Search Results (10,168)

Background and Objectives: Meniscal pathologies are common abnormalities of the knee joint and a frequent cause of knee pain. Prompt and accurate diagnosis is essential to ensure appropriate treatment. Ultrasonography is increasingly used due to its accessibility, cost- and time-efficiency, and capacity for dynamic assessment. This study aimed to evaluate the usefulness of ultrasonography in identifying specific types of meniscal tears and to assess their frequency of occurrence. Materials and Methods: A retrospective study was conducted to assess the frequency and sonographic appearance of various meniscal pathologies. The study population included all patients who underwent ultrasonographic examination of the knee in our clinic over one year for various indications (n = 430). Archived ultrasound images were retrospectively reviewed and analyzed. Results: Meniscal pathologies were identified in 134 patients. The findings included 95 cases of degenerative lesions (70.9%), 18 meniscal cyst-related pathologies (13.4%), 8 complex tears (6.0%), 5 flap tears (3.7%), 3 vertical pericapsular tears (2.2%), 3 partial thickness tears (2.2%), and 2 bucket-handle-type tears (1.5%). Each lesion type was characterized and illustrated through representative ultrasound images. Conclusions: Ultrasound imaging of meniscal pathology offers a valuable diagnostic option. By characterizing and visually documenting different meniscal lesions, this study highlights the practical potential of ultrasonography in routine clinical settings. These findings may enhance diagnostic accuracy and guide more targeted management strategies. Moreover, the results contribute to the expanding body of research on musculoskeletal ultrasonography and may encourage broader adoption of ultrasound in orthopedic diagnostics. Full article

The growing number of daylighting metrics—often overlapping in scope or terminology—combined with the need for prior familiarization to interpret and apply them effectively, has created a barrier to their adoption beyond academic settings. Consequently, this study analyzes a representative set of established and emerging daylighting metrics to evaluate applicability, synergies, and limitations. Particular attention is given to their implications for occupant health, well-being, performance, and energy use, especially within the context of sensorless smart control systems. A virtual room model was simulated using DaySim 3.1 in two contrasting climates—Seville and London—with varying window-to-wall ratios, orientations, and occupancy schedules. The results show that no single metric provides a comprehensive daylighting assessment, highlighting the need for combined approaches. Daylighting Autonomy (DA) proved useful for task illumination, while Useful Daylight Illuminance (UDI) helped identify areas prone to excessive solar exposure. Spatial metrics such as Spatial Daylight Autonomy (sDA) and Annual Sunlight Exposure (ASE) offer an overview but lack necessary granularity. Circadian Stimulus Autonomy (CSA) appears promising for evaluating circadian entrainment, though its underlying models remain under refinement. Continuous Overcast Daylight Autonomy (DAo.con) shows the potential for sensorless lighting control when adjusted for orientation. A nuanced, multi-metric approach is therefore recommended. Full article

Pathogenic variants in the MAP1B gene have been associated with neurological impairment, including intellectual disability, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, brain malformations, cognitive hearing loss, short stature, and dysmorphic features. However, few cases with detailed clinical characterization have been reported. We describe a 12-year-old boy carrying a loss-of-function MAP1B variant, presenting with severe elimination disorders despite normal intelligence. He was referred to the genetics service due to persistent elimination issues, including daytime urinary incontinence, nocturnal enuresis, and fecal incontinence. He had normal motor and cognitive development, with an IQ of 99; however, he also presented with ADHD, short stature, microcephaly, and myopia. Brain MRI revealed bilaterial subependymal periventricular nodular heterotopia (PVNH). Audiometry showed normal bilateral hearing. Testing fragile X syndrome (FXS) and karyotype analyses yielded normal results. Whole exome sequencing (WES) revealed a nonsense pathogenic variant in MAP1B (c.895 C>T; p.Arg299*). No other family members showed a similar phenotype; however, a great-uncle and a great-aunt had a history of nocturnal enuresis until age 10. The patient’s deceased mother had short stature and psychiatric disorders, and a history of consanguinity was reported on the maternal side. This case broadens the phenotypic spectrum associated with MAP1B syndrome, suggesting that elimination disorder, frequently reported in FXS, should also be evaluated in MAP1B pathogenic variant carriers. In addition, the presence of short stature also appears to be part of the syndrome. Full article

Background/Objectives: Pelvic floor disorders (PFDs) have multifactorial etiology. This makes treatment challenging and often unsatisfactory. This project introduces robust data on risk factors for PFDs and explores opportunities for their prevention, focusing on previous gynecological surgical interventions. Methods: We conducted a retrospective analytical cohort study analyzing demographic and clinical data from 832 consecutive patients who underwent pelvic organ prolapse (POP) surgery at a teaching hospital affiliated with the University of Cologne between 2010 and 2019. Patient characteristics—including age, body mass index (BMI), parity, mode of delivery, and symptoms—were collected from medical records. Associations between patient factors and surgical history were assessed using Kendall’s Tau (KT) for correlations and relative risks (RRs) with 95% confidence intervals (CIs) to evaluate the impact of previous hysterectomies and pelvic surgeries on PFD. Results: First vaginal delivery and age were the strongest factors associated with PFD. BMI had a smaller impact, and multiple vaginal deliveries did not significantly influence apical (KT 0.037), posterior (KT 0.007), anterior midline (KT 0.015), or lateral defects (KT 0.015). Cesarean section was protective. Subtotal hysterectomy showed no significant association with PFD. Total hysterectomy was strongly associated with posterior defects (RR 4.750, 95% CI: 1.871–12.059) and anterior midline defects (RR 1.645, 95% CI: 0.654–4.139). Recurrent urinary infections were associated with abdominal colposuspension (RR 4.485, 95% CI: 1.12–18.03). Dyspareunia occurred more frequently after vaginal (RR 3.971, 95% CI: 0.78–20.14) and abdominal hysterectomy (RR 1.620, 95% CI: 0.32–8.15). Vaginal hysterectomy was linked to fecal incontinence (RR 5.559, 95% CI: 1.17–26.30), MUI (RR 2.156, 95% CI: 1.09–4.23), and UUI (RR 4.226, 95% CI: 1.82–6.85). Conclusions: The factors identified as influencing (PFD) offer a solid foundation for evidence-based patient counseling within our population. Our large dataset confirmed key risk factors, notably childbirth and advancing age. However, the influence of BMI on symptoms and anatomical defects appears to be less significant than previously assumed. Subtotal hysterectomy was not associated with new PFD in our cohort and may represent a viable option when hysterectomy is indicated, though further studies are needed to confirm this potential advantage. Full article

This study evaluates leadership uniformity—the degree to which the proposer role is evenly distributed among validator nodes over time—in Quorum-based Byzantine Fault Tolerance (QBFT), a Byzantine Fault-Tolerant (BFT) consensus algorithm used in permissioned blockchain networks. By introducing simulated follower timeouts derived from uniform, normal, lognormal, and Weibull distributions, it models a range of network conditions and latency patterns across nodes. This approach integrates Raft-inspired timeout mechanisms into the QBFT framework, enabling a more detailed analysis of leader selection under different network conditions. Three leader selection strategies are tested: Direct selection of the node with the shortest timeout, and two quorum-based approaches selecting from the top 20% and 30% of nodes with the shortest timeouts. Simulations were conducted over 200 rounds in a 10-node network. Results show that leader selection was most equitable under the Weibull distribution with shape $k=0.5$, which captures delay behavior observed in real-world networks. In contrast, the uniform distribution did not consistently yield the most balanced outcomes. The findings also highlight the effectiveness of quorum-based selection: While choosing the node with the lowest timeout ensures responsiveness in each round, it does not guarantee uniform leadership over time. In low-variability distributions, certain nodes may be repeatedly selected by chance, as similar timeout values increase the likelihood of the same nodes appearing among the fastest. Incorporating controlled randomness through quorum-based voting improves rotation consistency and promotes fairer leader distribution, especially under heavy-tailed latency conditions. However, expanding the candidate pool beyond 30% (e.g., to 40% or 50%) introduced vote fragmentation, which complicated quorum formation in small networks and led to consensus failure. Overall, the study demonstrates the potential of timeout-aware, quorum-based leader selection as a more adaptive and equitable alternative to round-robin approaches, and provides a foundation for developing more sophisticated QBFT variants tailored to latency-sensitive networks. Full article

Hyaluronic acid (HA) is a key extracellular matrix component of vertebrates, where it mediates cell adhesion, immune regulation, and tissue remodeling through its interaction with specific receptors. Although HA has been detected in a few invertebrate species, the lack of fundamental components of the molecular HA pathway poses relevant objections about its functional role in these species. Mining genomic and transcriptomic data, we considered the conservation of the gene locus encoding for the extracellular link protein (XLINK) in marine mussels as well as its expression patterns. Structural and phylogenetic analyses were undertaken to evaluate possible similarities with vertebrate orthologs and to infer the origin of this gene in invertebrates. Biochemical analysis was used to quantify HA in tissues of Mytilus galloprovincialis. As a result, we confirm that the mussel can produce HA (up to 1.02 ng/mg in mantle) and that its genome encodes two XLINK gene loci. These loci are conserved in Mytilidae species and show a complex evolutionary path. Mussel XLINK genes appeared to be expressed during developmental stages in three mussel species, ranking in the top 100 expressed genes in M. trossulus at 17 h post-fertilization. In conclusion, the presence of HA and an active gene with the potential to bind HA suggests that mussels have the potential to synthesize and use HA and are among the few invertebrates encoding this gene. Full article

In recent decades, information technology has grown. Computers have become a daily activity, facilitating access to information, faster communication and faster work. If used responsibly, it has many advantages. Objectives: To explore the potential link between prolonged use of computer input devices—such as keyboards and mice—and the development of compressive neuropathies, including carpal tunnel syndrome (CTS) and cubital tunnel syndrome (CuTS), in individuals whose daily routines are heavily reliant on computer-based activities. Methods: A comprehensive review of the literature was undertaken to assess the correlation between the use of computer input devices and the incidence of compressive neuropathies in the upper limbs, with particular attention to repetitive strain, ergonomic posture deviations, and personal risk factors. Results: Current evidence indicates a potential association between prolonged computer use and the development of upper limb compressive neuropathies; however, a definitive consensus within the scientific literature remains elusive. Repetitive movements and non-neutral postures appear to be significant contributing factors, particularly among individuals with predisposing risk factors. Despite increasing awareness of this issue, standardized, evidence-based clinical guidelines for the evaluation and management of work-related nerve disorders remain lacking. Conclusions: While the relationship between computer use and compressive neuropathies remains debated, healthcare professionals should be aware of the risks, particularly in individuals exposed to repetitive strain and ergonomic stress. Further research and the development of clinical guidelines are needed to better understand and manage these work-related conditions. Full article

Background/Objectives: Frenotomy is the procedure of choice for treating ankyloglossia. The literature reports that readhesion of the frenulum occurs in 2.6–13% of cases. There is no published evidence to support performing tongue exercises to prevent it. We aimed to determine the readhesion rate of ankyloglossia, the benefits of tongue exercises to prevent it, and the characteristics of patients who experienced readhesion. Methods: This is a prospective, observational study of neonates who underwent a frenotomy between January and August 2024. Following the frenotomy, we recommended that all parents perform a series of exercises 6–8 times daily over 15 days. Patients were re-evaluated 10–15 days post-procedure for signs of ankyloglossia using the Hazelbaker tool and clinical variables such as nipple pain or cracks. Results: We enrolled 212 patients; thirty patients underwent a refrenotomy (14.1%). The raw risk of readhesion in our study was 0.335 (95%CI 0.275–0.401), and for symptomatic readhesion, 0.156 (95%CI 0.113–0.211). Adjusted by sex, the risk of readhesion for female patients was 0.236 (95%CI 0.155–0.344), and for males, 0.390 (95%CI 0.312–0.474). The appearance and function Hazelbaker scores were significantly lower before the frenotomy than post-procedure in all cases. In females, not following the exercise protocol multiplied the risk of readhesion by 1.61 (95%CI 1.03–2.56), whereas in males the risk was multiplied by 1.47 (95%CI 1.03–2.08). Symptomatic readhesion was significantly correlated with age at frenotomy and Hazelbaker score. Conclusions: Readhesion of tongue-tie was higher than previously published (33.5%); however, symptomatic readhesion was less frequent (15.6%). Proper adherence to post-frenotomy exercises significantly reduces the risk of readhesion, although it has less impact on symptomatic readhesion. Full article

Bose–Einstein condensation is an intensely studied quantum phenomenon that emerges at low temperatures. While preceding Bose–Einstein condensation models do not consider what statistics apply above the condensation temperature, we show that neglecting this question leads to inconsistencies. A mathematically rigorous calculation of Bose–Einstein condensation temperature requires evaluating the thermodynamic balance between coherent and incoherent particle populations. The first part of this work develops such an improved Bose–Einstein condensation temperature calculation, for both three-dimensional and two-dimensional scenarios. The progress over preceding Bose–Einstein condensation models is particularly apparent in the two-dimensional case, where preceding models run into mathematical divergence. In the Discussion section, we compare our mathematical model against experimental superconductivity data. A remarkable match is found between experimental data and the calculated Bose–Einstein condensation temperature formulas. Our mathematical model therefore appears applicable to superconductivity, and may facilitate a rational search for higher-temperature superconductors. Full article

Background/Objectives: Prostate cancer (PCa) remains a major global health issue, associated with significant mortality and morbidity. Despite advances in diagnosis and treatment, predicting biochemical recurrence (BCR) after radical prostatectomy remains challenging, highlighting the need for reliable biomarkers to guide prognosis and therapy. The study aimed to evaluate the prognostic significance of the PTEN and ERG biomarkers in predicting BCR and tumor progression in PCa patients who underwent radical prostatectomy. Methods: This study consisted of a cohort of 91 patients with localized PCa who underwent radical prostatectomy between 2016 and 2022. From this cohort, 77 patients were selected for final analysis. Tissue microarrays (TMAs) were constructed from paraffin blocks, and immunohistochemical (IHC) staining for PTEN and ERG was performed using specific antibodies on the Ventana BenchMark ULTRA system (Roche Diagnostics, Indianapolis, IN, USA). Stained sections were evaluated and correlated with clinical and pathological data. Results: PTEN expression showed a significant negative correlation with BCR (r = −0.301, p = 0.014), indicating that reduced PTEN expression is associated with increased recurrence risk. PTEN was not significantly linked to PSA levels, tumor stage, or lymph node involvement. ERG expression correlated positively with advanced pathological tumor stage (r = 0.315, p = 0.005) but was not associated with BCR or other clinical parameters. Conclusions: PTEN appears to be a valuable prognostic marker for recurrence in PCa, while ERG may indicate tumor progression. These findings support the potential integration of PTEN and ERG into clinical practice to enhance risk stratification and personalized treatment, warranting further validation in larger patient cohorts. Full article

Background: Magnesium (Mg) is an essential mineral that plays a vital role in various physiological processes, including enzyme regulation, neuromuscular function, and cardiovascular health. Dysmagnesemia has been associated with arrhythmias, neuromuscular dysfunction, and poor outcomes in intensive care unit (ICU) settings, representing diagnostic and therapeutic challenges. However, the relationship between dysmagnesemia and health outcomes in the ICU remains inadequately defined. Aim/Objective: This study aimed to assess the prevalence of dysmagnesemia and evaluate the correlation between total (tMg) and ionized magnesium (iMg) levels in a cohort of ICU and high dependency unit (HDU) patients. It also sought to evaluate patient characteristics and relevant health outcomes by comparing both concentrations of iMg and tMg. Methods: This prospective study was conducted among adult patients admitted to the ICU and the high dependency unit (HDU). Results: Among the 134 included patients, the median age was 63.5 years (IQR: 52.0–77.0). The majority, 91.0%, required mechanical ventilation. Additionally, 50.0% were diagnosed with diabetes, 28.4% had chronic kidney disease, and proton pump inhibitors (PPIs) were administered to 67.2% of the patients. The prevalence of hypomagnesemia, as measured by iMg, was 6.7%, while hypermagnesemia was at 39.6%. When measured by tMg, hypomagnesemia and hypermagnesemia were observed at rates of 14.9% and 22.4%, respectively. The iMg measurements showed an association between the incidence of atrial fibrillation and hypomagnesemia (p = 0.015), whereas tMg measurements linked hypomagnesemia with longer hospital stays. Notably, only a few patients identified with iMg-measured hypomagnesemia received magnesium replacement during their ICU stay. Conclusions: Dysmagnesemia is prevalent among critically ill patients, with discordance between iMg and tMg measurements. iMg appears more sensitive in detecting arrhythmia risk, while tMg correlates with length of stay. These findings support the need for larger studies and suggest considering iMg in magnesium monitoring and replacement strategies. Full article

Background/Objectives: Cochlear implants (CIs) and hearing aids (HAs) have enhanced auditory rehabilitation in elderly individuals, yet limitations in musical perception and psychosocial integration persist. This systematic review aimed to evaluate the effects of music therapy (MT) on the quality of life (QoL), self-esteem, auditory perception, and cognition in older CI and HA users. Methods: A comprehensive search of PubMed was conducted up to March 2022 following PRISMA guidelines. Studies involving participants aged ≥ 60 years with CIs and/or HAs were included. Ten studies (n = 21,632) met eligibility criteria. Data were extracted and assessed using the Newcastle–Ottawa Scale. Results: MT led to improved sound quality, with HISQUI19 scores rising from 60.0 ± 21.8 to 74.2 ± 27.5. Early MT exposure was associated with significantly better MUMU outcomes (p = 0.02). Bilateral CI users showed enhanced stereo detection (52% to 86%), and CI + HA users achieved CNC scores exceeding 95%. Postlingual CI users outperformed prelingual peers in musical discrimination (9.81 vs. 3.48; p < 0.001). Long-term HA use was linked to better a QoL and reduced loneliness. Conclusions: While music therapy appears to support auditory and psychosocial functioning in hearing-impaired older adults, the absence of randomized controlled trials limits causal inference regarding its effects. These results support its integration into hearing rehabilitation strategies for older adults. Full article

Background: Percutaneous electrolysis (PE) is a minimally invasive procedure that utilizes galvanic current delivered through a needle. PE is increasingly employed for musculoskeletal disorders, despite the scarcity of scientific evidence supporting its use. The aim of this systematic review is to synthesize the existing evidence and explore the applications of PE in rehabilitation. Methods: In line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search was conducted across the PubMed, Web of Science, Scopus, and PEDro databases from inception to July 2025. The search strategy employed the term “Percutaneous Electrolysis” without applying additional filters or time restrictions, ensuring a comprehensive search. Cited references from screened articles were also evaluated for potential inclusion. Studies were included if they met the following criteria: peer-reviewed articles, intervention-based research, relevance to the topic, and publication in English. Results: Of the 181 papers retrieved, 143 were excluded for various reasons, leaving 38 studies. The evidence suggests that PE appears effective in reducing pain and improving function, particularly when combined with exercises such as eccentric training or stretching, though inconsistencies in protocols and patient characteristics, along with unclear mechanisms, show that it warrants further investigation. Conclusions: In conclusion, while PE emerges as a promising therapeutic strategy for musculoskeletal disorders, its full integration into rehabilitation practice necessitates further rigorous research to standardize treatment protocols, elucidate the underlying mechanism, and validate its cost-effectiveness. These steps are essential to establish PE as a robust and evidence-based option within the field of rehabilitation. Full article

This study addresses the problem of agricultural waste utilization and nutrition for older adults by developing a food product based on a circular design approach. Pineapple core was used to produce a clean-label dietary powder without chemical or enzymatic treatment, relying on repeated rinsing and hot-air drying. The development process followed a structured analysis of physical, chemical, and sensory properties. The powder contained 83.46 g/100 g dietary fiber, 0° Brix sugar, pH 4.72, low water activity (aw < 0.45), and no detectable heavy metals or microbial contamination. Sensory evaluation by expert panelists confirmed that the product was acceptable in appearance, aroma, and texture, particularly for older adults. These results demonstrate the feasibility and safety of valorizing agri-waste into functional ingredients. The process was guided by the Transformative Circular Product Blueprint, which integrates clean-label processing, IoT-enabled solar drying, and decentralized production. This model supports traceability, low energy use, and adaptation at the community scale. This study contributes to sustainable food innovation and aligns with Sustainable Development Goals (SDGs) 3 (Good Health and Well-being), 9 (Industry, Innovation and Infrastructure), and 12 (Responsible Consumption and Production). Full article

Syphilis, which is caused by Treponema pallidum, remains one of the most common congenital infection worldwide and has tremendous consequences for the mother and her developing foetus if left untreated. The complexity of the exposure to this pathogen extends beyond the well-established clinical manifestations, as it can profoundly affect placental histomorphology. This study aimed to compare T. pallidum-exposed placental villi structures with healthy placentae at term to evaluate the histomorphological differences using stereology. In this case-control study conducted at term (38 weeks ± 2 weeks), 78 placentae were collected from the hospital delivery suites, comprising 39 cases (T. pallidum-exposed) and 39 controls (non-exposed), who were gestational age-matched with other potential confounders excluded. Blood samples from the umbilical vein and placental basal plate were tested for syphilis, using rapid diagnostic test (RDT) kits for T. pallidum (TP) antibodies (IgG and IgM) to classify placentae as exposed to T. pallidum (cases) and non-exposed (controls). Tissue sections were prepared and stained with haematoxylin and eosin, and the mean volume densities of syncytial knots, foetal capillaries, syncytial denuded areas, and intervillous spaces were estimated using stereological methods. Statistical analysis was performed to compare the mean values between the case and control groups. Stereological assessment revealed significant differences between the T. pallidum-exposed and non-exposed groups with regard to syncytial knots (p < 0.0001), syncytial denudation (p < 0.0001), and foetal capillaries (p < 0.0001), but no significant difference in the intervillous space was found (p = 0.1592). Therefore, our study shows, for the first time, that the histomorphology of human placental villi appears to be altered by exposure to T. pallidum. It will, therefore, be interesting to determine whether these changes in the placental villi translate into long-term effects on the baby. Full article