Search Results (9,295)

Rationale and objectives: Parkinson’s disease (PD) significantly affects visual function, especially convergence and eye movements, impacting tasks such as reading. The objective was to investigate preliminarily the impact of the use of digital visual training in PD patients with associated convergence insufficiency (CI). Materials and methods: Pre–post pseudo-experimental pilot study to evaluate the impact of a novel digital therapy system (video game for use on a mobile phone or tablet) in 13 patients with PD and CI, with a mean age of 67 years. A comprehensive visual assessment was performed before and after a 6-week home-based visual rehabilitation, including measurement of near point of convergence (NPC), near positive fusional vergence (PFV), oculomotor tests (NSUCO and King-Devick tests), and symptom assessments with two validated questionnaires (CISS and SQVD). Results: Treatment adherence was variable, ranging from 0.8% to 124.7%. Despite this, significant improvements were found after therapy in break (p = 0.022) and recovery points of the NPC (p = 0.007), as well as break (p = 0.003) and recovery points in near PFV (p < 0.001). In the NSUCO test, the total score improved significantly from 23.9 ± 4.2 to 26.2 ± 3.7 after therapy (p = 0.003). Furthermore, a significant reduction in the total King-Devick test time was observed, decreasing from 79.4 ± 28.8 s to 69.0 ± 21.5 s with therapy (p = 0.034). Finally, symptom questionnaire scores also decreased significantly with therapy (CISS p = 0.037, SQVD p < 0.001). Conclusions: The digital vision therapy system evaluated seems to improve oculomotor control and reduce visual symptoms associated with CI in PD patients. Studies with larger sample sizes and a control group are needed to fully validate the therapeutic effectiveness of this tool. Full article

Acorn flours from the six Mediterranean Quercus species (Quercus cerris, Quercus petraea, Quercus robur, Quercus ilex, Quercus pubescens, and Quercus rotundifolia) were systematically fractionated for polyphenols using ultrasonic-assisted extraction with seven solvent systems varying in polarity and composition (water at 20 and 40 min; acetone, ethanol, and methanol at 20% and/or 70% v/v). The total polyphenol content (TPC), non-tannic phenolic content (NTPC), tannin content (TC), antioxidant potential (DPPH, ABTS, and FRAP), and individual phenolic profiles through high-performance liquid chromatography (HPLC) were determined. The results showed that the botanical species primarily determined the TPC and TC, while the solvent composition significantly influenced the NTPC yield. Q. cerris yielded the highest average TPC (105.1 ± 3.8 mg GAE/g) and TC, supported by a gallotannin-dominated profile. Conversely, Q. rotundifolia exhibited the lowest values but the highest NTPC/TPC ratio (32.0%). Q. ilex featured species-exclusive ellagitannins, while Q. pubescens showed the highest specific antioxidant activity. For the targeted recovery, 20% acetone is recommended for tannins and 70% ethanol for the non-tannic fractions. These findings establish a species-resolved framework for valorizing acorn flours as functional ingredients, identifying high-tannin species requiring detannification and “sweet” varieties suitable for direct food application. Full article

Background/Objectives: Prolonged air leak (PAL) remains a common complication after lung resection and may delay postoperative recovery and subsequent treatment. This study aimed to identify clinical factors associated with PAL after robot-assisted thoracic surgery (RATS) and to explore potential nonlinear relationships using restricted cubic spline (RCS) modeling. Methods: A retrospective cohort of 1185 patients who underwent RATS for primary lung cancer was analyzed. Multivariable Firth logistic regression was used to identify independent predictors of PAL (≥5 days). A nomogram was constructed based on the final model and internally validated using 1000 bootstrap resamples; its clinical utility was assessed using decision curve analysis. RCS analysis was performed to evaluate potential nonlinear associations. Results: A total of 98 patients (8.3%) developed PAL. Male sex was independently associated with increased PAL risk (OR 3.29, p < 0.001), whereas higher FEV1 was associated with reduced risk (OR 0.50 per 1-L increase, p < 0.001). BMI showed a modest protective effect (OR 0.91, p = 0.01). Age was not significant in the linear model (p = 0.86), but RCS analysis demonstrated a significant nonlinear association, with increased risk at older ages. The nomogram demonstrated moderate discrimination (apparent C-statistic 0.670, optimism-corrected 0.644) and good calibration, with decision curve analysis confirming net clinical benefit over treat-all and treat-none strategies. Conclusions: Male sex and impaired pulmonary function are key predictors of PAL after RATS. Nonlinear modeling revealed complex age-related risk patterns not captured by conventional approaches. The proposed nomogram may assist in preoperative risk stratification and perioperative decision-making. Full article

Recent advancements in biology and medicine have facilitated the progress of nerve regeneration that markedly improves the treatment of peripheral nerve injuries, enhancing outcomes and recovery rates. It has been reported that erythropoietin (EPO) is currently being studied as a potential agent for neural repair. However, much evidence has confirmed that EPO treatment can induce systemic adverse effects in the clinical fields, including coronary stent thrombosis and deep vein thrombosis. Herein, a derivative of EPO without any hematopoietic activities, which is named carbamylated erythropoietin (CEPO), has been synthesized and investigated for its effects on peripheral neural repair both in vitro and in vivo. The in vitro experimental results demonstrated that CEPO enhanced Schwann cell viability, proliferation, migration, and nerve growth factor (NGF) expression, while the optimal concentration of CEPO was found to be 25 μg/mL. The in vivo observations at 21 days post-injection indicated that the CEPO group exhibited a significant functional improvement in the sciatic nerve injury model, guiding regrowing axons across the injury site. Thus, CEPO serves as a promising candidate or adjunctive strategy for peripheral nerve injuries, demonstrating promising clinical applications and potential for enhancing Schwann cell viability, proliferation, and migration, as well as anticipated nerve axon development. Full article

Background/Objectives: Vagus nerve stimulation (VNS) has evolved from a laboratory experiment to a standard of care in several neurological disorders like epilepsy, depression and stroke rehabilitation at present. Methods: We reviewed the published literature relevant to its origins in animal models leading to various clinical applications. Results: Bailey and Bremer published their observations following VNS in animals while further studies established its utility in some forms of epilepsy. Subsequent observations in epilepsy patients treated with VNS revealed the unequivocal improvement in psychological and behavioral disorders. Consequently, VNS received approval for its application in resistant depression disorders. Multiple studies revealed changes due to neuronal plasticity following VNS that could result in the significant clinical recovery of motor function in chronic ischemic stroke patients. Chronic incomplete cervical spinal cord injury, head injury and peripheral nerve injury deficits are also being studied for recovery patterns. Transcutaneous approaches and closed-loop stimulation are showing encouraging results that may facilitate the extension of the application of neuromodulation using VNS. Conclusions: For the recovery of motor function following paralysis in stroke patients or cervical spinal cord injuries, the timing of the stimulation after physical activity during rehabilitation has been identified as a key factor. In addition to the timing of the stimulation, the titration of the parameters is also being studied to obtain optimized recovery in cases of motor, sensory, or sphincter deficits. Full article

Urban water scarcity and climate change pose significant challenges for sustainable development, particularly in rapidly expanding metropolitan areas. In cities like Casablanca, these pressures also threaten the preservation of cultural heritage sites such as traditional public bathhouses (Hammams). This study investigates how Hammams can integrate sustainable water management solutions in alignment with Sustainable Development Goal 11 (SDG 11), focusing on the treatment and reuse of graywater. This study compares three graywater treatment systems, a Membrane Bioreactor (MBR), a Sequencing Batch Reactor (SBR), and a Moving Bed Biofilm Reactor (MBBR), evaluated through literature review and dimensioning calculations, and also integrates an existing treatment plant in Berlin that functions as a real-scale laboratory. The comparison is based on a set of technical, economic, and environmental criteria used for comparative engineering design assessment and evaluation for the selected Hammam water reuse applications. All systems are technically feasible but show distinct trade-offs. The SBR has the lowest energy demand and highest cost savings, the MBBR offers a compact and simple design, and the MBR provides the highest effluent quality at a higher energy cost. Heat recovery provides a significant thermal energy recovery potential but is reported separately from the electrical energy demand of the treatment systems. Full article

Avian influenza (AI) remains a serious threat to poultry and public health worldwide due to its zoonotic nature and pandemic potential. This paper develops and analyzes a coupled system of nonlinear ordinary differential equations and an SEIR-SEIR model that describes the transmission dynamics of avian influenza in both human and bird populations. The model incorporates multiple transmission routes (bird-to-bird, bird-to-human, human-to-human), exposed/latent compartments in both hosts, disease-induced mortality, and demographic processes. From a mathematical perspective, we present a rigorous analysis of this eight-dimensional dynamical system. We prove positivity and boundedness of solutions in ${\mathbb{R}}_{+}^8$, characterize the equilibrium points, and derive the basic reproduction numbers $R_0^b$ and $R_0^h$ using the next-generation matrix method. Local asymptotic stability of the disease-free equilibrium is established via the Routh–Hurwitz criterion. A composite Lyapunov function is constructed to prove global asymptotic stability when both reproduction numbers are less than unity—a result that exploits the cascade structure of the system and provides a template for analyzing similar multi-host models. Sensitivity analysis using normalized forward sensitivity indices identifies critical parameters. In addition, we use neural network models to validate both models and provide error analysis. These results emphasize the crucial role of controlling cross-species transmission and improving recovery efforts, which have significant implications for the design of effective intervention and surveillance programs in the context of the One Health framework. Full article

In recent years, the deployment of robots in human-centric environments has necessitated the development of artificial skins that integrate safety and durability. Traditional damage detection often relies on raw signal thresholds, lacking the functional integration of touch, pain, and damage found in biological systems. This study proposes a bio-inspired artificial skin model that separately evaluates these three states through a spatio-temporal anomaly detection framework. We developed an unsupervised model combining a Convolutional Autoencoder (CAE) and Convolutional LSTM (ConvLSTM) to learn the latent representations of tactile maps from intact skin. By quantifying spatial reconstruction and temporal prediction errors, the system generates individual scores for touch, pain, and damage. Pain is defined as an abstract signal of instantaneous abnormality, while damage is identified as a persistent structural deviation. We implemented a dynamic thresholding mechanism mimicking biological sensitization and recovery, with damage detection gated by a pain-flag constraint to minimize false positives. Experimental results across various conditions—including incisions (3–6 cm) and abrasions (10–30 times)—demonstrate that the model can distinguish between momentary noxious stimuli and sustained structural degradation. Quantitative evaluation shows that the proposed model achieves an Area Under the Curve (AUC) of 0.653, outperforming a threshold-based baseline and maintaining zero false positives under strong, non-damaging contact. Specifically, the system successfully mimics biological aftereffects and the pain-gating mechanism, where damage is only assessed in the presence of a pain-related trigger. This research provides a scalable, software-driven foundation for robot self-protection that overcomes the implementation constraints of hardware-dependent neuromorphic systems. Full article

Background/Objectives: Delayed neurological deficits after decompressive craniectomy may improve after cranioplasty, but quantitative imaging markers for postoperative monitoring remain limited. This study evaluated diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) as an exploratory diffusion-based marker of defect-referenced perivascular diffusivity asymmetry and examined its relationship with white matter microstructure. Methods: Forty-three adults undergoing first-time cranioplasty after decompressive craniectomy and thirty-four matched healthy controls underwent diffusion magnetic resonance imaging and neuropsychological assessment before cranioplasty; twenty-five patients were reassessed at 3 months. DTI-ALPS was quantified globally and according to defect laterality. The white matter microstructure was assessed using tract-based spatial statistics and automated fiber quantification. The associations between imaging measures and cognitive performance were also examined. Results: Global DTI-ALPS was significantly lower in patients than in controls both before cranioplasty and at 3-month follow-up, with no significant longitudinal increase. Defect-referenced hemispheric asymmetry persisted, with lower ALPS values on the affected side, and white matter abnormalities were widespread before cranioplasty and remained evident at follow-up. Associations between imaging measures and cognitive performance were not significant after multiple-comparison correction. Conclusions: DTI-ALPS may capture persistent defect-related hemispheric diffusion asymmetry after cranioplasty and provide complementary information to conventional white matter metrics. However, in patients with substantial postoperative anatomical and fiber-orientation changes, ALPS should be interpreted cautiously as an exploratory proxy of perivascular diffusivity rather than as a direct measure of glymphatic function or physiological recovery. Full article

Background: Anesthetizing frail patients for hip surgery is challenging; spinal (SA) and general anesthesia (GA) often cause hemodynamic instability. Traditional nerve blocks provide analgesia but rarely complete surgical anesthesia without motor block. We evaluate the clinical feasibility of the SAFE (Subarachnoid-alternative Anaesthesia For Endoprosthesis) protocol—combining Anterior Pericapsular Nerve Group (A-PENG), POsterior pericapsular Nerve Group (PONG), and Local Infiltration Analgesia (LIA) under intravenous sedation—as a primary anesthetic preserving motor function and avoiding SA/GA. Methods: This single-center retrospective series analyzed patients undergoing elective or trauma-related hip surgery using the SAFE protocol between September 2022 and April 2026. The primary outcome was success rate (completion without SA/GA conversion). Secondary outcomes included procedural timings, recovery room (RR) transit, and motor preservation. Variables are reported as medians [IQR]. Results: We included 48 patients (median age 83.5 years [IQR: 68.7–87.2]; 66.7% female) undergoing hip hemiarthroplasty (n = 28) or total hip arthroplasty (n = 20). The success rate was 100%, without SA/GA conversion or advanced airway management. Median anesthetic preparation and surgical durations were 55 [IQR: 50–76.2] and 85 min [IQR: 74–110], respectively. RR transit times (recorded for 35 patients) were brief (40 min [IQR: 34.0–67.5]). Crucially, lower-limb motor capacity was preserved in 100% of cases. The technique also proved opioid-sparing, substantially reducing postoperative opioid consumption. Conclusions: The SAFE protocol is a clinically feasible primary anesthetic strategy for hip surgery. By preserving motor function and enabling rapid fast-tracking, it aligns with ERAS pathways, offering a promising alternative to conventional anesthesia for elective and frail trauma patients. Randomized controlled trials are warranted to validate these outcomes. Full article

Submicron particulate matter in the 0.1–1.0 µm range is difficult to remove using conventional air pollution control devices because of its low capture efficiency. Condensation-induced particle enlargement has therefore been proposed as a preconditioning method to increase particle size before collection. This study aims to numerically investigate the condensation-induced growth of submicron particles in a cylindrical tube under different pressure-recovery conditions and to clarify how pressure-controlled supersaturation affects droplet-growth kinetics. A three-dimensional computational fluid dynamics (CFD) model was developed in ANSYS Fluent by coupling the Discrete Phase Model (DPM) with a custom User-Defined Function (UDF) growth law to predict droplet growth, condensation time, and associated heat and mass transfer characteristics. Initial particle diameters of 0.1–1.0 µm were examined for growth to a target diameter of 5 µm under initial pressure conditions of 0.5–0.9 bar followed by recovery to 1 atm, corresponding to calculated nominal supersaturated RH values of 202.65–112.58%, respectively. The results show that pressure-induced supersaturation is the dominant factor controlling condensation kinetics. Lower initial pressures resulted in shorter condensation times and higher mass and heat transfer rates. For an initial diameter of 0.5 µm, the condensation time decreased from approximately 0.1434 s at 0.9 bar to 0.0167 s at 0.5 bar, corresponding to an 88.35% reduction. These findings indicate that pressure-controlled supersaturation can significantly accelerate submicron particle enlargement and provide design guidance for condensation-assisted fine-particle removal technologies. Full article

This narrative review explores the potential role of cognitive–motor dual-task training (CMDT) approaches within training methods used in sports clubs, with particular emphasis on soccer clubs, to support performance enhancement, recovery, and injury prevention; improve agility, decision making, and functional readiness; and enhance training quality and specificity. The review discusses how CMDT may be integrated as part of the broader and more comprehensive planning of the club’s full training program, including during the preseason period, as part of preparation for training and competition, within recovery sessions, during periods of high load, and throughout the rehabilitation process and the transition back to team training and contact exposure, while also potentially contributing to variety, mental stimulation, enjoyment, and player engagement. The review also emphasizes the importance of implementing CMDT within a coordinated professional framework, through collaboration and synchronization within the professional and medical staff of the club, and in broad alignment with club goals, player characteristics, and sport-specific demands. The key insight is that CMDT has the potential to serve as a practical, complementary approach that helps bridge the gap between controlled training and rehabilitation settings and the dynamic demands of soccer participation. Based on this review, practical recommendations and future research directions are presented, while emphasizing that CMDT should be applied with caution, through gradual and context-specific progression, and in line with established training, recovery, and rehabilitation principles. Full article

Standard laboratory protocols for simulating short-term asphalt aging, including the Thin-Film Oven Test (TFOT) and Rolling Thin-Film Oven Test (RTFOT), are widely adopted but frequently lack sensitivity to the distinct thermo-oxidative kinetics of high-viscosity and polymer-modified systems. This study evaluates a severity-graded aging matrix incorporating the Pressure Aging Vessel (PAV) at variable durations (2, 5, and 10 h at 163 °C/2.1 MPa) as a potential alternative to conventional thin-film methods. Three binder systems BA-70 (PG 64-22), SBS-modified, and compatibilized functional thermoplastic (CFT)-modified asphalt were subjected to TFOT, RTFOT, and PAV variants. Comprehensive rheological characterization (DSR frequency/temperature sweeps, rutting parameter, MSCR) and SARA fractionation were employed to quantify oxidative stiffening, permanent deformation resistance, and compositional evolution. An Aging Severity Index (ASI) was developed to normalize multi-parameter responses and establish quantitative protocol equivalence thresholds. BA and SBS-modified binders exhibited pronounced protocol-dependent stiffening, with PAV-5h vs. RTFOT ASI gaps of 30.0% and 33.0%, respectively, confirming distinct aging severity under the tested conditions. Conversely, the CFT-modified binder demonstrated a compressed aging signature, maintaining stable complex modulus, minimal non-recoverable compliance escalation, and near-complete elastic recovery across all protocols. The ASI gap between PAV-5h and RTFOT for CFT was 6.0%, falling within the pre-defined ≤7% equivalence threshold established from combined rheological test uncertainty, specification-aligned engineering tolerance, and empirical gap clustering. SARA analysis corroborated these findings, showing CFT retained higher aromatic/resin fractions while limiting asphaltene accumulation compared to BA-70 and SBS. Importantly, the observed interchangeability between PAV-5h and RTFOT is strictly limited to the specific CFT-modified binder formulation tested under laboratory conditions. Broader specification adoption requires targeted validation across diverse modifier chemistries, dosages, and field-aged binders before generalization. Full article

Background and Aims: Patients with malignancy are frequently excluded from randomized thrombectomy trials, and evidence regarding the safety and efficacy of mechanical thrombectomy (MT) in this population remains incompletely defined. We aimed to compare procedural success, functional outcomes, and mortality between acute ischemic stroke (AIS) patients with and without malignancy undergoing MT. Methods: We retrospectively analyzed 110 patients treated with MT. Patients were stratified into two groups: those with malignancy (n = 48) and those without malignancy (n = 62). Baseline demographics, vascular risk factors, procedural metrics, angiographic outcomes, and clinical outcomes including functional independence (modified Rankin Scale [mRS] 0–2), 90-day mortality and intracranial hemorrhage were compared. Results: Baseline demographics and admission stroke severity were similar between groups. Smoking was significantly more frequent in the malignancy group (25% vs. 11.3%, p < 0.001). Successful reperfusion (TICI 2b-3) was achieved in 95.8% of malignancy patients and 98.4% of controls (p = 0.51). Functional independence at 90 days was lower in the malignancy group (42.6% vs. 61.3%, p = 0.04), whereas 90-day mortality was significantly higher (44.7% vs. 19.4%, p = 0.004); this increase in mortality remained significant after multivariate analysis. There were no significant differences in rates of intracranial hemorrhage between groups (p = 0.53). Conclusions: Mechanical thrombectomy is technically effective and safe in patients with malignancy; however, long-term functional recovery and survival are significantly worse, likely reflecting the effect of cancer itself rather than procedural factors. Careful patient selection and multidisciplinary decision-making are essential in this population. Full article

Background/Objectives: Bipolar disorder is characterized by psychosocial dysfunction, cognitive impairment, and incomplete recovery. Although inflammatory and neurotrophic mechanisms have been implicated, their relationships with multidimensional recovery outcomes remain unclear. We examined the relationships of inflammatory cytokines, brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF) with depressive symptoms, psychosocial functioning, cognitive performance, personal recovery, and quality of life (QOL) in patients with bipolar disorder. Methods: This cross-sectional study of 24 patients with bipolar disorder assessed depressive symptoms, psychosocial functioning, cognitive functions, personal recovery, and QOL. Plasma tumor necrosis factor alpha, interleukin (IL)-6, IL-1β, IL-2, BDNF, and VEGF-A were measured by assay. Results: Subjective cognitive dysfunction was significantly associated with depressive symptom severity (rho = 0.53, p = 0.0083) and reduced QOL (rho = −0.56, p = 0.0042). Depressive symptoms were also associated with lower WHO-QOL-26 scores (rho = −0.43, p = 0.038). Significant interrelationships were observed among objective cognitive measures, and after false discovery rate (FDR) correction, the associations between FAST and PDQ-5-D, Symbol Check and Codebreaker, and Codebreaker and Trail remained statistically significant. High plasma IL-6 levels were associated with worse executive function (rho = 0.43, p = 0.0068). Higher VEGF levels were associated with better attentional performance (rho = −0.42, p = 0.042). Plasma IL-1β levels were positively associated with QOL (rho = 0.54, p = 0.02). After FDR correction, only the association between IL-1β and QOL remained statistically significant. Conclusions: This pilot study suggests that there may be associations between cognitive impairment and cytokines, as well as between quality of life and VEGF, in bipolar disorder. Further studies with larger sample sizes are needed. Full article