Search Results (262)

Background/Objectives: Telemedicine has emerged as a valuable tool for overcoming access barriers in healthcare, particularly in rehabilitation. However, the validity and reliability of remotely conducted physical capacity assessments remain unclear. This study evaluated the agreement and intra-rater reliability between in-person and tele-assessment administration of the one-minute sit-to-stand test (1 min-STST) in individuals with chronic respiratory diseases (CRDs). Methods: In this cross-sectional study, forty adults (55% female; mean age 59.8 ± 15.9 years) diagnosed with CRDs—including chronic obstructive pulmonary disease (52.5%), asthma (20%), and pulmonary fibrosis (20%)—completed the 1 min-STST in two conditions: in person and via tele-assessment. The primary outcome was the number of repetitions completed in each condition. Intra-rater reliability was analyzed using the intraclass correlation coefficient (ICC), and agreement between methods was evaluated with Bland–Altman analysis. Results: The mean number of repetitions was 24.4 ± 8.0 in person and 24.3 ± 8.1 via tele-assessment, with no significant difference (p = 0.78). Excellent reliability was observed (ICC = 0.978, p < 0.001), and Bland–Altman analysis showed good agreement with a mean difference of 0.08 ± 1.7 repetitions and limits of agreement from −3.26 to 3.41. No adverse events were reported. Conclusions: Tele-assessment of the 1 min-STST shows excellent agreement and reliability compared to in-person assessment in individuals with CRDs. These findings support tele-assessment as a valid and practical alternative for evaluating functional capacity remotely. Further research is needed to confirm its implementation in home-based or less-controlled settings. Full article

Paeonia ludlowii, a critically endangered species endemic to Tibet, China, possesses significant ornamental, culinary, and medicinal value. However, its mitochondrial genome remains understudied, limiting insights into its evolutionary mechanisms and constraining conservation genetics applications and molecular breeding programs. We present the first complete assembly and comprehensive analysis of the P. ludlowii mitochondrial genome. Most remarkably, we discovered that the P. ludlowii mitogenome exhibits an atypical dual-circular structure, representing the first documented occurrence of this architectural feature within the genus Paeonia. The assembled genome spans 314,371 bp and encodes 42 tRNA genes, 3 rRNA genes, and 31 protein-coding genes, with a pronounced adenine–thymine bias. This multipartite genome structure is characterized by abundant repetitive elements (112 functionally annotated SSRs, 33 tandem repeats, and 945 dispersed repeats), which potentially drive genome rearrangements and facilitate adaptive evolution. Analyses of codon usage bias and nucleotide diversity revealed highly conserved gene expression regulation with limited variability. Phylogenetic reconstruction confirms that P. ludlowii, P. suffruticosa, and P. lactiflora form a monophyletic clade, reflecting close evolutionary relationships, while extensive syntenic collinearity with other Paeonia species underscores mitochondrial genome conservation at the genus level. Extensive inter-organellar gene transfer events, particularly from chloroplast to mitochondrion, suggest that such DNA exchanges enhance genetic diversity and promote environmental adaptation. The discovery of the dual-circular architecture provides novel insights into plant mitochondrial genome evolution and structural plasticity. This study elucidates the unique structural characteristics of the P. ludlowii mitochondrial genome and establishes a crucial genetic foundation for developing targeted conservation strategies and facilitating molecular-assisted breeding programs for this endangered species. Full article

Engaging in sports, particularly at a competitive level, requires sustained muscle contractions before the onset of physical fatigue. Fatigue is highly prevalent in neuromuscular diseases, especially those affecting neuromuscular transmission (e.g., myasthenia gravis) or muscle membrane excitability (e.g., myotonia, certain metabolic myopathies). A decremental response in repetitive nerve stimulation (RNS) represents the neurophysiological analogue of exercise-induced muscle weakness. Patients with such responses exhibit abnormal suppression of muscle activity during repetitive or prolonged effort. Consequently, it is often assumed they should avoid strenuous physical activity. To assess the safety of sports participation in individuals with fatigability-related neuromuscular disorders, we examined the literature and report a new case of a patient with myotonia congenita who engaged in competitive sports without adverse events. The review identified only a few cases involving patients with myasthenia gravis or muscular dystrophies who also participated in competitive sports safely and with favorable outcomes. No adverse events were reported. While these findings suggest that sports participation may be feasible for selected patients, they cannot be generalized. Large-scale studies involving athletes with neuromuscular conditions are needed to evaluate the safety and long-term impact of exercise in these populations. Full article

The systematics and phylogeny of the most speciose genus (Leopardus) of the felidae have historically been contentious and problematic. These issues have been compounded with the recent advancement of genetic techniques that make it possible to detect events such as incomplete lineage sorting (ILS), punctual historical ancestral introgression (PHAI), and repetitive introgression or recent hybridization (RI-RH). Each of these events have noteworthily affected the Leopardus genus. One Leopardus taxon (Leopardus tigrinus, herein called tigrina) has been especially complex from a phylogenetic point of view. In the last decade, one new species has been reported (L. guttulus) and two other new species likely exist within the tigrinas (L. emiliae and L. pardinoides). However, the most surprising find was the discovery of a new and not previously reported tigrina, the Nariño cat, from the southern Andean region of Colombia (2023). Later that same year, a new paper criticized the discovery. In response to that criticism, herein, we provide new molecular genetics results of the Nariño cat as well as new insights into the molecular phylogeny of the tigrinas inside the Leopardus genus: (1) In this new work, we analyzed the mtND5 gene of Nariño cat samples collected over four years (2001, 2007, 2017, 2023) as well as analyzed mitogenomes of Nariño cat samples collected in three different years (2001, 2017, 2023). The temporal Nariño cat samples (2001, 2007, 2017, 2023) refer to samples taken from a single specimen across different years. Based on these analyses, data from 2001 and 2007 represent the most reliable information. In contrast, samples from 2017 and 2023 may be contaminated with DNA from the Pampas cat and tigrina, respectively. (2) On the other hand, based on sequencing the mtND5 gene of 164 specimens of Leopardus, northern Andean and Central American tigrinas (37 specimens) are divided into at least six different groups (without counting the Nariño cat). Based on our analysis of sequenced mitogenomes of 102 specimens (including 34 northern Andean and Central American tigrinas) of the Leopardus genus, there are at least eight different groups of tigrinas (without counting the Nariño cat). Henceforth, there are strong datasets which support the existence of multiple lineages within the presumed “a priori” northern Andean tigrina and thus much of the genetic diversity of this wild cat has gone unnoticed. There are a series of potential taxa that have gone unnoticed due to a lack of sampling of this polyphyletic Andean feline. Full article

Smartphone-embedded inertia sensors are widely available nowadays. We have developed a smartphone application that could assess temporal gait characteristics using the built-in inertia measurement unit with the aim of enabling mass screening for gait abnormality. This study aimed to examine the test–retest reliability and concurrent validity of the smartphone-based gait assessment in assessing temporal gait parameters in level-ground walking. Twenty-six healthy young adults (mean age: 20.8 ± 0.7) were recruited. Participants walked at their comfortable pace on a 10 m pathway repetitively in two walking sessions. Gait data were simultaneously collected by the smartphone application and a VICON system during the walk. Gait events of heel strike and toes off were detected from the sensors signal by a peak detection algorithm. Further gait parameters were calculated and compared between the two systems. Pearson Product–Moment Correlation was used to evaluate the concurrent validity of both systems. Test–retest reliability was examined by the intraclass correlation coefficients (ICCs) between measurements from two sessions scheduled one to four weeks apart. The validity of smartphone-based gait assessment was moderate to excellent for parameters involving only heel strike detection (r = 0.628–0.977), poor to moderate for parameters involving detection of both heel strike and toes off (r = 0.098–0.704), and poor for the proportion of gait phases within a gait cycle. Reliability was good to fair for heel strike-related parameters (ICC = 0.845–0.388), good to moderate for heel strike and toes-off-related parameters (ICC = 0.827–0.582), and moderate to fair for proportional parameters. Validity was adversely affected when toe off was involved in the calculation, when there was an insufficient number of effective steps taken, or when calculating sub-phases with short duration. The use of smartphone-based gait assessment is recommended in calculating step time and stride time, and we suggest collecting no less than 100 steps per leg during clinical application for better validity and reliability. Full article

Subtle locomotor asymmetries are common in horses and may go unnoticed during routine pre-race clinical inspections, particularly when based solely on subjective evaluation. This study aimed to describe vertical head and pelvic movement asymmetries in racehorses that passed official pre-race inspections at a traditional racing event. Twenty-four horses were analysed using a markerless AI-based gait analysis system while trotting in-hand and during lungeing in both directions. Asymmetry parameters (HDmin, HDmax, PDmin, and PDmax) were extracted from video recordings, with values ≥0.5 considered clinically relevant. Vertical asymmetries were detected in 71% of horses during straight-line evaluation and in 79% during at least one lungeing direction. Some horses showed relevant asymmetries only under specific movement conditions, underscoring the complementary role of straight-line and lungeing assessments in comprehensive gait evaluation. These results suggest that objective gait analysis could enhance pre-race veterinary assessments, especially in traditional racing, where horses are subjected to significant biomechanical stress, including variable surface properties and repetitive directional loading. In such complex and dynamic environments, relying solely on visual assessment may result in the underdiagnosis of subtle locomotor alterations. The AI-based tools offer potential to improve the detection of subtle irregularities and support evidence-based decisions in performance horse management. Further investigations are warranted to validate the clinical relevance of currently adopted asymmetry thresholds, refine their diagnostic value, and support their integration into standardized pre-race evaluation protocols. Full article

Polyomaviruses have the potential to cause significant morbidity not only in transplant medicine, but also in other forms of disease or variants of immunosuppression. In kidney transplant recipients or recipients of human stem cell transplants, the BK-Virus is the major proponent of manifestations such as BKPyV-associated nephropathy or hemorrhagic cystitis. As no polyomavirus-specific drug with proven in vivo effects has been developed so far, methods to screen for such drugs are important. This work describes the establishment of a virus-secreting cell line. By infecting a pre-established monkey kidney cell line (COS-1) with a non-rearranged human BK polyomavirus isolated from a kidney transplant patient suffering from BKPyV-associated nephropathy, a continuously replicating cell type with consistent virus secretion could be established and was termed COSSA. Measurements of BKPyV replication, virion production, and secretion were performed both intracellularly and in the cell supernatant. Viral proteins such as VP1 and LTAg were accurately tracked by confocal microscopy, as well as by immunoblot and qPCR. An intracellular flow cytometry (FACS) assay detecting VP1 protein was established and revealed an expanded range of positive intracellular signals. The viruses produced proved to be infectious in human tubular epithelial cell lines. Long-range sequencing of the COSSA genome using Oxford Nanopore Technology revealed a total of five distinct BKPyV integration events. One integration of a partial BKPyV genome was located upstream of the epidermal growth factor receptor gene. The second and third, both truncated forms of integration, were close to histocompatibility gene locuses, while the fourth was characterized by a ninefold and the fifth by a fourfold tandem repeat of the BKPyV genome. From both of the repeat forms, virus replicates were derived showing deletions/duplications on early and late genes and inversions within the non-coding control region (NCCR). This pattern of repetitive viral genome integration is a potential key driver of enhanced viral replication and increased virion assembly, ultimately supporting efficient virus egress. Quantitative PCR analysis confirmed the release of approximately 10⁸/mL viral units per 48 h from 2 × 10⁵ COSSA cells into the culture supernatant. Notably, the NCCR region of the most frequent copies of circular virus and the integrated tetrameric tandem repeat exhibited a rearranged configuration, which may contribute to the observed high replication dynamics. The establishment of a consistent methodology to generate and secrete BKPyV from a cell line is expected to significantly facilitate antiviral drug development. Full article

The eri silkworm Samia cynthia ricini (S. ricini) is an economically and scientifically significant lepidopteran species, though its genomic resources have remained limited. Here, we present a chromosome-level genome assembly for S. ricini generated through integrated long-read, short-read, and Hi-C sequencing data. The final 456.16 Mb assembly spans 14 chromosomes, exhibiting 98.5% BUSCO completeness and a 48.51% repetitive content. Functional annotation of the 15,729 protein-coding genes against five major databases (NR, SwissProt, Pfam, GO, and KEGG) revealed a maximum annotation rate of 92.71%, demonstrating high gene set quality. Comparative genomics with B. mori uncovered conserved syntenic blocks interspersed with chromosomal fusion/fission events and inversions. We further identified 4.27 million SNPs, 1.02 million InDels, and 53,367 SVs, establishing the first comprehensive variation map for this species. These genomic variations provide a foundation for marker-assisted breeding programs and trait association studies. All the genomic resources and interactive visualization tools were integrated into the SilkMeta database. This study establishes S. ricini as a pivotal resource for comparative lepidopteran genomics and accelerates molecular breeding programs for this agriculturally valuable insect. Full article

Introduction: Combat sport athletes are exposed to repetitive head impacts yet also develop distinct performance-related brain adaptations. Electroencephalography (EEG) provides millisecond-level insight into both processes; however, findings are dispersed across decades of heterogeneous studies. This mechanistic review consolidates and interprets EEG evidence to elucidate how participation in combat sports shapes brain function and to identify research gaps that impede clinical translation. Methods: A structured search was conducted in March 2025 across PubMed/MEDLINE, Scopus, Cochrane Library, ResearchGate, Google Scholar, and related databases for English-language clinical studies published between January 1980 and March 2025. Eligible studies recorded raw resting or task-related EEG in athletes engaged in boxing, wrestling, judo, karate, taekwondo, kickboxing, or mixed martial arts. Titles, abstracts, and full texts were independently screened by two reviewers. Twenty-three studies, encompassing approximately 650 combat sport athletes and 430 controls, met the inclusion criteria and were included in the qualitative synthesis. Results: Early visual EEG and perfusion studies linked prolonged competitive exposure in professional boxers to focal hypoperfusion and low-frequency slowing. More recent quantitative studies refined these findings: across boxing, wrestling, and kickboxing cohorts, chronic participation was associated with reduced alpha and theta power, excess slow-wave activity, and disrupted small-world network topology—alterations that often preceded cognitive or structural impairments. In contrast, elite athletes in karate, fencing, and kickboxing consistently demonstrated neural efficiency patterns, including elevated resting alpha power, reduced task-related event-related desynchronization (ERD), and streamlined cortico-muscular coupling during cognitive and motor tasks. Acute bouts elicited transient increases in frontal–occipital delta and high beta power proportional to head impact count and cortisol elevation, while brief judo chokes triggered short-lived slow-wave bursts without lasting dysfunction. Methodological heterogeneity—including variations in channel count (1 to 64), reference schemes, and frequency band definitions—limited cross-study comparability. Conclusions: EEG effectively captures both the adverse effects of repetitive head trauma and the cortical adaptations associated with high-level combat sport training, underscoring its potential as a rapid, portable tool for brain monitoring. Standardizing acquisition protocols, integrating EEG into longitudinal multimodal studies, and establishing sex- and age-specific normative data are essential for translating these insights into practical applications in concussion management, performance monitoring, and regulatory policy. Full article

Human papillomaviruses (HPVs), like many other viruses, are able to integrate their genomes into the host cellular genome. This integration can activate viral oncogenes or alter the function of cellular oncogenes and tumor suppressor genes, thereby increasing the likelihood of HPV-associated tumor development. In particular, HPV types 16 and 18 are responsible for over 70% of all cervical, anal, and oropharyngeal cancers worldwide, with rising incidence. Even more, high-resolution mapping of preferred integration sites using LR-Seq technologies offers deep insights into the molecular mechanisms of HPV integration. LR-Seq enables the detection of complex integration patterns, where the viral genome can be replicated and amplified into virus–host concatemers, including events within large structural variations or highly repetitive genomic regions. Furthermore, aligning LR-Seq data to the latest T2T reference genome (hs1) is necessary to provide new information about viral integration in genomic regions that were previously inaccessible, such as centromeres and other structurally complex repeat-rich loci. In this review, we provide insights into HPV genomic integration revealed by LR-Seq technologies, with a particular focus on how the use of the complete T2T reference genome enhances the detection of integration events in previously uncharacterized, repeat-rich regions of the human genome. Full article

Background/Objective: Obesity is a documented risk factor for impaired pulmonary function and abnormal oxyhaemoglobin levels during sleep. This functional impairment becomes more significant when there are additional respiratory pathologies, such as obstructive sleep apnea (OSA) and/or chronic obstructive pulmonary disease (COPD). Overnight pulse oximetry may offer an effective evaluation of nocturnal oxyhaemoglobin levels/waveform patterns. We evaluated the correlation between obesity, overnight pulse oximetry (parameters, waveform patterns) and pulmonary function in patients diagnosed with moderate–severe OSA and normal oxyhaemoglobin saturation levels during waking hours. We also compared the overnight oxyhaemoglobin saturation levels between patients with OSA alone and those with associated COPD. Methods: This was a retrospective, transversal, non-interventional study on consecutive patients with moderate–severe OSA diagnosed using overnight cardiorespiratory polygraphy over a period of 18 months. After analyzing the study population’s characteristics, the patients were divided into two subgroups: one consisting of patients with OSA alone (Group A), and the second with coexisting OSA and COPD (Group B). Results: Seventy-six patients were included in the study, and 18% were diagnosed with COPD. A higher body mass index (BMI) correlated with a higher number of ≥3% SpO₂ drops/h (ODI3) and percentage of time with oxyhaemoglobin saturation < 90% (t90) and a lower average nocturnal oxyhaemoglobin saturation (avgSpO₂). ODI3 correlated negatively with avgSpO₂ and positively with t90. After eliminating BMI as a confounding factor, lower values of forced expiratory volume in the first second (FEV1) were associated with lower avgSpO₂ and higher t90. FEV1 did not corelate with ODI3. After dividing the study population into the two subgroups, patients from Group B had a tendency towards lower average nocturnal SpO₂ levels compared to Group A. Conclusions: Different phenotypes/patterns of nocturnal hypoxemia can be identified using quantitative and qualitative analyses of overnight pulse oximetry: repetitive, consecutive obstructive respiratory events with a characteristic intermittent (saw-tooth) hypoxemia pattern and alveolar hypoventilation, resulting in a continuous (plateau) hypoxemia pattern. According to our findings, nocturnal hypoxemia is more important at lower FEV1 values (correlating with lower avgSpO₂/higher t90, but not with ODI3). The presence of a continuous hypoxemia pattern in patients with OSA may suggest that pulmonary function tests should be performed in order to differentiate patients with alveolar hypoventilation secondary to obesity (restrictive syndrome) from those with associated COPD (obstructive syndrome). This can have an impact on the management of the case and the therapeutic approach (positive pressure therapy with/without supplemental oxygen). Full article

(1) Background: Traumatic brain injury (TBI) is caused from rapid head acceleration/deceleration, focal blows, blasts, penetrating forces, and/or shearing forces, whereas hypoxic–anoxic injury (HAI) is caused through oxygen deprivation events, including strangulation. Most service-seeking domestic violence (DV) survivors have prior mechanistic exposures that can lead to both injuries. At the time of our study, some evidence existed about the exposure to both injuries over the course of a survivor’s lifetime from abuse sources, yet little was known about their co-occurrence to the same survivor within the same episode of physical intimate partner violence (IPV). To better understand the lived experience of service-seeking DV survivors and the context in which partner-inflicted brain injury (PIBI) is sustained, we sought to understand intentional brain injury (BI) exposures that may need to be addressed and accommodated in services. Our aims were to 1. characterize the lifetime co-occurrence of strangulation and intentional head trauma exposures from all abuse sources to the same survivor and within select physical episodes of IPV and 2. establish the lifetime prevalence of PIBI. (2) Methods: Survivors seeking DV services in the state of Ohio in the United States of America (U.S.) completed interview-administered surveys in 2019 (n = 47). Community-based participatory action approaches guided all aspects of the study development, implementation, and interpretation. (3) Results: The sample was primarily women. Over 40% reported having Medicaid, the government-provided health insurance for the poor. Half had less than a postsecondary education. Over 80% of participants presented to DV services with both intentional head trauma and strangulation exposures across their lifetime from intimate partners and other abuse sources (i.e., child abuse, family violence, peer violence, sexual assault, etc.), though not always experienced at the same time. Nearly 50% reported an experience of concurrent head trauma and strangulation in either the first or last physical IPV episode. Following a partner’s attack, just over 60% reported ever having blacked out or lost consciousness—44% experienced a loss of consciousness (LOC) more than once—indicating a conservative estimate of a probable brain injury by an intimate partner. Over 80% of service-seeking DV survivors reported either a LOC or two or more alterations in consciousness (AICs) following an IPV attack and were classified as ever having a partner-inflicted brain injury. (4) Conclusions: Most service-seeking IPV survivors experience repetitive and concurrent exposures to abusive strangulation and head trauma through the life course and by intimate partners within the same violent event resulting in brain injury. We propose the use of the term partner-inflicted brain injury (PIBI) to describe the physiological disruption of normal brain functions caused by intentional, often concurrent and repeated, traumatic and hypoxic neurologic insults by an intimate partner within the context of ongoing psychological trauma, coercive control, and often past abuse exposures that could also result in chronic brain injury. We discuss CARE (Connect, Acknowledge, Respond, Evaluate), a brain-injury-aware enhancement to service delivery. CARE improved trauma-informed practices at organizations serving DV survivors because staff felt knowledgeable to address and accommodate brain injuries. Survivor behavior was then interpreted by staff as a “can’t” not a “won’t”, and social and functional supports were offered. Full article

To clarify the background of multiple burst (MB) specifications in the aviation lightning test standards, a broadband lightning electromagnetic field measurement system was employed to collect 91 sets of VLF/LF band nature flash data. A total of 719 typical repetitive pulse (RP) groups were identified, and 163,589 single pulse samples were analyzed statistically. The variational mode decomposition (VMD) method and a trend-free correlation on index (TFCI) were used to extract RPs from the slowly varying trends and high-frequency noises from the measured data. The time-domain characteristics of four kinds of RPs corresponding to the lightning discharge events—initial breakdown pulse (IBP), regular pulse bursts (RPB), chaotic pulse train (CPT), and dart-stepped leader (DSL)—were investigated. By comparing previous statistics and the definition in current international aviation standards, the intrinsic correlation between RPs and the defined parameters of MBs was explored. New recommendations for the MB test standard were subsequently proposed. Full article

Background: Gastrointestinal bleeding in patients with atrial fibrillation is an indication for left appendage occlusion. All endovascular devices mandate antithrombotic therapies: rebleeding risk remains an issue. To date, there are no reports on gastrointestinal rebleeding and stroke prevention by left appendage occlusion without any antithrombotic therapy in this category of patients. Methods: A total of 129 patients (male 85, mean age 76.6 ± 7.1, CHA₂DS₂Vasc 3.8 ± 1.5, HASBLED 3.3 ± 1.0; upper GI bleeding 10%, lower GI bleeding 86%, obscure occult 4.6%, on NOACS full dose 77.5%, NOACs reduced dose 13.1%, on anti-vitamin K 9.3%) with atrial fibrillation and history of repetitive gastrointestinal bleeding from ten centers underwent standalone thoracoscopic epicardial appendage closure without antithrombotic therapy for the entire follow up. Results: The observed bleeding rate was 0.91 events per year, equivalent to a relative risk of RR = 0.17 (p = 0.02) and a relative risk reduction (RRR) of 83%. The observed relative risk of stroke was 0.91 events per year, with a relative risk of RR = 0.19 (p = 0.03) and a relative risk reduction (RRR) of 81%. Conclusion: Standalone epicardial appendage occlusion without antithrombotic therapy in patients with repetitive gastrointestinal bleeding is safe and promising when rebleeding and stroke risk reduction need to be optimized. Full article

Objective: The aim of this study was to assess the safety and preliminary efficacy of repetitive magnetic stimulation (RMS) as a treatment intervention for dry eye disease (DED), focusing on symptom reduction. Methodology: This investigation involved 22 adult participants (85% females, aged between 22 and 79 years) diagnosed with moderate-to-severe DED. These individuals were subjected to RMS treatment targeting one or both eyes using the VIVEYE-Ocular Magnetic Neurostimulation System version 1.0 (Epitech-Mag LTD; National Institute of Health (NIH) clinical trials registry #NCT03012698). A placebo-controlled group was also included for comparative analysis, with all subjects being monitored over a three-month period. The evaluation of safety encompassed monitoring changes in best corrected visual acuity, ocular pathology, and the reporting of adverse events. Participant tolerance was gauged through questionnaires, measurements of intraocular pressure (IOP), Schirmer’s test, and vital signs. The efficacy of the treatment was assessed by comparing pre- and post-treatment scores for fluorescein staining (according to National Eye Institute (NEI) grading) and patient-reported outcomes. Results: No statistically significant changes were found in visual acuity, IOP, or Schirmer’s test results between the RMS-treated and control groups (p < 0.05), indicating that RMS does not negatively impact these ocular functions. However, RMS treatment was associated with improved tear film stability (p = 0.19 vs. p = 0.04) and corneal health (p = 0.52 vs. p = 0.004), with no improvements in the control group. Initial symptom improvement was observed in both RMS-treated and placebo groups (p = 0.007 vs. p = 0.008), suggesting a potential therapeutic benefit of RMS for ocular surface conditions beyond a placebo effect. Conclusions: This study presents RMS as a promising therapeutic approach for DED, highlighting its potential to promote corneal epithelial repair, enhance tear film stability, and improve patient-reported symptoms without negatively impacting IOP, visual acuity, or tear production. This confirms the safety and suggests the efficacy of RMS therapy for dry eye conditions. Full article