Search Results (800)

Background. Parkinson’s Disease (PD) is a neurological condition that can severely impair gait, often through changes to gait parameters including stride length, velocity, and variability. Therapeutic interventions such as Rhythmic Auditory Stimulation (RAS^®) target gait dysfunction in PD by using the regular beat of music or metronome clips to cue normalized walking patterns. Previous research has suggested that auditory cue properties (e.g., familiarity and groove) and individual factors (e.g., beat perception ability and susceptibility to dual-task interference) influence auditory cueing treatment efficacy in healthy young and older adults; however, optimization of rhythmic cueing across individuals with PD remains understudied. Methods. To address this, we explored the effects of familiarity, groove, beat perception ability, and synchronization instructions on gait in patients with PD during accelerated auditory cues. Individuals with idiopathic PD were randomized to walk freely or synchronized to music and metronome cues played 10% faster than their baseline walking cadence. Musical stimuli varied in self-reported familiarity and perceived groove and beat perception ability was assessed to classify participants as good or poor beat perceivers. Results. Overall, high-groove music and synchronized walking elicited faster gait patterns compared to low-groove music and free walking, respectively, as demonstrated by increased gait velocity and cadence. Familiarity and beat perception ability did not significantly affect gait in individuals with PD. Discussion. Altogether, our results indicate that high-groove music and synchronized walking lead to the greatest gait improvements during cueing, regardless of beat perception ability. Conclusion. Future studies and clinical interventions should consider stimulus type and synchronization instructions when implementing cueing therapies for gait dysfunction in PD in order to optimize treatment responses. Full article

From the moment we are born, and even before, in the womb, and until our last breath, our bodies move all the time. Adaptive behaviors necessarily depend not only on the successful integration of multisensory bodily signals but also on how we move our bodies in the world. This paper considers the notion of embodied selfhood through the perspective of dynamic and rhymical coupling between bodily movements and bodily actions. We propose a new theoretical framework suggesting that the dynamic coupling between bodily movements and bodily actions in the world are fundamental in constructing and maintaining a coherent sense of self. To support this idea, we use the Predictive Processing (PP) and Active Inference frameworks as our background theoretical canvas. Specifically, we will focus on the phenomenon of somatosensory attenuation in relation to dynamic selfhood and argue that rhythmic bodily signals such as heartbeats, breathing, and walking patterns are predictable and, thus, can be smoothly attenuated, i.e., processed in the background. We illustrate this hypothesis by discussing the case of Depersonalization Disorder as a failure to self-attenuate self-related information processing, leading to feelings of unreality and self ‘loss’. We conclude with potential implications of our hypothesis for therapy. Full article

Background and Objectives: There is a global rise of public interest in integrative medicine. The principles of integrative medicine combining conventional medicine with evidence-based complementary therapies have been implemented in many medical areas, including plastic surgery, to improve patient’s outcome. The aim of the present study was to systematically analyze the application and use of additional non-pharmacological interventions (NPIs) of patients of a German department of plastic surgery. Materials and Methods: The present real-world data study utilized data from the Network Oncology registry between 2016 and 2021. Patients included in this study were at the age of 18 or above, stayed at the department of plastic surgery and received at least one plastic surgical procedure. Adjusted multivariable logistic regression analyses were performed to detect associations between the acceptance of NPIs and predicting factors such as age, gender, year of admission, or length of hospital stay. Results: In total, 265 patients were enrolled in the study between January 2016 and December 2021 with a median age of 65 years (IQR: 52–80) and a male/female ratio of 0.77. Most of the patients received reconstructive surgery (90.19%), followed by hand surgery (5.68%) and aesthetic surgery (2.64%). In total, 42.5% of the enrolled patients accepted and applied NPIs. Physiotherapy, rhythmical embrocations, and compresses were the most often administered NPIs. Conclusions: This exploratory analysis provides a descriptive overview of the application and acceptance of NPIs in plastic surgery patients within a German integrative care setting. While NPIs appear to be well accepted by a subset of patients, further prospective studies are needed to evaluate their impact on clinical outcomes such as postoperative recovery, pain management, patient-reported quality of life, and overall satisfaction with care. Full article

Background: Colorectal cancer (CRC) is strongly influenced by miRNAs as well as the circadian system. Methods: High-throughput sequencing of miRNAs expressed in the rat colon during 24 h light (L)/dark (D) cycle was performed to identify rhythmically expressed miRNAs. The role of miR-150-5p in CRC progression was analyzed in DLD1 cell line and human CRC tissues. Results: Nearly 10% of mature miRNAs showed a daily rhythm in expression. A peak of miRNAs’ levels was in most cases observed during the first half of the D phase of the LD cycle. The highest amplitude was detected in expression of miR-150-5p and miR-142-3p. In the L phase of the LD cycle, the maximum in miR-30d-5p expression was detected. Gene ontology enrichment analysis revealed that genes interfering with miRNAs with peak expression during the D phase influence apoptosis, angiogenesis, the immune system, and EGF and TGF-beta signaling. Rhythm in miR-150-5p, miR-142-3p, and miR-30d-5p expression was confirmed by real-time PCR. Oncogenes bcl2 and myb and clock gene cry1 were identified as miR-150-5p targets. miR-150-5p administration promoted camptothecin-induced apoptosis. Expression of myb showed a rhythmic profile in DLD1 cells with inverted acrophase with respect to miR-150-5p. miR-150-5p was decreased in cancer compared to adjacent tissue in CRC patients. Decrease in miR-150-5p was age dependent. Older patients with lower expression of miR-150-5p and higher expression of cry1 showed worse survival in comparison with younger patients. Conclusions: miRNA signaling differs between the L and D phases of the LD cycle. miR-150-5p, targeting myb, bcl2, and cry1, can influence CRC progression in a phase-dependent manner. Full article

Background/Objectives: Huntington’s disease (HD) is a neurodegenerative disorder involving the basal ganglia and is characterized by psychiatric, cognitive, and movement dysfunction, including gait and balance impairment. Given the limited efficacy of pharmacological treatments for HD motor symptoms, nonpharmacological approaches like rhythmic auditory stimulation are being explored. This study aims to describe walking performance in people with HD during rhythmic auditory stimulation using external musical cues and internal singing cues. Methods: Individuals in the manifest stage of HD performed walking in four conditions: (1) comfortable pace, (2) cognitive dual task, (3) musical cue (music was played aloud), and (4) singing cue (participants sang aloud). Sensors measured cadence, velocity, stride length, and variability. Relationships between change in cadence and motor and cognitive measures were explored. Results: While no direct measurements of synchronization were performed, limiting our interpretation, neither the external musical cue nor the singing cue significantly improved walking performance. Both cues increased variability, similar to what was observed during the dual task. Greater subjective balance confidence and better cognitive performance were associated with positive cadence change during cueing. Conclusions: Musical cues may be too cognitively demanding for individuals with Huntington’s disease as they worsen gait variability without increasing gait speed, cadence, or stride length. Although global cognition and perceived balance confidence were related to the ability to increase cadence, very few people were able to increase their cadence during either cue. Therefore, the results do not support the use of musical cues to improve gait for individuals with Huntington’s disease. Full article

This review aimed to be comprehensive and to critically analyze the factors that may affect the macronutrient and energy content of breast milk. Systematic reviews were prioritized, even though other types of literature reviews on the subject, as well as studies not included in these reviews, were included. Reported factors that potentially affect the macronutrient and energy content of breast milk comprise: maternal factors, such as age, nutritional status, dietary intake, smoking habits, lactation stage, circadian rhythmicity, and the use of galactagogues; obstetrical factors, such as parity, preterm delivery, multiple pregnancies, labor and delivery, and pregnancy morbidities including intrauterine growth restriction, hypertensive disorders, and gestational diabetes mellitus; and newborn factors, including sexual dimorphism, and anthropometry at birth. Some factors underwent a less robust assessment, while others underwent a more in-depth analysis. For example, the milk from overweight and obese mothers has been reported to be richer in energy and fat. A progressive decrease in protein content and an increase in fat content was described over time during lactation. The milk from mothers with hypertensive disorders may have a higher protein content. Higher protein and energy content has been found in early milk from mothers who delivered prematurely. Full article

Freezing of gait (FoG) impairs mobility and daily functioning and increases the risk of falls, leading to a reduced quality of life (QoL) in people with Parkinson’s disease (PD). The Cue2walk, a wearable smart cueing device, can detect FoG and hereupon provides rhythmic cues to help people with PD manage FoG in daily life. This study investigated the user experiences and device usage of the Cue2walk, and its impact on health-related QoL, FoG and daily activities. Twenty-five users of the Cue2walk were invited to fill out an online survey, which included a modified version of the EQ-5D-5L, tailored to the use of the Cue2walk, and its scale for health-related QoL, three FoG-related questions, and a question about customer satisfaction. Sixteen users of the Cue2walk completed the survey. Average device usage per day was 9 h (SD 4). Health-related QoL significantly increased from 5.2/10 (SD 1.3) to 6.2/10 (SD 1.3) (p = 0.005), with a large effect size (Cohen’s d = 0.83). A total of 13/16 respondents reported a positive effect on FoG duration, 12/16 on falls, and 10/16 on daily activities and self-confidence. Customer satisfaction was 7.8/10 (SD 1.7). This pilot study showed that Cue2walk usage per day is high and that 15/16 respondents experienced a variety of positive effects since using the device. To validate these findings, future studies should include a larger sample size and a more extensive set of questionnaires and physical measurements monitored over time. Full article

Obesity is a multifactorial condition that influences metabolic, endocrine, inflammatory, circadian, and behavioral systems. These disruptions can adversely affect the initiation of lactogenesis II—the critical process marking the onset of copious milk secretion following childbirth. In mothers with obesity, prolonged inflammation within the mammary gland, a blunted hormonal response (notably of prolactin), altered progesterone and estrogen dynamics, high leptin levels, and misaligned circadian rhythms contribute significantly to delayed lactogenesis. In addition, mechanical difficulties and psychological factors further hinder effective breastfeeding. This report synthesizes evidence from human epidemiological studies and animal models that elucidate the diverse mechanisms linking maternal obesity to delayed lactogenesis. We review the role of obesity-associated inflammatory mediators in impairing mammary tissue remodeling, the endocrine aberrations that impair lactogenic signaling, the consequences of circadian disruption on hormonal rhythmicity, and the behavioral influences that challenge effective breastfeeding. Finally, we discuss the clinical implications of these findings and propose future research directions targeting endocrine modulation, anti-inflammatory therapy, circadian interventions, and enhanced lactation support strategies for mothers with obesity. Full article

Optically pumped magnetometer OPM-MEG has the potential to replace the traditional low-temperature superconducting quantum interference device SQUID-MEG. Coherence analysis can be used to evaluate the functional connectivity and reflect the information transfer process between brain regions. In this paper, a finger tapping movement paradigm based on auditory cues was used to measure the functional signals of the brain using OPM-MEG, and the coherence between the primary motor cortex (M1) and the primary motor area (PM) was calculated and analyzed. The results demonstrated that the coherence of the three frequency bands of Alpha (8–13 Hz), Beta (13–30 Hz), and low Gamma (30–45 Hz) and the selected reference signal showed roughly the same position, the coherence strength and coherence range decreased from Alpha to low Gamma, and the coherence coefficient changed with time. It was inferred that the change in coherence indicated different neural patterns in the contralateral motor cortex, and these neural patterns also changed with time, thus reflecting the changes in the connection between different functional areas in the time-frequency domain. In summary, OPM-MEG has the ability to measure brain coherence during finger movements and can characterize connectivity between brain regions. Full article

Network Music Performance (NMP) refers to network-based remote collaboration when applied to music performances, such as musical education, music production and live music concerts. In NMP, the most important parameter for the Quality of Experience (QoE) of the participants is low end-to-end audio delay. Increasing delays prevent musicians’ synchronization and lead to a suboptimal musical experience. Visual contact between the participants is also crucial for their experience but highly demanding in terms of bandwidth. Since audio compression induces additional coding and decoding delays on the signal path, most NMP systems rely on audio quality reduction when bandwidth is limited to avoid violating the stringent delay limitations of NMP. To assess the delay and quality tolerance limits for NMP and see if they can be satisfied by emerging 5G networks, we asked eleven pairs of musicians to perform musical pieces of their choice in a carefully controlled laboratory environment, which allowed us to set different end-to-end delays or audio sampling rates. To assess the QoE of these NMP sessions, each musician responded to a set of questions after each performance. The analysis of the musicians’ responses revealed that actual musicians in delay-controlled NMP scenarios can synchronize at delays of up to 40 ms, compared to the 25–30 ms reported in rhythmic hand-clapping experiments. Our analysis also shows that audio quality can be considerably reduced by sub-sampling, so as to save bandwidth without significant QoE loss. Finally, we find that musicians rely more on audio and less on video to synchronize during an NMP session. These results indicate that NMP can become feasible in advanced 5G networks. Full article

Objective: Retained primitive reflexes are associated with delayed motor and behavioral development in children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This study examined the effects of a 12-week structured exercise intervention on reflex integration, motor coordination, and socio-behavioral outcomes in these populations. Method: Fifteen children with ASD (13 boys, 2 girls) and twelve with ADHD (8 boys, 4 girls), aged 6–12 years, participated in rhythmic, balance, and coordination-based exercises. Primitive reflexes, including the asymmetrical tonic neck reflex (ATNR), were assessed using standardized protocols, and fine motor coordination was evaluated using the Finger and Thumb Opposition Test (FOT). Behavioral outcomes were measured using the Social Responsiveness Scale-2 (SRS-2) for the ASD group and the Conners 3 for the ADHD group. Results: The ASD group showed significant reductions in left-standing ATNR retention scores (p = 0.012) and improvements in right-hand FOT scores (p = 0.023). In the ADHD group, significant improvements were also observed in right-hand FOT scores (p = 0.007). Furthermore, Conners 3 Total and Global Index scores significantly decreased in the ADHD group (p = 0.016 and 0.020, respectively). Reflex retention patterns appeared broader and more bilateral in ASD than in ADHD, suggesting distinct motor developmental profiles. Conclusions: Short-term rhythmic, balance, and whole-body coordination exercise interventions may support behavioral and motor development in children with ASD and ADHD. Tailored programs emphasizing reflex integration hold promise for clinical and educational applications. Full article

The current opinion paper puts into perspective how altered microbiota transplanted from Alzheimer’s patients initiates the impairment of the microbiota–gut–brain axis of a healthy recipient, leading to impaired cognition primarily arising from the hippocampus, dysfunctional adult hippocampal neurogenesis, dysregulated systemic inflammation, long-term spatial memory impairment, or chronic pain with hippocampal involvement. This altered microbiota may induce acquired Piezo2 channelopathy on enterochromaffin cells, which, in turn, impairs the ultrafast long-range proton-based oscillatory synchronization to the hippocampus. Therefore, an intact microbiota–gut–brain axis could be responsible for the synchronization of ultradian and circadian rhythms, with the assistance of rhythmic bacteria within microbiota, to circadian regulation, and hippocampal learning and memory formation. Hippocampal ultradian clock encoding is proposed to be through a Piezo2-initiated proton-signaled manner via VGLUT3 allosteric transmission at a distance. Furthermore, this paper posits that these unaccounted-for ultrafast proton-based long-range oscillatory synchronizing ultradian axes may exist not only within the brain but also between the periphery and the brain in an analogous way, like in the case of this depicted microbiota–gut–brain axis. Accordingly, the irreversible Piezo2 channelopathy-induced loss of the Piezo2-initiated ultradian prefrontal–hippocampal axis leads to Alzheimer’s disease pathophysiology onset. Moreover, the same irreversible microdamage-induced loss of the Piezo2-initiated ultradian muscle spindle–hippocampal and cerebellum–hippocampal axes may lead to amyotrophic lateral sclerosis and Parkinson’s disease initiation, respectively. Full article

Alzheimer’s Disease (AD) is the most common type of dementia. The circadian system, which is controlled by the master clock in the Suprachiasmatic Nucleus (SCN) of the hypothalamus, is crucial for various physiological processes. Studies have shown that changes in the circadian rhythms can deteriorate neurodegenerative diseases. Changes in the SCN are associated with cognitive decline in AD. The cognitive impairments in AD, especially memory dysfunctions, may be related to Circadian Rhythm Disturbances (CRDs). Moreover, rhythmic expression of clock genes is disrupted in AD patients. There is a circadian pattern of inflammatory processes in AD, and dysregulation of core clock genes promotes neuroinflammation. The present narrative review addresses the intricate link between CRDs and AD, revisiting the relevant cellular and molecular mechanisms. The association between CRDs and AD highlights the need for further investigation of the underlying mechanisms. Full article

Background/Objective: This study aims to evaluate the predictive performance of three supervised machine learning algorithms—decision tree (DT), support vector machine (SVM), and k-nearest neighbors (KNN) in forecasting key visual skills relevant to rhythmic gymnastics. Methods: A total of 383 rhythmic gymnasts aged 4 to 27 years were evaluated in various sports centers across Madrid, Spain. Visual assessments included clinical tests (near convergence point accommodative facility, reaction time, and hand–eye coordination) and eye-tracking tasks (fixation stability, saccades, smooth pursuits, and visual acuity) using the DIVE (Devices for an Integral Visual Examination) system. The dataset was split into training (70%) and testing (30%) subsets. Each algorithm was trained to classify visual performance, and predictive performance was assessed using accuracy and macro F1-score metrics. Results: The decision tree model demonstrated the highest performance, achieving an average accuracy of 92.79% and a macro F1-score of 0.9276. In comparison, the SVM and KNN models showed lower accuracies (71.17% and 78.38%, respectively) and greater difficulty in correctly classifying positive cases. Notably, the DT model outperformed the others in predicting fixation stability and accommodative facility, particularly in short-duration fixation tasks. Conclusion: The decision tree algorithm achieved the highest performance in predicting short-term fixation stability, but its effectiveness was limited in tasks involving accommodative facility, where other models such as SVM and KNN outperformed it in specific metrics. These findings support the integration of machine learning in sports vision screening and suggest that predictive modeling can inform individualized training and performance optimization in visually demanding sports such as rhythmic gymnastics. Full article

Background: The coordination between the upper and lower limbs is essential for athletic performance. However, the structural features that influence coordination difficulty remain insufficiently understood. Few studies have systematically analyzed how task components such as the directional congruence or rhythm structure affect inter-limb coordination. Objective: This study aimed to clarify the structural factors that influence the difficulty of upper–lower limb coordination tasks under rhythmic constraints and to explore the feasibility of applying such tasks in future coordination assessments. Methods: Eighty-six male high school baseball players performed six Rhythm Jump tasks combining fixed upper limb movements with varying lower limb patterns. The task performance was analyzed using three indices: full task success, partial success, and average successful series. One year later, a follow-up test involving 27 participants was conducted to evaluate the reproducibility and sensitivity to the performance change. Results: The task difficulty was significantly affected by structural features, including directional incongruence, upper limb static holding, and rhythmic asynchrony. The tasks that exhibited these features had lower success rates. Some tasks demonstrated moderate reproducibility and captured subtle longitudinal changes in the performance. Conclusions: The results highlight the key structural factors contributing to coordination difficulty and support the potential applicability of Rhythm Jump tasks as a basis for future assessment tools. Although further validation is necessary, this study provides foundational evidence for the development of practical methods for evaluating inter-limb coordination. Full article