Search Results (562)

Background: Juvenile-onset Huntington disease (JoHD) is a rare form of Huntington disease characterized by symptom onset at or before 20 years of age. Early manifestations are often non-choreic and may be attributed to developmental, psychiatric, movement, metabolic, or epileptic disorders. We described three molecularly confirmed cases and examined early manifestations, diagnostic pathways, and epilepsy. Methods: We conducted a retrospective case series and a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 systematic review of PubMed, Scopus, and Web of Science Core Collection through 5 July 2026. The strict patient-level synthesis required attributable onset at or before 20 years, patient-specific molecular confirmation of a pathogenic HTT repeat expansion, and extractable clinical data. Complementary aggregate or linked reports using closely aligned JoHD criteria were retained for context but excluded from patient-level calculations. Results: The cases included childhood-onset JoHD with drug-resistant epilepsy, adolescent-onset JoHD with progressive motor-cognitive decline and epilepsy in a known Huntington disease pedigree, and childhood-onset JoHD without available family history, in whom status epilepticus prompted renewed diagnostic evaluation. Ninety-three reports were included; of these, 81 contributed 228 unique patients and 12 provided complementary data. Early manifestations were heterogeneous and broadly consistent with previously described childhood-onset JoHD phenotypes. Diagnostic delay was extractable in 180/228 patients; among 172 with point estimates, the median was 4.0 years. Definite epilepsy was reported in 60/145 patients with ascertainable seizure status and was descriptively more frequent in childhood-onset (<10 years) than adolescent-onset (10–20 years) JoHD (49/84 [58.3%] vs. 11/57 [19.3%]). Conclusions: JoHD should be considered in children and adolescents with progressive multisystem neurological involvement, particularly when epilepsy occurs with developmental regression, gait or speech deterioration, pyramidal or extrapyramidal signs, basal-ganglia abnormalities, or a compatible family history. Full article

While climate change is a significant pressure point for pollinators and honeybees, its long-term relationship with managed honeybee colonies and honey production remains unclear and context sensitive. This study, using FAOSTAT data from 1961 to 2024, examined the relationships between land surface temperature anomalies and the number of registered beehives, the constant-price honey production value, and the normalized honey production value per colony, both globally and specifically for 18 Mediterranean countries. To differentiate between long-term structural trends and short-term temperature relationships, correlation, regression, bootstrap confidence interval, temperature series sensitivity analysis, cross-correlation function, and normalized index analyses were used together. The study results show strong long-term co-movement between temperature anomalies and recorded beekeeping indicators at the global and Mediterranean scale in the level series; however, first-differenced (year-to-year) analyses show this association weakens substantially and, for Mediterranean honey production value, reverses sign, indicating that the level-series correlations are driven largely by common long-term trends. The relationship between temperature anomalies and beekeeping indicators shows a context-dependent structure among Mediterranean countries. The findings show that the increase in colony size does not always coincide with the increase in the constant-price honey production value per colony; in some cases, these two indicators can move in different directions. This indicates the need for an analytical decomposition of the dynamics of quantitative growth and economic production value per colony in the beekeeping sector. Full article

Background: Impaired lumbopelvic control and inefficient bending mechanics are associated with low back pain and functional limitations. The Founder Exercise is a movement retraining strategy intended to promote hip-dominant movement, trunk control, and postural awareness during forward bending. However, empirical evidence examining movement performance following Founder Exercise instruction is limited. This study examined immediate pre-to-post differences in hip hinge kinematics and movement confidence surrounding a standardized Founder Exercise instructional session in healthy adults. Methods: A within-subject pretest-posttest design was used. Thirty-three healthy adults (72.7% female; mean age, 25.1 ± 2.9 years) completed assessments of foot orientation, sagittal-plane joint kinematics, and movement confidence before and after a single Founder Exercise instructional session. Joint kinematics were assessed using two-dimensional video analysis. Paired-samples t-tests or Wilcoxon signed-rank tests, as appropriate based on the distributions of the paired differences, were used to evaluate the kinematic outcomes. The exploratory summed confidence score and individual ordinal confidence items were evaluated using Wilcoxon signed-rank tests. Holm adjustments were applied separately to the 11 kinematic comparisons and the 10 individual-item comparisons. Results: Statistically significant immediate pre-to-post differences were observed in several kinematic variables. Hip flexion increased from 80.7° ± 18.1° at pretest to 104.6° ± 14.3° at posttest, shoulder flexion increased from 62.8° ± 23.9° to 145.3° ± 13.9°, and craniovertebral angle decreased from 25.7° ± 12.9° to 11.2° ± 10.0° (all p < 0.001). The summed score from the unvalidated, study-specific confidence scale was higher at posttest (median = 49.0, IQR = 40.0–50.0) than at pretest (median = 40.0, IQR = 36.0–50.0; p < 0.001). After Holm adjustment of the individual ordinal-item analyses, statistically significant differences remained for five of the 10 items; all confidence findings were considered exploratory. No statistically significant differences were observed in knee flexion or ankle motion after Holm adjustment. Conclusions: A brief Founder Exercise instructional session was followed by immediate differences in selected two-dimensional hip hinge angles and higher exploratory movement-confidence scores in healthy adults. These findings do not establish changes in lumbopelvic control, muscle activation, spinal loading, movement efficiency, or clinical outcomes. Controlled studies incorporating direct measures of lumbar and pelvic motion, muscle activity, external forces, and clinically relevant outcomes are needed before biomechanical or clinical conclusions can be drawn. Full article

Abnormal ship behavior detection is important for maritime traffic surveillance, navigation safety, and risk prevention. However, existing methods often depend on handcrafted features or a single reconstruction or prediction signal, which limits their ability to detect both sustained trajectory abnormalities and abrupt vessel movement changes. This paper proposes a Dual-Error Fusion LSTM–Transformer framework, referred to as DEFLT, for AIS-based abnormal ship behavior detection. A motion-aware vessel representation was first constructed by combining the geographical position, speed over ground, course over ground, and their temporal variations. An LSTM autoencoder reconstructs historical trajectory windows, while a Transformer prediction module estimates subsequent vessel states. The standardized reconstruction and prediction errors are fused into a unified anomaly score to capture complementary evidence from historical trajectory inconsistency and unexpected future motion. Experiments were conducted using real-world AIS data collected during September 2019 from four representative Danish waters. The study considers four abnormal behaviors: speed anomalies, course anomalies, loitering, and route deviations. Compared with KNN, LOF, Isolation Forest, Random Forest, the LSTM-AE, and the Transformer, DEFLT achieves F1-scores of 0.96, 0.97, 0.88, and 0.93 across the four study areas. For type-specific detection, the Macro-F1 values range from 0.61 to 0.86, while Macro-Recall remains between 0.88 and 0.96. Friedman and post hoc Wilcoxon signed-rank tests further demonstrate that DEFLT provides a significant and consistent improvement over all baseline methods. These results verify the effectiveness of dual-error fusion for detecting heterogeneous abnormal ship behaviors from AIS trajectories. In operational settings, DEFLT can serve as an alert-prioritization tool for vessel traffic services and port authorities by directing attention to atypical trajectories that require timely review, thereby supporting safer and more resource-efficient maritime traffic coordination. Full article

Background: The movement of endemic diseases from tropical and disadvantaged areas is gradually spreading to developed countries as well. Amoebiasis, in particular, represents a significant threat to public health, amplified by globalization and increasing contact between humans and animals or vectors. In this way, atypical diseases may emerge in our country, also through an unusual mode of transmission—likely sexual, as “sexually transmitted enteric (STE) diseases”. Objective: We report and discuss the clinic approach to a rare case of dual human infestations by ecto- and endo-parasites with multiple liver abscesses presentation in a young truck driver residing in Northern Italy. Methods: The patient underwent a comprehensive screening with laboratory and microbiological tests, and CT images. Results: In July, the patient was admitted to our hepatology unit following the ultrasound identification of two hypoechoic lesions in the right lobe of the liver. In his medical history, in April, after a seemingly harmless infestation of body lice, effectively treated, he suffered from a prolonged and debilitating episode of acute diarrhea, lasting a month. This status was also accompanied by intestinal cramps, weight loss, and recurring fever episodes. Afterwards also appeared a Quincke’s-like angioedema involving the lips and mouth mucosa, with evening time exacerbation. Conclusions: The differential diagnosis of this complex and unusual clinical picture, together with the temporal evolution of the patient’s signs and symptoms, led us to hypothesize the presence of concomitant infections. These were most likely borreliosis and a STE disease, the latter ultimately diagnosed as amebiasis with hepatic invasion, allowing appropriate treatment and a favorable clinical outcome. Full article

Purpose: Upper extremity motor impairments following stroke substantially limit independence in daily living. Hand-tracking virtual reality (VR) rehabilitation systems may support intensive task-oriented practice while enhancing motivation; however, evidence integrating objective kinematic indicators with usability and patient-reported outcomes for controller-free consumer-grade VR remains limited. The primary aim of this single-arm pilot study was to evaluate the feasibility, safety (tolerability), and usability of a hand-tracking VR rehabilitation system delivered as an adjunct to conventional physiotherapy in individuals with stroke; describing its preliminary in-game kinematic profile and exploring participants’ experiences through open-ended feedback were secondary aims. The study was explicitly not designed or powered to test clinical efficacy. Materials and Methods: Ten individuals with stroke completed a 20-session (8-week) single-arm pilot intervention; all participants concurrently received standard hospital-based physiotherapy (median 3 sessions/week, ∼45 min/session). Early-phase (sessions 1–5) and late-phase (sessions 16–20) within-subject performance were compared using the Wilcoxon signed-rank test with Holm–Bonferroni correction across four pre-specified primary outcomes. Movement smoothness was assessed using the Spectral Arc Length (SPARC), usability was evaluated using the System Usability Scale (SUS), and cybersickness was monitored with the Simulator Sickness Questionnaire (SSQ). Results: Sixteen patients were screened, of whom fourteen started the intervention and ten completed the 8-week per-protocol program (intervention completion rate, 10/14 = 71.4%; per-protocol session adherence among the ten completers, 200/200 = 100%; no SSQ-defined adverse events). Within-subject comparisons showed a $+10.6$-point increase in success rate (adjusted $p=0.020$), a $+0.10$ m/s increase in mean movement speed (adjusted $p=0.020$), a $-341$ ms reduction in pause duration (adjusted $p=0.022$), and a $+27.0$-point Hodges–Lehmann median-difference increase in SS-QOL (95% CI $14.0$–$41.0$; participant-level median $\mathsf{\Delta }$$+18.5$; adjusted $p=0.020$). The mean SUS score was $78.5\pm 5.4$, indicating “good” usability. Thematic analysis of post-intervention open-ended feedback identified three themes—motivation and engagement, the value of feedback, and design and comfort suggestions—that converged with the high adherence and good usability ratings. Correlations between VR-derived kinematic change and clinical change were non-significant trends ($p\ge 0.12$). Conclusions: A controller-free hand-tracking VR system was found to be feasible, well tolerated, and rated as having good usability when delivered as an adjunct to conventional therapy. Because the study used a single-arm design, included only ten participants, and did not control for the confounding effect of concurrent conventional physiotherapy or natural recovery, the observed within-subject changes cannot be causally attributed to the VR intervention and should be interpreted as exploratory feasibility signals. Adequately powered randomized controlled trials with stroke-specific clinical scales (e.g., FMA-UE, ARAT) are required before clinical efficacy can be claimed. Full article

A sign language interpretation system aims to translate sign gestures into spoken or written language in real time, enabling signers and non-signers to communicate in their familiar linguistic forms. However, vision-based approaches suffer from hand occlusion, lighting variability, and complex backgrounds, while Deep Neural Network (DNN)-based methods incur heavy computational costs that hinder real-time use on resource-constrained platforms. In this paper, we propose sign language gloves and a lightweight motion retrieval method for real-time sign language interpretation that runs on mobile devices and embedded systems. The sign language gloves integrate flex sensors, an inertial measurement unit (IMU), and pressure sensors to accurately capture gesture features, including finger bending angles, hand orientation, movement trajectories, and fingertip contacts with body parts, enabling recognition of touch-based gestures. For the motion retrieval method, we build a comprehensive gesture dataset with the gloves and perform feature analysis on each sign language gesture to avoid redundant information in the dataset. During interpretation, our system employs a feature-labeling mechanism to ensure gesture distinguishability and a gesture retrieval algorithm to evaluate movement continuity and similarity. This allows the system to identify corresponding feature labels and consolidate them into complete sign language vocabulary entries. The proposed motion retrieval method is characterized by low computational complexity and a well-defined data structure. This makes it suitable for integration into embedded systems, offering real-time performance and high portability for practical deployment. In our experiments, the proposed system achieved an average recognition accuracy of $92\%$ on a gesture dataset covering 300 sign language words. Full article

Introduction: Approximately 50% of firefighter injuries occur in the musculoskeletal system and poor movement quality increases injury risk. Previous research suggests that corrective exercise interventions with integrated movements improve movement literacy; however, the long-term benefit of corrective exercise programming has not been established among firefighters. Purpose: To investigate, as a continuation of a previously published short-term (mean—267 days) outcome pilot study, the long-term effectiveness of auto-generated corrective exercise programming on movement literacy scores among firefighters with lower baseline scores. Methods: Nine male firefighters (mean age +/− standard deviation 40 (12)) with baseline Functional Movement System (FMS™) scores less than 14/21 were initially recruited from October 2021 to September 2022. Baseline FMS™ assessments included detailed explanations of the seven movement screens as well as five clearing procedures and scoring criteria. A certified FMS™ professional performed each test first, prior to scoring, to demonstrate what was expected and firefighters were permitted to attempt each test for a total of three times with the highest score retained. Scores ranged from 0 to 3 for each of the seven movement screens with a maximum composite score of 21. Upon completing the screenings, test scores were reviewed and a detailed report was provided to each firefighter through the FMS™PRO APP. Additionally, each participant received an auto-generated corrective exercise program from the FMS™PRO APP with exercise figures, descriptions, and videos to be performed prior to routine conditioning programs. Participants were re-evaluated an average of 813 days after baseline for the long-term follow-up (F2). Pairwise comparisons from baseline to F2, as well as from a previously reported short-term follow-up (F1) to F2, were evaluated using the Friedman and Wilcoxon signed-rank tests. A Bonferroni correction resulted in an adjusted alpha of p = 0.025. Results: Composite FMS™ scores improved from a baseline mean of 11.3/21 to 14.7/21 at F2. When F2 was compared to the F1 scores from the previously published data set, scores declined by a mean of 1.4 points. Compared with baseline, scores at F2 were significantly improved (p = 0.013) with a large effect size (r = 0.83). In contrast, score declines (r = −0.73) from F1 to F2 were not statistically significant after Bonferroni correction (p = 0.028). Conclusions: An auto-generated corrective exercise program combined with a detailed explanation of baseline performance was effective in improving overall movement literacy in a standardized movement assessment tool in a long-term follow-up exceeding 2 years. The composite score change exceeded the threshold of error based on a previously established minimal detectable change (MDC) of 2.5/21, indicating true change occurred from baseline to F2. The decline from F1 to F2 did not exceed the threshold of error based on the MDC and may represent a regression to the mean and participant acknowledgement of marginal adherence after F1. Long-term adherence to programming is necessary to prevent the tapering of improvements seen in this study. The absence of a comparison or control group is a study limitation. Full article

Expressway interchange guide signs must support rapid route decisions under limited viewing time, high information load, and potential vehicle occlusion. This study developed a human-centered framework for optimizing guide-sign information and presentation in complex expressway networks by integrating an on-road field experiment, driving simulation, eye-movement measures, physiological responses, and driving behavior. The field experiment involved ten drivers unfamiliar with the Fuzhou expressway network and yielded 119 valid sign-reading episodes. A separate simulation experiment with 60 licensed drivers examined character heights of 55, 65, and 75 cm and roadside, median-side, and dual-side installation under three ordinal traffic background conditions. Drivers generally initiated visual search in the upper-left region of sign panels and focused on route-relevant place names and directional arrows. Descriptive observations suggested that usable control-point information could support route inference when the destination was absent, whereas the absence of both destination and usable control-point information was accompanied by more sustained deceleration and more dispersed visual search. Effective viewing distance increased across the tested character-height conditions. At a design speed of 120 km/h and an assumed recognition time of 2.6 s, the required viewing distance was approximately 86.7 m. The mean viewing distance for the 55 cm condition was below this requirement, whereas the 65 and 75 cm conditions exceeded it. The findings were applied to Xiuzhai Interchange. In a dynamic screen-based route-choice test, 24 of 25 participants made acceptable choices. Overall, guide signs in complex networks should be designed as coordinated information systems integrating control-point hierarchy, information continuity, character height, and installation position. Full article

Artificial intelligence (AI) may influence economic performance through productivity, innovation, and the diffusion of advanced technologies, but direct country-level measures of AI adoption remain limited for small economies. This study examines the association between AI-related technological capability and economic growth in Cyprus. The descriptive analysis covers 1993–2024, while the econometric analysis uses the common annual sample for 2008–2024 after introducing one-period lags. High-technology exports as a percentage of manufactured exports are treated as an indirect indicator of technological sophistication and absorptive capacity, rather than as a direct measure of AI adoption. A sequential distributed lag ordinary least squares framework introduces current and lagged high-technology exports, merchandise trade, and inflation, with heteroskedasticity-consistent HC3 standard errors. A COVID-19 indicator for 2020–2021 and an observation-exclusion sensitivity analysis are used to assess the influence of exceptional pandemic-era movements. The preferred specification explains a substantial share of annual GDP growth variation, but the small sample requires cautious interpretation. The estimates indicate a positive contemporaneous and a negative lagged association for high-technology exports, a stronger lagged than contemporaneous trade association, and opposite-signed current and lagged inflation coefficients. The COVID-19 indicator is statistically insignificant and does not materially alter the principal coefficient pattern. Complementary DESI, Eurostat enterprise AI use, and ICT employment indicators show that Cyprus has broadly adequate digital inputs while enterprise AI adoption has not yet reached the European Union average, indicating considerable scope for further diffusion. The findings are exploratory statistical associations and do not identify causal effects of AI. The study contributes a country-specific macroeconomic assessment of technological capability, digital readiness, and growth in a small, highly open economy. Full article

Most studies of Wang Bi’s “Mingxiang” 明象 (“Clarifying the Images”) treat its “grasping the meaning lies in forgetting the words” as a methodological rule for interpreting the Yijing, overlooking the deeper philosophical position behind it. We argue that this position shifts the inquiry from objective entities assumed by other Wei-Jin thinkers to the mind’s own activity, offering an epistemological and religious perspective on how the Yijing conveys the sages’ insight. On this basis, we reinterpret two key terms in Wang Bi’s reading: jin 盡 should be understood not as “exhaust” but as “express properly”, capturing the dialectical interplay of “loss” and “gain” in the presentation of meaning; wang 忘 should be understood in the sense of Aufhebung (sublation), which negates, preserves, and transcends images and words. Wang Bi’s insight is that the “words–images–meaning” triad forms a living unity that emerges only within the concrete activity of the mind. Through imagination, images are not fixed signs but self-transcending movements toward meaning. A concrete reading of the Mingyi 明夷 hexagram illustrates this dynamic, and an analysis of the Chinese script (revealing the etymological link between yan 言 and yin 音 and the internality of yi 意) further supports the argument that meaning is inseparable from the mind’s activity. The comparison with Augustine’s distinction between vox and verbum then brings to light the universal religious significance of this hermeneutics framework: the “words–images–meaning” triad offers a model of how the transcendent becomes accessible through symbols, and a vision of scriptural reading as spiritual cultivation. “Clarifying the Images” thus advances not merely a hermeneutic method within the Yijing tradition, but opens an epistemological path that takes the mind’s own activity as its starting point. This, we hold, is the universal philosophical and religious value of Wang Bi’s text, and a contribution deserving attention in the study of how the Yijing informs the mind’s grasp of meaning. Full article

Dairy cattle are particularly susceptible to welfare challenges that can negatively impact their behaviour, physiological responses, milk yield, and overall health. These challenges include rough handling by unfamiliar people, extreme climatic conditions, inconsistent feeding, regrouping, and transportation. This pilot study investigated the interrelationships between behavioural and physiological responses and milk production of dairy cows reared in a smallholder stall housing system, restricting cow movement to standing and lying down in the Rajshahi district of Bangladesh. Fifty cows were observed, with all cows assessed over two days. Video recordings were made using a smartphone during the morning milking routine, focusing on specific behaviours: ear position (upright, forward, backward, downward), sniffing, stepping, and tail movement. Observations were conducted during the first two minutes after the start of the milking process manually. Physiological responses recorded included rectal temperature, vaginal temperature, and heart rate. Productivity outcomes include body condition score (BCS), milk yield per milking, daily milk yield, and milking frequency. Environmental data were collected to calculate the Temperature-Humidity Index (THI), which averaged 84.5 (±1.78 SD), exceeding the thermal comfort zone for dairy cattle (THI < 72). Statistical analyses comprised principal component analysis (PCA) to determine the most descriptive variables. Pearson correlation assesses the direction and strength of relationships between variables, and simple linear regression to evaluate milk production variables using all other variables as predictors. Results showed that cows displaying an upright ear position during milking had a positive relation with average daily milk yields (r = 0.456, p = 0.001). Milk yield was negatively correlated with THI (r = −0.331, p = 0.02), forward ear position (r = −0.356, p = 0.01), kicking (r = −0.531, p < 0.001), and sniffing behaviour during milking (r = −0.511, p < 0.001). The daily milk yields were positively correlated with body condition scores of milking cows (r = 0.661, p < 0.001). Rectal and vaginal temperatures were positively associated with each other (r = 0.777, p < 0.001). Similarly, rectal temperature and heart rate were positively associated with each other (r = 0.511, p < 0.001). Therefore, ear position, kicking, and sniffing behaviour during milking were used to assess emotional states, with forward ears associated with signs of stress. Healthy cows with higher body condition scores (BCS) produced more milk, requiring farmers to milk them more than twice a day. This pilot study highlights key behaviour and physiological responses relevant to stress and milk production, and thus overall welfare. For greater generalisability, future research should incorporate larger sample sizes and repeated environmental assessments over extended periods. Full article

In this study, changes in the surface area of Lake Burdur during the 2015–2025 period and the spatial direction of the associated shrinkage were examined using Sentinel-2 Level-2A satellite images. A total of 111 satellite images, each representing a monthly period, were analyzed using a fixed study window and a lake vicinity mask; a three-cluster unsupervised K-means segmentation method was applied to separate the water surface from bare/drained areas and vegetation classes. The resulting binary water masks were used to convert the lake surface area to km² on a pixel-by-pixel basis, and the geometric center of the lake mass was calculated for each observation date. The unique aspect of this study is that it evaluates lake shrinkage not only through a decrease in surface area but also as a directional spatial process via the movement of the centroid center. In this context, the cumulative displacement was decomposed into X/West and Y/South components using the initial centroid point as a reference; OLS-based linear and logarithmic trend models were established for both directions. Model performances were compared using a 15-fold Monte Carlo cross-validation approach with R², adjusted R², NSE, KGE, MAE, MAPE, MSE, and RMSE metrics; additionally, the statistical significance of model differences was assessed using the Wilcoxon signed-rank test. The findings indicate that the logarithmic model yields more balanced and reliable results in the X/West direction, while the linear model does so in the Y/South direction. Based on this model structure, spatial projections were generated for the 2026–2035 period, and it was observed that the projection bands remained stable despite Monte Carlo-based coefficient uncertainty. In conclusion, the study demonstrates that lake drawdowns in semi-arid closed basins can be monitored in a more interpretable and statistically robust manner using Sentinel-2-based segmentation, centroid kinematics, and cross-validated trend modeling. Full article

Background: As many as two-thirds of acutely dizzy patients presenting to the emergency department report intermittent symptoms only, consistent with a transient acute vestibular syndrome (single episode lasting < 24 h) or an episodic vestibular syndrome (recurrent episodes, each lasting < 24 h). A broad differential diagnosis, presentation outside the episode(s), and difficulties in describing the symptoms make the diagnostic workup of transient vestibular symptoms (TVS) challenging. Methods: This critical review provides an overview on the management of TVS, focusing on structured history-taking and bedside testing, but also reviewing the role of neuroimaging and eye movement recordings. Results: Asking about timing and triggers helps clarify the temporal evolution of symptoms (transient vs. persistent) and the circumstances of occurrence (spontaneous vs. triggered). Such structured history-taking narrows down the differential diagnosis and ensures appropriate bedside tests. On clinical examination, identifying focal neurologic signs, (subtle) ocular motor findings, and gait imbalance is essential. While positional testing should be applied in all patients with TVS, HINTS+ has not been validated in those patients without nystagmus or with transient (already resolved) symptoms. For neuroimaging, MRI with diffusion-weighted imaging is preferred, but early false-negative findings in up to 20% (to even 50% for small brainstem strokes) of cases must be considered. Quantitative eye movement recordings may be especially valuable in rural areas, supporting telemedicine consults. Conclusions: Special emphasis should be put on distinguishing vertebrobasilar transient ischemic attack from vestibular migraine and cardiac arrhythmia. In the case of triggered TVS, immediate and sustained response to liberation maneuvers strongly supports benign paroxysmal positional vertigo over vestibular migraine or structural central positional nystagmus. Treatment strategies in TVS strongly depend on the underlying cause, ranging from hyperacute stroke treatment to migraine prophylaxis to liberation maneuvers. Full article

Valentin Yakovlevich Parnakh (1891–1951)—poet, dancer, translator, critic, and indefatigable mediator between artistic milieux—developed idiosyncratic avant-garde poetics in which verbal texture, choreographic invention, and graphic inscription form a single communicative ecology. Focusing on Parnakh’s Parisian collection The Acrobat Climbs (Karabkaetsya acrobat) (1922), this article reconstructs how “low” temporal arts (cabaret, music hall, circus, pantomime) and the modernist revaluation of the body reoriented lyric practice away from a representational “image” toward a performative event and a kinetic sign. The argument proceeds from Parnakh’s struggle “to free oneself from the burden of the word” to the compensatory emergence of dance as an international, non-nationalized medium—at once existential (a “cry of the soul”) and formally experimental. Central attention is given to the author’s attempts to fix movement: the enigmatic “hieroglyphs of dances” printed in 1922 and their later clarification through more legible pictographic systems (“stick-figures”) published in the second half of the 1920s. By correlating poems, self-descriptions of choreography, and visual materials, this study reframes Parnakh’s apparent “obscurity” not as gratuitous zaum, but as a deliberately intermedial hermeneutic problem—one that presupposes translation between sign systems (word/line/body) as the very substance of avant-garde meaning. Full article