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Keywords = Impact of Visual Impairment Scale

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15 pages, 533 KB  
Article
Effects of Exergame with Biofeedback Training on Functional Status, Cognition, and Quality of Life in Outpatients with Polyneuropathies: A Longitudinal Pilot Study
by Francesco Zanatta, Daniela Mancini, Patrizia Steca, Monica Panigazzi, Elena Prestifilippo, Cesare Grilli, Marco D’Addario, Antonia Pierobon and Marina Maffoni
Brain Sci. 2026, 16(1), 45; https://doi.org/10.3390/brainsci16010045 - 29 Dec 2025
Viewed by 175
Abstract
Background: Polyneuropathies impair sensory, motor, and autonomic functions, affecting functional status, cognition, and quality of life. This pilot study investigated the effects of exergame with biofeedback training (Riablo system) versus standard rehabilitation on these outcomes in outpatients with mixed-etiology polyneuropathies. Methods: Seventeen outpatients [...] Read more.
Background: Polyneuropathies impair sensory, motor, and autonomic functions, affecting functional status, cognition, and quality of life. This pilot study investigated the effects of exergame with biofeedback training (Riablo system) versus standard rehabilitation on these outcomes in outpatients with mixed-etiology polyneuropathies. Methods: Seventeen outpatients were assigned to standard rehabilitation (Group 1, n = 9) or combined standard plus Riablo training (Group 2, n = 8) over three weeks. Functional status, pain, cognition, quality of life, and psychological well-being were assessed pre- and post-intervention, with a 6-month follow-up. Outcome measures included the Morse Fall Scale, Visual Analogue Scales for pain and autonomy, Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Stroop Test, Frontal Assessment Battery (FAB), Verbal fluency test, the Short-Form Health Survey-12 (SF-12), and the Patient Health Questionnaire-4 (PHQ-4). Longitudinal changes and between-group differences were analyzed using nonparametric statistics. Results: Both groups showed significant improvements in functional status and global cognition at post-intervention. Group 2 demonstrated greater improvements in executive functions and attention, with significant reductions in pain and fall risk. At 6-month follow-up, Group 2 maintained post-intervention gains in QoL and psychological outcomes, while Group 1 showed a significant decline. Technology evaluation revealed high usability and positive psychosocial impact in Group 2, with strong correlations between executive function improvements and device usability. Conclusions: Integrating exergames with biofeedback into standard rehabilitation may provide broader and longer-lasting benefits for polyneuropathy patients. These findings support further large-scale trials to confirm efficacy and optimize technology-assisted rehabilitation protocols. Full article
(This article belongs to the Special Issue Outcome Measures in Rehabilitation)
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28 pages, 6148 KB  
Article
A Fault Diagnosis Method for Pump Station Units Based on CWT-MHA-CNN Model for Sustainable Operation of Inter-Basin Water Transfer Projects
by Hongkui Ren, Tao Zhang, Qingqing Tian, Hongyu Yang, Yu Tian, Lei Guo and Kun Ren
Sustainability 2025, 17(24), 11383; https://doi.org/10.3390/su172411383 - 18 Dec 2025
Viewed by 274
Abstract
Inter-basin water transfer projects are core infrastructure for achieving sustainable water resource allocation and addressing regional water scarcity, and pumping station units, as their critical energy-consuming and operation-controlling components, are vital to the projects’ sustainable performance. With the growing complexity and scale of [...] Read more.
Inter-basin water transfer projects are core infrastructure for achieving sustainable water resource allocation and addressing regional water scarcity, and pumping station units, as their critical energy-consuming and operation-controlling components, are vital to the projects’ sustainable performance. With the growing complexity and scale of these projects, pumping station units have become more intricate, leading to a gradual rise in failure rates. However, existing fault diagnosis methods are relatively backward, failing to promptly detect potential faults—this not only threatens operational safety but also undermines sustainable development goals: equipment failures cause excessive energy consumption (violating energy efficiency requirements for sustainability), unplanned downtime disrupts stable water supply (impairing reliable water resource access), and even leads to water waste or environmental risks. To address this sustainability-oriented challenge, this paper focuses on the fault characteristics of pumping station units and proposes a comprehensive and accurate fault diagnosis model, aiming to enhance the sustainability of water transfer projects through technical optimization. The model utilizes advanced algorithms and data processing technologies to accurately identify fault types, thereby laying a technical foundation for the low-energy, reliable, and sustainable operation of pumping stations. Firstly, continuous wavelet transform (CWT) converts one-dimensional time-domain signals into two-dimensional time-frequency graphs, visually displaying dynamic signal characteristics to capture early fault features that may cause energy waste. Next, the multi-head attention mechanism (MHA) segments the time-frequency graphs and correlates feature-location information via independent self-attention layers, accurately capturing the temporal correlation of fault evolution—this enables early fault warning to avoid prolonged inefficient operation and energy loss. Finally, the improved convolutional neural network (CNN) layer integrates feature information and temporal correlation, outputting predefined fault probabilities for accurate fault determination. Experimental results show the model effectively solves the difficulty of feature extraction in pumping station fault diagnosis, considers fault evolution timeliness, and significantly improves prediction accuracy and anti-noise performance. Comparative experiments with three existing methods verify its superiority. Critically, this model strengthens sustainability in three key ways: (1) early fault detection reduces unplanned downtime, ensuring stable water supply (a core sustainable water resource goal); (2) accurate fault localization cuts unnecessary maintenance energy consumption, aligning with energy-saving requirements; (3) reduced equipment failure risks minimize water waste and environmental impacts. Thus, it not only provides a new method for pumping station fault diagnosis but also offers technical support for the sustainable operation of water conservancy infrastructure, contributing to global sustainable development goals (SDGs) related to water and energy. Full article
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14 pages, 545 KB  
Study Protocol
Impact of the Pilates Method on Quality of Life and Functional Well-Being in Women with Osteoporosis: Protocol for a Randomized Controlled Trial
by Sara García-Bravo, Cristina García-Bravo, Marta Gil-Manglano, MªPilar Rodríguez-Pérez, Ana Poveda-García and Elisabet Huertas-Hoyas
Healthcare 2025, 13(22), 2950; https://doi.org/10.3390/healthcare13222950 - 17 Nov 2025
Viewed by 1133
Abstract
Introduction: Osteoporosis is a major public health concern among postmenopausal women, characterized by decreased bone mineral density and microarchitectural deterioration, which lead to fragility fractures, pain, functional impairment, sleep disturbances, and a reduced quality of life. Exercise, particularly strength, weight-bearing, and balance training, [...] Read more.
Introduction: Osteoporosis is a major public health concern among postmenopausal women, characterized by decreased bone mineral density and microarchitectural deterioration, which lead to fragility fractures, pain, functional impairment, sleep disturbances, and a reduced quality of life. Exercise, particularly strength, weight-bearing, and balance training, represents a key non-pharmacological approach to prevention and management. Pilates, a low-impact, core-centered method increasingly incorporated into rehabilitation settings, appears especially suitable for women with osteoporosis. However, high-quality randomized controlled trials concurrently evaluating its effects on pain, balance, sleep, autonomy, and health-related quality of life remain scarce. Objective: To examine the efficacy and feasibility of a Pilates-based exercise program in improving pain, balance, sleep quality, functional autonomy, and quality of life in postmenopausal women with osteoporosis. Methods: A single-blind, parallel-group, randomized controlled trial will be conducted over 12 weeks at Physiocare Madrid (Spain). A total of 126 (63 per group) postmenopausal women aged 50–80 years, diagnosed with osteoporosis by densitometry or with a prior fragility fracture, will be randomly assigned (1:1; OxMaR software, version 2014) to one of two groups: (a) Experimental group: supervised Pilates mat sessions, 60 min, twice weekly for 12 weeks; or (b) Control group: ergonomics education for activities of daily living, two 60 min sessions held six weeks apart. Outcome assessors will remain blinded to group allocation. Evaluations will be conducted at baseline and post-intervention. Outcome measures will include balance and mobility (Timed Up and Go Test; Functional Reach Test), functional autonomy (Functional Independence Measure), pain intensity (Visual Analog Scale), sleep quality (Pittsburgh Sleep Quality Index), health-related quality of life (WHOQOL-BREF; QUALEFFO-41), and treatment satisfaction (CSQ-8). Feasibility parameters (recruitment, adherence, retention, and safety) will also be monitored. Data will be pseudonymized and analyzed descriptively to estimate variability and preliminary effects, informing the design of a definitive trial. Expected Results: It is hypothesized that Pilates will produce clinically meaningful improvements in balance, pain, sleep quality, and health-related quality of life compared with ergonomics education, with acceptable feasibility and safety outcomes. Conclusions: This randomized controlled trial will provide initial evidence regarding the efficacy and feasibility of Pilates as a complementary rehabilitation strategy for women with osteoporosis and provide key parameters to optimizing a future adequately powered trial. Ethics and Dissemination: This study will be conducted in accordance with the principles of the Declaration of Helsinki and has been approved by the Human Ethics Committee of Universidad Rey Juan Carlos. Potential risks will be minimized, and any adverse events will be systematically recorded and addressed. Full article
(This article belongs to the Special Issue Dysfunctions or Approaches of the Musculoskeletal System)
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14 pages, 4699 KB  
Article
Impact of Diet on Gut Microbiota in Diverticular Disease of the Colon: An Exploratory Retrospective Study
by Antonio Tursi, Giorgia Procaccianti, Federica D’Amico, Rudi De Bastiani, Leonardo Allegretta, Natale Antonino, Elisabetta Baldi, Carlo Casamassima, Giovanni Casella, Mario Ciuffi, Marco De Bastiani, Lorenzo Lazzarotto, Claudio Licci, Maurizio Mancuso, Antonio Penna, Giuseppe Pranzo, Guido Sanna, Cesare Tosetti, Maria Zamparella, Marcello Picchio and Silvia Turroniadd Show full author list remove Hide full author list
Microorganisms 2025, 13(11), 2428; https://doi.org/10.3390/microorganisms13112428 - 23 Oct 2025
Viewed by 843
Abstract
Symptomatic uncomplicated diverticular disease (SUDD) is the primary clinical manifestation of diverticular disease (DD). Although gut microbiota (GM) perturbation and dietary habits are considered important factors in the development of the disease, there is currently a lack of data on the potential relationship [...] Read more.
Symptomatic uncomplicated diverticular disease (SUDD) is the primary clinical manifestation of diverticular disease (DD). Although gut microbiota (GM) perturbation and dietary habits are considered important factors in the development of the disease, there is currently a lack of data on the potential relationship between diet, GM profile and SUDD. An exploratory retrospective study was conducted in a SUDD cohort of 47 patients to investigate this relationship; a diverticulosis cohort of 19 patients served as the control group. Patients were stratified by their self-reported dietary habits, i.e., Mediterranean diet, predominantly plant-based diet or omnivorous diet. GM was profiled using 16S rRNA amplicon sequencing of fecal swabs. SUDD patients following a Mediterranean or predominantly plant-based diet showed higher alpha diversity and enrichment of known fibre degraders and short-chain fatty acid producers, such as members of the Lachnospiraceae, Ruminococcaceae, Oscillospiraceae and Prevotellaceae families. This suggests that their gut (and whole-body) health is less impaired. In contrast, those following an omnivorous diet showed an increased presence of pro-inflammatory taxa, including the mucus degrader R. torques, which suggests impaired gut barrier function and potential systemic implications. Similar associations between GM profile and dietary habits were found when considering SUDD patients with moderate abdominal pain severity (according to visual analogue scale, VAS) and those scored as DICA 1 according to the endoscopic severity of the disease. However, no such associations or trends were observed in SUDD patients scored as DICA 2, which suggests that diet may be unable to impact GM dysbiosis as SUDD severity increases. Despite the study’s limitations, primarily its retrospective design and related biases, our findings suggest that other GM modulation tools should be employed in more severe cases of SUDD to reverse dysbiosis while alleviating symptoms. Full article
(This article belongs to the Special Issue Advances in Host-Gut Microbiota)
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14 pages, 837 KB  
Article
Patient-Reported Outcome Measures After Botulinum Toxin for Temporomandibular-Related Myalgia: A Prospective Study
by Martijn van Soest, Lianne Remijn, Igor Tak, Egbert van der Hoeve, Laurens Koppendraaier and Maurits de Ruiter
J. Clin. Med. 2025, 14(21), 7494; https://doi.org/10.3390/jcm14217494 - 23 Oct 2025
Viewed by 1474
Abstract
Introduction: Botulinum toxin-A (BTX-A) injections are regularly used to treat temporomandibular disorders (TMD). However, consensus regarding the long-term efficacy of BTX-A for TMD-related myalgia remains lacking. This pragmatic, practice-based clinical study aimed to evaluate the Patient-Reported Outcome Measures of pain, health status, quality [...] Read more.
Introduction: Botulinum toxin-A (BTX-A) injections are regularly used to treat temporomandibular disorders (TMD). However, consensus regarding the long-term efficacy of BTX-A for TMD-related myalgia remains lacking. This pragmatic, practice-based clinical study aimed to evaluate the Patient-Reported Outcome Measures of pain, health status, quality of life, and function after BTX-A injections in patients with TMD-related myalgia. Methods: This prospective cohort study included 35 patients with TMD-related myalgia who received BTX-A injections in the masseter and temporalis muscles. The Visual Analogue Scale for pain, the EQ-5D-3L for health status, the Oral Health Impact Profile-14 for oral health-related quality of life, the Mandibular Function Impairment Questionnaire for function and the maximum interincisal opening were assessed before treatment and at one, three and six months follow-up. Results: Patients reported a statistically significant and clinically relevant reduction in pain (p < 0.001), improvement of health status (p ≤ 0.003), and oral health-related quality of life (p < 0.001) at one-month follow-up, which remained present at three and six months post-treatment. Self-reported mandibular function and active and passive mouth opening showed no significant change over all time points. Conclusions: In this pragmatic cohort, BTX-A injections in the masseter and temporalis muscles seem to improve pain and oral health-related quality of life in patients with TMD-related myalgia within one month and show effects lasting up to six months, while mandibular function did not improve. Full article
(This article belongs to the Section Clinical Neurology)
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17 pages, 1424 KB  
Article
MiRNA-186 as a Biomarker of Disease Exacerbation in Rheumatoid Arthritis: Insights from Clinical Data and Molecular Marker Analysis
by Marek Cieśla, Dorota Darmochwał-Kolarz, Hubert Kubis and Bogdan Kolarz
Int. J. Mol. Sci. 2025, 26(16), 8039; https://doi.org/10.3390/ijms26168039 - 20 Aug 2025
Viewed by 826
Abstract
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by inflammation of the synovial tissue, leading to joint destruction, pain, stiffness, and progressive impairment of motor functions. Despite significant advances in diagnosis and treatment, RA remains a major clinical and social challenge, [...] Read more.
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease characterized by inflammation of the synovial tissue, leading to joint destruction, pain, stiffness, and progressive impairment of motor functions. Despite significant advances in diagnosis and treatment, RA remains a major clinical and social challenge, negatively impacting patients’ quality of life. The aim of this study was to assess the relationship between the expression of selected microRNAs (miRNAs) and the activity of the disease. A total of 46 RA patients and 20 healthy controls (HCs) were enrolled in the study. A quantitative real-time polymerase chain reaction was used to evaluate the expression of miRNAs in whole blood. MiRNA-186 exhibited decreased concentrations in RA patients compared to HCs (p = 0.03). Patients with an active form of the disease (DAS28 > 3.2) exhibited lower expression of miRNA-186 than HCs (p = 0.04). Additionally, ACPA-negative patients also demonstrated reduced miRNA-186 expression compared to controls. AUC analysis confirmed that the combination of miRNA-186, the erythrocyte sedimentation rate (ESR), and Visual Analog Scale—Patient Global Assessment (VAS PGA) may be effective in identifying RA exacerbation. The combination of classical laboratory markers, clinical data, and molecular markers enhances the ability to assess RA exacerbation. MiRNA-186 may be considered a potential marker of disease activity in RA. Full article
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11 pages, 310 KB  
Article
The Impact of Mental Fatigue on the Accuracy of Penalty Kicks in College Soccer Players
by Qingguang Liu, Ruitian Huang, Zhibo Liu, Caiyu Sun, Linyu Qi and Antonio Cicchella
Sports 2025, 13(8), 259; https://doi.org/10.3390/sports13080259 - 7 Aug 2025
Cited by 1 | Viewed by 1703
Abstract
Purpose: To investigate the impact of mental fatigue on the shooting accuracy and movement timing in the instep kick of Asian high-level soccer players. Methods: Eight male collegiate soccer players (age 22.00 ± 0.93 years) were tested before and after mental fatigue induction. [...] Read more.
Purpose: To investigate the impact of mental fatigue on the shooting accuracy and movement timing in the instep kick of Asian high-level soccer players. Methods: Eight male collegiate soccer players (age 22.00 ± 0.93 years) were tested before and after mental fatigue induction. Mental fatigue was induced via a 30 min Stroop task. The effectiveness of fatigue induction was assessed using heart rate variability (HRV), a visual analog scale (VAS), rating of perceived exertion (RPE), and the Athlete Burnout Questionnaire (ABQ). Shooting performance was evaluated before and after mental fatigue using the Loughborough Soccer Shooting Test (LSST) and by evaluating timing by means of high-speed imaging. Results: Following mental fatigue induction, HRV decreased. Subjects’ motivation (VAS) to exercise significantly decreased (p < 0.001), while VAS mental fatigue level (p < 0.001) and mental effort level (p < 0.002) significantly increased. Significant differences were observed after completing the Stroop task for ABQ Emotional/Physical Exhaustion (p < 0.007), Reduced Sense of Accomplishment (p < 0.007), Sport Devaluation (p < 0.006), and overall burnout level (p < 0.002). LSST showed that the subjects’ left foot test scores (−4.13, p < 0.013), right foot test scores (−3, p < 0.001), and total scores (−3.16, p < 0.001) significantly decreased. Although movement times increased slightly after fatigue, they did not reach statistical significance. Conclusions: Mental fatigue significantly impairs the shooting accuracy of collegiate soccer players, as evidenced by decreased LSST scores. However, it has no significant effect on event duration during shooting execution. Mental fatigue affected decision-making but not shooting movement timing. More cognitively challenging tasks are more affected by mental fatigue. Full article
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13 pages, 640 KB  
Article
Transforming Patient Experience: Real-World Impact of Mepolizumab on Symptom Burden in Chronic Rhinosinusitis with Nasal Polyps—A Multicenter Perspective
by Alfonso García-Piñero, Tomás Pérez-Carbonell, María-José Gómez-Gómez, Encarna Domenech-Campos, Fernando Martinez-Expósito, Noelia Muñoz-Fernández, Jordi Calvo-Gómez, Carmen García-Navalón, Lucas Fito-Martorell, Felip Ferrer-Baixauli, Ainhoa García-Lliberós, Nezly Mosquera-Lloreda, Chakib Taleb, Carlos Zac-Romero, Cecilia López-Valdivia, Juan Pardo-Albiach and Miguel Armengot-Carceller
J. Clin. Med. 2025, 14(15), 5248; https://doi.org/10.3390/jcm14155248 - 24 Jul 2025
Viewed by 2422
Abstract
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic upper airway disease that may involve different inflammatory endotypes, although in Western populations it is most commonly associated with type 2 inflammation. CRSwNP has a significant impact on the patient’s quality of [...] Read more.
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic upper airway disease that may involve different inflammatory endotypes, although in Western populations it is most commonly associated with type 2 inflammation. CRSwNP has a significant impact on the patient’s quality of life. The recommended appropriate medical therapy is effective in controlling CRSwNP symptoms in many patients; however, a subset continues to exhibit persistent type 2 inflammation, evidenced by recurrent nasal polyps, elevated eosinophil counts, or the need for systemic corticosteroids or surgery. Monoclonal antibodies have recently become a novel and personalized treatment that can help refractory patients restore disease control. Objective: The present study aims to evaluate the effectiveness of mepolizumab in real-world settings in a diverse patient population, focusing on assessing the impact of this therapy on patient-reported outcomes after six months of treatment. Methods: This is a multicenter, observational study of CRSwNP patients treated with mepolizumab carried out in five hospitals located in Spain. Adult patients with a diagnosis of uncontrolled CRSwNP were included in the study. The change in the nasal polyp score (NPS) was the main clinical endpoint. Changes in the Sinonasal Outcome Test (SNOT-22), nasal congestion and smell impairment visual analogue scale scores, and blood and nasal polyp tissue eosinophil counts were among other endpoints included. Results: In total, 47 patients were included, and 91% were asthmatic. The nasal polyp score (0–8) was reduced significantly in the cohort (mean change: −2.56, p < 0.0001). The mean SNOT-22 score improved 25.29 points. Nasal congestion (−3.57, p < 0.0001) and smell impairment (−4.0, p < 0.0001) visual analog scale scores (0–10) showed a significant improvement. Blood and tissue eosinophil median counts showed significant reductions versus baseline of 86% and 26%, respectively. Among those patients with asthma, the asthma control test score achieved a median value of 24 points. Conclusions: This study provides real-world evidence supporting the effectiveness of mepolizumab in managing CRSwNP in patients with features suggestive of type 2 inflammation. The observed improvements in patient-reported outcomes, nasal polyp burden, and asthma control suggest that mepolizumab may be a valuable therapeutic option for this patient population. Full article
(This article belongs to the Section Otolaryngology)
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16 pages, 330 KB  
Article
The Role of Age in Shaping Cognitive, Physical, and Psychosocial Outcomes in Hemodialysis Patients: A Cross-Sectional Study
by Leszek Sułkowski, Andrzej Matyja and Maciej Matyja
Medicina 2025, 61(7), 1295; https://doi.org/10.3390/medicina61071295 - 18 Jul 2025
Viewed by 1282
Abstract
Background and Objectives: Chronic kidney disease frequently progresses to end-stage renal disease, requiring dialysis, which imposes significant physical, psychological, and social burdens. Age is a key factor influencing symptom experience and quality of life in dialysis patients, yet findings on its impact remain [...] Read more.
Background and Objectives: Chronic kidney disease frequently progresses to end-stage renal disease, requiring dialysis, which imposes significant physical, psychological, and social burdens. Age is a key factor influencing symptom experience and quality of life in dialysis patients, yet findings on its impact remain mixed. This study aimed to examine how age relates to a broad range of health domains—including fatigue, pain, cognition, mental health, sexual satisfaction, bowel control, visual impairment, social support, and quality of life—among hemodialysis patients. Materials and Methods: A cross-sectional study was conducted at a single dialysis center in Poland, involving 79 adult patients undergoing maintenance hemodialysis. Standardized, validated psychometric instruments were used, including the Modified Fatigue Impact Scale (MFIS), Perceived Deficits Questionnaire (PDQ), Pain Effects Scale (PES), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), and WHOQOL-BREF for quality of life. Spearman’s or Pearson’s correlation coefficients were used to evaluate relationships between age and scale scores. Full and abbreviated versions of scales were also compared. Results: Age showed moderate positive correlations with fatigue (ρ = 0.44–0.53), cognitive deficits (ρ = 0.37–0.45), pain (r = 0.41), bowel control issues (ρ = 0.32), and visual impairment (ρ = 0.37), all statistically significant (p < 0.01). No significant associations were observed between age and mental health (MHI), perceived social support (MSSS), or quality of life (WHOQOL-BREF). Abbreviated versions of the scales showed strong correlations with their full versions (ρ > 0.9). Conclusions: While age is linked to increased symptom burden in select domains such as cognition, fatigue, and pain, it does not significantly affect mental health, perceived social support, or overall quality of life in hemodialysis patients. These findings support the use of age-sensitive, multidimensional assessments to inform individualized care strategies. Full article
(This article belongs to the Section Urology & Nephrology)
13 pages, 1527 KB  
Article
Assessment of Visual Function in Patients Undergoing Prone Positioning for COVID-19-Related ARDS: A Qualitative Observational Study
by Iacopo Cappellini, Elena Schirru, Laura Vannucci, Federico Scandagli and Vittorio Pavoni
Anesth. Res. 2025, 2(2), 14; https://doi.org/10.3390/anesthres2020014 - 11 Jun 2025
Viewed by 948
Abstract
Background/Objectives: Prone positioning is a key strategy to improve oxygenation in ARDS patients, particularly used during the COVID-19 pandemic. However, its impact on visual function remains poorly investigated. This study assesses the effect of prone positioning on self-perceived visual acuity and functional vision [...] Read more.
Background/Objectives: Prone positioning is a key strategy to improve oxygenation in ARDS patients, particularly used during the COVID-19 pandemic. However, its impact on visual function remains poorly investigated. This study assesses the effect of prone positioning on self-perceived visual acuity and functional vision in ARDS patients after ICU discharge. Methods: A single-center observational study was conducted at Santo Stefano Hospital (Prato, Italy) from March 2020 to April 2023. We included adult COVID-19 ARDS patients, ventilated invasively, and subjected to at least one prone positioning cycle. Patients with pre-existing visual disorders were excluded. Visual function was evaluated through the CATQUEST-9SF questionnaire administered via telephone follow-up. Rasch analysis was applied to generate a linear visual function scale. Logistic regression was used to identify predictors of reduced visual function. Results: Out of 300 ICU admissions, 182 met the inclusion criteria, and 39 completed the follow-up. Older age (OR 1.148, p < 0.05), female sex (OR 0.066, p < 0.05), and increased number of prone cycles (OR 3.576, p < 0.05) were significantly associated with reduced visual function. The model’s predictive performance was excellent (AUC = 0.8997). Conclusions: Prone positioning improves respiratory outcomes but may have unintended visual consequences. Monitoring visual function should be integrated into ICU follow-up programs to mitigate long-term visual impairment. Full article
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16 pages, 482 KB  
Case Report
The Potential Role of Bio Extra Virgin Olive Oil (BEVOO) in Recovery from HPV 16-Induced Tonsil Cancer: An Exploratory Case Study
by Ivan Uher, Eva Bergendyová, Janka Poráčová and Jarmila Bernasovská
Healthcare 2025, 13(8), 944; https://doi.org/10.3390/healthcare13080944 - 19 Apr 2025
Viewed by 1299
Abstract
The human papillomavirus type 16 (HPV 16) is a high-risk human papillomavirus strain commonly associated with oropharyngeal cancers, including lymph node involvement. The treatment for HPV 16-related tonsil cancer, commonly involving surgery, radiation, and chemotherapy, presents significant challenges. Complications such as oral mucositis, [...] Read more.
The human papillomavirus type 16 (HPV 16) is a high-risk human papillomavirus strain commonly associated with oropharyngeal cancers, including lymph node involvement. The treatment for HPV 16-related tonsil cancer, commonly involving surgery, radiation, and chemotherapy, presents significant challenges. Complications such as oral mucositis, xerostomia, dysphagia, dysgeusia, hypogeusia, impaired gustatory function, and significant weight loss frequently arise, leading to reduced nutritional intake, impaired healing, and recovery progression. These challenges underscore the need for supportive interventions to enhance rehabilitation and the post-recovery period, improve treatment tolerance, and maintain quality of life. Objective: This single-subject study examines a 67-year-old male patient diagnosed with a T1N3b (small primary tumor with advanced lump node involvement) associated with HPV 16 positivity, indicating a virus-associated oncogenesis. Methods: The patient underwent radiation therapy and chemotherapy, leading to treatment-associated side effects. After having dietary drinks for daily nourishment, the patient routinely incorporated oral bio extra virgin olive oil (BEVOO) to cope with indicated challenges. Results: Body composition and metabolic parameters showed treatment-induced declines, followed by substantial but not complete recovery during follow-up examination. Visual Analog Scale (VAS) scores reflected gradual improvements in dysphagia, xerostomia, mucositis, and subtle but ongoing enhancement of the dysgeusia, gustatory perception, and oral palatability. The BEVOO supplementation and mindfulness were associated with positive recovery trends. Additional variables could have impacted the outcomes, preceding and throughout treatment, including the patient’s cognitive and somatic health, environmental conditions, dietary habits, individual attitudes toward recovery, physical activity, and patient way of life. Conclusions: These results emphasize the need for additional research employing a comprehensive, multi-factorial framework that accounts for the complex interplay of physiological, psycho-social, and environmental contributors. More extensive, more diverse studies are essential to confirm these observations and substantiate the role of BEVOO as a supportive intervention in cancer recovery. Full article
(This article belongs to the Section Nutrition and Public Health)
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31 pages, 412 KB  
Review
Visual Function After Schlemm’s Canal-Based MIGS
by Masayuki Kasahara and Nobuyuki Shoji
J. Clin. Med. 2025, 14(7), 2531; https://doi.org/10.3390/jcm14072531 - 7 Apr 2025
Viewed by 2180
Abstract
Filtration surgery is highly effective in lowering intraocular pressure; however, it is associated with a higher risk of severe complications. Visual dysfunction may persist in relatively uneventful cases because of induced astigmatism or worsening optical aberrations. Therefore, for early- to moderate-stage glaucoma, an [...] Read more.
Filtration surgery is highly effective in lowering intraocular pressure; however, it is associated with a higher risk of severe complications. Visual dysfunction may persist in relatively uneventful cases because of induced astigmatism or worsening optical aberrations. Therefore, for early- to moderate-stage glaucoma, an increasing number of surgeons are prioritizing surgical safety and preserving postoperative visual function by opting for minimally invasive glaucoma surgery (MIGS). Among the various MIGS techniques, canal-opening surgery—targeting aqueous outflow through the Schlemm’s canal (Schlemm’s canal-based MIGS, CB-MIGS)—has gained increasing popularity. Unlike filtration surgery, CB-MIGS does not require creating an aqueous outflow pathway between the intraocular and extraocular spaces. Consequently, it is considered a minimally invasive procedure with a reduced risk of severe complications and is increasingly being chosen for suitable cases. Although this surgical technique has limitations in lowering intraocular pressure, it avoids the manipulation of the conjunctiva or sclera and is primarily performed through a small corneal incision. Therefore, a minimal impact on induced astigmatism or postoperative refractive changes is expected. However, few reviews comprehensively summarize postoperative changes in visual function. Therefore, this study reviews the literature on visual function after CB-MIGS, focusing on changes in best-corrected visual acuity (BCVA), refraction, astigmatism, and the effectiveness of visual field preservation to assess the extent of these postoperative changes. Hyphema is the primary cause of early postoperative vision loss and is often transient in cases in which other complications would have led to visual impairment. Severe complications that threaten vision are rare. Additionally, compared with filtration surgery, postoperative visual recovery tends to be faster, and the degree of induced astigmatism is comparable to that of standalone cataract surgery. When combined with cataract surgery, the refractive error is at the same level as that of cataract surgery alone. However, in some cases, mild hyperopic shifts may occur because of axial length shortening, depending on the extent of intraocular pressure reduction. This possibility has been highlighted in several studies. Regarding the effectiveness of slowing the progression of visual field defects, most studies have focused on short- to medium-term postoperative outcomes. Many of these studies have reported the sufficient suppression of progression rates. However, studies with large sample sizes and long-term prospective designs are limited. To establish more robust evidence, future research should focus on conducting larger-scale, long-term investigations. Full article
(This article belongs to the Special Issue Clinical Debates in Minimally Invasive Glaucoma Surgery (MIGS))
21 pages, 627 KB  
Article
A Comparative Study of Short-Term Social Media Use with Face-to-Face Interaction in Adolescence
by Inês Mendonça, Franz Coelho, Belén Rando and Ana Maria Abreu
Children 2025, 12(4), 460; https://doi.org/10.3390/children12040460 - 3 Apr 2025
Cited by 1 | Viewed by 7856
Abstract
Background/Objectives: Previous research suggests that social media use can have immediate cognitive effects, raising concerns about its impact on adolescent cognition. This study aimed to examine the short-term cognitive effects of acute social media exposure and screen time habits by comparing cognitive performance [...] Read more.
Background/Objectives: Previous research suggests that social media use can have immediate cognitive effects, raising concerns about its impact on adolescent cognition. This study aimed to examine the short-term cognitive effects of acute social media exposure and screen time habits by comparing cognitive performance in adolescents (13–15 years old) following 30 min of social media interaction versus face-to-face conversation, according to their screen time habits (more or less time spent in front of a screen). Methods: A total of 66 participants were divided into four groups: a social media group who used to spend less than 540 min per week in front of a screen (n = 19, a social media group with a habit of more than 540 min per week of screen time (n = 14), a face-to-face conversation group with a habit of less screen time per week (n = 15), and a face-to-face conversation group who used to spend more time per week in front of a screen (n = 18). Cognitive performance was assessed through attention (D2 Test), working memory (Corsi Blocks), abstract reasoning (Abstract Reasoning Test Battery), and inhibitory control (Go/No-Go Task). Additionally, mental effort was measured using a Visual Analogue Scale. Results: Contrary to our hypothesis, no significant differences emerged between groups in any cognitive domain or mental effort, with interaction modality and screen time showing no impact on response variables. Also, we found no significant interaction effect between factors. This suggests that a single 30-min session of social media use does not immediately impair cognition, nor does face-to-face interaction enhance it, despite screen time spent per week (when it varies from 135 to 540 min and from more than 540 to 1320 min). Conclusions: The absence of cognitive effects may be explained by excessive screen time as a key factor in cognitive impact and by the cultural integration of social media, creating a “ceiling effect” that minimizes the impact of short-term exposure and resembles addictive behavior. These findings emphasize the importance of a holistic approach involving families, schools, and governments to address both acute and cumulative social media use in adolescents. Full article
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12 pages, 1136 KB  
Article
Investigating the Impact of Acetabular Dysplasia on Sexual Dysfunction and Psychological Well-Being in Women
by Özgür Ağlamış, Selver Kübra Akkaya, Burcu Erol and Seval Yılmaz Ergani
J. Clin. Med. 2025, 14(7), 2385; https://doi.org/10.3390/jcm14072385 - 30 Mar 2025
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Abstract
Background: This study aimed to explore the relationship between acetabular dysplasia (AD), a known risk factor for pelvic floor dysfunction (PFD), and its effects on sexual function and psychological well-being in women. Methods: A cross-sectional study was conducted with 125 female patients experiencing [...] Read more.
Background: This study aimed to explore the relationship between acetabular dysplasia (AD), a known risk factor for pelvic floor dysfunction (PFD), and its effects on sexual function and psychological well-being in women. Methods: A cross-sectional study was conducted with 125 female patients experiencing genitopelvic pain and penetrative disorders. Participants were categorized into AD-positive and AD-negative groups based on anteroposterior pelvic radiographs. Sexual function was evaluated using the Golombok–Rust Sexual Satisfaction Inventory (GRISS), while pain and psychological well-being were assessed using the Visual Analog Scale (VAS) and the Beck Depression Inventory (BDI), respectively. Results: Results showed that AD-positive patients had significantly higher pain (VAS: 8.15 ± 1.1, p < 0.001) and anxiety scores (BDI: 12.3 ± 11.0, p < 0.02). Sexual function was notably impaired in the AD-positive group, with lower sexual satisfaction and a higher prevalence of anorgasmia (p = 0.01). The AD-negative group demonstrated better scores in frequency and satisfaction with touch (p = 0.04, p = 0.03). Additionally, AD-positive patients exhibited limited hip rotation and a higher incidence of osteoarthritis and Legg–Calvé–Perthes disease. Conclusions: This study highlights the broader impact of AD on women’s quality of life, emphasizing the need for targeted therapeutic interventions to address sexual dysfunction and psychological distress in affected patients. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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13 pages, 2068 KB  
Article
Acetyl-L-Carnitine as an Add-On Treatment in Fibromyalgia Syndrome: A Retrospective Analysis on 183 Patients, According to the Generalized Linear Mixed Model for Longitudinal Data
by Vittorio Schweiger, Libera Villagrossi, Francesco Taus, Leonardo Gottin, Eleonora Bonora, Marco Anderloni, Giustino Varrassi, Luca Polati, Marta Nizzero, Alvise Martini and Enrico Polati
Biomedicines 2025, 13(4), 820; https://doi.org/10.3390/biomedicines13040820 - 28 Mar 2025
Cited by 2 | Viewed by 4685
Abstract
Background. Fibromyalgia Syndrome (FMS) is characterized by chronic widespread pain, sleep disturbances, fatigue and cognitive impairment. Methods. In this retrospective study, we analyzed data collected between 2017 and 2022 regarding Acetyl-L-Carnitine (ALC) as an add-on treatment in 183 adult patients with [...] Read more.
Background. Fibromyalgia Syndrome (FMS) is characterized by chronic widespread pain, sleep disturbances, fatigue and cognitive impairment. Methods. In this retrospective study, we analyzed data collected between 2017 and 2022 regarding Acetyl-L-Carnitine (ALC) as an add-on treatment in 183 adult patients with FMS according to the 2016 ACR (American College of Rheumatology) criteria and patients’ pain lasting for over three months. Patients with prior exposure to ALC or without informed consent were excluded. Results. Regarding efficacy, in the 137 analyzed patients, the change from baseline to the end of observation in Visual Analogue Scale score (VAS) was statistically significant, ranging from 75.9 ± 1.56 to 51.9 ± 1.99 (p < 0.001). Patients without FMS concomitant drug treatments achieved better VAS reduction than patients who were not drug-free at baseline. Regarding quality of life, a significant improvement in the Revised Fibromyalgia Impact Questionnaire (FIQ-R) score was evidenced, ranging from 75.1 ± 1.13 to 53.5 ± 1.34 (p < 0.001). The Short Form 12 Health Survey (SF12) scores showed a statistically significant improvement in both physical and mental components. Finally, the Pittsburgh Sleep Quality Index (PSQI) did not show a statistically significant difference from baseline. In the whole population, 23 patients (16.7%) reported Adverse Events (AEs), predominantly insomnia, shivering, headaches, and nausea. Only six patients reporting AEs discontinued the ALC treatment. Conclusions. This retrospective study evidenced the efficacy and safety of ALC in FMS patients. This may represent a useful approach, particularly for long-term treatments. Methodologically stronger studies will be necessary to validate our observations. Full article
(This article belongs to the Special Issue Mechanisms and Pharmacological Targets for Pain)
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