Search Results (9,710)

This study examines the diversity of terminologies associated with assistive technology (AT), a crucial field that promotes autonomy and inclusion for people with disabilities. Although the wide use of assistive technology is observed in the literature, a variety of terms are often used interchangeably, which hinders research, technological development, and the formulation of public policies. In this sense, this systematic review aimed to identify, categorise, and analyse the diversity of terms used to describe AT in the scientific literature, contributing to greater conceptual clarity and supporting structured and interdisciplinary development in the field. A comprehensive search was conducted in July 2024 across the Scopus, Web of Science, and PubMed databases, covering publications from 1989 to 2024. Eligible studies were peer-reviewed journal articles in English that conceptually defined at least one AT-related term. The selection process followed the PRISMA 2020 guidelines and included studies from Q1 and Q2 journals to ensure academic rigour. A total of 117 studies were included out of 11,941 initial records. Sixteen distinct terms were identified and grouped into five clusters based on semantic and functional similarities: Cluster 1—Technologies for assistance and inclusion. Cluster 2—Functional assistive devices. Cluster 3—Assistive interaction interfaces. Cluster 4—Assistive environmental technologies. Cluster 5—Assistive systems. A complementary meta-analysis revealed geographic and temporal trends, indicating that terms such as “assistive technology” and “assistive device” are globally dominant. In contrast, others, like “enabling technology,” are more context-specific and emerging. The findings contribute theoretically by providing a structured framework for understanding AT terminology and practically by supporting the design of public policy and interdisciplinary communication. Full article

Introduction: With the emergence of the expert patient and the expansion of health literacy, the importance of planning and building health technologies aimed at teaching and training health professionals, especially nurses, due to their activities with patients in Primary Health Care, with the aim of meeting the real and constant demands of the expert patient, is evident. Methods: Methodological study with a quantitative approach. The course was constructed based on a scope review, scientific reference, and observational visits during the months of September 2021 and August 2022. For validation, an organized electronic form was used with general information about the research and items of the course constructed for later evaluation by the judges with the three-point Likert scale and with the application of the Delphi Technique between the months of September and October 2022; for the agreement of the judges, the Content Validation Coefficient > 0.8 was considered. Results: Based on the content selected in the scope review, the reference contribution, and the observational visits, the course was constructed. Nine judges participated in the validation stage in Delphi I with a total Content Validation Coefficient above 0.90 and with some suggestions for modifications and improvements pointed out by them. In Delphi II, six judges evaluated the course, resulting in a total Content Validation Coefficient of 0.99. Conclusions: The course developed was considered valid to support the training of Primary Health Care nurses in the formation of the expert patient, with a view to promoting patient autonomy in self-care management, optimizing Primary Health Care, and reducing unnecessary hospital admissions. Full article

Background/Objectives: Iron deficiency without anemia (IDWA) is common among female patients with chronic kidney disease (CKD), yet the clinical implications of iron therapy in this population remain uncertain. While iron supplementation is frequently used in anemic CKD patients, evidence regarding its outcomes in non-anemic, iron-deficient individuals is limited and conflicting. Methods: This retrospective cohort study utilized the multi-institutional TriNetX database to examine the 5-year outcomes of iron therapy in adult women with stage 3 CKD, normal hemoglobin (≥12 g/dL), normal mean corpuscular volume (MCV), and low serum ferritin (<100 ng/mL). Primary outcomes included all-cause mortality, major adverse cardiovascular events (MACE), acute kidney injury (AKI), pneumonia, progression to advanced CKD (estimated glomerular filtration rate ≤30 mL/min/1.73 m²), and gastrointestinal (GI) bleeding. Results: We identified 53,769 eligible non-anemic patients with stage 3 CKD, low serum ferritin levels, and normal MCV. Propensity score matching (1:1) was conducted on demographic variables to compare iron-treated (n = 6638) and untreated (n = 6638) cohorts. Over the 5-year follow-up, iron therapy in non-anemic females with stage 3 CKD, low ferritin levels, and iron supplementation was significantly associated with increased risks of MACE, AKI, pneumonia, CKD progression, and GI bleeding (log-rank p < 0.0001). No significant difference in all-cause mortality was observed. Data on transferrin saturation and the dosage of iron supplementation were unavailable. Conclusions: In non-anemic women with stage 3 CKD and low ferritin levels, iron supplementation was linked to increased MACE, renal, and pneumonia risks without evident survival benefits. These findings suggest that iron therapy in this group of patients may not confer cardiovascular benefit and may pose risks. Full article

The representation and assessment of static liquefaction in mine tailings is a significant challenge due to the severe environmental and social damage it can cause. This phenomenon, known for its catastrophic nature, is triggered when the undrained shear strength is exceeded by a static loading stress. In this study, the constitutive models HSS and NS were evaluated to calibrate the experimental curves from an isotropically consolidated undrained (CIU) triaxial test on a low-plasticity silt derived from mine tailings. An axisymmetric model was developed in Plaxis 2D for calibration, followed by a sensitivity analysis of the parameters of both constitutive models, using the RMSE to validate their accuracy. The results indicate that the proposed methodology adequately simulates the experimental curves, achieving an RMSE of 8%. After calibration, a numerical model was implemented to evaluate the propagation of the PFS of a mine tailings storage facility using both models, in terms of excess pore pressures, shear strains, and p’-q diagrams at three control points. The results show that both models are capable of representing the PFS; however, the HSS model reproduces the experimental curves more accurately, establishing itself as an ideal tool for simulating undrained behavior and, consequently, the phenomenon of static liquefaction in mine tailings. Full article

The Lidia cattle breed is featured in several traditional popular bullfighting festivals throughout Spain, including the “Toro de Cuerda” event, in which the animals are subjected to intense physical exercise. However, the physiological impact and welfare implications of these activities remain poorly characterized. This study aimed to evaluate the stress response and muscle damage in Lidia breed bulls during roping bull celebrations through comprehensive blood analysis. Blood samples were collected from 53 adult male Lidia bulls before and after a standardized 45 min continuous running exercise during traditional roping bull events in four Spanish autonomous regions. Hematological parameters, muscle enzymes (creatine kinase, lactate dehydrogenase, lactate), and stress hormones (cortisol and ACTH) were analyzed. Significant increases (p < 0.05) were observed in leukocytes, lymphocytes, monocytes, eosinophils, neutrophils, erythrocytes, hematocrit, hemoglobin, and post-exercise platelets. Muscle enzymes showed marked elevations, with creatine kinase increasing up to 10-fold above baseline values. Stress hormones, cortisol and ACTH, also demonstrated significant increases. Despite the magnitude of these changes, all parameters remained within established reference ranges for the bovine species. This study provides the first physiological assessment of Lidia cattle during popular bullfighting celebrations, establishing baseline data for evidence-based welfare evaluation and management protocols. Full article

Constipation is a prevalent gastrointestinal disorder that significantly impairs quality of life. While pharmacological agents such as loperamide are widely used to induce constipation in experimental models, there is increasing interest in natural alternatives for alleviating intestinal dysfunction. In this study, we investigated the laxative effects of soybean powder fermented by Bacillus subtilis DKU_09 in a loperamide-induced rat model of constipation. The probiotic strain was isolated from cheonggukjang, a traditional Korean fermented soybean paste, and its identity was confirmed through 16S rRNA sequencing. Fermented soybean powder was characterized morphologically via scanning electron microscopy and chemically via HPLC to assess its isoflavone content. Rats were administered loperamide (5 mg/kg) for four days to induce constipation and were then treated with fermented soybean powder at doses of 100, 200, or 300 mg/kg. No pharmacological laxatives (e.g., PEG) were used as a positive control; instead, values from the treatment groups were compared with those from the loperamide-only constipation group. Key outcomes of fecal output, water content, colonic fecal retention, and gastrointestinal transit ratio were measured. The fermented product significantly improved stool frequency and moisture content, reduced colonic fecal retention, and restored gastrointestinal transit in a dose-dependent manner. Notably, the 300 mg/kg group demonstrated nearly complete recovery of fecal parameters without affecting body weight. Statistical analysis was performed using one-way ANOVA followed by Tukey’s post hoc test. These findings suggest that Bacillus subtilis-fermented soybean powder exerts synergistic laxative effects through the combined action of probiotic viability and fermentation-enhanced bioactive compounds such as aglycone isoflavones. This study supports the potential use of fermented soybean-based nutraceuticals as a natural and safe intervention for constipation and gastrointestinal dysregulation. Full article

Understanding how energy use and economic activity shape carbon emissions is pivotal for achieving global climate targets. This study quantifies the dynamic nexus between disaggregated energy consumption, economic growth, and CO₂ emissions in India and China—two economies that together account for more than one-third of global emissions. Using annual data from 1990 to 2021, we implement Long Short-Term Memory (LSTM) neural networks, which outperform traditional linear models in capturing nonlinearities and lagged effects. The dataset is split into training (1990–2013) and testing (2014–2021) intervals to ensure rigorous out-of-sample validation. Results reveal stark national differences. For India, coal, natural gas consumption, and economic growth are the strongest positive drivers of emissions, whereas renewable energy exerts a significant mitigating effect, and nuclear energy is negligible. In China, emissions are dominated by coal and petroleum use and by economic growth, while renewable and nuclear sources show weak, inconsistent impacts. We recommend retrofitting India’s coal- and gas-plants with carbon capture and storage, doubling clean-tech subsidies, and tripling annual solar-plus-storage auctions to displace fossil baseload. For China, priorities include ultra-supercritical upgrades with carbon capture, utilisation, and storage, green-bond-financed solar–wind buildouts, grid-scale storage deployments, and hydrogen-electric freight corridors. These data-driven pathways simultaneously cut flagship emitters, decouple GDP from carbon, provide replicable models for global net-zero research, and advance climate-resilient economic growth worldwide. Full article

The emergence and spread of HIV drug resistance mutations (DRMs) pose a threat to current and future treatment options. To inform policy, this review aimed to determine the magnitude and patterns of DRMs in patients on ART in Tanzania. A systematic literature search was conducted in MEDLINE through PubMed, Embase, and CINAHL up to December 2024. A total of 9685 HIV patients from 23 eligible studies were analyzed. The prevalence of virological failure in studies that used a threshold of >1000 and >400 copies/mL was 24.83% (95% CI: 17.85–32.53%) and 36.94% (95% CI: 24.79–50.00%), respectively. Major DRMs were observed at 87.61% (95% CI: 76.25–95.91%). A decrease in prevalence was observed in studies conducted from 2019, with a pooled prevalence of 62.15% (95% CI: 31.57–88.33%). The most frequently observed HIV-1 subtypes were subtype C at 36.20% (95% CI: 30.71–41.85%), A1 at 33.13% (95% CI: 28.23–38.20%), and subtype D at 16.00% (95% CI: 11.41–21.12%), while recombinant forms of the virus were observed at 13.29% (95% CI: 9.79–17.17%). The prevalence of DRMs against NRTIs and NNRTIs was significantly high, while that against INSTIs and PIs was low, supporting the continued use of PI- and INSTI-based regimens in Tanzania and the need for continued surveillance of DRMs. Full article

This study aims to investigate asymmetries in muscle activation and co-contraction of main lower limb muscles during flamenco Zap-3 footwork with consideration of the footwork speed and dancer proficiency. Twelve flamenco dancers participated, including six professionals and six amateurs. Each participant performed the Zap-3 sequence under three speed conditions: 160 beats per minute (bpm), 180 bpm and the fastest speed level (F). The normalized surface electromyography was recorded in the gastrocnemius medialis (GM), biceps femoris (BF), tibialis anterior (TA) and rectus femoris (RF) in the dominant (DL) and non-dominant leg (NDL). The co-contraction index was also calculated for selected muscle pairs. The results showed that significant asymmetries occurred only in professional dancers and exclusively at the F speed level. Specifically, the value of the GM in the NDL was higher than that of the DL (p < 0.05, d = 1.97); the value of the BF in the DL was higher than that of the NDL (p < 0.05, d = 1.86) and the co-contraction index of BF/RF in the DL was higher than that of the NDL (p < 0.05, d = 1.87). Understanding these asymmetries may help to inform individualized training strategies aimed at optimizing performance and reducing potential risks. Full article

Background: Peritoneal metastases (PM) represent a common and challenging manifestation of several gastrointestinal and gynecologic malignancies. Bidirectional treatment—combining Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC) with systemic chemotherapy—has emerged as a strategy to enhance locoregional control while maintaining systemic coverage. Objective: This systematic review aimed to analyze the study design, characteristics, and timing of the treatments administered—including the type of systemic chemotherapy, intraperitoneal agents used in PIPAC, and interval between administrations—as well as the clinical outcomes, safety profile, and overall methodological quality of the available literature on bidirectional treatment for peritoneal metastases. Methods: A systematic literature search was conducted across the PubMed, Embase, and Cochrane Library databases up to April 2025. Studies were included if they reported clinical outcomes of patients undergoing bidirectional treatment. Data extraction focused on survival, response assessment (PRGS, PCI), adverse events, systemic and intraperitoneal regimens, treatment interval, and study methodology. Results: A total of 22 studies involving 1015 patients (742 treated with bidirectional therapy) were included. Median overall survival ranged from 2.8 to 19.6 months, with the most favorable outcomes observed in gastric and colorectal cancer cohorts. PRGS improvement after multiple PIPAC cycles was reported in >80% of evaluable cases. High-grade adverse events (CTCAE ≥ 3) occurred in up to 17% of patients in most studies, with only one study reporting treatment-related mortality. However, methodological quality was generally moderate, with considerable heterogeneity in treatment protocols, response criteria, systemic regimens, and toxicity attribution. Conclusions: Bidirectional therapy with PIPAC and systemic chemotherapy appears to be a feasible and potentially effective strategy for selected patients with peritoneal metastases. Despite encouraging outcomes, definitive conclusions are limited by the retrospective nature and heterogeneity of available studies. Prospective standardized trials are needed to confirm efficacy, clarify patient selection, and optimize treatment protocols. Full article

This article aims to analyze the role of migration in the process of the third demographic transition (TDT) in the context of key mediating determinants, such as migrants’ religiosity and economic conditions in the countries of origin and settlement. TDT refers to population changes resulting from migration as a demographic compensatory mechanism in countries with a low total fertility rate (TFR). The study is based on a network analysis of keywords in the scientific literature using the Scopus database and VOSviewer. The results point to three main research approaches to TDT—investigating quantitative population changes, the sociodemographic consequences of migration, and its effect on urbanization—and to the fact that economic and axionormative determinants are under-researched. This article contributes to TDT theory, pointing to the need for that theory to include cultural, economic, and axiological factors as key determinants influencing the permanence of TDT. Full article

Background: Coronavirus disease 2019 (COVID-19) has led to the expansion of the spectrum of invasive fungal infections beyond traditional immunocompromised populations. Although COVID-19-associated pulmonary aspergillosis is increasingly being recognised, COVID-19-associated mucormycosis remains rare, particularly in non-endemic regions. Concurrent COVID-19-associated invasive tracheobronchial aspergillosis and pulmonary mucormycosis with histopathological confirmation is exceedingly uncommon and poses significant diagnostic and therapeutic challenges. Case presentation: We report the case of a 57-year-old female with myelodysplastic syndrome who underwent haploidentical allogeneic haematopoietic stem cell transplantation. During post-transplant recovery, she developed COVID-19 pneumonia, complicated by respiratory deterioration and radiological findings, including a reverse halo sign. Bronchoscopy revealed multiple whitish plaques in the right main bronchus. Despite negative serum and bronchoalveolar lavage fluid galactomannan assay results, cytopathological examination revealed septate hyphae and Aspergillus fumigatus was subsequently identified. Given the patient’s risk factors and clinical features, liposomal amphotericin B therapy was initiated. Subsequent surgical resection and histopathological analysis confirmed the presence of Rhizopus microsporus. Following antifungal therapy and surgical intervention, the patient recovered and was discharged in stable condition. Conclusions: This case highlights the critical need for heightened clinical suspicion of combined invasive fungal infections in severely immunocompromised patients with COVID-19, even in non-endemic regions for mucormycosis. Early tissue-based diagnostic interventions and prompt initiation of optimal antifungal therapy are essential for obtaining ideal outcomes when co-infection is suspected. Full article

This article explores how Japanese anime has become a space of theological imagination, where viewers encounter the divine not as fixed dogma but as a lived process. Through symbolic analysis of five spiritually resonant anime series: Puella Magi Madoka Magica, To Your Eternity, Sunday Without God, Code Geass, and The Promised Neverland, the study examines how characters such as Madoka, Fushi, Ai, Lelouch, Emma, and Mujika embody a form of theosis that unfolds through memory, sacrifice, refusal, and care. Rather than representing God as omnipotent or remote, these narratives invite a vision of the divine as vulnerable, suffering, and becoming, emerging through grief, relationships, and transformations. Drawing on theological and philosophical frameworks, especially process theology and symbolic interpretation, the article argues that anime collapses the traditional boundaries between theology and philosophy by embodying both in story. In these narrative worlds, divinity is not merely represented, it is approached, co-created, and remembered. The sacred is not a theory to master, but an encounter to undergo. Anime, thus, does not offer theology as a system but rather theology as a journey: a reenchanted vision of the world where God is still becoming. Full article

Aging is a complex physiological process that profoundly affects the functionality of the musculoskeletal system, contributing to an increase in the incidence of diseases such as osteoporosis, osteoarthritis, and sarcopenia. Cellular senescence plays a crucial role in these degenerative processes, promoting chronic inflammation and tissue dysfunction through the senescence-associated secretory phenotype (SASP). Recently, senotherapeutics have shown promising results in improving musculoskeletal health. Natural compounds such as resveratrol, rapamycin, quercetin, curcumin, vitamin E, genistein, fisetin, and epicatechin act on key signaling pathways, offering protective effects against musculoskeletal decline. On the other hand, molecules such as dasatinib, navitoclax, UBX0101, panobinostat, and metformin have been shown to be effective in eliminating or modulating senescent cells. However, understanding the mechanisms of action, long-term safety, and bioavailability remain areas for further investigation. In this context, physical exercise emerges as an effective non-pharmacological countermeasure, capable of directly modulating cellular senescence and promoting tissue regeneration, representing an integrated strategy to combat age-related diseases. Therefore, we have provided an overview of the main anti-aging compounds and examined the potential of physical exercise as a strategy in the management of age-related musculoskeletal disorders. Further studies should focus on identifying synergistic combinations of pharmacological and non-pharmacological interventions to optimize the effectiveness of anti-aging strategies and promoting healthier musculoskeletal aging. Full article

Fat embolism is a critical medical emergency often resulting from long bone fractures or amputations, leading to acute respiratory distress syndrome (ARDS). The NOD-like receptor pyrin domain-containing 3 (NLRP3) inflammasome, a key regulator of innate immunity, is activated by reactive oxygen species and tissue damage, contributing to inflammatory responses. This study examines the role of NLRP3 in fat embolism-induced ARDS and evaluates the therapeutic potential of MCC950, a selective NLRP3 antagonist. Fat embolism was induced by fatty micelle injection into the tail vein of Sprague Dawley rats. Pulmonary injury was assessed through lung weight gain as an edema indicator, NLRP3 expression via Western blot, and IL-1β levels using ELISA. Histological damage and macrophage infiltration were evaluated with hematoxylin and eosin staining. Fat embolism significantly increased pulmonary NLRP3 expression, lipid peroxidation, IL-1β release, and macrophage infiltration within four hours, accompanied by severe pulmonary edema. NLRP3 was localized in type I alveolar cells, co-localizing with aquaporin 5. Administration of MCC950 significantly reduced inflammatory responses, lipid peroxidation, pulmonary edema, and histological damage, while attenuating MAPK cascade phosphorylation of ERK and Raf. These findings suggest that NLRP3 plays a critical role in fat embolism-induced acute respiratory distress syndrome, and its inhibition by MCC950 may offer a promising therapeutic approach. Full article