Search Results (204)

Objectives: The primary objective was to investigate and compare the effects of three paired-pulse repetitive trans-spinal magnetic stimulation (PP-rTSMS) protocols on balance control and corticospinal network function. Methods: PP-rTSMS (800 pulses, frequency 100 Hz, intensity 70% of the resting motor threshold) was applied over the eighth thoracic vertebra (Th8) in twenty-seven young healthy individuals. Each proband received three verum sessions (using a verum coil with handle oriented (i) cranially, (ii) caudally, and (iii) laterally) and (iv) one sham session (using a sham coil) in a randomised order. Balance ability (Y Balance Test) and corticospinal network functions (motor evoked potentials (MEPs), cortical silent periods (SCPs)) were tested immediately (i) prior to and (ii) after each interventional session. Results: Each verum session induced a significant improvement in balance ability (cranially (F_1,26 = 8.009; p = 0.009; η² = 0.236), caudally (F_1,26 = 4.846; p = 0.037; η² = 0.157), and laterally (F_1,26 = 23,804; p ≤ 0.001; η² = 0.478) oriented grip) as compared to the sham session. In addition, the laterally oriented coil grip was associated with significantly greater balance benefits than both the cranial (F_1,26 = 10.173; p = 0.004; η² = 0.281) and caudal (F_1,26 = 14.058; p ≤ 0.001; η² = 0.351) grip orientations. No significant intervention-induced effects were detected on corticospinal network functions. Conclusions: Our data show that PP-rTSMS effectively supports balance control and that coil orientation significantly influences these effects. Further studies should test variations of this promising approach on healthy and disabled cohorts. Full article

Background/Objectives: Diabetic retinopathy is a leading cause of vision impairment worldwide, and the development of reliable automated classification systems is crucial for early diagnosis and clinical decision-making. This study presents a comprehensive comparative evaluation of two state-of-the-art deep learning families for the task of classifying diabetic retinopathy using retinal fundus images. Methods: The models were trained and tested in both binary and multi-class settings. The experimental design involved partitioning the data into training (70%), validation (20%), and testing (10%) sets. Model performance was assessed using standard metrics, including precision, sensitivity, specificity, F1-score, and the area under the receiver operating characteristic curve. Results: In binary classification, the ResNeXt101-64x4d model and RegNetY32GT model demonstrated outstanding performance, each achieving high sensitivity and precision. For multi-class classification, ResNeXt101-32x8d exhibited strong performance in early stages, while RegNetY16GT showed better balance across all stages, particularly in advanced diabetic retinopathy cases. To enhance transparency, SHapley Additive exPlanations were employed to visualize the pixel-level contributions for each model’s predictions. Conclusions: The findings suggest that while ResNeXt models are effective in detecting early signs, RegNet models offer more consistent performance in distinguishing between multiple stages of diabetic retinopathy severity. This dual approach combining quantitative evaluation and model interpretability supports the development of more robust and clinically trustworthy decision support systems for diabetic retinopathy screening. Full article

Background and Objectives: Although the use of allografts in revision anterior cruciate ligament reconstruction is associated with theoretical advantages, it has historically led to poorer clinical results and lower survival rates. However, the heterogeneity of the available literature makes it difficult to elucidate the effectiveness of allographs, as most of the studies published do not make any reference to some of the key aspects related to the processing of the allograft employed. The present study analyzed the clinical results and the survival of allografts in patients undergoing revision anterior cruciate ligament reconstruction with a well-characterized, single type of allograft. Materials and Methods: This was a retrospective observational study analyzing a series of patients undergoing revision anterior cruciate ligament reconstruction with an Achilles tendon allograft with a bone block (FlexiGraft, LifeNet Health), subjected to low-dose irradiation at dry ice temperatures. Preoperative and follow-up clinical variables (IKDC, pain, hop test, and YBT scores) were recorded. Survival was analyzed using the Kaplan–Meier methodology. Results: A total of 39 patients (34 male, 5 female) were included in the study. The mean patient age was 37.3 years and mean postoperative follow-up was 78.7 months. Forty-one percent of patients were competitive athletes, and all of the patients in the sample exhibited preoperative instability. The mean allograft thickness was 9.2 mm. During surgery, 51.3% of patients required meniscus repair and 20.5% had to be treated for chondral defects. At the last follow-up visit, 92.3% of the subjects presented with IKDC grade A and 7.7% with IKDC grade B. The mean subjective IKDC score was 0.79 and mean pain intensity was 1.15 according to the VAS scale. Limb symmetry, as measured by the various hop tests and the Y balance test, were within the safety range, with 74.4% of patients succeeding in returning to their previous level of sport. Ten-year survival was estimated at 97.4%. Conclusions: Allografts obtained and processed following the current regulations governing patient selection and graft harvesting, which are additionally processed without recourse to chemical procedures and sterilized at less than 2 MRad in dry ice conditions, represent an effective and safe alternative in revision anterior cruciate ligament reconstruction. Full article

This study investigated the effects of a single-night sleep extension protocol on physical performance and cognitive function in physically active university students across different times of day. Using a within-subjects, counterbalanced crossover design, 24 physically active university students (17 males, 7 females; age: 22.7 ± 1.6 years) completed performance assessments under normal-sleep and sleep-extension conditions. Participants’ sleep was monitored via wrist actigraphy, and a comprehensive assessment battery comprising vertical jumps, Y-Balance tests, medicine-ball throws, 5 m shuttle-run tests, reaction-time tests, and digit-cancellation tests was administered at baseline (8 PM), morning (8 AM), and afternoon (4 PM). Sleep extension increased total sleep time by approximately 55 min (531.3 ± 56.8 min vs. 476.5 ± 64.2 min; p < 0.001, d = 0.91). Significant improvements were observed in 5 m shuttle-run performance at 8 AM (best distance: 102.8 ± 11.9 m vs. 93.3 ± 8.5 m, p < 0.001, d = 0.93; fatigue index: 13.1 ± 8.3% vs. 21.2 ± 9.5%, p < 0.001, d = 0.90), squat-jump heights (28.2 ± 8.0 cm vs. 26.3 ± 7.2 cm, p = 0.005, d = 0.25), simple reaction time (252.8 ± 55.3 ms vs. 296.4 ± 75.2 ms, p < 0.001, d = 0.66), and digit-cancellation performance (67.6 ± 12.6 vs. 63.0 ± 10.0 targets, p = 0.006, d = 0.40). Sleep extension significantly enhances both physical and cognitive performance in physically active individuals, with effects more pronounced during morning hours, partially attenuating typical circadian performance decline and establishing sleep extension as an effective, non-pharmacological strategy for optimizing performance capabilities. Full article

Objectives: To identify cognitive domains predictive of dynamic balance performance in older adults and inform targeted cognitive-motor interventions aimed at improving balance and reducing fall risk. Methods: This cross-sectional study used hierarchical multiple regression to analyze relationships between cognitive domains and dynamic balance among 62 community-dwelling older adults (≥65 years). Balance was assessed using the Y Balance Test (YBT) and Timed Up and Go Test (TUG), while cognitive function was measured using the Mini-Mental State Examination (global cognition), Stroop Test (inhibition), N-back Test (working memory), and Deary–Liewald Reaction Time Test (processing speed). Statistical analyses were conducted using SPSS, version 28, with significance set at p < 0.05. Results: Although all cognitive domains correlated with dynamic balance, regression analyses indicated that only global cognition and inhibition were significant predictors. Specifically, global cognition significantly predicted both TUG and YBT performance, whereas inhibition uniquely predicted YBT performance (all p < 0.05). Conclusions: Our findings suggest global cognition and inhibition are key cognitive predictors of dynamic balance in older adults. Assessing these domains could identify individuals at risk of impaired balance, facilitating the design of targeted, personalized cognitive-motor interventions. Future research should investigate cognitively enriched exercise programs, including digital therapeutics and wearable technologies, to effectively target these cognitive domains, enhance balance outcomes, and promote sustained physical activity adherence in aging populations. Full article

Injury prevention and performance enhancement are key objectives in sports training. The FIFA 11+ program, originally developed to reduce injury risks, has gained attention for its potential benefits in improving physical performance and dynamic balance. This study aimed to examine the impact of an 8-week FIFA 11+ training program on vertical jump, Illinois Agility, and Y-Balance Test (YBT) performances in adult male handball players. Twenty-five players from two senior national male handball teams were recruited and randomly assigned to an experimental group (n = 13) or a control group (n = 11). Assessments were conducted before and after the intervention, including the countermovement jump (CMJ), the Illinois Agility Test (IAT), and the Y-Balance Test (YBT), which measured anterior (AT), posteromedial (PM), and posterolateral (PL) reach directions as well as a composite score (CS). The FIFA 11+ group showed significant improvements after the eight-week program, with increased CMJ (p = 0.013) and reduced IAT time (p < 0.001). Dynamic balance, as measured by the YBT, improved significantly in both lower limbs (p = 0.022–0.001), with enhanced postural stability across multiple directions (F = 6.92–20.23, p = 0.022–0.001, ηp² = 0.366–0.628, power = 0.68–0.98). In contrast, the control group exhibited minimal or no significant changes. While the results suggest that the FIFA 11+ program can improve specific performance outcomes in this population, the relatively small sample size and focus on a single sport and age group warrant caution in generalizing these findings. Further studies involving larger and more diverse cohorts are recommended. Full article

Background/Objectives: Dominant leg use in badminton may contribute to lower limb asymmetry, potentially affecting performance and injury risk. This study investigated the effects of a 12-week integrated neuromuscular training (NMT) program on sports performance. Methods: Twenty-four well-trained male badminton players (age: 13.5 ± 1.15 years) were randomly assigned to groups based on maturation status (pre-peak height velocity [pre-PHV] and post-peak height velocity [post-PHV]; n = 12 each). All participants completed two NMT sessions weekly. Pre- and post-training assessments included a 20 m sprint, countermovement jump (CMJ), agility t-text, hexagon test, and Y-balance test. Results: Both groups improved significantly across most tests. The post-PHV group (ES: 0.70–1.35) showed greater improvements in sprinting, CMJ, and agility, while the pre-PHV group (ES: 0.39–1.23) improved more in balance and asymmetry. Conclusions: These results underscore the need for age- and maturity-specific training strategies to optimize performance and address asymmetries in youth athletes. Full article

In volleyball, successful offensive performance is influenced not only by physical muscle function but also by injury status. The purpose of this study was to analyze the relationship between muscle function—including strength, balance, and symmetry—and injury history in relation to offensive performance (OP) and ultimately sought to find factors required to improve OP. The final analysis included 60 players in attacking positions (36 in the symmetry group and 24 in the asymmetry group). Muscle strength was assessed using isokinetic testing for shoulder and knee extension. Balance was evaluated using the Upper Quarter Y-Balance Test (UQ-YBT) and the Lower Quarter Y-Balance Test (LQ-YBT). The asymmetry index (AI, ≥10%) was calculated by comparing the dominant and non-dominant sides. The results showed that the asymmetry group had a higher injury rate and lower offensive performance (OP) than the symmetry group (p < 0.05). In multiple regression analysis, no significant predictors were found on the non-dominant side, whereas significant variables were identified only on the dominant side. The key variables influencing OP were shoulder and knee extension strength, UQ-YBT scores, and the AI of knee extension. A 13.8% improvement in shoulder extension strength on the dominant side increased the likelihood of enhanced offensive performance (OP) by 2.54 times. A 10.5% improvement in the asymmetry index (AI) of knee extension was associated with a 1.52-fold increase in OP (p < 0.05). Shoulder and knee flexion did not significantly affect OP in any of the tests (p > 0.05). In conclusion, offensive performance in volleyball is associated with the greater shoulder and knee extension strength of the dominant side, as well as positive changes in UQ-YBT scores and the AI of knee extension. Full article

Early detection of modifiable motor deficits is essential for safe, long-term athletic development, yet most field screens provide only binary risk scores. We therefore designed a practical and interpretable profiling system that classifies youth athletes into one of four functional categories—Functionally Weak, Strength-Deficient, Stability-Deficient, or No Clear Dysfunction—using three common assessments: Functional Movement Screen, hand-held dynamometry, and Y-Balance Test. A total of 46 youth athletes aged 11–16 years participated in the study, including 37 male soccer players (13.3 ± 1.6 y) in the development cohort and 9 handball players (5 male, 4 female; 12.8 ± 0.7 y) in the external validation group. Expert rules based on FMS quartiles and ≤−0.5 SD Z-scores for strength or balance generated the reference labels. The random forest model achieved 81% cross-validated accuracy (with balanced performance across classes) and 89% accuracy on the external handball group, exceeding the performance of the decision tree model. SHAP analysis confirmed that model predictions were driven by domain relevant variables rather than demographics. An accompanying web-based application automatically generates personalized reports, visualizations, and targeted training recommendations, making the system directly usable by coaches and clinicians. Rather than merely predicting injury, this field-ready framework delivers actionable, profile-based guidance to support informed decision making in athlete development. Further validation in larger, sport-diverse cohorts is needed to assess its generalizability and long-term value in practice. Full article

This study investigates occupant kinematic and injury responses in zero-gravity seats under rear impacts at 16 km/h, 40 km/h, and 56 km/h and evaluates the protective performance of a conventional three-point seat belt system and a four-point seat belt system. First, a THUMS (Total Human Model for Safety)-based finite element assembly consisting of a regular seat model and a conventional three-point seat belt system was verified by comparing the kinematic responses and time-history curves of head acceleration, head rotation, and the T1 acceleration of PMHS (Postmortem Human Subject) tests. Then, a THUMS-based finite element assembly in a zero-gravity seat with a three-point seat belt system was created, and computational biomechanical analyses revealed that at low-to-medium impact speeds (16 and 40 km/h), the occupant exhibited backward sliding in the zero-gravity seat along the seatback with lower limb rotation and did not experience head and neck injury. However, a 56 km/h impact induced an excessive seatback rotation and caused the head to become out of position. The neck collided with the upper part of the headrest and caused a surge in the contact force between the neck and the headrest. The head injury and neck injury were comprehensively analyzed via the head injury metrics and neck injury metrics, including cervical spine injury metrics and cervical ligament injury metrics. Further, a four-point seat belt system was adopted and demonstrated better and more balanced restraining effects by reducing the relative displacement between the occupant’s head and chest in the x- and y-directions by 26% and 84%, respectively. Therefore, the occupant’s head remains in position and the collision between the neck and the headrest can be avoided. Maximum reductions in the head and neck injury metrics reached 70% and 57%, respectively. The current study illustrates the disadvantages of the traditional three-point seat belt system in restraining the occupant in a zero-gravity seat under rear impact and shows the four-point seat belt to be a better alternative. This study sheds light on seat belt system design and optimization towards future zero-gravity seats under rear impact. Full article

Background: Participation in on-duty exercise is critical to enhance firefighter safety and readiness. However, these sessions are often interrupted with emergency responses and require firefighters to work in a fatigued state that may increase injury risk. Objective: To assess the impact of on-duty resistance training on neuromuscular function. Methods: A sample of 18 firefighters (Age: 38.8 ± 8.0 y; Body fat: 24.9 ± 7.0%) completed three testing sessions, separated by at least 72 h to compare the effects of circuit (CT) versus heavy resistance training (HRT) fatigue on neuromuscular function. During Session 1, anthropometrics and familiarization trials of balance and neuromuscular function were completed, which included single-leg drop landing (SLDL), postural sway (PS), and modified Functional Balance Test (mFBT). Sessions 2 and 3 were randomized, where participants completed either HRT or CT. Isometric midthigh pull (IMTP), long jump (LJ), and lower body power (LBP) tests were conducted pre- and immediately post exercise, whereas static and dynamic balance assessments were conducted pre- and 10 min post exercise to simulate an emergency response time course. Repeated measures ANOVA, effect sizes, and difference scores were used to analyze the effects of condition and time. The level of significance was set at p < 0.05. Results: CT decreased IMTP, LJ, and LBP, whereas HRT decreased LJ and LBP (p ≤ 0.001, ES ≥ 0.476). Despite several significant condition by time interaction effects on balance outcomes, there were no differences within CT or HRT over time (p ≥ 0.066). Conclusions: These findings suggest that on-duty resistance training reduces firefighters’ power and/or strength immediately post exercise but does not influence most firefighters’ balance 10 min post exercise. Thus, firefighters are recommended to perform resistance training on-duty during low emergency call volume times. Full article

Objective: Falciparum malaria is a major global health concern, affecting more than half of the world’s population and causing over half a million deaths annually. Red cell invasion is a crucial step in the parasite’s life cycle, where the parasite invade human erythrocytes to sustain infection and ensure survival. Two parasite proteins, Apical Membrane Antigen 1 (AMA-1) and Rhoptry Neck Protein 2 (RON2), are involved in tight junction formation, which is an essential step in parasite invasion of the red blood cell. Targeting the AMA-1 and RON2 interaction with inhibitors halts the formation of the tight junction, thereby preventing parasite invasion, which is detrimental to parasite survival. This study leverages machine learning (ML) to predict potential small molecule inhibitors of the AMA-1–RON2 interaction, providing putative antimalaria compounds for further chemotherapeutic exploration. Method: Data was retrieved from the PubChem database (AID 720542), comprising 364,447 inhibitors and non-inhibitors of the AMA-1–RON2 interaction. The data was processed by computing Morgan fingerprints and divided into training and testing with an 80:20 ratio, and the classes in the training data were balanced using the Synthetic Minority Oversampling Technique. Five ML models developed comprised Random Forest (RF), Gradient Boost Machines (GBMs), CatBoost (CB), AdaBoost (AB) and Support Vector Machine (SVM). The performances of the models were evaluated using accuracy, F1 score, and receiver operating characteristic—area under the curve (ROC-AUC) and validated using held-out data and a y-randomization test. An applicability domain analysis was carried out using the Tanimoto distance with a threshold set at 0.04 to ascertain the sample space where the models predict with confidence. Results: The GBMs model emerged as the best, achieving 89% accuracy and a ROC-AUC of 92%. CB and RF had accuracies of 88% and 87%, and ROC-AUC scores of 93% and 91%, respectively. Conclusions: Experimentally validated inhibitors of the AMA-1–RON2 interaction could serve as starting blocks for the next-generation antimalarial drugs. The models were deployed as a web-based application, known as PLASMOpred. Full article

Background: Great physical requirements are necessary to maintain the entire body in a streamlined and aerodynamic position during downhill skiing. Balance control has an important role in alpine skiing and depends on muscle endurance and strength. The central processing of proprioception and the force capacity of muscle are altered by fatigue. The objective of this study was to assess the effects of fatigue and visual input on balance control in alpine skiing. Methods: Eleven male professional skiers participated in the study. Balance control with eyes open and eyes closed was assessed before and after performing a maximal effort specific alpine ski test. Variables: the total travel distance (TTD) (mm), radial area (RA) (mm²), ratio between TTD and RA (TTD/RA) (1/mm), mean center of pressure (COP) velocity (total length of the COP path per unit time) (mm/s), the mean mediolateral (ML) COP oscillation velocity (Lat_Vel) (mm/s), the mean anteroposterior (AP) COP oscillation velocity (AP_Vel) (mm/s), mean ML (MLD) (mm) and mean AP (APD) (mm) displacements of the COP and the distance from the ordinate origin (mean X and mean Y) (theoretical point where the COP should be) to the point at which the COP is located, and heart rate were measured. Results: The results showed differences in the variables related to postural control and balance before and after the stress test (p = 0.002–0.037). However, no differences were found when the results obtained with open and closed eyes were compared. Conclusions: The results showed that performance in alpine skiing could be negatively affected by fatigue. However, the dynamic parameters are not decreased by visual input during muscle fatigue. Full article

Understanding the impact of irrigation levels on maize (Zea mays L.) nutritional properties is crucial for optimizing water use in sustainable agriculture. This study investigates the effects of three irrigation levels (I75: 75%, I100: 100%, and I125: 125% of depleted water from field capacity) on the biochemical composition, mineral content, and fatty acid profile of five maize cultivars’ grain. Biplot analysis was employed to identify superior irrigation levels and cultivars regarding nutritional traits and to visually interpret their interrelationships. The findings indicate that increased irrigation enhances oil, protein, ash, total starch, amylopectin, resistant starch, and non-resistant starch while reducing dietary fiber, phytic acid, and amylose levels. Mineral contents generally increased with irrigation, except for sulfur, which declined, and potassium, which peaked at I100 before decreasing. The fatty acid composition was largely cultivar-dependent, with no significant effect from irrigation. Among the tested irrigation levels, I100 was the most optimal, providing the best nutritional quality and mineral composition balance across the maize cultivars. Pioneer PR31Y43 and Syngenta Dracma cultivars stood out under limited irrigation conditions (I75), Pioneer PR31G98 and Tareks OSSK644 cultivars under optimum irrigation conditions (I100), and Syngenta Inove and Tareks OSSK644 cultivars under over-irrigation conditions (I125). These results highlight the necessity of cultivar-specific irrigation strategies to maximize maize nutritional quality and resource efficiency. Full article

This study aimed to investigate the effect of the FIFA 11+ program on knee instability and motor performance in male youth soccer players. Thirty male youth soccer players were divided into two groups: the experimental group (FIFA+) performed the FIFA 11+ program for 10 weeks, while the control group followed their usual warm-up routine. Dynamic knee valgus (DKV) and squat depth were assessed using a Microsoft Azure Kinect camera and dynaknee software. Maximal isometric muscle force was measured with a dynamometer. The Y Balance test was used to evaluate dynamic balance, while a countermovement jump test assessed lower limb power. The knee range of motion was measured with a goniometer, and the t-test was used to evaluate agility. After the intervention, the FIFA+ group showed a significant decrease in DKV and squat depth (p < 0.05), while the control group showed no significant changes (p > 0.05). Both groups improved in motor performance, with slight progress noted in the FIFA+ group. However, neither group demonstrated significant improvement in dynamic balance (p > 0.05). While the FIFA 11+ program may not substantially enhance overall motor performance or match the effectiveness of other training regimens, it shows potential for addressing biomechanical deficiencies and reducing the risk of injuries, particularly those related to dynamic knee valgus. Full article