Search Results (1,487)

Objective. The main objective of this study was to examine the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on psychological, sleep, and performance outcomes in powerlifters. Previous research has primarily focused on taVNS in clinical or healthy samples and showed improvements in psychological functioning, recovery, and sleep. Evidence for beneficial effects of taVNS in healthy athletes, however, is missing so far. Methods. Over the course of 4 weeks, 10 healthy adult powerlifters self-administered taVNS five times a week for 30 min after strength training or before bedtime, in an uncontrolled, single-arm pilot design without a sham or control condition. Measurements were taken at three time points: before the intervention phase (pre), immediately after the 4-week intervention phase (post) and 1 month after the post-assessment (follow-up). Pre, post, and follow-up measurements included various subjective psychological domains (recovery, stress, perceived stress, affect, memory, attention, anxiety, and well-being), objective sleep domains (nocturnal HRV, sleep score, sleep duration, and subjective sleep quality), and submaximal strength performance outcomes in squat, bench press, and deadlift. The small sample size required non-parametric testing. Additionally, a responder analysis was conducted to explore individual differences in outcome-specific responses. Results. Results showed nominally significant pre-post improvements (uncorrected for multiple comparisons) in positive affect and self-reported attentional difficulties, both revealing large effect sizes; however, given the absence of a control group and the lack of correction for multiple comparisons across multiple outcomes tested, these findings should be interpreted as exploratory and hypothesis-generating rather than confirmatory. The remaining psychological domains and sleep outcomes did not show meaningful changes. Regarding performance, only two of the ten participants provided complete baseline training data, so no reliable conclusions about a beneficial effect of taVNS on strength performance could be drawn. The responder analysis was consistent with the two nominally significant findings but did not reveal a clear overall pattern of taVNS effectiveness. Conclusions. The current study is the first to implement a 4-week taVNS intervention in strength training and demonstrate differences in domain-specific responsiveness to taVNS in athletes for psychological health and self-reported cognitive performance. These findings offer important insights into the feasibility and practical application of taVNS in sports settings. Further studies with larger, sham-controlled samples, a pre-registered primary outcome and a longer intervention period are needed to determine whether these preliminary, hypothesis-generating findings reflect genuine effects of taVNS. Full article

Reliable control-oriented bedroom state recognition is needed because room-level occupancy sensing cannot distinguish in-bed, out-of-bed, movement, nocturnal bed-exit, and wake-related conditions. This study developed a privacy-preserving bed-centered sensing framework and a sleep-aware hierarchical multimodal fusion model, termed SA-HMF, for recognizing eight operational bedroom states (S0–S7). SA-HMF uses a bed-conditioned, quality-aware asymmetric architecture: bed-load and bed-mounted accelerometry are first encoded into a bed-interaction representation, which then conditions the fusion of bedside indoor environmental quality, room-context, temporal, and sensing quality information. Data were collected from 20 healthy adults across 127 valid participant-nights in one experimental bedroom. The recordings generated 342,684 overlapping 30 s windows using a 10 s stride; these windows were treated as correlated model instances rather than independent observations. Under the primary subject-independent split, SA-HMF achieved 0.925 Accuracy, 0.874 Macro-F1, 0.927 Weighted-F1, and 0.864 Balanced Accuracy. LOSO evaluation yielded a Macro-F1 of 0.852 ± 0.043, with a participant-level 95% confidence interval of 0.833–0.870. Using non-overlapping 30 s windows, SA-HMF retained 0.918 Accuracy, 0.865 Macro-F1, and 0.856 Balanced Accuracy. Retrospective event extraction F1-scores ranged from 0.846 to 0.950. The optimized model was 2.7 MB and required 15.6 ± 3.2 ms per inference. These results support feasibility and transfer to unseen healthy participants within the tested bedroom and sensing configuration. External validation across bedrooms, beds, sensing installations, and populations remains necessary. Full article

Circadian–behavioral misalignment, defined as a mismatch between internal circadian timing and daily sleep activity behavior, is associated with sleep quality, daytime function, cognitive performance, and long-term health risks. However, practical approaches for integrating circadian-phase-related physiological markers with behavioral and environmental sensing under free-living conditions remain limited. This study presents a multimodal wearable and lifelog monitoring workflow that combines a heat-flux-based wearable temperature-estimation sensor, a wrist-worn actigraph, melanopic equivalent daylight illuminance (EDI) measurement, and web-based lifelog entries. Ten healthy young adults were monitored for approximately one week in daily life. The midpoint between the descending and ascending mid-level crossings of the nocturnal temperature rhythm was extracted as a circadian-phase-related temperature rhythm marker. In a practical comparison with gastrointestinal temperature measured using an ingestible capsule, the wearable-derived rhythm marker showed a mean absolute difference of 27.1 ± 16.6 min. The temporal difference between the two markers was defined as the phase angle, and coupling stability was evaluated using phase angle variability and the correlation between the markers. After excluding one participant who traveled overseas, clustering and principal component analyses were used to visualize exploratory participant-level differences in circadian–behavioral coupling. Integrated analysis with melanopic EDI, activity, and lifelog-derived features suggested that light exposure, activity timing, and behavioral timing may provide contextual information for interpreting coupling patterns in this small cohort. These findings support the feasibility of a sensing system application that integrates physiological, behavioral, environmental, and lifelog data for the exploratory assessment of circadian–behavioral coupling under free-living conditions, rather than the development of new sensor hardware. Full article

Neuroendocrine and circadian dysfunctions are thought to underlie bipolar disorder (BD) and could be implemented as markers of complex symptom conditions, including the presence of Post-Traumatic Stress Disorder (PTSD) comorbidity. The primary objective of this study was to investigate neuroendocrine profiles in different BD phenotypes through the measure of nocturnal urinary levels of Cortisol (stress-response factor) and 6-sulfatoxymelatonin (aMT6s; light/dark signal) in euthymic BD patients diagnosed with PTSD (PTSD group) or with major depressive episodes without trauma symptoms (DEP group). Both groups were compared against healthy controls (CTL). Nighttime urinary levels of aMT6s and Cortisol were analyzed by competitive ELISA, with ensuing values normalized for specific gravity. The Cortisol-to-aMT6s ratio (Cort/aMT6s) was calculated as an exploratory proxy for the homeostatic balance between HPA-mediated catabolic/coping activities and Melatonin-related reparative functions. Clinical severity and psychosocial activities were assessed by using mood HAM-D, YMRS, trauma IES-R and functioning WSAS scales. Results revealed distinct biological patterns: PTSD subjects showed increased nocturnal Cortisol compared to DEP and CTL groups, whereas DEP patients exhibited lower aMT6s levels and an elevated Cort/aMT6s ratio. Cortisol and aMT6s correlated positively in PTSD, while the ratio correlated positively with Cortisol solely in controls. Clinically, Cortisol correlated positively with IES-R and functional impairment (WSAS), whereas aMT6s correlated negatively with HAM-D and YMRS scores. Present findings suggest a possible neuroendocrine divergence in BD patients with depression versus PTSD: nocturnal Melatonin deficiency may be associated with depression, while HPA-axis hyperactivity and altered crosstalk between the two systems may characterize PTSD comorbidity, with the Cort/aMT6s ratio as a potential index of impaired daily functioning. These results could be promising for the use of biomarkers linked to allostatic and circadian responses within the BD spectrum. Full article

Although nocturnal surface urban heat islands, which impede physiological recovery during rest, have been characterized in many cities worldwide, Syria’s capital, Damascus, situated in the Eastern Mediterranean region, remains without a quantitative, multi-time assessment of its nocturnal thermal behavior. This study delivers that assessment for the city and its surroundings during 2023–2025, using 138 MOD11A2 (Collection 6.1) nighttime scenes processed within Google Earth Engine and Python. Six complementary axes were integrated: the thermal gradient across functional classes, the anomaly field, SUHI intensity (SUHII) against three rural references, the Getis–Ord Gi* statistic, a multivariate topographic regression, and the Urban Thermal Field Variance Index (UTFVI). A consistent nocturnal gradient emerged (urban: 16.28 °C; bare land: 14.74 °C), with an annual intensity of 1.50 °C, about 36% above the global mean. A genuine seasonal crossover between the bare-land and agricultural references occurred in June, reflecting the phenological cycle of soil thermal inertia. Topography explained only ~10% of the spatial variance (R² = 0.102), and the topographically corrected intensity retained about 90% of its original value. The Gi* statistic identified a single central hot spot (p < 0.01 after false-discovery-rate correction, with significance adjusted for spatial autocorrelation) that coincided spatially with the “poor” thermal-stress nucleus delineated by UTFVI, covering 11.92% of the study area. The convergence of these complementary lines of evidence confirms the persistence of the phenomenon and provides a scientific basis for climate-aware urban planning in semi-arid Mediterranean cities. Full article

Aquatic and semiaquatic beetles are important components of wetland ecosystems serving as bioindicators, predators, and vital prey resources. Numerous studies examined how their dispersal flights are influenced by biotic and abiotic factors, but the wavelength-specific attraction of different artificial light sources remains understudied. This study evaluated the attractiveness of three portable light traps equipped with different light sources emitting light with different wavelength ranges: a compact light tube, an LED light source, and a UV lamp. A total of 6568 individuals representing 54 species were captured. Total nightly abundance correlated positively with mean nocturnal temperature. Light source type significantly affected both species richness and abundance, with the broad-spectrum compact light tube outperforming the other tested light sources both in abundance and species richness. For Dytiscidae and Hydrophilidae, the compact light tube was significantly more attractive only than the blue LED source, while its attractiveness did not differ significantly from that of the UV lamp, demonstrating family-level differences in attraction. The light source-dependent attraction remained stable across phenological periods. Our findings suggest that while broad-spectrum lights improve the efficiency of faunistic surveys and support conservation-oriented monitoring of aquatic beetle assemblages, their integration into public lighting networks near vulnerable wetlands must be strictly avoided to prevent severe ecological trapping. Full article

Background/Objectives: Pediatric lower urinary tract symptoms and bladder–bowel dysfunction are common and clinically related problems recognized within the ICCS framework, but no bibliometric study has previously mapped this broad field comprehensively. This study aimed to map the global structure, thematic evolution, and emerging research trends in pediatric lower urinary tract dysfunction using bibliometric methods. Methods: A total of 3004 publications published between 1945 and May 2026 and retrieved from the Web of Science Core Collection were analyzed. Keyword co-occurrence networks, country co-authorship networks, and document citation networks were constructed using VOSviewer (version 1.6.20)). Results: Annual publication counts first exceeded 100 in 2013 and remained largely at or above this level thereafter, peaking at 135 in 2020, with a subsequent plateau. The USA (26.1%), Turkiye (10.5%), and the United Kingdom (6.5%) were the most productive countries. Harvard University led institutional output (n = 131). Keyword network analysis identified 15 clusters, the most coherent of which centered on enuresis pathophysiology/pharmacology, overactive bladder treatment, sleep medicine, and core urinary and bowel symptoms. Overlay visualization identified artificial intelligence (~2024), telemedicine (~2022), and autism spectrum disorder (~2021) as the most recent emerging research themes. Conclusions: This is the first bibliometric analysis to map global pediatric lower urinary tract dysfunction research across the broader field. Artificial intelligence, telemedicine, and autism spectrum disorder emerged as the most recent research themes, while substantial geographic gaps remained in sub-Saharan Africa and South Asia. Full article

Atmospheric bacteria and fungi are key components of urban bioaerosols, and their community structures are closely related to urban air quality, bioaerosol concentration, and environmental driving factors. However, the temporal dynamics and environmental drivers of bacterial and fungal community structures remain poorly characterized in megacities such as Shanghai, China. From November 2024 to November 2025, we conducted a year-long, cross-seasonal bioaerosol sampling and high-throughput DNA sequencing campaign to investigate the seasonal and diel variations, environmental covariation, and meteorological responses of atmospheric bacteria and fungi in Shanghai. The results show that seasonal transitions cannot significantly alter the α-diversity of bacterial or fungal communities, but significantly shift their community compositions, exhibiting a stronger differentiation for fungi than bacteria (PERMANOVA R² = 0.133 vs. 0.054, p = 0.001). At the diel scale, bacterial communities exhibit weak diurnal variation, whereas fungal communities display significantly higher nocturnal Chao1 richness and Shannon diversity, along with distinct compositional separation. Cladosporium and Alternaria are enriched during the day, while saprotrophic basidiomycetes such as Irpex and Trametes are more abundant at night. Fungal composition covaries most strongly with meteorological gradients governed by boundary layer height, clear-sky surface downward solar radiation, temperature, relative humidity, atmospheric pressure and visibility, whereas bacterial–environment associations are weaker. The Relative Exposure-Relevant Proportion (RERP), dominated by Cladosporium and Alternaria, is higher during daytime and negatively associated with relative humidity (β = −0.23, q = 0.001). During a strong cold-air event, bacterial communities shifted rapidly following immediate air mass replacement and high wind shear before stabilizing, whereas fungal communities underwent a more gradual and cumulative turnover. The RERP also elevated during this event, accompanied by a greater contribution from Talaromyces. These findings reveal contrasting dynamics between airborne bacteria and fungi under both background and transient synoptic disturbances, providing crucial observational insights for bioaerosol modeling and risk prediction in urban environments. Full article

Background and Clinical Significance: Tarui disease, or glycogen storage disease type VII, is a rare autosomal recessive metabolic myopathy caused by muscle phosphofructokinase deficiency. Its manifestations include exercise intolerance, exertional myalgia, muscle cramps, myoglobinuria, rhabdomyolysis, hyperuricemia, and compensated hemolysis. The hematologic phenotype may obscure the underlying metabolic disorder and raise concern for a clonal myeloid neoplasm. Case Presentation: A 23-year-old man was referred for persistent mild thrombocytopenia following evaluation for jaundice and hepatosplenomegaly. He had undergone cholecystectomy at 18 years of age and reported exercise-induced myalgia, muscle cramps, and episodes of dark urine. Laboratory investigations demonstrated mild monocytosis, reticulocytosis, thrombocytopenia, hyperuricemia, elevated lactate dehydrogenase, and predominantly unconjugated hyperbilirubinemia, with a negative direct antiglobulin test. Selected inherited hemolytic disorders, hemoglobinopathies, and paroxysmal nocturnal hemoglobinuria were excluded. Bone marrow examination showed marked erythroid hyperplasia and mild megakaryocytic dysplasia. Testing for JAK2, CALR, and MPL mutations and an extended myeloid next-generation sequencing panel identified no pathogenic variants, and monocytosis resolved during follow-up. Whole-exome sequencing identified a homozygous PFKM missense variant, NM_001354735.1:c.1087A>T, p.(Ile363Phe), classified as a variant of uncertain significance. The patient subsequently developed severe rhabdomyolysis, with a creatine kinase level of 225,000 U/L and recovered after intensive intravenous hydration without renal impairment. Conclusions: Tarui disease should be considered in young patients with compensated hemolysis, hyperuricemia, exertional muscle symptoms, dark urine, or rhabdomyolysis, even when hematologic abnormalities suggest a myeloid disorder. The highly concordant phenotype and homozygous PFKM variant support a clinically probable diagnosis, although pathogenicity remains unconfirmed. Functional and segregation evidence may strengthen causal interpretation and support future variant reclassification. Full article

The summer performance of Saharan residential courtyards in developer-built (“promotional”) housing remains poorly documented. This study characterises a representative courtyard in Laghouat, Algeria (Köppen BWk), enclosed by R+3 buildings, combining in situ measurement at five stations with ENVI-met simulation. All stations remained in the EXTREME physiological-stress category (PET = 51.1–52.3 °C), with a minimum relative humidity of 9.26–10.35%; the sky view factor correlated with thermal amplitude (r = 0.936) and building shading with humidity (r = 0.977) and PET (r = −0.887). A vegetation paradox emerges: the unshaded vegetated station recorded the highest thermal surplus and lowest humidity, consistent with stomatal closure under extreme aridity, whereas the same vegetation, façade-shaded, performed best. Building shading, not ground vegetation, is the primary regulator, with a 9.5 °C surface-temperature differential between the two. These findings, specific to this single, intensively characterised courtyard, translate into six ranked design suggestions, led by built shading targeting 60–70% coverage at peak hours and temporally modulated nocturnal ventilation; the resulting assessment framework—rather than its site-specific values—offers a structure transferable to Saharan collective housing more broadly. Full article

Background/Objectives: Bedtime snacks are frequently used in youth with type 1 diabetes (T1D) to reduce nocturnal hypoglycemia risk; however, the optimal macronutrient composition remains uncertain, particularly in those treated with multiple daily injections (MDI). This randomized crossover study evaluated whether standardized whole-food bedtime snacks with different macronutrient profiles yield distinct overnight continuous glucose monitoring (CGM) patterns. Methods: Twelve children and adolescents with T1D using glargine/lispro-based MDI completed four bedtime snack protocols: carbohydrate-only (CHO), carbohydrate-plus-protein (CHO + PRO), carbohydrate-plus-fat (CHO + FAT), and carbohydrate-plus-fiber (CHO + FIB). Each snack was consumed for three consecutive nights at 21:00 without additional bolus insulin. Blinded CGM data were analyzed for 21:00–09:00 and for predefined postprandial intervals. Because no a priori sample size calculation was performed, the study was conducted as an exploratory pilot trial. Nights per snack were averaged before within-subject comparisons. Results: Overnight time in range (TIR; 70–180 mg/dL) varied across protocols (p = 0.014), with the highest TIR following CHO + PRO (85.8% ± 12.1%) and the lowest following CHO + FAT (70.9% ± 19.1%); however, adjusted whole-night pairwise comparisons were not statistically significant. Differences were more pronounced during the first 6 h following snack consumption, when CHO + PRO was associated with higher TIR than CHO + FAT (91.2% ± 7.6% vs. 71.4% ± 20.8%; adjusted p = 0.011). Moreover, CHO + PRO was associated with lower peak-to-nadir glucose amplitude than CHO + FAT (88.1 ± 24.9 vs. 123.9 ± 36.5 mg/dL; adjusted p = 0.041). Hypoglycemic and hyperglycemic event rates did not significantly differ across protocols. Conclusions: In children and adolescents with T1D using MDI, bedtime snack composition was associated with differences in early nocturnal glycemic stability. CHO + PRO demonstrated higher early night TIR and lower glucose amplitude than CHO + FAT; however, event-based safety outcomes did not significantly differ. Because only two pairwise comparisons remained significant after correction for multiple testing and the four snacks were not matched for energy content, these findings should be regarded as preliminary and hypothesis-generating; in particular, they do not demonstrate that any snack composition protects against nocturnal hypoglycemia. Confirmation is required in larger, adequately powered studies that include energy-matched snacks and a no-snack control condition. Full article

Circadian rhythms regulate hepatic metabolism and physiological homeostasis, which are essential for organisms to adapt to environmental cycles. Bats are the only mammals capable of sustained powered flight, accompanied by extreme metabolic demands and a nocturnal lifestyle. However, the regulatory mechanisms underlying hepatic circadian rhythms in bats remain poorly understood. Herein, we employed data-independent acquisition (DIA)-based quantitative proteomics to characterize the diurnal dynamics of hepatic proteins in Vespertilio sinensis across four representative physiological states, and further conducted integrative multi-omics analysis combined with transcriptomic data. The results revealed that approximately 5% of hepatic proteins exhibited circadian rhythmicity in V. sinensis, a proportion markedly higher than that of rhythmic transcripts and metabolites. Prominent transcription-protein rhythm decoupling was observed, implying that post-transcriptional regulatory processes may play critical roles in shaping circadian rhythms. Core metabolic pathways displayed temporally dynamic enrichment. The diurnal functional switching of the liver was achieved via stable expression of core proteins and temporal turnover of specific proteins, which efficiently coordinated energy supply, oxidative defense and detoxification metabolism. Trend clustering and functional enrichment analyses suggested that the liver may undergo lysosome-mediated immune repair during the daytime, while exhibiting enriched energy metabolic profiles that potentially support the elevated energy expenditure required for flight at night. This study systematically elucidates the protein regulatory patterns underlying hepatic diurnal rhythms in V. sinensis, and provides molecular clues for exploring extreme energy adaptation and circadian evolutionary scenarios in nocturnal flying mammals. Full article

This research presents an integrated techno-energetic framework to decouple electric vehicle (EV) fleet growth from urban grid instability, using Bogotá, Colombia, as a case study. As emerging megacities confront rising charging demands, conventional reactive grid reinforcements are becoming technically and economically constrained. To address this, we develop a multi-layered optimization model that transforms urban Voronoi polygons into operational energy catchment units. Utilizing a Monte Carlo Tree Search (MCTS) algorithm, the framework determines infrastructure deployment sequences under two operational thresholds: a target high-resilience EV-to-charger ratio and a conservative scenario. Each localized node is technically dimensioned as a Representative Charging Station (RCS) equipped with a photovoltaic array and a Battery Energy Storage System (BESS). The results reveal spatial heterogeneity; high-density polygons in specific commercial and residential districts exhibit elevated infrastructure utilization alongside a stable solar resource baseline. Furthermore, the model demonstrates that this distributed architecture alleviates transformer thermal stress during the peak nocturnal charging period, mitigating localized overload risks and supporting distribution grid operational reliability. This study provides a scalable decision-making tool that bridges geospatial urban planning with renewable energy engineering to support the transition of constrained electrical networks. Full article

Objectives: The aim of this study was to determine the differences between groups with and without nocturnal pain (NP) in patients with knee osteoarthritis (KOA) in terms of radiographic stage, disease severity, neuropathic pain, central sensitivity, sleep quality, physical activity level, and number of hospital visits. Methods: The study included 150 patients with KOA (101 women, 49 men; mean age 64 years (IQR: 9; range: 40–81)). Kellgren–Lawrence (KL) grading was used for radiographic staging, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for KOA disease severity, the Douleur Neuropathique 4 (DN-4) questionnaire for neuropathic pain, the Central Sensitization Inventory (CSI) for central sensitization, the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the International Physical Activity Questionnaire–Short Form (IPAQ-SF) for physical activity level. Results: In our KOA patient group, the prevalence of NP was found to be 64.7%. A multivariable binary logistic regression analysis was performed as the primary inferential analysis. Age, sex, educational level, body mass index, disease duration, KL grade, and WOMAC total score were entered simultaneously into the model. After adjustment for the included covariates, only the WOMAC total score remained independently associated with NP. Each one-point increase in the WOMAC total score was associated with an 11.7% increase in the odds of NP (adjusted OR = 1.117, 95% CI 1.068–1.168, p < 0.001). Conclusions: Given that it affects more than half of patients with KOA and is associated with higher disease severity, we emphasize the need for careful management of NP in KOA patients. Full article

Background/Objectives: Wearable devices provide multidimensional measures of cardiometabolic health. We aimed to derive latent physiological dimensions from ECG and motion variables collected by a wearable device and evaluate their associations with the individual health metrics of the Longevity Check-Up 8+ (LC8+) programme. Methods: Community-dwelling adults voluntarily participating in four Longevity Check-Up 8+ (LC8+) events underwent 24-h multiparameter recording using a wearable device. Eight wearable-derived variables were entered into principal component analysis (PCA) to derive latent physiological dimensions. Component scores were subsequently evaluated for associations with overall LC8+ health, while exploratory analyses examined associations with individual health metric domains. Results: Ninety-seven participants (mean age 51.3 ± 13.4 years; 36% female) were enrolled. Among the 96 participants with complete data for the PCA, three latent physiological components were identified, explaining 70.1% of the total variance. PC1, which was characterised by high SDNN, high RMSSD, and low nocturnal heart rate, was independently associated with overall LC8+ health (LM: B = +0.402, 95% CI [+0.103, +0.700], p = 0.009). Among the eight LC8+ domains, only the association between PC1 and glycaemic health remained statistically significant after Benjamini–Hochberg correction in the primary fixed-effects analysis (95% CI [1.32, 4.62], adjusted p = 0.039). Conclusions: A wearable-derived autonomic component was associated with overall cardiometabolic health in community-dwelling adults. Among the individual LC8+ domains, the strongest association was observed for glycaemic health. These preliminary findings support further investigation of wearable device monitoring as a complementary tool for cardiovascular health assessment in preventive medicine. Full article