Search Results (40)

Differentiating Alzheimer’s disease (AD) from frontotemporal dementia (FTD) using resting-state electroencephalography (EEG) remains clinically challenging because of their overlapping electrophysiological characteristics. Although EEG suits large-scale dementia screening, current method often overestimates performance because of epoch-level data leakage and multiclass feature competition in unified models. We propose a task-decoupled, two-stage hierarchical deep learning framework utilizing multiband EEG microstate dynamics. Continuous microstate sequences, modeled via Hungarian matching to preserve fine-grained temporal information, are processed using a normalizer-free 1D convolutional neural network (1D-CNN-NFNet) integrated with multi-head attention. By decoupling the workflow, Stage 1 performs generalized dementia screening using alpha and delta microstates, achieving an area under the curve (AUC) of 0.851. Stage 2 disentangles AD from FTD using delta and theta dynamics, yielding an AD-locking specificity of 86.1%. Evaluated under a strict subject-level leave-one-subject-out (LOSO) cross-validation protocol, the two-stage framework achieved 63.9% balanced accuracy, outperforming the single-stage baseline (55.4%) with a negligible inference latency of 0.733 ms. Furthermore, attention-based interpretability analysis links frequency-specific microstate alterations to underlying cortical disconnection syndromes. These results demonstrate that the framework provides a reproducible and interpretable auxiliary reference for dementia screening and subtyping in clinical neurology. Full article

Locked-in Syndrome (LIS) is a neurological condition in which individuals remain conscious but experience complete paralysis of voluntary muscles, except for eye movements—highlighting the need for reliable assistive communication technologies. This study presents the design and evaluation of an Arabic electrooculogram (EOG)-based communication system with adaptive classification capabilities for LIS applications. A custom-designed EOG acquisition circuit incorporating filtering and amplification stages was implemented and compared with the OpenBCI Cyton board. The system employed a hybrid classification approach combining amplitude, temporal, and statistical features to distinguish between blinks and voluntary vertical eye movements. Testing with ten healthy subjects yielded a mean classification accuracy of 83.96% ± 4.59% and an information transfer rate of 10.43 letters per minute, corresponding to a 30.38% improvement over conventional approaches. The custom-designed circuit achieved a signal-to-noise ratio of 25.21 dB, outperforming the OpenBCI Cyton board by 8% while reducing system cost by 62%. The integration with a Morse code-based interface enabled Arabic letter composition, while the system incorporated auto-completion and text-to-speech functionalities to further enhance communication efficiency. This cost-effective solution addresses a critical gap in assistive technologies for Arabic-speaking individuals with LIS and shows strong potential for enhancing their communication abilities and overall quality of life. Full article

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a positive-sense RNA virus, and its genome includes a highly conserved 5′ untranslated region (5′UTR). This region contains the so-called ‘leader sequence’, a crucial genomic region responsible for the viral replication and the synthesis of all subgenomic RNAs (sgRNAs). It has been demonstrated that targeting highly conserved genomic regions is essential for developing broad-spectrum antiviral therapies that resist viral mutation and evasion. Hypothesis: Given the high level of nucleotide homology between SARS-CoV and SARS-CoV-2, particularly in essential regions like the 5′UTR, the identification of a perfect sequence alignment across SARS-CoV-2 variants within this conserved region would provide a robust, mutation-resistant target for novel RNA-based drugs, such as small interfering RNAs (siRNAs) or microRNAs (miRNAs). Materials and Methods: Sequence alignment was performed across the different SARS-CoV-2 strains (i.e., the different variants that have appeared so far) to identify conserved genomic areas, leading to the selection of potential target sites for antiviral molecules. Specifically, computational analyses were utilized to map available binding sites for human miRNAs within the SARS-CoV-2 5′UTR. Results: Comparative alignments revealed that the leader sequence/5′UTR region is highly stable and conserved in all the considered SARS-CoV-2 sequences, representing a common therapeutic target across different variants and strains. Discussion: The perfect alignment observed in the 5′UTR confirms that this region is a highly critical target, less prone to mutations in all the considered variants. This property makes the region ideal for therapeutic intervention using non-coding RNAs. If endogenous miRNAs were found to bind this region (e.g., miR-638, miR-3150b-3p, etc.) and promote viral replication similarly to mechanisms observed in viruses like hepatitis C virus (HCV), their activity could be inhibited using chemically modified antisense analogs, such as locked nucleic acid (LNA) oligonucleotides. Full article

Objective: This study aimed to describe the main microorganisms causing catheter-related bloodstream infections (CRBSIs) and to evaluate the effectiveness of taurolidine catheter lock therapy in children with intestinal failure (IF) receiving parenteral nutrition (PN). Study design: This retrospective study included 31 pediatric patients with IF admitted between 2017 and 2022 who received PN via central venous catheters (CVCs). Demographic, clinical, and laboratory data were collected, along with information on PN use, catheter characteristics, and infection episodes, including clinical signs, microbiological cultures, and antimicrobial therapy. Serum C-reactive protein and albumin levels, as well as the use of taurolidine lock therapy, were analyzed. Results: The median age was 54.4 days among patients who developed CRBSI and 154.1 days among those without CRBSI. The median duration of PN was 119 days in patients with CRBSI and 89 days in those without. Nineteen patients experienced CRBSI, accounting for 55 infection episodes confirmed by blood cultures obtained from CVCs. The most frequently isolated microorganisms were Staphylococcus epidermidis, Enterococcus faecalis, and Klebsiella pneumoniae. Taurolidine lock therapy was significantly associated with lower infection rates per 1000 catheter days, with most infected catheters and infection episodes occurring in the absence of taurolidine use. Conclusions: These findings contribute to the characterization of the microbiological profile of CRBSIs in pediatric patients with IF and support the use of advanced preventive strategies, such as taurolidine lock therapy, to reduce infection rates in children receiving long-term PN. Full article

Background/Objectives: The vestibular labyrinth is classically viewed as a sensor of low-frequency head motion—linear acceleration for the otoliths and angular velocity/acceleration for the semicircular canals. However, there is now substantial evidence that air-conducted sound (ACS) can also activate vestibular receptors and afferents in mammals and other vertebrates. This sound sensitivity underlies sound-evoked vestibular-evoked myogenic potentials (VEMPs), sound-induced eye movements, and several clinical phenomena in third-window pathologies. The cellular and biophysical mechanisms by which a pressure wave in the cochlear fluids is transformed into a vestibular neural signal remain incompletely integrated into a single framework. This study aimed to provide a narrative synthesis of how ACS activates the vestibular labyrinth, with emphasis on (1) the anatomical and biophysical specializations of the maculae and cristae, (2) the dual-channel organization of vestibular hair cells and afferents, and (3) the encoding of fast, jerk-rich acoustic transients by irregular, striolar/central afferents. Methods: We integrate experimental evidence from single-unit recordings in animals, in vitro hair cell and calyx physiology, anatomical studies of macular structure, and human clinical data on sound-evoked VEMPs and sound-induced eye movements. Key concepts from vestibular cellular neurophysiology and from the physics of sinusoidal motion (displacement, velocity, acceleration, jerk) are combined into a unified interpretative scheme. Results: ACS transmitted through the middle ear generates pressure waves in the perilymph and endolymph not only in the cochlea but also in vestibular compartments. These waves produce local fluid particle motions and pressure gradients that can deflect hair bundles in selected regions of the otolith maculae and canal cristae. Irregular afferents innervating type I hair cells in the striola (maculae) and central zones (cristae) exhibit phase locking to ACS up to at least 1–2 kHz, with much lower thresholds than regular afferents. Cellular and synaptic specializations—transducer adaptation, low-voltage-activated K⁺ conductances (K_LV), fast quantal and non-quantal transmission, and afferent spike-generator properties—implement effective high-pass filtering and phase lead, making these pathways particularly sensitive to rapid changes in acceleration, i.e., mechanical jerk, rather than to slowly varying displacement or acceleration. Clinically, short-rise-time ACS stimuli (clicks and brief tone bursts) elicit robust cervical and ocular VEMPs with clear thresholds and input–output relationships, reflecting the recruitment of these jerk-sensitive utricular and saccular pathways. Sound-induced eye movements and nystagmus in third-window syndromes similarly reflect abnormally enhanced access of ACS-generated pressure waves to canal and otolith receptors. Conclusions: The vestibular labyrinth does not merely “tolerate” air-conducted sound as a spill-over from cochlear mechanics; it contains a dedicated high-frequency, transient-sensitive channel—dominated by type I hair cells and irregular afferents—that is well suited to encoding jerk-rich acoustic events. We propose that ACS-evoked vestibular responses, including VEMPs, are best interpreted within a dual-channel framework in which (1) regular, extrastriolar/peripheral pathways encode sustained head motion and low-frequency acceleration, while (2) irregular, striolar/central pathways encode fast, sound-driven transients distinguished by high jerk, steep onset, and precise spike timing. Full article

Background: Amyotrophic lateral sclerosis (ALS) progressively impairs motor function, compromising speech and limiting communication. Augmentative and alternative communication (AAC) is essential to maintain autonomy, social participation, and quality of life for people with ALS (PALS). This review maps technological developments in AAC, from low-tech tools to advanced brain–computer interface (BCI) systems. Methods: We conducted a scoping review following the PRISMA extension for scoping reviews. PubMed, Web of Science, SciELO, MEDLINE, and CINAHL were screened for studies published up to 31 August 2025. Peer-reviewed RCT, cohort, cross-sectional, and conference papers were included. Single-case studies of invasive BCI technology for ALS were also considered. Methodological quality was evaluated using JBI Critical Appraisal Tools. Results: Thirty-seven studies met inclusion criteria. High-tech AAC—particularly eye-tracking systems and non-invasive BCIs—were most frequently studied. Eye tracking showed high usability but was limited by fatigue, calibration demands, and ocular impairments. EMG- and EOG-based systems demonstrated promising accuracy and resilience to environmental factors, though evidence remains limited. Invasive BCIs showed the highest performance in late-stage ALS and locked-in syndrome, but with small samples and uncertain long-term feasibility. No studies focused exclusively on low-tech AAC interventions. Conclusions: AAC technologies, especially BCIs, EMG and eye-tracking systems, show promise in supporting autonomy in PALS. Implementation gaps persist, including limited attention to caregiver burden, healthcare provider training, and the real-world use of low-tech and hybrid AAC. Further research is needed to ensure that communication solutions are timely, accessible, and effective, and that they are tailored to functional status, daily needs, social participation, and interaction with the environment. Full article

This study aimed to identify electrophysiological markers (event-related potentials, ERPs) of intentional, need-related mental activity under controlled gaze fixation, with potential applications in brain–computer interface (BCI) development for individuals with severe motor impairments. Methods: Using stimuli from the PAIN Pictionary—a pictogram database for non-verbal communication in locked-in syndrome (LIS) contexts—neural responses were recorded via high-density EEG in 30 neurologically healthy adults (25 included after artifact-based exclusion). Participants viewed randomized sequences of pictograms representing ten fundamental need categories (e.g., “I am cold”, “I’m in pain”), with one category designated as the target per sequence. Each pictogram was followed by a visual cue prompting a button press: during training, participants executed the press; during the main task, they performed right-hand motor imagery while maintaining central fixation. Results: ERP analyses revealed a robust P300 response (450–650 ms; p < 0.0002) over centro-parietal regions for target cues, reflecting enhanced attentional allocation and stimulus choice. An early Contingent Negative Variation (CNV, 450–750 ms; p = 0.008) over fronto-lateral sites indicated anticipatory attention and motor preparation, while a left-lateralized late CNV (2250–2750 ms; p = 0.035) appeared to embody the preparation of a finalized motor plan for the forthcoming right-hand imagined response. A centro-parietal P600 component (600–800 ms; p = 0.044) emerged during response monitoring, reflecting evaluative and decisional processes. SwLORETA source analyses localized activity within a distributed network spanning prefrontal, premotor, motor, parietal, and limbic areas. Conclusions: These findings demonstrate that motor imagery alone can modulate pattern-onset ERP components without overt movement or gaze shifts, supporting the translational potential of decoding need-related intentions for thought-driven communication systems in individuals with profound motor impairments. Full article

We here delve into the intricate and evolving concepts of brain death and consciousness, particularly at the end of life. We examine the historical and technological advancements that have influenced our understanding of death, such as mechanical ventilation and resuscitation techniques. These developments have challenged traditional definitions of death, leading to the concept of brain death, defined as the irreversible loss of all brain functions, including the brainstem. We emphasize that consciousness exists on a continuum, ranging from full alertness to deep coma and complete cessation of brain activity. It explores various disorders of consciousness, including coma, vegetative state, minimally conscious state, and locked-in syndrome, each with distinct characteristics and levels of awareness. Neuroimaging techniques, such as EEG, fMRI, and DTI, are highlighted for their crucial role in diagnosing and understanding disorders of consciousness. These techniques help to detect covert consciousness, assess brain activity, and predict recovery potential. The phenomenon of the “wave of death,” which includes a paradoxical surge in brain activity at the point of death, is also discussed. We address the challenges in defining and understanding both death and consciousness, calling for biologically grounded, ethically defensible, and culturally sensitive definitions. We advocate for standardized neuroimaging protocols, longitudinal studies, and the integration of artificial intelligence to improve diagnosis and treatment. In conclusion, the document underscores the importance of an integrated, evidence-based approach to understanding the gray zones between life and death, recognizing that consciousness and death are dynamic processes with both biological and experiential dimensions. Full article

Visual imagery (VI) is a mental process in which an individual generates and sustains a mental image of an object without physically seeing it. Recent advancements in assistive technology have enabled the utilization of VI mental tasks as a control paradigm to design brain–computer interfaces (BCIs) capable of generating numerous control signals. This, in turn, enables the design of control systems to assist individuals with locked-in syndrome in communicating and interacting with their environment. This paper presents an electroencephalogram (EEG) dataset captured from 30 healthy native Arabic-speaking subjects (12 females and 18 males; mean age: 20.8 years; age range: 19–23) while they visually imagined the 28 letters of the Arabic alphabet. Each subject conducted 10 trials per letter, resulting in 280 trials per participant and a total of 8400 trials for the entire dataset. The EEG signals were recorded using the EMOTIV Epoc X wireless EEG headset (San Francisco, CA, USA), which is equipped with 14 data electrodes and two reference electrodes arranged according to the 10–20 international system, with a sampling rate of 256 Hz. To the best of our knowledge, this is the first EEG dataset that focuses on visually imagined Arabic letters. Full article

Considering the presence of airborne viruses, there is a need for renovation in refuse chutes, regarded as the first step in recycling household waste in buildings. This study aimed to revise the design of existing refuse chutes in light of the challenging experiences in waste management and public health during the coronavirus pandemic. This research primarily focused on the risks posed by various types of coronaviruses, such as the novel coronavirus (COVID-19) and acute respiratory syndrome (SARS and SARS-CoV), on stainless steel surfaces, with evidence of their survival under certain conditions. Refuse chutes are manufactured from stainless steel to resist the corrosive effects of waste. In examining the existing studies, it was observed that Casanova et al. and Chowdhury et al. found that the survival time of coronaviruses on stainless steel surfaces decreases as the temperature increases. Based on these studies, mechanical revisions have been made to the sanitation system of the refuse chute, thus increasing the washing water temperature. Additionally, through mechanical improvements, an automatic solution spray entry is provided before the intake doors are opened. Furthermore, to understand airflow and clarify flow parameters related to airborne infection transmission on residential floors in buildings equipped with refuse chutes, a computational fluid dynamics (CFD) analysis was conducted using a sample three-story refuse chute system. Based on the simulation results, a fan motor was integrated into the system to prevent pathogens from affecting users on other floors through airflow. Thus, airborne pathogens were periodically expelled into the atmosphere via a fan shortly before the intake doors were opened, supported by a PLC unit. Additionally, the intake doors were electronically interlocked, ensuring that all other intake doors remained locked while any single door was in use, thereby ensuring user safety. In a sample refuse chute, numerical calculations were performed to evaluate parameters such as the static suitability of the chute body thickness, static compliance of the chute support dimensions, chute diameter, chute thickness, fan airflow rate, ventilation duct diameter, minimum rock wool thickness for human contact safety, and the required number of spare containers. Additionally, a MATLAB code was developed to facilitate these numerical calculations, with values optimized using the Fmincon function. This allowed for the easy calculation of outputs for the new refuse chute systems and enabled the conversion of existing systems, evaluating compatibility with the new design for cost-effective upgrades. This refuse chute design aims to serve as a resource for readers in case of infection risks and contribute to the literature. The new refuse chute design supports the global circular economy (CE) model by enabling waste disinfection under pandemic conditions and ensuring cleaner source separation and collection for recycling. Due to its adaptability to different pandemic conditions including pathogens beyond coronavirus and potential new virus strains, the designed system is intended to contribute to the global health framework. In addition to the health measures described, this study calls for future research on how evolving global health conditions might impact refuse chute design. Full article

Background/Objectives: The treatment of periarticular distal radius fractures remains challenging. Different surgical treatment options have been proposed as alternatives to conservative treatment. This systematic review aims to compare the functional outcomes, radiological outcomes, and complications among volar locking plates (VLPs), Kirschner-wire fixations, and external fixations (EFs) for distal radius fractures in patients aged 60 years and older. Methods: We conducted a comprehensive search of PubMed, Cochrane, and Science Direct databases assessing the effects of VLP, EF, and K-wire treatments for distal radius fractures in patients aged 60 years and over. The primary outcome was the evaluation of the range of motion (ROM) degrees after three surgical procedures, trying to assess the best treatment option. The secondary outcome included evaluation of the Disabilities of the Arm, Shoulder, and Hand (DASH) score, quick-DASH score, Patient-Rated Wrist Evaluation (PRWE) score, Visual Analog Scale (VAS) score, grip strength, radiographic assessment, and complications comparing VLPs, EFs and K-wires. Results: A total of 23 studies were included, comparing VLP, EF, and K-wire fixation. The overall population comprised 5618 patients, with 4690 females and 1015 males, of which 4468 patients were treated with VLP, 503 with EF, and 647 with K-wire. The most common complications among the VLP group were complex regional pain syndrome (7.5%) and carpal tunnel syndrome (6.8%); for the EF group, infections (9.8%) and carpal tunnel syndrome (6.8%); and for the K-wire group, carpal tunnel syndrome (7.5%) and infections (6.9%). Conclusions: VLP showed better clinical outcomes in the first few months after treatment. However, these differences decreased over time and became similar after one year. EF and K-wire fixations remain easier to manage during surgery. Full article

Acquired immunodeficiency syndrome (AIDS) is an enormous global health threat stemming from human immunodeficiency virus (HIV-1) infection. Up to now, the tremendous advances in combination antiretroviral therapy (cART) have shifted HIV-1 infection from a fatal illness into a manageable chronic disorder. However, the presence of latent reservoirs, the multifaceted nature of HIV-1, drug resistance, severe off-target effects, poor adherence, and high cost restrict the efficacy of current cART targeting the distinct stages of the virus life cycle. Therefore, there is an unmet need for the discovery of new therapeutics that not only bypass the limitations of the current therapy but also protect the body’s health at the same time. The main goal for complete HIV-1 eradication is purging latently infected cells from patients’ bodies. A potential strategy called “lock-in and apoptosis” targets the budding phase of the life cycle of the virus and leads to susceptibility to apoptosis of HIV-1 infected cells for the elimination of HIV-1 reservoirs and, ultimately, for complete eradication. The current work intends to present the main advantages and disadvantages of United States Food and Drug Administration (FDA)-approved anti-HIV-1 drugs as well as plausible strategies for the design and development of more anti-HIV-1 compounds with better potency, favorable pharmacokinetic profiles, and improved safety issues. Full article

Combination antiretroviral therapy (cART) has significantly improved the prognosis of individuals living with human immunodeficiency virus (HIV). Acquired immunodeficiency syndrome has transformed from a fatal disease to a treatable chronic infection. Currently, effective and safe anti-HIV drugs are available. Although cART can reduce viral production in the body of the patient to below the detection limit, it cannot eliminate the HIV provirus integrated into the host cell genome; hence, the virus will be produced again after cART discontinuation. Therefore, research into a cure (or remission) for HIV has been widely conducted. In this review, we focus on drug development targeting cells latently infected with HIV and assess the progress including our current studies, particularly in terms of the “Shock and Kill”, and “Block and Lock” strategies. Full article

The third window syndrome, often associated with the Tullio phenomenon, is currently most often observed in patients with a superior semicircular-canal dehiscence (SCD) but is not specific to this pathology. Clinical and vestibular tests suggestive of this pathology are not always concomitantly observed and have been recently complemented by the skull-vibration-induced nystagmus test, which constitutes a bone-conducted Tullio phenomenon (BCTP). The aim of this work was to collect from the literature the insights given by this bedside test performed with bone-conducted stimulations in SCD. The PRISMA guidelines were used, and 10 publications were included and analyzed. Skull vibration-induced nystagmus (SVIN), as observed in 55 to 100% of SCD patients, usually signals SCD with greater sensitivity than the air-conducted Tullio phenomenon (ACTP) or the Hennebert sign. The SVIN direction when the test is performed on the vertex location at 100 Hz is most often ipsilaterally beating in 82% of cases for the horizontal and torsional components and down-beating for the vertical component. Vertex stimulations are more efficient than mastoid stimulations at 100 Hz but are equivalent at higher frequencies. SVIN efficiency may depend on stimulus location, order, and duration. In SCD, SVIN frequency sensitivity is extended toward high frequencies, with around 400 Hz being optimal. SVIN direction may depend in 25% on stimulus frequency and in 50% on stimulus location. Mastoid stimulations show frequently diverging results following the side of stimulation. An after-nystagmus observed in 25% of cases can be interpreted in light of recent physiological data showing two modes of activation: (1) cycle-by-cycle phase-locked activation of action potentials in SCC afferents with irregular resting discharge; (2) cupula deflection by fluid streaming caused by the travelling waves of fluid displacement initiated by sound or vibration at the point of the dehiscence. The SVIN direction and intensity may result from these two mechanisms’ competition. This instability explains the SVIN variability following stimulus location and frequency observed in some patients but also discrepancies between investigators. SVIN is a recent useful insight among other bedside examination tests for the diagnosis of SCD in clinical practice. Full article

Locked-in syndrome (LIS) is a rare and challenging condition that results in tetraplegia and cranial nerve paralysis while maintaining consciousness and variable cognitive function. Once acute management is completed, it is important to work with the patient on developing a plan to maintain and improve their quality of life (QOL). A key component towards increasing or maintaining QOL within this population involves the establishment of a functional communication system. Evaluating cognition in patients with LIS is vital for evaluating patients’ communication needs along with physical rehabilitation to maximize their QOL. In the past decade or so, there has been an increase in research surrounding brain–computer interfaces to improve communication abilities for paralyzed patients. This article provides an update on the available technology and the protocol for finding the best way for patients with this condition to communicate. This article aims to increase knowledge of how to enhance and manage communication among LIS patients. Full article