Search Results (950)

The reduction in aviation-induced climate impacts requires not only decreasing CO2 emissions, but also mitigating non-CO2 effects such as persistent contrail cirrus. Alternative propulsion systems and fuels are therefore discussed as potential pathways toward climate-neutral aviation. However, their influence on contrail formation and evolution remains insufficiently understood, particularly regarding how emission characteristics translate into contrail microphysical behavior and lifetime. This study aims to bridge this knowledge gap by systematically evaluating the contrail-forming potential of SAF and hydrogen-based propulsion systems, with a clear focus on identifying the key emission parameters that govern contrail persistence. To assess the impact of reduced particle emissions on contrail evolution, scenarios with lower initial ice crystal number concentrations $N_{\mathrm{ice}}$, representative of alternative propulsion concepts, were simulated using a Gaussian plume contrail evolution model. The results demonstrate that high ice crystal number concentrations ($N_{\mathrm{ice}}\approx {10}^{14}$–${10}^{15}$ kg${}^{-1}$), characteristic of kerosene and many SAF combustion cases, lead to persistent contrails with lifetimes of approximately 9–12 h due to suppressed crystal growth and sedimentation. Conversely, low initial ice crystal concentrations ($N_{\mathrm{ice}}\approx {10}^9$–${10}^{10}$ kg${}^{-1}$), expected for hydrogen systems under aerosol-limited nucleation conditions, promote short-lived contrails in the order of minutes. The findings indicate that contrail impacts are influenced not only by the fuel type itself, but also by combustion processes, atmospheric conditions, and the prevailing nucleation mechanisms. Consequently, the potential of SAF and hydrogen propulsion systems to mitigate contrail-related climate effects will likely depend on further technological optimization as well as additional experimental and in-flight observations to better quantify their atmospheric impacts. This work underscores the importance of linking emission measurements directly to contrail microphysics and provides a framework for evaluating future propulsion technologies based on their actual contrail-forming potential, rather than solely on fuel composition or CO2 reduction. Full article

Background: Enterococcus faecalis is a common gastrointestinal commensal and an important opportunistic pathogen. While vancomycin resistance is well characterized, data on virulence-associated genes in colonizing isolates remain limited. Methods: A total of 44 colonizing E. faecalis isolates recovered from routine VRE screening (rectal swabs) were included in the study. The presence of the virulence-associated genes asa, esp, eep, ccf, and cpd was investigated by PCR. Antimicrobial susceptibility testing was performed using standardized methods, and isolates were subsequently classified as either vancomycin-resistant (VRE) or vancomycin-susceptible (VSE). A cumulative virulence gene score was calculated for each isolate and compared between the two groups. Results: Virulence-associated genes were heterogeneously distributed. Overall, the prevalence of the investigated virulence genes was cpd (33/44), eep (26/44), esp (24/44), ccf (22/44), and asa (8/44). Among these, only esp was significantly more prevalent in VRE than in VSE isolates (p < 0.01). VRE isolates showed a significantly higher median virulence gene score compared to VSE isolates (3 [IQR: 2–4] vs. 2 [IQR: 2–3]; p = 0.028, Mann–Whitney U test). The esp gene was more frequently detected among VRE isolates, while pheromone-associated genes displayed no clear group-specific pattern. Conclusions: Colonizing E. faecalis isolates carried a heterogeneous repertoire of the selected virulence-associated genes, with a higher burden of these genes among VRE isolates. These findings contribute additional data from Eastern Europe on the molecular characteristics of colonizing E. faecalis populations and support further investigation of their epidemiological relevance in healthcare settings. Full article

Rainfall–runoff modeling is a key challenge in hydrological research. Despite the extensive application of long short-term memory (LSTM) networks in rainfall–runoff modeling, our understanding of the influence of different hyperparameter configurations on various hydrograph components, as well as the linkages between hydrological concepts and LSTM architectures, remains elusive. Here, we integrated Multi-Objective Particle Swarm Optimization (MOPSO) with LSTM hyperparameter optimization by targeting the root mean square error of the overall hydrograph (RMSE_all), high-flow (RMSE_high) and low-flow (RMSE_low) dynamics, and water volume deviation (Dv). The MOPSO-LSTM framework was applied to the upstream catchments of the Miyun Reservoir in Beijing, China. At a lead time of 1d, the optimal solution achieved an NSE of 0.920 in the Chaohe River Basin, with a minimum RMSE_all of 0.848 m³/s, RMSE_high of 2.081 m³/s, RMSE_low of 0.382 m³/s, and Dv of 0.002%. However, as the lead time increased to 3 and 7 days, the maximum NSE declined to 0.747 and 0.560, respectively, with process-related metrics deteriorating more substantially than water balance-related metrics. The Baihe River Basin performed better, with maximum NSE and KGE values of 0.949 and 0.970 at a lead time of 1d. Clear trade-offs among different evaluation objectives were further identified, particularly the competitive relationship between RMSE_high and RMSE_low, as well as the coupling between RMSE_low and Dv. SHAP (Shapley additive explanation) and partial dependence plots (PDPs) were used to quantify and interpret the effects of hyperparameters on model performance, and the results showed that learning rate, number of units, and lookback window served as the most influential hyperparameters. Moreover, optimization preferences resulted in distinct hyperparameter configurations, where Dv-oriented solutions favored smaller learning rates, longer lookback windows, and larger batch sizes than RMSE-oriented solutions. Compared with the Chaohe River Basin, the larger Baihe River Basin favored LSTM configurations with longer lookback windows, more hidden units, higher learning rates, and lower dropout rates, which was associated with the hydrological memory of the catchment. Overall, this study provides a novel multi-objective LSTM optimization framework, improving the understanding of LSTM hyperparameters and offering practical guidance for hydrological prediction and water resource management. Full article

The integration of Information and Communication Technologies (ICT) into face-to-face compulsory education has accelerated globally, but the conceptual definition and pedagogical application of Digital Education (DE) remain unclear. This systematic review explores how DE is defined, implemented, and assessed in in-person primary and secondary school settings. Guided by PRISMA methodology, 33 peer-reviewed empirical studies published between January 2012 and June 2025 were selected from Scopus and Web of Science, and through reference checking. Methodological quality and potential sources of bias were appraised using the Mixed Methods Appraisal Tool (MMAT), and that appraisal informed the interpretation of the evidence. The results indicate significant ambiguity surrounding the term DE, which is often conflated with ICT use or digital competence. While many studies report positive outcomes in student engagement and basic skill acquisition, few articulate clear operational frameworks or pedagogical strategies for effective implementation. DE is predominantly applied to low-cognitive-demand tasks and is underused in promoting deeper learning. Key barriers include insufficient teacher training, fragmented educational policies, and infrastructural limitations. Nonetheless, when digital tools are intentionally combined with pedagogical goals—such as personalized instruction, learner autonomy, and content creation—DE demonstrates potential to improve motivation and support achievement. The findings suggest that well-designed DE can contribute to educational sustainability by strengthening learning opportunities, supporting equity and inclusion, and advancing Sustainable Development Goal 4 (Quality Education), but they also highlight the need for coherent policies, teacher training, and equitable access to digital resources. Full article

Despite the traditional application of Sophora moorcroftiana seeds (SMS) in Tibetan medicine for heat-clearing, damp-drying, anti-inflammatory and detoxifying properties, the anti-inflammatory mechanisms of SMS remain insufficiently understood and warrant systematic investigation. This study evaluated the protective effects of an ethanolic SMS extract against lipopolysaccharide (LPS)-induced oxidative stress and inflammation in RAW 264.7 macrophages, with emphasis on the p62/Keap1/Nrf2 signaling pathway. In vitro, the extract exhibited significant DPPH, ABTS and ·OH radical scavenging activities, as well as ferric-reducing antioxidant power, in a clear concentration dependent manner. An inflammatory model was established by stimulating RAW 264.7 cells with LPS, followed by treatment with graded concentrations of the ethanolic SMS extract. The extract significantly reduced LPS-induced nitric oxide production and decreased the secretion of TNF-α, IL-6 and IL-1β, while suppressing iNOS and COX-2 expression at both mRNA and protein levels. In parallel, the extract alleviated oxidative stress, as evidenced by reduced intracellular reactive oxygen species (ROS) and MDA levels, increased antioxidant defenses including SOD, GSH and CAT, and decreased LDH release. At the protein-expression level, SMS treatment was accompanied by differential changes in p62, Keap1, total Nrf2 and HO-1 expression, suggesting that its effects may involve regulatory processes associated with cellular stress and antioxidant defense. Collectively, the ethanolic extract of SMS attenuated LPS-induced inflammatory and oxidative stress responses in RAW 264.7 macrophages. These effects may be associated with the suppression of inflammatory mediator production, reduction in the cellular oxidative stress burden and modulation of proteins involved in cellular stress responses and antioxidant defense. Full article

Background/Objectives: Psoriatic disease (PsD) is a chronic, systemic inflammatory disorder characterized by a wide spectrum of clinical manifestations extending beyond skin and joint involvement. Increasing evidence suggests a relevant role of the gut microbiota in the pathogenesis of psoriatic arthritis (PsA), although a clear causal relationship remains to be fully established. The aim of this review is to summarize current evidence on the role of the gut microbiome in PsD, with a focus on immune modulation, disease pathogenesis and potential therapeutic implications. Methods: A narrative review of the literature was conducted, focusing on studies investigating gut microbiota composition, dysbiosis patterns, and microbiome-related mechanisms in PsD and PsA, as well as emerging microbiota-targeted interventions. Results: Recent advances in high-throughput sequencing technologies have identified distinct microbial signatures associated with PsA onset and progression. Dysbiosis appears to influence immune system regulation, contributing to systemic inflammation through mechanisms involving intestinal barrier dysfunction and immune activation. Patients with PsA exhibit specific alterations in gut microbial composition compared to healthy controls. Emerging therapeutic strategies targeting the microbiota—including dietary interventions, probiotics, and fecal microbiota transplantation—show potential as adjunctive approaches in disease management, although clinical evidence remains limited. Conclusions: The gut microbiome represents a promising area of research in PsD, offering novel insights into disease mechanisms and potential therapeutic targets. Further studies are needed to clarify causal relationships and to define the clinical applicability of microbiota-based interventions. Full article

This exploratory proof-of-concept study aimed to develop and preliminarily evaluate a 3D-printed holder designed for reuse in cone beam computed tomography (CBCT) in dental research, particularly for comparative studies requiring pre- and post-intervention tooth assessment. The holder was designed using computer-aided design software and fabricated from polylactic acid using 3D printing. A conventional alginate-based holder was used for comparison. The comparison therefore concerned two complete positioning systems with different geometries and modes of adaptation to the CBCT headrest. The two positioning devices were independently placed by two operators with different levels of experience, and all CBCT scans were acquired by the same operator. The procedure was repeated after a 5-day interval. Root canal morphology was assessed using volumetric and surface measurements, as well as voxel counts. The independently segmented canal models were qualitatively displayed together in their native coordinate space to visualize positional consistency between acquisitions. Paired analyses showed substantially lower positional deviations with the 3D-printed holder than with the conventional holder in all four acquisition comparisons (Holm-adjusted p < 0.001). Mean deviations ranged from 0.126 to 0.172 mm for the 3D-printed holder and from 3.626 to 8.318 mm for the conventional holder. Morphometric parameters derived from 3D analysis remained identical across all acquisitions, regardless of operator, time point, or positioning method. Qualitative 3D analysis showed near-complete overlap for the 3D-printed holder and clear spatial discrepancies for the conventional holder. Under the evaluated conditions, the 3D-printed holder exhibited less positional variability than the conventional alginate-based holder. Full article

During ultra-deep well drilling, the bottomhole circulating temperature (BHCT) can easily exceed 150 °C, causing a series of problems such as drilling-fluid degradation, downhole instrument failure, and intensified well-control risks. Conventional surface-cooling methods experience sharply diminishing effectiveness under deep well conditions, while an insulated drill-pipe (IDP) offers good engineering feasibility as a passive cooling technique. However, existing studies lack a transient wellbore-formation coupled model validated by field data, and the influence patterns and interaction mechanisms of key parameters of the insulation coating under varying well depths remain unclear. Therefore, this study integrates a thermal-resistance representation into a transient wellbore-formation heat-transfer framework to characterize the insulation effect via an overall heat-transfer coefficient. Based on this framework, the cooling mechanism is systematically investigated from two perspectives: heat-absorption rate and cumulative blocked heat. Based on this model, the cooling mechanism is systematically investigated from two perspectives: heat-absorption rate and cumulative blocked heat. The results show that a 2000 m IDP section reduces BHCT from 161.81 °C (with a conventional drill-pipe, CDP) to 144.15 °C after 50 h of circulation. This yields an additional cooling of 17.66 °C and a cumulative blocked heat of 180.03 GJ. Parameter analysis further shows that lower thermal conductivity, longer coating length, and placement 200–400 m above the bottomhole enhance cooling, whereas coating thickness exhibits a marginal benefit threshold of 1 mm. More importantly, Sobol’ global sensitivity analysis reveals a distinct evolution of the dominant parameter controls with increasing well depth: at 6000 m measured depth (MD), coating length is the absolute governing factor; at 8000 m, coating position and length become equally important; at 10,000 m, the coupling between thermal conductivity and length emerges as critical; and at 12,000 m, thermal conductivity, thickness, position, and length jointly determine the cooling performance. This evolutionary pattern provides a depth-dependent priority framework for IDP parameter design, offering clear guidance for engineering application across varying well depths. Full article

This study presents a systematic taxonomic review of risk modelling and assessment methods in construction projects over the past 35 years (1990–2025). Through a structured four-stage process, 91 peer-reviewed articles from 15 leading journals were analysed. The taxonomic approach enabled the classification and mapping of methods according to chronological evolution, study type, authorship patterns, and focus areas, while thematic analysis was employed to synthesise key themes, trends, and research gaps. The review examines publication trends, geographical distribution of research contributions, and methodological developments. The findings reveal that the probability-impact (P-I) model remains the dominant approach, despite its well-documented limitations in capturing risk interdependencies and their cascading effects on project quality and overall performance. Fuzzy Set Theory (FST), Analytic Hierarchy Process (AHP), and Monte Carlo Simulation (MCS) emerged as the most frequently adopted techniques. The analysis demonstrates a clear evolution in the field: from predominantly basic probabilistic methods in the 1990s to increasingly sophisticated hybrid, fuzzy logic-based, and AI-enhanced approaches after 2010. Notwithstanding these advancements, significant gaps persist, particularly the lack of integrated frameworks capable of simultaneously addressing risks across multiple project objectives—cost, time, quality, and performance. This review synthesises the state of knowledge in the field, identifies persistent theoretical and practical shortcomings, and offers a comprehensive roadmap for future research. Key directions include the development of machine learning applications, dynamic modelling techniques, and holistic multi-objective risk assessment frameworks to better align risk management theory with the complex realities of modern construction projects. Full article

Ascorbic acid and its hydrophilic derivatives, ascorbyl phosphate, ascorbyl glucoside, and 3-O-ethyl ascorbic acid, are wide used active ingredients in cosmetics, with concentrations increasingly declared on product labels. Since such products are not subject to routine quality control, this study aimed to evaluate the content-related quality and stability of a comprehensive sample of commercial cosmetics. For this purpose, a selective HPLC-UV analytical method for their simultaneous determination was developed, validated, and applied to 41 products. The analysis revealed 0–31.7% (m/m) contents and inappropriate labeling in 22% of the products, including the absence and replacement of the labeled vitamin C form. Over half (57%) of the determined contents corresponded to the labels, which was claimed for 31 products, while the remaining contents were considerably lower (<80%). The stability study, performed on selected cosmetics and standard solutions under ambient and elevated temperatures, demonstrated instability, which could account for their inadequate content. Thus, the instability was found to be temperature-dependent and most pronounced for ascorbic acid, whereas the product price did not show a clear correlation with greater content or stability. Overall, these results highlight the need for proper quality control and stricter cosmetics regulation as well as formulation design to achieve sufficient stabilization, as observed in certain products. Full article

Phenolic compounds are critical components that determine the processing quality of wine grapes, and their accumulation is jointly affected by environmental conditions and genotype. However, the respective contributions of production site and cultivar, as well as the response differences in various phenolic components to environmental changes, remain unclear in northern China. In this study, three major red wine grape cultivars (Vitis vinifera L. cvs. Marselan, Cabernet Franc, Cabernet Sauvignon) were sampled from three typical producing areas, including Turpan, the Hexi Corridor, and Huailai in 2024. Botanical characteristics, quantitative agronomic traits, physicochemical indexes, and five phenolic components in berry skins and seeds were determined with three biological replicates. A general linear model (GLM) was used to quantify the effects of production site and genotype on berry quality, and principal component analysis (PCA) and Pearson correlation analysis were performed to explore the relationships between quality indicators. Our results indicate that clear quality differences were observed among the three studied production sites, which were the main source of variation in this dataset, accounting for 65.7% to 82.1% of total variance across most traits. Three distinct regional patterns were observed: grapes from Xinjiang had the highest sugar content, those from Gansu had the highest phenolic levels, and those from Zhangjiakou were richest in anthocyanins. The responsiveness of individual phenolic components to ecological conditions varied markedly, with anthocyanins being the most sensitive, followed by proanthocyanidins, tannins, total phenolics, and flavonoids. Marselan maintained a stable genotypic advantage in proanthocyanidin accumulation across all three sites, with skin levels 12.5–230.5% higher than other cultivars under the same growing conditions. Additionally, a potential tissue-specific association between cluster weight and phenolic components was preliminarily observed: higher cluster weight was associated with lower concentrations of late-accumulating anthocyanins and proanthocyanidins, but did not negatively affect total phenolics and tannins that form in early fruit development. Based on the above results, preliminary suggestions for cultivar–site matching were provided for reference. This study provides preliminary baseline data for cultivar selection and viticultural management in northern China, pending further multi-year validation. Full article

Hempseed press cake-derived protein hydrolysate (HPH) is a promising plant biostimulant, but its effects on strawberry fruit production under smart greenhouse conditions remain unclear. The objective of this study was to evaluate the effects of foliar HPH application on growth, mineral accumulation, reproductive traits, yield, fruit quality, and antioxidant properties of strawberry cv. ‘Pharachatan 80’. Plants were grown in a smart greenhouse and treated with water (control), a commercial biostimulant, and HPH at 7.5 and 10.0% (w/v) (HPH7.5 and HPH10.0, respectively). Foliar application was initiated 25 days after transplanting and repeated weekly for five applications. HPH applications showed clear concentration-specific improvements in vegetative growth, mineral accumulation, reproductive performance, fruit yield, and antioxidant quality. As the most effective treatment for overall crop performance, HPH7.5 enhanced plant growth and mineral accumulation, particularly K and Mg. Consequently, it improved both yield components (fruit set, number, weight, size, and total yield) and fruit quality attributes, such as total soluble solids, total phenolics, flavonoids, ascorbic acid, and ABTS radical-scavenging activity. Conversely, HPH10.0 was more closely associated with N, P, Ca, Fe, Zn, and Mn accumulation, as well as fruit firmness and total anthocyanin content, and DPPH radical-scavenging activity. Principal component analysis confirmed distinct response patterns between HPH concentrations. Thus, HPH7.5 serves as an effective foliar biostimulant to improve strawberry productivity and quality in smart greenhouses. Full article

The Nujiang Fault Zone is located in the Three Parallel Rivers region on the southeastern margin of the Qinghai–Tibet Plateau, serving as a discordogenic fault that must be traversed by the Sichuan–Tibet transportation corridor project. Because of the scarcity of direct geological evidence, the late Quaternary activity of the Nujiang Fault Zone remains highly controversial. Focusing on the late Quaternary activity and active intensity of this fault, we conducted detailed field investigations along the Zuogong segment of the Nujiang Fault Zone based on high-resolution remote sensing images. Two trenches were excavated within a linear trough near Ranmi Village. Fourteen ¹⁴C samples were collected for AMS dating, and two fault gouge samples were obtained for microstructural analysis, aiming to reconstruct the paleoseismic sequence and estimate the corresponding earthquake magnitude. Clear fault planes were exposed in the trenches, which distinctly offset the middle-late Holocene strata. Three paleoseismic events were recorded by trench exposures: Event E1 prior to 5824 ± 61 cal BP (approximately 7031 ± 688 cal BP), Event E2 at 4560 ± 321 cal BP, and Event E3 at 1464 ± 142 cal BP. Analogous to the northern-central segment of the Longmenshan Fault Zone, where the Ms 8.0 2008 Wenchuan earthquake occurred, and its southern segment was associated with the Ms 7.0 2013 Lushan earthquake, microstructural observations of the fault gouge from the Zuogong segment also revealed typical brittle deformation characteristics. In terms of trenching-offset features, as well as the composition and microscopic properties of clay minerals in the fault gouge, the Zuogong segment exhibited geological signatures that were intermediate between the southern and northern-central segments of the Longmenshan Fault Zone, with greater similarity to the southern segment. Accordingly, the maximum potential earthquake magnitude of this segment was estimated to be Ms 7.0–7.5. The paleoseismic sequence of the Zuogong segment indicated an earthquake recurrence interval of approximately 2500–3000 years, with approximately 1500 elapsed years since the most recent seismic event. Although the full recurrence cycle has not yet been approached, implying low probability of great earthquakes with magnitudes of Ms 7.0–7.5 in the near future, the occurrence of non-characteristic seismic events cannot be ruled out. This study reveals direct evidence for Holocene activity along the Zuogong segment of the Nujiang Fault Zone, providing a critical scientific basis for quantitative seismic hazard assessment and major engineering planning and construction in the research area. Full article

Background: Immigrant working women’s well-being is shaped not only by formal health and settlement services but also by everyday opportunities for rest, social connection, cultural expression, and participation in community life. This study examined how three community-based leisure activities were experienced by Farsi-speaking Iranian immigrant women aged 30 to 55 living in Ottawa, Canada. Methods: Organized in partnership with PAND Settlement Services, the activities included a group walk along the Rideau Canal, a Classical Persian dance workshop, and a group visit to the National Gallery of Canada. Data were drawn from 32 post-activity evaluation surveys, researcher field notes, and two follow-up semi-structured feedback sessions. Structured items were analyzed descriptively; open-ended responses and feedback sessions notes were analyzed thematically following Braun and Clarke’s six-phase approach. Results: Participants rated all three activities positively across enjoyment, accessibility, and social contact. Leisure was experienced as a meaningful break from routine, a source of emotional relief, an opportunity to meet other women, and a setting in which shared language and migration experience made participation easier and more comfortable. Sustained participation remained shaped by time pressure, caregiving demands, weather, transportation, cost, and access to clear and trusted information. Conclusions: Leisure activities contributed to the well-being and sense of belonging for the women who participated in the study. Full article

Background/Objectives: Preterm birth is associated with increased risk of motor delay and broader neurodevelopmental vulnerability. Existing reviews have examined neonatal therapy, family-centered care, or early developmental intervention broadly, but the independent evidence for physiotherapy-based interventions in which parents actively deliver or support motor or sensorimotor activities remains uncertain. This review evaluated the effects of early physiotherapy with structured, guided parental involvement on motor development in preterm infants and examined intervention content, parental burden, safety, adherence, and durability of effects. Methods: The review followed PRISMA 2020 and a prespecified PICO framework. The original PubMed, Scopus, and PEDro search was updated through 9 July 2026 using PubMed/MEDLINE, PEDro, Cochrane CENTRAL, ClinicalTrials.gov, backward and forward citation tracking, and linked-report searches. Eligible studies were randomized controlled trials of early physiotherapy, motor, or structured sensorimotor intervention with an active parent-delivered or parent-supported component and a validated motor or neurodevelopmental outcome. Multiple publications from the same randomized cohort were linked and participants were counted once. Risk of bias was evaluated with Cochrane RoB 2, intervention reporting with TIDieR, and certainty with GRADE. Results: Ten reports represented five independent randomized cohorts and 393 unique randomized infants. The Norwegian Parent-Administered Physical Therapy Intervention (NOPPI) produced a moderate short-term improvement in TIMP performance at term-equivalent age, but no consistent advantage in general movements, motor performance at 3 or 24 months, or school-age motor outcomes. COPCA and a NICU-to-home physiotherapy program produced developmental improvement over time or selected short-term gains, without consistent superiority over active or developmental care comparators. A parent-administered sensorimotor intervention by Fucile et al. improved oral-feeding outcomes but not TIMP motor performance, and its linked 18-month follow-up did not demonstrate a clear developmental advantage. Badura et al. found no significant effect of a 10-week parent-delivered general-movement-based program on MOS-R or Bayley-III motor outcomes; adherence was variable, and a transient increase in maternal depressive symptoms at discharge highlighted the importance of treatment burden. Conclusions: Guided parental involvement is feasible and may enhance short-term motor performance when activities are individualized, active, cue-responsive, and closely supervised. However, current evidence does not establish sustained superiority over well-structured usual or traditional care, developmental normalization, or benefit from passive sensorimotor input alone. Clinical implementation should combine competency-based parent training, explicit infant stress cues and stopping rules, realistic dose targets, ongoing professional support, and monitoring of adherence, parental well-being, and adverse events. Full article