Search Results (1,126)

Introduction: Learning disabilities (LD) compromise academic achievement in approximately 5–10% of school-aged children, yet the neurophysiological signatures that could facilitate earlier detection or stratification remain poorly defined. Resting-state electroencephalography (rs-EEG) offers millisecond resolution and is cost-effective, but its findings have never been synthesized systematically across pediatric LD cohorts. Methods: Following a PROSPERO-registered protocol (CRD420251087821) and adhering to PRISMA 2020 guidelines, we searched PubMed, Embase, Web of Science, Scopus, and PsycINFO through 31 March 2025 for peer-reviewed studies that recorded eyes-open or eyes-closed rs-EEG using ≥ 4 scalp electrodes in children (≤18 years) formally diagnosed with LD, and compared the results with typically developing peers or normative databases. Four reviewers independently screened titles and abstracts, extracted data, and assessed the risk of bias using ROBINS-I. Results: Seventeen studies (704 children with LD; 620 controls) met the inclusion criteria. The overall risk of bias was moderate, primarily due to small clinic-based samples and inconsistent control for confounding variables. Three consistent electrophysiological patterns emerged: (i) a 20–60% increase in delta/theta power over mesial-frontal, fronto-central and left peri-Sylvian cortices, resulting in markedly elevated θ/α and θ/β ratios; (ii) blunting or anterior displacement of the posterior alpha rhythm, particularly in language-critical temporo-parietal regions; and (iii) developmentally immature connectivity, characterized by widespread slow-band hypercoherence alongside hypo-connected upper-alpha networks linking left-hemisphere language hubs to posterior sensory areas. These abnormalities were correlated with reading, writing, and IQ scores and, in two longitudinal cohorts, they partially normalized in parallel with academic improvement. Furthermore, a link between reduced posterior/overall alpha and neuroinflammation has been found. Conclusions: Rs-EEG reveals a robust yet heterogeneous electrophysiological profile of pediatric LD, supporting a hybrid model that combines maturational delay with persistent circuit-level atypicalities in some children. While current evidence suggests that rs-EEG features show promise as potential biomarkers for LD detection and subtyping, these findings remain preliminary. Definitive clinical translation will require multi-site, dense-array longitudinal studies employing harmonized pipelines, integration with MRI and genetics, and the inclusion of EEG metrics in intervention trials. Full article

Background: Maintaining long-term exercise adherence in occupational settings remains a challenge, particularly in remote or unsupervised environments. This study aimed to investigate the effect of individualized feedback on exercise adherence, body composition, and physical function during a remote home-based training intervention utilizing the video-based exercise system “SUKUBARA^®”. Methods: In total, 66 care facility workers were randomly categorized into either a feedback (FB) group or a non-feedback (NF) group. Both groups performed a combined exercise program comprising low-load resistance training (slow squats) and balance exercises (one-leg standing time of closed eye) for approximately 15 min, thrice weekly over 12 weeks. The FB group received individualized feedback sheets visualizing total video play time (TT), exercise frequency, and interruptions, alongside reminder emails. The primary outcome was TT. Secondary outcomes included body composition measures (body weight, fat-free mass, and body fat mass rate) and one-leg standing time of opened eye. Results: The FB group demonstrated significantly greater TT, approximately 1.5 times that of the NF group, indicating enhanced exercise adherence. Moreover, significant improvements in fat-free mass and body fat mass rate were observed in the FB group. A significant correlation was identified between changes in TT and body composition parameters, suggesting TT as a valid proxy for exercise engagement. Conclusions: Individualized feedback within a remote monitoring home exercise program effectively improved exercise adherence and body composition among care workers. The “SUKUBARA^®” system shows promise as a tool to support exercise continuity in occupational health and long-term care settings. Full article

Background: Open-angle glaucoma (OAG) is a leading cause of irreversible blindness. While trabeculectomy remains the surgical gold standard, bleb-forming minimally invasive procedures such as the XEN63 gel stent offer a safer alternative. However, early postoperative management remains critical, as needling is frequently required to preserve bleb function. Healaflow^® (HF), a cross-linked hyaluronic acid gel, has been proposed as an adjunct in glaucoma surgery to maintain the subconjunctival space and modulate fibrosis. This study aimed to evaluate the outcomes of XEN63 implantation with or without HF in terms of IOP reduction, glaucoma medication use, surgical success, and postoperative intervention rates. Methods: This retrospective, comparative study included 20 pseudophakic eyes with medically uncontrolled OAG undergoing XEN63 implantation with mitomycin-C (MMC), either with (n = 10) or without (n = 10) adjunctive HF. Follow-up included IOP measurements, medication use, and the need for postoperative procedures up to 3 months. Results: At 3 months, both groups showed significant IOP reduction from baseline (−31.8% in XENhf vs. −38.8% in XENa, p > 0.05) with minimal medication use. Complete success was achieved in 90% of XENhf eyes and 80% of XENa eyes. Although the proportion of eyes requiring needling did not differ significantly, the total number of procedures was lower in the HF group (2 vs. 8; p = 0.004). Conclusions: Adjunctive HF use in XEN63 surgery may reduce the number of postoperative procedures while maintaining equivalent efficacy and safety, potentially easing the early management burden for both patients and clinicians. Full article

Background/Objectives: Glaucoma refers to a group of eye diseases that damage the optic nerve, causing irreversible vision loss. It typically begins with peripheral vision impairment and, in severe cases, leads to complete blindness. A major advancement in glaucoma treatment is Microinvasive Glaucoma Surgery (MIGS), including trabecular bypass and ab interno trabeculectomy, which are generally used for mild to moderate glaucoma. This review aimed to evaluate the efficacy and safety of iStent micro-bypass implantation and Kahook Dual Blade (KDB) goniotomy combined with phacoemulsification in patients with open-angle glaucoma (OAG). Methods: A review of recent studies was conducted using PubMed, Google Scholar, Scopus, Web of Science, and Embase. Both prospective and retrospective clinical studies were included. These MIGS methods were compared for reducing intraocular pressure (IOP) and medication burden at baseline and endpoint. Results: Eleven studies involving 1925 eyes were analyzed. All studies showed that iStent (first- and second-generation) micro-bypass implantation and KDB goniotomy reduced IOP, favoring the phaco-KDB group. Antiglaucoma medication use also decreased significantly. The success rate was sufficient and most complications were minimal. Conclusions: In conclusion, iStent implantation and KDB goniotomy offer a high safety profile, meaningful IOP reduction, a minimally invasive approach, and quick recovery. Full article

Purpose: The aim of this study was to evaluate the different approaches used in the treatment of meibomian gland dysfunction (MGD). Materials and Methods: This open-label, single-center, prospective pilot study with a parallel-group design was conducted in February 2025. Ninety-two patients presenting to our clinic with symptoms and signs of MGD were enrolled and diagnosed according to Japanese MGD diagnostic criteria. Patients were assigned to five treatment groups: conservative management alone, conservative management plus intense pulsed light (IPL) therapy, conservative management plus oral azithromycin, conservative management plus oral doxycycline, and conservative management plus topical cyclosporine. Conservative management consisted of preservative-free artificial tears containing polyvinyl alcohol and povidone, warm compresses, and eyelid hygiene. Primary outcome measures included ocular surface parameters such as the Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), Standard Patient Evaluation of Eye Dryness (SPEED) scores, and meibomian gland parameters evaluated using a slit-lamp examination. All parameters were assessed at baseline and during follow-up examinations after treatment initiation to observe changes in symptoms and signs. Results: A statistically significant increase was determined in meibum grade plugging (grades 0–3; higher = greater obstruction) and Marx line scores with IPL therapy (p < 0.05). The group receiving doxycycline treatment exhibited a significant improvement in OSDI and SPEED scores, plugging, TBUT, and meibum grades. The group receiving cyclosporine registered a significant improvement in OSDI and SPEED scores, plugging, TBUT, and meibum grades. A statistically significant increase was observed in the conservative treatment group in terms of lid margin irregularity, Marx line score, and OSDI and SPEED scores. In the group receiving azithromycin treatment, plugging, lid margin irregularity, TBUT, and OSDI and SPEED scores increased significantly. Compared with conservative care, the doxycycline group exhibited lengthened TBUT and lowered meibomian gland plugging and symptoms (p < 0.05), and the oral azithromycin group achieved a similar TBUT gain with slightly greater symptom relief. The topical cyclosporine group principally registered improved lid vascularity and meibum quality (p < 0.05), while the IPL group achieved the greatest overall improvements, reducing plugging and Marx line scores and adding ≈3 s to TBUT (p < 0.05 for all endpoints). Doxycycline exhibited notable short-term improvements, with 35.26% meibum grade improvement and a 40.48% foaming response, while IPL therapy demonstrated substantial OSDI improvements at 54.06%, with traditional parameters indicating limited treatment responsiveness. Conclusions: Various methods can be used in the treatment of MGD. All the conservative treatment methods used in this study were successful. Full article

Background/Objectives: Maintaining proper posture and preventing musculoskeletal pain are essential for the healthy development of young football players. Contemporary concepts of postural control emphasize the importance of the lumbopelvic-hip complex and the activation of deep trunk muscles. This study aimed to evaluate the effects of a structured core stabilization training program on postural parameters and pain reduction in young football players. Methods: A total of 182 male football players, aged 9–15 years, were enrolled and allocated to either the intervention or control group. The 12-week intervention consisted of exercises targeting both local and global trunk stabilizers. Assessments included measurements of spinal curvatures, trunk rotation angles, lower limb loading symmetry, and postural stability using the TMX-127 digital inclinometer (Saunders Group Inc., Chaska, MN, USA) and the Baseline scoliometer (Fabrication Enterprises, Inc. New York, USA). Pain intensity was measured using the Visual Analogue Scale (VAS). Repeated-measures statistical analyses were performed with a significance level set at p ≤ 0.05. Results: The intervention group showed significant improvements in trunk rotational parameters, with reductions in ATR values at C7/Th1 (−0.54°) and L5/S1 (−0.49°). SATR values decreased by −0.28° between the second and third assessments. Symmetry of lower limb loading under eyes-open conditions improved significantly (p < 0.00195). No significant changes were observed in dynamic balance, as assessed by the Y-Balance Test (p > 0.05). Pain intensity decreased from 3.33 to 2.55 on the VAS, reflecting a reduction of 0.78 points. Conclusions: Systematic core stabilization training enhances postural quality and reduces the occurrence and severity of musculoskeletal pain in young football players, with lasting effects—except for postural control under conditions of reduced visual input. This type of training represents an effective physioprophylactic strategy, supporting postural control and lowering the risk of injuries. To maintain these benefits, continued training that incorporates balance and proprioceptive exercises is recommended. Full article

To describe a technique for managing acute corneal hydrops in eyes with keratoconus using dome stromal drainage with intracameral air injection under real-time three-dimensional (3D) microscope-integrated optical coherence tomography (OCT) guidance. We describe a retrospective case series of six eyes from six patients with keratoconus who developed acute corneal hydrops. All eyes underwent intracameral air injection with controlled dome puncture for stromal fluid drainage, without the use of sutures. The procedure was performed using a 3D visualization system that enables integrated and simultaneous viewing of the surgical field and intraoperative OCT scan (a 3D digitally assisted visualization system that displayed a split-screen view of the surgical field and OCT cross-sections simultaneously). Postoperative resolution of edema and improvement in clarity were documented. The resolution of corneal edema allowed for subsequent mushroom-shaped penetrating keratoplasty performed with a femtosecond laser in four eyes of four patients. All six eyes showed significant resolution of corneal edema within 2 to 4 weeks. Stromal clefts collapsed rapidly after drainage. In each case, the thick edema was reduced to a confined leucoma. No intraoperative or postoperative complications were observed. All four eyes that underwent a femtosecond laser-assisted mushroom-shaped penetrating keratoplasty showed optimal anatomical and functional success. Air-assisted dome drainage, combined with simultaneous 3D and OCT visualization, is a safe and effective technique for treating acute corneal hydrops. This technology enables real-time decision-making and enhances surgical precision, opening the door to advanced procedures that are otherwise limited by corneal opacity. Full article

Background/Objectives: Autorefractometers are valuable tools in clinical practice, but their accuracy is often questioned, especially in the pediatric population. This study aimed to compare refraction data from open-field and close-field autorefractometers and subjective refraction without using cycloplegia. Methods: A total of 50 eyes of 50 participants (19 males and 31 females, 11.8 ± 1.56 years) were evaluated. In a single visit, objective refraction was performed using NVision-K 5001 (open-field) and Visionix VX120 (close-field) autorefractometers, and subjective refraction using the fogging technique. Differences between procedures were assessed for sphere, spherical equivalent, and cylindrical vectors J₀ and J₄₅ using the Friedman test, followed by the post hoc Wilcoxon test as needed. Results: Significant differences were found in the sphere between the three procedures (all p ≤ 0.032). For the spherical equivalent, the Visionix VX120 differed significantly with the other two techniques (both p < 0.001), whereas no significant differences were found between NVision-K 5001 and subjective refraction (p = 0.193). Finally, no significant differences were observed for J₀ and J₄₅ vectors among the procedures (both p ≥ 0.166). Conclusions: There are certain discrepancies between autorefractometers and the subjective assessment of refractive error, most evident in measurements taken with the close-field device, possibly due to greater accommodative stimulation. However, in contexts such as visual screening or as a preliminary guide in the clinic, the values obtained by autorefractometry can provide useful information. Full article

Tomicus yunnanensis, a notorious forest pest in southwest China, primarily employs infochemicals to coordinate mass attacks that overcome host tree defenses. However, secondary visual cues, particularly detection of host color changes, also aid host location. This study characterized the compound eye structure and vision of T. yunnanensis using electron microscopy and phototaxis tests. The apposition eye contains 224–266 ommatidia, with asymmetry between left and right. Quadrilateral facets occupy the dorsal third, while hexagonal facets dominate elsewhere. Each ommatidium comprises a large corneal lens, an acone-type crystalline cone from four cone cells, and an open-type rhabdom formed by eight retinular cells (R7–R8 centrally, R1–R6 peripherally), surrounded by two primary and at least seventeen secondary pigment cells. Dark/light adaptation alters cone size/shape and rhabdom cross-sectional area/outline (without pigment granule movement) to regulate light reaching the photoreceptors. Behavioral observations showed peak flight activity occurs between 7:00–11:00 AM, with no nighttime activity. Phototaxis tests revealed females are highly sensitive to 360 nm, 380 nm, and 700 nm wavelengths, while males exhibit high sensitivity to 360 nm and 400 nm. This work enhances knowledge on the integration of visual and olfactory sensory information in beetles for host location and non-host avoidance. Full article

An environmentally friendly and highly sensitive analytical method for the determination of the dye Eosin Y (EY) was developed utilizing vortex-assisted liquid–liquid microextraction based on deep eutectic solvents (DESs), combined with fluorescence detection (LPME-FLD). The extraction efficiencies of conventional solvents and various DES systems, composed of tetrabutylammonium bromide (TBAB) and alcohols (hexanol, octanol, and decanol) in different ratios, were systematically compared. DFT calculations provided insights into the most stable forms of EY in solvents of varying polarity. Theoretical Hansen solubility parameters and the COSMO-RS solvation model were applied to assess extraction efficiency. Hansen parameters were obtained via semiempirical PM7 calculations, while BP86/def2-TZVPD DFT computations were employed within the openCOSMO-RS framework. The developed method exhibited a linear calibration range between 0.1 and 130 µg·L⁻¹, with a high correlation coefficient (R² = 0.9982). The limit of detection (LOD) was established at 0.028 µg·L⁻¹. Method precision and repeatability were confirmed over two days, with relative standard deviations (RSDs) ranging from 1.1% to 2.7% and with recoveries between 99.0% and 106.2%. The proposed analytical approach was successfully applied to the determination of EY in real water samples, demonstrating both its practical applicability and alignment with green chemistry principles. Full article

Background: In glaucoma screening programs, a large proportion of patients remain free of open-angle glaucoma (OAG) or have no need of intraocular eye pressure (IOP)-lowering therapy within 10 years of follow-up. Is it possible to identify a large proportion of patients already at the initial examination and, thus, to safely exclude them already at this point? Methods: A total of 6889 subjects received a complete ophthalmological examination, including objective optic nerve head and quantitative disc measurements at the initial examination, and after an average follow-up period of 11.1 years, complete data were available of 585 individuals. Two neural network models were trained and extensively tested. To allow the models to refuse to make a prediction in doubtful cases, a reject option was included. Results: A prediction for the first endpoint, ‘remaining OAG-free and no IOP-lowering therapy within 10 years’, was rejected in 57% of cases, and in the remaining cases (43%), 253/253 (=100%) received a correct prediction. The second prediction model for the second endpoint ‘remaining OAG-free within 10 years’ refused to make a prediction for 46.4% of all subjects. In the remaining cases (53.6%), 271/271 (=100%) were correctly predicted. Conclusions: Most importantly, no eye was predicted false-negatively or false-positively. Overall, 43% all eyes can safely be excluded from a glaucoma screening program for up to 10 years to be certain that the eye remains OAG-free and will not need IOP-lowering therapy. The corresponding model significantly reduces the screening performed by and work load of ophthalmologists. In the future, better predictors and models may increase the number of patients with a safe prediction, further economizing time and healthcare budgets in glaucoma screening. Full article

Background/Objectives: Frailty is a prevalent geriatric syndrome associated with impaired postural control and elevated fall risk. Although conventional exercise is a core strategy for frailty management, adherence remains limited. Virtual reality (VR)-based interventions have emerged as potentially engaging alternatives, but their effects on objective postural control and task-specific confidence in frail populations remain understudied. This study aimed to evaluate the effectiveness of a supervised VR training program using the Nintendo Ring Fit Plus™ on postural control, functional mobility, and balance confidence among frail community-dwelling older adults. Methods: Fifty-one adults aged ≥65 years classified as frail or prefrail were enrolled in a four-week trial. Participants were assigned to either a VR intervention group (n = 28) or control group (n = 23). Participants were non-randomly assigned based on availability and preference. Outcome measures were collected at baseline and post-intervention. Primary outcomes included center of pressure (CoP) metrics—sway area, mean velocity, and sway path. Secondary outcomes were the Timed Up and Go (TUG), Berg Balance Scale (BBS), Activities-specific Balance Confidence (ABC), and Falls Efficacy Scale–International (FES-I). Results: After adjusting for baseline values, age, and BMI, the intervention group showed significantly greater improvements than the control group across all postural control outcomes. Notably, reductions in sway area, mean velocity, and sway path were observed under both eyes-open and eyes-closed conditions, with effect sizes ranging from moderate to very large (Cohen’s d = 0.57 to 1.61). For secondary outcomes, significant between-group differences were found in functional mobility (TUG), balance performance (BBS), and balance confidence (ABC), with moderate-to-large effect sizes (Cohen’s d = 0.53 to 0.73). However, no significant improvement was observed in fear of falling (FES-I), despite a small-to-moderate effect size. Conclusions: A supervised VR program significantly enhanced postural control, mobility, and task-specific balance confidence in frail older adults. These findings support the feasibility and efficacy of VR-based training as a scalable strategy for mitigating frailty-related mobility impairments. Full article

Objectives: We assessed the difference between quiet stance and gait in the spatial distribution and intensity of foot plantar pressures and whether it is possible to estimate the distribution during gait from data obtained during stance. Methods: A total of 60 healthy subjects with a mean age of 31.0 ± 9.4 years performed two trials for quiet stance and four trials for gait on a baropodometric walkway with their eyes open. Foot plantar pressures were recorded from 10 areas of the foot sole. Results: During quiet stance, the highest plantar pressure occurred at metatarsal heads (M2 to M4) and the medial (MH) and lateral halves of the heel (LH). During gait, the profile of plantar pressure values was like that during stance, but significantly higher. The differences concentrated at the big toe (T1), M2 to M4, MH, and LH, whilst toes (T2,3,4,5) and midfoot (MF) showed the smallest difference. A significant positive correlation was found between the corresponding areas of foot pressure during gait and stance. Conclusions: During quiet stance and gait, the overall profile of plantar pressure distribution was similar. During quiet stance, the subjects loaded more on the heels, in keeping with the known position of the center of pressure just in front of the ankles. During gait, higher pressures on the metatarsal areas are related to the forward propulsion of the center of mass. The correlation between the corresponding areas of foot pressure during gait and stance suggests that the pressure distribution during gait can partly be estimated from that during stance. This finding might be useful in most clinical settings when a single sensorized platform rather than a complete walkway is available. Full article

Existing research predominantly focuses on the preservation or renewal models of the physical forms of historic cultural districts, with limited exploration of their roles in stimulating tourists’ cognitive, affective resonance, and behavioral interactions. This study addresses historic cultural districts by evaluating the space quality and its impact on tourist experiences through the “cognition-affect-behavior” framework, integrating GIS, street view semantic segmentation, VR eye-tracking, and web crawling technologies. The findings reveal significant multidimensional differences in how space quality influences tourist experiences: the impact intensities of functional diversity, sky visibility, road network accessibility, green visibility, interface openness, and public facility convenience decrease sequentially, with path coefficients of 0.261, 0.206, 0.205, 0.204, 0.201, and 0.155, respectively. Additionally, space quality exerts an indirect effect on tourist experiences through the mediating roles of cognitive, affective, and behavioral dimensions, with a path coefficient of 0.143. This research provides theoretical support and practical insights for empowering cultural heritage space governance with digital technologies in the context of cultural and tourism integration. Full article

Objective: This study aims to examine the anterior chamber structure and related factors in 8-year-old children based on data from The Yamanashi Adjunct Study of the Japan Environment and Children’s Study (JECS). Methods: A total of 709 children aged 8 years (350 boys and 359 girls) who participated in the JECS Adjunct Study were included. The right eyes were primarily used for measurements. Optical Coherence Tomography (OCT) was utilized to scan the anterior chambers of the participants’ eyes. The following parameters were measured: Angle Opening Distance (AOD500, 750), Trabecular Iris Space Area (TISA500, 750), Anterior Chamber Angle (ACA500, 750), Peripheral Iris Thickness (IT500, 750), and Peripheral Corneal Thickness (PCT500, 750). The relationships between anterior chamber structure, axial length (AL), spherical equivalent (SE), logMAR (without correction), and body height were analyzed. Results: A significant negative correlation was found between SE and ACA (500: coefficient = −0.19; 750: −0.24), AOD (500: −0.19; 750: −0.24), and TISA (500: −0.17; 750: −0.23) (p < 0.001). Conversely, a significant positive correlation was observed between AL and ACA (500: 0.22; 750: 0.26), AOD (500: 0.25; 750: 0.30), and TISA (500: 0.24; 750: 0.29) (p < 0.001). Boys exhibited a longer AL (boys: girls = 23.30 ± 0.76 mm; girls = 22.79 ± 0.72 mm) and greater CT (500: boys = 812.82 ± 51.94 mm; girls = 784.48 ± 51.81 mm; 750: boys = 776.01 ± 48.64 mm; girls = 751.34 ± 49.63 mm) compared to girls (p < 0.001) despite no significant difference in body height. CT and IT showed no correlation with AL or SE, and visual acuity had minimal correlation with IT and CT. Conclusions: In our cohort of eight-year-old children, the anterior chamber angle structure correlates with ocular structures and refractive error, revealing notable differences between boys and girls. Full article