Search Results (311)

Blind and visually impaired (BVI) people face significant challenges in perception, navigation, and safety during travel. Existing infrastructure (e.g., blind lanes) and traditional aids (e.g., walking sticks, basic audio feedback) provide limited flexibility and interactivity for complex environments. To solve this problem, we propose a real-time travel assistance system based on deep learning. The hardware comprises an NVIDIA Jetson Nano controller, an Intel D435i depth camera for environmental sensing, and SG90 servo motors for feedback. To address embedded device computational constraints, we developed a lightweight object detection and segmentation algorithm. Key innovations include a multi-scale attention feature extraction backbone, a dual-stream fusion module incorporating the Mamba architecture, and adaptive context-aware detection/segmentation heads. This design ensures high computational efficiency and real-time performance. The system workflow is as follows: (1) the D435i captures real-time environmental data; (2) the processor analyzes this data, converting obstacle distances and path deviations into electrical signals; (3) servo motors deliver vibratory feedback for guidance and alerts. Preliminary tests confirm that the system can effectively detect obstacles and correct path deviations in real time, suggesting its potential to assist BVI users. However, as this is a work in progress, comprehensive field trials with BVI participants are required to fully validate its efficacy. Full article

Blindness and low vision are increasing serious public health issues that affect a significant percentage of the population worldwide. Vision plays a crucial role in spatial navigation and daily activities. Its reduction or loss creates numerous challenges for an individual. Assistive technology can enhance mobility and navigation in outdoor environments. In the field of orientation and mobility training, technologies with haptic interaction can assist individuals with visual impairments in learning how to navigate safely and effectively using the sense of touch. This paper presents a virtual reality platform designed to support the development of navigation techniques within a safe yet realistic environment, expanding upon existing research in the field. Following extensive optimization, we present a visual representation that accurately simulates various 3D tile textures using graphics replicating real tactile surfaces. We conducted a user interaction study in a virtual environment consisting of 3D navigation tiles enhanced with tactile textures, placed appropriately for a real-world scenario, to assess user performance and experience. This study also assess the usability and user experience of the platform. We hope that the findings will contribute to the development of new universal navigation techniques for people with visual impairments. Full article

Background/Objectives: Systemic lupus erythematosus is an autoimmune disease. The musculoskeletal system is affected in 90% of patients. The most common symptoms are myalgia, arthralgia, and arthritis. The objective was to analyze the efficacy of an intervention using myofascial techniques and proprioceptive neuromuscular facilitation in patients with systemic lupus erythematosus. Methods: A randomized, single-blind, crossover clinical trial. Seventeen patients with systemic lupus erythematosus were randomly assigned to two sequences: Sequence A–B (intervention phase first, then control phase) and Sequence B–A (control phase first, then intervention phase). The intervention lasted for four weeks, with two weekly sessions lasting 50 min each. The intervention consisted of myofascial and proprioceptive neuromuscular facilitation techniques. The variables were: pain intensity (Visual Analog Scale), functional capacity of lower limbs (2-Minute Walk Test), physical function (Timed Up and Go Test), and fatigue (Fatigue Assessment Scale). After a 2-week follow-up and a 2-week washout period, the patients switched groups, and the methodology was replicated. Results: None of the patients developed injury or adverse effects as a direct consequence of the intervention. There were statistically significant differences between groups (p < 0.001) in the intensity of ankle (η²_p = 0.38) and knee (η² = 0.37) pain, functional capacity (η² = 0.33), and physical function (η² = 0.56). There were also intergroup changes in fatigue (η² = 0.52), and the relevant mental (η² = 0.26) and physical (η² = 0.45) components. Conclusions: Proprioceptive myofascial and neuromuscular facilitation techniques are safe in patients with systemic lupus erythematosus. This physical therapy protocol can improve the intensity of knee and ankle joint pain in these patients. This intervention can improve functional capacity, physical function, and fatigue in people with systemic lupus erythematosus. Full article

Obesity is considered a global pandemic. In Mexico, 7/10 adults, 4/10 adolescents, and 1/3 children are overweight or obese, and it is estimated that 90% of cases of type 2 diabetes (T2D) are attributable to these pathologies. Visceral adipose tissue (VAT) presents increased lipolysis, lower insulin sensitivity, and greater metabolic alterations. Glucagon-like peptide-1 (GLP-1) is a polypeptide incretin hormone that stimulates insulin secretion dependent on the amount of oral glucose consumed, reduces plasma glucagon concentrations, slows gastric emptying, suppresses appetite, improves insulin synthesis and secretion, and increases the sensitivity of β cells to glucose. Liraglutide is a synthetic GLP-1 analog that reduces VAT and improves the expression of Glucose transporter receptor type 4 (GLUT 4R), Mitogen-activated protein (MAP kinases), decreases Fibroblast growth factor type β (TGF-β), reactivates the peroxisome proliferator-activated receptor type ɣ (PPAR-ɣ) pathway, and decreases chronic inflammation. Currently, there are many studies that explain the decrease in VAT with these medications, but there are no studies that compare the decrease in patients with obesity and prediabetes vs. obesity and type 2 diabetes to know which population obtains a greater benefit from treatment with this pharmacological group; this is the reason for this study. The primary objective was to compare the difference in the determination of visceral adipose tissue in people with obesity and type 2 diabetes vs. obesity and prediabetes treated with liraglutide. Methods: A quasi-experimental, analytical, prolective, non-randomized, non-blinded study was conducted over a period of 6 months in a tertiary care center. A total of 36 participants were divided into two arms; group 1 (G1: Obesity and prediabetes) and group 2 (G2: Obesity and type 2 diabetes) for 6 months. Inclusion criteria: men and women ≥18 years with type 2 diabetes, prediabetes, and obesity. Exclusion criteria: Glomerular filtration rate (GFR) < 60 mL/min/1.73 m² elevated transaminases (>5 times the upper limit of normal), and use of non-weight-modifying antidiabetic agents. Conclusions: No statistically significant difference was found in the decrease in visceral adipose tissue when comparing G1 (OB and PD) with G2 (OB and T2D). When comparing intragroup in G2 (OB and T2D), greater weight loss was found [(−3.78 kg; p = 0.012) vs. (−3.78 kg; p = 0.012)], as well differences in waist circumference [(−3.9 cm; p = 0.049) vs. (−3.09 cm; p = 0.017)], and glucose levels [(−1.75 mmol/L; p = 0.002) vs. (−0.56 mmol/L; p = 0.002)], A1c% [(−1.15%; p = 0.001) vs. (−0.5%; p = 0.000)]. Full article

Background: Nearly 5 million people in Peru live with visual impairments, many of which are irreversible. within addition to eye care services, these individuals could benefit from government services and rehabilitation to improve their quality of life and promote equitable, inclusive social participation. Although numerous government policies address this, little is known about their perception and implementation. Methods: Semi-structured individual online interviews were conducted with 29 people (7 low vision, 12 blind, 6 educators/rehabilitators, 4 medical doctors) in Peru between July and November 2024. Each participant was asked to respond to the same 16 open-ended questions. Their transcripts were coded into themes in 5 domains: assistive devices, vision rehabilitation services, government assistance programs, accessibility for people with visual impairments, and eye care services. The themes were compared among members of each group. Results: Themes from educators/rehabilitators aligned well with those with blindness but much less with ophthalmologists and those with low vision. Participants mentioned that assistive devices are not traditionally provided by the government. There was little mention of vision rehabilitation services, particularly from low vision participants. Additionally, participants with visual impairments mentioned a lack of sensitivity from teachers, employers, and transport drivers. Interestingly, none of the participants with visual impairments benefitted from financial assistance. Conclusions: Many of the barriers are societal, referring to the lack of understanding from the public in relation to employment, education, transportation, or the use of assistive devices. People with visual impairments and educators should be included in any policy decisions to promote equality for Peruvians with vision loss. Full article

Worldwide, millions of people suffer from visual impairments, ranging from partial to total blindness, with far-reaching consequences on personal, societal, and governmental levels. Corneal-related issues are among the leading causes of blindness, with corneal transplantation (keratoplasty) being the primary treatment. However, the demand for donor tissues far exceeds supply. The rise of printing technologies marks a revolution in tissue engineering, with 3D bioprinting at the forefront of developing innovative tissue repair and replacement solutions. The cornea emerges as an ideal candidate for this technology due to its distinct layers (epithelium, stroma, and endothelium). From a materials engineering standpoint, these layers resemble a hydrogel structure that facilitates fabrication. This review explores advancements in 3D bioprinting, focusing on the methodologies developed for corneal tissue engineering. It highlights design and construction aspects, including biomechanical and biocompatibility properties essential for creating synthetic implants and corneal scaffolds through bioprinting. Additionally, the review discusses the challenges and opportunities that could further drive innovation in tissue engineering. Full article

Background: Low levels of zinc are prevalent in patients living with HIV and are associated with higher morbidity. Zinc has major immunomodulatory effects. This study aimed to assess the effect of zinc supplementation on inflammatory and gut integrity markers and on zinc levels among HIV patients with zinc deficiency. Methods: This was a double-blind randomized placebo-controlled trial assessing the efficacy and safety of zinc supplementation on inflammation and gut markers in people with HIV (PWH) ≥ 18 years old, on stable antiretroviral therapy (ART) with undetectable HIV-1 viral load, and with zinc levels of ≤0.75 mg/L. Participants were randomized 2:1 to zinc gluconate tablets at a dose of 90 mg of elemental zinc or a matching placebo daily for 24 weeks. At baseline and at week 24, we measured plasma levels of zinc and markers of inflammation and gut barrier integrity. Results: Among the 95 participants enrolled in this study, 74% were male, and 65% were non-white, with a median CD4 count of 722 cells/μL. The primary analysis showed an increase in zinc levels in the active group. A decrease in the monocyte activation marker soluble CD14 was observed in the treatment group at −56.31 ng/mL (−263.24; 134.19), compared to an increase in the placebo group of 101.71 ng/mL (−90.50; 243.20); p = 0.021. The stratified analysis showed that the group with the lowest zinc levels at baseline had the greatest improvements in soluble CD14 levels during zinc supplementation. No changes were seen in other inflammation markers or gut integrity markers. Conclusions: This is the most comprehensive study on the effect of zinc supplementation in PWH on inflammatory and gut integrity markers. Decreases were seen in the monocyte activation marker sCD14. In the contemporary HIV era with potent effective therapies, suppressed viremia, and high CD4 cells, zinc supplementation does not offer consistent benefits on inflammation. Full article

This paper presents the development and evaluation of a smartphone application designed to improve accessibility for blind users. It uses the lightweight EfficientDet-lite2 model and the comprehensive COCO dataset in order to provide real-time object detection. The novelty of the application is in the integration of haptic feedback, which is activated when users touch objects that are detected on the screen, combined with audio notifications that announce the name of the detected object in multiple languages. This multimodal feedback mechanism helps blind users to recognize, explore, and move within their environment more effectively and safely. Extensive usability and user experience evaluation was conducted with blind and blindfolded users. The evaluation assessed the usability, effectiveness, accessibility, and user satisfaction and experience of the application. Additionally, a comparative analysis was performed between the use of haptic feedback and scenarios where haptic feedback was disabled. The results show a higher level of user satisfaction, greater ease of use, and significant potential for improving the independence of blind people when the haptic feedback is enabled. The findings also suggest that the inclusion of haptic feedback significantly enhances the user experience. This study underlines the importance of multimodal feedback systems in assistive technologies and the potential of mobile applications to provide accessible solutions for blind users. Full article

Introduction—Aim: Agitation and aggression are common symptoms in people with Alzheimer’s disease and other dementias. This systematic review outlines the current evidence for the effect of antidementia treatments on agitation and aggression in patients with Alzheimer’s disease. Methods: The literature search was performed by manually checking articles published since 2000 in the following databases: PubMed, ResearchGate, and Google Scholar, following the PRISMA guidelines. Results: Nineteen double blinded placebo-controlled trials were included. Treatment with galantamine seems to provide more credible evidence for treating or preventing agitation/aggression. Studies on memantine often presented with an improvement of the neuropsychiatric inventory but not specifically on agitation/aggression. The trials on donepezil and rivastigmine either did not include enough information on agitation/aggression or did not provide compelling results. The incidence of agitation as an adverse event was not higher in antidementia treatments compared to placebo. Conclusions: Agitation and aggression are common symptoms of Alzheimer’s disease and have a significant impact on the patient, caregiver, and the broader healthcare system. The current literature lacks robust evidence on which of the antidementia treatments could be used to manage or prevent agitation and aggression in Alzheimer’s disease. In most included studies, no specific scores that assess those symptoms were used. Future research that specifically focuses on different disease phenotypes and behavioral profiles to enhance and facilitate the management of these symptoms is needed. Full article

The number of individuals with disabilities around the world and in Poland is constantly increasing. Social inclusion, anti-discrimination, and social integration are among the Sustainable Development Goals, which include inclusive tourism. Fostering inclusion in the tourism industry contributes to improving quality of life in marginalised communities, community involvement in tourism development planning, and ethical activities related to the production and consumption of tourism services. Making attractions accessible to people with disabilities also contributes to enriching the tourist offerings of a region. The aim of this study is to assess the accessibility of tourist attractions in the Świętokrzyskie region, located in central Poland. The natural, cultural, and historical attractions there create potential for the development of various forms of tourism. The accessibility of 20 major tourist attractions for people with mobility, sight, and hearing impairments was examined. The results indicate a varying level of adaptation of facilities to the needs of the surveyed groups. Recreation and entertainment facilities are the best adapted, while sacred and historical facilities are the least adjusted. The majority of adaptations were directed towards individuals with mobility impairments, with blind and partially sighted people as well as deaf and partially hearing people often being overlooked. The identified barriers to adaptation included the excessive cost of adaptation and the limitations of the historic nature of the building. The inadequate preparation of attraction staff to support disabled individuals was also highlighted, as well as the importance of modern technology in creating accessibility and the need to promote inclusion among attraction managers and in regional policy. The article also includes an analysis of the local government’s measures aimed at social inclusion. Full article

Introduction: Non-communicable chronic diseases, such as overweight and obesity, are considered a high risk for type 2 diabetes. Globally, there are 536.6 million people with diabetes. Mexico has a high prevalence of these diseases. Objective: The objective of this study was to evaluate the effects of a synbiotic beverage and a 12-week dietary intervention on body composition and biochemical parameters in women with T2D, overweight, or obesity as an additional strategy for treatment. Methods: This was a double-blind, randomized, and experimental study of a 12-week dietary intervention with a synbiotic fermented beverage with n = 51 women divided into four groups: G1 followed a moderate calorie-restricted diet, G2 followed the same moderate calorie-restricted diet and consumed a synbiotic beverage, G3 only consumed the synbiotic beverage, and G4 consumed a placebo beverage. Results: Significant changes were seen in BMI (p < 0.001) and fat mass (kg) (%) (p < 0.001) after the 12-week dietary intervention, proving that the synbiotic beverage had an effect on body composition. Conclusions: Significant decreases in different body composition and biochemical profiles were seen, showing the benefits of the beverage. A dietary intervention and the consumption of a fermented beverage could be an additional treatment for non-communicable diseases. Full article

Glaucoma is a visual disease that affects millions of people, and early diagnosis can prevent total blindness. One way to diagnose the disease is through fundus image examination, which analyzes the optic disc and cup structures. However, screening programs in primary care are costly and unfeasible. Neural network models have been used to segment optic nerve structures, assisting physicians in this task and reducing fatigue. This work presents a methodology to enhance morphological biomarkers of the optic disc and cup in images obtained by a smartphone coupled to an ophthalmoscope through a deep neural network, which combines two backbones and a dual decoder approach to improve the segmentation of these structures, as well as a new way to combine the loss weights in the training process. The models obtained were numerically evaluated through Dice and IoU measures. The dice values obtained in the experiments reached a Dice of 95.92% and 85.30% for the optical disc and cup and an IoU of 92.22% and 75.68% for the optical disc and cup, respectively, in the BrG dataset. These findings indicate promising architectures in the fundus image segmentation task. Full article

Eye illness detection is important, yet it can be difficult and error-prone. In order to effectively and promptly diagnose eye problems, doctors must use cutting-edge technologies. The goal of this research paper is to develop a sophisticated model that will help physicians detect different eye conditions early on. These conditions include age-related macular degeneration (AMD), diabetic retinopathy, cataracts, myopia, and glaucoma. Common eye conditions include cataracts, which cloud the lens and cause blurred vision, and glaucoma, which can cause vision loss due to damage to the optic nerve. The two conditions that could cause blindness if treatment is not received are age-related macular degeneration (AMD) and diabetic retinopathy, a side effect of diabetes that destroys the blood vessels in the retina. Problems include myopic macular degeneration, glaucoma, and retinal detachment—severe types of nearsightedness that are typically defined as having a refractive error of –5 diopters or higher—are also more likely to occur in people with high myopia. We intend to apply a user-friendly approach that will allow for faster and more efficient examinations. Our research attempts to streamline the eye examination procedure, making it simpler and more accessible than traditional hospital approaches. Our goal is to use deep learning and machine learning to develop an extremely accurate model that can assess medical images, such as eye retinal scans. This was accomplished by using a huge dataset to train the machine learning and deep learning model, as well as sophisticated image processing techniques to assist the algorithm in identifying patterns of various eye illnesses. Following training, we discovered that the CNN, VggNet, MobileNet, and hybrid Deep Learning models outperformed the SVM and Random Forest machine learning models in terms of accuracy, achieving above 98%. Therefore, our model could assist physicians in enhancing patient outcomes, raising survival rates, and creating more effective treatment plans for patients with these illnesses. Full article

Background/Objective: Postprandial vascular responses impact vascular health. This study investigated whether eating pulses or whole grains can acutely relax blood vessels in people with arterial stiffness. Methods: A single-blinded, controlled randomized cross-over clinical trial was conducted to compare the effects of pulses (¾ cup black beans) versus whole grains (¾ cup whole wheat kernels, also known as wheat berries) versus white rice (¾ cup) on postprandial vascular responses in males and females with established arterial stiffness (n = 9, 3M/6F, 50–64 years old). Peripheral and central hemodynamic measurements were obtained non-invasively prior to and 2 h after food consumption and were compared by t-test within a food type. Results: Peripheral and central systolic blood pressure was increased (4%) after eating white rice but not after the consumption of wheat or beans. A marked decline in augmentation index at 75 bpm (arterial stiffness) from 26.1 ± 3.6% to 16.2 ± 2.0% was observed 2 h after eating whole wheat but not beans or white rice. All foods slightly decreased heart rate at 2 h but had limited effects on other parameters of circulatory or heart health. Conclusions: Eating whole wheat or beans acutely improved overall vascular and heart health when compared to white rice. The effects of wheat and beans were distinct, with whole wheat having a major positive effect on blood vessel stiffness. The findings suggest that regular inclusion of both whole wheat and beans in the diet would be beneficial for improving cardiovascular health in persons exhibiting signs of arterial dysfunction, thus providing a potential therapeutic benefit for individuals who are at risk of heart attack and stroke. The study was registered (NCT05818358) on ClinicalTrials.gov. Full article

Railways are crucial in economic development and improving people’s livelihoods. Therefore, defect detection and maintenance of rails are particularly important. In order to accurately separate and identify the rail defect from the mixed signals by acoustic emission (AE) techniques, this paper proposes a novel time–frequency separation neural network (TFSNN) architecture to solve the problems existing in the blind source separation (BSS), such as in non-stationary signals and low stability in the convergence. Combined with the smoothed pseudo Wigner–Ville distribution (SPWVD), this method can increase the spectrogram resolution, suppress the noise interference, and effectively improve the extraction performance of crack signals. In addition, 1D-CNN and GRU structures were introduced in the TFSNN structure to exploit the dominant features from AE signals. A dense regressor was also subsequently used to estimate the separation weights. Simulation and experiments showed that compared with traditional algorithms like independent component analysis, shallow neural networks, and time–frequency blind source separation, the proposed algorithm can provide better separation performance and higher stability in rail crack detection. Full article