Background: Simulation may supplement operative exposure in cleft lip surgery, but the strength and clinical relevance of evidence remain uncertain. This systematic review evaluated cleft lip repair simulators, focusing on characteristics, validity evidence, educational effectiveness, and implementation. Methods: PubMed, Scopus, Web of Science, and Embase were searched on 1 August 2026. Eligible studies were original English-language studies published in 2016–2026 evaluating cleft lip repair simulators for training or assessment. Non-original reports and studies without an eligible training or assessment component were excluded. Two reviewers independently selected studies and extracted data. Validity evidence was assessed using Messick’s framework, educational effectiveness using an adapted McGaghie framework, and methodological quality using the Mixed Methods Appraisal Tool (MMAT) 2018. Findings were synthesized narratively. The protocol was submitted to PROSPERO on 5 August 2026, and registered on 11 August 2026 (CRD420261469105). Results: Twenty-four publications were included. Two publications (8.3%) were categorized as educational effectiveness not evaluated, 14 (58.3%) as McGaghie Level 1, and eight (33.3%) as Level 2; none reached Levels 3–5. Eight publications demonstrated objectively measured improvement in knowledge or performance following an educational intervention or repeated simulation. Response Process validity evidence was identified in 19 publications (79.2%), whereas Content-related validity evidence was identified in 13 publications (54.2%). Internal Structure and Relations to Other Variables were less frequently supported, and Consequences evidence was absent. Evidence was limited by small samples, heterogeneous designs, and frequent reliance on subjective outcomes. Conclusions: Cleft lip simulation can produce measurable educational benefits, but evidence of transfer to clinical performance or patient outcomes is lacking. Future studies should prioritize objective assessment, stronger validity and reliability evidence, accessible task-specific models, and evaluation of clinical transfer. No external funding was received.

Background: Micro- and nanoplastics (MNPs) are emerging contaminants increasingly detected in human tissues and biological fluids. Their presence in blood, vascular tissues, thrombi, and atherosclerotic plaques raises concern about their possible association with cardiovascular disease. This systematic review synthesized evidence on associations between MNPs and cardiovascular pathology. Methods: A systematic search was conducted in October 2025 in PubMed, Scopus, Web of Science, and Embase according to PRISMA guidelines and a PICOS-based strategy. Original human studies from the last 10 years were eligible. Fourteen studies were included. Due to methodological heterogeneity, a narrative synthesis was performed. Risk of bias was assessed using ROBINS-E, and certainty of evidence was evaluated using a GRADE-informed approach. Results: MNPs were detected in multiple cardiovascular-related matrices. Included studies suggested possible associations with major adverse cardiovascular events, acute coronary syndrome, myocardial infarction, arterial stenosis, vascular calcification, thromboembolic disease, hypertension, inflammatory markers, coagulation-related parameters, and lipid profiles. However, the certainty of evidence was very low, and most studies had a high or very high risk of bias. Conclusions: Current evidence suggests a possible association between MNPs and cardiovascular pathology, but causality remains unproven. Larger prospective studies using standardized detection protocols, rigorous contamination control, and adjustment for confounders are needed.

Background. The endothelial glycocalyx is a dynamic layer covering the luminal surface of endothelial cells and contributes to vascular permeability, blood cell–vessel wall interactions, and shear-stress mechanotransduction. Exercise alters hemodynamic conditions, but glycocalyx responses may vary with exercise characteristics and training status. Aim. To summarize current evidence on the effects of acute exercise and regular training on the endothelial glycocalyx, with emphasis on exercise intensity, modality, and high training load. Material and methods. A narrative review of PubMed/MEDLINE, Scopus, and Web of Science was conducted, including human studies available up to September 1, 2026. Results. Glycocalyx responses to exercise were heterogeneous. Acute exercise was associated with either no significant change or increased circulating shedding markers, whereas imaging-derived measures did not consistently change. Chronic training studies reported favorable changes in some markers or no significant group-level effects. High training load and ultra-endurance exercise were also associated with variable glycocalyx-related responses. Conclusions. The endothelial glycocalyx response to exercise is context-dependent. Acute responses, long-term adaptations, and changes associated with high training load should be considered separately. Standardized studies are needed to clarify the relevance of glycocalyx-related measures for monitoring training adaptation in athletes.

Background: Muscle and tendon injuries of the lower limb are common in athletes and often require prolonged rehabilitation before returning to sport. Shear-wave elastography (SWE) enables quantitative assessment of tissue mechanical properties and may provide information beyond conventional morphological imaging.Aim: Sports activity resumption after lower-limb muscle and tendon injuries is a key focus of this narrative review, which summarizes current evidence on SWE in diagnosis, monitoring of healing and rehabilitation, and assessment of readiness to return to sport.Material and methods: Studies evaluating SWE in lower-limb muscle and tendon injuries were reviewed.Results: Studies demonstrate measurable SWE changes in hamstring and calf muscle injuries, Achilles tendon pathology and rupture, and patellar tendinopathy. However, the direction and magnitude of stiffness changes vary according to tissue type, injury stage, loading conditions, training status, acquisition protocol, and ultrasound system. Serial SWE measurements may therefore be more informative than isolated absolute values, particularly when performed under standardized conditions and interpreted alongside clinical and functional recovery.Conclusions: At present, SWE should be considered a complementary tool rather than a stand-alone diagnostic or return-to-sport criterion. Universal reference ranges and validated cutoff values are lacking, and the relationship between SWE normalization, re-injury risk, and readiness to return to sport remains uncertain. Further prospective studies using standardized protocols and clinically relevant outcomes are needed.