Search Results (665)

(1) Background: The scarcity and imbalance of real fault data significantly limit the development of data-driven fault diagnosis methods for liquid rocket engines (LREs), especially under few-shot conditions. (2) Methods: To address this issue, this study proposes a GAN-based fault data augmentation framework for multivariate LRE time-series signals and a hybrid diagnostic classifier combining convolutional neural networks (CNNs), bidirectional long short-term memory (BiLSTM), and multi-head attention (MHA). The GAN component is introduced to alleviate fault-data scarcity and class imbalance by generating additional fault-like samples, while the classifier is designed to capture local features, long-range temporal dependencies, and diagnostically informative temporal regions. (3) Results: A multidimensional evaluation based on temporal similarity, statistical consistency, and global distribution discrepancy indicates that the generated samples preserve important characteristics of the original signals under the current evaluation protocol. On the augmented LRE dataset, the proposed classifier achieved strong diagnostic performance. In addition, supplementary experiments on the public HIT aero-engine dataset further support the effectiveness of the classifier architecture, its component-wise contribution, and its behavior under imbalanced few-shot settings, while also demonstrating the value of uncertainty-aware prediction. (4) Conclusions: The results provide encouraging evidence that the proposed framework can improve LRE fault diagnosis under data-scarce conditions. However, the present findings should be interpreted within the scope of the available data and evaluation setting. More comprehensive generator-side ablation, broader external validation, and physics-oriented assessment of the generated signals are still needed before stronger conclusions can be made. Full article

Background: Fasting-based interventions are increasingly investigated as adjuncts to cancer treatment for the potential to reduce therapy-related toxicities, improve metabolic health, and enhance quality of life. However, clinical evidence regarding their efficacy, tolerability, and acceptability remains limited and fragmented. This scoping review aimed to systematically map the current evidence on fasting-based interventions in cancer patients and survivors. Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and CINAHL up to 10 June 2025. Eligible interventional studies included cancer patients or survivors and evaluated fasting-based interventions, such as time-restricted eating, intermittent fasting, short-term fasting, or fasting-mimicking diets. Studies were categorized by fasting types and outcomes like fatigue, treatment toxicity, metabolic and hematologic parameters, weight, quality of life, adherence, acceptability, illness perception, and adverse events were assessed. Result: Twenty interventional studies of FMD, TRE, STF, IF, or fasting combined with altered dietary approaches conducted across 10 countries were included, comprising a total of 871 participants. Participant ages ranged from 28 to 75 years. Overall, 9 of 20 studies exclusively enrolled breast cancer patients or survivors, and chemotherapy was the most common treatment context in 11 studies. Five of six studies reported reductions in fatigue. Among the five studies assessing quality of life, one demonstrated improvement, three reported no change, and one yielded mixed results. Six of eight studies reported reductions in chemotherapy-related toxicity, and weight loss was observed in 10 of 12 studies. Reductions in IGF-1 and insulin levels were reported in six of seven and four of five studies, respectively. Hematologic changes were noted in six studies, and only one study assessed illness perceptions, reporting positive findings. Fasting-related adverse events, reported in nine studies, were generally mild and transient. High adherence and acceptability were observed across studies; however, findings were heterogeneous across intervention types and were largely derived from small or moderate-strength studies. A descriptive quality metric assessment indicated that most studies were of moderate methodological strength. More intensive fasting protocols, such as FMD and STF, appeared to demonstrate more consistent metabolic effects, whereas TRE showed higher adherence but more variable clinical outcomes. Conclusions: Fasting-based interventions have the potential to be feasible and well tolerated among cancer patients and survivors, with early evidence suggesting benefits in reducing fatigue, minimizing treatment-related toxicities, and favorable metabolic effects. Large, well-designed trials including diverse cancer populations are needed to confirm long-term outcomes and guide clinical integration. Full article

Background: Pediatric adenotonsillectomy is commonly performed for infectious and obstructive indications, but postoperative hemorrhage remains a concern. This study describes outcomes from a high-volume territorial network in southern Modena province, Italy. Methods: Retrospective observational study of 10,753 pediatric patients (aged 3–18 years) undergoing adenotonsillectomy at Sassuolo Hospital and affiliates (Vignola, Pavullo) from 2005 to 2024. Indications included recurrent tonsillitis (Paradise criteria), obstructive sleep apnea (OSA) (polysomnography-confirmed or clinical), and recurrent otitis media or otitis media with effusion (OME). Surgical techniques included curettage adenoidectomy and Colorado microdissection needle tonsillectomy. Our institutional postoperative care protocol included analgesics, oral hydration, soft diet, antibiotics (amoxicillin) and scheduled follow-up; however, no analysis regarding this protocol was intended to demonstrate correlations with study outcomes. Primary outcomes were postoperative hemorrhage (overall and requiring revision), stratified by indication, age, and technique, and contextualized against ranges reported in large published cohorts (qualitative, exploratory comparison). Secondary outcomes included pain (VAS scores), infection rates, and tissue regrowth. Data completeness was verified via electronic records (95.6%). Statistical analyses used descriptive statistics with 95% confidence intervals (95% CI) and inferential tests for within-cohort comparisons (χ² tests, Fisher’s exact test, and t-tests where appropriate). Results: A total of 10,753 procedures were analyzed (4325 tonsillectomies, 3942 adenotonsillectomies, 2486 adenoidectomies). Postoperative hemorrhage occurred in 202 patients (1.88%; 95% CI 1.64–2.15%); surgical revision was required in 75 (0.70%; 95% CI 0.56–0.87%), with multifactorial stratification showing higher risk for infectious indications (OR 1.41 vs. OSA), younger age < 5 years (OR 2.1), and tonsillectomy origin (OR 8.25 vs. adenoidectomy); all rates are at the lower end of literature ranges (2–5% and 0.9–2.5%, respectively), in line with large published cohorts, although these comparisons are qualitative and exploratory. Mean VAS pain scores decreased from 3.2 (day 1) to 1.1 (day 7). No significant infections occurred; tissue regrowth rates aligned with the literature (adenoidal 6–26%, tonsillar 5–10%). Conclusions: Sassuolo Hospital’s experience highlights favorable postoperative outcomes and low complication rates in adenotonsillar surgery. Limitations include the retrospective design, potential selection bias and long period evaluation. Prospective studies are needed to confirm these findings. Full article

Background/Objectives: Distal biceps tendon rupture (DBTR) significantly impairs upper-limb function, particularly in movements requiring elbow flexion and forearm supination. This condition continues to attract clinical interest due to its complex biomechanics, evolving surgical strategies, and the growing emphasis on comprehensive rehabilitation. Contemporary evidence highlights the value of a multidisciplinary approach that integrates precise surgical repair with structured, progressive physiotherapy to optimize outcomes effectively. Methods: We performed a comprehensive review of the literature by searching PubMed/MEDLINE, and a narrative review format was adopted to synthesize the available evidence. Results: Studies comparing single-incision and double-incision techniques show that both achieve excellent outcomes, although the decision should be tailored to patient-specific factors, surgeon expertise, and the reported complication risk, which may vary between 5% and 63%. Regardless of technique, restoring tendon integrity is essential for regaining normal strength and supination capability. Rehabilitation following DBTR repair relies on a phased and carefully monitored program. Early physiotherapy focuses on a controlled range of motion and the prevention of stiffness while protecting the repair. As healing progresses, strengthening exercises targeting the biceps, triceps, and brachialis are introduced, alongside endurance training to enhance overall functional capacity. Evidence strongly supports early mobilization protocols, where active motion and graded resistance are initiated within the first postoperative week, resulting in faster and more complete functional recovery compared to prolonged immobilization. Conclusions: Long-term outcomes after DBTR repair are consistently favorable. Most patients return to full activity or sport at an average of 5.4 months, although timelines vary with rehabilitation intensity and baseline fitness. Notably, 93–100% recover their pre-injury activity level, including participation in competitive sports. Full article

Radicular cysts (RCs) represent the most frequent inflammatory cystic lesions of the jaw, typically arising from non-vital teeth. While standard management via enucleation is well-documented, complex cases involving the anterior maxilla present significant surgical challenges due to their proximity to the nasal cavity floor (NCF) and the maxillary sinus floor (MSF). This report provides a comprehensive revision of a clinical case series involving seven patients (ages 17–50) treated with multimodal surgical and regenerative protocols. The patients were stratified into five distinct anatomical risk groups (A–E) based on the integrity of the bony boundaries and the presence of oronasal communications. The treatment strategies combined meticulous cyst enucleation with advanced regenerative techniques, including platelet-rich fibrin (PRF), allogeneic and xenograft bone substitutes, and local flaps such as the buccal fat pad (BFP). The results across all seven cases demonstrated favorable clinical and radiographic outcomes, with no instances of oronasal fistula formation or recurrence during follow-up periods ranging from 12 months to three years. This report emphasizes the necessity of structured anatomical stratification and multimodal planning to ensure scientific precision and surgical predictability in the management of complex maxillary lesions. The differences between approaches towards the nasal cavity and maxillary sinus have to be highlighted. Further studies with larger cohorts are warranted to evaluate the long-term outcomes of different treatment modalities. Full article

Background: There is limited information about treatment success and outcomes in retrovirus-positive cats diagnosed with feline infectious peritonitis (FIP). Methods: A survey was distributed to caretakers of cats with feline leukemia virus (FeLV) and/or feline immunodeficiency virus (FIV) that were treated with GS-441524 for presumptive effusive FIP based on survey responses. Results: Cats with FIV developed FIP at an older age and longer after retrovirus infection than cats with FeLV. The average starting dosage (7 mg/kg/d) was increased in 65% of cats, and treatment was extended in 35%. Three cats relapsed (18%). There was a 94% (16/17) twelve-week survival rate and 82% (14/17) one-year survival rate. Seven cats were alive at follow-up, a median of 1306 days (range 983–2069) after FIP diagnosis, but many cats succumbed to neoplasia. Conclusions: Treatment success for retrovirus-positive cats with presumptive FIP was similar to previously reported outcomes for FIP alone. This could support current evidence of successful antiviral therapy for similar populations, if noncurrent, unstandardized protocols and unlicensed product use are considered. Additional studies are needed to determine ideal protocols for rapid resolution of FIP, good long-term survival, and limited relapse in retrovirus-positive cats, and the impact of the FeLV proviral load. Full article

To clarify the genetic classification, diagnostic strategies, and precision treatment pathways of steroid-resistant nephrotic syndrome (SRNS), this review systematically reviews the genetic stratification system of SRNS by integrating recent advances in genetic testing technologies and pathogenesis research. It contains the pathogenic mechanisms, diagnostic protocols, and therapeutic correlations of different genetic subtypes, while summarizing current progress and clinical challenges in gene therapy. Results indicate SRNS can be categorized into genetic (38–58%) and non-genetic/immune-mediated (40–60%). A stepwise diagnostic system comprising core proteinuria gene panel testing, whole-genome sequencing (WGS), whole-exome sequencing (WES), and supplementary multi-omics/long-range sequencing is proposed, suited for populations with “typical phenotypes and moderate genetic risk”, “atypical phenotypes and high genetic suspicion”, and “complex structural/non-coding region variants” respectively. Pathogenic mechanisms directly determine therapeutic strategies: COQ2/PDSS2 mutations respond to coenzyme Q10 suplementation, while NPHS1 mutations necessitate early renal transplantation. Adeno-associated virus (AAV)-mediated gene therapy and CRISPR-Cas editing show preclinical promise but face challenges including incomplete detection coverage and clinical translation difficulties. Genetic technologies are driving SRNS management transformation from “empirical treatment” to “mechanism-oriented precision diagnosis and therapy”. Future efforts should focus on overcoming genetic testing limitations and gene therapy translation bottlenecks to enhance diagnostic and therapeutic efficacy. Full article

This systematic review examines how gait analysis has been applied to understand, detect, and manage diabetes and its complications, with a focus on wearable sensor technologies and computational methods. A total of 30 studies were identified from IEEE Xplore, Scopus, and Google Scholar databases using systematic search and screening processes. Data extraction followed a structured framework addressing research questions on gait applications, technologies, and associated parameters. Results indicate that wearable sensor technologies, coupled with advanced computational modeling and machine learning, can capture meaningful gait alterations associated with long-term metabolic dysregulation and neuropathic changes. Applications range from diabetic neuropathy detection and foot ulcer prevention to intervention evaluation and early biomarker identification. The review highlights current progress and outlines future directions toward predictive gait analytics that may serve as indirect, secondary markers of metabolic status and improve diabetes care outcomes. Furthermore, this synthesis provides evidence for integrating wearable gait assessment into diabetes management protocols, potentially enabling early detection of complications, personalized intervention strategies, and non-invasive monitoring approaches that complement traditional glucose measurements. Full article

Background and Objectives: Dental implant placement in grafted alveolar cleft sites has become an integral component of comprehensive cleft rehabilitation. However, survival outcomes vary across studies, and temporal trends in clinical performance have not been systematically quantified. This review aimed to evaluate implant survival in grafted alveolar cleft patients and to compare outcomes between early and modern treatment eras. Materials and Methods: A systematic search of the PubMed, Web of Science, Cochrane Library, and Wiley databases was performed in accordance with PRISMA guidelines. Clinical studies reporting implant survival in grafted alveolar cleft sites with a minimum follow-up of 12 months were included. Data extraction encompassed implant survival, timing of placement, grafting protocols, and reported causes of failure. For temporal comparison, studies were stratified into an early era (1997–2008) and a modern era (2010–2026). Weighted pooled survival rates were calculated, and differences between proportions were assessed using a two-proportion Z-test (p < 0.05). Results: 18 studies met the inclusion criteria, representing 1561 implants placed in grafted alveolar cleft sites. Overall reported survival ranged from 80% to 100%. Weighted pooled survival increased from 91.2% (95% CI: 87.9–94.5) in early studies to 94.2% (95% CI: 92.9–95.5) in modern cohorts, demonstrating a statistically significant 3.0% absolute improvement (p = 0.038). Implant failures occurred predominantly during the early osseointegration phase and were commonly associated with insufficient graft volume or inadequate primary stability. Late biological complications were infrequently reported. Conclusions: When appropriate bone reconstruction, healing, and multidisciplinary coordination are achieved, implant therapy represents a reliable component of comprehensive cleft care. Further prospective studies with standardized protocols and long-term follow-up are needed to strengthen evidence-based recommendations. Full article

This study adheres to a logistic regression modeling protocol originally developed for long-range intelligence analyses and employs data from UN demographic estimates (the 2024 revision) to generate a set of statistical functions that suggest a moderately strong relationship between increasing median age and the probability of a persistently positive international net migration rate (NMR). According to this relationship, the post-Cold War probability (data from 1990 to 2015) of experiencing a persistently positive net migration rate (defined as a +NMR, directly followed by five consecutive years of +NMRs) rose from less than 0.12 at a population median age of 15 years, to a probability greater than 0.55 at 36 years, and then to more than 0.77 at 45 years. The author hypothesizes a speculative set of predictions aimed at providing long-term tests for this model. These predictions assume that, by a median age of 36.0 years, at least one country in the hypothesized cluster of countries will have shifted to experiencing a series of +NMRs. If, as this model predicts, the age-structurally associated transition to sustained +NMRs transpires by 2055, there could be a substantially larger pool of migrant net-receiving states in parts of Asia, Latin America, and North Africa than the UN’s future scenarios currently project. Full article

Background: Chronic pain is a prevalent and disabling condition that affects physical health but also cognitive domains. Executive functions, including inhibitory control, cognitive flexibility, and working memory, essentials for self-regulation, treatment adherence, and coping with symptoms, are particularly compromised. Physiotherapy interventions, traditionally aimed at physical outcomes, may also influence executive functions; however, their impact remains unclear. Objective: This review aimed to synthesize current evidence regarding the effects of physiotherapy-related interventions on executive function in adults with chronic pain. Methods: The review followed the Cochrane Handbook and Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD42024611800). A comprehensive search was performed. Randomized controlled trials (RCTs) included adults with chronic pain (≥3 months) whose executive function outcomes were evaluated after physiotherapy-based interventions. Results: Out of 12,391 records, 10 randomized controlled trials were included. Populations primarily had fibromyalgia, chronic low back pain, and chronic musculoskeletal pain. Interventions encompassed transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (rTMS), neurofeedback, structured exercise, and multimodal physical-cognitive-mindfulness training. Intervention durations ranged from one session to 16 weeks. Executive function was assessed with diverse neuropsychological tests. tDCS improved attention, inhibitory control, cognitive flexibility, and working memory. Exercise interventions showed benefits in working memory and inhibitory control. Conclusions: Preliminary evidence suggests that physiotherapy interventions, particularly anodal tDCS and structured exercise, may improve executive functions in individuals with chronic pain. Future trials should incorporate long-term follow-up. Integrating cognitive targets into physiotherapy may enhance the multidimensional management of chronic pain. Full article

Respiratory diseases constitute a major global health burden, necessitating accurate and reliable diagnostic support tools. Conventional auscultation, despite its widespread clinical use, remains inherently subjective and susceptible to inter-observer variability. In this study, we propose a unified deep learning framework for the automated classification of respiratory sound recordings into four clinically relevant categories: Normal, Crackles, Wheezes, and Crackles + Wheezes. The experimental evaluation was conducted on a publicly available dataset comprising heterogeneous respiratory recordings collected from both patients with pulmonary pathologies and healthy individuals. All audio signals were subjected to standardized preprocessing procedures to enhance signal consistency and ensure reliable feature extraction across acquisition conditions. To ensure methodological rigor and prevent optimistic bias, a strict subject-independent validation strategy was adopted using 5-fold GroupKFold cross-validation based on patient identifiers. Six deep learning architectures were systematically implemented and comparatively evaluated under a controlled and reproducible training protocol, including convolutional (1D-CNN, Deep-CNN), recurrent hybrid (CNN–LSTM, CNN–BiLSTM), and attention-based (CNN–Attention, CNN–Transformer) models. Performance metrics were reported as mean ± standard deviation across folds. The CNN–Attention architecture achieved the best overall performance, yielding a Balanced Accuracy of 90.1% ± 1.8% and a macro F1-score of 89.7% ± 2.1%, demonstrating stable inter-patient generalization. These findings indicate that attention-enhanced hybrid architectures effectively capture both local spectral structures and long-range temporal dependencies inherent in respiratory signals. The proposed framework provides a robust foundation for subject-independent automated lung sound classification and contributes to the development of clinically reliable decision-support systems. Full article

Three-dimensional (3D) scanning and printing technologies enable the production of personalized rehabilitation splints, yet challenges such as scanning artifacts in complex anatomical areas (e.g., finger webs), lengthy post-processing, long printing times, and material limitations (e.g., brittleness and poor breathability) hinder routine clinical adoption. This feasibility study developed and evaluated a clinician-accessible protocol for fabricating cock-up wrist splints using 3D scanning (Creaform GO!SCAN 50 with VXelements 4.1), modeling (Materialise Magics), and fused deposition modeling printing with polylactic acid (PLA) on a MakerBot Replicator+. Five healthy participants wore the splints for one week, with user satisfaction assessed via the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0; average total score 4.14/5, range 3.75–4.42) questionnaire. An experienced occupational therapist provided expert feedback. High satisfaction was reported for weight (4.6/5) and ease of use (4.6/5), confirming advantages over traditional thermoplastic splints in lightness and esthetics. However, lower scores for durability (3.6/5), comfort (3.6/5), and effectiveness (3.6/5) stemmed from PLA brittleness (cracking under load or overtightening), rough surfaces despite vapor polishing, inadequate ventilation causing moisture buildup, and fit issues (e.g., pressure points). Printing time averaged 9–19 h per splint. The protocol demonstrates proof-of-concept feasibility for clinicians with basic computer techniques, but material constraints and process refinements are required for reliable application in patient populations. Full article

Chronic osteoarthritis (COA) is a progressive and degenerative condition that causes joint inflammation and pain, often requiring long-term pharmacological management. Conventional treatments may lead to adverse effects, tolerance, and limited analgesic efficacy. This randomized, double-blind clinical trial evaluated the analgesic potential of a full-spectrum Cannabis sativa oil extract administered orally twice daily over six weeks in dogs with COA. Subjects were assigned to three groups: Cannabis, Placebo, and Control. Pain was assessed using the Canine Brief Pain Inventory (CBPI) and the Canine Osteoarthritis Staging Tool (COAST), which ranges from 0 to 4. The Cannabis extract (46.4 mg/mL) total cannabinoids: Cannabidiol (CBD), Cannabidiolic acid (CBDA), Delta-9-Tetrahydrocannabinol (Δ⁹-THC), and Tetrahydrocannabinolic acid (THCA), were administered using a cautious dose escalation protocol. Treatment began at ~0.1 mg/kg every 12 h, increasing by one drop (1.16 mg) every 72 h. This gradual titration continued until reaching the maximum tolerated dose (2 mg/kg every 12 h), which was maintained for the final two weeks. The protocol was designed to minimize adverse effects and allow close monitoring, especially in geriatric or clinically fragile dogs. By day 28, when the DMT was reached, the Cannabis group showed a 39.6% reduction in CBPI scores, compared to 24.7% in the Placebo group and a 1.6% increase in the Control group. COAST scores improved from level 4 to level 3 in 55.5% of dogs in the Cannabis group, with no changes observed in the other groups. We hypothesize that the co-administration of carprofen, meloxicam, or pregabalin with a full-spectrum Cannabis sativa extract—rich in acidic cannabinoids and terpenes—enhances pain relief and mobility in dogs with COA more effectively than conventional therapies alone. This study aimed to assess the efficacy of an oily full-spectrum Cannabis sativa extract as an adjunctive treatment to NSAIDs in twenty-seven dogs diagnosed with COA, and to compare pain intensity across three treatments groups. Full article

The growing demand for sustainable soil management strategies has intensified interest in hydrochar (HC), a waste-derived amendment produced via hydrothermal carbonization (HTC). This review synthesizes recent advances in HC production, characterization, and agri-environmental applications within a waste-to-resource framework. It covers studies conducted mainly over the last decade, encompassing a wide range of feedstocks, including agricultural residues, sewage sludge, animal manures, and food waste. HTC is typically performed at 130–280 °C under autogenous pressure (2–15 MPa), generating HCs with low intrinsic surface area (<50 m²g⁻¹) and oxygen-containing functional groups that govern nutrient dynamics and soil interactions. Reported application rates vary broadly between 10 and 60 t ha⁻¹, with most experiments conducted under greenhouse conditions. Positive effects on soil pH, cation exchange capacity, water retention, and phosphorus availability are frequently observed. However, plant responses vary according to the type of stimulation promoted by HC, as well as its processing conditions, application rates, and the soil characteristics in which it is applied. Advanced molecular-level analyses (e.g., FT-ICR-MS, GC-MS, and ¹³C-NMR) have provided mechanistic insights into carbon stability, nutrient release, and interaction with soil organic matter. Reusing HTC process water offers an additional pathway for nutrient recovery, although concerns about phytotoxic compounds remain. Despite promising short-term results, long-term field evaluations and standardized assessment protocols are still limited. This review integrates structural, functional and agri-environmental perspectives to identify critical knowledge gaps and guide the optimized and context specific use of hydrochar in sustainable agricultural systems. At the same time, it emphasizes its role in advancing carbon sequestration and in operationalizing resource-circular strategies, thereby underscoring its broader practical and strategic relevance. Full article