Search Results (246)

Background: Immunization is a highly effective intervention for controlling over 20 life-threatening infectious diseases, significantly reducing both morbidity and mortality rates. One notable achievement in vaccination efforts was the global eradication of smallpox, which the World Health Assembly declared on 8 May 1980. Additionally, there has been a remarkable 99.9% reduction in wild poliovirus cases since 1988, decreasing from more than 350,000 cases that year to just 30 cases in 2022. Objectives: The objective of this review was to assess the effects of various interventions designed to increase vaccination uptake among adults. Search Methods: A thorough search was conducted in the CENTRAL, Embase Ovid, Medline Ovid, PubMed, Web of Science, and Global Index Medicus databases for primary studies. This search was conducted in August 2021 and updated in November 2024. Selection Criteria: Randomized trials were eligible for inclusion in this review, regardless of publication status or language. Data Analysis: Two authors independently screened the search outputs to select potentially eligible studies. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for each randomized controlled trial (RCT). A meta-analysis was conducted using a random-effects model, and the quality of the evidence was assessed using the GRADE approach. Main Results: A total of 35 randomized controlled trials met the inclusion criteria and were included in this review, with the majority conducted in the United States. The interventions targeted adults aged 18 and older who were eligible for vaccination, involving a total of 403,709 participants. The overall pooled results for interventions aimed at increasing influenza vaccination showed a risk ratio of 1.41 (95% CI: 1.15, 1.73). Most studies focused on influenza vaccination (18 studies), while the remaining studies examined various other vaccines, including those for hepatitis A, COVID-19, hepatitis B, pneumococcal disease, tetanus, diphtheria, pertussis (Tdap), herpes zoster, and human papillomavirus (HPV). The results indicate that letter reminders were slightly effective in increasing influenza vaccination uptake compared to the control group (RR: 1.75, 95% CI: 0.97, 1.16; 6 studies; 161,495 participants; low-certainty evidence). Additionally, participants who received education interventions showed increased levels of influenza vaccination uptake compared to those in the control group (RR: 1.88, 95% CI: 0.61, 5.76; 3 studies; 1318 participants; low-certainty evidence). Furthermore, tracking and outreach interventions also led to an increase in influenza vaccination uptake (RR: 1.87, 95% CI: 0.78, 4.46; 2 studies; 33,752 participants; low-certainty evidence). Conclusions: Letter reminders and educational interventions targeted at recipients are effective in increasing vaccination uptake compared to control groups. Full article

Background: The increasing complexity of global supply chains and environmental expectations has highlighted the strategic importance of digital transformation in the transport, forwarding, and logistics (TFL) sector. Despite a growing portfolio of available tools, adoption rates—particularly among small and medium-sized enterprises (SMEs) in Central and Eastern Europe—remain low. This study investigates the barriers and motivations related to the implementation of digital planning tools supporting intermodal transport planning. Methods: A structured online survey was conducted among 80 Polish TFL enterprises, targeting decision-makers responsible for operational and digital strategies. The questionnaire included 17 closed and semi-open questions grouped into three thematic sections: tool usage, implementation barriers, and digital readiness. Results: The findings indicate that only 20% of respondents use dedicated route planning tools, and merely 10% report satisfaction with their performance. Key barriers include lack of awareness, organizational inertia, and the prioritization of other initiatives, with financial cost cited less frequently. While environmental sustainability is declared as a priority by most enterprises, digital support for emission tracking is limited. The results highlight the need for targeted education, integration support, and differentiated platform functionalities for SMEs and larger firms. Conclusions: This study offers evidence-based recommendations for developers, policymakers, and logistics managers aiming to accelerate digital adoption in the intermodal logistics landscape. Full article

(1) Introduction: Precise femoral component rotation is critical for achieving symmetric flexion-gap balance and physiologic patellofemoral tracking in mechanically aligned total knee arthroplasty (TKA). Surgeons often infer an appropriate rotational target from the patient’s coronal limb alignment, yet the strength of this relationship remains uncertain. (2) Methods: We identified 695 consecutive patients undergoing primary TKA with a preoperative planning CT scan. The surgical transepicondylar axis (sTEA) and posterior condylar axis (PCAxis) were identified and the angle between them was measured. The angle between the mechanical axis of the femur and tibia was used to measure the coronal alignment of the limb. (3) Results: The mean sTEA was 3.0° externally rotated to the PCAxis (range 3.1° internal to 9.2° external). The mean coronal alignment was 4.3° varus (range −12.5° valgus to 24.5° varus). There were 465 patients with >2° varus and 101 patients with >2° valgus. The mean sTEA was 2.9 ± 1.9° externally rotated relative to the PCAxis in the valgus group and 2.8 ± 2.0° in the varus group, with no statistically significant difference (p = 0.7). (4) Conclusions: There is significant variation in the femoral rotation axes between patients, but no significant relationship between overall limb coronal alignment and the magnitude of femoral rotation axes variation. This reinforces the need for independent assessment of rotational landmarks when performing mechanically aligned TKA. Full article

Background: The impact of exogenous explicit knowledge on early motor learning is highly variable and may be influenced by excitability within the procedural sensorimotor network. Recent transcranial magnetic stimulation (TMS) studies suggest that variability in interneuron recruitment by anterior–posterior (AP) currents is linked to differences in functional connectivity between premotor and motor regions. Objectives: This study used controllable pulse parameter TMS (cTMS) to assess how AP-sensitive interneuron excitability interacts with explicit knowledge to influence motor learning. Methods: Seventy-two participants were grouped as AP-positive (n = 36) and AP-negative groups (n = 36) based on whether an AP threshold could be obtained before reaching maximal stimulator output. A narrow (30 µs) stimulus was employed to target the longest latency corticospinal inputs selectively. Participants then practiced a continuous visuomotor tracking task and completed a delayed retention test. Half of each group received explicit knowledge of a repeated sequence embedded between random sequences. Random sequence tracking performance assessed general sensorimotor efficiency; repeated sequence performance assessed sequence-specific learning. Results: Both AP₃₀-positive participants, with and without explicit knowledge, and the AP₃₀-negative without explicit knowledge demonstrated similar improvements in sensorimotor efficiency driven by offline consolidation. However, AP₃₀-negative participants given explicit instruction exhibited significantly reduced improvement in sensorimotor efficiency, primarily due to impaired offline consolidation. Conclusions: These findings suggest that individuals with low excitability in long-latency AP-sensitive inputs may be more vulnerable to interference from explicit instruction. The current results highlight the importance of accounting for individual differences in interneuron excitability when developing instructional strategies for motor learning. Full article

Lifelong learning, particularly in adult education, has gained considerable attention due to rapid lifestyle changes, including pandemic-induced lockdowns. This research targets adult learners returning to higher education after gap years, emphasizing their preference for technology with clear, practical benefits. However, many still need help operating digital media. This research aims to identify best practices for sustainably providing digital scientific materials to students by examining respondents’ tendencies in viewing journal article pages and scientific posters, with a focus on layout designs that include both textual and schematic elements. The research questions focus on (1) identifying the characteristics of Areas of Interest (AoI) that effectively attract learners’ attention and (2) determining the preferred characteristics for each learner group. Around 110 respondents were selected during the experiments using web tracking technology. Utilizing this web-based eye-tracking tool, we propose eight activities to detect learners’ perceptions of text-based learning object materials. The fact that first language significantly shapes learners’ attention was confirmed by time-leap analysis and AoI distances showing they focus more on familiar elements. While adult learners exhibit deeper engagement with scientific content and sustained concentration during reading, their unique preferences toward digital learning materials result in varied focus patterns, particularly in initial interest and time spent on tasks. Thus, it is recommended that lecturers deliver digital content for adult learners in a textual format or by placing the important parts of posters in the center. Full article

In the context of global population aging, identifying reliable, objective tools to assess physical function and postural stability in older adults is increasingly important to mitigate fall risk. This study presents a non-contact platform that uses a Microsoft Azure Kinect depth camera to evaluate functional performance related to lower-limb muscular capacity and static balance through self-selected depth squats and four progressively challenging stances (feet apart, feet together, semitandem, and tandem). By applying markerless motion capture algorithms, the system provides key biomechanical parameters such as center of mass displacement, knee angles, and sway trajectories. A comparison of older and younger individuals showed that the older group tended to perform shallower squats and exhibit greater mediolateral and anteroposterior sway, aligning with age-related declines in strength and postural control. Longitudinal tracking also illustrated how performance varied following a fall, indicating potential for ongoing risk assessment. Notably, in 30 s balance trials, the first 10 s often captured meaningful differences in stability, suggesting that short-duration stance tests can reliably detect early signs of imbalance. These findings highlight the feasibility of low-cost, user-friendly depth-camera technologies to complement traditional clinical measures and guide targeted fall-prevention strategies in older populations. Full article

This study investigated the role of exosomes in the pathological processes of gouty arthritis (GA), with the aim of clarifying their mechanistic role and pathological significance in the onset and progression of GA. Using a rat model of GA established through potassium oxonate and yeast gavage combined with intra-articular monosodium urate (MSU) injection, we isolated and characterized plasma exosomes using transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA), and Western blotting. Differential exosomal protein expression was analyzed using 4D label-free proteomics technology, followed by GO and KEGG enrichment analyses, and protein–protein interaction (PPI) network construction to identify core targets. In vivo experiments measured the expression levels of CTSD in synovial tissues and joint fluid, as well as HPRT1 in renal tissues, while in vitro experiments involved co-culturing NRK cells with exosomes to validate target protein expression. The results indicated that serum uric acid levels were significantly elevated in the model group (p < 0.01), accompanied by pronounced joint swelling and inflammation. Exosome characterization confirmed their typical bilayer membrane structure and the expression of marker proteins (CD63/TSG101). Proteomic analysis identified 40 differentially expressed proteins (12 upregulated and 28 downregulated) enriched in pathways such as complement and coagulation cascades, autophagy, lysosomal function, and purine metabolism. In vivo and in vitro experiments demonstrated significantly increased CTSD expression (p < 0.05/p < 0.01) and decreased HPRT1 expression (p < 0.05/p < 0.01) in the model group, suggesting that exosomes are involved in the occurrence and development of GA by regulating purine metabolism and lysosomal dysfunction. These findings offer new insights into disease mechanisms and potential therapeutic targets. Full article

Reading comprehension of connected texts is a key skill in high school education, yet students exhibit varying proficiency levels, particularly in inferential reasoning. This study investigates reading behavior by means of finger-tracking technique and question answering among Italian 10th, 11th, and 12th year high school students, analyzing their performance on different types of questions: synonymy and reference vs. inference-based questions. Despite similar reading times and lexical effects across grades, students’ accuracy in answering inferential questions reveals significant variability. Subsequently, we identify three comprehension profiles—poor, medium, and good comprehenders—with the first two groups showing markedly lower performance on inference-based questions. These findings suggest that schooling alone may not be sufficient for all students to develop strong inferential skills, and some may benefit from targeted instructional support. Full article

Background/Objectives: Transcranial Direct Current Stimulation (tDCS) has proven to be a promising intervention for major depressive disorder (MDD). Even so, the specific neurophysiological mechanisms underlying its therapeutic effects, particularly regarding frontal EEG markers, remain insufficiently understood. This pilot study investigated both the clinical efficacy and neurophysiological impact of frontal tDCS in individuals with mild to severe depression, with particular focus on mood changes and alterations in Frontal Alpha Asymmetry (FAA), Beta Symmetry, and Theta/Alpha Ratios at the F3 and F4 electrode sites. Methods: A total of thirty–one participants were enrolled and completed a standardized Flow Neuroscience tDCS protocol targeting the dorsolateral prefrontal cortex using a bilateral F3/F4 montage. The intervention included an active phase of five stimulations per week for three weeks, followed by a Strengthening Phase with two stimulations per week. Clinical outcomes were assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS), while neurophysiological changes were evaluated via standardized quantitative EEG (QEEG) recordings obtained before and after the treatment course. Among the participants, fourteen individuals had a baseline MADRS score of ≥20, indicating moderate to severe depressive symptoms. Results: Following tDCS treatment, significant reductions in MADRS scores were observed across the cohort, with clinical response rates notably higher in the moderate/severe group (71.4%) compared to the mild depression group (20.0%). Neurophysiological effects were modest: no significant changes were detected in FAA or Beta Symmetry measures. However, a substantial reduction in the Theta/Alpha Ratio at F4 was found in participants with moderate to severe depression (p = 0.018, Cohen’s d = −0.72), suggesting enhanced frontal cortical activation associated with clinical improvement. Conclusions: These findings indicate that frontal tDCS is effective in reducing depressive symptoms, particularly in cases of moderate to severe depression. While improvements in FAA and Beta Symmetry were not significant, changes in the Theta/Alpha Ratio at F4 point toward dynamic neurophysiological reorganization potentially linked to therapeutic outcomes. The Theta/Alpha Ratio may serve as a promising biomarker for tracking tDCS response, whereas other EEG metrics might represent more stable trait characteristics. Future research should prioritize individualized stimulation protocols and incorporate more sensitive neurophysiological assessments, including functional connectivity analyses and task-evoked EEG paradigms, to understand the mechanisms underlying clinical improvements. Full article

Limited labels and detailed changed land-cover interpretation requirements pose challenges for time-series PolSAR change monitoring research. Accurate labels and supervised models are difficult to reuse between massive unlabeled time-series PolSAR data due to the complex distribution shifts caused by different imaging parameters, scene changes, and random noises. Moreover, many related methods can only detect binary changes in PolSAR images and struggle to track the detailed land cover changes. In this study, an unsupervised cross-domain method based on limited-label transfer learning and a vision transformer (LLTL-ViT) is proposed for PolSAR land-cover change monitoring, which effectively alleviates the problem of difficult label reuse caused by domain shift in time-series SAR data, significantly improves the efficiency of label reuse, and provides a new paradigm for the transfer learning of time-series polarimetric SAR. Firstly, based on the polarimetric scattering characteristics and manifold-embedded distribution alignment transfer learning, LLTL-ViT transfers the limited labeled samples of source-domain PolSAR data to unlabeled target-domain PolSAR time-series for initial classification. Secondly, the accurate samples of target domains are further selected based on the initial transfer classification results, and the deep learning network ViT is applied to classify the time-series PolSAR images accurately. Thirdly, with the reliable secondary classification results of time-series PolSAR images, the detailed changes in land cover can be accurately tracked. Four groups of cross-domain change monitoring experiments were conducted on the Radarsat-2, Sentinel-1, and UAVSAR datasets, with about 10% labeled samples from the source-domain PolSAR. LLTL-ViT can reuse the samples between unlabeled target-domain time-series and leads to a change detection accuracy and specific land-cover change tracking accuracy of 85.22–96.36% and 72.18–88.06%, respectively. Full article

Background: Parkinsonism, characterized by motor symptoms, is typically attributed to basal ganglia dysfunction. Recent evidence suggests that the cerebellum may also influence these symptoms. This study investigated Crus II, the dentate nucleus (DN), and the inferior olive (IO) in a rat model of parkinsonism induced by a bilateral ventrolateral striatal (VLS) lesion. Materials and Methods: Twenty-four male Wistar rats were divided into control (n = 12) and experimental (n = 12) groups. Monopolar electrodes were implanted in target structures. The experimental group received a bilateral VLS lesion. Animals underwent four weekly sessions of electrophysiological recordings and blind behavioral assessments (resting, grooming, locomotion, rearing, sniffing) via video tracking. Power spectral density (PSD) in the 300–500 Hz band was computed. Statistical analyses included Mann–Whitney U, Friedman with Wilcoxon post hoc, and Spearman correlation tests. Results: During weeks one and two, there were significant PSD increases in the experimental group compared to the control, particularly in Crus II—grooming (p = 0.005), locomotion (p = 0.007), and rearing (p = 0.026); in IO—sniffing (p = 0.0167); and in DN—grooming (p < 0.001) and locomotion (p = 0.0008). Additionally, intragroup analysis revealed significant PSD elevations relative to baseline in these structures. Significant correlations were observed only for grooming (negative correlations) and sniffing (positive correlations) across all cerebellar regions. Conclusions: These findings suggest compensatory cerebellar hyperactivity induced by VLS lesion, potentially modulating hypokinetic symptoms and highlighting dynamic network interactions. Interpretation warrants caution due to limitations inherent to the acute lesion model and experimental duration. Full article

Background: The “fast track” addition (within 48 h) of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) to the optimized oral lipid-lowering therapy (LLT) during hospitalization for acute coronary syndrome (ACS) has been shown to rapidly achieve the low-density lipoprotein cholesterol (LDL-C) therapeutic targets. However, so far, its efficacy in real-world settings remains understudied. Methods: We retrospectively analyzed 128 ACS patients treated at our center, comparing “PCSK9i fast track” use within 48 h to standard “stepwise” LLT. Lipid levels and incidence of major adverse cardiovascular events (MACEs) were evaluated at 30 and 180 days. Results: The “PCSK9i fast track” group achieved significantly lower LDL-C levels at 30 days (41.5 ± 27.5 vs. 85.6 ± 35.9 mg/dL, p < 0.001) and 180 days (29.6 ± 21.0 vs. 59.0 ± 32.4 mg/dL, p < 0.001). Recommended LDL-C targets (<55 mg/dL) were met by 88.3% of the “PCSK9i fast track” group at 180 days, compared with 61.9% of controls (p < 0.001). No significant differences in MACEs were observed between groups. No adverse effects from PCSK9i use were noted. Conclusions: The “PCSK9i fast track” strategy was safe and effective in achieving LDL-C targets more rapidly than conventional approaches in real-world ACS patients. Full article

Single-class object detection, which focuses on identifying, counting, and tracking a specific animal species, plays a vital role in optimizing farm operations. However, dense occlusion among individuals in group activity scenarios remains a major challenge. To address this, we propose YOLO-SDD, a dense detection network designed for single-class densely populated scenarios. First, we introduce a Wavelet-Enhanced Convolution (WEConv) to improve feature extraction under dense occlusion. Following this, we propose an occlusion perception attention mechanism (OPAM), which further enhances the model’s ability to recognize occluded targets by simultaneously leveraging low-level detailed features and high-level semantic features, helping the model better handle occlusion scenarios. Lastly, a Lightweight Shared Head (LS Head) is incorporated and specifically optimized for single-class dense detection tasks, enhancing efficiency while maintaining high detection accuracy. Experimental results on the ChickenFlow dataset, which we developed specifically for broiler detection, show that the n, s, and m variants of YOLO-SDD achieve AP_50:95 improvements of 2.18%, 2.13%, and 1.62% over YOLOv8n, YOLOv8s, and YOLOv8m, respectively. In addition, our model surpasses the detection performance of the latest real-time detector, YOLOv11. YOLO-SDD also achieves state-of-the-art performance on the publicly available GooseDetect and SheepCounter datasets, confirming its superior detection capability in crowded livestock settings. YOLO-SDD’s high efficiency enables automated livestock tracking and counting in dense conditions, providing a robust solution for precision livestock farming. Full article

Gamification has been extensively applied to aerobic and cardiovascular training, but its adoption in resistance training remains limited. Unlike traditional strength training, which often relies on intrinsic motivation and discipline, gamification introduces extrinsic incentives and real-time feedback that improves engagement and adherence, affecting overall training outcomes. In this work, we develop a gamified resistance training program using wearable sensors to explore the potential benefits of interactive and data-driven exercise experiences. By leveraging real-time feedback and performance tracking, our system provides participants feedback to properly control key training variables such as form and tempo, essential factors for muscle hypertrophy and strength development. To evaluate the effectiveness of our approach, we conducted a short-term comparative study in which participants were assigned to either a gamified training group or a conventional resistance training control group. Over a four-week period, we assessed volitional adherence to prescribed tempo and repetition schemes, along with strength adaptations in the biceps and triceps. Our findings indicate that gamified resistance training significantly enhances adherence to tempo and repetition targets while fostering better adaptation to the workout regime. Participants in the gamified group exhibited measurable improvements in upper body strength compared to the control group. These results suggest that gamification when integrated with wearable sensor technology, can be a powerful tool for optimising resistance training effectiveness and motivation. Full article

Implementing video instance segmentation (VIS) to detect, segment, and track targets based on vision system is important research for air cruiser. Large data with high sampling difficulty result in inefficient network training and limit the air cruisers in adapting to natural scenes during mission. A multi-scale localization grouping weighted weakly supervised VIS (MLGW-VIS) is proposed. Firstly, a spatial information refinement module is designed to supplement the multi-scale spatial location information of the high-level features of the feature pyramid. Secondly, feature interaction among the channels in each sub-space of mask features is strengthened by grouping weighting module. Thirdly, projection and color similarity loss are introduced to achieve weak supervised learning. The experimental results on the data from YouTube-VIS 2019 show that MLGW-VIS has increased the average segmentation accuracy by 5.7% and reached 37.9%, and has achieved positive effects on the perception and location accuracy of objects on the air cruiser platform. Full article