Search Results (2,640)

Objectives: To investigate the reliability and validity of the Singer Reflux Symptom Score (sRSS), a new patient-reported outcome questionnaire documenting the severity of reflux symptoms in singing voice is proposed. Methods: Amateur and professional singers consulting the European Reflux Clinic for laryngopharyngeal reflux disease (LPRD) symptoms and findings were prospectively recruited from January 2022 to February 2023. The diagnosis was based on a Reflux Symptom Score (RSS) > 13 and Reflux Sign Assessment (RSA) > 14. A control group of asymptomatic singer subjects was recruited from the University of Mons. The sRSS was rated within a 7-day period to assess test–retest reliability. Internal consistency was measured using Cronbach’s α in patients and controls. A correlation analysis was performed between sRSS and Singing Voice Handicap Index (sVHI) to evaluate convergent validity. Responsiveness to change was evaluated through pre- to post-treatment sRSS changes. The sRSS threshold for suggesting a significant impact of LPRD on singing voice was determined by receiver operating characteristic (ROC) analysis. Results: Thirty-three singers with suspected LPRD (51.5% female; mean age: 51.8 ± 17.2 years) were consecutively recruited. Difficulty reaching high notes and vocal fatigue were the most prevalent LPRD-related singing complaints. The sRSS demonstrated high internal consistency (Cronbach-α = 0.832), test–retest reliability, and external validity (correlation with sVHI: r = 0.654; p = 0.015). Singers with suspected LPRD reported a significant higher sRSS compared to 68 controls. sRSS item and total scores significantly reduced from pre-treatment to 3 months post-treatment except for the abnormal voice breathiness item. ROC analysis revealed superior diagnostic accuracy for sRSS (AUC = 0.971) compared to sRSS-quality of life (AUC = 0.926), with an optimal cutoff at sRSS > 38.5 (sensitivity: 90.3%; specificity: 85.0%). Conclusions: The sRSS is a reliable and valid singer-reported outcome questionnaire for documenting singing symptoms associated with LPRD leading to personalized management of Singers. Future large-cohort studies are needed to evaluate its specificity for LPRD compared to other vocal fold disorders in singers. Full article

Background/Objectives: Although numerous prognostic biomarkers have been proposed for colorectal cancer (CRC), their longitudinal evaluation remains limited. The aim of this study was to investigate longitudinal changes in biomarkers calculated from routinely used laboratory markers and their relationships to common chronic diseases (comorbidities). Methods: A retrospective longitudinal observational study was completed with the inclusion of 817 CRC patients and a total of 4542 measurement points. Pan-immune inflammation value (PIV), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) were calculated based on complete blood count and albumin measurement data. Results: Longitudinal data analyses confirmed the different values and slopes of the parameters tested at the different endpoints. Survivors had the lowest and most constant PIVs and SII values, and the highest and most slowly decreasing PNI values. Those patients with non-cancerous death had similar values to the previous cohort, but an increase/decrease occurred towards the death event. Patients with CRC-related death had significantly higher PIVs and SII values and significantly lower PNI values (p < 0.0001), and a significant increase/decrease was observed at the early observational periods. The presence of lymph node and/or distant metastases, adjuvant chemotherapy, and hypertension significantly affected PIVs and SII and/or PNI values. The changes in PIVs and SII and PNI values toward pathological values are poor prognostic signs (p < 0.0001). Conclusions: Each of the three calculated markers demonstrates suitability for longitudinal patient follow-up, and their pathological alterations over time serve as valuable prognostic indicators. They may also be useful to detect certain clinicopathological parameters early. Full article

Background: The use of lower limb prosthesis can impact all aspects of daily life, activities and participation. Various studies have compared the microprocessor-controlled knee (MPK) to the non-microprocessor-controlled knee (NMPK) using a variety of different outcome measures, but results are inconsistent and raise the question of which type of knee is most effective. Therefore, we aimed to assess the effect of MPKs compared to NMPKs across all classified ICF domains in adult prosthesis users. Methods: Participants performed baseline measurements with the NMPK (T0). One week later, they started a four-to-six-week trial period with the MPK. Afterward, measurements were repeated with the MPK (T1). Functional tests (6MWT, TUG-test and activity monitor) and questionnaires (ABC, SQUASH, USER-P and PEQ) were used. For statistical analyses, paired t-tests, Wilcoxon signed-rank tests and Chi² test were applied. The Benjamini–Hochberg procedure was applied to correct for multiple testing. Results: Twenty-five participants were included. Using an MPK compared to an NMPK significantly resulted in improvements in balance and walking confidence, safety, walking distance and self-reported walking ability, as well as a decrease in number of stumbles and falls. Additionally, participants using an MPK were significantly more satisfied with their participation, experienced fewer restrictions, reported greater satisfaction with the appearance and utility of the MPK, experienced less social burden and reported better well-being, compared to using an NMPK. Conclusions: Using an MPK instead of an NMPK can lead to significant improvements in all classified ICF domains, such as improved walking ability, confidence and satisfaction and reduced fall risk. Full article

Newton’s law of cooling requires a reference temperature ($T_{ref}$) to define the heat-transfer coefficient ($h$). For external flows with multiple temperatures in the freestream, obtaining $T_{ref}$ is a challenge. One widely used method, referred to as the adiabatic-wall (AW) method, obtains $T_{ref}$ by requiring the surface of the solid exposed to convective heat transfer to be adiabatic. Another widely used method, referred to as the linear-extrapolation (LE) method, obtains $T_{ref}$ by measuring/computing the heat flux ($q_s^{\prime \prime }$) on the solid surface at two different surface temperatures ($T_s$) and then linearly extrapolating to $q_s^{\prime \prime }=0$. A third recently developed method, referred to as the state-space (SS) method, obtains $T_{ref}$ by probing the temperature space between the highest and lowest in the flow to account for the effects of $T_s$ or $q_s^{\prime \prime }$ on $T_{ref}$. This study examines the foundation and accuracy of these methods via a test problem involving film cooling of a flat plate where $q_s^{\prime \prime }$ switches signs on the plate’s surface. Results obtained show that only the SS method could guarantee a unique and physically meaningful $T_{ref}$ where $T_s=T_{ref}$ on a nonadiabatic surface $q_s^{\prime \prime }=0$. The AW and LE methods both assume $T_{ref}$ to be independent of $T_s$, which the SS method shows to be incorrect. Though this study also showed the adiabatic-wall temperature, $T_{AW}$, to be a good approximation of $T_{ref}$ (<10% relative error), huge errors can occur in $h$ about the solid surface where $|T_s-T_{AW}|$ is near zero because where $T_s=T_{AW}$, $q_s^{\prime \prime }\ne 0$. Full article

Background/Objectives: ¹⁸F-PSMA-1007 is one of the more widely used radioligands in prostate cancer imaging with PET/CT. Its major advantage lies in the low urinary tracer activity due to primarily hepatobiliary clearance, but unexpectedly high tracer accumulation in the bladder can occur, potentially hindering assessment of lesions near the prostate bed. This study assesses the impact of furosemide on ¹⁸F-PSMA-1007 tracer accumulation in the bladder. Methods: In this single-center, retrospective, intra-individual comparative analysis, 18 patients undergoing two consecutive ¹⁸F-PSMA-1007 PET/CT scans for biochemical relapse (BCR) or persistence (BCP)—one with and one without prior furosemide administration—were included. Images were acquired 60 min post-injection of 250 MBq of tracer activity. Standardized Uptake Values (SUVmax, SUVpeak, SUVmean) were measured in the bladder and in tissues with physiological uptake by three readers. Differences were analyzed using Wilcoxon signed-rank tests. The inter-reader agreement was assessed using intraclass correlation coefficient. Results: Furosemide significantly decreased bladder SUVmax, SUVpeak, and SUVmean (all p < 0.001). Mean bladder SUVmax decreased from 13.20 ± 10.40 to 3.92 ± 3.47, SUVpeak from 10.94 ± 8.02 to 3.47 ± 3.13, and SUVmean from 8.74 ± 6.66 to 2.81 ± 2.56, representing a large effect size (r ≈ 0.55). Physiological tracer uptake in most organs was not significantly influenced by furosemide (all p > 0.05). Conclusions: Despite the predominantly hepatobiliary clearance of ¹⁸F-PSMA-1007, furosemide-induced forced diuresis leads to a significant reduction in tracer activity in the bladder, which in clinical practice could help in early detection of tumor recurrence. Full article

There is limited published guidance available to help less experienced practitioners assess and manage shoulder conditions, including spasticity, after acquired central nervous system (CNS) lesions. To address this gap, 11 spasticity and dystonia experts convened in a 2023 meeting to build on existing guidance, provide consensus on best treatment practice, and develop expert recommendations to guide the diagnosis and treatment of complications of shoulder conditions following CNS lesions. Presentations by each expert on diagnosis and management were followed by discussion; consensus on assessment and treatment practices was identified and recommendations developed. The expert panel recommended an assessment approach structured using the following components: patient history, including interpretation of reported symptoms; observation of postures and pain responses; clinical examination with targeted tests for specific signs; diagnostic tests; and assessment of upper limb impairment, activity limitations, and participation restrictions. This assessment process and the recommended measures recognize the importance of identifying shoulder involvement in upper limb spasticity as part of the diagnostic process in shoulder conditions following CNS lesions. These recommendations provide a practical approach to diagnosis and treatment for clinicians who are less experienced in evaluating and treating such conditions, simplifying otherwise complicated clinical scenarios. Full article

Spin transport behaviors in heavy metal/ferromagnetic insulator (HM/FI) bilayers have attracted considerable attention due to various novel phenomena and applications in spintronic devices. Herein, we investigate the planar Hall effect (PHE) in Pt/Tm₃Fe₅O₁₂ (Pt/TmIG) heterostructures at low temperatures; moment switching in the ferrimagnetic insulator TmIG is detected by using electrical measurements. Double switching hysteresis PHE curves are found in Pt/TmIG bilayers, closely related to the magnetic moment of Tm³⁺ ions, which makes a key contribution to the total magnetic moment of TmIG film at low temperature. More importantly, a magnetoresistance (MR) curve with double switching is found, which has not been reported in this simple HM/FI bilayer, and the sign of this MR effect is sensitive to the angle between the magnetic field and current directions. Our findings of these effects in this HM/rare earth iron garnet (HM/REIG) bilayer provide insights into tuning the spin transport properties of HM/REIG by changing the rare earth. Full article

Multivalent lectin–glycan interactions (MLGIs) are vital for viral infection, cell-cell communication and regulation of immune responses. Their structural and biophysical data are thus important, not only for providing insights into their underlying mechanisms but also for designing potent glycoconjugate therapeutics against target MLGIs. However, such information remains to be limited for some important MLGIs, significantly restricting the research progress. We have recently demonstrated that functional nanoparticles, including ∼4 nm quantum dots and varying sized gold nanoparticles (GNPs), densely glycosylated with various natural mono- and oligo- saccharides, are powerful biophysical probes for MLGIs. Using two important viral receptors, DC-SIGN and DC-SIGNR (together denoted as DC-SIGN/R hereafter), as model multimeric lectins, we have shown that α-mannose and α-manno-α-1,2-biose (abbreviated as Man and DiMan, respectively) coated GNPs not only can provide sensitive measurement of MLGI affinities but also reveal critical structural information (e.g., binding site orientation and mode) which are important for MLGI targeting. In this study, we produced mannuronic acid (ManA) coated GNPs (GNP-ManA) of two different sizes to probe the effect of glycan modification on their MLGI affinity and antiviral property. Using our recently developed GNP fluorescence quenching assay, we find that GNP-ManA binds effectively to both DC-SIGN/R and increasing the size of GNP significantly enhances their MLGI affinity. Consistent with this, increasing the GNP size also significantly enhances their ability to block DC-SIGN/R-augmented virus entry into host cells. Particularly, ManA coated 13 nm GNP potently block Ebola virus glycoprotein-driven entry into DC-SIGN/R-expressing cells with sub-nM levels of EC₅₀. Our findings suggest that GNP-ManA probes can act as a useful tool to quantify the characteristics of MLGIs, where increasing the GNP scaffold size substantially enhances their MLGI affinity and antiviral potency. Full article

Colonic ischemia (CI) is a serious and potentially fatal complication after major abdominal vascular surgery. This literature review explores the pathogenesis, risk factors, diagnostic methods, and preventive strategies associated with CI, emphasizing the differences between emergency and elective treatments. Early diagnosis through clinical signs and instrumental diagnostics, such as sigmoidoscopy and computed tomography, is crucial. Preventive measures, including preoperative evaluation and perioperative management, are emphasized to reduce the incidence of CI. The results of different studies suggest that endovascular aneurysm repair (EVAR), both emergency and elective, has lower risks of ischemic complications than open surgical repair (OSR), as well as better survival for patients. Further research and standardized clinical guidelines are needed to improve patient outcomes and minimize CI severity. Full article

Background/Objectives: Nutrition in inflammatory bowel disease (IBD) is a central concern for both patients and healthcare professionals, as it plays a key role not only in daily life but also in disease outcomes. The Mediterranean diet represents a healthy dietary pattern that may be suitable in many cases of IBD. Among other factors, health literacy (HL) influences patients’ dietary habits and their ability to follow nutritional recommendations. The aim of this study was to assess HL and dietary patterns in adolescent and pediatric patients with IBD. Methods: We conducted a cross-sectional study that included a total of 99 participants (36 patients with IBD receiving biological therapy recruited from a single center and 63 healthy controls). HL was assessed using the Newest Vital Sign (NVS) tool regardless of disease activity, whereas diet quality was evaluated by the KIDMED questionnaire exclusively in patients in remission. Linear regression models were used to evaluate the effects of sex, age and group (patients vs. control) on NVS and KIDMED scores. Results: Most participants (87.9%) had an adequate HL, which was positively associated with age. While the most harmful dietary habits (such as frequent fast-food consumption) were largely absent in the patient group, KIDMED scores indicated an overall poor diet quality. Conclusions: Although HL increased with age and was generally adequate in this cohort, it did not translate into healthier dietary patterns as measured by the KIDMED score. Further research with larger, more diverse samples is needed to clarify the relationship between HL and dietary adherence in adolescents with IBD. Full article

Objectives: Pelvic tumor resections demand high surgical precision to ensure clear margins while preserving function. Although patient-specific instruments (PSIs) improve osteotomy accuracy, positioning errors remain a limitation. This study evaluates the feasibility, accuracy, and usability of a novel dual-function augmented reality (AR) system for intraoperative guidance in PSI positioning and osteotomy execution using a head-mounted display (HMD). The system provides dual-function support by assisting both PSI placement and osteotomy execution. Methods: Ten fresh-frozen cadaveric hemipelves underwent AR-assisted internal hemipelvectomy, using customized 3D-printed PSIs and a new in-house AR software integrated into an HMD. Angular and translational deviations between planned and executed osteotomies were measured using postoperative CT analysis. Absolute angular errors were computed from plane normals; translational deviation was assessed as maximum error at the osteotomy corner point in both sagittal (pitch) and coronal (roll) planes. A Wilcoxon signed-rank test and Bland–Altman plots were used to assess intra-workflow cumulative error. Results: The mean absolute angular deviation was 5.11 ± 1.43°, with 86.66% of osteotomies within acceptable thresholds. Maximum pitch and roll deviations were 4.53 ± 1.32 mm and 2.79 ± 0.72 mm, respectively, with 93.33% and 100% of osteotomies meeting translational accuracy criteria. Wilcoxon analysis showed significantly lower angular error when comparing final executed planes to intermediate AR-displayed planes (p < 0.05), supporting improved PSI positioning accuracy with AR guidance. Surgeons rated the system highly (mean satisfaction ≥ 4.0) for usability and clinical utility. Conclusions: This cadaveric study confirms the feasibility and precision of an HMD-based AR system for PSI-guided pelvic osteotomies. The system demonstrated strong accuracy and high surgeon acceptance, highlighting its potential for clinical adoption in complex oncologic procedures. Full article

Traditional 3D millimeter-wave radars lack target height information, leading to identification failures in complex scenarios. Upgrading to 4D millimeter-wave radars enables four-dimensional information perception, enhancing obstacle detection and improving the safety of autonomous driving. Given the high cost-sensitivity of in-vehicle radar systems, single-chip 4D millimeter-wave radar solutions, despite technical challenges in imaging, are of great research value. This study focuses on developing single-chip 4D automotive millimeter-wave radar, covering system architecture design, antenna optimization, signal processing algorithm creation, and performance validation. The maximum measurement error is approximately ±0.2° for azimuth angles within the range of ±30° and around ±0.4° for elevation angles within the range of ±13°. Extensive road testing has demonstrated that the designed radar is capable of reliably measuring dynamic targets such as vehicles, pedestrians, and bicycles, while also accurately detecting static infrastructure like overpasses and traffic signs. Full article

Objective: This study aimed to explore the acute neurophysiological effects of a single oral dose of Astragaloside IV (AS-IV) on EEG-measured brain oscillations and cognitive-relevant spectral markers in healthy young adults. Methods: Twenty healthy adults (8 females, 12 males; mean age: $23.4\pm 2.1$) underwent eyes-closed resting-state EEG recordings before and approximately 90 min after oral intake of 150 mg AS-IV. EEG data were collected using a 21-channel 10–20 system and cleaned via Artifact Subspace Reconstruction and Independent Component Analysis. Data quality was confirmed using a signal-to-noise ratio and 1/f spectral slope. Absolute and relative power values, band ratios, and frontal alpha asymmetry were computed. Statistical comparisons were made using paired t-tests or Wilcoxon signed-rank tests. Results: Absolute power decreased in delta, theta, beta, and gamma bands (p < 0.05) but remained stable for alpha. Relative alpha power increased significantly (p = 0.002), with rises in relative beta, theta, and delta and a drop in relative gamma (p = 0.003). Alpha/beta and theta/beta ratios increased, while delta/alpha decreased. Frontal alpha asymmetry was unchanged. Sex differences were examined in all measures that showed significant changes; however, no sex-dependent effects were found. Conclusions: A single AS-IV dose may acutely modulate brain oscillations, supporting its potential neuroactive properties. Larger placebo-controlled trials, including concurrent psychometric assessments, are needed to verify and contextualize these findings. A single AS-IV dose may acutely modulate brain oscillations, supporting its potential neuroactive properties. Full article

Data over sound (DoS) is an established technique that has experienced a resurgence in recent years, finding applications in areas such as contactless payments, device pairing, authentication, presence detection, toys, and offline data transfer. This study introduces CardiaWhisper, a system that extends the DoS concept to the medical domain by using a medical data-over-sound (MDoS) framework. CardiaWhisper integrates wearable biomedical sensors with home care systems, edge or IoT gateways, and telemedical networks or cloud platforms. Using a transmitter device, vital signs such as ECG (electrocardiogram) signals, PPG (photoplethysmogram) signals, RR (respiratory rate), and ACC (acceleration/movement) are sensed, conditioned, encoded, and acoustically transmitted to a nearby receiver—typically a smartphone, tablet, or other gadget—and can be further relayed to edge and cloud infrastructures. As a case study, this paper presents the real-time transmission and processing of ECG signals. The transmitter integrates an ECG sensing module, an encoder (either a PLL-based FM modulator chip or a microcontroller), and a sound emitter in the form of a standard piezoelectric speaker. The receiver, in the form of a mobile phone, tablet, or desktop computer, captures the acoustic signal via its built-in microphone and executes software routines to decode the data. It then enables a range of control and visualization functions for both local and remote users. Emphasis is placed on describing the system architecture and its key components, as well as the software methodologies used for signal decoding on the receiver side, where several algorithms are implemented using open-source, platform-independent technologies, such as JavaScript, HTML, and CSS. While the main focus is on the transmission of analog data, digital data transmission is also illustrated. The CardiaWhisper system is evaluated across several performance parameters, including functionality, complexity, speed, noise immunity, power consumption, range, and cost-efficiency. Quantitative measurements of the signal-to-noise ratio (SNR) were performed in various realistic indoor scenarios, including different distances, obstacles, and noise environments. Preliminary results are presented, along with a discussion of design challenges, limitations, and feasible applications. Our experience demonstrates that CardiaWhisper provides a low-power, eco-friendly alternative to traditional RF or Bluetooth-based medical wearables in various applications. Full article

This study assesses the risk of geoheritage degradation along a low-lying coastal stretch Okin the municipalities of Macau, Guamaré, and Galinhos, located in the central portion of Rio Grande do Norte’s northern coastline, Brazil. Twelve geosites, inventoried based on their scientific value, susceptibility to degradation, and representation of diverse coastal processes and landforms, were numerically assessed for their degradation risk. The methodology comprised 11 sub-criteria grouped into three main criteria: natural vulnerability, anthropogenic vulnerability, and public use. The results indicate that all 12 geosites in the study area are subject to moderate to high degradation risk, with the highest levels observed in those with the most evident signs of human use and intervention. To mitigate these impacts, the implementation of access restrictions or protective measures by local authorities is recommended. Furthermore, raising awareness among local communities about the environmental consequences of their activities and the geosites’ role in promoting sustainability is essential. Given the region’s heightened vulnerability to sea level oscillations, future assessments should incorporate climate change implications into the assessment criteria. Full article