Search Results (105)

Spinal cord injury (SCI) remains one of the toughest obstacles in neuroscience and regenerative medicine due to both severe functional loss and limited healing ability. This article aims to provide a key integrative, mechanism-focused review of the molecular landscape of SCI and the new disruptive therapy technologies that are now evolving in the SCI arena. Our goal is to unify a fundamental pathophysiology of neuroinflammation, ferroptosis, glial scarring, and oxidative stress with the translation of precision treatment approaches driven by artificial intelligence (AI), CRISPR-mediated gene editing, and regenerative bioengineering. Drawing upon advances in single-cell omics, systems biology, and smart biomaterials, we will discuss the potential for reprogramming the spinal cord at multiple levels, from transcriptional programming to biomechanical scaffolds, to change the course from an irreversible degeneration toward a directed regenerative pathway. We will place special emphasis on using AI to improve diagnostic/prognostic and inferred responses, gene and cell therapies enabled by genomic editing, and bioelectronics capable of rehabilitating functional connectivity. Although many of the technologies described below are still in development, they are becoming increasingly disruptive capabilities of what it may mean to recover from an SCI. Instead of prescribing a particular therapeutic fix, we provide a future-looking synthesis of interrelated biological, computational, and bioengineering approaches that conjointly chart a course toward adaptive, personalized neuroregeneration. Our intent is to inspire a paradigm shift to resolve paralysis through precision recovery and to be grounded in a spirit of humility, rigor, and an interdisciplinary approach. Full article

Our study explored the accuracy of Fitbit recorded step count during the use of an assistive device (two-wheeled walker and standard cane) at various body positions (wrists, hips, and ankles). Participants (n = 11) ambulated an obstacle course (50 m total, including turns and a step up/down) a total of three times (two-wheeled walker, standard cane, and a deviceless control trial). Fitbit generated step counts (at the wrists, hips, and ankles) were then compared to the individual’s “actual” step count captured through video analysis. During the cane trial and the deviceless trial, all positions were significantly correlated (r = 0.764 to 0.984; p < 0.006) with the actual step count. However, increased variability (demonstrated by increased limits of agreement) was observed when the Fitbit was worn on the wrist (compared to the hips or ankles). During the walker trial, the step count was significantly correlated to the actual step count at the ankle and hip positions (r = 0.669 to 0.888; p < 0.017) with an average error of 1.5%, while it was not statistically correlated at the wrist with a 31.2% average error. Our study suggests that Fitbits are a good predictor of actual step count, with the caveat that the location of the Fitbit should be considered if an assistive device (e.g., two-wheeled rolling walker and single-point cane) is being used. Full article

Children with onco-hematological diseases require intensive medical treatments that can affect various aspects of their development. In addition to the disease itself, what influences the course of development most are the neurotoxic effects of therapies and frequent hospitalizations, especially if they occur in the first three years of the child’s life. Among these challenges there is the potential for language delay, a condition that can impact their communication abilities and overall development. Background/Objectives: The aim of this study is to examine communicative and linguistic development in a small group of young children diagnosed with different forms of leukemia, rhabdomyosarcoma, and CNS tumors, recruited through the Hematology–Oncology Clinic of the Department of Child and Woman Health (University of Padova). Methods: Child direct (Griffiths III, PinG, PCGO) and parent indirect assessments (PVB, ABAS-II, ASCB) were provided. Results: Griffiths communication subscale scores in children were mainly below average (55.6%), and 44.4% attested at the clinical level in ABAS-II, with the ability to understand being significantly higher than the production of words. However, the two levels of assertiveness–responsiveness obtained balance in 66.7% of cases, and using the Griffiths personal subscale, only 22.2% of children attested below average. Conclusions: Understanding and addressing children’s communication needs is crucial to improve the quality of life of these young patients and foster optimal communicative and linguistic development despite the obstacles they face in order to implement interventions designed specifically for this type of population and their respective families, if necessary. Full article

For many Native American students, the thirty-seven existing tribal colleges improve their access to post-secondary education, especially for those living in reservation communities and surrounding rural areas. They also support tribal nations’ goals of offering accredited degree programs, as well honoring Indigenous knowledge. This is important for students enrolled in STEM courses since Native Americans are under-represented in these fields. In the early 2000s, Chief Dull Knife College (CDKC), the tribal college of the Northern Cheyenne Nation, was supported by National Science Foundation funding in developing a new math program to meet the unique cultural and instructional needs of its students. In this case study of a culturally responsive math program, we hypothesize that students participating in the new developmental math program attempt and earn more credits compared to cohorts participating in previous math programs and take less time on average to reach college-level math. We present information on the math outcomes of the participants in two variations of the math program reforms that have addressed the obstacles to student retention and achievement. The panel data available include students’ demographic characteristics, placement test scores, and math course grades and the credits for all students enrolled from 2006 to 2019. While the number of credits attempted or earned did not differ statistically across the cohorts, the qualitative data further show that the students appreciate the culturally responsive aspects of the program. Ultimately, we have found that these aspects resulted in increased confidence of the students in their academic skills, stronger Native identities and engagement as students, as well as an improved sense of belonging in this higher education environment, all of which were important goals of the developmental math program. Full article

In ship navigation, determining a safe and economic path from start to destination under dynamic and complex environment is essential, but the traditional algorithms of current research are inefficient. Therefore, a novel differential evolution deep reinforcement learning algorithm (DEDRL) is proposed to address problems, which are composed of local path planning and global path planning. The Deep Q-Network is utilized to search the best path in target ship and multiple-obstacles scenarios. Furthermore, differential evolution and course-punishing reward mechanism are introduced to optimize and constrain the detected path length as short as possible. Quaternion ship domain and COLREGs are involved to construct a dynamic collision risk detection model. Compared with other traditional and reinforcement learning algorithms, the experimental results demonstrate that the DEDRL algorithm achieved the best global path length with 28.4539 n miles, and also performed the best results in all scenarios of local path planning. Overall, the DEDRL algorithm is a reliable and robust algorithm for ship navigation, and it also provides an efficient solution for ship collision avoidance. Full article

With vocabulary playing an essential role in the learning of English for Specific Purposes, teachers face the challenge of organising and teaching lexis in a way that maximises opportunities for acquisition. Specialised word lists offer a solution, but a major obstacle is how to integrate these lists into learning materials containing items used in actual discourse. In this paper, we report on research involving the creation of a medical English word list (MEWL), integrated into a set of specially designed materials for students at a national university in Japan. These materials, developed through needs analysis at the university’s medical school, are primarily organised around body systems, with an additional focus on doctor–patient communication. The MEWL is complemented by a list of word parts, aiming to sensitise students to complex medical terms. We describe the delivery of the list, first through the courses and materials, and then via the development of a vocabulary learning tool, Hi-Lex, which analyses texts against any word lists it contains. Hi-Lex allows learners to create personalised word lists and understand word usage in context. The findings of a small trial study of Hi-Lex (N = 31) illustrate how the software provides insight into students’ selections of words in specialised texts. Full article

Background: Post-traumatic pseudomeningoceles are common findings after a brachial or lumbar plexus trauma, in particular after nerve root avulsion. Unlike meningoceles, pseudomeningoceles are CSF full-filled cysts confined by the paraspinous soft tissue, along the normal nerve course, in communication with the spinal subarachnoid spaces. Normally no more than a radiological finding at MRI, in rare instances they might be symptomatic due to their size or might constitute an obstacle during a reconstructive surgery. Methods: A review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a time span ranging from November 1972 to May 2024. A total of five articles were found meeting the inclusion criteria. A case report at our institution was added to the case history. Results: A 30-year-old man with complete right brachial plexus nerve roots avulsion and a voluminous pseudomeningocele at the C6-C7 level after a motorcycle incident in January 2023. The pseudomeningocele covered the entirety of the injured brachial plexus. Pre-operative external lumbar drainage was utilized to prevent relapse or worsening of the already existing cerebral spinal fluid collection, with good results at 6 months. The full case report is reported in detail. Conclusions: To date, no clear guidelines about the management of post-traumatic pseudomeningoceles are reported in the literature. The lack of symptoms or signs related to them does not usually require any surgical intervention. If not, a possible management strategy with the use of an external lumbar drainage is proposed, a solution already in use in other surgical contexts with successful results in preventing CSF fistula or its relapse. Full article

Background: If left untreated, glaucoma—the second most common cause of blindness worldwide—causes irreversible visual loss due to a gradual neurodegeneration of the retinal ganglion cells. Conventional techniques for identifying glaucoma, like optical coherence tomography (OCT) and visual field exams, are frequently laborious and dependent on subjective interpretation. Through the fast and accurate analysis of massive amounts of imaging data, artificial intelligence (AI), in particular machine learning (ML) and deep learning (DL), has emerged as a promising method to improve the early detection and management of glaucoma. Aims: The purpose of this study is to examine the current uses of AI in the early diagnosis, treatment, and detection of glaucoma while highlighting the advantages and drawbacks of different AI models and algorithms. In addition, it aims to determine how AI technologies might transform glaucoma treatment and suggest future lines of inquiry for this area of study. Methods: A thorough search of databases, including Web of Science, PubMed, and Scopus, was carried out to find pertinent papers released until August 2024. The inclusion criteria were limited to research published in English in peer-reviewed publications that used AI, ML, or DL to diagnose or treat glaucoma in human subjects. Articles were chosen and vetted according to their quality, contribution to the field, and relevancy. Results: Convolutional neural networks (CNNs) and other deep learning algorithms are among the AI models included in this paper that have been shown to have excellent sensitivity and specificity in identifying glaucomatous alterations in fundus photos, OCT scans, and visual field tests. By automating standard screening procedures, these models have demonstrated promise in distinguishing between glaucomatous and healthy eyes, forecasting the course of the disease, and possibly lessening the workload of physicians. Nonetheless, several significant obstacles remain, such as the requirement for various training datasets, outside validation, decision-making transparency, and handling moral and legal issues. Conclusions: Artificial intelligence (AI) holds great promise for improving the diagnosis and treatment of glaucoma by facilitating prompt and precise interpretation of imaging data and assisting in clinical decision making. To guarantee wider accessibility and better patient results, future research should create strong generalizable AI models validated in various populations, address ethical and legal matters, and incorporate AI into clinical practice. Full article

US college students are typically required to take at least one mathematics or statistics course, either as part their major area of study, or as a general education requirement. College mathematics requirements are an obstacle for many college students. Active learning, a pedagogical approach that places emphasis on students’ collaborative work, has been shown to increase student learning and course success in STEM fields of study and in mathematics courses. Active learning has also been shown to be adaptable to courses involving computer software and programming, such as introductory statistics. This case study is based on the author’s experience implementing an active learning model in an introductory statistics course for students majoring in sociology and related social sciences. Results indicate that the active learning approach was adaptable to the structure and particular learning goals of the course. Students perceived greater learning relative to other courses despite doing less work outside of class, and attributed this to the active learning structure of the course. These findings align with more systematic studies on the impacts of active learning in science and mathematics courses. Full article

Although a lack of diversity in genetic studies is an acknowledged obstacle for personalized medicine and precision public health, Latin American populations remain particularly understudied despite their heterogeneity and mixed ancestry. This gap extends to COVID-19 despite its variability in susceptibility and clinical course, where ethnic background appears to influence disease severity, with non-Europeans facing higher hospitalization rates. In addition, access to high-quality samples and data is a critical issue for personalized and precision medicine, and it has become clear that the solution lies in biobanks. The creation of the Chilean COVID-19 Biorepository reported here addresses these gaps, representing the first nationwide multicentric Chilean initiative. It operates under rigorous biobanking standards and serves as one of South America’s largest COVID cohorts. A centralized harmonization strategy was chosen and included unified standard operating procedures, a sampling coding system, and biobanking staff training. Adults with confirmed SARS-CoV-2 infection provided broad informed consent. Samples were collected to preserve blood, plasma, buffy coat, and DNA. Quality controls included adherence to the standard preanalytical code, incident reporting, and DNA concentration and absorbance ratio 260/280 assessments. Detailed sociodemographic, health, medication, and preexisting condition data were gathered. In five months, 2262 participants were enrolled, pseudonymized, and sorted by disease severity. The average Amerindian ancestry considering all participant was 44.0% [SD 15.5%], and this value increased to 61.2% [SD 19.5%] among those who self-identified as Native South Americans. Notably, 279 participants self-identified with one of 12 ethnic groups. High compliance (>90%) in all assessed quality controls was achieved. Looking ahead, our team founded the COVID-19 Genomics Network (C19-GenoNet) focused on identifying genetic factors influencing SARS-CoV-2 outcomes. In conclusion, this bottom-up collaborative effort aims to promote the integration of Latin American populations into global genetic research and welcomes collaborations supporting this endeavor. Interested parties are invited to explore collaboration opportunities through our catalog, accessible online. Full article

The Law enforcement profession is known to impart high stress. Members of Special Weapons and Tactics (SWAT) teams are allocated particularly demanding law enforcement operations and may therefore attain high fitness levels but may accumulate excessive stress. Heart rate variability (HRV), an assessment of time differences between heartbeats, likely indicates holistic load in field settings. To date, though, little research measuring HRV has been conducted involving SWAT units. The purpose of this study was to explore HRV measurements following (1) annual firearms qualification and (2) potential stress exposure with respect to completion time on an anaerobically taxing obstacle course. Officers with greater obstacle course performance were hypothesized to also exhibit greater HRV. HRV was also expected to stratify personnel more effectively than heart rate. Prospective 3-lead ECGs were obtained from a cohort of male SWAT operators (n = 15) with 5.2 ± 4.3 years of experience at three time points throughout one training day. HRV was assessed by time, frequency, and non-linear domains. Differences between baseline and post-training values were significant as assessed by the Wilcoxon signed-ranks test for heart rate, SDRR, LF, HF, and SD2. An enter-method linear regression model predicted post-training HF HRV by obstacle course time; r² = 0.617, F (1,6) = 9.652, p = 0.021. Anaerobic performance may be highly valuable in SWAT units. HRV analysis may also be beneficial in measuring the psychophysiological impact of SWAT activities. Full article

Cancer continues to impose a substantial global health burden, particularly among the elderly, where the ongoing global demographic shift towards an ageing population underscores the growing need for early cancer detection. This is essential for enabling personalised cancer care and optimised treatment throughout the disease course to effectively mitigate the increasing societal impact of cancer. Liquid biopsy has emerged as a promising strategy for cancer diagnosis and treatment monitoring, offering a minimally invasive method for the isolation and molecular profiling of circulating tumour-derived components. The expansion of the liquid biopsy approach to include the detection of tumour-derived extracellular vesicles (tdEVs) holds significant therapeutic opportunity. Evidence suggests that tdEVs carry cargo reflecting the contents of their cell-of-origin and are abundant within the blood, exhibiting superior stability compared to non-encapsulated tumour-derived material, such as circulating tumour nucleic acids and proteins. However, despite theoretical promise, several obstacles hinder the translation of extracellular vesicle-based cancer biomarkers into clinical practice. This critical review assesses the current prospects and challenges facing the adoption of tdEV biomarkers in clinical practice, offering insights into future directions and proposing strategies to overcome translational barriers. By addressing these issues, EV-based liquid biopsy approaches could revolutionise cancer diagnostics and management. Full article

The coronavirus 2019 pandemic has influenced the internationalization of higher education, reflecting its broader impacts on the economic, geopolitical, and technological development of countries. Governments have prioritized the internationalization of higher education post-pandemic to generate income and create a sustainable economy by cultivating foreign language talents. Although there are studies analyzing the internationalization of higher education through the students’ mobility, in our case, there is a scarcity of studies on the internationalization between China and Spain; in particular, Spanish universities lack references to attract more Chinese students. To bridge this gap in the literature, we conducted semi-structured interviews with eight experts in the implementation of internationalization in higher education from four universities in China and Spain. The findings reveal that internationalization is associated with promoting Chinese regional development, and their students can access better quality education. Key motivators for Chinese students in Spain include the improved world ranking of universities and the demand for more courses in English. Although the biggest obstacle to cooperation between both countries is communication, a trusted intermediary could overcome part of this problem. Moreover, the use of new technologies could facilitate sustainable internationalization and regional development. Full article

Somatoform symptoms are widely spread in outpatient care. For treating physicians, it can be challenging to establish a relationship that is conducive to compliance and to take stabilising action when dealing with affected patients. As primary care providers, GPs are usually the first point of contact for patients with somatoform disorders; they set the course for stabilisation and further care. To date, there is a lack of studies that focus on how GPs respond to such patients. In particular, strategies for establishing a stable doctor–patient relationship have hardly been explored. Consequently, this study investigated how GPs recognise the symptoms of somatoform disorders, what significance they attach to them and how they handle patients. The primary focus is on experienced patient properties, assumed causes of somatoform disorders, obstacles and complexities in consultation, care and stabilisation strategies, as well as diagnostic forms of support. A total of 2797 GPs in the German federal states of Hesse, Rhineland-Palatinate and Baden-Württemberg were surveyed anonymously by means of a written questionnaire between January and August 2023. A t-test was performed with independent samples to determine significant differences between two groups. In addition, 64 GPs were interviewed between March and April by means of qualitative semi-standardised interviews. The respondents make use of a wide range of communication and stabilisation strategies when treating somatoform physical complaints. The GPs combine the establishment of a tangential doctor–patient relationship with measures to consistently exclude physical causes and to enable the best possible assessment of patients, as well as to gently introduce them to the clinical picture of somatoform disorders. Most physicians are not familiar with current clinical guidelines. Cooperation with specialists and therapists is widely described as complicated. GPs have access to a wide range of communication and stabilisation strategies for the management of somatoform physical complaints. Yet, they experience interaction with this patient group as difficult in daily practice. GPs articulate a clear need for more external support. Apart from increasing therapeutic care capacities and interdisciplinary structures, it seems advisable to extend low-threshold therapy and support services. Full article

Musculoskeletal diseases (MSDs), including osteoarthritis (OA), osteosarcoma (OS), multiple myeloma (MM), intervertebral disc degeneration (IDD), osteoporosis (OP), and rheumatoid arthritis (RA), present noteworthy obstacles associated with pain, disability, and impaired quality of life on a global scale. In recent years, it has become increasingly apparent that N6-methyladenosine (m6A) is a key regulator in the expression of genes in a multitude of biological processes. m6A is composed of 0.1–0.4% adenylate residues, especially at the beginning of 3′-UTR near the translation stop codon. The m6A regulator can be classified into three types, namely the “writer”, “reader”, and “eraser”. Studies have shown that the epigenetic modulation of m6A influences mRNA processing, nuclear export, translation, and splicing. Regulated cell death (RCD) is the autonomous and orderly death of cells under genetic control to maintain the stability of the internal environment. Moreover, distorted RCDs are widely used to influence the course of various diseases and receiving increasing attention from researchers. In the past few years, increasing evidence has indicated that m6A can regulate gene expression and thus influence different RCD processes, which has a central role in the etiology and evolution of MSDs. The RCDs currently confirmed to be associated with m6A are autophagy-dependent cell death, apoptosis, necroptosis, pyroptosis, ferroptosis, immunogenic cell death, NETotic cell death and oxeiptosis. The m6A–RCD axis can regulate the inflammatory response in chondrocytes and the invasive and migratory of MM cells to bone remodeling capacity, thereby influencing the development of MSDs. This review gives a complete overview of the regulatory functions on the m6A–RCD axis across muscle, bone, and cartilage. In addition, we also discuss recent advances in the control of RCD by m6A-targeted factors and explore the clinical application prospects of therapies targeting the m6A–RCD in MSD prevention and treatment. These may provide new ideas and directions for understanding the pathophysiological mechanism of MSDs and the clinical prevention and treatment of these diseases. Full article