Search Results (381)

Background: Sensorimotor differences have frequently been reported in children with developmental dyslexia, but are often considered secondary or comorbid to phonological deficits. Within an embodied cognition perspective, reading acquisition emerges from dynamic interactions between bodily regulation, multisensory integration, and learning-related neural plasticity. Proprioception contributes to spatial orientation, motor coordination, and perceptual stabilization, while sleep-dependent processes play a critical role in the consolidation and automatization of cognitive and motor skills. Objectives: Building on early clinical observations, including the hypothesis proposed by Martins da Cunha, this review explores whether variations in proprioceptive processing and sensorimotor regulation may influence multisensory stability and the conditions under which reading skills develop in some individuals with dyslexia. Methods: This narrative synthesis integrates clinical observations and experimental paradigms examining proprioceptive function in children with dyslexia, including studies conducted in our laboratory over the past two decades. These investigations address postural regulation under varying attentional demands, laboratory measures of proprioceptive acuity, visuospatial localization tasks, multisensory interactions, and exploratory observations concerning sleep–wake regulation. Results: Across studies, children with dyslexia often show differences in proprioceptive processing associated with variations in postural regulation, visuospatial stability, and multisensory tasks. Laboratory measurements suggest reduced proprioceptive acuity in some individuals, with moderate correlations observed between proprioceptive sensitivity and reading-related measures. Additional observations suggest that nocturnal physiological regulation—including respiratory dynamics and sleep architecture—may interact with daytime sensorimotor stability and attentional functioning. Conclusions: Taken together, these findings support the hypothesis that variations in sensorimotor regulation across the sleep–wake cycle may influence the stability of multisensory processing and attentional conditions relevant for reading acquisition. Within this perspective, proprioception is not proposed as an alternative explanation for dyslexia but as a complementary dimension that may contribute to the heterogeneity of dyslexic profiles. Further longitudinal and controlled studies are required to clarify the relationships between sensorimotor regulation, sleep-dependent plasticity, and learning processes. Full article

Background: Childhood hypertension is an important predictor of adult cardiovascular disease. Idiopathic erythrocytosis in adolescent males is characterized by elevated hemoglobin and hematocrit levels, which may increase blood viscosity and potentially influence blood pressure (BP) regulation. However, the relationships between erythrocytosis, renal tubular–glomerular function, and systemic hypertension in adolescents remain unclear. Methods: This prospective observational case–control study was conducted between October of 2023 and April of 2024, including 37 male adolescents with idiopathic erythrocytosis and 24 age-matched healthy male controls. Complete blood count parameters were confirmed using two samples obtained at separate time points. Biochemical, urinalysis, tubular phosphorus reabsorption, and fractional excretion of sodium tests were performed to assess renal tubular and glomerular function, and 24 h ambulatory blood pressure monitoring (ABPM) was performed in all participants and interpreted according to the 2022 American Heart Association recommendations. Results: The mean systolic and diastolic BP values measured via ABPM did not differ significantly between the groups. However, adolescents with idiopathic erythrocytosis demonstrated significantly higher systolic and diastolic BP load values during 24 h, daytime, and nighttime periods when compared with healthy controls (p < 0.05). Renal tubular and glomerular function parameters were similar between groups. Hematocrit levels showed significant correlations with multiple ABPM load parameters. In the multivariable linear regression analysis, hematocrit remained independently associated with 24 h systolic BP load after adjustment for age, BMI, and serum creatinine. Conclusions: Adolescent males with idiopathic erythrocytosis exhibited increased ambulatory BP load despite similar mean BP values to controls. Elevated hematocrit may contribute to early alterations in BP regulation in adolescents with idiopathic erythrocytosis. Full article

Background/Objectives: While the number and severity of comorbidities affecting survivors of craniopharyngioma (CP) are well documented, little is known about the perspectives of caregivers and survivors regarding treatment priorities. This study aimed to describe the views of caregivers and self-reported survivors on the comorbidities that most significantly impact CP survivors and to identify areas where new treatments are most needed. Methods: Completed surveys of 161 participants recruited in the hypothalamic–pituitary brain tumor patient registry were analyzed. Results: Participants represented 40% caregivers (mostly children) and 60% adult CP survivors, with notable differences in disease duration, age, CP onset, and living conditions. Seventeen health challenges were identified as most important by more than 50% of participants, including symptoms characteristic of hypothalamic dysfunction, neurological issues, and visual impairment. Notably, those differed from the most frequently experienced symptoms. No significant differences emerged between the two groups except for polydipsia, which had a greater impact on self-reported survivors. Most challenges primarily affected the survivors’ daily functioning; however, abnormal social behaviors equally impaired their ability to achieve long-term goals. Temperature dysregulation was the only symptom not deemed very or extremely important in prioritizing new treatment development. Both groups generally aligned on treatment priorities, though survivors placed a modest but significantly greater importance on fatigue and excessive daytime sleepiness, while caregivers placed a modest but significantly greater importance on obesity. Conclusions: Real-world survivor and caregiver perspectives on priority symptoms and treatments can inform care management, strengthen support strategies, and guide patient-focused drug development meaningful to CP survivors. Full article

Background: Sexual dysfunction (SD) and sleep disturbances are frequent but underrecognized non-motor symptoms in Parkinson’s disease (PD) and significantly affect quality of life. However, the relationships among sexual dysfunction, sleep quality, and excessive daytime sleepiness (EDS) and the possible sex-related differences remain insufficiently investigated. Methods: In this cross-sectional case–control study, we evaluated these non-motor symptoms in 147 Turkish patients with PD and 160 age- and sex-matched healthy controls, and we assessed their associations and impact on quality of life, with particular attention to sex-specific patterns. Sexual function was assessed using the Arizona Sexual Experiences Scale (ASEX), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), daytime sleepiness using the Epworth Sleepiness Scale (ESS), quality of life using the 39-item Parkinson’s Disease Questionnaire (PDQ-39), and disease severity using the Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr (H&Y) staging scale. Group comparisons, correlation analyses, and sex-stratified subgroup analyses were performed. Results: Patients with PD had significantly higher ASEX, PSQI, and ESS scores compared with controls (p < 0.01), and women with PD had significantly higher total ASEX scores than men, indicating greater sexual dysfunction. Sexual dysfunction was significantly associated with poor sleep quality and excessive daytime sleepiness but showed no significant association with the motor severity measures (UPDRS, H&Y stage). Sleep quality, as measured via PSQI scores, was worse in patients with PD, and poor sleep quality and excessive daytime sleepiness were both associated with significantly worse quality of life. Conclusions: According to our findings, sexual dysfunction and sleep disturbances are interrelated non-motor symptoms that significantly impair quality of life, largely independently of motor severity, and these associations were particularly pronounced among women. A combined evaluation of sleep and sexual function may therefore improve the recognition and management of the non-motor burden in PD. Full article

Wind is a primary driver of nonuniform water application in traveling gun sprinklers, yet design guidance often treats wind only as speed. This study quantifies how diurnal wind regimes (day vs. night) and wind incidence relative to the towpath (φ) affect application-rate patterns and the Christiansen uniformity coefficient (UC) as a function of towpath spacing expressed as a fraction of wetted diameter (WD). Class-specific sprinkler patterns were generated with the Simulation Model for Sprinkler Irrigation (SIA) and combined with local daytime and nighttime wind-frequency data to build composite application-rate fields; these drove traveler simulations that computed cross-track depth, lateral overlap across spacings, and UC for representative wind speeds (0–6 m s⁻¹) and φ (0°, 45°, 90°). Nighttime operation yielded higher UC, with a day–night crossover near ~50% WD and an average UC gain of ~9.5 percentage points; typical gains were +6 to +9 points between 55% and 90% WD. Wind incidence was as influential as speed: at 65.6% WD, increasing wind from 0 to 6 m s⁻¹ reduced UC from 84.4% to 28.6% for φ = 0°, to 52.0% for 45°, and to 76.1% for 90°. Findings support nighttime scheduling, towpaths avoiding wind-parallel operation, and tighter spacings under windy conditions. Full article

Plants respond to ultraviolet B radiation (280–320 nm) with an integrated reaction that includes the reception of the acting stress factor, followed by the generation of reactive oxygen species and damage to macromolecules and membrane structures, as well as changes in cellular metabolism and the formation of protective systems. However, the involvement of key UV-B–related signalling components such as HY5, SPA1 and BIC1 or BIC2 proteins in physiological, biochemical and molecular responses remains insufficiently understood. The effects of 8, 16 and 24 h of UV-B exposure (within an 8 h photoperiod over three days) on the net photosynthetic rate (Pn), chlorophyll fluorescence parameters Y(II) and F_v/F_m, reflecting the functional state of PSII, nonphotochemical quenching (NPQ), pigment contents (Chl(a+b), carotenoids, anthocyanins and UV-absorbing pigments (UAPs) and the expression of key light-induced genes in wild-type Arabidopsis thaliana and spa1, bic1,2 and hy5 mutants were studied. UV-B irradiation resulted in a gradual reduction in the Pn, Y(II), F_v/F_m values and Chl(a+b) but caused a marked increase in the anthocyanin and UAP contents and only minor changes in the carotenoid content. The hy5 mutant presented the lowest net photosynthetic rate (Pn), chlorophyll fluorescence parameters, and chlorophyll and carotenoid contents under all the UV-B exposures. In addition, the accumulation of anthocyanins and UAPs during UV-B treatment was consistently the lowest in hy5. After any UV-B exposure, the highest accumulation of UAPs and anthocyanins was observed in the spa1 mutant, whereas the highest Pn values were detected after 24 h in bic1,2. One of the reasons for the reduced photosynthetic activity and antioxidant capacity in hy5 may be the lower expression levels of CHS and PAL in this variety than in the other genotypes. Our results indicate that HY5 is required to maintain antioxidant responses and photosynthetic performance under repeated daytime UV-B exposure (16.8 kJ m⁻² per day). In contrast, BIC1, BIC2, and SPA1 also contribute to UV-B tolerance, but through distinct regulatory mechanisms and to a lesser extent. Full article

Background and Clinical Significance: Posterior urethral valves are rare congenital anomalies characterized by persistent urethral mucosal folds and causing varying degrees of obstruction. The increasing use of prenatal ultrasound has contributed to the early diagnosis of posterior urethral valves (PUV), a condition associated with a severe prognosis, as approximately one-fifth of affected patients develop chronic kidney disease. Early diagnosis and intervention—namely, valve ablation—provide obstruction alleviation and renal function preservation. Therefore, it is uncommon for patients to be diagnosed in adolescence or adulthood, when patients usually present with frequency, voiding dysfunction, daytime incontinence, enuresis, recurrent urinary tract infections, and renal insufficiency. Case Presentation: We present a 14-year-old adolescent with recurrent urinary tract infections. A thorough medical history, clinical examination, and standard imaging revealed bilateral vesicoureteral reflux and posterior urethral valves. The patient underwent urethrocystoscopy for diagnostic and therapeutic purposes and posterior urethral valve ablation. Despite these interventions, the persistence of his symptoms necessitated endoscopic correction of the vesicoureteral reflux and circumcision. During the 2-year follow-up, the patient remained asymptomatic. Conclusions: Symptomatic adolescent boys should undergo a standard urinary evaluation to identify undiagnosed congenital urinary tract diseases and maintain renal and bladder function. Full article

Urban wetlands on the Qinghai–Tibetan Plateau are increasingly recognized as potentially important components of city-scale carbon budgets; however, their CO₂ flux dynamics and associated environmental drivers remain insufficiently quantified, particularly under high-altitude urban conditions. In this study, we addressed this knowledge gap by conducting continuous eddy covariance observations at Haihu Wetland Park in Xining City, China. Carbon fluxes were monitored throughout 2023 using the Huangshui Park Station flux tower. We quantified the temporal dynamics of gross primary productivity (GPP), ecosystem respiration (Re), and net ecosystem exchange (NEE), and systematically assessed their responses to key environmental drivers across multiple temporal scales. GPP and Re exhibited unimodal seasonal patterns, with substantially higher values during the growing season. NEE showed pronounced diel cycling, with nighttime CO₂ release and daytime uptake, and shifted seasonally between net source and net sink states. At the daily scale (n = 365), Pearson correlations showed that air temperature (T_a), 5 cm soil temperature (T_s5) and volumetric soil water content (SWC) exhibited the strongest associations with the flux components, whereas photosynthetic photon flux density (PPFD) showed moderate associations and precipitation was weak. At the monthly scale (n = 12), Mantel tests further highlighted a dominant thermal control on GPP and Re (T_a and T_s5), whereas precipitation showed additional associations with Re and NEE. Overall, the ecosystem acted as a net CO₂ sink in 2023 (annual NEE = −292.25 g C m⁻² yr⁻¹ under our sign convention), with uptake concentrated in the first eight months of the year. Under the combined effects of multiple environmental factors, plateau urban wetlands functioned as a strong carbon sink, and the results of this study provide a data basis for improving the accuracy of carbon budget estimates for this type of ecosystem. Full article

Early adolescence is a critical developmental period marked by emotional, behavioral, and biological changes. The COVID-19 pandemic disrupted adolescents’ daily routines, potentially producing lasting effects on mental and physical health. This study investigated anxiety and depressive symptoms, risk of extreme social withdrawal, use of technological devices, physical activity, and sleep–wake functioning in 276 early adolescents (54% females; Mage = 12.28, SD = 0.81) living in a forested and geographically isolated area of Emilia-Romagna in Italy. Participants completed validated self-report questionnaires assessing internalizing symptoms, use of technological devices (including problematic online gaming and smartphone use), gaming motivations, physical activity, chronotype, sleep disturbances, and daytime sleepiness. Scores on the anxiety and depressive symptom scales were within the normative range, except for scores on certain scales suggesting a moderate degree of severity that was not clinically significant. Females reported higher levels of anxiety, depressive symptoms, and problematic smartphone use, whereas males showed greater involvement in problematic online gaming and stronger achievement-, social-, and immersion-related motives. A substantial proportion of participants reported excessive daytime sleepiness (42.4% of females; 26.1% of males). Significant patterns of association were found among internalizing symptoms, domains of sleep–wake functioning, use of technological devices, and risk of extreme social withdrawal. Overall, these findings support the relevance of predisposing preventive strategies aimed at improving different domains of physical and mental health among youth in underserved or geographically isolated communities. Full article

Obstructive sleep apnea (OSA) is a highly prevalent sleep-related breathing disorder associated with significant cardiometabolic morbidity, impaired neurocognitive functioning, daytime sleepiness, and reduced quality of life. Although continuous positive airway pressure (CPAP) therapy remains the cornerstone of treatment for moderate-to-severe OSA, long-term adherence is frequently suboptimal, and a substantial proportion of patients experience residual symptoms despite adequate therapy. These limitations have driven increasing interest in non-CPAP treatment strategies and, more recently, in pharmacological approaches tailored to specific OSA pathophysiological mechanisms. This narrative review provides an updated overview of non-CPAP therapies for OSA, including oral appliances, surgical interventions, positional therapy, hypoglossal nerve stimulation, and behavioral strategies, with a particular focus on emerging and established pharmacological treatment and their role in endotype/phenotype-guided management of OSA. Overall, the expanding pharmacological landscape of OSA reflects a paradigm shift toward personalized, multimodal management. Integrating non-CPAP and pharmacological therapies with patient-specific pathophysiology may improve symptom control, adherence, and long-term outcomes in OSA. Full article

The Ice, Cloud, and Land Elevation Satellite-2 (ICESat-2), equipped with the Advanced Topographic Laser Altimeter System (ATLAS), is capable of acquiring large-scale terrain and forest structural information through photon-counting LiDAR. However, photon point clouds exhibit significant noise variability due to diurnal changes and variations in beam intensity, which undermines the accuracy and stability of terrain and canopy height retrievals in forested regions. To address the limited adaptability of existing methods under daytime/nighttime and strong/weak beam conditions, this study proposes a multi-stage processing framework integrating photon denoising, classification, and quasi-full-waveform reconstruction. First, local statistical features combined with adaptive parameter optimization were employed, applying Gaussian and exponential fitting to denoise daytime strong and weak beams and enhance the signal-to-noise ratio (SNR). Subsequently, an improved random sample consensus (RANSAC) algorithm was introduced to remove residual noise and classify photons under both diurnal and beam-intensity variations. Finally, a radial basis function (RBF) interpolation was used to reconstruct quasi-full-waveform curves for terrain and canopy heights. Compared with the ATL08 product (terrain root mean square error (RMSE): 2.65 m for daytime strong beams and 5.77 m for daytime weak beams), the proposed method reduced RMSE by 0.53 m and 1.30 m, respectively, demonstrating enhanced stability and robustness under low-SNR conditions. For canopy height estimation, all beam types showed high consistency with airborne LiDAR measurements, with the highest correlation achieved for nighttime strong beams (R = 0.90), accompanied by the lowest RMSE (4.82 m) and mean absolute error (MAE = 2.97 m). In comparison, ATL08 canopy height errors for nighttime strong beams were higher (RMSE = 5.67 m; MAE = 4.16 m). Notably, significant improvements were observed for weak beams relative to ATL08. These results indicate that the proposed framework effectively denoises and classifies photon point clouds under diverse daytime/nighttime and strong/weak beam conditions, providing a robust methodological reference for high-precision terrain and forest canopy height estimation in forested regions. Full article

Background/Objectives: Cognitive impairment and sleep disturbances are highly prevalent in individuals with multiple sclerosis (MS), particularly during middle age, and negatively affect functional independence and quality of life. Although physical exercise has demonstrated cognitive and sleep-related benefits in MS, tolerance to high-intensity training is often limited. Blood flow restriction (BFR) training, which combines low-load resistance exercise with partial vascular occlusion, has emerged as a feasible alternative. This study aimed to evaluate the effects of a 12-week BFR training program on performance in specific cognitive domains and sleep quality in middle-aged adults with MS. Methods: A randomized controlled trial was conducted in 65 adults with relapsing–remitting multiple sclerosis (RRMS) aged 40–65 years and an Expanded Disability Status Scale score below 7. Participants were randomly assigned to a BFR training group or a usual-care control group. The intervention consisted of supervised low-load resistance training with BFR performed twice weekly for 12 weeks. Outcomes assessed before and after the intervention included processing speed (Symbol Digit Modalities Test), executive function (Trail Making Test A and B), verbal fluency (Isaacs Set Test), and self-reported sleep quality (Pittsburgh Sleep Quality Index). Results: Compared with controls, participants in the BFR group showed significant improvements in specific cognitive domains, including processing speed, executive function, and verbal fluency. Significant reductions were also observed in self-reported global sleep disturbance and daytime dysfunction. No adverse events were reported. Conclusions: A 12-week BFR training program improved performance in key cognitive domains and self-reported sleep quality in middle-aged adults with MS, supporting its feasibility and potential clinical relevance as an exercise-based intervention. Full article

Existing studies on urban public space vitality predominantly focus on single temporal scales or macro-urban levels, lacking a systematic understanding of day–night and weekday–weekend differentiation patterns at the meso-scale. This study examines 149 public spaces in the Yuexiu District, Guangzhou, employing Baidu heatmap data and the geographically weighted random forest (GWRF) model to analyze built environment impacts across four temporal scenarios. The SHAP interaction analysis is incorporated to quantitatively evaluate factor interdependencies and their temporal variations. Findings reveal significant spatiotemporal heterogeneity. Building density shows greater night-time importance while residential density exhibits enhanced daytime importance, particularly on weekend. Weekday–weekend comparison demonstrates contrasting spatial reorganization patterns, with weekday showing divergence and weekend showing convergence in factor importance distributions. The factor interaction analysis highlights stable synergistic relationships between density and diversity, alongside temporal transitions in density–residential density interactions from competitive to synergistic during night-time. Low-vitality public spaces are concentrated in peripheral areas with high building density but insufficient commercial facilities and functional mix. These findings deepen our understanding of the spatiotemporal mechanisms underlying public space vitality generation and the interaction effects among built environment factors, thereby providing an empirical foundation for the formulation of temporally adaptive planning strategies. Full article

Introduction: The metabolic complications and poor biocompatibility of conventional glucose-based (GLU) peritoneal dialysis fluid (PDF) have driven the need for improved alternatives. To address this, we developed and evaluated a novel PDF utilizing succinylated gelatin (GEL) as osmotic agent and citrate as buffer, designed to provide effective solute clearance while offering enhanced biocompatibility. Methods: Physicochemical parameters (pH and osmolality) of the novel GEL-PDF were measured. Its performance was assessed in rats with chronic kidney disease. A total of 20 rats were randomized into short-term experiments to evaluate 4 h creatinine clearance and ultrafiltration (UF). A 12-week long-term experiment (n = 35) compared the GEL-PDF against normal saline (NS), GLU, and icodextrin-based (ICO) PDFs, monitoring survival, biochemical parameters, peritoneal membrane histology, and kidney histology. Results: The GEL-PDF demonstrated a neutral pH (7.30) and lower osmolality (317 mOsm/L) compared to GLU-PDF. In the short-term experiment, GEL-PDF achieved effective creatinine clearance by 4 h and provided higher 4 h UF than NS and GLU, comparable to ICO. However, during prolonged dwells (6–16 h), its UF was inferior to ICO. In the long-term experiment, GEL-PDF preserved peritoneal membrane structure, showing the least thickness and collagen deposition. Furthermore, the GEL-PDF demonstrated superior preservation of serum albumin compared to the GLU-PDF. It also exhibited a more favorable lipid profile, as evidenced by significantly lower total cholesterol levels than the ICO group at 12 weeks (p = 0.035), with no adverse effects on electrolytes, liver function, or glucose metabolism. Conclusions: The novel GEL and citrate-based PDF provide effective short-dwell UF and solute removal while exhibiting superior biocompatibility, as evidenced by significant protection against peritoneal membrane injury and favorable metabolic profiles. Although its long-duration UF was lower than that of ICO, it substantially outperformed GLU-PDF. These properties position the GEL-PDF as a promising candidate for short- to medium-dwell exchanges, particularly for daytime use, where it could fill an important clinical gap by providing enhanced UF without the high GLU exposure associated with conventional PDF. Full article

Physical activity (PA) and quality sleep are essential for cognitive health, providing synergistic protection against age-related cognitive decline. However, the shared molecular pathways that explain their combined and interactive benefits remain poorly understood. This review suggests that lactate, long dismissed as a metabolic waste product, is a unifying mechanism. We introduce the “Lactate Nexus”, a conceptual framework that proposes lactate functions as a key signalling molecule, mechanistically linking the pro-cognitive effects of both daytime exercise and nighttime sleep. We begin by outlining lactate’s evolving role—from an energy substrate shuttled from astrocytes to neurons (the Astrocyte–Neuron Lactate Shuttle) to a pleiotropic signal. As a signal, lactate influences neuroplasticity via NMDA receptors, neuroinflammation via the HCAR1 receptor, and gene expression through the epigenetic modification of histone lactylation. We then compile evidence demonstrating how PA provides a substantial lactate signal that activates these pathways and primes the brain’s metabolic infrastructure. Crucially, we integrate this with proof that lactate levels naturally increase during slow-wave sleep to support memory consolidation and glymphatic clearance. The “Lactate Nexus” framework offers a comprehensive molecular explanation for the synergy between PA and sleep, positioning lactate as a key signalling mediator and a promising biomarker and therapeutic target for fostering lifelong cognitive resilience. Full article