Search Results (2,669)

Background/Objectives: Perinatal mortality causes substantial economic losses in dairy and beef suckler industries, yet diagnosis remains challenging as post-mortem autolysis can mask lesions and hinder definitive diagnosis. To establish a standardized tool for objectively quantifying carcass decomposition and aiding in the categorization of perinatal timing of death, this study developed a simple, visual 3-point scoring scale based on the macroscopic evaluation of nine parameters. Methods: Retrospective scoring was performed using necropsy findings and high-resolution photography from 127 calves, including a Reference group (n = 32; comprising 26 perinatal mortality cases which breathed and six live-born control calves with normal vitality that were euthanized), and a test group (n = 95; perinatal mortality calves which did not breathe). Hierarchical clustering was performed on the total autolysis score, calculated as the sum of points across all evaluated parameters, using Ward’s linkage method with Euclidean distance. Results: Calves in the test group were clustered into three distinct decomposition profiles, with total autolysis scores differing highly significantly across all study groups (H(3) = 111.71, p ≤ 0.0001). Cluster 1 represented an early decomposition stage where most organs showed no macroscopically detectable autolysis; Cluster 2 exhibited advanced but variable autolysis with intermediate tissue decay and the absence of rigor mortis; and Cluster 3 was marked by advanced, uniform decomposition across all features. Neither the calving/death-to-necropsy interval (p = 0.09) nor season (p = 0.43) significantly affected the severity of autolysis. The Kruskal–Wallis test confirmed highly significant differences (p ≤ 0.001) for all nine individual parameters, demonstrating a stepwise progression of post-mortem changes. Conclusions: This novel visual scoring scale provides an objective numerical proxy for carcass decomposition, offering a practical tool for categorizing general perinatal death timing rather than precise chronological dating. Full article

Plant-based beverages (PBBs) can be fortified to contribute to vitamin D intake. The nutritional composition of vitamin D-fortified PBBs (FPBBs) and consumer use of PBBs are examined through a three-phase technique that included a 2010–2025 national registry retrospective study (vitamin D FPBBs = 167), an on-shelf market survey (vitamin D FPBBs = 111), and a consumer survey on 225 subjects. Coconut-based PBBs had the highest vitamin D mean (0.84 μg/100 mL) in the registry database, although in the market survey oat-based PBBs had the highest vitamin D average (0.91 μg/100 mL). The compositional heterogeneity of FPBB matrices was confirmed by non-parametric Kruskal–Wallis tests across five broader botanical categories (soy, nuts, coconut, grains, blended), for carbohydrate content (χ² = 52.43, df = 4, p < 0.001), protein content (χ² = 55.85, df = 4, p < 0.001), lipid content (χ² = 26.94, df = 4, p < 0.001), and calorie content (χ² = 34.31, df = 4, p < 0.001). In contrast, vitamin D content did not differ significantly across these categories (χ² = 8.21, df = 4, p = 0.084). Dietary preferences were the main drivers of daily use (48.3% of consumers), while the subgroup driven by general health benefits or vitamin D fortification tended to consume these products mainly weekly (33.3%) or occasionally (42.8%). The mean serving size reported by respondents was 157.14 mL. Since vitamin D status was not biochemically assessed, this study does not evaluate whether current consumption addresses population-level vitamin D status. These findings highlight the need for front-of-pack labelling on nutritional density and fortification. Full article

Background/Objectives: Directly printed orthodontic appliances rely mostly on vat-photopolymerisation resins; pre-polymerised thermoplastics processed by fused deposition modelling (FDM) and selective laser sintering (SLS) are a less-explored, single-component route, but are poorly characterised. This study compared six thermoplastic material–process systems, supplied for biomedical or dental use, using a single intraoral-simulating protocol. Methods: Thin specimens (25 × 5 × 0.6 mm) of polyethylene terephthalate glycol (PETG), polycarbonate (PC), polyamide (PA), polyether-ether-ketone (PEEK) and a thermoplastic copolyester elastomer (TPC) printed by FDM, and of polyamide 12 (PA12) by SLS, underwent three-point bending and 10 min stress relaxation at 37 °C in artificial saliva (n = 5). Differences were assessed using the Kruskal–Wallis test with Dunn post hoc comparisons (Holm correction), and Fourier-transform infrared (FTIR) spectroscopy was used to compare virgin and printed materials for the five FDM polymers. Results: Apparent flexural moduli were 989 (PA12), 750 (PC), 687 (PEEK), 509 (PETG), 85 (PA) and 32 MPa (TPC), a very large material effect (ε² = 0.95), with post hoc comparisons separating only the extremes of that range. Relaxation over 10 min ranged from 2.6% (PC) to 22.1% (PA12) among the five materials in which it could be quantified, with TPC falling below the load-cell resolution; expressed as force, PA12 lost the most (0.86 N) and yet still delivered 3.01 N, which was above the initial force of PEEK, PETG, PA and TPC, though not separable from that of PC, which retained 97.4% of its own. Virgin and printed spectra were concordant (Pearson r ≥ 0.986, against ≤ 0.80 between different materials). Conclusions: The PA12/SLS system was the stiffest, followed by PC and PEEK, but, as the only laser-sintered material, its polymer and process effects cannot be separated. PETG and PC combine useful stiffness with accessible FDM; PA and TPC are far more compliant. These specimen-level findings provide a screening basis for selecting material–process systems for printed orthodontic appliances, preceding device-level validation. Full article

Background: Evidence regarding the longitudinal use of infrared thermography in elite under-18 soccer players remains limited. Most previous studies have relied on cross-sectional designs or short observation periods. Methods: This prospective longitudinal observational study monitored 18 elite under-18 male outfield soccer players across 16 official matches (96 valid assessments). Thermographic evaluations were performed 48 h post-match under standardized conditions across six bilateral lower-limb regions. A thermal asymmetry was defined as relevant if ΔTsk ≥ 0.5 °C. Linear mixed-effects models, paired t-tests and chi-square tests were used for statistical analysis. Results: Relevant asymmetries were detected in 79.2% of assessments (mean maximum ΔTsk 0.77 ± 0.43 °C). Posterior Thigh BF (40.6%) and Posterior Thigh ST (35.4%) showed the highest prevalence (χ² = 16.31, p = 0.006). Significant side-to-side differences were found for Anterior Thigh (p = 0.004), Adductor (p = 0.039) and Posterior Thigh BF (p = 0.032). The intraclass correlation coefficient for Thermal Asymmetry Burden was very low (ICC = 0.024). Fifteen athletes (83.3%) showed recurrent asymmetry and 13 (72.2%) showed a recurrent same-region pattern. Match-to-match variation in TAB was significant (Kruskal–Wallis p = 0.025; ANOVA p = 0.011). No time-loss muscle injuries occurred. Conclusions: Post-match thermal asymmetries are highly prevalent in elite youth soccer and appear to reflect dynamic, load-dependent recovery responses rather than stable thermal phenotypes. Longitudinal thermographic monitoring may help characterise individual recovery patterns when interpreted alongside other monitoring tools. Full article

Background: To conserve wild populations and ensure a sustainable supply of musk, China initiated the captive breeding of forest musk deer. The temporal dynamics of gut antibiotic resistance gene (ARG) profiles in captive forest musk deer along a breeding duration gradient remain poorly characterized. Methods: In this study, we employed metagenomic sequencing to systematically characterize the profiles and potential mobility of ARGs. Samples were divided into short-term, medium-term and long-term groups according to breeding durations. Results: A total of 331 ARG subtypes and 71 mobile genetic element (MGE) subtypes were annotated across all samples. ARG Shannon diversity differed overall across groups (Kruskal-Wallis, p = 0.03); Bonferroni-adjusted Dunn’s test showed no significant pairwise differences. PCoA (Bray–Curtis) demonstrated distinct separation of the ST group (p = 0.002), and shared core ARG subtypes gradually increased with extended breeding years. A strong positive correlation between ARG and MGE abundances was identified (r = 0.85, p = 0.0001). In total, 63 contigs carrying co-localized ARG-MGE complexes were recovered. The ST group contained the highest proportion of such contigs. The ST group displayed tight physical ARG-MGE linkage within 1–3 kb genomic intervals. Conclusions: Our results reveal that breeding duration is associated with the gut ARG characteristics of captive forest musk deer. Short-term captivity has higher ARG-MGE co-localization, suggesting a higher possibility of mobilization. Full article

Three-dimensionally (3D)-printed denture teeth are increasingly used in clinical practice; however, their wear resistance and surface hardness may be insufficient for long-term clinical application. Moreover, the effect of post-treatment under elevated temperature and pressure on these properties remains unclear. This study aimed to evaluate the effect of such post-treatment on the wear resistance and Vickers hardness of 3D-printed denture teeth resin. One hundred disk-shaped specimens (10 × 2 mm) were 3D-printed using Dima denture teeth resin and randomly assigned to four post-treatment groups (121 °C at 2 bar for 4, 30, 60, and 90 min) and one untreated control group. Within each group, specimens were allocated for wear resistance (n = 10) and Vickers hardness (n = 10) testing. Wear resistance was measured using an impact-sliding wear testing machine in a polymethyl methacrylate slurry, while Vickers hardness was measured using a hardness tester under a 50 g load with a 15 s dwell time. Statistical analyses included one-way analysis of variance (ANOVA), Kruskal–Wallis, and Welch’s ANOVA (α = 0.05). All post-treatment groups exhibited significantly lower depth loss and higher hardness than the control group (p < 0.05). Specimens post-treated for ≥30 min exhibited significantly lower volume loss than the control group (p < 0.05). The 121 °C/90 min group demonstrated the highest wear resistance and Vickers hardness. Within the limitations of this study, post-treatment under elevated temperature and pressure significantly improved the wear resistance and Vickers hardness of the tested 3D-printed denture teeth resin, with the 90 min protocol yielding the greatest enhancement. Thus, thermal-pressure post-treatment may be a promising approach for enhancing the mechanical performance of additively manufactured denture teeth. Full article

In plants, pathogen-associated molecular patterns (PAMPs) activate pattern-triggered immunity and can contribute to resistance against phytopathogenic infections. Identifying novel microbial elicitors is important for developing resistance-inducing strategies that reduce reliance on pesticides. This study evaluated BV801-derived protein preparations obtained from Xanthomonas euvesicatoria strain BV801 grown in host-associated media containing lyophilized Solanum lycopersicum or Capsicum annuum tissue. Six treatments were evaluated in C. annuum against bacterial spot caused by X. euvesicatoria (BSX) under in vitro conditions: SP-AWSL and SP-AWCA (obtained from BV801 grown in the host-associated AWSL and AWCA media), SP-NYGA and SP-M9 (obtained from BV801 grown in rich and minimal control media), and two commercial reference inducers, Actigard^® 50 GS (acibenzolar-S-methyl) and Messenger Gold^® (commercial harpin formulation). Plants were treated 48 h before pathogen inoculation. SDS-PAGE revealed protein bands in the 12–26 kDa range that were enriched in SP-AWSL and SP-AWCA relative to the control-media preparations. Several BV801-derived preparations produced localized necrosis in N. tabacum leaves consistent with a hypersensitive-response-like reaction. SP-AWSL and SP-AWCA reduced BSX severity in chili pepper by up to 67% compared with the diseased control (Kruskal–Wallis, p ≤ 0.05) and significantly reduced bacterial proliferation (Tukey, p ≤ 0.05). At the final sampling point, plants pretreated with BV801-derived protein preparations and subsequently challenged with X. euvesicatoria showed higher CaBPR1 expression than corresponding pretreated but unchallenged plants, a pattern consistent with a priming-like defense response. These findings support the potential of BV801-derived protein preparations obtained under putative Hrp-inducing conditions as candidates for sustainable resistance-inducing strategies against bacterial spot in chili pepper. Full article

This study presents a high-resolution geomorphological and habitat map of the Sinuessa coastal sector (Tyrrhenian Sea), revealing the presence of an extensive and exceptionally shallow coralligenous bank developed between 5 and 16 m water depth. Multibeam bathymetry, side-scan sonar backscatter, sediment analyses, and Remotely Operated Vehicle (ROV) observations were integrated within a Geographic Information System (GIS) framework to characterize seabed morphology, acoustic facies, and associated benthic habitats. ROV surveys document a diverse macro- and epimegabenthic community, including both sciaphilous and photophilous taxa, as well as several protected and structuring species. Water depth alone does not discriminate among the mapped substrate classes (Kruskal–Wallis, p = 0.578), whereas acoustic backscatter, slope, and terrain ruggedness all do (p < 0.01), indicating that depth-independent controls govern the distribution of the bioconstruction. We hypothesize that persistently elevated turbidity and terrigenous input from the Volturno and Garigliano river systems reduce light penetration and generate, at 5–16 m, optical conditions comparable to those normally found at greater depths. This hypothesis is consistent with the geomorphological, sedimentological, and biological evidence presented here and with published oceanographic observations in the Gulf of Gaeta, but it has not been verified by in situ optical measurement, which we identify as the priority for future work. Relative backscatter intensity correlates significantly with mean grain size (Spearman ρ = −0.710, p < 0.001) and with gravel and mud content, and the four mapped classes differ significantly in backscatter, slope, and terrain ruggedness. These findings provide new insights into the environmental controls on coralligenous development and highlight the ecological relevance of shallow, turbidity-driven coralligenous systems within highly impacted Mediterranean coastal areas, with direct implications for habitat conservation and spatial management. Full article

Background/Objectives: Days alive and out of the hospital at 30 days (DAOH30) integrates survival, index hospitalization, and readmission. We characterized DAOH30 after gastrectomy, assessed its complication-severity gradient and readmission burden, and explored its association with an index-cancer-excluded Charlson Comorbidity Index (CCI). Methods: This single-center retrospective analysis included adults undergoing R0 total gastrectomy or subtotal distal gastrectomy for non-metastatic gastric adenocarcinoma between January 2020 and April 2026. DAOH30 was derived from the index postoperative length of stay, readmission days, and 30-day mortality. Rank-based tests and median quantile regression were used. Results: Among 123 patients, median DAOH30 was 21 days (interquartile range, 18–22; range, 4–26). No 30-day deaths occurred; eight patients (6.5%) were readmitted. Median DAOH30 decreased from 22 days without complications to 21 days after Clavien–Dindo grade I–II complications and 17 days after grade ≥ III complications (Kruskal–Wallis p < 0.001; one-sided Jonckheere–Terpstra p < 0.001; two-sided permutation sensitivity p < 0.001). After adjustment, grade ≥ III complications were associated with 4.00 fewer median DAOH30 days (bootstrap 95% confidence interval, −7.31 to −2.25; model-based p < 0.001). Readmissions contributed 73 additional inpatient days, with a median decrement of 9.5 days per readmitted patient. No statistically significant independent association was detected between the index-cancer-excluded CCI and DAOH30 (adjusted median difference, −0.17 days per point; bootstrap 95% confidence interval, −1.34 to 0.40; model-based p = 0.640). Conclusions: DAOH30 summarized early hospital burden, but in this no-mortality, low-readmission cohort it was largely determined by index length of stay. Multicenter validation with patient-reported anchoring is warranted. Full article

Background/Objectives: Endometrial polyps are a prevalent pathological condition within the uterine cavity. While the majority of lesions are classified as benign, histopathological examinations indicate a potential for malignant transformation occurring in 0.5–5% of cases. The present study aimed to evaluate the prevalence of endometrial carcinoma and pre-malignant histopathological findings (glandular hyperplasia without atypia and atypical glandular hyperplasia) associated with endometrial polyps and to identify pertinent risk factors among Polish women undergoing hysteroscopic polypectomy under local anesthesia. Methods: A retrospective cohort study was conducted at the Outpatient Hysteroscopy Center of the Heliodor Swiecicki University Hospital of Gynecology and Obstetrics, affiliated with Poznan University of Medical Sciences. The study included patients treated using the GUBBINI mini-resectoscope under local anesthesia with the Hystero-Block system (Tontarra Medizintechnik GmbH, Wurmlingen, Germany) between December 2022 and July 2026. Statistical analysis of risk factors was performed using the Kruskal–Wallis H test and Fisher’s exact test. Odds ratios for potential risk factors were also calculated. Results: The study comprised 2588 patients. Endometrial carcinoma associated with endometrial polyps was identified in 16 women (0.62%). Additional histopathological findings included glandular hyperplasia in 360 patients (13.91%) and atypical hyperplasia in 35 patients (1.35%), with the remaining patients diagnosed with benign uterine polyps (84.12%). Patients with malignant and pre-malignant lesions were significantly older than those with benign polyps (p < 0.001). Regarding polyp size, patients diagnosed with glandular hyperplasia without atypia had significantly larger polyps than those with benign lesions (p < 0.001). Estimated postmenopausal status was associated with significantly higher odds of endometrial carcinoma (Odds Ratio [OR] = 6.56, 95% Confidence Interval [CI]: 2.12–20.30, p = 0.001) and atypical glandular hyperplasia (OR = 3.13, 95% CI: 1.41–6.96, p = 0.005) compared to benign polyps. Similarly, obesity increased the odds of glandular hyperplasia without atypia (OR = 1.32, 95% CI: 1.01–1.74, p = 0.045) and atypical glandular hyperplasia (OR = 3.33, 95% CI: 1.67–6.65, p < 0.001). Furthermore, hypertension was associated with higher odds of glandular hyperplasia without atypia compared to benign polyps (OR = 1.41, 95% CI: 1.02–1.97, p = 0.040). Other evaluated risk factors, including type II diabetes mellitus, infertility, abnormal uterine bleeding, breast cancer history, hypothyroidism and polyendocrine metabolic ovarian syndrome (PMOS), did not reach statistical significance (p > 0.05). This large cohort provides important data regarding the prevalence and risk factors of carcinoma associated with endometrial polyps and pre-malignant uterine lesions in Polish women. Conclusions: Endometrial carcinoma associated with endometrial polyps is a rare entity among Polish women undergoing outpatient hysteroscopy (0.62%). Nevertheless, the primary diagnostic value of this large-scale study lies in demonstrating that despite the low prevalence of malignancy in standard “see-and-treat” outpatient settings, systematic histopathological evaluation remains an absolute diagnostic mandate, as relying solely on visual or clinical parameters is insufficient to exclude malignancy. Furthermore, identified risk factors, such as age, polyp size, estimated postmenopausal status, obesity and hypertension, serve as critical diagnostic red flags, associated with increased odds of concurrent premalignant lesions or carcinoma. Full article

Road safety is an important aspect of sustainable mobility in urban transportation, with excessive speed a primary contributor to the severity of traffic accidents. Monitoring it is a challenge for current transport systems; however, the current state of open data technologies allows for the collection, monitoring and analysis of traffic data using low-cost devices that can help local citizens verify and support their concerns about dangerous situations in specific areas. This study presents the results of speeding on various street segments in the city of Žilina, Slovakia, based on the data gathered from Telraam low-cost traffic sensors. Differences among the various locations were tested with nonparametric statistical tests (Kruskal–Wallis test and Dunn’s post hoc comparisons). The data provide insight into the largely passenger-car traffic at all sites and show significant variation in the proportions of bikes, pedestrians, and heavy vehicles. The particular differences in speeding behaviour in the spatial context were observed in some locations: Oslobodenia, Okruzna, and Zavodskeho showed the highest V85 values and increased proportions of vehicles exceeding 50 km/h, while Hviezdoslavova, Osvety, and Univerzitna showed substantially lower operating speeds. The findings indicate that some residential collector road segments record a higher share of overspeeding than the main road. Such findings suggest that low-cost devices may be useful technology to support citizens and their initiatives in a real way, enhancing road safety. The findings suggest that low-cost open-data sensors can support preliminary speed-management screening by identifying locations with elevated speeding indicators that warrant more detailed investigation. Full article

Academic laboratories increasingly deploy DC motor-driven equipment, but wireless control faces two challenges: congestion in the 2.4 GHz band and the absence of application-layer confidentiality. This paper presents a 433 MHz LoRa-based wireless joystick control system with AES-128 confidentiality protection, validated using an ABU Robocon robot as a representative testbed. Performance was characterized outdoors across six Spreading Factors (SF7–SF12) under line-of-sight (LoS) and non-line-of-sight (NLoS) propagation (n = 6 per condition), and across three indoor campaigns (n ≈ 100 packets per condition) to quantify the gap between outdoor boundary estimates and indoor deployment. One-way ANOVA confirmed significant SF effects on latency, RSSI, and SNR (F = 10.4–5812, p < 0.001); normality and homogeneity-of-variance assumptions were formally tested, frequently violated for RSSI/SNR, and corroborated by Kruskal–Wallis tests, with large effect sizes (η² = 0.27–0.99). A preliminary low-antenna indoor test showed severe PDR degradation (as low as 14%), plausibly from ground-reflection multipath; elevating both antennas (≈70/60 cm) produced mixed, not uniformly improved, results. Indoor-NLoS testing showed low Spreading Factors failing almost completely beyond 5 m (SF7/SF8 near 0% PDR at 10–15 m) while SF10–SF12 remained robust (89–100%), a more consequential finding than outdoor boundary conditions (100% PDR at 5–15 m) suggest alone. Interference experiments characterized position-dependent and cross-Spreading-Factor resilience, with an explicit literature-grounded caveat rather than an unconditional quasi-orthogonality claim. SF10/SF11 with a 5 dBi antenna remains the best outdoor compromise (147–176 m range, 206–357 ms latency); indoor deployments require SF-specific de-rating and antenna-height practice. AES-128 added no measurable latency overhead. Contributions include a validated retrofit blueprint, a statistically grounded SF selection matrix spanning outdoor and indoor conditions, a practical antenna-height recommendation, and a controlled characterization of indoor interference resilience. The AES-128 ECB implementation provides confidentiality only, not authentication or replay resistance; limitations and a migration roadmap are discussed. Full article

Background/Objectives: Emergency Department (ED) attendance is characterized by substantial temporal variability, creating challenges for workforce scheduling, resource allocation and short-term operational planning. This study aimed to characterize the temporal patterns of daily ED presentations and to evaluate the short-term forecasting performance of SARIMA and Prophet models in a Romanian hospital setting. Methods: Daily ED visits recorded at the Craiova County Emergency Clinical Hospital between January 2025 and April 2026 were analyzed (485 consecutive days). The analytical framework combined descriptive statistics, normality assessment, the Kruskal–Wallis test, and post hoc Mann–Whitney U tests with Holm correction and time-series modeling. A SARIMA(1,0,5)(0,0,1)₇ model incorporating a Romanian legal-holiday dummy and weekly seasonality and a Prophet model incorporating Romanian holidays and weekly seasonality without yearly seasonality were evaluated using a common rolling-origin out-of-sample framework. Predictive accuracy was assessed using RMSE and MAPE, while differences in forecasting performance were examined using the Diebold–Mariano test with a HAC/Newey–West correction. Results: ED attendance differed significantly across weekdays (H(6) = 52.365, p < 0.001), with the highest mean attendance observed on Mondays (257.6 patients/day). Post hoc analysis confirmed significant differences between several weekday distributions after Holm adjustment, supporting a structured weekly pattern. Time-series analysis demonstrated serial dependence and recurrent weekly seasonality. Both forecasting models showed good short-term predictive performance across the four common validation windows. Over the complete out-of-sample period of 1–30 April 2026, SARIMA achieved an RMSE of 22.59 patients and a MAPE of 7.46%, compared with 23.54 patients and 7.56%, respectively, for Prophet. Although the aggregate results slightly favored SARIMA, the difference in predictive accuracy was not statistically significant (Diebold–Mariano test, p-value = 0.575). Conclusions: Daily ED attendance at SCJU Craiova exhibits systematic weekly variation, serial dependence and calendar-related effects that can be incorporated into short-term forecasting models. SARIMA and Prophet provided comparable out-of-sample predictive accuracy, with neither model demonstrating statistically significant superiority. These findings support the use of short-term forecasting as an operational planning tool for anticipating variations in ED demand and informing adaptive resource allocation. Full article

Background/Objectives: Wearable powered gait orthoses are prescribed as assistive equipment, on the premise that torque at an impaired joint improves walking while the device is worn; the device also adds mass. Where a hip module and a knee–ankle–foot module can be worn together, the combined configuration places the mass of both on one limb, and whether its walking cost exceeds that of either module alone has not been tested under a common protocol. Methods: We analysed individual participant data from two previously published prospective studies, neither of which compared configurations. Forty-three adults with central neurological gait impairment, enrolled during 2024, were trained over six supervised sessions with a bilateral hip orthosis (HO, n = 13), a unilateral knee–ankle–foot orthosis (KAFO, n = 15), or both worn together (HKAFO, n = 15); the primary 6MWT analysis was performed on the complete-case subsample (n = 41, with HO n = 12, KAFO n = 14, HKAFO n = 15). The assisted–unassisted differential was computed per participant as (device-assisted − unassisted)/unassisted × 100; negative values indicate a shorter distance with the device. Results: No statistically significant baseline differences were detected across the three groups. The six-minute walk differential was larger for the HKAFO than for either single-region configuration at baseline (−24.9% versus −6.0% and −7.6%; Kruskal–Wallis p = 0.008) and after six sessions (−17.1% versus −5.9% and −4.3%; p = 0.012), whereas the two single-region configurations were indistinguishable at both assessments (p = 0.397 and 0.916). Short-distance gait speed did not differ between configurations (p = 0.290 and 0.457). Conclusions: The walking cost of the combined configuration was associated with a larger assisted–unassisted differential than that of either constituent module. We propose that this reflects the mass carried on a single limb rather than a shortfall in assistance, a reading these data support but cannot establish in the absence of kinematic or metabolic measurements. These findings should be regarded as hypothesis-generating and require prospective replication in a larger, adequately powered cohort. Full article

Background: Systemic inflammation contributes to the pathobiology of multiple sclerosis (MS), yet serum biomarker data from Middle Eastern populations remain limited. This study evaluated serum levels of IL-6, IL-16, IL-18, and IL-36 in Saudi adults with MS compared with matched healthy controls and examined associations with disease duration, phenotype, treatment, and disability. Methods: This single-center, cross-sectional, matched case–control study enrolled 26 MS patients and 26 age- and sex-matched controls. Serum cytokines were measured by ELISA. Disability was assessed using EDSS and the Timed 25-Foot Walk (T25FW). Matched comparisons used Wilcoxon signed-rank tests; subgroup comparisons used Wilcoxon rank-sum or Kruskal–Wallis tests; associations used Spearman’s correlation. Results: No correction for multiple comparisons was applied given the exploratory design. All four interleukins were higher in MS patients than in controls (p < 0.001). Age correlated with EDSS (r = 0.573, p = 0.002) and T25FW (r = 0.464, p = 0.014). Only IL-6 showed a notable correlation with disability, with T25FW (r = 0.53, p = 0.008) and, weaker, EDSS (r = 0.38, p = 0.052); IL-18 showed a weak, non-significant correlation with T25FW (r = 0.35, p = 0.126); IL-16 and IL-36 showed no relevant associations. IL-16 was higher in newly diagnosed than in long-standing cases (p = 0.012); no differences by phenotype or treatment were observed for any marker. Conclusions: Serum IL-6, IL-16, IL-18, and IL-36 were elevated in Saudi MS patients versus controls. IL-6 alone showed a modest, unadjusted association with disability, supporting its evaluation as a candidate biomarker in larger, longitudinal, covariate-adjusted cohorts. These findings are hypothesis-generating and should not be interpreted as evidence of independent or clinically actionable biomarker utility. Full article