REVIEW
No full textBackground: Sleep and circadian rhythm disturbances constitute modifiable risk factors for type 2 diabetes mellitus (T2DM). Meta-analytic evidence demonstrates that short sleep duration (<6h/night) increases T2DM risk by 28–33% (OR 1.28–1.33), while shift work elevates incidence by 9–40% (RR 1.09–1.40).
Aims: The aim of this narrative review is to synthesise current epidemiological, interventional, and mechanistic evidence on how sleep disturbances and circadian rhythm disruptions influence type 2 diabetes pathophysiology in adults.
Methods: A structured narrative review was conducted using literature from PubMed, Scopus, Web of Science, and Google Scholar (2015–2025). Searches employed terms: "sleep duration glucose metabolism", "circadian rhythm type 2 diabetes", "clock genes insulin resistance", "shift work diabetes risk", "melatonin glucose homeostasis". Meta-analyses, systematic reviews, cohort studies, and randomized controlled trials were included.
Results: Epidemiological evidence reveals a U-shaped sleep–T2DM relationship with optimal risk at 7–8 hours/night. Short sleep (<6h) and long sleep (>9h) both increase T2DM risk (OR 1.28–1.48). Night shift work elevates risk dose-dependently (RR 1.40, 95% CI 1.15–1.71) across 1.16 million participants. Molecular mechanisms involve desynchronized clock genes (CLOCK, BMAL1, PER2, CRY1), mitochondrial dysfunction reducing oxidative capacity 20–30%, and altered melatonin signaling. Sleep extension interventions improve insulin sensitivity 17–45% within 1 week. Evening chronotherapy with glucose-lowering drugs demonstrates superior efficacy compared to morning dosing. CBT-I (cognitive behavioral therapy for insomnia) reduces T2DM incidence by 42% in prediabetic populations.
Conclusion: Sleep and circadian optimization represent cost-effective, modifiable strategies for T2DM prevention. Personalized chronotherapy guided by genetic profiling and objective sleep/activity monitoring warrants implementation in clinical practice and public health policies
AI-BASED GUIDEBOOKS: CONCEPTS, KEY FEATURES, AND CHALLENGES
No full textThe digital transformation of tourism and information services has accelerated the adoption of artificial intelligence in travel-related applications. An outcome of this process is the emergence of AI-based guidebooks, which differ from traditional guidebooks in their ability to personalize content, adapt to changing conditions, and interact with users in real time. This study aims to examine the core features, technological foundations, and challenges of AI-based guidebooks and their implications for contemporary tourism. The object of the research is AI-based guidebooks as intelligent guidance systems. It is focused on their functional characteristics, including personalization, context awareness, and interactive capabilities. The methodology is based on a conceptual and analytical review of academic literature on intelligent recommendation systems, natural language processing, geospatial analytics, and multimodal information delivery. The analysis identifies key advantages of AI-based guidebooks, such as adaptive content generation, context-sensitive recommendations, conversational interaction, and multimodal engagement. At the same time, important limitations are highlighted, including issues of information reliability, privacy and ethical concerns, and the risk of over-reliance on automated systems. The study concludes that AI-based guidebooks mark an important advancement in tourism information systems and stresses the need for more research on transparency, user trust, and hybrid methods that blend AI personalization with human-edited cultural content
SPORT-RELATED DYSTONIA – CURRENT STATE OF KNOWLEDGE IN DIAGNOSIS AND TREATMENT
No full textSports-related dystonia (SRD) is believed to arise as a consequence of repetitive motor activity, often involving tens of thousands of movement repetitions performed during high-level athletic training. Professional sports practice is characterized by prolonged physical exertion and the frequent execution of specific motor tasks, repeated hundreds or even thousands of times in pursuit of technical perfection. This intensive regimen may lead to both physical and mental fatigue, potentially resulting in overuse injuries. SRD has been most frequently described in golfers, runners, cricketers, basketball players, and gymnasts. Despite growing awareness of its clinical presentation, SRD remains a diagnostic and therapeutic challenge.The aim of this study is to provide a comprehensive review of the current state of knowledge regarding SRD, based on publications available in the PubMed database.A literature search was conducted using relevant keywords to identify scientific publications not older than five years, retrieved from academic databases.
SRD represents a complex clinical syndrome that requires a multidisciplinary and individualized approach. The absence of specific diagnostic tests, combined with the variability and subtlety of symptoms, often results in significant diagnostic challenges. Effective treatment must be tailored to the specific symptom profile presented by each athlete, taking into account both motor and non-motor aspects of the condition. Currently, further research is needed to improve both the diagnostic criteria and therapeutic strategies for managing SRD. Early identification and preventive strategies—particularly in young athletes—should be emphasized. Educational efforts aimed at raising awareness of the potential career-threatening nature of SRD may facilitate earlier recognition of symptoms and help prevent premature discontinuation of athletic careers.Treatment of this disorder must be individualized and focused on the specific range of symptoms present in each athlete. Currently, further research on the diagnosis and therapeutic options for patients affected by this condition is necessary