Search Results (7,992)

Knee osteoarthritis (OA) is increasingly recognized as a whole-joint disorder involving periarticular soft tissues in addition to intra-articular structures. A recently published technical report described an ultrasound-guided posteromedial knee injection targeting a fascial–periarticular convergence region operationally termed the popliteal fascial retinaculum. In the present study, we evaluated preliminary longitudinal clinical outcomes after this procedure in patients with mild-to-moderate knee OA. Background/Objectives: Knee OA is a common cause of chronic pain, stiffness, and disability. In the present study, we evaluated preliminary 12-month WOMAC outcomes after a three-session ultrasound-guided posteromedial fascial–periarticular injection in patients with Kellgren–Lawrence grade 1–3 knee OA. Methods: This retrospective analysis of a prospectively maintained single-center clinical registry included 10 patients treated between October 2023 and October 2025. Each patient received three monthly ultrasound-guided posteromedial injections using 30 mL of 5% dextrose with 0.1% lidocaine (lignocaine). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was recorded at baseline and at 1, 3, 6, and 12 months after the final injection. Data are mean ± SD, median (IQR), and 95% CI. In exploratory inferential analyses, we used Friedman tests and Wilcoxon signed-rank tests with Bonferroni correction. Results: The mean WOMAC total score improved from 59.5 ± 4.33 at baseline to 38.6 ± 4.50 at 1 month, 34.3 ± 4.45 at 3 months, 30.6 ± 3.06 at 6 months, and 28.5 ± 2.51 at 12 months after the final injection, corresponding to a mean 12-month within-patient change of −31.0 points (95% CI −32.58 to −29.42; −52.1%). Mean pain improved from 12.6 ± 1.35 to 5.6 ± 0.70, stiffness from 4.7 ± 0.48 to 2.1 ± 0.32, and physical function from 42.2 ± 2.62 to 20.8 ± 2.15. All 10 patients had lower WOMAC total scores at 12 months than at baseline. Friedman tests were significant for all four WOMAC domains (all p ≤ 5.05 × 10⁻⁷); Wilcoxon signed-rank tests versus baseline reached the theoretical minimum p at n = 10 (Bonferroni-adjusted p = 7.81 × 10⁻³) at every follow-up timepoint. No serious adverse events were documented; mild transient post-procedural soreness occurred in three patients. Conclusions: In this small retrospective pilot cohort, ultrasound-guided posteromedial fascial–periarticular injection was associated with sustained improvement in WOMAC pain, stiffness, physical function, and total scores over 12 months. These findings are preliminary and hypothesis-generating; non-specific effects including placebo, regression to the mean, and natural symptomatic fluctuation cannot be excluded. Prospective controlled trials are required to establish safety, reproducibility, mechanism, and comparative effectiveness. Full article

The crosslinking of IgE-bound FcεRI by multivalent allergens initiates mast cell and basophil signaling underlying Type 1 allergy. Yet, how allergen properties and IgE occupancy impact receptor aggregation and downstream signaling remains unclear. We used Phl p 1-specific IgE and recombinant fusion proteins presenting a Phl p 1-derived peptide in defined valencies and positions (MB1N, MB1N1C, MB2N, and MB4N) to probe antigen-dependent signaling. Tetravalent MB4N evoked stronger degranulation and Ca2+ response than bivalent antigens MB1N1C and MB2N. MB4N was also capable of signaling at low IgE occupancy and in Lyn-deficient cells. Monte Carlo simulations predicted that MB4N forms larger, complex receptor aggregates, while MB1N1C and MB2N produce linear chains. Consistently, the addition of MB4N showed larger aggregates by electron microscopy and slower mobility by single-particle tracking, compared to bivalent antigens. Thus, allergen valency and epitope spatial arrangement dictate FcεRI aggregate organization and subsequent effector cell activation. Full article

Background: Postoperative bleeding remains an important source of morbidity following Bentall procedures despite numerous technical refinements aimed at improving hemostasis. We evaluated whether a modified hybrid cardioplegia strategy incorporating intermittent blood cardioplegia during aortic root reconstruction could reduce bleeding-related complications compared with a conventional double-dose del Nido strategy. Methods: A total of 103 consecutive patients who underwent Bentall procedures were retrospectively analyzed. Patients were divided according to the myocardial protection strategy employed: conventional double-dose del Nido cardioplegia (Group 1, n = 46) and a modified hybrid strategy consisting of initial del Nido cardioplegia followed by intermittent blood cardioplegia during root reconstruction (Group 2, n = 57). The primary endpoint was postoperative re-exploration for bleeding during the index hospitalization. Additional bleeding-related outcomes included 24 h drainage volume and blood product transfusion requirements. Secondary endpoints were intensive care unit (ICU) stay, hospital stay, and in-hospital mortality. Results: Baseline characteristics, cardiopulmonary bypass times, and aortic cross-clamp durations were comparable between groups. Group 2 demonstrated significantly lower 24 h postoperative drainage volumes compared with Group 1 (450 [350–550] mL vs. 550 [400–650] mL, p = 0.005). Postoperative re-exploration for bleeding occurred significantly less frequently in Group 2 than in Group 1 (3.5% vs. 19.6%, p = 0.011). No significant differences were observed in red blood cell transfusion (p = 0.112), fresh frozen plasma transfusion (p = 0.339), or platelet transfusion requirements (p = 0.147). Mechanical ventilation duration (p = 0.423), intensive care unit stay (p = 0.342), and hospital stay (p = 0.103) were similar between groups. In-hospital mortality did not differ significantly between the groups (4.3% vs. 3.5%, p = 1.000); however, the study was not powered to detect differences in mortality because of the low number of events. Conclusions: In patients undergoing Bentall procedures, a modified hybrid cardioplegia strategy incorporating intermittent blood cardioplegia during aortic root reconstruction was associated with lower postoperative drainage volumes and fewer re-explorations for bleeding compared with a conventional double-dose del Nido strategy. These findings suggest that cardioplegia delivery may contribute to intraoperative hemostatic optimization beyond its traditional role in myocardial protection. Larger prospective studies are warranted to validate these observations. Full article

Background: Psychosocial assessment is a core component of lung transplant candidate evaluation, but total scores and broad candidate categories do not necessarily show how individual psychosocial concerns co-occur or which modifiable domains require further clinical attention. This study describes the development and internal evaluation of a clinical decision-support application that reorganizes Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) data into structured multidomain profiles. Methods: The application was developed using a retrospective single-center dataset of 496 adult lung transplant candidates. It integrates the SIPAT total score and candidate category with seven SIPAT-derived domain indicators, domain burden scores, cohort-referenced z-scores, graphical displays, and a ranked summary of domains for clinical review. All seven indicator targets were prespecified deterministic functions of SIPAT items or domain scores obtained during the same assessment. Random forest algorithms with sigmoid calibration were used to transform these targets into percentage-scaled display values; they were not trained using independently assessed clinical outcomes. Analyses included descriptive statistics, Spearman correlations, exploratory clustering, resampling-based cluster stability assessment, threshold sensitivity analyses, and subgroup analyses by age, sex, and primary pulmonary diagnosis. Results: Upper display-band classifications were identified for depression-related concerns in 32 candidates (6.5%), anxiety-related concerns in 11 (2.2%), nicotine-related concerns in 56 (11.3%), alcohol-related concerns in 22 (4.4%), illicit drug-use concerns in 11 (2.2%), social-support deficits in 40 (8.1%), and non-adherence-related concerns in 7 (1.4%). Exploratory clustering yielded a low-burden majority group (n = 432), a nicotine-dominant group (n = 53), and a small multidomain-elevation group (n = 11). The generated percentage-scaled indicators were positively associated with their conceptually corresponding SIPAT domains (Spearman’s ρ = 0.321–0.774) and with the total SIPAT score (ρ = 0.406–0.802; all p < 0.001). Sensitivity analyses showed that the smaller clusters were less stable under bootstrap resampling. These findings demonstrate internal alignment with the source instrument but do not constitute validation against independent clinical outcomes. Conclusions: The application provides an early-stage framework for organizing and visualizing SIPAT information and identifying domains that may warrant additional clinical assessment. Its outputs should be interpreted as SIPAT-derived decision-support indicators, not as independently validated probabilities of future clinical events. Prospective studies are required to evaluate usability, clinical impact, and associations with longitudinal outcomes. Full article

Cholinesterase inhibitors with distinct pharmacological profiles may influence exploratory behavior, yet their effects on recall-related exploration in physiologically intact animals remain insufficiently characterized. The present study aimed to directly compare the effects of donepezil, a relatively selective acetylcholinesterase inhibitor, and tacrine, a cholinesterase inhibitor with broader enzymatic and pharmacological activity, on exploratory allocation during memory recall in healthy rats. Male Wistar rats were assigned to five groups (n = 8/group): control, donepezil 1 mg/kg, donepezil 3 mg/kg, tacrine 3 mg/kg, and tacrine 5 mg/kg. Treatments were administered intraperitoneally 50 min before the acquisition trial, while recall performance was evaluated 24 h later without additional treatment using a two-trial Y-maze paradigm. Time spent and entries into the familiar and novel arms, novel-to-familiar ratios, and mean time per entry were analyzed. Control animals showed no marked preference for the novel arm, whereas donepezil produced only limited, non-significant behavioral changes. Tacrine 5 mg/kg significantly increased the U/K time ratio compared with controls (p = 0.0006) and the U/K entry ratio (p = 0.001), primarily through reduced time spent in the familiar arm (p = 0.0004) and fewer familiar-arm entries (p = 0.025). Absolute time spent in, and entries into, the novel arm did not differ significantly among groups (p = 0.689 and p = 0.883, respectively). Overall, these findings suggest that tacrine, but not donepezil, modified recall-phase exploratory preference in healthy rats, predominantly by reducing persistence in the familiar arm. Full article

Background: The thoracolumbar junction (TLJ) includes the T11–L2 vertebral segments. It is a pivotal biomechanical transition zone between the rigid thoracic spine and the more mobile lumbar spine. Accurate morphometric data from this region are crucial for understanding human axial biomechanics and supporting forensic investigations. Objective: This study was designed to establish a normative multi-detector computed tomography (MDCT) database of the human thoracolumbar junction (T11–L2) in an adult population. Specifically, the primary objectives were to quantify normal vertebral and pedicle dimensions and to investigate the prevalence of congenital rib anomalies. The ultimate clinical goal is to translate these anatomical metrics into practical guidelines for spinal surgery and tools for forensic sex estimation. Materials and Methods: A retrospective analysis of 517 adults (277 men, 240 women) who received thoracic CT for various clinical indications was conducted. Morphometric parameters, including anterior, middle, and posterior vertebral heights; transverse and sagittal pedicle diameters; pedicle length; and transverse pedicle angle, were systematically measured. Costal variations, including hypoplastic and supernumerary ribs, were carefully recorded. Results: Vertebral and pedicle linear dimensions were generally larger in men than in women. The mean transverse pedicle diameter (TPD) increased progressively from T11 to L2. Significant sexual dimorphism in TPD was observed at the T11, L1, and L2 levels (p < 0.05), whereas both transverse (p = 0.168) and sagittal (p = 0.251) pedicle dimensions remained statistically comparable between sexes exclusively at the T12 transitional segment. The transverse pedicle angle (TPA) showed a consistent, increasing medial trajectory from T11 (~21°) to L2 (~28°) in both sexes, with no significant sex-based difference (p > 0.05). The overall prevalence of congenital rib variations was 18.57%. The most frequent structural anomaly was 12th-rib hypoplasia. Conclusions: This study provides a detailed morphometric baseline for the TLJ in an adult cohort (n = 517) of Turkish adults. The findings show that while absolute pedicle size and volumetric mass are influenced by sexually dimorphic physical geometry, the spatial trajectory and angulation of the pedicles (TPA) are determined by biomechanical principles that are independent of sex. In addition, pronounced sexual dimorphism and a high prevalence of unique costal variations were observed. These factors provide valuable biological markers that serve as reliable radiological fingerprints for forensic anthropologists who estimate sex from skeletal remains and identify unknown individuals. Full article

Background and Objectives: Placenta accreta spectrum (PAS) complicating placenta praevia is associated with increased maternal morbidity; however, neonatal respiratory burden may be underappreciated. We compared neonatal outcomes between pregnancies complicated by placenta praevia with and without histopathologically confirmed PAS, with additional adjustment of respiratory outcomes for gestational age at delivery. Materials and Methods: We conducted a retrospective single-centre cohort study (n = 82). Based on placental histopathology, women were classified as PAS (n = 37; accreta/increta/percreta) or non-PAS (n = 45). Respiratory endpoints included respiratory resuscitation at birth, non-invasive respiratory support, and supplemental oxygen requirement with fraction of inspired oxygen (FiO₂) > 0.21 during neonatal intensive care unit (NICU) hospitalization. Logistic regression models adjusted respiratory endpoints for gestational age. Results: Data were available for 80/82 neonates. Compared with non-PAS, PAS cases had higher rates of respiratory resuscitation at birth (26/36 [72.2%] vs. 19/44 [43.2%], p = 0.013), non-invasive respiratory support (31/36 [86.1%] vs. 24/44 [54.5%], p = 0.003), and supplemental oxygen requirement (29/36 [80.6%] vs. 21/44 [47.7%], p = 0.003). After adjustment for gestational age, PAS remained associated with respiratory resuscitation (adjusted odds ratio [aOR] 3.34, 95% confidence interval [CI] 1.21–9.27; p = 0.020) and supplemental oxygen requirement (aOR 4.60, 95% CI 1.35–15.75; p = 0.015). The association with non-invasive respiratory support did not reach statistical significance (aOR 4.46, 95% CI 0.92–21.68; p = 0.064). Conclusions: Histopathologically confirmed PAS was associated with higher neonatal respiratory support requirements after adjustment for gestational age, supporting anticipatory obstetric–neonatal planning when PAS is suspected. Full article

This study evaluated a compound chemical additive (CA) composed of potassium sorbate, sodium benzoate, and sodium nitrite. Potassium sorbate is suitable for high-temperature ensiling, while sodium nitrite functions well under low-temperature conditions, and sodium benzoate inhibits bacterial energy metabolism. This compound theoretically provides stable antibacterial effects across variable storage temperatures. The effects of CA on fermentation quality, aerobic stability, and microbial communities of high-moisture corn (HMC) silage were investigated at 35 °C and 5 °C, including the control group (CON) and CA group. After 28 days of fermentation and 7 days of aerobic exposure, microbial communities were analyzed via high-throughput sequencing. CA significantly improved silage quality at both temperatures, increasing lactic acid and crude protein content, reducing pH, NH₃-N and neutral detergent fiber, and suppressing yeasts and enterobacteria to enhance aerobic stability. Storage temperature dominated microbial community composition, while CA further optimized microbial structure. At 35 °C, CA eliminated spoilage yeast Nakaseomyces glabratus and enriched Levilactobacillus brevis and Aspergillus spp. with elevated relative abundance. At 5 °C, CA inhibited cold-resistant spoilage microbes, promoted the accumulation of Latilactobacillus curvatus, and restricted cyanobacteria growth. Metabolic prediction indicated that CA was correlated with pathways related to enhanced lactic acid synthesis and inhibited proteolysis and silage spoilage. In conclusion, CA effectively stabilizes HMC silage by regulating microbial and metabolic characteristics under different temperatures, serving as a promising temperature-adaptive preservative. Full article

Background: Vitamin D is involved in musculoskeletal function, but evidence that supplementation improves athletic performance remains inconsistent, particularly in athletes with sufficient baseline vitamin D status. Methods: In this double-blind randomized controlled trial, 18 professional female soccer players were randomized during the autumn preparatory period (August–September) to receive vitamin D₃ (4000 IU/day; n = 9) or placebo (n = 9) for eight weeks. Outcomes included total serum 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)₂D] concentrations, hematological variables, RAST total sprint time, 5- and 30-m sprint performance, and countermovement-jump outcomes. Results: At baseline, after summer exposure, 25% of participants had insufficient or deficient 25(OH)D concentrations (≤30 ng/mL). The remaining cohort (75%) had sufficient 25(OH)D concentrations (>30 ng/mL). After eight weeks, no statistically significant between-group differences were observed in vitamin D metabolites, hematological variables, or performance outcomes (Δ25(OH)D: SG +12.4 ± 8.2 ng/mL vs. PG +3.1 ± 6.5 ng/mL; p = 0.12). RAST total sprint time (p = 0.001) and 30-m sprint performance (p = 0.005) improved over time. Conclusions: Vitamin D₃ supplementation at 4000 IU/day for eight weeks was not associated with additional improvements in muscle strength, sprint performance, or countermovement-jump outcomes compared with placebo. Because most participants had sufficient baseline 25(OH)D concentrations, larger trials in female athletes with confirmed vitamin D insufficiency or deficiency are needed to determine whether individualized supplementation or longer intervention periods provide additional physiological or performance-related benefits. The trial was retrospectively registered at ClinicalTrials.gov (NCT07641075) on 8 June 2026. Full article

Background/Objectives: This study assesses the outcomes of integrating deep learning-augmented zero echo time (ZTE DL) MRI sequences into standard MRI protocols for assessment of the hands and feet. Methods: In this single-center, retrospective study, a standard MRI protocol of hands and feet at 1.5 T was compared with the same protocol with an added ZTE DL sequence. Pathological changes in the bone, including subcortical sclerosis, osteophytes, joint space narrowing and fractures, were rated as present or absent. Indeterminate intraosseous lesions (erosions/ganglia) and indeterminate extraosseous lesions (ossicles/soft tissue calcifications) were additionally assessed on a semi-quantitative 4-point Likert scale. Diagnostic confidence was rated as low, moderate, or high. Standard MRI vs. ZTE-DL-augmented MRI comparisons were evaluated using a mixed-effects model with reader as a random effect, and X-ray vs. ZTE-DL-augmented MRI comparisons using a paired Wilcoxon signed-rank test. Interreader agreement (two readers) was assessed using Kappa statistics. Results: The cohort encompassed 59 datasets (feet = 22, hands = 37) of 40 patients with an average age of 51.79 (SD ± 11.84) years (58% women (n = 34), 42% men (n = 25)). Additional ZTE DL sequences resulted in similar findings, but with higher diagnostic confidence for assessment of bone changes when compared to conventional MR sequences (p-values < 0.05) and, overall, when compared to radiographs in a subgroup (p < 0.05 for five of six pathologic bone changes). Interreader agreement of diagnostic confidence was moderate to substantial (kappa 0.59–0.71). Conclusions: Addition of ZTE DL sequences to standard MRI protocols of hands and feet at 1.5 T demonstrated similar findings in the assessment of pathological bone changes, but with higher diagnostic confidence compared to conventional MR sequences and radiographs. However, further validation against a reference standard is required to determine diagnostic accuracy. Full article

Background/Objectives: Pegylated liposomal doxorubicin (PLD) has been used in hyperthermic intraperitoneal chemotherapy and early postoperative intraperitoneal chemotherapy. However, the safety and feasibility of repeated intraperitoneal administration of PLD have not been previously reported. This retrospective comparative study aimed to evaluate the feasibility, safety, and preliminary clinical outcomes of repeated intraperitoneal platinum combined with PLD in women with first recurrent ovarian cancer, compared with conventional intravenous platinum/PLD. Methods: We retrospectively reviewed all consecutive women with first recurrent ovarian cancer who received either repeated intraperitoneal platinum combined with intraperitoneal and intravenous PLD (IP group, n = 13) or intravenous platinum combined with intravenous PLD (IV group, n = 17) at a tertiary referral center. Results: Median progression-free survival was 13.7 months (95% confidence interval [CI], 10.2 months to not reached) in the IP group and 11.9 months (95% CI, 7.0–14.2 months) in the IV group (p = 0.179). Median overall survival was not reached in the IP group and 30.5 months in the IV group (p = 0.510). Toxicity profiles were comparable between groups. No cases of peritoneal sclerosis or adhesion-related bowel obstruction were observed following repeated intraperitoneal PLD. Conclusions: Repeated intraperitoneal administration of platinum combined with PLD appears to be a safe and feasible treatment strategy for recurrent epithelial ovarian cancer. However, whether this intraperitoneal approach provides additional clinical benefit over conventional intravenous platinum/PLD remains uncertain and warrants further investigation in large-scale studies. Full article

Mycoplasma bovis (M. bovis) is a major pathogen in cattle, primarily responsible for bovine respiratory disease complex (BRDC). Characterized by high infectivity and morbidity, M. bovis spreads rapidly within herds and is challenging to control and eradicate, underscoring the need for early and accurate diagnosis. To address this, we developed a competitive enzyme-linked immunosorbent assay (cELISA) for detecting M. bovis-specific antibodies in bovine sera. The assay uses recombinant MbovP579 protein (1 μg/mL) as the coating antigen and an HRP-conjugated 1A2 monoclonal antibody against MbovP579 (mAb, 0.35 μg/mL) as the competitor. With a cut-off value of 40.69% (percentage inhibition, PI), the cELISA demonstrated apparent sensitivity (90%; 95% CI: 78.64–95.65%) and specificity (96.15%; 95% CI: 90.53–98.49%) using the known background positive and negative sera. In addition, it yielded 100% positivity (9/9) against sera collected from 21 days post-immunization. The assay showed no cross-reactivity with other Mycoplasma species or two common bovine bacterial pathogens, confirming its high specificity. The intra- and inter-assay coefficients of variation (CVs) were below 10%. In clinical evaluations, this cELISA generated a 55.57% positivity rate for field samples (n = 1069) and exhibited 90.46% overall agreement (967/1069; 95% CI: 88.54–92.15%) with the commercial indirect ELISA kit, demonstrating strong diagnostic consistency. Discrepant specimens were further analyzed by a metabolic inhibition test (MIT), which suggested improved specificity, although further validation is required of this cELISA. Full article

Background/Objectives: Compression therapy serves as first-line conservative management for low-flow vascular malformations and Klippel–Trénaunay syndrome (KTS). However, ready-made garments are frequently ill-fitting for patients with limb overgrowth, asymmetry, deformity, or heterogeneous body habitus. Custom-made compression elastic garments offer an individualized solution, yet systematic data across diverse clinical entities remain scarce. This study evaluated objective and subjective outcomes of custom-made compression garments across vascular anomalies and edematous disorders in a multi-institutional real-world setting. Methods: A retrospective observational case series was conducted between May 2023 and September 2025 at four institutions: a tertiary medical center, a pediatric specialty hospital, a corporate hospital, and a corporate clinic. Patients who received custom-made compression elastic garments for vascular anomalies, edema, varicose veins, post-traumatic or post-burn venous stasis, or postoperative conditions were included. Objective outcome (limb circumference change) and subjective outcome (patient satisfaction) were analyzed. Results: A total of 191 patients who received custom-made garments were described (117 females, 61.3%; 74 males, 38.7%; mean age 36.3 years; median 22 years; range 1–96 years). The age distribution was bimodal, with 91 patients (47.6%) aged 0–19 years and 50 patients (26.2%) aged ≥70 years. The tertiary center and pediatric hospital treated vascular anomaly patients exclusively (n = 102), while the corporate hospital and clinic primarily served adult and elderly edematous disorder patients (n = 88; one additional vascular anomaly case was managed at the corporate hospital). Quantitative paired outcome analysis was feasible in the subgroups with complete paired data: 20 vascular anomaly patients (objective outcome) and 20 edematous disorder patients (subjective outcome). In the vascular anomaly subgroup (n = 20), the affected limb showed a significantly greater circumference reduction at the ankle’s narrowest point (median −2 mm, IQR −4.2 to 0.0) compared with the unaffected contralateral limb (median +0.5 mm, IQR −0.2 to +1.0; Wilcoxon signed-rank test T = 4; p < 0.001; effect size r = 0.83). In the edematous disorder subgroup (n = 20), patient satisfaction scores improved significantly from a median of 3 (IQR 2.0–4.0) to 4 (IQR 3.0–6.0) after garment use (Wilcoxon signed-rank test T = 0; p < 0.001; effect size r = 0.83). Representative cases illustrated pediatric vascular anomaly (Case A, vascular malformation; Case C, KTS) and adult edematous disorder (Case B, chronic lower limb edema) presentations and outcomes. Conclusions: Custom-made compression elastic garments were feasible and well tolerated across a broad real-world spectrum of vascular anomalies and edematous disorders. In the analyzed subgroups, a measurable reduction in affected-limb circumference was observed in pediatric vascular anomaly patients, and patient satisfaction improved in adult and elderly edematous disorder patients. Because each subgroup was evaluated with only one outcome domain and no head-to-head comparison of measures was performed, these findings should be regarded as hypothesis-generating. We propose that outcome measures may need to be tailored to disease background and age, a hypothesis that warrants testing in prospective studies capturing both objective and subjective endpoints across all patient groups. Full article

Background: Hemiplegic shoulder pain (HSP) can hinder post-stroke rehabilitation. This trial evaluated the incremental effect of adding a floss-band procedure with active shoulder movement to conventional physiotherapy in a selected chronic HSP subgroup. Methods: In this randomized trial with blinded goniometric assessment, 40 adults aged 30–55 years, ≥6 months post-stroke, with VAS pain ≥ 3, restricted shoulder motion, ≥90° active flexion and abduction, and Modified Ashworth Scale score 0 were allocated to conventional physiotherapy plus the floss-band procedure (n = 20) or physiotherapy alone (n = 20), three times weekly for 6 weeks. SPADI and PSQI were co-primary outcomes; VAS and shoulder range of motion were secondary outcomes. SPADI and PSQI were analyzed using group × baseline interaction models with HC3 robust inference; secondary outcomes used baseline-adjusted ANCOVA. Holm correction covered seven outcome-level tests. Results: Experimental-minus-control differences favored the experimental group for SPADI at the 25th percentile, median, and 75th percentile of baseline severity (−20.87, −25.32, and −28.34 points) and for PSQI (−2.48, −2.91, and −3.87 points; all p < 0.001). Adjusted differences also favored the experimental group for VAS (−2.33), flexion (+32.68°), abduction (+29.13°), internal rotation (+16.35°), and external rotation (+15.95°). Both co-primary joint tests and all five secondary-outcome tests remained significant after Holm correction. The experimental group had worse baseline pain and mobility. No adverse events were observed. Conclusions: In this younger, higher-functioning, non-spastic subgroup, the complete experimental procedure produced greater short-term improvements than physiotherapy alone. Because it also included additional movement, treatment time, therapist interaction, and novelty, the specific effect of tissue flossing or band compression cannot be isolated. Larger matched-control trials are required. Full article

Background/Objectives: Youth are increasingly engaged in mental health research, but many models remain consultative rather than participatory. We examined the Technology and Adolescent Mental Health Internship (TAMI) as an implementation-focused instrumental case study of a structured youth participatory action research internship for high school students recruited through schools serving Chicago’s West and South Sides. Methods: The case study included an embedded multimethod formative evaluation with participatory interpretation by a post-program youth advisory board (n = 8). In Year 3, 18 participants completed baseline surveys, and 16 provided matched pre–post surveys (matched survey completion = 89%). Measures included a study-developed five-item research-task self-efficacy indicator, post-program attitudes and intentions, and four open-ended items. We conducted one exploratory paired-samples t-test and an inductive descriptive content analysis. Results: In exploratory analyses, mean research-task self-efficacy scores increased from 21.8 (SD = 2.1) at baseline to 23.8 (SD = 1.4) post-program, t(15) = 4.09, p = 0.001, d_z = 1.02. Among the 15 respondents who responded to each of these post-program items, all reported being confident or very confident explaining youth mental health research, and all reported being at least somewhat likely to participate in future research, advocacy, or mental health activities. Participants described learning related to literature review, research design, ethics, data interpretation, and science communication. They recommended a longer program, additional applied practice, and more guest speakers. Conclusions: The TAMI was delivered within one program cycle and was viewed favorably by respondents. This case illustrates how youth-generated questions, adult scaffolding, collaborative interpretation, and youth co-authorship can be incorporated into a structured research internship. Larger, independent evaluations are needed to assess outcomes, sustainability, and transferability. Full article