Search Results (2,859)

This in vitro study compared the antimicrobial and antibiofilm efficacy of four commercially available chlorhexidine (CHX)-based mouthwashes, with different nominal CHX concentrations, against clinically relevant postoperative oral pathogens, including Staphylococcus aureus, Streptococcus mutans, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, and Candida auris. Antimicrobial potency was evaluated using MIC and CEMIC indices, while biofilm thickness reduction was quantified using 3D digital microscopy and custom image analysis software. Among the tested formulations, the excipient-enriched formulation exhibited the lowest MIC values and the most significant reduction in biofilm thickness, particularly against Gram-negative bacteria and Candida species. All mouthwashes achieved CEMIC < 0.1, confirming high theoretical applicability margins; however, CEMIC reflects potential clinical usefulness rather than clinical superiority. The findings demonstrate that the antimicrobial and antibiofilm activity of CHX rinses is formulation-dependent and cannot be predicted solely by CHX concentration. The influence of excipients is discussed as a possible contributing factor, but related mechanisms remain speculative and require direct validation in future studies. This work supports a formulation-driven, evidence-based approach to antiseptic comparison in postoperative dentistry, without assessing clinical wound-healing outcomes. Full article

Background: Developmental coordination Disorder (DCD) is a prevalent and persistent neurodevelopmental condition characterized by motor learning difficulties that significantly affect daily functioning and participation. Despite growing interest in artificial intelligence (AI) applications within healthcare, the extent and nature of AI use in the evaluation and intervention of DCD remain unclear. Objective: This scoping review aimed to systematically map the existing literature on the use of AI and AI-assisted approaches in the evaluation, screening, monitoring, and intervention of DCD, and to identify current trends, methodological characteristics, and gaps in the evidence base. Methods: A scoping review was conducted in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR) guidelines and was registered on the Open Science Framework. Systematic searches were performed in Scopus, PubMed, Web of Science, and IEEE Xplore, supplemented by snowballing. Peer-reviewed studies applying AI methods to DCD-relevant populations were included. Data was extracted and charted to summarize study designs, populations, AI methods, data modalities, clinical purposes, outcomes, and reported limitations. Results: Seven studies published between 2021 and 2025 met the inclusion criteria following a literature search covering the period from January 2010 to 2025. One study listed as 2026 was included based on its early access online publication in 2025. Most studies focused on AI applications for assessment, screening, and classification, using supervised machine learning or deep learning models applied to movement-based data, wearable sensors, video recordings, neurophysiological signals, or electronic health records. Only one randomized controlled trial evaluated an AI-assisted intervention. The evidence base was dominated by early-phase development and validation studies, with limited external validation, heterogeneous diagnostic definitions, and scarce intervention-focused research. Conclusions: Current AI research in DCD is primarily centered on evaluation and early identification, with comparatively limited evidence supporting AI-assisted intervention or rehabilitation. While existing findings suggest that AI has the potential to enhance objectivity and sensitivity in DCD assessment, significant gaps remain in clinical translation, intervention development, and implementation. Future research should prioritize theory-informed, clinician-centered AI applications, including adaptive intervention systems and decision-support tools, to better support occupational therapy and physiotherapy practice in DCD care. Full article

Family caregivers provide up to 90% of care in Alberta’s communities and play an essential role in sustaining the province’s health and social care systems, yet they remain under-recognized and insufficiently supported. To address this gap, we co-designed the Alberta Family Caregiver Strategy and Action Plan (2024–2025), a provincial framework developed through participatory research and collective impact methods. Guided by principles of co-production, equity, and lived experience, the project engaged over 500 stakeholders, including caregivers, healthcare providers, educators, employers, and policymakers, through Phase 1 interviews (health/community leaders, n = 44; Family and Community Support Services (FCSS), n = 47; navigation experts, n = 9), Phase 2 co-design team consultations, and Phase 3 sector roundtables (n = 52). Using reflexive thematic analysis, we identified four foundational caregiver strategies, Recognition, Partnership, Needs Assessment, and Navigation, and four enabling conditions: Education, Workplace Supports, Policy and Research and Data Infrastructure. These elements were synthesized into an eight-priority Alberta Caregiver Strategy and Action Plan Framework, a practical way to connect validated priorities with coordinated, measurable implementation across settings. Participants emphasized four key enablers essential to making caregiver inclusion more feasible and sustainable: education, workplace supports, policy infrastructure, and research and evaluation. Findings highlight strong cross-sector consensus that caregiver inclusion must be embedded into routine practice, supported by consistent policy, and reinforced through provincial coordination with local adaptation. The Alberta Family Caregiver Strategy provides a practical, evidence-informed plan for transforming fragmented supports into a coherent, caregiver-inclusive ecosystem that strengthens both caregiver well-being and system sustainability. Full article

We introduce a new method for preparing a percolation system by employing an inverse percolation model. Unlike standard percolation, where the site occupancy is uniform, the new model imposes a distance-dependent probability of site removal, where sites closer to the lattice center have a higher probability of being removed and are more prone to damage as compared to those at the periphery of the system. The variation in this removal probability is a function of the distance $\left(d\right)$ from the central point. Thus, the central point plays a key role. This is reflected in our effort to model the role of a tumor cell and its surroundings (the tumor microenvironment). The tumor causes a decrease in the concentration of key elements, such as ${\mathrm{O}}_2$ (resulting in hypoxia) and Ca, in the region close to it, which in turn is an impediment to the efficiency of radiotherapy and chemotherapy. This decrease is the largest in sites adjacent to the tumor and smaller away from the tumor. Such change in the concentrations of these elements is vital in the mechanism of cancer therapies. Starting from a fully occupied lattice, we introduce a distance-dependent removal probability $q\left(d\right)$. The value of $q\left(d\right)$ is 1 at and next to the tumor (center) and decreases linearly away from it to a limiting value $q_p$, which is the value of q at the lattice boundaries. We investigate the system properties as a function of $q_p$ and observe a significant decrease in the critical percolation threshold $p_c$ as $q_p$ decreases, falling from the standard value of $p_c=0.5927$ to approximately $p_c=0.20$. Furthermore, we demonstrate that the size of the spanning cluster and the total number of clusters exhibit a strong dependence on $q_p$ as well. Full article

Background/Objectives: The aim of our study was to evaluate the transverse stiffness of selected soft tissues in the knee joint region on the previously injured and uninjured sides of female handball players and non-athlete women, in the lying and standing positions, and to investigate the relationship between stiffness, age, sporting practice, and clinical assessments of the knees. Methods: A total of 25 young female handball players (the SPORT group) and 27 healthy non-athletic individuals (the CONTROL group) were examined. The MyotonPRO device was used to measure the stiffness of the patellar tendon (PT), rectus femoris (RF), and biceps femoris (BF) muscles on both sides and in both positions. The function of the knee joints was clinically assessed using the Knee Outcome Survey—Sports Activities Scale and the Lysholm Knee Scoring Scale. Results: ANOVA indicated a significant effect of group (p < 0.003) on the PT’s stiffness, and a significant effect of position (p < 0.0001) on the PT, RF, and BF muscle stiffness. The SPORT group demonstrated significantly higher PT transverse stiffness when lying down (p < 0.01), but not when sitting up (p > 0.05), compared to the CONTROL group. Significant negative correlations were found between PT stiffness and both clinical scales in the SPORT group (rho from −0.39 to −0.71, p < 0.05). Conclusions: In female handball players, only the patellar tendon transverse stiffness was higher than in the control group. While this higher stiffness could indicate an adaptive rebuilding process, it was negatively correlated with the clinical assessment of joint function, meaning poorer knee joint function. Full article

This study aimed to examine the association between physical activity and individuals’ health status, healthcare utilization, socio-demographic characteristics, and health behaviors in a large representative sample from Northern Greece. A cross-sectional study was conducted involving 1227 participants (47.4% males, mean age 49.94 ± 14.87 years) from Thrace, Greece, selected through a two-stage stratified sampling method. According to the Greek version of IPAQ, participants were classified as inactive/insufficiently active, sufficiently and highly active. Data on socio-demographic, lifestyle, and health-related variables were collected through structured interviews. Multivariate logistic regression analysis was performed to determine the independent effect of physical activity on subjects’ characteristics using SPSS ver. 19. Half of the participants (49.8%) were inactive/insufficiently active, 418 participants (34.1%) were sufficiently active, and 198 participants (16.1%) were highly active. In univariate analysis, smoking (p < 0.001), higher coffee consumption (p = 0.002), higher adherence to Mediterranean diet (p < 0.001), napping during the day (p = 0.017) and short sleep duration (p < 0.001) were associated with lower prevalence of high activity. In adjusted analyses, sufficiently active participants had a lower risk for bad self-rated health (aOR = 0.63), hypertension (aOR = 0.41), dyslipidemia (aOR = 0.42), diabetes (aOR = 0.53), obesity (aOR = 0.61), cardiovascular diseases (aOR = 0.43), anxiety (aOR = 0.65), depression (aOR = 0.56), daily sleepiness (aOR = 0.62), poor sleep quality (aOR = 0.71), as well as for primary (aOR = 0.54) and secondary (aOR = 0.40) healthcare utilization compared to inactive participants. Higher-intensity physical activity did not enhance these beneficial effects of sufficient activity on subjects’ characteristics. Physical inactivity significantly compromises health across multiple domains. Promoting even moderate-intensity physical activity may reduce chronic disease burden and healthcare utilization. Full article

Background: Adolescents in residential care frequently face functional challenges, yet few interventions integrate functional-cognitive models with motivational theories to support their daily function. Methods: This mixed-methods feasibility study is an innovative conceptual integration that links motivational and metacognitive approaches with growth-mindset principles to address both beliefs about the ability to change and functional performance. Quantitative data were collected from staff (n = 44), alumnae (n = 5), and current residents (n = 3), assessing mindset and functional-skill confidence among three focus groups (n = 16). The qualitative insights highlighted the motivational processes, strategy use, and barriers each group faced. Results: The findings informed the development of structured intervention psychoeducation protocol to facilitate goal-setting and reflective questioning. The feasibility and acceptability were tested by a pilot study among five staff members. Before implementation, staff demonstrated lower confidence in promoting daily autonomy and providing strategy-focused feedback. Alumnae and residents reported high emotional support, yet persistent gaps in functional independence. Conclusions: The pilot findings may inform the development of structured staff practices for delivering functional guidance, pending further evaluation. This study offers a novel conceptual contribution by positioning growth mindset as an active mechanism that supports functional-cognitive processes to enhance autonomy among adolescents in residential care settings. Full article

Background/Objectives: Meaningful social connections are critical for well-being in later life, yet older adults living with HIV frequently experience social isolation and loneliness, compounded by stigma, mental health conditions, and systemic inequities. This study aimed to explore how older adults living with HIV and a concurrent mental health diagnosis experience social isolation and cultivate meaningful relationships, situating these experiences within Social Convoy Theory. Methods: Using a Heideggerian phenomenological approach, we conducted in-depth, semi-structured interviews with 33 adults aged 50 and older in Ontario, Canada, who self-identified as living with HIV and a diagnosed mental health condition. Participants were recruited through community-engaged strategies and snowball sampling. Data were analyzed iteratively, combining descriptive and interpretive coding to identify patterns in social isolation, relational meaning, and the influence of intersecting social, structural, and health determinants. Results: Participants described social isolation as both a physical and existential experience, influenced by stigma, mental health challenges, and contextual factors such as urban versus rural settings. Meaningful relationships were characterized by authenticity, trust, emotional safety, and reciprocity, often formed within peer networks sharing similar lived experiences. Community engagement and virtual platforms facilitated connection, while rural or suburban environments often intensified isolation. Relationships providing validation, agency, and continuity of experience were particularly impactful on participants’ well-being. Conclusions: Social isolation among older adults living with HIV and mental health conditions extends beyond objective network measures to include emotional and identity-related dimensions. Interventions should prioritize affirming, context-sensitive spaces that support disclosure, trust, and reciprocal relationships, recognizing the nuanced needs of this population for both social and existential connectedness. Full article

Background/Objectives: Adolescents and young adults (AYAs) with cancer often begin their careers later in life and are at risk of negative work-related outcomes. Research into and tailored support programs for AYAs diagnosed during higher education remain limited. An improved understanding of AYAs’ experiences is essential in guiding the development of age-appropriate support programs. This study explored the impact of cancer and the challenges AYAs face in educational participation and the transition to work. Methods: A qualitative study was conducted with thirteen AYAs diagnosed with cancer during higher education. Participants were interviewed using a semi-structured guide. In collaboration with patient experts as co-researchers, data were analyzed via thematic analysis. Results: Eight analytically derived themes reflected AYA students’ experiences: (1) Meaning and importance of education, (2) Reduced performance, (3) Recovery and expectations, (4) Interruption and delay, (5) Transition to work, (6) Disclosure, (7) Challenges related to the context of students, and (8) Experienced lack of support. The themes were clustered into four overarching thematic categories: Meaningful participation, Impact on performance, Academic progress and career transition, and Challenges in navigation. Conclusions: Our findings provide greater insight into the significance of educational participation for AYAs. AYA students encounter challenges stemming from both diagnosis-related changes in functioning and from contextual factors tied to their roles as students and new starters in the labor market. Navigating the healthcare, education, and social systems is complex and AYAs often lack adequate support when resuming their education or transitioning to work. Tailored support programs in healthcare and educational settings should be developed to help AYAs harness their strong motivation to resume studies, enter the labor market, and achieve their full potential. Full article

Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week core-focused plank exercise program on fatigue and HRQoL in women with LC, using validated patient-reported measures. Materials and Methods: A pilot quasi-experimental design was implemented, with non-randomized group allocation. Thirty-nine women with LC were recruited from the Madrid Long COVID Association. Participants were assigned to either an intervention group (n = 20), which completed a supervised plank-based motor control program, or a control group (n = 19), which maintained usual activity. Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and HRQoL was measured using the EQ-5D-5L and EQ Visual Analog Scale (EQ-VAS). Body composition was evaluated via bioelectrical impedance analysis. Results: The intervention group showed significant reductions after intervention in the MFIS total scores compared to the control group, particularly in the physical (21.26 ± 6.76 vs. 25.21 ± 6.06; p < 0.001) and psychosocial domains (4.51 ± 0.41 vs. 5.21 ± 0.38; p < 0.001), without triggering PESE. EQ-VAS scores improved significantly (63.94 ± 15.33 vs. 46.31 ± 14.74; p = 0.034). No significant changes were found in body composition parameters, suggesting that benefits were driven by neuromuscular adaptations rather than morphological changes. Conclusions: A core-focused, non-aerobic exercise program effectively reduced fatigue and improved perceived health status in women with LC. These findings support the use of motor control-based interventions as a safe and feasible strategy for LC rehabilitation, particularly in populations vulnerable to PESE, suggesting clinical applicability for the rehabilitation of women with LC. Further randomized trials are warranted to confirm these results and explore long-term outcomes. Full article

Background: Children with ADHD and children with intellectual disability (ID) often have problems with daily time management (DTM). It is, however, less well-known how the underlying time-processing ability (TPA) may impact children’s DTM and autonomy. The purpose of this study was to investigate DTM, TPA, and self-rated autonomy in the activities of everyday life among children aged 9–15 years with and without disabilities. Methods: The participants were matched samples of children with ADHD (n = 47), with ID (n = 47), and typically developing (TD) children (n = 47). A descriptive, comparative, and cross-sectional design was used. Group comparisons with one-way analysis of variance (ANOVA), Tukey post-hoc tests, bootstrapping, and a cluster analysis were used to analyze the data. Results: Children with ADHD and children with ID had significantly lower TPA and DTM than TD children. Children with ADHD had even lower DTM than those with ID. Children with ADHD and ID have the same overall pattern of TPA, but it may be delayed, affecting their DTM and autonomy. However, there was considerable heterogeneity among the children with ADHD and ID, ranging from skilled to having significant problems in TPA. For all children, the levels of self-rated autonomy seemed to follow the level of TPA. Conclusions: Children with ADHD and children with ID have an increased risk of delayed TPA, affecting their DTM and autonomy, which may also influence their participation in daily activities. The results indicate a need to measure TPA and DTM to tailor interventions for each child. Full article

As the population ages, autonomous shuttles (AS) present a potential solution for older adults’ mobility needs. However, acceptance—often assessed through hypothetical scenarios rather than lived experience—remains a significant barrier. This study aimed to explore older adults’ perceptions of AS through pre- and post-exposure, and to examine how these experiences shape their AS acceptance within the Diffusion of Innovations (DOI) framework. Using existing qualitative data from pre- and post-exposure focus groups, with 32 older adults across Florida, we used hybrid thematic analysis, grounded in DOI theory. The results revealed that the technology’s ease of use, as experienced when riding the AS (Trialability), reduced initial concerns related to Complexity. While participants acknowledged the Relative Advantage of AS in enhancing their mobility and safety, their acceptance was conditional upon addressing the AS’s slow speed and abrupt braking. Acceptance was also contingent upon Compatibility with personal lifestyles and the establishment of clear AS Regulations, to build trust. The findings indicate that for older adults, AS acceptance is a dynamic process where direct exposure is essential for overcoming initial concerns. However, widespread adoption will ultimately be influenced by AS performance, seamless integration of AS into their daily lives, and a robust regulatory framework. Full article

Objective: To identify key predictors of clinical outcomes in burn survivors and clarify the role of mixed-depth burns and confounding by indication in observational rehabilitation research. Design: Retrospective cohort study using data from a burn rehabilitation registry (January 2024 to July 2025). Setting: Burn rehabilitation center. Participants: 120 adult patients (age ≥ 18 years) with burns affecting ≥1% total body surface area (TBSA) and complete baseline data. Interventions: Not applicable. Main Outcome Measures: Primary outcome was functional improvement (ΔFIM). Secondary outcomes included pain reduction (ΔPain), scar severity (Vancouver Scar Scale; VSS), Activities of Daily Living (ADL) improvement, and Range of Motion (ROM) recovery. Multivariable linear and logistic regression models were used to identify predictors. Results: Patients achieved significant improvements in function (mean ΔFIM = 11.3 ± 8.9 points) and pain (mean ΔPain = 1.28 ± 0.81). Having a mixed-depth burn was the strongest predictor of worse scar outcomes (β = 2.52, 95% CI: 0.93 to 4.12, p = 0.002) and failure to achieve full ROM (OR = 0.089, 95% CI: 0.008 to 0.930, p = 0.043). An apparent association between inpatient ward care and better scar outcomes (β = −1.30, p = 0.020) was determined to be an artifact of confounding by indication, as the outpatient group had a higher proportion of high-risk mixed-depth burns (6.2% vs. 3.5%). Longer therapy duration was the only significant predictor of achieving ADL goals (OR = 1.014, 95% CI: 1.002 to 1.026, p = 0.025). Conclusions: Injury characteristics, particularly the presence of a mixed-depth burn, emerged as the dominant predictors of long-term scar and functional outcomes. This study identifies mixed-depth burns as a potentially high-risk clinical phenotype requiring targeted therapeutic strategies and demonstrates the critical importance of accounting for confounding by indication when evaluating rehabilitation outcomes in observational burn research. Full article

Background: Acquired brain injury (ABI) affects manual dexterity (MD) and cognitive functions, limiting daily activity performance. Occupational therapy aims to improve functionality and quality of life. Objective: To examine and describe the available evidence on the impact of MD training on cognitive processes and functional performance in adults with stroke, as well as to identify the most commonly used assessment tools and intervention techniques. Methods: Scoping review. A systematic literature search was conducted in PubMed and Scopus to identify experimental studies from the last 10 years involving adults with ABI who participated in interventions targeting upper-limb, MD, and cognitive function. A three-phase screening was carried out by two authors with duplicates removed using Zotero version 7.0. Results: Ten articles published between 2016 and 2023 were included. The most frequent interventions involved robotics and virtual reality. Eight studies were conducted by occupational therapists or included occupational therapy involvement, while two were conducted by physiotherapists. Training MD and upper-limb motor skills led to improvements in attention, memory, and executive functions. Conclusions: Findings support combined motor–cognitive interventions carried out by occupational therapists or physiotherapists to optimize rehabilitation outcomes, although further research is needed to strengthen the evidence. Full article

Background/Objectives: Low back pain (LBP) is increasingly prevalent among children and adolescents and represents a growing public health concern due to its potential persistence into adulthood. Screen-based sedentary behavior has substantially increased in pediatric populations. However, evidence regarding its association with LBP remains inconsistent, and the existence of a dose–response relationship is not well established. Methods: A systematic review and meta-analysis of observational studies was conducted in accordance with PRISMA guidelines. Studies examining the association between screen-based sedentary behavior and LBP in children and adolescents aged 6–18 years were included. Random-effects meta-analyses were used to pool continuous exposure estimates, and a multivariate random-effects dose–response meta-analysis was performed to assess changes in LBP risk across increasing levels of daily screen time. Results: A total of 30 studies were included. The pairwise meta-analysis of continuous exposure showed no statistically significant association between screen time and LBP, with OR = 1.02 (95% CI 0.65 to 1.59). In contrast, the dose–response meta-analysis demonstrated a significant positive association, with a 26% (95% CI 8% to 48%) increase in the odds of LBP for each additional hour of daily screen time. High between-study heterogeneity was observed, and most studies relied on self-reported measures of screen exposure and LBP, which may have introduced recall and misclassification bias and warrants cautious interpretation of the findings. Conclusions: Higher levels of screen-based sedentary behavior were associated with an increased risk of LBP in children and adolescents when examined using a dose–response approach, whereas pairwise meta-analyses did not identify a significant association. Nevertheless, substantial between-study heterogeneity and high risk of bias limit causal inference and require cautious interpretation. Full article