Search Results (2,637)

Background and Clinical Significance: Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent and limiting complication of oncological treatment, particularly in patients receiving oxaliplatin. Its onset can significantly affect the quality of life and compromise the continuity of the antineoplastic therapy. Due to the limited efficacy of available pharmacological therapies, percutaneous electrical nerve stimulation (PENS) has been proposed as a non-invasive alternative for symptom management. Case presentation: We report the case of a 75-year-old woman with colorectal adenocarcinoma who developed CIPN following oxaliplatin administration. She underwent a 12-week course of PENS targeting the median nerve, with weekly sessions conducted without interruption of chemotherapy and without adverse effects. The patient showed progressive improvement in neurosensory symptoms, as measured by the EORTC QLQ-CIPN20 questionnaire. Quantitative sensory testing revealed normalization of thermal and vibratory sensitivity and improved mechanical detection thresholds. The cumulative oxaliplatin dose was maintained throughout treatment. Conclusions: PENS may offer an effective and safe therapeutic option for managing CIPN, enabling symptom control without compromising oncological treatment. This case supports the need for controlled clinical trials to confirm efficacy and establish standardized protocols. Full article

Background and Objectives: Doppler abnormalities in the ductus venosus (DV) during the first trimester can serve as an early marker for the detection of congenital heart defects (CHDs), but the feasibility of systematically assessing the DV remains underexplored. This study aimed to evaluate the feasibility of performing DV assessments during routine first-trimester ultrasound screenings. Materials and Methods: A multicenter, prospective, and descriptive study was conducted, including singleton pregnancies undergoing routine ultrasound screening between 11 + 0 and 13 + 6 weeks of gestation. Sonographers were instructed to acquire DV Doppler images during the scan, and each image was blindly reviewed by an expert using predefined quality criteria. The images were categorized as “good”, “medium”, or “unsatisfactory”, and feasibility was defined as the proportion of “good” images. Factors associated with feasibility were analyzed, including sonographer satisfaction, the Herman score and the acquisition time. Results: Of the 87 patients included in this study, a suitable DV Doppler image was feasible in 58.6% of cases. The feasibility was significantly higher when the sonographer was satisfied with the image, when the Herman score exceeded seven (p = 0.01), and when the acquisition time was less than five minutes. A strong correlation was observed between the expert’s assessment and the sonographer’s satisfaction. However, the gestational age, maternal BMI, parity, and operator-perceived image quality were not significantly associated with feasibility. Conclusions: The Doppler assessment of the ductus venosus during first-trimester ultrasound screening is feasible and reproducible in routine clinical practice without significantly increasing the examination time. This suggests DV measurements to enhance the early nuchal translucency measurement to enhance the early detection of congenital heart defects during the first trimester. Full article

Memory is a fundamental neurological function, essential for animal survival. Over the course of vertebrate evolution, elaborations in the forebrain telencephalon create new memory mechanisms, meaning basal vertebrates such as amphibians must have a less sophisticated system of memory acquisition, storage, and retrieval than the well-known hippocampal-based circuitry of mammals. Personality also appears to be a fundamental vertebrate trait and is generally defined as consistent individual behavior over time and across life history stages. In anuran amphibians (frogs), personality studies generally ask whether adult frogs retain the personality of their tadpole stage or whether personality shifts with metamorphosis, an idea behavioral ecologists term adaptive decoupling. Using a multidisciplinary perspective and recognizing there are ~7843 species of frogs, each with some molecular, morphological, physiological, or behavioral feature that makes it unique, we review, clarify, and provide perspective on what we collectively know about memory and personality and their mechanisms in anuran amphibians. We propose four working hypotheses: (1) as tadpoles grow, new telencephalic neurons become integrated into functional networks, producing behaviors that become more sophisticated with age; (2) since carnivores tend to be more bold/aggressive than herbivores, carnivorous anuran adults will be more aggressive than herbivorous tadpoles; (3) each amphibian species, and perhaps life history stage, will have a set point on the Shy–Bold Continuum; and (4) around this set point there will be a range of individual responses. We also suggest that several factors are slowing our understanding of the variety and depth of memory and personality possibilities in anurans. These include the scala natura approach to comparative studies (i.e., the idea that one frog represents all frogs); the assumption that amphibians are no more than simple reflex machines; that study species tend to be chosen more for convenience than taxonomic representation; and that studies are designed to prove or disprove a construct. This latter factor is a particular hindrance because what we are really seeking as scientists is not the confirmation or refutation of ideas, but rather what those ideas are intended to produce, which is understanding. Full article

Background: Pediatric-onset multiple sclerosis (POMS) is a rare but often more aggressive form of multiple sclerosis, associated with early cognitive impairment and significant impact on quality of life. Multiple sclerosis and primary headaches, particularly migraine, are well established in adults, but data on pediatric populations remain limited. Methods: The purpose of this retrospective study was to examine 64 POMS patients, divided into groups with and without headaches, to determine potential correlations between headache presence, age at POMS onset, and MRI lesion burden. Results: Headaches were reported by 78% of patients, predominantly migraines (68%), with a significantly higher prevalence in females (74%). No significant differences were found in age at MS onset or lesion load on brain MRI between patients with and without headaches. Among those with headaches, migraines represented a higher frequency of attacks and a greater need for prophylactic treatment compared to other headache types. Headache characteristics, including pain location and associated symptoms, showed no correlation with age at MS onset or lesion burden. Conclusions: These findings indicate that while headaches are common in POMS and more frequent in females, their presence and features do not appear to directly influence the clinical or neuroradiological course of the disease. Further research with larger cohorts and longitudinal follow-up is warranted to better understand the underlying mechanisms and long-term impact of headaches in pediatric MS. Full article

Lublin University of Technology has been offering computer science studies for over 25 years. From the beginning, computer graphics have played a crucial role in the studies program. The Lab3D international efforts aimed at cultural heritage 3D digitization allowed for enriching the regular introductory course of computer graphics with elements of digitized real-life heritage, without disturbing the regular didactic process, nor the scope of the course learning outcomes. Such an activity was aimed at increasing the students’ engagement in learning and fits into the contemporary trend of including real-life cases in the course of teaching. The article presents the curriculum (including the changes introduced) together with an extensive analysis of the effect of such changes on students’ achievements. In total, 3042 grades of 1522 students from the years 2018–2024 underwent statistical analysis in order to support answering placed hypotheses related to keeping the effects positive or neutral. Luckily, students’ achievements did not worsen, and in fact significantly improved. To the authors’ knowledge, such an analysis in relation to computer graphics courses has never been published before. Full article

Background/Objectives: Intramural pregnancy (IMP) is a rare type of ectopic pregnancy where the embryo implants within the uterine myometrium. This condition carries a high risk of massive hemorrhage, uterine rupture, and potentially life-threatening complications. Methods: We present a case of a 35-year-old patient who underwent in vitro fertilization (IVF) and was diagnosed with an IMP located in the back-isthmian portion of the uterus by ultrasound scan. Results: We performed a conservative treatment approach based on the gestational sac location and the patient’s stable clinical condition and desire for future fertility. We first administered mifepristone 600 mg, followed by intracavitary methotrexate under ultrasound guidance. Although originally planned, a uterine artery embolization was not performed due to the evidence of bilateral anastomoses between the uterine and ovarian arteries. Progressive reabsorption of pregnancy was observed over the course of 8 months. Conclusions: Non-surgical management can be considered for IMP, thus allowing fertility preservation. Full article

This paper clarified the correlation among quality of life (QoL) indicators, exercise implementation level, and exercise habits in middle-aged and older adults under identical exercise intervention conditions. The survey items were anthropometric and physiologic measurements, physical strength measurements, and exercise habits. During the 3-month experimental period, a weekly “health exercise course” served as the primary intervention. For all participants, anthropometric and physiologic measurements, physical strength tests, questionnaire surveys, and other surveys were conducted before and after the experiment; then, the pre- and post-intervention effects were compared. After the exercise intervention, significant differences were observed among middle-aged and older adults in terms of various parameters, such as weight, fat rate, diastolic pressure, systolic pressure, sit-up, standing on one foot, lower limb extension force, activity of daily living (ADL), and subjective well-being (PGC). ADL and PGC changed significantly in the participants who engaged in exercise more than twice a week. However, the participants who engaged in exercise for less than twice a week showed no significant differences in any parameters except the life satisfaction (LSI) mean; the LSI increased in the “Less than twice a week” exercise group but decreased in the “More than twice a week” group. In terms of average walking time per session, the “More than 30 min” exercise group showed significant differences in ADL and PGC, whereas the “Less than 30 min” group showed significant differences only in the LSI. The influence of exercise on QoL indicators of middle-aged and older adults, under the same exercise intervention conditions, is related to their exercise habits. This study highlights the benefits of physical exercise in middle-aged and older adults, emphasizing the importance of regular and sustained exercise for this population. Furthermore, the study provides a scientific basis for improving QoL in middle-aged and older adults, thus, to some extent, addressing the concerns related to the growing population of older adults. Full article

Background: Digital technologies offer innovative opportunities for recovering and maintaining intellectual and mental health. The use of a multitask approach that combines motor component with various cognitive tasks in a virtual environment can optimize cognitive and physical functions and improve the quality of life of cardiac surgery patients. This study aimed to localize current sources of theta and alpha power in patients who have undergone virtual multitask training (VMT) and a control group in the early postoperative period of coronary artery bypass grafting (CABG). Methods: A total of 100 male CABG patients (mean age, 62.7 ± 7.62 years) were allocated to the VMT group (n = 50) or to the control group (n = 50). EEG was recorded in the eyes-closed resting state at baseline (2–3 days before CABG) and after VMT course or approximately 11–12 days after CABG (the control group). Power EEG analysis was conducted and frequency-domain standardized low-resolution tomography (sLORETA) was used to assess the effect of VMT on brain activity. Results: After VMT, patients demonstrated a significantly higher density of alpha-rhythm (7–9 Hz) current sources (t > −4.18; p < 0.026) in Brodmann area 30, parahippocampal, and limbic system structures compared to preoperative data. In contrast, the control group had a marked elevation in the density of theta-rhythm (3–5 Hz) current sources (t > −3.98; p < 0.017) in parieto-occipital areas in comparison to preoperative values. Conclusions: Virtual reality-based multitask training stimulated brain regions associated with spatial orientation and memory encoding. The findings of this study highlight the importance of neural mechanisms underlying the effectiveness of multitask interventions and will be useful for designing and conducting future studies involving VR multitask training. Full article

Desmoid tumors are rare, deep-seated myofibroblastic tumors with an unpredictable course, ranging from spontaneous regression to infiltrative growth and locally aggressive behavior, but without metastatic potential. Over the past few decades, advances in understanding their natural history, underlying molecular pathways, and patient care priorities have shifted the treatment paradigm from upfront surgical resection to initial active surveillance, with further treatment dictated by continuous disease progression or associated symptoms. However, there are still specific scenarios where surgery continues to play an important role in locoregional treatment and symptom control. This article will focus on current treatment strategies and surgical indications in adult patients with desmoid tumors, emphasizing patient selection, anatomic site-specific considerations, and surgical technique. Understanding the nuanced role of surgery within the growing treatment landscape is key for individualized patient care in a multidisciplinary setting to optimize quality of life and long-term outcomes. Full article

Inclusion in play, physical education, outdoor life, organized sports, and other movement-based activities can promote resilience and support physical, emotional, and social well-being. These arenas are particularly important for reducing health disparities and preventing social marginalization across the lifespan. Yet, children and adolescents from vulnerable or disadvantaged backgrounds encounter persistent barriers to participation, rooted in broader inequalities related to their socioeconomic position, disability, gender, ethnicity, and access to supportive environments. This perspective outlines how inclusive movement contexts, when informed by developmental systems theory and resilience frameworks, can interrupt trajectories of marginalization and promote long-term equity in health, education, and work inclusion. We emphasize the need for interdisciplinary approaches, combining longitudinal and qualitative methods, to uncover how vulnerability and participation interact dynamically over time. By integrating insights from developmental science, education, public health, and spatial ecology, we identify strategic pathways for research and action. Addressing these challenges requires coordinated efforts across sectors and stakeholders to co-create inclusive, context-sensitive interventions. Full article

Decision management is the systems engineering life cycle process for making program/system decisions. The purpose of the decision management process is: “…to provide a structured, analytical framework for objectively identifying, characterizing and evaluating a set of alternatives for a decision at any point in the life cycle and select the most beneficial course of action”. Systems engineers and systems analysts need to inform decisions in a digital engineering environment. This paper describes a Decision Analysis Data Model (DADM) developed in model-based systems engineering software to provide the process, methods, models, and data to support decision management. DADM can support digital engineering for waterfall, spiral, and agile development processes. This paper describes the decision management processes and provides the definition of the data elements. DADM is based on ISO/IEC/IEEE 15288, the INCOSE SE Handbook, the SE Body of Knowledge, the Data Management Body of Knowledge, systems engineering textbooks, and journal articles. The DADM was developed to establish a decision management process and data definitions that organizations and programs can tailor for their system life cycles and processes. The DADM can also be used to assess organizational processes and decision quality. Full article

Community-engaged learning (CEL) is a popular educational approach for sociology teaching across Canada and globally. Students in sociology courses with this experiential component can opt in to enhance their learning by working with community members and organizations in structured, low-stakes ways that forward community priorities. Evidence shows that CEL in sociology courses supports students in developing a wide variety of skills. However, little is known about how international students in sociology courses engage with this pedagogy. Drawing on 20 semi-structured interviews with international students from Asia, South America, and Eastern Europe who completed CEL programming as part of their sociology course curriculum at a large Canadian university, I show how these students engaged in unique learning practices. The findings indicate that international students draw upon their life experiences from diverse national contexts to navigate and reflect upon their CEL placement in sociological ways. These students’ voices offer rich insights for sociology educators designing course-based CEL opportunities with a multinational student body. Full article

Background and aims: The Last Aid Course (LAC) has been established to enhance the discussion about dying, death and grief and to raise the public’s awareness of palliative care. The aim of this study was to explore the views and experiences of German Last Aid Course instructors with the LAC as means for Public Palliative Care Education (PPCE), including their opinion about the course content and format and practical aspects of teaching in different settings. Methods: A longitudinal mixed-methods approach was used to explore the views and experiences of the Last Aid Course instructors over a period of five years. Social space orientation was used as the framework for the data analysis. Results: The LAC participants felt empowered after the LACs. Continuing development was a characteristic of the LAC project. The positive effects of the LACs included empowerment and positive interactions between the instructors and participants. In addition, the LACs had a positive impact on all five principles of social space orientation. Conclusions: LACs can contribute to raising public awareness about dying, death, grief and palliative care and empower people to participate in caring for those who are serious ill, dying and grieving. Full article

The growing prevalence of AI chatbots in everyday life has prompted educators to explore their potential applications in promoting student success, including support for classroom engagement and communication. This exploratory study emerged from semester-long observations of class participation apprehensions in an introductory educational psychology course, examining how chatbots might scaffold students toward active and independent classroom contribution. Four students experiencing situational participation anxiety voluntarily participated in a pilot intervention using AI chatbots as virtual peer partners. Following comprehensive training in AI use and prompt design given to the entire class, participants employed systematic consultation frameworks for managing classroom discourse trepidations. Data collection involved regular instructor meetings documenting student experiences, challenges, and developmental trajectories through qualitative analysis emphasizing contextual interpretation. While students reported general satisfaction with chatbot integration, implementation revealed three critical complexities: temporal misalignment between AI consultation and real-time discussion dynamics; feedback inflation creating disconnects between AI reassurance and classroom reception; and unintended progression from supportive scaffolding toward technological dependency. Individual outcomes varied, with some students developing independence while others increased reliance on external validation. AI-assisted participation interventions demonstrate both promise and limitations, requiring careful consideration of classroom dynamics. Effective implementation necessitates rehearsal-based rather than validation-focused applications, emphasizing human mentorship and community-centered approaches that preserve educational autonomy while leveraging technological scaffolding strategically. Full article

Achieving health equity for people with disabilities requires addressing the barriers that they face when accessing healthcare. Older adults with disabilities may experience compounded disparities, yet little research has explored their satisfaction with health facility personnel, including non-healthcare staff. This study examines differences in satisfaction with health facility personnel between younger (18–59 years) and older (60+) adults with disabilities in Chile. Data from the 2024 Disability and Citizenship (DISCA) survey were analysed using chi-square tests to examine differences between younger and older people with disabilities with regard to their satisfaction with health facility personnel. Ordered logistic regressions were employed to predict high satisfaction, given socioeconomic and health-related variables. Findings indicated that a higher percentage of older adults with disabilities reported high satisfaction with health facility personnel compared to younger adults. Ordered logistic regressions confirmed that older adults had greater odds of reporting high satisfaction with doctors (OR: 3.83), other health professionals (OR: 4.66), paramedical technicians (OR: 4.31), and administrative staff (OR: 3.13). These results suggest that age influences satisfaction levels among people with disabilities, potentially due to varying expectations, experiences, or interactions with health facility personnel. Understanding the underlying reasons for these age-related differences is essential to inform policies and practices that ensure equitable, person-centred care for people with disabilities across the life course. Full article