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Search Results (2,354)

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22 pages, 626 KiB  
Systematic Review
Exercise as Modulator of Brain-Derived Neurotrophic Factor in Adolescents: A Systematic Review of Randomized Controlled Trials
by Markel Rico-González, Daniel González-Devesa, Carlos D. Gómez-Carmona and Adrián Moreno-Villanueva
Sports 2025, 13(8), 253; https://doi.org/10.3390/sports13080253 - 1 Aug 2025
Abstract
Adolescence represents a critical period of neurodevelopment during which brain-derived neurotrophic factor (BDNF) plays a fundamental role in neuronal survival and synaptic plasticity. While exercise-BDNF relationships are well-documented in adults, evidence in adolescents remains limited and inconsistent. This systematic review examined the effects [...] Read more.
Adolescence represents a critical period of neurodevelopment during which brain-derived neurotrophic factor (BDNF) plays a fundamental role in neuronal survival and synaptic plasticity. While exercise-BDNF relationships are well-documented in adults, evidence in adolescents remains limited and inconsistent. This systematic review examined the effects of exercise modalities on circulating BDNF concentrations in adolescent populations. A systematic search was conducted following PRISMA guidelines across multiple databases (FECYT, PubMed, SPORTDiscus, ProQuest Central, SCOPUS, Cochrane Library) through June 2025. Inclusion criteria comprised adolescents, exercise interventions, BDNF outcomes, and randomized controlled trial design. Methodological quality was assessed using the PEDro scale. From 130 initially identified articles, 8 randomized controlled trials were included, with 4 rated as excellent and the other 4 as good quality. Exercise modalities included aerobic, resistance, concurrent, high-intensity interval training, Taekwondo, and whole-body vibration, with durations ranging 6–24 weeks. Four studies demonstrated statistically significant BDNF increases following exercise interventions, four showed no significant changes, and one reported transient reduction. Positive outcomes occurred primarily with vigorous-intensity protocols implemented for a minimum of six weeks. Meta-analysis was not feasible due to high heterogeneity in populations, interventions, and control conditions. Moreover, variation in post-exercise sampling timing further limited comparability of BDNF results. Future research should standardize protocols and examine longer interventions to clarify exercise-BDNF relationships in adolescents. Full article
(This article belongs to the Special Issue Neuromechanical Adaptations to Exercise and Sports Training)
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18 pages, 385 KiB  
Review
Fetal Supraventricular Tachycardia: What Do We Know up to This Day?
by Sophia Tsokkou, Ioannis Konstantinidis, Vasileios Anastasiou, Alkis Matsas, Eleni Stamoula, Emmanuela Peteinidou, Antonia Sioga, Theodora Papamitsou, Antonios Ziakas and Vasileios Kamperidis
J. Pers. Med. 2025, 15(8), 341; https://doi.org/10.3390/jpm15080341 (registering DOI) - 1 Aug 2025
Abstract
Fetal tachyarrhythmias, particularly supraventricular tachycardia (SVT) and atrial flutter (AFL), pose significant clinical challenges, especially when complicated by hydrops fetalis. This article provides a comprehensive review of the tachyarrhythmia types, the diagnostic modalities applied, and the therapeutic strategies followed in fetal tachyarrhythmias. Diagnostic [...] Read more.
Fetal tachyarrhythmias, particularly supraventricular tachycardia (SVT) and atrial flutter (AFL), pose significant clinical challenges, especially when complicated by hydrops fetalis. This article provides a comprehensive review of the tachyarrhythmia types, the diagnostic modalities applied, and the therapeutic strategies followed in fetal tachyarrhythmias. Diagnostic techniques such as M-mode echocardiography and fetal magnetocardiography (fMCG) are highlighted for their capacity to provide real-time, high-quality assessments of fetal cardiac rhythms. The review, also, focuses on pharmacologic management via transplacental therapy, discussing the safety and efficacy of the key agents including digoxin, flecainide, and sotalol, under different clinical scenarios, such as hydropic fetus and renal impairment. In addition to transplacental administration, alternative approaches such as direct fetal intramuscular or intravascular injections are examined. These direct methods, while potentially more effective in refractory cases, carry risks that necessitate specialized expertise and careful consideration of maternal and fetal safety. The limitations of current evidence, largely based on small case studies and retrospective analyses, underscore the need for larger, prospective multicenter observational studies and randomized control trials to establish standardized protocols for fetal tachyarrhythmia management. Overall, this review advocates for a personalized, multidisciplinary approach, emphasizing early fetal tachyarrhythmias diagnosis, tailored treatment regimens that balances efficacy with safety, and rigorous monitoring to optimize outcomes for both the fetus and the mother. Full article
(This article belongs to the Special Issue Advances in Prenatal Diagnosis and Maternal Fetal Medicine)
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18 pages, 1518 KiB  
Systematic Review
Effectiveness of Psychological Therapy for Treatment-Resistant Depression in Adults: A Systematic Review and Meta-Analysis
by Sabrina Giguère, Alexandra Fortier, Julie Azrak, Charles-Édouard Giguère, Stéphane Potvin and Alexandre Dumais
J. Pers. Med. 2025, 15(8), 338; https://doi.org/10.3390/jpm15080338 (registering DOI) - 1 Aug 2025
Abstract
Background: Depression that is resistant to two or more adequate treatment trials—treatment-resistant depression (TRD)—is a prevalent clinical challenge. Although psychotherapies have been recommended by clinical guidelines as an alternative or adjunctive treatment strategy, the effectiveness of psychotherapy in individuals with TRD has not [...] Read more.
Background: Depression that is resistant to two or more adequate treatment trials—treatment-resistant depression (TRD)—is a prevalent clinical challenge. Although psychotherapies have been recommended by clinical guidelines as an alternative or adjunctive treatment strategy, the effectiveness of psychotherapy in individuals with TRD has not yet been evaluated through meta-analytic methods, primarily due to a limited number of trials. This highlights the necessity of personalized research targeting this specific population. This systematic review and meta-analysis aimed to summarize the evidence on psychotherapy in treating TRD. Methods: A systematic search was conducted following the Guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were included if they quantitatively examined the efficacy of psychotherapy on depression symptoms in individuals diagnosed with depression who had not responded to at least two prior treatments (i.e., pharmacotherapy and/or psychotherapy). Results: A total of 12 studies were included. The quality of evidence was evaluated as being globally moderate. When pooling all psychotherapies, a small-to-moderate, but significant, effect on depressive symptoms was observed compared to the control group (SMD = −0.49, CI = −0.63; −0.34). The observed effect remained unchanged after removing the outlier (SMD = −0.47, CI = −0.62; −0.32). When examining depressive symptoms by type of psychotherapy, Mindfulness-Based Cognitive Therapy (SMD = −0.51, CI = −0.76; −0.25), Cognitive Behavioral Therapy (SMD = −0.53, CI = −0.92; −0.14), and Cognitive Therapy (SMD = −0.51, CI = −1.01; −0.01) showed a moderately significant effect on depressive symptoms compared to the control group. Conclusions: Although this potentially represents the first meta-analysis in this area, the number of studies specifically addressing this complex population remains limited, and the existing literature is still in its early stages. Research focusing on TRD is notably sparse compared to the broader body of work on depression without treatment resistance. Consequently, it was not possible to conduct meta-analyses by type of psychotherapy across all treatment modalities and by type of control group. Due to several study limitations, there is currently limited evidence available about the effectiveness of psychotherapy for TRD, and further trials are needed. Beyond the treatments usually offered for depression, it is possible that TRD requires a personalized medicine approach. Full article
(This article belongs to the Special Issue Personalized Medicine in Psychiatry: Challenges and Opportunities)
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23 pages, 5770 KiB  
Article
Assessment of Influencing Factors and Robustness of Computable Image Texture Features in Digital Images
by Diego Andrade, Howard C. Gifford and Mini Das
Tomography 2025, 11(8), 87; https://doi.org/10.3390/tomography11080087 (registering DOI) - 31 Jul 2025
Abstract
Background/Objectives: There is significant interest in using texture features to extract hidden image-based information. In medical imaging applications using radiomics, AI, or personalized medicine, the quest is to extract patient or disease specific information while being insensitive to other system or processing variables. [...] Read more.
Background/Objectives: There is significant interest in using texture features to extract hidden image-based information. In medical imaging applications using radiomics, AI, or personalized medicine, the quest is to extract patient or disease specific information while being insensitive to other system or processing variables. While we use digital breast tomosynthesis (DBT) to show these effects, our results would be generally applicable to a wider range of other imaging modalities and applications. Methods: We examine factors in texture estimation methods, such as quantization, pixel distance offset, and region of interest (ROI) size, that influence the magnitudes of these readily computable and widely used image texture features (specifically Haralick’s gray level co-occurrence matrix (GLCM) textural features). Results: Our results indicate that quantization is the most influential of these parameters, as it controls the size of the GLCM and range of values. We propose a new multi-resolution normalization (by either fixing ROI size or pixel offset) that can significantly reduce quantization magnitude disparities. We show reduction in mean differences in feature values by orders of magnitude; for example, reducing it to 7.34% between quantizations of 8–128, while preserving trends. Conclusions: When combining images from multiple vendors in a common analysis, large variations in texture magnitudes can arise due to differences in post-processing methods like filters. We show that significant changes in GLCM magnitude variations may arise simply due to the filter type or strength. These trends can also vary based on estimation variables (like offset distance or ROI) that can further complicate analysis and robustness. We show pathways to reduce sensitivity to such variations due to estimation methods while increasing the desired sensitivity to patient-specific information such as breast density. Finally, we show that our results obtained from simulated DBT images are consistent with what we see when applied to clinical DBT images. Full article
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19 pages, 12094 KiB  
Article
Intelligent Active Suspension Control Method Based on Hierarchical Multi-Sensor Perception Fusion
by Chen Huang, Yang Liu, Xiaoqiang Sun and Yiqi Wang
Sensors 2025, 25(15), 4723; https://doi.org/10.3390/s25154723 (registering DOI) - 31 Jul 2025
Viewed by 17
Abstract
Sensor fusion in intelligent suspension systems constitutes a fundamental technology for optimizing vehicle dynamic stability, ride comfort, and occupant safety. By integrating data from multiple sensor modalities, this study proposes a hierarchical multi-sensor fusion framework for active suspension control, aiming to enhance control [...] Read more.
Sensor fusion in intelligent suspension systems constitutes a fundamental technology for optimizing vehicle dynamic stability, ride comfort, and occupant safety. By integrating data from multiple sensor modalities, this study proposes a hierarchical multi-sensor fusion framework for active suspension control, aiming to enhance control precision. Initially, a binocular vision system is employed for target detection, enabling the identification of lane curvature initiation points and speed bumps, with real-time distance measurements. Subsequently, the integration of Global Positioning System (GPS) and inertial measurement unit (IMU) data facilitates the extraction of road elevation profiles ahead of the vehicle. A BP-PID control strategy is implemented to formulate mode-switching rules for the active suspension under three distinct road conditions: flat road, curved road, and obstacle road. Additionally, an ant colony optimization algorithm is utilized to fine-tune four suspension parameters. Utilizing the hardware-in-the-loop (HIL) simulation platform, the observed reductions in vertical, pitch, and roll accelerations were 5.37%, 9.63%, and 11.58%, respectively, thereby substantiating the efficacy and robustness of this approach. Full article
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15 pages, 835 KiB  
Review
Optimising Exercise for Managing Chemotherapy-Induced Peripheral Neuropathy in People Diagnosed with Cancer
by Dhiaan Sidhu, Jodie Cochrane Wilkie, Jena Buchan and Kellie Toohey
Cancers 2025, 17(15), 2533; https://doi.org/10.3390/cancers17152533 - 31 Jul 2025
Viewed by 63
Abstract
Background: Chemotherapy-induced peripheral neuropathy is a common and debilitating side effect of cancer treatment. While exercise has shown promise in alleviating this burden, it remains underutilised in clinical practice due to the lack of accessible, clinician-friendly guidance. Aim: This review aimed to synthesise [...] Read more.
Background: Chemotherapy-induced peripheral neuropathy is a common and debilitating side effect of cancer treatment. While exercise has shown promise in alleviating this burden, it remains underutilised in clinical practice due to the lack of accessible, clinician-friendly guidance. Aim: This review aimed to synthesise current evidence on exercise interventions for managing chemotherapy-induced peripheral neuropathy and provide practical insights to support clinicians in integrating these approaches into patient care. Methods: A search was conducted across MEDLINE, CINAHL, and SPORTDiscus using keywords related to exercise and CIPN. Studies were included if they involved adults receiving neurotoxic chemotherapy and exercise-based interventions. Two authors independently screened studies and resolved conflicts with a third author. Study quality was assessed using the JBI Critical Appraisal Tools, and only studies meeting a minimum quality standard were included. A balanced sampling approach was employed. Data on study design, participant characteristics, interventions, and outcomes were extracted. Results: Eleven studies were included, covering various exercise modalities: multimodal (n = 5), yoga (n = 2), aerobic (n = 1), resistance (n = 1), balance (n = 1), and sensorimotor (n = 1). Exercise interventions, particularly multimodal exercise, significantly improved symptom severity, functionality, and quality of life (p < 0.05). The studies had high methodological quality, with randomised controlled trials scoring between 9/13 and 11/13, and quasi-experimental studies scoring 8/9 on JBI tools. Conclusions: This review highlights the significant benefits of exercise, especially multimodal exercise, for managing CIPN and provides guidance for integrating these strategies into clinical practice. Future research is needed to refine exercise prescriptions and develop standardised guidelines. Full article
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17 pages, 475 KiB  
Review
The Rationale and Explanation for Rehabilitation Interventions in the Management of Treatment-Induced Trismus in People with Head and Neck Cancer: A Scoping Review of Randomized Controlled Trials
by Ernesto Anarte-Lazo, Ana Bravo-Vazquez, Carlos Bernal-Utrera, Daniel Torres-Lagares, Deborah Falla and Cleofas Rodríguez-Blanco
Medicina 2025, 61(8), 1392; https://doi.org/10.3390/medicina61081392 - 31 Jul 2025
Viewed by 119
Abstract
Background and objectives: Trismus is a frequent and debilitating complication in people with head and neck cancer (HNC) which leads to significant functional limitations and reduced quality of life. Rehabilitation interventions are commonly recommended to manage or prevent trismus. However, in many [...] Read more.
Background and objectives: Trismus is a frequent and debilitating complication in people with head and neck cancer (HNC) which leads to significant functional limitations and reduced quality of life. Rehabilitation interventions are commonly recommended to manage or prevent trismus. However, in many randomized controlled trials (RCTs), the theoretical justification for these interventions is poorly articulated, and the underlying biological or physiological mechanisms are not described in detail, limiting our understanding of why certain treatments may (or may not) work. This review aimed to identify and analyze how RCTs report the rationale for rehabilitation interventions and the explanations used to manage this population. Materials and Methods: A scoping review was conducted in accordance with the PRISMA-ScR guidelines. Five databases (PubMed, PEDro, Web of Science, Scopus, and EMBASE) were searched up to May 2025 for RCTs evaluating rehabilitation interventions for the management or prevention of treatment-induced trismus in patients with HNC. Data were extracted and synthesized narratively, focusing on the type of intervention, the rationale for its use, and the proposed mechanisms of action. Results: Of 2215 records identified, 24 RCTs met the inclusion criteria. Thirteen studies focused on preventive interventions—primarily exercise therapy—while the remainder addressed established trismus using exercise, manual therapy, electrotherapy, or combined treatment modalities. The rationales provided for intervention selection were heterogeneous and often lacked depth, with most studies justifying interventions based on their potential to improve mouth opening or reduce fibrosis but rarely grounding these claims in detailed pathophysiological models. Only half of the studies provided any mechanistic explanation for the intervention’s effects, and these were typically generic or speculative. Conclusions: RCTs investigating rehabilitation interventions for treatment-induced trismus in patients with HNC frequently lack comprehensive rationales and mechanistic explanations for their interventions. This gap limits the ability to refine and optimize treatment approaches, as the underlying processes driving clinical improvements remain poorly understood. Future research should be guided by theoretical models and include objective outcomes to better elucidate the mechanisms of action of interventions to inform clinical practice. Full article
(This article belongs to the Special Issue Advances in Head and Neck Cancer Management)
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15 pages, 4667 KiB  
Article
Longitudinal High-Resolution Imaging of Retinal Sequelae of a Choroidal Nevus
by Kaitlyn A. Sapoznik, Stephen A. Burns, Todd D. Peabody, Lucie Sawides, Brittany R. Walker and Thomas J. Gast
Diagnostics 2025, 15(15), 1904; https://doi.org/10.3390/diagnostics15151904 - 29 Jul 2025
Viewed by 193
Abstract
Background: Choroidal nevi are common, benign tumors. These tumors rarely cause adverse retinal sequalae, but when they do, they can lead to disruption of the outer retina and vision loss. In this paper, we used high-resolution retinal imaging modalities, optical coherence tomography [...] Read more.
Background: Choroidal nevi are common, benign tumors. These tumors rarely cause adverse retinal sequalae, but when they do, they can lead to disruption of the outer retina and vision loss. In this paper, we used high-resolution retinal imaging modalities, optical coherence tomography (OCT) and adaptive optics scanning laser ophthalmoscopy (AOSLO), to longitudinally monitor retinal sequelae of a submacular choroidal nevus. Methods: A 31-year-old female with a high-risk choroidal nevus resulting in subretinal fluid (SRF) and a 30-year-old control subject were longitudinally imaged with AOSLO and OCT in this study over 18 and 22 months. Regions of interest (ROI) including the macular region (where SRF was present) and the site of laser photocoagulation were imaged repeatedly over time. The depth of SRF in a discrete ROI was quantified with OCT and AOSLO images were assessed for visualization of photoreceptors and retinal pigmented epithelium (RPE). Cell-like structures that infiltrated the site of laser photocoagulation were measured and their count was assessed over time. In the control subject, images were assessed for RPE visualization and the presence and stability of cell-like structures. Results: We demonstrate that AOSLO can be used to assess cellular-level changes at small ROIs in the retina over time. We show the response of the retina to SRF and laser photocoagulation. We demonstrate that the RPE can be visualized when SRF is present, which does not appear to depend on the height of retinal elevation. We also demonstrate that cell-like structures, presumably immune cells, are present within and adjacent to areas of SRF on both OCT and AOSLO, and that similar cell-like structures infiltrate areas of retinal laser photocoagulation. Conclusions: Our study demonstrates that dynamic, cellular-level retinal responses to SRF and laser photocoagulation can be monitored over time with AOSLO in living humans. Many retinal conditions exhibit similar retinal findings and laser photocoagulation is also indicated in numerous retinal conditions. AOSLO imaging may provide future opportunities to better understand the clinical implications of such responses in vivo. Full article
(This article belongs to the Special Issue High-Resolution Retinal Imaging: Hot Topics and Recent Developments)
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17 pages, 1908 KiB  
Article
BDE-47 Disrupts Gut Microbiota and Exacerbates Prediabetic Conditions in Mice: Therapeutic Potential of Grape Exosomes and Antioxidants
by Zaoling Liu, Fang Cao, Aerna Qiayimaerdan, Nilupaer Aisikaer, Zulipiya Zunong, Xiaodie Ma and Yale Yu
Toxics 2025, 13(8), 640; https://doi.org/10.3390/toxics13080640 - 29 Jul 2025
Viewed by 140
Abstract
Background: BDE-47, a pervasive environmental pollutant detected in >90% of human serum samples, is increasingly linked to metabolic disorders. This study investigates the specific impact of BDE-47 exposure on the gut microbiota in prediabetic mice and evaluates the efficacy of therapeutic interventions [...] Read more.
Background: BDE-47, a pervasive environmental pollutant detected in >90% of human serum samples, is increasingly linked to metabolic disorders. This study investigates the specific impact of BDE-47 exposure on the gut microbiota in prediabetic mice and evaluates the efficacy of therapeutic interventions in mitigating these effects. Objectives: To determine whether BDE-47 exposure induces diabetogenic dysbiosis in prediabetic mice and to assess whether dietary interventions, such as grape exosomes and an antioxidant cocktail, can restore a healthy microbiota composition and mitigate diabetes risk. Methods: In this study, a prediabetic mouse model was established in 54 male SPF-grade C57BL/6J mice through a combination of high-sugar and high-fat diet feeding with streptozotocin injection. Oral glucose tolerance tests (OGTT) were conducted on day 7 and day 21 post-modeling to assess the establishment of the model. The criteria for successful model induction were defined as fasting blood glucose levels below 7.8 mmol/L and 2 h postprandial glucose levels between 7.8 and 11.1 mmol/L. Following confirmation of model success, a 3 × 3 factorial design was applied to allocate the experimental animals into groups based on two independent factors: BDE-47 exposure and exosome intervention. The BDE-47 exposure factor consisted of three dose levels—none, high-dose, and medium-dose—while the exosome intervention factor included three modalities—none, Antioxidant Nutrients Intervention, and Grape Exosomes Intervention. Fresh fecal samples were collected from mice two days prior to sacrifice. Cecal contents and segments of the small intestine were collected and transferred into 1.5 mL cryotubes. All sequences were clustered into operational taxonomic units (OTUs) based on defined similarity thresholds. To compare means across multiple groups, a two-way analysis of variance (ANOVA) was employed. The significance level was predefined at α = 0.05, and p-values < 0.05 were considered statistically significant. Bar charts and line graphs were generated using GraphPad Prism version 9.0 software, while statistical analyses were performed using SPSS version 20.0 software. Results: The results of 16S rDNA sequencing analysis of the microbiome showed that there was no difference in the α diversity of the intestinal microbiota in each group of mice (p > 0.05), but there was a difference in the Beta diversity (p < 0.05). At the gate level, the abundances of Proteobacteria, Campylobacterota, Desulfobacterota, and Fusobacteriota in the medium-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Patellar bacteria was lower than that of the model control group (p < 0.05). The abundances of Proteobacteria and Campylobacterota in the high-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Planctomycetota and Patescibacteria was lower than that of the model control group (p < 0.05), while the abundance of Campylobacterota in the grape exosome group was higher than that of the model control group (p < 0.05). The abundance of Patescibacteria was lower than that of the model control group (p < 0.05), while the abundance of Firmicutes and Fusobacteriota in the antioxidant nutrient group was higher than that of the model control group (p < 0.05). However, the abundance of Verrucomicrobiota and Patescibacteria was lower than that of the model control group (p < 0.05). At the genus level, the abundances of Bacteroides and unclassified Lachnospiraceae in the high-dose BDE-7 group were higher than those in the model control group (p < 0.05). The abundance of Lachnospiraceae NK4A136_group and Lactobacillus was lower than that of the model control group (p < 0.05). The abundance of Veillonella and Helicobacter in the medium-dose BDE-7 group was higher than that in the model control group (p < 0.05), while the abundance of Lactobacillus was lower (p < 0.05). The abundance of genera such as Lentilactobacillus and Faecalibacterium in the grape exosome group was higher than that in the model control group (p < 0.05). The abundance of Alloprevotella and Bacteroides was lower than that of the model control group (p < 0.05). In the antioxidant nutrient group, the abundance of Lachnospiraceae and Hydrogenophaga was higher than that in the model control group (p < 0.05). However, the abundance of Akkermansia and Coriobacteriaceae UCG-002 was significantly lower than that of the model control group (p < 0.05). Conclusions: BDE-47 induces diabetogenic dysbiosis in prediabetic mice, which is reversible by dietary interventions. These findings suggest that microbiota-targeted strategies may effectively mitigate the diabetes risk associated with environmental pollutant exposure. Future studies should further explore the mechanisms underlying these microbiota changes and the long-term health benefits of such interventions. Full article
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23 pages, 974 KiB  
Systematic Review
Biofeedback in Pediatric, Adolescent, and Young Adult Cancer Care: A Systematic Review
by Marie Barnett, Shari A. Langer, Konstantina Matsoukas, Sanjana Dugad, Anelisa Mdleleni and Inna Khazan
Children 2025, 12(8), 998; https://doi.org/10.3390/children12080998 - 29 Jul 2025
Viewed by 216
Abstract
Background/Objectives: Biofeedback interventions are increasingly utilized in pediatric and adult care, with evidence in treating specific medical conditions and specific symptoms. However, evidence supporting their efficacy among children and adolescents and young adults (AYAs, aged 15–39) with cancer is limited. The aims [...] Read more.
Background/Objectives: Biofeedback interventions are increasingly utilized in pediatric and adult care, with evidence in treating specific medical conditions and specific symptoms. However, evidence supporting their efficacy among children and adolescents and young adults (AYAs, aged 15–39) with cancer is limited. The aims of this systematic review are to present, assess, and synthesize the existing research on biofeedback in pediatric and AYA oncology, identify gaps in biofeedback research within this population, and provide recommendations for future research and clinical implications. Methods: A systematic search for articles was conducted using six bibliographic databases—PubMed/MEDLINE (NLM), EMBASE (Elsevier), CINAHL (EBSCO), SPORTDiscus (EBSCO), PsycINFO (OVID), and PEDro (NeuRA)—with an update on 5/7/2025. Included were studies involving pediatric/AYA oncology participants (0–39 years old) and those receiving at least one biofeedback modality. The methodological quality and risk of bias among included articles were assessed using the Cochrane Risk of Bias (ROB) Tool (modified version for non-randomized studies). A narrative synthesis of included studies examined the type of cancer studied, type of biofeedback used, study designs and methodological quality, and key outcomes evaluated. Results: While the literature suggests that biofeedback may offer beneficial outcomes for managing various pediatric/AYA oncology-related symptoms, such as pain, anxiety, and fatigue, only 8 studies out of 1013 screened (<1%) met inclusion criteria. Limitations included low study quality (small sample sizes, lack of control groups, and methodological inconsistencies). Conclusions: While biofeedback shows promise as a feasible and effective intervention, there is a call to action for well-designed, methodologically rigorous studies to substantiate its effectiveness and inform evidence-based practice specifically for pediatric/AYA oncology patients and clinicians. Full article
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17 pages, 627 KiB  
Review
Non-Invasive Positive Pressure Ventilation for Pre-Oxygenation of Critically Ill Patients Before Intubation
by Luigi La Via, Giuseppe Cuttone, Tarek Senussi Testa, Gilberto Duarte-Medrano, Natalia Nuno-Lambarri, Cristian Deana, Antonino Maniaci, Daniele Salvatore Paternò, Ivana Zdravkovic and Massimiliano Sorbello
J. Clin. Med. 2025, 14(15), 5356; https://doi.org/10.3390/jcm14155356 - 29 Jul 2025
Viewed by 309
Abstract
Pre-oxygenation is the key step prior to endotracheal intubation, particularly in a critically ill patient, to prevent life-threatening peri-procedural hypoxemia. This narrative review explores the emerging interest of Non-Invasive Positive Pressure Ventilation (NIPPV) as a pre-oxygenation modality in the intensive care unit (ICU) [...] Read more.
Pre-oxygenation is the key step prior to endotracheal intubation, particularly in a critically ill patient, to prevent life-threatening peri-procedural hypoxemia. This narrative review explores the emerging interest of Non-Invasive Positive Pressure Ventilation (NIPPV) as a pre-oxygenation modality in the intensive care unit (ICU) context. We reviewed data from randomized controlled trials (RCTs) and observational studies published from 2000 to 2024 that compare NIPPV to conventional oxygen therapy and High Flow Nasal Cannula Oxygen (HFNCO). The pathophysiological mechanisms for the successful use of NIPPV, including alveolar recruitment, the decrease of shunting, and the maintenance of functional residual capacity, were reviewed in depth. Existing studies show that NIPPV significantly prolongs the apnea time, reduces the rate of peri-intubation severe hypoxaemia in selected patients and is especially effective for patients with acute hypoxaemic respiratory failure. Nevertheless, appropriate patient selection is still crucial because some diseases can contraindicate or even be harmful with NIPPV. We further discussed the practical aspects of how to use this ventilatory support (the best ventilator settings, which interface, and when to apply it). We lastly discuss unanswered questions and offer suggestions and opportunities for future exploration in guiding the role of NIPPV use in the pre-oxygenation of the critically ill patient requiring emergent airway management. Full article
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32 pages, 6323 KiB  
Article
Design, Implementation and Evaluation of an Immersive Teleoperation Interface for Human-Centered Autonomous Driving
by Irene Bouzón, Jimena Pascual, Cayetana Costales, Aser Crespo, Covadonga Cima and David Melendi
Sensors 2025, 25(15), 4679; https://doi.org/10.3390/s25154679 - 29 Jul 2025
Viewed by 252
Abstract
As autonomous driving technologies advance, the need for human-in-the-loop systems becomes increasingly critical to ensure safety, adaptability, and public confidence. This paper presents the design and evaluation of a context-aware immersive teleoperation interface that integrates real-time simulation, virtual reality, and multimodal feedback to [...] Read more.
As autonomous driving technologies advance, the need for human-in-the-loop systems becomes increasingly critical to ensure safety, adaptability, and public confidence. This paper presents the design and evaluation of a context-aware immersive teleoperation interface that integrates real-time simulation, virtual reality, and multimodal feedback to support remote interventions in emergency scenarios. Built on a modular ROS2 architecture, the system allows seamless transition between simulated and physical platforms, enabling safe and reproducible testing. The experimental results show a high task success rate and user satisfaction, highlighting the importance of intuitive controls, gesture recognition accuracy, and low-latency feedback. Our findings contribute to the understanding of human-robot interaction (HRI) in immersive teleoperation contexts and provide insights into the role of multisensory feedback and control modalities in building trust and situational awareness for remote operators. Ultimately, this approach is intended to support the broader acceptability of autonomous driving technologies by enhancing human supervision, control, and confidence. Full article
(This article belongs to the Special Issue Human-Centred Smart Manufacturing - Industry 5.0)
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15 pages, 1922 KiB  
Article
Idiopathic Syringomyelia: Diagnostic Value of Cranial Morphometric Parameters
by Birol Özkal and Hakan Özçelik
Brain Sci. 2025, 15(8), 811; https://doi.org/10.3390/brainsci15080811 - 29 Jul 2025
Viewed by 138
Abstract
Background: Identifying the etiological factors of syringomyelia, which can cause progressive neurological deficits in the spinal cord, is critically important for both diagnosis and treatment. This study aimed to assess the cranial morphometric features of patients with idiopathic syringomyelia by conducting comparative analyses [...] Read more.
Background: Identifying the etiological factors of syringomyelia, which can cause progressive neurological deficits in the spinal cord, is critically important for both diagnosis and treatment. This study aimed to assess the cranial morphometric features of patients with idiopathic syringomyelia by conducting comparative analyses with individuals diagnosed with Chiari Type I, Chiari Type I accompanied by syringomyelia, and healthy controls, in order to elucidate the potential structural contributors to the pathogenesis of idiopathic syringomyelia. Methods: In this retrospective and comparative study, a total of 172 patients diagnosed with Chiari Type I and/or syringomyelia between 2016 and 2024, along with 156 radiologically normal individuals, were included. The participants were categorized into four groups: healthy controls, Chiari Type I, Chiari Type I with syringomyelia, and idiopathic syringomyelia (defined as syringomyelia without an identifiable cause). Midline sagittal T1-weighted MR images were used to obtain quantitative measurements of the posterior fossa, cerebellum, intracranial area, and foramen magnum. All measurements were stratified and statistically analyzed by sex. Results: In cases with idiopathic syringomyelia, both the posterior fossa area and the cerebellum/posterior fossa ratio differed significantly from those of healthy controls. In male patients, the foramen magnum diameter was significantly larger in the Chiari + syringomyelia group compared with the idiopathic group. A significant correlation was found between the degree of tonsillar descent and selected morphometric parameters in female subjects, whereas no such correlation was observed in males. Both Chiari groups exhibited significantly smaller posterior fossa dimensions compared with the healthy and idiopathic groups, indicating greater neural crowding. Additionally, in Chiari Type I patients, increasing degrees of tonsillar descent were associated with a decreased incidence of syringomyelia. Conclusions: Anatomical variations such as a reduced posterior fossa area or altered foramen magnum diameter may contribute to the pathogenesis of idiopathic syringomyelia. Cranial morphometric analysis appears to offer diagnostic value in these cases. Further prospective, multicenter studies incorporating advanced neuroimaging modalities, particularly those assessing cerebrospinal fluid dynamics, are warranted to better understand the mechanisms underlying syringomyelia of unknown etiology. Full article
(This article belongs to the Special Issue Current Research in Neurosurgery)
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9 pages, 464 KiB  
Review
Photobiomodulation as a Hypothetical Strategy to Reverse Botulinum Toxin Effects: Exploring the Neuroregenerative Mechanisms and Translational Potential
by Rodrigo Álvaro Brandão Lopes-Martins, Francisco Gonzalez-Lima, Sérgio Gomes da Silva, Patrícia Sardinha Leonardo, Cristiane Soncino, Roberto Fernandes Pacheco, Carolina Lúcia de Oliveira e Oliveira and Fabrizio dos Santos Cardoso
Life 2025, 15(8), 1206; https://doi.org/10.3390/life15081206 - 28 Jul 2025
Viewed by 268
Abstract
Background: Botulinum toxin type A (BoNT/A) is widely used in both clinical and aesthetic settings to induce temporary neuromuscular paralysis by inhibiting acetylcholine release. Although generally regarded as safe and effective, complications such as iatrogenic ptosis or facial asymmetry may occur and persist [...] Read more.
Background: Botulinum toxin type A (BoNT/A) is widely used in both clinical and aesthetic settings to induce temporary neuromuscular paralysis by inhibiting acetylcholine release. Although generally regarded as safe and effective, complications such as iatrogenic ptosis or facial asymmetry may occur and persist for several weeks or even months, with no standardized method currently available to accelerate recovery. Objective: This article explores the hypothesis that photobiomodulation (PBM)—a non-invasive modality recognized for its neuroregenerative potential—may facilitate the reversal of BoNT/A-induced neuromuscular blockade. Discussion: PBM enhances mitochondrial activity by stimulating cytochrome c oxidase in nerve and muscle tissues, thereby increasing ATP production and modulating intracellular signaling pathways associated with neuroplasticity, cell survival, and synaptogenesis. Preclinical studies have demonstrated that PBM can upregulate neurotrophic factors (e.g., BDNF, NGF), enhance SNAP-25 expression, and promote structural remodeling of neurons in both young and aged brains. These mechanisms are biologically consistent with the regenerative processes required for recovery from BoNT/A-induced effects. While controlled clinical trials for this specific application are currently lacking, anecdotal clinical reports suggest that PBM may accelerate functional recovery in cases of BoNT/A-related complications. Conclusions: Although this approach has not yet been tested in clinical trials, we propose that photobiomodulation may hypothetically serve as a supportive strategy to promote neuromuscular recovery in patients experiencing adverse effects from BoNT/A. This hypothesis is grounded in robust preclinical evidence but requires validation through translational and clinical research. Full article
(This article belongs to the Section Physiology and Pathology)
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20 pages, 6495 KiB  
Article
Fractal Characterization of Pore Structures in Marine–Continental Transitional Shale Gas Reservoirs: A Case Study of the Shanxi Formation in the Ordos Basin
by Jiao Zhang, Wei Dang, Qin Zhang, Xiaofeng Wang, Guichao Du, Changan Shan, Yunze Lei, Lindong Shangguan, Yankai Xue and Xin Zhang
Energies 2025, 18(15), 4013; https://doi.org/10.3390/en18154013 - 28 Jul 2025
Viewed by 273
Abstract
Marine–continental transitional shale is a promising unconventional gas reservoir, playing an increasingly important role in China’s energy portfolio. However, compared to marine shale, research on marine–continental transitional shale’s fractal characteristics of pore structure and complete pore size distribution remains limited. In this work, [...] Read more.
Marine–continental transitional shale is a promising unconventional gas reservoir, playing an increasingly important role in China’s energy portfolio. However, compared to marine shale, research on marine–continental transitional shale’s fractal characteristics of pore structure and complete pore size distribution remains limited. In this work, high-pressure mercury intrusion, N2 adsorption, and CO2 adsorption techniques, combined with fractal geometry modeling, were employed to characterize the pore structure of the Shanxi Formation marine–continental transitional shale. The shale exhibits generally high TOC content and abundant clay minerals, indicating strong hydrocarbon-generation potential. The pore size distribution is multi-modal: micropores and mesopores dominate, contributing the majority of the specific surface area and pore volume, whereas macropores display a single-peak distribution. Fractal analysis reveals that micropores have high fractal dimensions and structural regularity, mesopores exhibit dual-fractal characteristics, and macropores show large variations in fractal dimension. Characteristics of pore structure is primarily controlled by TOC content and mineral composition. These findings provide a quantitative basis for evaluating shale reservoir quality, understanding gas storage mechanisms, and optimizing strategies for sustainable of oil and gas development in marine–continental transitional shales. Full article
(This article belongs to the Special Issue Sustainable Development of Unconventional Geo-Energy)
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