Search Results (2,748)

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

Background: Art therapy is increasingly recognized as a valuable complementary intervention for individuals with eating disorders (EDs), who frequently experience comorbid anxiety and difficulties with emotional regulation. However, few studies have examined its short-term effects on state and trait anxiety within structured clinical settings. Methods: This pilot study involved 19 adolescent females (mean age 17.7 ± 2.1 years) diagnosed with anorexia nervosa (AN) or bulimia nervosa (BN) and admitted to the Mariconda Regional Residence for Eating Disorders (ASL Salerno, Italy) in residential or semi-residential treatment. Participants completed a structured six-week cycle of weekly textile-based art therapy sessions, designed to promote emotional expression and body reconnection. State and trait anxiety levels were assessed pre- and post-session using the State-Trait Anxiety Inventory (STAI). Repeated-measures ANOVA was used to analyze state anxiety changes; a linear mixed-effects model was applied to trait anxiety. Results: State anxiety significantly decreased immediately after sessions (p = 0.002). A significant main effect of session (p = 0.01) and a time × session interaction (p = 0.025) indicated variability across sessions. Trait anxiety showed a non-significant trend toward reduction (p = 0.11); however, reductions were significant at sessions 4 (p = 0.015), 5 (p < 0.001), and 6 (p = 0.005). Conclusions: Art therapy may offer immediate reductions in state anxiety and may contribute to a longer-term reduction in trait anxiety with 4–6 sessions. These findings support integrating creative interventions within multidisciplinary ED treatment programs. Future research with larger samples and control groups is needed to confirm and expand upon these preliminary results. Full article

Background and Objectives: Diabetes mellitus (DM) significantly impacts post-surgical recovery and fracture healing; however, few studies have specifically investigated the impact of DM on outcomes in patients undergoing surgical stabilization of rib fractures (SSRF). This study investigated the potential influence of DM on perioperative outcomes following SSRF, using data from Taiwan’s National Health Insurance Research Database (NHIRD). Materials and Methods: Data of 1603 patients with multiple rib fractures who underwent SSRF between 2001 and 2019 were retrospectively analyzed. Patients were categorized into three groups: no DM, DM without chronic complications, and DM with chronic complications. The associations between DM status and perioperative outcomes, including hospital length of stay (LOS), in-hospital mortality, readmission rates, and complications such as pneumonia, surgical site infection (SSI), acute myocardial infarction (AMI), and total hospital costs were determined using univariate and multivariable regression analyses. Results: The mean age of the 1603 patients was 52.0 years, and 71% were male. Patients with DM and chronic complications had higher risks of 14-day readmission (adjusted odds ratio [aOR] = 2.99; 95% confidence interval [CI]: 1.18–7.62), 15–30 day readmission (aOR = 3.28; 95% CI: 1.25–8.60), SSI (aOR = 2.90; 95% CI: 1.37–6.14), AMI (aOR = 3.44; 95% CI: 1.28–9.24), and acute respiratory distress syndrome (ARDS) (aOR = 1.96; 95% CI: 1.03–3.74). In conclusion, DM, particularly DM with chronic complications, significantly increases the risk of adverse short-term outcomes following SSRF. Conclusions: These findings emphasize the need for enhanced care for patients with DM to optimize the outcomes of SSRF. Full article

Background and Objectives: Adverse clinical outcomes are associated with malnutrition and frailty, which are highly prevalent among hospitalized older patients. This study aimed to evaluate their predictive value for the duration of hospitalization, short-term survival, and rehospitalization of patients admitted to internal medicine wards. Materials and Methods: This prospective cohort study included 134 acutely ill patients aged ≥50 years who were hospitalized in an internal medicine department and evaluated within the first 48 h of admission. Nutritional status was evaluated using the Mini nutritional assessment–short form (MNA-SF), Nutritional Risk Screening 2002 (NRS-2002), and Global Leadership Initiative on Malnutrition (GLIM) criteria. Frailty was evaluated using the FRAIL scale and Clinical Frailty Scale (CFS). The primary outcomes were prolonged hospitalization (>10 days), mortality, and rehospitalization at 3 and 6 months post-discharge. Results: According to MNA-SF, 33.6% of patients were malnourished; 44% had nutritional risk per NRS-2002, and 44.8% were malnourished per GLIM. Frailty prevalence was 53.7% (FRAIL) and 59% (CFS). Malnutrition defined by all three scales (MNA-SF, NRS-2002, GLIM) was significantly associated with prolonged hospitalization (p = 0.043, 0.014, and 0.023, respectively), increased rehospitalization at both 3 months (p < 0.001) and 6 months (p < 0.001). Mortality was also significantly higher among malnourished patients. Higher CFS scores and low handgrip strength were additional predictors of adverse outcomes (p < 0.05). In multivariable analysis, GLIM-defined malnutrition and CFS remained independent predictors of rehospitalization and mortality. Conclusions: Frailty and malnutrition are highly prevalent and independently associated with prolonged hospital stay, short-term rehospitalization and mortality. Routine screening at admission may facilitate early identification and guide timely interventions to improve patient outcomes. These findings might guide hospital protocols in aging health systems and support the development of standardized geriatric care pathways. Full article

Background/Objectives: Aging adults are at an increased risk of depression, anxiety, and poor mood. Research indicates that interacting with companion animals may benefit vulnerable older adults’ mental health. Methods: This study randomly assigned 44 medical inpatients (59+ years) to one of three 20 min daily conditions over 3 days: interactions with a dog and handler (AAI: animal-assisted intervention), handler-only control (CC: conversational control), or usual care (UC). Participants were measured at baseline, daily pre/post-intervention, on day 5 post-intervention, and at 1- and 6-month follow-ups. Results: The results show a significant change in trajectory for the AAI group from pre- to post-intervention for anxiety and mood. Study satisfaction was significantly better in the AAI group than in the UC condition. Depression scores did not change significantly. The effects were not sustained from day 1 to day 5 or to either follow-up. Conclusions: The results suggest that short-term interactions with dogs may provide immediate improvements in anxiety and mood, and dog presence adds value above that of the handler alone. Full article

(1) Background: This study investigates whether older adult individuals support childcare policies not only out of altruism, but also due to extended self-interest arising from intergenerational co-residence. It challenges the conventional view that welfare attitudes are shaped solely by one’s own life-cycle needs. (2) Methods: Using the 2013 and 2016 waves of the Korean Welfare Panel Study waves of the Korean Welfare Panel Study, a difference-in-differences (DiD) approach compares attitudes toward government childcare spending between older adults living with children (Co-residing Older Adults) and those who do not (Non-co-residing Older Adults), before and after universal childcare policies were introduced in 2013. (3) Results: The Co-residing Older Adults consistently expressed stronger support for family policies than their counterparts. However, this support did not significantly increase after the 2013 reform, indicating that extended self-interest may not be sensitive to short-term policy changes. (4) Conclusions: Extended self-interest appears to be a stable orientation shaped by family context rather than a flexible, policy-reactive stance. These findings highlight the role of intergenerational household ties in shaping welfare attitudes and offer implications for fostering generational solidarity in aging societies. Full article

Coronary artery bypass grafting (CABG) has evolved into a cornerstone treatment for coronary artery disease, with graft selection playing a critical role in long-term outcomes. Multiple arterial grafting (MAG) represents a significant advancement over single arterial grafting, utilizing conduits such as the internal thoracic artery and radial artery to enhance graft durability and patient survival. This review examines the outcomes, challenges, and controversies associated with MAG, highlighting its superior patency rates and reduced need for repeat revascularization procedures. While the technique provides long-term survival benefits, concerns such as the complexity of surgical techniques, increased operative time, and higher resource utilization underscore the importance of surgeon expertise and institutional infrastructure. Patient selection remains critical, as factors like age, comorbidities, and gender influence outcomes and highlight disparities in access to MAG. Emerging evidence addresses debates regarding optimal graft choice and balancing long-term benefits against short-term risks. Future directions focus on ongoing clinical trials, innovations in minimally invasive and robotic-assisted CABG, and technological advancements aimed at improving graft patency. Professional guidelines and best practices underscore the need for personalized approaches to optimize MAG’s potential. This article underscores the promise of MAG in redefining CABG care, paving the way for enhanced patient outcomes and broadened applicability. This article highlights the promise of MAG in transforming CABG care, leading to improved patient outcomes and expanded applicability. Full article

The widespread integration of electric vehicles (EVs) into smart grid infrastructures necessitates intelligent and robust battery health diagnostics to ensure system resilience and performance longevity. While numerous studies have addressed the estimation of State of Health (SOH) and the prediction of remaining useful life (RUL) using machine and deep learning, most existing models fail to capture both short-term degradation trends and long-range contextual dependencies jointly. In this study, we introduce V2G-HealthNet, a novel hybrid deep learning framework that uniquely combines Long Short-Term Memory (LSTM) networks with Transformer-based attention mechanisms to model battery degradation under dynamic vehicle-to-grid (V2G) scenarios. Unlike prior approaches that treat SOH estimation in isolation, our method directly links health prediction to operational decisions by enabling SOH-informed adaptive load scheduling and predictive maintenance across EV fleets. Trained on over 3400 proxy charge-discharge cycles derived from 1 million telemetry samples, V2G-HealthNet achieved state-of-the-art performance (SOH RMSE: 0.015, MAE: 0.012, $R^2$: 0.97), outperforming leading baselines including XGBoost and Random Forest. For RUL prediction, the model maintained an MAE of 0.42 cycles over a five-cycle horizon. Importantly, deployment simulations revealed that V2G-HealthNet triggered maintenance alerts at least three cycles ahead of critical degradation thresholds and redistributed high-load tasks away from ageing batteries—capabilities not demonstrated in previous works. These findings establish V2G-HealthNet as a deployable, health-aware control layer for smart city electrification strategies. Full article

Speaker profiling systems are often evaluated on a single corpus, which complicates reliable comparison. We present a fully reproducible evaluation pipeline that trains Convolutional Neural Networks (CNNs) and Long-Short Term Memory (LSTM) models independently on three speech corpora representing distinct recording conditions—studio-quality TIMIT, crowdsourced Mozilla Common Voice, and in-the-wild VoxCeleb1. All models share the same architecture, optimizer, and data preprocessing; no corpus-specific hyperparameter tuning is applied. We perform a detailed preprocessing and feature extraction procedure, evaluating multiple configurations and validating their applicability and effectiveness in improving the obtained results. A feature analysis shows that Mel spectrograms benefit CNNs, whereas Mel Frequency Cepstral Coefficients (MFCCs) suit LSTMs, and that the optimal Mel-bin count grows with corpus Signal Noise Rate (SNR). With this fixed recipe, EfficientNet achieves 99.82% gender accuracy on Common Voice (+1.25 pp over the previous best) and 98.86% on VoxCeleb1 (+0.57 pp). MobileNet attains 99.86% age-group accuracy on Common Voice (+2.86 pp) and a 5.35-year MAE for age estimation on TIMIT using a lightweight configuration. The consistent, near-state-of-the-art results across three acoustically diverse datasets substantiate the robustness and versatility of the proposed pipeline. Code and pre-trained weights are released to facilitate downstream research. Full article

Background/Objectives: Platelet-rich plasma (PRP) is emerging as a safe and effective treatment for facet-mediated pain. Studies have demonstrated reductions in pain and improvements in function, both in the short (3 months) and longer term (6 and 12 months). The mechanisms underlying clinical improvements are largely unknown. It is also unclear whether reported outcomes are due to the PRP administered or concurrently applied rehabilitation. Methods: A prospective case series was conducted in a single, multidisciplinary chronic pain centre. Forty-two participants with chronic WAD and cervical facet-mediated pain who received PRP (64% female; mean age (SD) 42.8 (11.6) years; median WAD duration [IQR] 23 [18,29] mths), attended rehabilitation, and reported successful outcomes 3 months post-PRP fulfilled the inclusion criteria. Measures of pain, cervical isometric strength, and range of motion were collected at baseline and 3 months post-PRP. Mediation analyses were performed to determine how these factors influenced disability. Results: Participants demonstrated clinically significant and relevant improvements in pain, disability, and isometric strength measures (all p < 0.01). Causative mediation analyses demonstrated independent direct, but not indirect, effects of both pain and strength on disability (both p < 0.001), with no direct or indirect effects of cervical ROM on disability. Full article

Background/Objectives: Total knee arthroplasty (TKA) is an effective surgical intervention for end stage knee osteoarthritis in elderly patients, with emerging robotically assisted techniques aiming to enhance surgical precision and patient outcomes. This study aimed to compare medium-term balance and functional outcomes between robotically assisted and conventional manual TKA in community-dwelling elderly patients. Methods: This cross-sectional study included 50 elderly patients undergoing TKA, who were divided into robotically assisted (n = 25) and conventional manual (n = 25) groups. Demographic and clinical data, balance performance, and functional outcomes were compared at nearly 1.5 years postoperatively. Outcome measures included balance performance assessed by the Berg Balance Scale (BBS), pain via the Visual Analog Scale (VAS), knee function as measured by the Lysholm Knee Scoring Scale, quality of life using the Short Form-12 (SF-12), joint awareness as evaluated by the Forgotten Joint Score-12 (FJS-12), and surgical satisfaction. Results: The groups had similar demographic and clinical data regarding age, gender, follow-up duration, surgical time, and anesthesia type (p > 0.05). The robotically assisted group demonstrated better balance performance on the BBS (p = 0.043) and had a statistically shorter length of hospital stay (1.22 vs. 1.42 days; p = 0.005). However, no statistically significant differences were observed in VAS activity pain (p = 0.053), Lysholm Knee Scoring Scale (p = 0.117), SF-12 physical and mental scores (p = 0.174 and p = 0.879), FJS-12 (p = 0.760), and surgical satisfaction (p = 0.218). Conclusions: Robotically assisted TKA is associated with advantageous postoperative recovery, particularly in terms of balance performance, showing no clinical difference in other functional outcomes compared to the conventional manual technique. From a physical therapy perspective, these findings emphasize the importance of developing tailored and effective rehabilitation strategies in the medium term for functional recovery in the elderly population. Full article

Aim: This study aimed to assess the effect of educational programs on symptom severity for women at high risk of carpal tunnel syndrome (CTS). Methods: A quasi-experimental design was applied. A purposive sample of 250 women at high risk of CTS was selected from the Faculty of Nursing, Assiut University, Egypt. Data collection instruments included a structured interview questionnaire and the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). Results: Most participants were middle-aged (41–50 years), married, and had higher education. At baseline, 61.2% of participants reported mild symptoms, 24.8% moderate, and 11.6% were asymptomatic. Following the educational program, symptom severity was significantly improved (p = 0.007). The proportion of asymptomatic participants increased from 11.6% to 20.4%, while those with moderate symptoms decreased from 24.8% to 6.4%. Functional status also improved significantly, with the percentage of participants reporting no difficulty increasing from 17.6% to 30% (p = 0.008). We found a significant reduction in symptom severity scores (p = 0.05) and functional impairment (p = 0.008). Conclusions: The educational program effectively reduced CTS symptoms and improved hand function, demonstrating its potential as a preventive and therapeutic intervention for women at high risk of CTS. However, this study’s quasi-experimental design without a control group and a short follow-up period limits conclusions regarding long-term effectiveness and causal inference. Full article

Objectives: To investigate the real-world outcomes of a population-based gastric cancer (GC) screening program in Kawasaki City, a major urban area with a growing aging population and relatively high screening participation rates. Methods: Between December 2012 and 2021, a total of 337,842 citizens in Kawasaki City underwent population-based GC screening, leading to the detection of 1087 GC cases. Esophageal cancer (EC) has been recorded since 2016, with 236 cases detected. To evaluate the short- and long-term clinical outcomes of screening-detected GC and EC, we conducted a retrospective study using the electronic medical records of patients treated at our hospital, a high-volume institution for GC and EC treatment in the city. As a control group, we included 34 GC and EC cases diagnosed based on symptoms at our hospital in 2018. Results: Among the 1087 GC cases detected through population-based screening, 102 cases treated at our hospital were included in the analysis. Of them, 91 patients (89%) were diagnosed with early-stage GC. All screening-detected GC cases underwent either surgery (27 cases) or endoscopic submucosal dissection (75 cases). The five-year survival rates for GC were 90% in males and 86% in females. Eighteen EC cases were also included in the study. The five-year survival rate for screening-detected advanced GC was 70.0%, while for screening-detected EC, it was 100%. Both survival rates were significantly higher than those for symptom-diagnosed GC (30.0%) and EC (40.8%). Conclusions: The prognosis of GC and EC detected through population-based endoscopic screening is significantly better than that of cancers diagnosed based on symptoms. This underscores the effectiveness of endoscopic screening as a valuable tool for the early detection of upper gastrointestinal tract cancers. Full article

Reward processing is a vital function for health and survival and is impaired in various psychiatric and neurological disorders. Using a monetary gambling task, the current study aims to elucidate neural substrates in the reward network underlying the evaluation of win versus loss outcomes and their association with behavioral characteristics, such as impulsivity and task performance, and neuropsychological functioning. Functional MRI was recorded in thirty healthy, male community volunteers (mean age = 27.4 years) while they performed a monetary gambling task in which they bet with either 10 or 50 tokens and received feedback on whether they won or lost the bet amount. Results showed that a set of key brain structures in the reward network, including the putamen, caudate nucleus, superior and inferior parietal lobule, angular gyrus, and Rolandic operculum, had greater blood oxygenation level-dependent (BOLD) signals during win relative to loss trials, and the BOLD signals in most of these regions were highly correlated with one another. Furthermore, exploratory bivariate analyses between these reward-related regions and behavioral and neuropsychological domains showed significant correlations with moderate effect sizes, including (i) negative correlations between non-planning impulsivity and activations in the putamen and caudate regions, (ii) positive correlations between risky bets and right putamen activation, (iii) negative correlations between safer bets and right putamen activation, (iv) a negative correlation between short-term memory capacity and right putamen activity, and (v) a negative correlation between poor planning skills and left inferior occipital cortex activation. These findings contribute to our understanding of the neural underpinnings of monetary reward processing and their relationships to aspects of behavior and cognitive function. Future studies may confirm these findings with larger samples of healthy controls and extend these findings by investigating various clinical groups with impaired reward processing. Full article

The climate crisis poses profound risks to present and future generations. Nonetheless, the perspectives of children and young people internationally, and more specifically in Brazil, remain underexplored. Based on a multi-discipline literature review on climate anxiety and nature (dis)connectedness, the hypothesis is that the effects and symptoms of increasing (dis)connection with natural environments have short-, medium-, and long-term consequences. Access to natural spaces is a vital response to counteract the negative impacts of climate change. This article discusses findings from a study conducted in urban Brazil with 200 young people aged 12 to 18 years old, with the aim of addressing three research questions from ten questions that comprised the complete survey. The major research questions were as follows: 1. ‘Climate change worries me’: How do you relate to this statement? 2. How does climate change affect you?, and 3. Do you think some young people are more affected by climate change than others? The results show that young people care about and are preoccupied with climate change, especially when they reflect on their futures and the future generations. Although young participants are deeply concerned about climate change and feel its effects them personally in the form of anxiety, fear, and insecurity, they often lack clear pathways for contributing to broader environmental efforts beyond individual actions. These findings highlight an urgent need to foster community-based approaches and enhance education and resources for enlarging and improving youth engagement, especially to rethink the everyday strategies addressing these challenges, and to foster new paradigms of interaction with the natural world based on (re)connection with natural spaces. The correlation between climate anxiety and nature (dis)connection offers an approach that is still little explored, especially concerning children and young people. Full article