Abundant experimental data suggest that hydrogen sulfide (H₂S) is related to the pathophysiology of Diabetes Mellitus (DM). Multiple molecular mechanisms, including receptors, membrane ion channels, signalingmolecules, enzymes, and transcription factors, are known to be responsible for the H₂S biological actions; however, H₂S is not fully documented as a gaseous signaling molecule interfering with DM and vascular-linked pathology. In recent decades, multiple approaches regarding therapeutic exploitation of H₂S have been identified, either based on H₂S exogenous apport or on its modulated endogenous biosynthesis. This paper aims to synthesize and systematize, as comprehensively as possible, the recent literature-related data regarding the therapeutic/rehabilitative role of H₂S in DM. This review was conducted following the “Preferred reporting items for systematic reviews and meta-analyses” (PRISMA) methodology, interrogating five international medically renowned databases by specific keyword combinations/“syntaxes” used contextually, over the last five years (2017–2021). The respective search/filtered and selection methodology we applied has identified, in the first step, 212 articles. After deploying the next specific quest steps, 51 unique published papers qualified for minute analysis resulted. To these bibliographic resources obtained through the PRISMA methodology, in order to have the best available information coverage, we added 86 papers that were freely found by a direct internet search. Finally, we selected for a connected meta-analysis eight relevant reports that included 1237 human subjects elicited from clinical trial registration platforms. Numerous H₂S releasing/stimulating compounds have been produced, some being used in experimental models. However, very few of them were further advanced in clinical studies, indicating that the development of H₂S as a therapeutic agent is still at the beginning.

Diabetes mellitus (DM) is a frequent medical problem, affecting more than 4% of the population in most countries. In the context of diabetes, the vascular endothelium can play a crucial pathophysiological role. If a healthy endothelium—which is a dynamic endocrine organ with autocrine and paracrine activity—regulates vascular tone and permeability and assures a proper balance between coagulation and fibrinolysis, and vasodilation and vasoconstriction, then, in contrast, a dysfunctional endothelium has received increasing attention as a potential contributor to the pathogenesis of vascular disease in diabetes. Hyperglycemia is indicated to be the major causative factor in the development of endothelial dysfunction. Furthermore, many shreds of evidence suggest that the progression of insulin resistance in type 2 diabetes is parallel to the advancement of endothelial dysfunction in atherosclerosis. To present the state-of-the-art data regarding endothelial dysfunction in diabetic micro- and macroangiopathy, we constructed this literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We interrogated five medical databases: Elsevier, PubMed, PMC, PEDro, and ISI Web of Science.

Background and Objectives: Increased and unstructured digital exposure has raised growing concerns about its potential impact on children’s cognitive and behavioral development. Executive functions (EFs)—encompassing attention, working memory, inhibition, and cognitive flexibility—are particularly sensitive to environmental influences during development. Beyond its empirical aim, this study also sought to address a theoretical gap by clarifying how multiple dimensions of digital exposure (quantity, content quality, and sleep-related timing) jointly relate to EF performance, an area insufficiently integrated into current EF frameworks. This study aimed to examine the quantitative and qualitative dimensions of digital exposure in relation to sleep duration and EF performance among Romanian school-aged children and adolescents. Materials and Methods: A cross-sectional study was conducted among 142 students aged 5–19 years, using standardized cognitive tasks and structured parent questionnaires to assess screen time, digital content type, and sleep duration. Analyses included correlational tests, group comparisons, regression models, and moderation procedures. Results: Higher daily screen time was associated with poorer attention and working-memory performance and shorter nocturnal sleep. Children and adolescents who exceeded the recommended daily screen-time limits performed worse on executive-function measures than those within recommended limits. Digital content type and sleep duration each contributed uniquely to executive performance, and recreational digital content as well as younger age intensified the negative effects of screen exposure. Conclusions: Excessive daily screen time, especially involving passive or recreational content, is associated with poorer EF performance and shorter sleep in children. Adequate sleep and educational or interactive digital engagement may mitigate these effects. The findings underscore the importance of age-appropriate, structured, and balanced digital habits to support healthy cognitive development.

Background/Objectives: Although numerous studies have examined associations between screen time and early language development, less is known about how screen exposure interacts with developmental stage, digital content quality, and parental mediation across childhood and adolescence, particularly with respect to pragmatic communication. This study aimed to address these gaps by examining the joint associations of screen time, content composition, and parental mediation with multiple linguistic and pragmatic domains across a broad age range. Methods: A cross-sectional study was conducted with 286 Romanian participants aged 5–19 years, grouped into four developmental stages. Measures included daily screen time, proportion of educational versus recreational content, parental mediation practices, and standardized assessments of vocabulary, verbal fluency, grammatical competence, and pragmatic communication. Analyses included descriptive statistics, Pearson correlations, 4 × 3 factorial ANOVAs (age group × screen-time category), and multiple linear regression. Results: Higher levels of screen exposure were consistently associated with lower performance across all linguistic and pragmatic domains (r = −0.19 to −0.28, all p < 0.01). Participants viewing >2 h/day showed significantly weaker outcomes than those with ≤1 h/day, particularly in semantic and phonemic fluency and pragmatic communication (p < 0.001). Educational content correlated positively with linguistic scores, whereas recreational content showed negative associations. Parental mediation emerged as a significant positive predictor. In the regression model (R² = 0.42), age (β = 0.47), parental mediation (β = 0.21), and educational content (β = 0.18) predicted better linguistic performance, while screen time (β = −0.29) predicted lower performance. Conclusions: The findings indicate that associations between digital media use and linguistic and pragmatic performance vary across developmental stages and contextual factors. Rather than screen time alone, digital content quality and parental mediation are associated with differences in communicative performance. These results highlight the value of a nuanced, developmentally informed perspective when considering children’s digital media environments.

Background/Objectives: The increasing prevalence of digital media use among children and adolescents has raised concerns regarding its potential impact on cognitive and communication development. Previous research has linked higher screen exposure to poorer language outcomes; however, the mechanisms underlying these associations remain insufficiently understood, particularly with respect to pragmatic communication. The present study aimed to examine the relationships between daily screen time, executive functioning (EF), and communication-related outcomes, and to test whether EF mediates the association between digital media exposure and pragmatic communication and language performance. Methods: A cross-sectional observational study was conducted with 240 children and adolescents aged 6–15 years. Caregivers reported children’s daily screen time, digital consumption and communication skills. EF was assessed using performance-based tasks measuring inhibitory control, working memory, and cognitive flexibility. Language performance was evaluated using a standardized composite measure. Pearson correlations, mediation analyses with bootstrapped confidence intervals, and factorial analyses of variance were performed, controlling for age, sex, parental mediation, and educational content exposure. Results: Higher daily screen time was significantly associated with lower EF, weaker pragmatic communication, and poorer language performance. EF was positively related to both pragmatic and language outcomes and partially mediated the relationship between screen time and communication measures. Educational digital content and parental mediation showed positive associations with EF and communication outcomes, whereas recreational content exhibited negative associations. Group comparisons indicated that negative associations between screen exposure and developmental outcomes were more pronounced in younger children. Conclusions: These findings suggest that EF may represent a key intermediary mechanism underlying the association between digital media exposure and communication-related development. The results highlight the importance of considering not only the quantity but also the quality and context of children’s digital media use, particularly during early developmental stages.