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Petroglyph motifs from 23 sites and 37 panels in northern Georgia and western North Carolina foothills and mountains are analyzed within their archaeological, ethnographic, and landscape contexts. The Track Rock Tradition comprises 10 chronologically sequenced marking categories: (1) Cupules/Meanders/Open Circles; (2) Soapstone Extraction cars; (3) Vulva Shapes; (4) Figures; (5) Feet/Hands/Tracks; (6) Nested Circles; (7) Cross-in-Circles; (8) Spirals; (9) Straight Lines; and (10) Thin Incised Lines. Dating spans approximately 3800 years. Early cupules and meanders predate 3000 years ago, truncated by Late Archaic soapstone extraction. Woodland period (3000–1050 years ago) motifs include vulva shapes, figures, feet, tracks, and hands. Early Mississippian concentric circles date to 1050–600 years ago, while Middle Mississippian cross-in-circles span 600–350 years ago. Late Mississippian spirals (350–200 years ago) and post-contact metal tool incisions represent the most recent phases. The Track Rock Tradition differs from western Trapp and eastern Hagood Mill traditions. Given the spatial overlap with Iroquoian-speaking Cherokee territory, motifs are interpreted through Cherokee beliefs, supplemented by related Muskogean Creek ethnography. In Cherokee cosmology, the matrilocal Thunderers hierarchy includes the Female Sun/Male Moon, Selu (Corn Mother)/Kanati (Lucky Hunter), Medicine Woman/Judaculla (Master of Game), and Little People families. Ritual practitioners served as intermediaries between physical and spirit realms through purification, fasting, body scratching, and rock pecking. Meanders represent trails, rivers, and lightning. Cupules and lines emphasize the turtle appearance of certain rocks. Vulva shapes relate to fertility, while tracks connect to life-giving abilities. Concentric circles denote townhouses; cross-in-circles and spirals represent central fires. The tradition shows continuity in core beliefs despite shifting emphases from hunting (Woodland) to corn cultivation (Mississippian), with petroglyphs serving as necessary waypoints for spiritual supplicants. Full article

Reactions of the angular 4,4′-oxybis[N-(pyridin-3-ylmethyl)benzamide] (L) with dicarboxylic acids and transition metal salts afforded non-entangled {[Cd(L)(1,3-BDC)(H₂O)]∙2H₂O}_n (1,3-BDC = 1,3-benzenedicarboxylic acid), 1; {[Cd(L)(1,4-HBDC)(1,4-BDC)_0.5]∙2H₂O}_n (1,4-BDC = 1,4-benzenedicarboxylic acid), 2; {[Cu₂(L)₂(1,3-BDC)₂]∙1.5H₂O}_n, 3; {[Ni(L)(1,3-BDC)(H₂O)]∙2H₂O}_n, 4; {[Zn(L)(1,3-BDC)]∙4H₂O}_n, 5; {[Zn(L)(1,4-BDC)]∙2H₂O}_n, 6; and [Cd₃(L)₂(1,4-BDC)₃]_n, 7, which have been structurally characterized by using single-crystal X-ray diffraction. Complexes 1–5 and 7 are 2D layers, giving (6⁴·8·10)(6)-2,4L3, (4²·8²·10²)(4²·8⁴)₂(4)₂, (4·5·6)(4·5⁵·6³·7)-3,5L66, (6⁴·8·10)(6)-2,4L3, interdigitated (8⁴·12²)(8)₂-2,4L2 and (3⁶·4⁶·5³)-hxl topologies, respectively, and 6 is a 1D chain with the (4³·6²·8)(4)-2,4C3 topology. The factors that govern the structures of 1–7 are discussed and the thermal properties of 1–7 and the luminescent properties of complexes 1, 2, 5 and 6 are investigated. The stabilities of complexes 1 and 5 toward the detection of Fe³⁺ ions are also evaluated. Full article

Oncology physiotherapists frequently provide care for patients experiencing severe immunosuppression. Exercise immunology, the science that studies the effects of exercise on the immune system, is a rapidly evolving field with direct relevance to oncology physiotherapists. Understanding oncology physiotherapists’ perspectives on the subject of immune functioning is essential to explore its possible integration into clinical reasoning. This study aimed to assess the perspectives of oncology physiotherapists concerning immune functioning in oncology physiotherapy. For this qualitative research, semi-structured interviews were performed with Dutch oncology physiotherapists. Results were analyzed via inductive thematic analysis, followed by a validation step with participants. Fifteen interviews were performed. Participants’ ages ranged from 30 to 63 years. Emerging themes were (1) the construct ‘immune functioning’ (definition, and associations with this construct in oncology physiotherapy), (2) characteristics related to decreased immune functioning (in oncology physiotherapy), (3) negative and positive influences on immune functioning (in oncology physiotherapy), (4) tailored physiotherapy treatment, (5) treatment outcomes in oncology physiotherapy, (6) the oncology physiotherapist within cancer care, and (7) measurement and interpretation of immune functioning. In conclusion, oncology physiotherapists play an important role in the personalized and comprehensive care of patients with cancer. They are eager to learn more about immune functioning with the goal of better informing patients about the health effects of exercise and to tailor their training better. Future exercise-immunology research should clarify the effects of different exercise modalities on immune functioning, and how physiotherapists could evaluate these effects. Full article

Mycobacterium avium subsp. hominissuis (MAH) is a zoonotic pathogen with a broad host range and diverse clinical manifestations. We report here the first documented case of MAH-induced fatal vasculitis in zebra finch (Taeniopygia guttata). Histopathological examination revealed acid-fast bacilli within macrophages and endothelial cells, primarily affecting the heart and aorta. Mycobacterial DNA was detected in cloacal swabs from affected finches and environmental samples from their housing facility. PCR targeting the rpoB gene and insertion elements IS1245 and IS901, followed by sequencing, confirmed MAH infection. MAH DNA was identified in 4 of 13 finch cloacal swabs and 7 of 28 environmental samples. This study describes a novel, highly pathogenic manifestation of MAH in birds and underscores the potential for avian involvement in environmental and zoonotic transmission. Full article

Callistemon citrinus has shown antioxidant and anti-inflammatory properties in certain tissues. However, its impact on the brain remains unproven. This study investigates the effect of C. citrinus extract and phytosomes on the oxidative status of the brains of rats fed a high-fat–fructose diet (HFD). Fifty-four male Wistar rats were randomly divided into nine groups (n = 6). Groups 1, 2, and 3 received a standard chow diet; Group 2 also received the vehicle, and Group 3 was supplemented with C. citrinus extract (200 mg/kg). Groups 4, 5, 6, 7, 8, and 9 received a high-fat diet (HFD). Additionally, groups 5, 6, 7, 8, and 9 were supplemented with orlistat at 5 mg/kg, C. citrinus extract at 200 mg/kg, and phytosomes loaded with C. citrinus at doses of 50, 100, and 200 mg/kg, respectively. Administration was oral for 16 weeks. Antioxidant enzymes, biomarkers of oxidative stress, and fatty acid content in the brain were determined. A parallel artificial membrane permeability assay (PAMPA) was employed to identify compounds that can cross the intestinal and blood–brain barriers. The HFD group (group 4) increased body weight and adipose tissue, unlike the other groups. The brain fatty acid profile showed slight variations in all of the groups. On the other hand, group 4 showed a decrease in the activities of antioxidant enzymes SOD, CAT, and PON. It reduced GSH level, while increasing GPx activity as well as MDA, 4-HNE, and AOPP levels. C. citrinus extract and phytosomes restore the antioxidant enzyme activities and mitigate oxidative stress in the brain. C. citrinus modulates oxidative stress in brain tissue through 1.8-cineole and α-terpineol, which possess antioxidant and anti-inflammatory properties. Full article

Objective: This study aimed to improve the understanding of the lives of patients with chronic neuropathic pain planned for invasive motor cortex stimulation (iMCS) and assess their expectations towards this intervention and its impact. Methods: Semi-structured face-to-face interviews were conducted until saturation of data was reached. Patients were recruited from one university medical center in the Netherlands. All interviews were audio-recorded, transcribed verbatim, and subjected to thematic analysis using iterative and inductive coding by two researchers independently. Results: Fifteen patients were included (11 females; mean age 63 ± 9.4 yrs). Analysis of the coded interviews revealed seven themes: (1) the consequences of living with chronic neuropathic pain; (2) loss of autonomy and performing usual activities; (3) balancing energy and mood; (4) intimacy; (5) feeling understood and accepted; (6) meaning of life; and (7) the expectations of iMCS treatment. Conclusions: This is the first qualitative study that describes the suffering of patients with chronic neuropathic pain, and their expectations prior to invasive brain stimulation. Significant themes in the lives of patients with chronic pain have been brought to light. The findings strengthen communication between physicians, caregivers, and patients. Practice Implications: The insights gathered from the interviews create a structured framework for comprehending the values and expectations of patients living with central pain and reveal the impact of symptoms due to the central pain. This knowledge improves the communication between physicians and caregivers on one side and the patient on the other side. Furthermore, the framework enhances the capacity for shared decision-making, particularly in managing expectations related to iMCS. Full article

Simulation has become a pivotal tool in the design, analysis, and optimization of the built environment, and has been widely adopted by professionals in architecture, engineering, and urban planning. These techniques enable stakeholders to test hypotheses, evaluate design alternatives, and predict performance outcomes prior to construction. Applications span energy consumption, airflow, thermal comfort, lighting, structural behavior, and human interactions within buildings and urban contexts. This study maps the scientific landscape of simulation research in the built environment through a bibliometric analysis of 12,220 publications indexed in Scopus. Using VOSviewer 1.6.20, it conducted citation and keyword co-occurrence analyses to identify key research themes, leading countries and journals, and central publications in the field. The analysis revealed seven primary thematic clusters: (1) human-focused simulation, (2) building-scale energy performance simulation, (3) urban-scale energy performance simulation, (4) sustainable design and simulation, (5) indoor environmental quality simulation, (6) building aerodynamics simulation, and (7) computing in building simulation. By synthesizing these trends and domains, this study provides an overview of the field, facilitating greater accessibility to the simulation literature and informing future interdisciplinary research and practice in the built environment. Full article

Introduction and Objectives: Risk-sharing agreements (RSAs) have emerged as a key strategy for financing high-cost medical technologies while ensuring financial sustainability. These payment mechanisms mitigate clinical and financial uncertainties, optimizing pricing and reimbursement decisions. Despite their widespread adoption globally, Latin America has reported limited implementation, particularly for high-cost medical devices. This study aims to share insights from designing RSAs in the form of Outcome Protection Programs (OPPs) for medical devices in Latin America from the perspective of a medical devices company. Methods: The report follows a structured approach, defining key OPP dimensions: payment base, access criteria, pricing schemes, risk assessment, and performance incentives. Risks were categorized as financial, clinical, and operational. The framework applied principles from prior models, emphasizing negotiation, program design, implementation, and evaluation. A multidisciplinary task force analyzed patient needs, provider motivations, and payer constraints to ensure alignment with health system priorities. Results: Over two semesters, a panel of seven experts from the manufacturer designed n = 105 innovative payment programs implemented in Argentina (n = 7), Brazil (n = 7), Colombia (n = 75), Mexico (n = 9), Panama (n = 4), and Puerto Rico (n = 3). The programs targeted eight high-burden conditions, including Coronary Artery Disease, atrial fibrillation, Heart Failure, and post-implantation arrhythmias, among others. Private providers accounted for 80% of experiences. Challenges include clinical inertia and operational complexities, necessitating structured training and monitoring mechanisms. Conclusions: Outcome Protection Programs offer a viable and practical risk-sharing approach to financing high-cost medical devices in Latin America. Their implementation requires careful stakeholder alignment, clear eligibility criteria and endpoints, and robust monitoring frameworks. These findings contribute to the ongoing dialogue on sustainable healthcare financing, emphasizing the need for tailored approaches in resource-constrained settings. Full article

Monitoring the activity index of animals is crucial for assessing their welfare and behavior patterns. However, traditional methods for calculating the activity index, such as pixel intensity differencing of entire frames, are found to suffer from significant interference and noise, leading to inaccurate results. These classical approaches also do not support group or individual tracking in a user-friendly way, and no open-access platform exists for non-technical researchers. This study introduces an open-source web-based platform that allows researchers to calculate the activity index from top-view videos by selecting individual or group animals. It integrates Segment Anything Model2 (SAM2), a promptable deep learning segmentation model, to track animals without additional training or annotation. The platform accurately tracked Cobb 500 male broilers from weeks 1 to 7 with a 100% success rate, IoU of 92.21% ± 0.012, precision of 93.87% ± 0.019, recall of 98.15% ± 0.011, and F1 score of 95.94% ± 0.006, based on 1157 chickens. Statistical analysis showed that tracking 80% of birds in week 1, 60% in week 4, and 40% in week 7 was sufficient (r ≥ 0.90; p ≤ 0.048) to represent the group activity in respective ages. This platform offers a practical, accessible solution for activity tracking, supporting animal behavior analytics with minimal effort. Full article

Background: Aortic stenosis (AS) is the most common valvular heart disease, associated with poor outcomes if left untreated. Current guidelines recommend that transcatheter aortic valve implantation (TAVI) procedures be performed in hospitals with an on-site cardiac surgery unit due to potential complications requiring surgical intervention. Objective: Based on our experience, we evaluated the feasibility and outcomes of implementing a TAVI program in a cardiology department without an on-site cardiac surgery unit, in collaboration with a remote hospital for surgical backup. Methods: The TAVI program involved pre- and post-procedural evaluations conducted at Meir Medical Center (Kfar Saba, Israel) with a remote surgical team available. The study population included 149 consecutive patients with severe aortic stenosis treated at the Meir valve clinic between November 2019 and December 2023. Procedures were performed by the center’s interventional cardiology team. Results: The mean age of the 149 patients was 80 ± 6 years, and 75 (50%) were female. The average STS score was 4.3, and the EuroSCORE II was 3.1. Among the patients, 68 (45%) were classified as New York Heart Association (NYHA) class III-IV. The valve types used included ACURATE neo2 (57 patients, 38%), Edwards SAPIEN 3 (43 patients, 28%), Evolut-PRO (41 patients, 27%), and Navitor (7 patients, 4%). There were no cases of moderate to severe paravalvular leak and no elevated post-implantation gradients, and there was no need for urgent cardiac surgery. One case of valve embolization was successfully managed percutaneously during the procedure. In-hospital follow-up revealed no deaths and only one major vascular complication. At one-year follow-up, six patients had died, with only one death attributed to cardiac causes. Conclusions: Our findings support the safe and effective performance of transfemoral TAVI in cardiology departments without on-site cardiac surgery, in collaboration with a remote surgical team. Further prospective, multicenter studies are warranted to confirm these results and guide broader clinical implementation of this practice. Full article

(1) Insulin-like growth factor-1 (IGF-1) is a neurotrophin with anti-inflammatory properties. Neuroinflammation and stress activate peripheral immune mechanisms, which may contribute to the development of depression and anxiety in sporadic Alzheimer’s disease (sAD). This study aims to evaluate whether intracerebroventricular (ICV) premedication with IGF-1 in a rat model of streptozotocin (STZ)-induced neuroinflammation can prevent the emergence of anhedonia and anxiety-like behavior by impacting the peripheral inflammatory responses. (2) Male Wistar rats were subjected to double ICVSTZ (total dose: 3 mg/kg) and ICVIGF-1 injections (total dose: 2 µg). We analyzed the level of anhedonia (sucrose preference), anxiety (elevated plus maze), peripheral inflammation (hematological and cytometric measurement of leukocyte populations, interleukin (IL)-6), and corticosterone concentration at 7 (very early stage, VES), 45 (early stage, ES), and 90 days after STZ injections (late stage, LS). (3) We found that ICVIGF-1 administration reduces behavioral symptoms: anhedonia (ES and LS) and anxiety (VES, ES), and peripheral inflammation: number of leukocytes, lymphocytes, T lymphocytes, monocytes, granulocytes, IL-6, and corticosterone concentration (LS) in the rat model of sAD. (4) The obtained results demonstrate beneficial effects of central IGF-1 administration on neuropsychiatric symptoms and peripheral immune system activation during disease progression in the rat model of sAD. Full article

Introduction: Biodegradable Temporizing Matrix (BTM) is a new synthetic dermal substitute suitable for wound closure and tissue regeneration. The data in paediatric population remain limited. The study purpose is to review the indications for BTM application in paediatric patients, evaluate the short-term and long-term results, including complications and functional outcomes, as well as to share some unique observations regarding the use of BTM in paediatric population. Patients and Methods: Patients undergoing reconstructive surgery and BTM application during the last three years were included. Data collected included patient demographics, primary diagnosis, previous surgical management, post-operative complications and final outcomes. BTM was used in 32 patients. The indications varied including epidermolysis bullosa (n = 6), burns (n = 4), trauma (n = 7), infection (n = 4), ischemia or necrosis (n = 11). Results: The results were satisfying with acceptable aesthetic and functional outcomes. Complications included haematoma underneath the BTM leading to BTM removal and re-application (n = 1), BTM infection (n = 1) and split-thickness skin graft failure on top of BTM requiring re-grafting (n = 2). Conclusions: BTM can be a good alternative to large skin grafts, locoregional flaps or even free flaps. The big advantages over other dermal substitutes or skin grafts are that BTM is less prone to infection and offers excellent scarring by preserving the normal skin architecture. Specifically in children, BTM might not require grafting, resulting in spontaneous healing with good scarring. In critically ill patients, BTM reduces the operation time and there is no donor site morbidity. BTM should be considered in the reconstructive ladder when discussing defect coverage options in children and young people. Full article

Objectives: This study explored perceptions, experiences, and outcomes associated with the choice of insulin therapies among pediatric patients with type 1 diabetes mellitus (T1D). Methods: This study included 20 adolescents (8 male and 12 female) with T1D, with a mean age of 15.05 ± 0.91 years, a mean diabetes duration of 5.19 ± 1.2 years, and a mean most recent HbA1c of 7.03 ± 0.16%. Ten of the participants were using an insulin pump (n = 10) and another 10 had either refused (n = 7) or discontinued (n = 3) insulin pump therapy. A qualitative inductive method was employed, using in-depth individual interviews. The interview material was transcribed verbatim and grounded theory was used to analyze the verbal material. Results: Four main thematic categories were identified from the narrations that captured both common and divergent perceptions of insulin pump users versus non-users: (1) adjusting to the lifelong diagnosis, (2) exposing diabetes versus hiding it, (3) becoming autonomous and integrating insulin pump therapy into daily life, and (4) worrying over the pump. The third theme, capturing autonomy and integration, surfaced as the core thematic category of this study. Conclusions: This grounded theory study revealed that, by using insulin pump therapy, adolescent T1D patients can enhance their autonomy and facilitate the integration of insulin treatment into their life. This study identified processes that inform diabetes education and contribute to ameliorating gaps in the uptake and maintenance of pump therapy in pediatric care. Full article

Background/Objectives: Neck pain caused by myofascial pain syndrome (MPS) is a highly prevalent musculoskeletal condition. Repetitive peripheral magnetic stimulation (rPMS) is a promising treatment option; however, its therapeutic effect and optimal treatment frequency remain unclear. This study aimed to investigate the therapeutic effect and duration of effect of rPMS in patients with MPS of the neck. Methods: In this randomized, sham-controlled, crossover trial, 27 patients with neck MPS and baseline visual analog scale (VAS) scores ≥ 40 were enrolled. The mean age was 43.8 ± 9.1 years, and 63% were female. Participants were randomly assigned to receive either an initial rPMS treatment (a 10 min session delivering 3900 pulses at 5–10 Hz) or sham stimulation. After 7 days, groups crossed over. Pain intensity (VAS), disability (Neck Disability Index; NDI), and analgesic use were recorded daily for seven consecutive days. A linear mixed-effects model was used for analysis. Results: At baseline, the VAS and NDI scores were 61.8 ± 10.5 and 26.0 ± 6.3, respectively. rPMS produced a significantly greater reduction in both VAS and NDI scores, with the greatest differences observed on Day 4: the differences were −24.1 points in VAS and −8.5 points in NDI compared to the sham group. There was no significant difference in analgesic use between the two groups. Conclusions: A single rPMS session provides short-term improvement in pain and disability in neck MPS. Based on the observed therapeutic window, more frequent sessions (e.g., twice weekly) may provide sustained benefit and should be explored in future studies. Full article

Background/Objectives: Neurodegenerative proteinopathies, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB), are increasingly prevalent worldwide mainly due to population aging. These conditions are marked by complex etiologies, overlapping pathologies, and progressive clinical decline, with significant consequences for patients, caregivers, and healthcare systems. This review aims to synthesize evidence on the healthcare complexities of major neurodegenerative proteinopathies to highlight current knowledge gaps, and to inform future care models, policies, and research directions. Methods: We conducted a comprehensive literature search in PubMed/MEDLINE using combinations of MeSH terms and keywords related to neurodegenerative diseases, proteinopathies, diagnosis, sex, management, treatment, caregiver burden, and healthcare delivery. Studies were included if they addressed the clinical, pathophysiological, economic, or care-related complexities of aging-related neurodegenerative proteinopathies. Results: Key themes identified include the following: (1) multifactorial and unclear etiologies with frequent co-pathologies; (2) long prodromal phases with emerging biomarkers; (3) lack of effective disease-modifying therapies; (4) progressive nature requiring ongoing and individualized care; (5) high caregiver burden; (6) escalating healthcare and societal costs; and (7) the critical role of multidisciplinary and multi-domain care models involving specialists, primary care, and allied health professionals. Conclusions: The complexity and cost of neurodegenerative proteinopathies highlight the urgent need for prevention-focused strategies, innovative care models, early interventions, and integrated policies that support patients and caregivers. Prevention through the early identification of risk factors and prodromal signs is critical. Investing in research to develop effective disease-modifying therapies and improve early detection will be essential to reducing the long-term burden of these disorders. Full article