Search Results (54)

Endometriosis is a benign and often underdiagnosed condition that affects women of reproductive age, typically between 18 and 45 years. It can cause infertility and pain, including radicular pain and low back pain (LBP). The aim of this case report is to emphasize the importance of making a differential diagnosis when facing LBP and radicular symptoms. We report the case of a 17-year-old female patient, R.A., presented with a significant LBP (NPRS 8/10) radiating from her lumbar spine to her right buttock and occasionally to both legs, accompanied by weakness. She revealed exacerbation of pain during menstruation, despite being under hormonal contraceptive treatment. After three physiotherapy sessions that included education, manual therapy and exercise, the patient’s pain persisted so her physiotherapist recommended an evaluation in the emergency department, where standard radiography did not reveal any significant findings. Physiotherapy continued until the fifth session, when the patient agreed to undergo evaluation at a specialized endometriosis centre. Further investigations revealed endometriotic tissue on the uterosacral ligament, leading to hormonal therapy adjustment, with which pain gradually decreased to a manageable level (NPRS 2/10). This case report highlights the importance of an early differential diagnosis in patients with LBP, as endometriosis can present not only in older women but also in younger patients, including those already on oral contraceptives. Therefore, to mitigate the risk of pattern recognition bias, clinicians must maintain a high index of suspicion for endometriosis, even in atypical or unlikely clinical presentations. Full article

Helmets are crucial for protecting motorcycle riders from head injuries in accidents. This study proposes a helmet pad design based on a negative-Poisson’s-ratio (NPR) structure and comprehensively evaluates its protective effect on head injuries. A concave hexagonal honeycomb structure was embedded into the energy-absorbing lining of a motorcycle helmet, and finite element collision simulations were conducted according to the ECE R22.05 standard. These simulations compared and analyzed the differences in protective performance between concave hexagonal honeycomb helmets with different parameter configurations and traditional expanded polystyrene (EPS) helmets under flat anvil impact scenarios. Using biomechanical parameters, including peak linear acceleration (PLA), head injury criterion (HIC), intracranial pressure (ICP), maximum principal strain (MPS), and the probability of AIS2+ traumatic brain injury, the protective effect of the helmets on traumatic brain injury was evaluated. The results showed that when the wall angle of the honeycomb structure was 60°, honeycomb helmets with wall thicknesses of 0.8 mm and 1.0 mm significantly reduced PLA and HIC values. In particular, the honeycomb helmet with a wall thickness of 1.0 mm reduced ICP by 25.7%, while the honeycomb helmet with a wall thickness of 1.2 mm exhibited the lowest maximum principal strain in the skull compared to EPS helmets and reduced the probability of AIS2+ brain injury by 7.2%. Concave hexagonal honeycomb helmets demonstrated an excellent protective performance in reducing the risk of traumatic brain injury. These findings provide important theoretical foundations and engineering references for the design and optimization of new protective helmets. Full article

Triazolopyrimidine and its analogs represent an important scaffold in medicinal chemistry research. The heterocycle of 1,2,4-triazolo[1,5-a] pyrimidine (1,2,4-TAP) serves as a bioisostere candidate for purine scaffolds, N-acetylated lysine, and carboxylic acid. This study modeled the quantitative structure–activity relationship (QSAR) of 125 congeners of 1,2,4-TAP from the ChEMBL database in the inhibition of Plasmodium falciparum using six machine learning algorithms. The most significant features among 306 molecular descriptors, including one molecular outlier, were selected using recursive feature elimination. A ratio of 20% was used to split the x- and y-matrices into 99 training and 24 test compounds. The regression models were built using machine learning sci-kit-learn algorithms (multiple linear regression (MLR), k-nearest neighbours (kNN), support vector regressor (SVR), random forest regressor (RFR) RIDGE regression, and LASSO). Model performance was evaluated using the coefficient of determination (R²), mean squared error (MSE), mean absolute error (MAE), root mean squared error (RMSE), p-values, F-statistic, and variance inflation factor (VIF). Five significant variables were considered in constructing the model (p < 0.05) with the following regression equation: pIC₅₀ = 5.90 − 0.71npr1 − 1.52pmi3 + 0.88slogP − 0.57vsurf-CW2 + 1.11vsurf-W2. On five-fold cross-validation, three algorithms—kNN (MSE = 0.46, R² = 0.54, MAE = 0.54, RMSE = 0.68), SVR (MSE = 0.33, R² = 0.67, MAE = 0.46, RMSE = 0.57), and RFR (MSE = 0.43, R² = 0.58, MAE = 0.51, RMSE = 0.66)—showed strong robustness, efficiency, and reliability in predicting the pIC₅₀ of 1,2,4-triazolo[1,5-a]pyrimidine. The models provided useful data on the functionalities necessary for developing more potent 1,2,4-TAP analogs as anti-malarial agents. Full article

This pilot study examines the relationship between pain intensity and trunk sitting postural control in 10 office workers with chronic spinal pain, using field-based real-time inertial sensors. Pain intensity was assessed with the Numeric Pain Rating Scale (NPRS) before and after work across three non-consecutive workdays, while postural control was evaluated through estimated center of pressure (COP) displacements. Linear and nonlinear metrics, including sway range, velocity, the Hurst exponent, and sample entropy, were derived from the estimated COP time series. Pearson correlation coefficients (r) and corresponding p-values were used to analyze the relationship between pain intensity and postural control. Significant correlations, though limited to specific metrics, were found (r = −0.860 to 0.855; p < 0.05), suggesting that higher pain intensity may be correlated with reduced postural variability. These findings provide preliminary insights into the potential link between pain intensity and postural control. Understanding trunk posture dynamics could inform the development of targeted ergonomic interventions to reduce musculoskeletal stress and improve sitting comfort in office environments. Full article

Background/Objectives: Due to rigidity, musculoskeletal pain is more common in people with Parkinson’s disease (PD) compared with age-matched older adults, and the shoulder is one of the body parts that is most involved. In the literature, there is no clear standard for the treatment of shoulder pain in people with PD. This clinical trial study aimed to evaluate the effectiveness of physiotherapy treatment for people with PD with painful shoulders. Methods: The main goals were improvements in pain intensity, balance, quality of life (QoL), and activities of daily living (ADL), evaluated with the Parkinson’s Disease Questionnaire 39 (PDQ-39), Berg Balance Scale (BBS), Community Integration Questionnaire (CIQ-R), 12-Item Short-Form Survey (SF-12), Disabilities of the Arm, Shoulder, and Hand (DASH) scale, and Numeric Pain Rating Scale (NPRS). Also, the evaluation comprised range of motion (ROM) evaluation with a goniometer and the Medical Research Council (MRC) scale. The inclusion criteria of this study were a diagnosis of PD associated with shoulder pain, and a stage of disease of 1–2 on the Hoehn and Yahr scale. Results: The sample comprised 16 participants; the mean age of the participants was 72. Through feedback collected from the individuals participating in this study, it emerged that the rehabilitation approach specifically designed for individuals suffering from shoulder pain associated with Parkinson’s disease produced remarkable results. Conclusions: These results were confirmed by a series of statistically significant data, which showed significant improvements in several areas: joint mobility, muscle strength, motor coordination, the ability to perform daily activities, emotional state, pain reduction, QoL improvement, and balance in both dynamic and static conditions. Full article

Plants are sessile organisms that overcome environmental stress by activating specific metabolic pathways, leading to adaptation and survival. In addition, they recruit beneficial bacterial strains to further improve their performance. As plant-growth-promoting rhizobacteria (PGPR) are able to trigger multiple targets to improve plant fitness, finding effective isolates for this purpose is of paramount importance. This metabolic activation involves the following two stages: the priming pre-challenge with no evident changes, and the post-challenge, which is characterized by a faster and more intense response. Eight Bacillus strains, obtained in a previous study, were tested for their ability to improve plant growth, and to protect Arabidopsis thaliana plants against biotic and abiotic stress. After the 16S rRNA gene sequencing, three isolates were selected for their ability to improve growth (G7), and to protect against biotic and abiotic stress (H47, mild protection, with a similar intensity for biotic and abiotic stress; L44, the highest protection to both); moreover the expression of Non-Expresser of Protein Resistance Gene 1 (NPR1) and Protein resistance (PR1) as markers of the Salicylic Acid (SA) pathway, and lipooxygenase (LOX2) and plant defensin gene (PDF1) as markers of the Ethylene/Jasmonic Acid (Et/Ja) pathway, was determined 24 h after the stress challenge and compared to the expression in non-stressed plants. The results indicated that (i) the three strains prime Arabidopsis according to the more marked and faster increases in gene expression upon stress challenge, (ii) all three strains activate the SA-mediated and the Et/Ja-mediated pathways, therefore conferring a wide protection against stress, and (iii) PR1 and PDF1, traditionally associated to Systemic Acquired Resistance (SAR) and Induced Systemic Resistance (ISR) protection against pathogenic stress, are also overexpressed under abiotic stress conditions. Therefore, it appears that the priming of the plant adaptive metabolism is strain-dependent, although each stress factor determines the intensity in the response of the expression of each gene; hence, the response is determined by the following three factors: the PGPR, the plant, and the stress factor. Full article

Bacterial wilt caused by Ralstonia solanacearum is one of the most important diseases in solanaceous plants, including peppers. It generally tends to be more serious under warm−temperature and moist (WM) conditions than at moist room−temperature (RM) conditions. Although immunity mechanisms at room temperature have been intensively studied, the mechanisms underlying WM conditions remain poorly understood. Herein, the pepper cysteine protease CaZingipain2 was expressed and functionally characterized in pepper immunity against R. solanacearum at WM conditions and at room temperature. The results showed that CaZingipain2 localized to the nucleus and was upregulated at the transcript level in pepper plants upon R. solanacearum infection under WM conditions (RSWM). Virus−induced gene silencing of CaZingipain2 significantly increased the susceptibility of pepper plants to RSWM, and was coupled with the downregulation of CaPRP1 and CaMgst3, which are specifically related to pepper immunity against RSWM, according to our previous studies, while its overexpression significantly reduced the susceptibility of N. benethamiana plants to RSWM compared to that of wild−type plants. In addition, our data showed that CaZingipain2 also acts positively in pepper immunity against R. solanacearum infection at room temperature by upregulating the SA− and JA−responsive PR genes, including CaNPR1 and CaDEF1. All these results indicate that CaZingipain2 improves pepper immunity against R. solanacearum under WM conditions and at room temperature by regulating different PR genes. Full article

Objective: The objective of this work was to assess the effect of physical therapy in patients with somatosensory tinnitus (ST) and explore the influence of physical therapy on clinical variables obtained before treatment. Methods: A total of 43 patients with ST were randomized to the immediate-start group (n = 20) and delayed-start group (n = 23). All patients received physical therapy for 1 week (seven sessions). Each session lasted 60 min. The Visual Analogue Scale (VAS), Tinnitus Handicap Inventory (THI), and numerical pain rating scale (NPRS) scores were documented at baseline and after treatment (week 1) for all patients. For subjects in the immediate-start group, the THI, VAS, and NPRS scores were measured after therapy (weeks 6, 9, and 12, respectively). Medical history characteristic functional activity scale (HCFA) scores were measured at baseline to assess the association between somatic symptoms and tinnitus. Results: At week 1, VAS, THI, and NPRS scores of patients in the immediate-start group were improved by 1.25 ± 1.59, 11.10 ± 15.10, and 0.95 ± 1.54 points, respectively, and were significantly higher than those in the delayed-start group (p < 0.05). The change in VAS, THI, and NPRS scores in the treatment group was significantly positively correlated with the scores of the HCFA before treatment (r = 0.786, p < 0.001; r = 0.680, p = 0.001; r = 0.796, p < 0.001). There was no significant difference in THI, VAS, and NPRS scores among patients in the immediate-start group between weeks 1, 6, 9, and 12 after treatment (p > 0.05). Conclusions: Although more participants were necessary in the further study, the study implies that physical therapy can reduce physical pain, improve tinnitus symptoms, and quality of life in ST patients without hearing loss, and the short-term curative effect is stable, especially for tinnitus patients with clear somatic symptoms. Full article

We assessed the feasibility of implementing a virtually guided Neuromuscular Electrical Stimulation (NMES) protocol over the tibialis anterior (TA) muscle while collecting heart rate (HR), Numeric Pain Rating Scale (NPRS), and quality of contraction (QoC) data. We investigated if HR, NPRS, and QoC differ ON and OFF the TA motor point and explored potential relationships between heart rate variability (HRV) and the NPRS. Twelve healthy adults participated in this cross-sectional study. Three NMES trials were delivered ON and OFF the TA motor point. HR, QoC, and NPRS data were collected. There was no significant difference in HRV ON and OFF the motor point (p > 0.05). The NPRS was significantly greater OFF the motor point (p < 0.05). The QoC was significantly different between motor point configurations (p < 0.05). There was no correlation between the NPRS and HRV (p > 0.05, r = −0.129). We recommend non-electrical methods of measuring muscle activity for future studies. The NPRS and QoC can be administered virtually. Time-domain HRV measures could increase the validity of the protocol. The variables should be explored further virtually to enhance the protocol before eventual ICU studies. Full article

Members of the Bacillus cereus group are spore-forming Gram-positive bacilli that are commonly associated with diarrheal or emetic food poisoning. They are widespread in nature and frequently present in both raw and processed food products. Here, we genetically characterized 24 B. cereus group isolates from foodstuffs. Whole-genome sequencing (WGS) revealed that most of the isolates were closely related to B. cereus sensu stricto (12 isolates), followed by B. pacificus (5 isolates), B. paranthracis (5 isolates), B. tropicus (1 isolate), and “B. bingmayongensis” (1 isolate). The most detected virulence genes were BAS_RS06430, followed by bacillibactin biosynthesis genes (dhbA, dhbB, dhbC, dhbE, and dhbF), genes encoding the three-component non-hemolytic enterotoxin (nheA, nheB, and nheC), a gene encoding an iron-regulated leucine-rich surface protein (ilsA), and a gene encoding a metalloprotease (inhA). Various biofilm-associated genes were found, with high prevalences of tasA and sipW genes (matrix protein-encoding genes); purA, purC, and purL genes (eDNA synthesis genes); lytR and ugd genes (matrix polysaccharide synthesis genes); and abrB, codY, nprR, plcR, sinR, and spo0A genes (biofilm transcription regulator genes). Genes related to fosfomycin and beta-lactam resistance were identified in most of the isolates. We therefore demonstrated that WGS analysis represents a useful tool for rapidly identifying and characterizing B. cereus group strains. Determining the genetic epidemiology, the presence of virulence and antimicrobial resistance genes, and the pathogenic potential of each strain is crucial for improving the risk assessment of foodborne B. cereus group strains. Full article

(1) Background: Dislocations of articular disk can occur as a result of parafunctions in the Temporo Mandibular Joint (TMJ), which limits the opening of the mandible and other movements. The aim of this study was to evaluate the effectiveness of rehabilitation in patients with disk displacement of the TMJ. A total of 327 subjects with Temporo Mandibular Disorders underwent stomathognatic physiotherapy. (2) Methods: Based on the results obtained by a manual functional analysis, 35 patients who were identified with articular disk locking (disk displacement without reduction) were included in the study. The study group (N = 35) was subjected to passive repositioning of the articular disk, reposition splints, and physiotherapy. The patient’s TMJs were then examined before the therapy, immediately after the therapy, and during the follow-up visit 3–6 weeks after the therapy. The Diagnostic Criteria for the Most Common Intra-articular Temporomandibular Disorders was used to evaluate the effects of rehabilitation on the patients’ range of motions and the Numeric Pain Rating Scale (NPRS). For the statistical analysis, Pearson’s r correlation coefficient test and Wilcoxon signed-rank test were used. (3) Results: The results showed a significant improvement in the range of motion of the mandible movements. The level of improvement was dependent on the time from the incident until undergoing rehabilitation. (4) Conclusions: The stomatognathic physiotherapy applied increased the range of motion of the mandible and reduced pain levels to the expected range. Full article

By reacting nitrilium derivative of the closo-dodecaborate anion, Bu₄N[B₁₂H₁₁N≡CR] (where R = Me, Et, nPr, iPr, p-tolyl), with lithium aluminum hydride (LiAlH₄), N-alkylammonium derivatives of the closo-dodecaborate anion, and Bu₄N[B₁₂H₁₁NH₂CH₂R], were obtained. The reduction reaction procedure was optimized, achieving yields close to quantitative (90–95%). The structure of the compound Bu₄N[B₁₂H₁₁NH₂CH₂CH₃] was determined using X-ray structural analysis. It was found that substituting lithium aluminum hydride (LiAlH₄) with sodium borohydride (NaBH₄) leads to the same products but only upon heating, while the reaction with LiAlH₄ proceeds at room temperature. Full article

The Italian Spine Youth Quality of Life (ISYQOL) is a validated health-related quality of life (HRQOL) questionnaire for teenagers with adolescent idiopathic scoliosis (AIS). We culturally-adapted ISYQOL to traditional Chinese (ISYQOL-TC) and then recruited 133 conservatively treated teenagers with AIS to complete the ISYQOL-TC and the Chinese version of the Scoliosis Research Society-22 revised (SRS-22r) questionnaire, nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder scale (GAD-7), and numeric pain rating scale (NPRS). They repeated ISYQOL-TC two weeks later. The internal consistency, unidimensionality, and test–retest reliability were measured using the Cronbach’s alpha, Rasch measurement models, and intra-class correlation coefficients (ICC3,1), respectively. The concurrent validity of the ISYQOL-TC with SRS-22r, and its construct validity with other questionnaires were evaluated using Spearman correlation coefficients. The ISYQOL-TC demonstrated good internal consistency (Cronbach’s alpha 0.90 and 0.89 for items 1–13 and items 1–20), and excellent test–retest reliability (ICC3,1 = 0.95–0.96). The Rasch analysis supported the unidimensionality of all 20 items in ISYQOL-TC. The ISYQOL-TC percentage scores were positively correlated with SRS-22r total scores (r = 0.65; p < 0.05), but were negatively related to PHQ-9, GAD-7, and NPRS scores (r = −0.46 to −0.39; p < 0.01). Collectively, the ISYQOL-TC is a reliable and valid instrument for evaluating HRQOL in Chinese teenagers with AIS. Full article

The aim of this study was to examine the responsiveness of the Arabic Disabilities of the Arm, Shoulder and Hand (DASH) and to quantify its minimal important change (MIC) for improvement. People with upper extremity musculoskeletal problems who were receiving physical therapy were evaluated at baseline and again during a follow-up appointment, with a median time frame of 7 days between the two testing sessions (range of 6 to 72 days). The participants completed the Arabic DASH, Global Assessment of Function (GAF), Numeric Pain Rating Scale (NPRS) and Global Rating of Change Scale (GRC). The responsiveness of the Arabic DASH was assessed by examining the pre-specified hypotheses. The MIC for improvement was determined using the receiver operating characteristic method (MIC_ROC) and the predictive modeling method (MIC_pred). As hypothesized, a change in the Arabic DASH demonstrated a significant positive correlation with changes in the GAF (r = 0.69), NPRS (r = 0.68) and GRC (r = 0.73). Consistent with our hypotheses, the DASH change scores could be used to differentiate between participants who improved and those who did not improve (area under the receiver operating characteristic curve = 0.87), and they showed a large magnitude of change (effect size = 1.53, standardized response mean = 1.42) in patients who improved. All the hypotheses specified a priori were supported by the results. The Arabic DASH MIC_ROC and MIC_pred were estimated to be 14.22 and 14.85. The interaction between the DASH change and baseline score was not a significant predictor of status (improved vs. not improved) (p = 0.75), indicating that the DASH MIC was not baseline-dependent. The Arabic DASH demonstrated sufficient responsiveness, supporting the idea that the Arabic DASH is capable of detecting changes in upper extremity function over time. The value of the Arabic DASH MIC was similar when estimated using the predictive modeling and ROC methods, and the MIC was not dependent on baseline status. Full article

This study aimed to examine the responsiveness of the Arabic Disabilities of the Arm, Shoulder and Hand short version (Quick-DASH) in patients with upper extremity musculoskeletal disorders. Participants with upper extremity musculoskeletal disorders (N = 88) under physical therapy care were assessed at initial visit and later at a follow-up visit, and they completed the Arabic Quick-DASH, DASH, Numeric Pain Rating Scale (NPRS), Global Assessment of Function (GAF), and the Global Rating of Change Scale (GRC). Responsiveness of the Arabic Quick-DASH was assessed by examining six pre-defined hypotheses. Consistent with the pre-defined hypotheses, the Arabic Quick-DASH changes scores exhibited significant positive correlation with the change in DASH (r = 0.98), GAF (r = 0.67), NPRS (r = 0.72), and the GRC (r = 0.78). As hypothesized, the Arabic Quick-DASH showed a large effect size above the pre-determined level (ES = 1.61, SRM = 1.49) in patients who reported improved upper extremity function. The Arabic Quick-DASH change score discriminated between patients who reported improvement versus no improvement in upper extremity function (area under the receiver operating characteristic curve = 0.90). The results supported 100% (six out of six) of the pre-defined hypotheses. The Arabic Quick-DASH demonstrated sufficient responsiveness where all the pre-defined hypotheses were supported, leading to the established validity of the Arabic Quick-DASH change score as a measure of change in upper extremity function and symptoms. The minimal importance change in the Arabic Quick-DASH needs to be determined in future studies. Full article