Search Results (146)

Providing inclusive education and engaging all students in reading and writing activities presents an ongoing challenge for teachers, not necessarily resolved by implementing digital technology. This study addresses the need to better understand teacher competencies within the digitally infused classroom, specifically in relation to inclusive education and reading and writing practices. The study investigates the competencies and supportive strategies of middle school teachers who perceive themselves as successful in this area. The study employs the Delphi technique, using iterative surveys through which these teachers describe and rate aspects of their competencies and strategies. The results are analyzed through a modified version of the Technological, Pedagogical, and Content Knowledge (TPACK) framework, with particular attention to how teachers support students using their content knowledge and digital competency. Findings reveal a range of strategies and competency aspects related to both proactive accessibility and reactive individualization, using a variety of digital tools and text modalities. The teachers describe a dual orientation in their ability to curiously explore digital tools while simultaneously being able to critically appraise their usefulness. The findings contribute insights on what can support teachers when collaboratively developing knowledge of local practices and their agency in relation to available digital tools. Full article

Virtual reality (VR) can enrich neuropsychological testing, yet the ergonomic trade-offs of its input modes remain under-examined. Seventy-seven healthy volunteers—young (19–29 y) and middle-aged (35–56 y)—completed a VR Trail Making Test with three pointing methods: eye-tracking, head-gaze, and a six-degree-of-freedom hand controller. Completion time, spatial accuracy, and error counts for the simple (Trail A) and alternating (Trail B) sequences were analysed in 3 × 2 × 2 mixed-model ANOVAs; post-trial scales captured usability (SUS), user experience (UEQ-S), and acceptability. Age dominated behaviour: younger adults were reliably faster, more precise, and less error-prone. Against this backdrop, input modality mattered. Eye-tracking yielded the best spatial accuracy and shortened Trail A time relative to manual control; head-gaze matched eye-tracking on Trail A speed and became the quickest, least error-prone option on Trail B. Controllers lagged on every metric. Subjective ratings were high across the board, with only a small usability dip in middle-aged low-gamers. Overall, gaze-based ray-casting clearly outperformed manual pointing, but optimal choice depended on task demands: eye-tracking maximised spatial precision, whereas head-gaze offered calibration-free enhanced speed and error-avoidance under heavier cognitive load. TMT-VR appears to be accurate, engaging, and ergonomically adaptable assessment, yet it requires age-specific–stratified norms. Full article

Background: Cochlear implantation is widely used to provide auditory rehabilitation to individuals with severe-to-profound sensorineural hearing loss. However, electrode insertion during cochlear implantation leads to inner ear trauma, damage to sensory structures, and consequently, loss of residual hearing. There is very limited information regarding the target proteins involved in electrode insertion trauma (EIT) following cochlear implantation. Methods: The aim of our study was to identify target proteins and host molecular pathways involved in cochlear damage following EIT utilizing the iTRAQ™ (isobaric tags for relative and absolute quantification) technique using our ex vivo model. The organ of Corti (OC) explants were dissected from postnatal day 3 rats and subjected to EIT or left untreated (control). The proteins were extracted, labelled, and subjected to ultra-high performance liquid chromatography–tandem mass spectrometry. Results: We identified distinct molecular pathways involved in EIT-induced cochlear damage. Confocal microscopy confirmed the expression of these identified proteins in OC explants subjected to EIT. By separating the apical, middle, and basal cochlear turns, we deciphered a topographic array of host molecular pathways that extend from the base to the apex of the cochlea, which are activated post-trauma following cochlear implantation. Conclusions: The identification of target proteins involved in cochlear damage will provide novel therapeutic targets for the development of effective treatment modalities for the preservation of residual hearing in implanted individuals. Full article

Major depressive disorder is a mental illness characterized by persistent sadness or loss of interest that affects a person’s daily life. Early detection of this disorder is crucial for providing timely and effective treatment. Neuroimaging modalities, namely, functional magnetic resonance imaging, can be used to identify changes in brain regions related to major depressive disorder. In this study, regional homogeneity images, one of the derivative of functional magnetic resonance imaging is employed to detect major depressive disorder using the proposed feature/sample evolving voting ensemble approach. A total of 2380 subjects consisting of 1104 healthy controls and 1276 patients with major depressive disorder from Rest-meta-MDD consortium are studied. Regional homogeneity features from 90 regions are extracted using automated anatomical labeling template. These regional homogeneity features are then fed as an input to the proposed feature/sample selective evolving voting ensemble for classification. The proposed approach achieves an accuracy of 91.93%, and discriminative features obtained from the classifier are used to identify brain regions which may be responsible for major depressive disorder. A total of nine brain regions, namely, left superior temporal gyrus, left postcentral gyrus, left anterior cingulate gyrus, right inferior parietal lobule, right superior medial frontal gyrus, left lingual gyrus, right putamen, left fusiform gyrus, and left middle temporal gyrus, are identified. This study clearly indicates that these brain regions play a critical role in detecting major depressive disorder. Full article

Under cyclic moving load action, tensile-dominant structures are prone to crack initiation due to cumulative damage effects. The presence of cracks leads to structural stiffness degradation and nonlinear redistribution of dynamic characteristics, thereby compromising str18uctural integrity and service performance. The current research on the dynamic behavior of cracked structures predominantly focuses on transient analysis through high-fidelity finite element models. However, the existing methodologies encounter two critical limitations: computational inefficiency and a trade-off between model fidelity and practicality. Thus, this study presents an innovative analytical framework to investigate the dynamic response of cracked simply supported beams subjected to moving loads. The proposed methodology conceptualizes the cracked beam as a system composed of multiple interconnected sub-beams, each governed by the Euler–Bernoulli beam theory. At crack locations, massless rotational springs are employed to accurately capture the local flexibility induced by these defects. The transfer matrix method is utilized to derive explicit eigenfunctions for the cracked beam system, thereby facilitating the formulation of coupled vehicle–bridge vibration equations through modal superposition. Subsequently, dynamic response analysis is conducted using the Runge–Kutta numerical integration scheme. Extensive numerical simulations reveal the influence of critical parameters—particularly crack depth and location—on the coupled dynamic behavior of the structure subjected to moving loads. The results indicate that at a constant speed, neither crack depth nor position alters the shape of the beam’s vibration curve. The maximum deflection of beams with a 30% crack in the middle span increases by 14.96% compared to those without cracks. Furthermore, crack migration toward the mid-span results in increased mid-span displacement without changing vibration curve topology. For a constant crack depth ratio (γ_i = 0.3), the progressive migration of the crack position from 0.05 L to 0.5 L leads to a 26.4% increase in the mid-span displacement (from 5.3 mm to 6.7 mm). These findings highlight the efficacy of the proposed method in capturing the complex interactions between moving loads and cracked concrete structures, offering valuable insights for structural health monitoring and assessment. Full article

Background: The treatment and management of atrial fibrillation poses substantial complexity. A delicate balance in the trade-off between the minimising risk of stroke without increasing the risk of bleeding through anticoagulant optimisations. Natural compounds are often associated with low-toxicity effects, and their effects on atrial fibrillation have yet to be fully understood. Whilst deep learning (a subtype of machine learning that uses multiple layers of artificial neural networks) methods may be useful for drug compound interaction and discovery analysis, graphical processing units (GPUs) are expensive and often required for deep learning. Furthermore, in limited-resource settings, such as low- and middle-income countries, such technology may not be easily available. Objectives: This study aims to discover the presence of any new therapeutic candidates from a large set of natural compounds that may support the future treatment and management of atrial fibrillation anywhere using a low-cost technique. The objective is to develop a deep learning approach under a low-resource setting where suitable high-performance NVIDIA graphics processing units (GPUs) are not available and to apply to atrial fibrillation as a case study. Methods: The primary training dataset is the MINER-DTI dataset from the BIOSNAP collection. It includes 13,741 DTI pairs from DrugBank, 4510 drug compounds, and 2181 protein targets. Deep cross-modal attention modelling was developed and applied. The Database of Useful Decoys (DUD-E) was used to fine-tune the model using contrastive learning. This application and evaluation of the model were performed on the natural compound NPASS 2018 dataset as well as a dataset curated by a clinical pharmacist and a clinical scientist. Results: the new model showed good performance when compared to existing state-of-the-art approaches under low-resource settings in both the validation set (PR AUC: 0.8118 vs. 0.7154) and test set (PR AUC: 0.8134 vs. 0.7206). Tenascin-C (TNC; NPC306696) and deferoxamine (NPC262615) were identified as strong natural compound interactors of the arrhythmogenic targets ADRB1 and HCN1, respectively. A strong natural compound interactor of the bleeding-related target Factor X was also identified as sequoiaflavone (NPC194593). Conclusions: This study presented a new high-performing model under low-resource settings that identified new natural therapeutic candidates for pharmacological cardioversion and anticoagulation. Full article

Achilles mid-portion tendinopathy is defined as a painful thickening of the tendon, identified also on different imagistic examinations, occurring in sport people as well in inactively middle-aged individuals. The chronic and/or relapsing evolution interfere with daily living and alter the quality of life. Eccentric physical exercise is a cornerstone in her management and several injectable agents are used in clinical settings to reduce pain and improve function. According to the presumed pathogenic mechanisms, many classes of agents are in use: corticosteroids, protease inhibitors, sclerosing agents, pro-inflammatory agents, autologous products. The modalities of administration, either intra- or peritendon, the timing and number of sessions are displayed. Practical approach of chronic mid-portion Achilles tendinopathy consists of rest, tendon protection, eccentric exercise and therapeutical injections. The clinicians must choose between a spectrum of agents active on different pathogenic mechanisms, with benefits in the short and medium term. Future research may be focused on comparison between the different agents and on long term evolution. Full article

The 2025 EuDial Consensus systematically compared hemodiafiltration (HDF) to high-flux hemodialysis (HD), highlighting HDF’s superior removal of middle-molecular-weight uremic toxins, potential survival advantages, and immunomodulatory properties. High-Volume HDF (HVHDF), defined by a substitution volume exceeding 23 L per session, was associated with improved cardiovascular outcomes, reduced infection-related mortality, and decreased systemic inflammation. Background/Objectives: Nevertheless, the consensus refrains from endorsing HDF as the standard of care, citing insufficient evidence to prevent sudden cardiac death, reduce intradialytic hypotension, or significantly lower hospitalization rates compared to HD. Methods: This review critically evaluates the EuDial Consensus, highlighting its methodological strengths while noting potential limitations stemming from an exclusive reliance on randomized controlled trials (RCTs). The exclusion of real-world evidence (RWE) and mechanistic studies may have led to an underestimation of HDF’s broader clinical benefits, particularly in cardiovascular stability, inflammation control, and anemia management. Results: Multiple studies have demonstrated HDF’s capacity to enhance immune function, improve erythropoiesis, and increase the clearance of beta-2 microglobulin (β2M) and other pro-inflammatory toxins. Furthermore, the CONVINCE trial’s economic analysis supports HDF’s cost-effectiveness, especially when considering improved survival and reduced dependency on erythropoiesis-stimulating agents. Conclusions: Future research should integrate RWE and mechanistic insights to better define HDF’s therapeutic potential, particularly concerning anemia control, infection mitigation, and hemodynamic stability. While the EuDial Consensus provides valuable clinical guidance, its conclusions should be contextualized within a broader and evolving evidence base. Given its multidimensional benefits, post-dilution HVHDF is increasingly viewed as a preferred renal replacement therapy modality, warranting wider adoption in clinical practice. Full article

Aims and Objectives: The present study aimed to examine the effects of 6 months of unsupervised training, walking at maximal fat oxidation (FATmax), on body composition and cardiovascular function at rest and exercise, in middle aged obese subjects. Methods and results: A single group with pre-test/post-test study design was conducted. Eighteen obese subjects (11 males and 7 females) over 45 were engaged in a non-supervised walking training for 6 months, 40 min, 3 times per week, at the targeted HR corresponding to FATmax (5.5 ± 0.6 km·h⁻¹). This training modality led to a reduction in obesity-related indicators among participants, including weight (−3.7 ± 3.4 kg), BMI (−1.4 ± 1.3 kg/m²), waist circumference (−5.6 ± 4.7 cm), and body fat percentage (−2.1 ± 2.7%). However, we observed a great variability in this response to training according to individuals. Furthermore, heart rate and rate of pressure product (RPP) at rest significantly decreased (6% and 11% respectively) as well as the cardiac load during exercise (RPP −11% and cardiac cost −8%) after training. In conclusion, walking at FATmax is an efficient non-supervised training modality, allowing improvement in both body parameters and cardiovascular markers at rest and during exercise in middle age obese subjects. Even if body parameter changes were modest, the cardiac load decrease is an important factor for reducing the risk of cardiovascular diseases in this population. Full article

Background/Objectives: Our study aimed to verify the effects of 6 weeks of concurrent training composed of resistance training (RT) and different modalities of aerobic exercise (moderate-intensity continuous training (MICT) or high-intensity interval training (HIIT)) on body composition, blood pressure, vascular function, autonomic nervous system (ANS) function, blood lipid levels, cardiometabolic index (CMI), and health-related fitness in obese middle-aged women with prehypertension. Methods: We selected 26 middle-aged women with obesity and prehypertension and divided them equally into the RT + MICT (n = 13) and RT + HIIT (n = 13) groups. The concurrent training program consisted of warm-up, RT, aerobic exercise (MICT or HIIT), and cool-down, and was performed for 6 weeks, three times a week, 85–100 min per session. The measured dependent parameters were analyzed before and after training. Results: Concurrent training (RT + MICT and RT + HIIT) for 6 weeks showed significant improvements in body composition, blood pressure, vascular function, ANS function, CMI, and health-related fitness. However, the RT + HIIT group showed a relatively greater improvement in blood lipid levels compared to the RT + MICT group. Conclusions: Our study confirmed that both RT + MICT and RT + HIIT yielded similar positive effects on most health-related parameters in obese middle-aged women with prehypertension. Among them, RT + HIIT appeared to be relatively more effective in improving blood lipid profiles. Full article

Objective: Acute ischemic stroke (AIS) remains one of the most common causes of death and disability in the world. Mechanical thrombectomy (MT) is the modality of choice in the treatment of AIS and large vessel occlusion (LVO). The endovascular treatment of medium and distal vessel occlusions (DMVO) is currently under intensive scientific investigation. The aim of our study was to prove the feasibility, effectiveness and safety of MT in patients with a primary, isolated occlusion of the M2 segment of the middle cerebral artery (MCA), with a focus on the recanalization level and the first-pass effect (FPE) as predictors. Methods: We prospectively assessed patients after MT for primary isolated occlusion of the M2 MCA segment that were treated at our center during a three-year period between July 2021 and June 2024. Our final cohort included 137 patients who met the inclusion criteria. Epidemiological, clinical and technical data, as well as the clinical and safety outcomes of MT procedures, were recorded and analyzed. The primary outcome was defined as a modified Rankin scale (mRS) score of 0–2. Secondary outcomes included excellent functional independence (mRS 0–1) and successful recanalization, defined by a modified thrombolysis in cerebral infarction (mTICI) score of 2c–3. Safety outcomes included symptomatic intracerebral hemorrhage (sICH), any intracerebral (IC) hemorrhage and 90-day mortality. Results: The mean age of our cohort was 71.8 ± 12.5 years; 59 were men (43.1%). The primary outcome (mRS 0–2) was achieved in 89 (65%) patients. An excellent functional outcome (mRS 0–1) was reached in 58 (42.3%) and successful recanalization (mTICI 2c–3) in 118 (86.1%) patients. sICH was present in 5 cases (3.7%), any IC hemorrhage in 42 (30.7%) and 90-day mortality in 28 (20.4%). We found a statistically significant correlation between the primary outcome (mRS 0–2) and a successful recanalization mTICI of 2c–3 (p—0.024). This correlation was even stronger between excellent functional outcomes and a recanalization mTICI of 2c-3 (p < 0.001). The study did not confirm the importance of the first-pass effect (FPE) during MT of the M2 segment (p—0.489). We also noticed a significant 31.3% mortality increase in the group of patients in which recanalization of the occluded M2 branch was insufficient. Conclusions: MT is a powerful and effective treatment method for AIS caused by an occlusion of the M2 segment in real-life conditions. Patients have a higher probability of a long-term good functional outcome when complete or near-complete reperfusion is achieved. Full article

With the transformation of urban development patterns and profound changes in population structure in China, outdoor activity spaces in residential areas are facing common issues such as obsolete infrastructure, insufficient barrier-free facilities, and intergenerational conflicts, which severely impact residents’ quality of life and hinder high-quality urban development. Guided by the principles of all-age friendly and inclusive design, this study innovatively integrates eye-tracking and multi-modal physiological monitoring technologies to collect both subjective and objective perception data of different age groups regarding outdoor activity spaces in residential areas through human factor experiments and empirical interviews. Machine learning methods are utilized to analyze the data, uncovering the differentiated response mechanisms among diverse groups and clarifying the inclusive characteristics of these spaces. The findings reveal that: (1) Common Demands: All groups prioritize spatial features such as unobstructed views, adequate space, diverse landscapes, proximity accessibility, and smooth pavement surfaces, with similar levels of concern. (2) Differentiated Characteristics: Children place greater emphasis on environmental familiarity and children’s play facilities, while middle-aged and elderly groups show heightened concern for adequate space, efficient parking management, and barrier-free facilities. (3) Technical Validation: Heart Rate Variability (HRV) was identified as the core perception indicator for spatial inclusivity through dimensionality reduction using Self-Organizing Maps (SOM), and the Extra Trees model demonstrated superior performance in spatial inclusivity prediction. By integrating multi-group perception data, standardizing experimental environments, and applying intelligent data mining, this study achieves multi-modal data fusion and in-depth analysis, providing theoretical and methodological support for precisely optimizing outdoor activity spaces in residential areas and advancing the development of all-age friendly communities. Full article

Visible–infrared person re-identification (VI-ReID) aims to minimize the modality gaps of pedestrian images across different modalities. Existing methods primarily focus on extracting cross-modality features from the spatial domain, which often limits the comprehensive extraction of useful information. Compared with conventional approaches that either focus on single-frequency components or employ simple multi-branch fusion strategies, our method fundamentally addresses the modality discrepancy through systematic frequency-space co-learning. To address this limitation, we propose a novel bi-frequency feature fusion network (BiFFN) that effectively extracts and fuses features from both high- and low-frequency domains and spatial domain features to reduce modality gaps. The network introduces a frequency-spatial enhancement (FSE) module to enhance feature representation across both domains. Additionally, the deep frequency mining (DFM) module optimizes cross-modality information utilization by leveraging distinct features of high- and low-frequency features. The cross-frequency fusion (CFF) module further aligns low-frequency features and fuses them with high-frequency features to generate middle features that incorporate critical information from each modality. To refine the distribution of identity features in the common space, we develop a unified modality center (UMC) loss, which promotes a more balanced inter-modality distribution while preserving discriminative identity information. Extensive experiments demonstrate that the proposed BiFFN achieves state-of-the-art performance in VI-ReID. Specifically, our method achieved a Rank-1 accuracy of 77.5% and an mAP of 75.9% on the SYSU-MM01 dataset under the all-search mode. Additionally, it achieved a Rank-1 accuracy of 58.5% and an mAP of 63.7% on the LLCM dataset under the IR-VIS mode. These improvements verify that our model, with the integration of feature fusion and the incorporation of frequency domains, significantly reduces modality gaps and outperforms previous methods. Full article

Background: Obesity is a growing public health issue, increasing the risk of metabolic disorders and cardiovascular diseases. Physical activity is a key factor in obesity treatment; however, the effectiveness of different exercise modalities remains unclear, especially considering age-related physiological differences. High-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) are two commonly recommended strategies, but their impact on fat reduction across different age groups has not been thoroughly analyzed. This study aims to determine which training modality is most effective for fat reduction in individuals with obesity, considering age as a crucial factor in exercise response. Methods: A systematic review was conducted, analyzing studies published between 2014 and 2024. The inclusion criteria focused on the studies comparing HIIT and MICT effects on body composition in obese individuals of different age groups. The data extraction included training protocols, fat mass reduction, and adherence levels. The primary outcomes measured changes in body fat percentage and muscle mass retention. Results: HIIT was found to be most effective for younger individuals (18–30 years), promoting fat oxidation and muscle retention. In middle-aged adults (31–40 years), both HIIT and MICT yielded similar benefits, with MICT preferred due to better adherence. In older adults (41–60 years), MICT provided a more sustainable strategy for fat reduction and muscle preservation. However, the variability across the studies limits definitive conclusions. Conclusions: Age influences the effectiveness of HIIT and MICT for obesity treatment, highlighting the need for age-specific exercise recommendations. Future studies should standardize training protocols and assess long-term metabolic adaptations to optimize physical activity guidelines. Full article

Background: While MRI is the gold standard for meniscal assessment, its cost and accessibility limitations have led to growing interest in ultrasound, though its validity for quantifying meniscal tissue remains unclear. To validate the use of ultrasound in quantifying meniscal tissue across the anterior, middle, and posterior regions of both menisci (medial and lateral) in longitudinal and transverse planes by comparison with cadaveric dissection. Methods: A cross-sectional study was conducted on ten cryopreserved anatomical donors, obtaining a total of 120 ultrasound scans from the different meniscal regions. Following ultrasound imaging, cadaveric dissection was performed to facilitate photometric measurements, thereby enabling validation of the ultrasound findings. The intra-examiner reliability of the ultrasound measurements was also assessed. Results: The intra-examiner reliability of ultrasound measurements ranged from moderate to excellent. A strong and statistically significant positive correlation was observed between ultrasound and photometric measurements across all meniscal regions (r > 0.821; p < 0.05). In the medial meniscus, ultrasound visualized 99.1% of the anterior region (8.71 mm with ultrasound; 8.64 mm with photometry), 96.3% of the middle region (9.09 mm with ultrasound; 9.39 mm with photometry), and 98.5% of the posterior region (10.54 mm with ultrasound; 10.61 mm with photometry). In the lateral meniscus, ultrasound visualized 107.1% of the anterior region, 105.1% of the middle region, and 97.8% of the posterior region. The observed excess in tissue visualization in some regions likely reflects the inclusion of adjacent connective tissue, indistinguishable from meniscal tissue on ultrasound. Conclusions: Ultrasound is a valid and reliable modality for visualizing most meniscal tissue across regions, with a measurement discrepancy under 0.7 mm compared to anatomical dissection. However, caution is advised as adjacent connective tissue may sometimes be misidentified as meniscal tissue during evaluations. Full article