Search Results (7,303)

Background: Anorexia nervosa (AN) and obsessive–compulsive disorder (OCD) share core features of cognitive rigidity, anxiety, and altered reward processing. Pharmacological options remain limited, and combined modulation of serotonergic and dopaminergic systems may provide new therapeutic directions. This naturalistic study explored the combined use of lurasidone and fluvoxamine in individuals with restrictive AN (AN-r) and comorbid OCD. Methods: Forty-five female inpatients with AN-r and OCD were followed for six months. Participants received either lurasidone + fluvoxamine (n = 14) or heterogeneous SSRI/antipsychotic regimens (n = 31). Primary outcomes were the Recovery Assessment Scale (RAS) and Body Uneasiness Test Global Severity Index (BUT-GSI). Secondary outcomes included the Eating Disorder Examination-Questionnaire (EDE-Q) and Eating Disorder Inventory-3 (EDI-3). Bayesian repeated-measures ANOVAs were conducted, reporting BF10, BFInclusion, and P(M│data) values, with multiple imputation applied to manage missing data. Results: Analyses indicated time-related changes across primary outcomes (RAS and BUT-GSI), with moderate-to-strong evidence (BF10 = 4.2–18.6) supporting overall improvement during treatment. Secondary and exploratory measures showed weaker or inconsistent trends (BF10 < 3). No evidence emerged for group-by-time interactions exceeding anecdotal strength. Conclusions: Within the constraints of this small, all-female inpatient cohort, the findings illustrate directional, time-related changes compatible with global rehabilitation effects rather than drug-specific efficacy. The study demonstrates the feasibility—and methodological challenges—of applying Bayesian longitudinal modeling to incomplete clinical datasets. Future randomized or adaptive trials incorporating objective endpoints and data-quality pipelines are warranted to test whether serotonergic–dopaminergic–σ-1 synergy provides genuine clinical benefit in the AN–OCD spectrum. Full article

Background: Accurate assessment of foot morphology is essential in sports medicine, orthopaedics, and footwear design. Manual examination remains common but may lack accuracy and reproducibility. Alternative techniques, such as pedobarography and handheld 3D scanning, may offer more objective and reliable data, given that their reliability and agreement with established methods are confirmed. Methods: Twenty-six healthy adults (age 25.8 ± 4.7 years; BMI 24.1 ± 2.0 kg/m²) were investigated. Foot dimensions were assessed via manual examination, pedobarography, and handheld 3D scanning, each performed in random order by two independent investigators on two separate occasions. Relative and absolute intra-rater reliability were analysed using intraclass correlation coefficients (ICC), the change in the mean of repeated measurements (bias), limits of agreement (LoA), and the typical error (TE). Inter-method agreement was evaluated using Lin’s concordance correlation coefficients (CCC), mean bias, and LoA to assess interchangeability as well as systematic bias. Results: Good-to-excellent relative and absolute intra-rater reliability was found for the distance-related foot dimensions across all methods, except for heel width assessed via pedobarography (small bias but wide LoA and high TE). Relative and absolute reliability of the angular parameters assessed via pedobarography and 3D scanning ranged from poor to excellent. Inter-method agreement between manual examination, pedobarography, and 3D scanning appeared low when considering all three agreement indices (i.e., CCC, mean bias, and LoA). The largest discrepancies were observed for heel width and arch-related measures. Conclusions: All three methods seem reliable for assessing distance-related foot dimensions. However, limited agreement among the three methodological approaches indicates that they cannot be used interchangeably without standardisation. Full article

Chemical emergencies in transport are rare but operationally demanding. This study presents a framework that converts the timeline of a real intervention involving a cyclohexylamine leak after a tanker truck overturned into a Petri net and subsequently into an absorbing Markov model. This provides decision-oriented indicators for the intervention phases and enables what-if analysis. Application to a case study shows that the capacity of the decontamination line has a significant impact on the duration of the incident resolution, while introducing a small probability of returning from technical measures to decontamination slightly prolongs the course while leaving the certainty of successful completion unchanged. Mapping between activities, Petri net locations, and aggregated states promotes transparency and the repeatability of procedures and highlights activities with a high number of repeat visits. The outputs are useful for decision making related to personnel and material resources, post-review analyses, and exercise planning. The limitations lie in calibration to a single incident, the partial use of expertly estimated parameters, and the approximate conversion of “steps” to time. Future work will focus on multiple cases, finer-grained time handling, and explicit capacity modelling. Full article

Background/Objectives: Loneliness is a significant public health issue among older adults, especially in rural and socioeconomically vulnerable groups. Telephone-based interventions have become a scalable, cost-effective way to reduce social isolation, although evidence of their long-term effects on various health outcomes remains limited. This study aimed to assess how effective HELPeN, a structured telephone program delivered by trained nursing students, is in decreasing loneliness and enhancing psychosocial and cognitive health in community-living older adults. Methods: A randomized controlled trial was conducted with 119 older adults (≥65 years) residing in the community. Participants were allocated to either an intervention group (n = 65), which received weekly structured telephone calls over 9 months, or a control group (n = 54), which received standard care. Outcomes were evaluated at baseline (M0), mid-intervention (M1–M3), and 3 months after the intervention (M4). The primary outcomes measured included loneliness and perceived social support. Secondary outcomes comprised functional status, comorbidities, depressive symptoms, quality of life, sleep quality, and cognitive function. The data were analyzed using repeated-measures ANOVA with Greenhouse–Geisser correction. Results: Significant group interactions over time were identified for loneliness (F = 5.92, p = 0.001, η² = 0.067), social support (F = 3.39, p = 0.023, η² = 0.043), depressive symptoms (F = 3.87, p = 0.019, η² = 0.046), and cognitive status (F = 5.35, p = 0.002, η² = 0.063). No significant differences were found for functional status, comorbidity, sleep quality, or quality of life. Conclusions: The HELPeN program demonstrated significant effectiveness in reducing loneliness and social isolation, and in improving emotional, cognitive, and sleep-related outcomes in older adults. As a low-cost and scalable model, this intervention strengthens the role of nursing students in addressing social determinants of health and may be integrated into community and public health strategies targeting vulnerable aging populations. Full article

Background: Balneotherapy (BT) has been proposed as a supportive intervention for post-COVID-19 musculoskeletal (MSK) and fatigue-related symptoms; however, comparative evidence across different BT delivery modes remains limited. This study aimed to evaluate the long-term effects of a BT-based treatment program on MSK health and related functional outcomes in individuals with a history of COVID-19. Methods: This secondary analysis was derived from a multicenter, randomized, controlled, single-blinded trial conducted from January to September 2023 across six Lithuanian medical spa centers. Participants with a self-reported history of COVID-19 and persistent multisystem symptoms were assigned to one of three BT modalities or a control group. Primary outcomes included MSK pain, muscle tension and spasm, handgrip strength, and trunk flexibility. Secondary outcomes included fatigue, sleep, quality of life, and analgesic use. Assessments were performed at baseline, post-treatment, and at three- and six-month follow-ups. The 2-week BT program consisted of daily sessions of light pool exercise, mineral baths, sapropel body wraps, and halotherapy. Data were analyzed using repeated-measures GLM in IBM SPSS Statistics (version 28.0). Results: Significant time effects were observed for MSK pain, muscle tension, spasms, fatigue, sleep disturbance, flexibility, and quality of life (all p < 0.05). Improvements occurred primarily within groups and were most pronounced immediately post-treatment, with partial maintenance at 3–6 months. Between-group differences were modest; however, ambulatory BT, inpatient BT, and BT combined with nature therapy demonstrated greater long-term improvements in several outcomes. Conclusions: BT was associated with beneficial changes across MSK and psychosocial domains in individuals recovering from COVID-19, although differences between BT modalities were limited. These findings support BT as a complementary component within multimodal post-COVID rehabilitation frameworks and highlight the need for further research on long-term maintenance and individualized treatment strategies. Full article

Background: Preeclampsia is a major obstetric disorder characterized by platelet activation and dysregulated thrombopoiesis. While conventional platelet indices reflect platelet morphology, the immature platelet fraction (IPF) provides insight into thrombopoietic activity. This study assessed IPF discrimination at presentation and its early post-treatment change in preeclampsia while controlling for potential confounding factors. Methods: In a prospective design, demographic and laboratory parameters—particularly platelet indices—were evaluated in women with preeclampsia and normotensive pregnant controls. Measurements were obtained at diagnosis and repeated 24–48 h after treatment, including initiation of medical treatment or delivery. Logistic regression and ROC analyses were performed, adjusting for age and gestational age. Results: Sixty-four women with preeclampsia and 25 normotensive controls were included; the preeclampsia group was older (31.3 ± 5 vs. 28.4 ± 4 years), and delivery occurred in 73.4%. At diagnosis, IPF, MPV, and PDW were higher, and platelet counts were lower compared with controls. After treatment, IPF decreased markedly (ΔIPF = 3.4; p < 0.001), accompanied by reductions in MPV and PDW, while platelet counts remained unchanged in the preeclampsia group. ΔIPF showed subtype-related differences, being higher in late-onset preeclampsia. Only IPF retained an independent association with preeclampsia (OR = 27.29; p = 0.006), whereas age, platelet count, MPV, PDW, BUN, and CRP were not significant. On ROC analysis, IPF demonstrated strong diagnostic performance (AUC = 0.992; cut-off ≥4%), with 98.4% sensitivity and 100% specificity. Conclusions: Easily measurable as part of a routine complete blood count, IPF may support diagnostic evaluation and clinical monitoring, consistent with its early post-treatment decline and subtype-related patterns. Full article

We developed a three-degree-of-freedom touch trigger probe integrated with two optical sensors. The probe includes an XY-axis cantilever stylus and a Z-axis structure supported by four parallel leaf springs. A laser diode combined with 1D and 2D position-sensing detectors (PSDs) detects angular shifts and displacement when the probe tip touches the measured surface. The optical path change amplifies the PSD response, enhancing sensitivity. Finite-element analysis verifies structural performance, and experimental validation shows the probe achieves a unidirectional repeatability of 0.18 μm. Full article

This study examined how variability in phonetic training input (high vs. low) influences the perception and acquisition of Spanish stop consonants by English-speaking beginners. A total of 128 participants completed 20 online identification sessions targeting /p, t, k, b, d, g/. In the high-variability condition (HVPT), learners heard tokens from six speakers, and in the low-variability condition (LVPT), all input came from a single speaker. Training followed an interleaved-talker design with immediate feedback, and perceptual learning was evaluated using a Bayesian hierarchical logistic regression analysis. Results showed improvement across sessions for both groups, with identification accuracy reaching ceiling by the end of the training sessions. Differences between HVPT and LVPT were small: LVPT showed steeper categorization trajectories in some cases due to slightly lower baselines, but neither condition yielded a measurable advantage. The pattern observed suggests that for boundary-shift contrasts such as Spanish stops, perceptual improvements are driven primarily by input quantity rather than variability. This interpretation aligns with input-based models of L2 speech learning (SLM-r, L2LP) and underscores the role of repeated exposure in restructuring phonological categories. Full article

Background: Video-based biomechanical running gait analysis is widely used to optimise technique, guide footwear selection, and identify orthopaedic risk factors. Despite the increasing availability of such assessments, it is often assumed—without strong empirical support—that key kinematic parameters of running gait remain stable over short periods of time. This study aimed to examine the short-term stability of key joint angles during running using a standard 2D video-based kinematic analysis. Specifically, it was investigated whether these angles change within the first 4 min of treadmill running under three defined conditions: barefoot at 12 km h⁻¹, shoed at 12 km h⁻¹, and shoed at 14 km h⁻¹, in a homogeneous sample of twelve young, trained, male recreational soccer players. Methods: Participants completed three four-minute runs. Joint angles were quantified manually from 2D video recordings. Temporal variation was analysed using repeated-measures statistics, intraclass correlation coefficients (ICCs), and minimal detectable changes (MDCs). Results: Six out of nine joint angles showed statistically significant temporal changes, mainly in hip extension, knee flexion, the Duchenne angle, the Trendelenburg angle, the leg axis angle, and heel-bottom angle. Lower leg angle and Achilles tendon angle remained stable. ICCs showed moderate to excellent agreement, indicating high within-session consistency across all angles. Discussion: Under the applied study protocol, significant short-term variations were observable in several joint angles during the first four minutes of running. These findings highlight the importance of analysing multiple strides and considering measurement uncertainty when interpreting short-duration running kinematics. Full article

Background: Objective, reproducible assessment of deep cervical muscle mechanics is clinically relevant, yet the reliability of shear-wave elastography (SWE) for the longus colli (LC) has not been established. Therefore, the aim of this study was to determine intra- and inter-examiner reliability of LC stiffness measured by SWE under a tightly standardized protocol in patients with mechanical neck pain. Methods: A longitudinal reliability study was conducted. Adults suffering from neck pain for ≥6 months were recruited. Two examiners (with different levels of experience) acquired bilateral LC images using fixed presets. The SWE region of interest covered the full muscle thickness (excluding fascia) to measure the LC shear-wave speed and Young’s modulus. Intraclass correlation coefficients (ICCs), standard error of measurement and minimal detectable changes were computed. Results: Nineteen participants with neck pain completed imaging (left and right sides analyzed). Inter-examiner agreement was good to excellent for single measurements (ICC_3,2 > 0.818) and improved when averaging two acquisitions (ICC_3,2 > 0.866). Intra-examiner repeatability was good to excellent for the novel examiner (ICC_3,1 > 0.891) and excellent for the experienced examiner (ICC_3,1 > 0.973). No meaningful stiffness differences by sex or side were observed in this sample (p > 0.05). Conclusions: A standardized SWE workflow yields reproducible LC stiffness measurements in mechanical neck pain. For longitudinal use, keep a single operator when feasible; in multi-examiner settings, average at least two acquisitions per side to enhance sensitivity to true change. Full article

Center of pressure is a valuable biomechanical variable, predicting joint loading contributions during movement and giving insight into compensatory patterns. The purpose of this study was to assess the validity and reliability of force insoles in calculating vertical ground reaction force and center of pressure during return-to-sport jump testing. Ten healthy individuals performed double- and single-leg vertical and horizontal jumps on an instrumented treadmill while wearing instrumented force insoles. Vertical ground reaction force and anterior–posterior and medial–lateral center of pressure were collected at peak vertical ground reaction force from both devices. Repeat testing occurred 7 ± 5 days following the initial session. Force insoles were valid for measuring vertical ground reaction force (mean absolute error (MAE): 4.34 N/kg) and anterior–posterior center of pressure (MAE: 10% foot length) but were not valid for medial–lateral center of pressure (MAE: 50% foot width). During double-leg vertical, single-leg vertical, double-leg horizontal, and single-leg horizontal jumps, force insoles demonstrated good reliability for measurements of vertical ground reaction force (ICC: 0.89, 0.75, 0.89, and 0.91), anterior–posterior center of pressure (ICC: 0.88, 0.89, 0.94, and 0.97), and medial–lateral center of pressure (ICC: 0.72, 0.09, 0.82, and 0.73). Force insoles are a valid and reliable alternative to evaluating vertical ground reaction force and anterior–posterior center of pressure during return-to-sport jump testing. Full article

Time evolution of open quantum systems is governed by the master equation. The master equation, which is a matrix formalism, is the time derivative of the density matrix, which contains the complete information on the state of a quantum system. Instead of implementing successive measurements on repeated identically prepared systems, which are inevitably imperfect and can only be performed a limited number of times, a state estimator can be designed to obtain the whole information about the state of a quantum system represented in a density matrix. Trace-one and positive semi-definite properties of the density matrix arising from physical constraints have to be preserved during state estimation in quantum systems. To address this challenge, we present a projection technique that incorporates Dykstra’s algorithm and physical constraints into state estimation. This technique, which is an iterative method, ensures convergence and includes a designed oracle that projects the estimated state into intersections of admissible closed convex sets. The oracle structure is constructed using Hilbert projection, which looks for the best approximation of the projected estimated state within a Hilbert space into a closed convex set. According to the Hilbert projection theorem, this proposed oracle guarantees the existence and uniqueness of the best approximation of the projected state. Full article

Background/Objectives: Accurate full-arch implant impressions are essential for predictable digital prosthodontics, yet the performance of different intraoral scanners (IOSs) remains variable. This in vitro study compared the trueness and precision of three widely used IOSs-Sirona Primescan, 3Shape TRIOS Core, and Medit i700-in a standardized full-arch implant model. Methods: A maxillary model with six multi-unit implants was digitized using a high-accuracy laboratory scanner to obtain the reference dataset. Each IOS was used to perform ten scans, exported as unmodified STL files. Accuracy was evaluated in Geomagic Control X through a two-step alignment and a peri-implant region-of-interest deviation analysis. Trueness (mean absolute surface deviation, µm) and precision (SD) were compared using one-way ANOVA with Tukey’s test (α = 0.05). Results: Primescan and TRIOS Core showed comparable trueness (202.76 ± 13.89 µm and 204.21 ± 2.61 µm, respectively), while Medit i700 demonstrated significantly higher deviations (221.05 ± 6.28 µm) (p < 0.05). TRIOS Core exhibited the highest reproducibility across repeated scans. Conclusions: The three scanners demonstrated measurable accuracy differences under standardized conditions. Primescan and TRIOS Core performed similarly in trueness, with TRIOS Core achieving superior precision. Medit i700 showed higher deviation values but remained consistent in its performance. These findings highlight measurable differences in accuracy and reproducibility among intraoral scanners under standardized laboratory conditions and may assist clinicians in selecting appropriate devices for full-arch digital implant workflows; however, clinical validation is required to confirm their performance in vivo. Full article

This paper presents the design, implementation, and experimental validation of a high-precision angular measurement system based on a round inductosyn. Dedicated hardware circuits, including excitation, signal conditioning, and resolver-to-digital conversion modules, together with software algorithms for coarse–fine data fusion and linear interpolation-based error compensation, are developed to achieve accurate and stable angular measurement. Experimental results obtained from repeated measurements over a full rotation demonstrate reliable system operation and effective suppression of nonlinear errors. After compensation, the residual angular error is limited to within ±3″, while measurement consistency across repeated experiments is significantly improved. The output angle exhibits good continuity and stability, confirming the feasibility and effectiveness of the proposed system for high-precision servo control and aerospace attitude measurement applications. Full article

Background: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity that requires effective conservative management to prevent progression and reduce surgical risk. Although bracing is effective, predictors of long-term outcomes and the prognostic value of short-term results remain insufficiently defined. Objective: This study aimed to identify clinical and radiological determinants of final treatment success in AIS patients treated with the Chêneau modified brace (CMB), with special emphasis on short-term predictors. Methods: A prospective longitudinal cohort study was conducted at the Institute for Physical Medicine, Rehabilitation, and Orthopaedic Surgery “Dr. Miroslav Zotović”, Banja Luka (2018–2024). Fifty AIS patients (mean age 13.5 ± 1.4 years; 80% female) with Cobb angles between 20 and 45° and Risser sign 0–3 were analyzed. Cobb angles were measured at four timepoints: baseline, 4 weeks (in-brace), 6 months (out-of-brace), and final follow-up (48.3 ± 9.4 months). Statistical analyses included repeated-measures ANOVA, Pearson correlation, and multivariate regression. Results: The mean Cobb angle improved significantly from 28.7° ± 7.1° to 22.1° ± 10.5° (p < 0.001). The six-month out-of-brace Cobb angle was the strongest predictor of treatment success (OR = 0.726, p = 0.001), surpassing initial in-brace correction. Lumbar curves demonstrated the most stable correction (28.1° → 20.5°, p < 0.001), while thoracic curves showed partial loss of improvement (30.5° → 26.9°, p = 0.373). Single-curve and non-compensatory deformities achieved greater correction than complex or double curves (p = 0.014). Conclusions: The six-month out-of-brace radiograph represents a key prognostic milestone in AIS management. Incorporating this dynamic assessment into routine follow-up may enhance individualized treatment planning and long-term outcomes. Full article