Search Results (1,168)

Background/Objectives: Multifactorial prevention of falls in persons with dementia has minimal or non-significant effects. Personalised prevention is recommended. We have previously shown that gait speed, basic activities of daily living (ADL), and depression (high Cornell scores) were independent predictors of falls in persons with mild and moderate cognitive impairment. This study explored person-specific risks of falls related to physical, mental, and cognitive functions and types of dementia: Alzheimer’s disease (AD), vascular dementia (VD), mixed Alzheimer’s disease/vascular dementia (MixADVD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB). Methods: The study used data from “The Norwegian Registry of Persons Assessed for Cognitive Symptoms” (NorCog). Differences between the dementia groups and predictors of falls, gait speed, ADL, and Cornell scores were analysed. Results: Among study participants, 537/1321 (40.7%) reported a fall in the past year, with significant variations between dementia diagnoses. Fall incidence increased with age, comorbidity/polypharmacy, depression, and MAYO fluctuation score and with reduced physical activity, gait speed, and ADL. Persons with VD and MixADVD had high fall incidences and impaired gait speed and ADL. Training of physical fitness, endurance, muscular strength, coordination, and balance and optimising treatment of comorbidities and medication enhance gait speed. Improving ADL necessitates, in addition, relief of cognitive impairment and fluctuations. Relief of depression and fluctuations by psychological and pharmacological interventions is necessary to reduce the high fall risk in persons with DLB. Conclusions: The fall incidence and fall predictors varied significantly. Personalised interventions presuppose knowledge of each individual’s fall risk factors. Full article

Long-range underwater gliders (LRUGs) have emerged as essential platforms for sustained and autonomous observation in deep and remote marine environments. This paper provides a comprehensive review of their developmental status, performance characteristics, and application progress. Emphasis is placed on two critical enabling technologies that fundamentally determine endurance: lightweight, pressure-resistant hull structures and high-efficiency buoyancy-driven propulsion systems. First, the role of carbon fiber composite pressure hulls in enhancing energy capacity and structural integrity is examined, with attention to material selection, fabrication methods, compressibility compatibility, and antifouling resistance. Second, the evolution of buoyancy control systems is analyzed, covering the transition to hybrid active–passive architectures, rapid-response actuators based on smart materials, thermohaline energy harvesting, and energy recovery mechanisms. Based on this analysis, the paper identifies four key technical challenges and proposes strategic research directions, including the development of ultralight, high-strength structural materials; integrated multi-mechanism antifouling technologies; energy-optimized coordinated buoyancy systems; and thermally adaptive glider platforms. Achieving a system architecture with ultra-long endurance, enhanced energy efficiency, and robust environmental adaptability is anticipated to be a foundational enabler for future long-duration missions and globally distributed underwater glider networks. Full article

Background: The progression of Alzheimer’s Disease (AD) deeply affects not only the diagnosed person but also their close relatives, who are often called to take on the role of informal caregivers. This transition is frequently unplanned and emotionally complex, yet poorly understood in its deeper processual dimensions. This study aims to explore and theorize the transition experienced by a family member becoming the primary informal caregiver for a person with advanced AD. Methods: A qualitative study based on the Constructivist Grounded Theory according to Charmaz’s approach (2006) was conducted. In-depth interviews were carried out with 10 participants who had become informal caregivers for a loved one with advanced AD. Data were analyzed using initial coding, focused coding, the constant comparative method, and theoretical coding. Results: Ten caregivers (mean age 39 years, range 35–54; nine females) of patients with advanced AD participated in the study. The analysis revealed a complex, emotionally intense caregiving experience marked by sacrifice, feelings of powerlessness, identity loss, and the necessity of sharing caregiving responsibilities. A core category emerged: A Silent and Certain Willingness to Care, representing the caregivers’ deep, often unconscious commitment to prioritize the care of their loved ones above their own needs. Four interconnected phases characterized the caregiving process: (1) The Changing Daily Life—involving significant sacrifices in personal and social life; (2) Feeling Powerless—confronting the inevitable decline without means to alter the course; (3) Losing Oneself—experiencing physical and psychological exhaustion and a sense of identity loss; and (4) Sharing with Others—seeking external support to sustain caregiving. These findings highlight the evolving nature of becoming a caregiver and the enduring dedication that sustains this role despite the challenges. Conclusions: The progression of AD deeply transforms the lives of caregivers, who become co-sufferers and active participants in the disease’s management. The results underscore the urgency of designing integrative care strategies—including psychological, social, and potentially technological support—that can enhance both patient outcomes and caregiver resilience. Grounded in real-world experiences, this study contributes to the broader neurodegeneration discourse by emphasizing caregiving as a critical factor in long-term disease management and therapeutic success. Full article

Background/Objectives: Physical activity is a cornerstone of diabetes mellitus (DM) management and is strongly recommended in the American Diabetes Association (ADA)’s guidelines. This study aims to investigate the self-reported physical activity levels of individuals with DM in Germany, as well as the barriers and facilitators they encounter. Methods: Individuals with type 1 DM (T1DM) and type 2 DM (T2DM) were asked to fill out an online questionnaire that was partly based on the International Physical Activity Questionnaire (IPAQ). Results: The questionnaire was completed by 338 persons with either T1DM (57.1%) or T2DM (42.9%) (females: 56.2%, males: 42.0%, gender diverse persons: 1.8%) of all age groups (at least 18 years). In total, 80.5% of respondents were aware of the current physical activity recommendations. Among the respondents, 58% reported meeting the recommendations for endurance-type physical activity, while only 30.5% reported meeting those for strength training. The three most frequently cited barriers to physical activity were lack of time, lack of motivation and current state of health. Supporting factors included coverage of costs, availability of exercise programs in close proximity to the patient’s home and target group specific exercise programs. Conclusions: The results imply that many individuals with DM in Germany do not meet ADA’s physical activity recommendations, especially considering that self-reports often overestimate actual behavior. In particular, the actual number of individuals who regularly engage in strength training may be too low. There is a clear need to better communicate the benefits of different forms of physical training and to provide physical activity programs aligned with patients’ individual needs. Full article

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, the most common enzymatic disorder, affects over 500 million people worldwide and is often linked to exercise intolerance due to oxidative stress, but its true impact on physical performance remains unclear. This study aimed to evaluate the physiological and metabolic effects of G6PD deficiency on endurance capacity. Using humanized mice carrying the African G6PD variant [V68M; N126D] (hG6PD_A−), we show that despite reduced pentose phosphate pathway activity, these mice exhibit a 10.8% increase in treadmill critical speed (CS)—suggesting enhanced endurance capacity. Multi-omics profiling across red blood cells, plasma, skeletal muscle, spleen, kidney, and liver reveals metabolic adaptations, including elevated glycolysis, fatty acid oxidation, and increased mitochondrial activity, alongside heightened oxidative phosphorylation in muscle and accelerated red blood cell turnover in the spleen and liver. These findings indicate that systemic metabolic reprogramming may offset antioxidant deficiencies, potentially conferring a performance advantage. Given that G6PD deficiency affects up to 13% of African Americans and is associated with cardiovascular health disparities, our results challenge conventional exercise restrictions and highlight the need for personalized exercise guidelines for affected individuals. Full article

Background/Objectives: Urinary incontinence (UI), defined as the involuntary loss of urine, is common among female athletes. As more women engage in competitive sports, numerous studies have explored UI in young, nulliparous, and physically active women. The objectives of this study were (i) to analyze the prevalence, severity, and characteristics of UI in professional nulliparous female soccer players and (ii) to compare the status of the pelvic floor muscles (PFMs) between professional soccer players and physically active young women. Methods: This descriptive cross-sectional study included professional soccer players (n = 18) and physically active women (n = 14). UI was assessed using the ICIQ-SF questionnaire, and PFM function was evaluated through intracavitary examination using the PERFECT method. Additional data were collected on body composition and on urinary, bowel, and sexual health. Results: UI affected 35.7% of physically active women and 50% of professional soccer players. Stress urinary incontinence (SUI) was the most common type, present in 100% of affected soccer players and 60% of affected active women. The severity of UI was mostly mild, with no significant differences between groups. PFM assessment revealed deficiencies in control, relaxation, endurance, and rapid contractions, as well as difficulties performing an effective perineal locking (PL) maneuver during increased intra-abdominal pressure. Conclusions: These findings highlight the need for targeted programs focused on strengthening and educating athletes about their PFMs, aiming to prevent UI and improve both performance and quality of life. The study reinforces the importance of preventive strategies for pelvic floor health in sports. Full article

Memristors with resistive switching capabilities are vital for information storage and brain-inspired computing, making them a key focus in current research. This study demonstrates non-volatile analog resistive switching behavior in Al/TiO_x/TiN/Si(n⁺⁺)/Al memristive devices. Analog resistive switching offers gradual, controllable conductance changes, which are essential for mimicking brain-like synaptic behavior, unlike digital/abrupt switching. The amorphous titanium oxide (TiO_x) active layer was deposited using the pulsed-DC reactive magnetron sputtering technique. The impact of increasing the oxide thickness on the electrical performance of the memristors was investigated. Electrical characterizations revealed stable, forming-free analog resistive switching, achieving endurance beyond 300 DC cycles. The charge conduction mechanisms underlying the current–voltage (I–V) characteristics are analyzed in detail, revealing the presence of ohmic behavior, Schottky emission, and space-charge-limited conduction (SCLC). Experimental results indicate that increasing the TiO_x film thickness from 31 to 44 nm leads to a notable change in the current conduction mechanism. The results confirm that the memristors have good stability (>1500 s) and are capable of exhibiting excellent long-term potentiation (LTP) and long-term depression (LTD) properties. The analog switching driven by oxygen vacancy-induced barrier modulation in the TiO_x/TiN interface is explained in detail, supported by a proposed model. The remarkable switching characteristics exhibited by the TiO_x-based memristive devices make them highly suitable for artificial synapse applications in neuromorphic computing systems. Full article

During hypersonic flight, the air rudder shaft can undergo huge aerodynamic heating load, where it is necessary to design the thermal protection system of the air rudder shaft. Aiming to prevent the rudder shaft from thermal failure due to the heat endurance limit of materials, numerical investigations are conducted systemically to predict the active cooling performance of the rudder shaft with liquid water considering phase change. The validation of the numerical simulation method considering phase-change heat transfer is further investigated by experiments. The effect of coolant injection flow velocity on the active cooling performance is further analyzed for both the steady state and transient state. Finally, to achieve better cooling performance, an optimized design of the cooling channels is performed in this work. The results of the transient numerical simulation show that, employing the initial cooling structures, it may undergo the heat transfer deterioration phenomenon under the coolant injection velocity below 0.2 m/s. For the rudder shaft with an optimized structure, the heat transfer deterioration can be significantly reduced, which significantly reduces the risk of thermal failure. Moreover, the total pressure drop of the optimized rudder shaft under the same coolant injection condition can be reduced by about 19% compared with the initial structure. This study provides a valuable contribution to the thermal protection performance for the rudder shaft, as a key component of aircraft under the aero heating process. Full article

The expansion of global maritime activities threatens marine ecosystems and biodiversity. Collisions between ships and marine megafauna profoundly impact vulnerable species such as whales, who serve as keystone predators. However, the specific regions most heavily affected by shipping traffic and the multi-species facing collision risk remain poorly understood. Here, we analyzed global shipping data to assess the distribution of areas with high shipping pressure and identify global hotspots for whale–ship collisions. The results reveal that high-pressure habitats are primarily distributed within exclusive economic zones (EEZs), which are generally consistent with the distribution of collision hotspots. High-pressure habitats exhibit significant spatial mismatch: 32.9% of Marine Protected Areas endure high shipping stress and yet occupy merely 1.25% of protected ocean area. Additionally, 25.1% of collision hotspots (top 1% risk) affect four or more whale species, forming critical aggregation in regions like the Gulf of St. Lawrence and Northeast Asian marginal seas. Most of these high-risk areas lack protective measures. These findings offer actionable spatial priorities for implementing targeted conservation strategies, such as the introduction of mandatory speed restrictions and dynamic vessel routing in high-risk, multi-species hotspots. By focusing on critical aggregation areas, these strategies will help mitigate whale mortality and enhance marine biodiversity protection, supporting the sustainable coexistence of maritime activities with vulnerable marine megafauna. Full article

The Stability Toolkit for the Appraisal of Bio/Pharmaceuticals’ Level of Endurance (STABLE) is introduced and proposed as a comprehensive tool and software to evaluate the stability of active pharmaceutical ingredients (APIs) under various stress conditions. In the pharmaceutical industry, stability testing is a critical step in the drug development process, ensuring the quality, safety, and efficacy of APIs. Traditional stability tests—such as real-time, accelerated, and forced degradation testing—often face challenges, including inconsistent interpretation and implementation across different regions and organizations. STABLE addresses these challenges by providing a standardized and holistic approach to assessing drug stability across five key stress conditions: oxidative, thermal, acid-catalyzed hydrolysis, base-catalyzed hydrolysis, and photostability. Beyond its role as an evaluation tool, STABLE also serves as a practical guide for chemists, encouraging a more complete and thoughtful approach to stability studies. While many investigations focus solely on acid- and base-catalyzed hydrolysis, other critical conditions—such as photostability—are often underexplored or entirely omitted. By highlighting the importance of evaluating all relevant degradation pathways, STABLE promotes more robust and informed stability testing protocols. The index utilizes a color-coded scoring system to quantify and compare stability, facilitating consistent assessments across different APIs. This paper discusses the methodology of STABLE, including the scoring system and specific criteria applied under each condition. This tool is introduced to reflect intrinsic degradation susceptibility under forced conditions. The software is freely available as an open-source tool at bit.ly/STABLE2025, enabling broader accessibility and implementation across the pharmaceutical research community. Full article

Objectives: Shoulder injury prevalence appears to be the highest among all injuries in CrossFit (CF) athletes. Nevertheless, there is no evidence deriving from prospective studies to explain this phenomenon. The purpose of this study was to document shoulder injury incidence in CF participants over a 12-month period and prospectively investigate the risk factors associated with their demographic, epidemiological, and functional characteristics. Methods: The sample comprised 109 CF athletes in various levels. Participants’ data were collected during the baseline assessment, using a specially designed questionnaire, as well as active range of motion, muscle strength, muscle endurance, and sport-specific tests. Non-parametric statistical tests and inferential statistics were employed, and in addition, linear and regression models were created. Logistic regression models incorporating the study’s continuous predictors to classify injury occurrence in CF athletes were developed and evaluated using the Area Under the ROC Curve (AUC) as the performance metric. Results: A shoulder injury incidence rate of 0.79 per 1000 training hours was recorded. Olympic weightlifting (45%) and gymnastics (35%) exercises were associated with shoulder injury occurrence. The most frequent injury concerned rotator cuff tendons (45%), including lesions and tendinopathies, exhibiting various severity levels. None of the examined variables individually showed a statistically significant correlation with shoulder injuries. Conclusions: This is the first study that has investigated prospectively shoulder injuries in CrossFit, creating a realistic profile of these athletes. Despite the broad spectrum of collected data, the traditional statistical approach failed to identify shoulder injury predictors. This indicates the necessity to explore this topic using more sophisticated techniques, such as advanced machine learning approaches. Full article

Whether pattern or amount of daily activity determines neuromuscular properties is the focus of this review. The fast-to-slow conversion of many properties of fast-twitch muscles, by stimulating their nerves electrically with the continuous low-frequency pattern typical of slow motoneurons, argued that muscle properties are determined by their pattern of activity. However, the composition of the motor units (MUs) in almost all muscles is heterogeneous, with the MUs grouped into slow, fast-fatigue-resistant and fast-fatigable types that match corresponding histochemical fiber types. Nonetheless, their contractile forces lie on a continuum, with MUs recruited into activity in order of their size. This ‘size principle’ of MU organization and function applies in normally innervated and reinnervated muscles and, importantly, begs the question of whether it is the amount rather than the pattern of the MU activation that determines their properties. Experimental evidence that uniform daily amounts of ~<0.5, 5%, and 50% ES, converted motoneuron, nerve, and muscle properties to one physiological and histochemical type, argued in favor of the amount of activity determining MU properties. Yet, that the properties were not confined to the expected narrow range argued that factors other than the pattern and/or amount of neuromuscular activity must be considered. These include the progressive increase in the synaptic inputs onto motoneurons. The range of the effects of endurance and intermittent exercise programs on healthy subjects and those suffering nerve injuries and disease is also consistent with the argument that factors other than pattern or amount of neuromuscular activity should be investigated. Full article

Background: Bertolotti syndrome describes a painful lumbosacral transitional vertebra (LSTV) with a pseudoarticulation between an enlarged lateral process of the caudal lumbar vertebra (L5) and ilium or sacrum. It often presents with chronic lower back pain with or without radiculopathy. The current literature emphasizes Bertolotti as a differential diagnosis in young adults. However, it is presumably underdiagnosed in middle-aged and older patients. Treatment ranges from conservative treatment with physiotherapy, infiltration, and radiofrequency ablation to surgical interventions. Case Description: In this case illustration, we present the diagnostic and therapeutic challenges in a 48-year-old female triathlete with persistent left gluteal pain caused by Bertolotti syndrome. When conservative treatment with physiotherapy, infiltrations, thermocoagulation, and radiofrequency ablation of the pseudoarticulation failed, microsurgical reduction of the hypertrophic transverse process was performed. This minimally invasive intervention achieved satisfactory pain relief of at least 70% one year after surgery, allowing the patient to resume her athletic activities. Conclusions: Bertolotti syndrome should be considered a potential differential diagnosis in patients of all ages. Since many patients endure years of misdiagnosis, adequate treatment is crucial upon diagnosis. If conservative measures fail, surgical treatment such as “processectomy” or spinal fusion should be evaluated. This case follows the CARE reporting guidelines. Full article

The Harry Potter fandom community around the world prefers a universe of wizards and witches that includes all people, but also has concerns about the author’s perspective regarding gender identity. This disjunction paralyzes the cultural reader with moral confusion, which is a danger to their emotional investment in the text. Although scholars have analyzed this phenomenon using fragmented prisms, such as social media activism, cognitive engagement, translation, pedagogy, and fan creativity, there is no unifying model that can be used to understand why reading pleasure endures. This article aims to fill this gap by examining these strands of research in a divergent manner, adopting a convergent mixed-methods study approach. Based on neurocognitive (EEG) values, cross-cultural focus groups, social media analysis, and corpus linguistics, we outline the terrain of reader coping mechanisms. We identify separate fan fractions and examine the corresponding practices. The results are summarized by proposing a model called the MDRL (Moral dissonance repair loop) which is a theoretical model that shows how translation smoothing, pedagogical reframing and fan-based re-moralization interact with one another in creating a system that enables the reader to be collectively able to obtain their relations with the text back to a manageable point and continue being engaged. This model makes a theoretical contribution to new areas in the study of fans, moral psychology, and cognitive literature. Full article

While the interest and participation in general endurance training and recreational sports competitions have continuously increased in recent decades, the number of recreational master-level endurance athletes has additionally multiplied. Athletes, active men and women older than 40 years of age, who participate in competitive athletics are usually referred to by the term master athletes (MAs). Previous research revealed the significant benefits of regular moderate physical activity, i.e., its positive influence on cardiovascular risk factors and cardiovascular health; however, recent data have raised concerns that long-term endurance exercise participation is associated with cardiac remodeling and potential adverse cardiovascular outcomes. Previous research also indicated potential structural, functional, and electrical remodeling in MAs due to prolonged and repeated exposure to high-intensity endurance exercise—a condition known as athlete’s heart. In this review, we focus on the association between extreme levels of endurance exercise and potential cardiovascular controversies, such as arrhythmogenesis due to new-onset atrial fibrillation, accelerated coronary artery atherosclerosis, and exercise-induced cardiac remodeling. Additionally, the exercise-dependent modulation of immunological response, such as proteomic response and cytokine alterations, is discussed. Furthermore, we discuss the impact of nutritional supplements in MAs and their potential benefits and harmful interactions. We aim to provide sports medicine practitioners with knowledge of these contemporary longevity controversies in sports cardiology and to highlight the importance of shared decision making in situations of clinical uncertainty. Full article