Search Results (131)

Aim: Pacifiers play a critical role in the early stages of craniofacial and palate development during infancy. While they provide comfort and aid in soothing, their use can also have significant impacts on the growth and function of the oral cavity. This study aimed to simulate and predict the behavior of six different types of pacifiers and their functional interaction with the tongue and palate, with the goal of understanding their potential effects on orofacial growth and development. Materials and Methods: Biomechanical analysis using Finite Element Analysis (FEA) mathematical models was employed to evaluate the behavior of six different commercial pacifiers in contact with the palate and tongue. Three-dimensional solid models of the palate and tongue were based on the mathematical framework from a 2007 publication. This allowed for a detailed investigation into how various pacifier designs interact with soft and hard oral tissues, particularly the implications on dental and skeletal development. Results: The findings of this study demonstrate that pacifiers exhibit different interactions with the oral cavity depending on their geometry. Anatomical–functional pacifiers, for instance, tend to exert lateral compressions near the palatine vault, which can influence the hard palate and contribute to changes in craniofacial growth. In contrast, other pacifiers apply compressive forces primarily in the anterior region of the palate, particularly in the premaxilla area. Furthermore, the deformation of the tongue varied significantly across different pacifier types: while some pacifiers caused the tongue to flatten, others allowed it to adapt more favorably by assuming a concave shape. These variations highlight the importance of selecting a pacifier that aligns with the natural development of both soft and hard oral tissues. Conclusions: The results of this study underscore the crucial role of pacifier geometry in shaping both the palate and the tongue. These findings suggest that pacifiers have a significant influence not only on facial bone growth but also on the stimulation of oral functions such as suction and feeding. The geometry of the pacifier affects the soft tissues (tongue and muscles) and hard tissues (palate and jaw) differently, which emphasizes the need for careful selection of pacifiers during infancy. Choosing the right pacifier is essential to avoid potential negative effects on craniofacial development and to ensure that the benefits of proper oral function are maintained. Therefore, healthcare professionals and parents should consider these biomechanical factors when introducing pacifiers to newborns. Full article

Steady-state visual evoked potential (SSVEP) paradigms are widely used in brain–computer interface (BCI) systems due to their reliability and fast response. However, traditional static stimuli may reduce user comfort and engagement during prolonged use. This study proposes a dynamic stimulation paradigm combining periodic motion trajectories with speed control. Using four frequencies (6, 8.57, 10, 12 Hz) and three waveform patterns (sinusoidal, square, sawtooth), speed was modulated at 1/5, 1/10, and 1/20 of each frequency’s base rate. An offline experiment with 17 subjects showed that the low-speed sinusoidal and sawtooth trajectories matched the static accuracy (85.84% and 83.82%) while reducing cognitive workload by 22%. An online experiment with 12 subjects participating in a fruit-slicing game confirmed its practicality, achieving recognition accuracies above 82% and a System Usability Scale score of 75.96. These results indicate that coordinated trajectory and speed modulation preserves SSVEP signal quality and enhances user experience, offering a promising approach for fatigue-resistant, user-friendly BCI application. 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

Obstructive sleep apnea (OSA) is a prevalent and heterogeneous sleep disorder associated with significant health and societal burdens. While continuous positive airway pressure (CPAP) remains the gold standard treatment, its limitations in adherence and patient tolerance have highlighted the need for alternative therapies. Positional therapy (PT), which targets apneas that occur predominantly in the supine position, has emerged as a promising option for individuals with positional OSA (POSA). This narrative review synthesizes the current literature on PT, examining its clinical indications, typologies, comparative efficacy with CPAP, oral appliances, and hypoglossal nerve stimulation, as well as data on adherence and barriers to long-term use. Traditional methods such as the tennis ball technique have largely been replaced by modern vibrotactile devices, which demonstrate improved comfort, adherence, and comparable short-term outcomes in selected POSA subjects. While PT remains inferior to CPAP in reducing overall AHI and oxygen desaturation, it performs favorably in terms of mean disease alleviation (MDA) and sleep continuity. Importantly, treatment effectiveness is influenced by both anatomical and non-anatomical traits, underscoring the need for accurate phenotyping and individualized care. PT should be considered within a broader patient-centered model that incorporates preferences, lifestyle, and motivational factors. Further research is needed to validate long-term efficacy, optimize selection criteria, and integrate PT into personalized OSA management strategies. Full article

Background/Objectives: Preimplantation genetic screening improves embryo selection in intracytoplasmic sperm injection cycles, especially for women of advanced maternal age. As chromosomal normality declines with age, high-dose gonadotropins are commonly used to enhance follicular response. This study compares minimal and high-dose stimulation protocols in terms of euploidy, pregnancy, and live birth rates following single embryo transfer. Methods: In this prospective study, 198 women aged 38–45 years were enrolled and divided into two groups: minimal stimulation (100 mg clomiphene citrate and 75 IU human menopausal gonadotropin) and high stimulation (300–450 IU gonadotropins). Women with severe male factor infertility, endometriosis, or absolute tubal factor were excluded. Clinical outcomes were compared using a t-test or Mann–Whitney U test. Results: Baseline characteristics were similar between groups. The high-dose group had a significantly higher number of retrieved oocytes (p = 0.009) and metaphase II oocytes (p = 0.003). However, there were no significant differences in euploid embryo rates (35.4% vs. 37.4%, p = 0.768), clinical pregnancy rates (67.6% vs. 69.4%, p > 0.999), gestational sac rates (58.8% vs. 58.3%, p > 0.999), or live birth rates (47.1% vs. 50.0%, p = 0.995). Conclusions: This is the first prospective study to compare euploid embryo rates, pregnancy rates, and live birth rates between minimal stimulation protocol and high stimulation protocol in AMA patients. Although there has been no difference in euploid and pregnancy rates, minimal stimulation protocol has advantages in cost and comfort. Full article

Epilepsy is a neurological disorder characterized by recurrent, unprovoked seizures, affecting millions worldwide. While anti-seizure medications serve as first-line treatment, approximately one-third of patients develop drug-resistant epilepsy (DRE), necessitating alternative interventions. Deep brain stimulation (DBS) has emerged as a promising therapy for DRE, particularly for patients who are ineligible for resective surgery. DBS involves stereotactic implantation of electrodes into target brain regions, such as the anterior nucleus of the thalamus (ANT), centromedian nucleus (CMT), and hippocampus (HC), to modulate aberrant neural activity and to reduce seizure frequency. Anesthesia plays a critical role in DBS implantation, influencing both patient safety and procedural success. The choice of anesthetic technique must balance patient comfort with the preservation of neurophysiological signals used for intraoperative electrode localization. A well-chosen anesthetic strategy can enhance the efficacy of electrode placement by minimizing patient movement and preserving critical neurophysiological signals for real-time monitoring. This precise targeting enhances safety via a reduction in perioperative risks and an improvement in long-term seizure control. Anesthetic considerations in epilepsy patients differ from those in movement disorders due to variations in their nuclei targets during DBS. Despite the increasing use of DBS for epilepsy following its FDA approval in 2018, research on anesthetic effects specific to this population remains limited. This narrative review, therefore, examines anesthetic approaches, pharmacological implications, potential complications, and evolving methods for DBS implantation in epilepsy patients, highlighting new insights and unique considerations in this population. Understanding these factors is essential for optimizing surgical outcomes and improving the safety and efficacy of DBS in epilepsy treatment. Full article

Introduction: Hypoglossal nerve stimulation (HNS) “Inspire_© therapy” has garnered popularity among obstructive sleep apnea (OSA) patients seeking an alternative to continuous positive airway pressure (CPAP) therapy. The growth in HNS has been particularly high in older adults living with OSA. Consistent and proper use of HNS in the geriatric population faces unique age-associated barriers: a high rate of multiple chronic conditions (MCC) and polypharmacy (being on five or more drugs). Early recognition and patient-centered management of these barriers will allow older patients to obtain maximum benefits from HNS. HNS has distinct advantages in the geriatric population because it overcomes many concerns related to CPAP therapy adherence, such as mechanical limitations due to manual dexterity, maxillofacial anatomy, dental issues such as usage of dentures, allergy/otolaryngology-related disorders, and pre-existing post-traumatic stress disorder-related claustrophobia. This paper describes how we worked with older patients with OSA and their care partners to overcome these barriers so patients can continue to derive cardiovascular, neurologic, and quality of life benefits resulting from optimal OSA management. These benefits are especially important in the older population because of higher rates of comorbidities (dementia, coronary artery disease, and atrial fibrillation) exacerbated by sub-optimally treated OSA. In this article, we describe our clinical experience with elderly patients on Inspire_© therapy, with a focus on the everyday difficulties faced by these patients and the measures implemented to address and mitigate these barriers. Methods: A retrospective chart review was conducted to identify patients aged 65 and above who underwent hypoglossal nerve stimulator insertion. Experiences of older patients during and after the insertion procedure were documented and compared to a younger population of patients on HNS therapy. We specifically collected information on difficulties encountered during activation or follow-up visits and compared them between the different age groups. Using this information, we identified areas to improve treatment adherence from the patients’ perspectives. Results: We identified 43 geriatric (65 to 86 years old) patients who received the Inspire implant at a tertiary academic medical center and compared them to a younger population of 23 patients. Most common challenges noted—with a potential to impact adherence—included orofacial and lingual neuropraxia (ischemic or demyelination-induced neuropathy) at activation, cognitive dysfunction (memory problems), preexisting anxiety, and insomnia. Other difficulties that are less commonly reported but equally important to consistent and proper use of HNS included headaches, concerns of device malfunction, change in comfort levels after cardiac procedures, and general intolerance of the device. The older patient population had a statistically significant higher incidence of cognitive difficulties (30.2% vs. 4.4%) and a smaller social support system (62.8% vs. 91.3%) affecting device usage compared to the younger population. There were no statistically significant differences in the rates of other more commonly reported adverse effects such as headaches, dry mouth, and anxiety between the two age groups. Conclusion: Despite several challenges faced by geriatric patients, Inspire_© hypoglossal nerve stimulation remains a viable, alternative treatment option for OSA with improved tolerance and adherence compared to CPAP. After identifying less commonly reported barriers such as cognitive decline, sensory deficits, and decreased social support systems, minor adjustments and appropriate education on use allows older patients to correctly use and benefit from Inspire_© device therapy, with subsequent improvement in sleep and overall quality of life. Full article

(1) Background: Brain–computer interfaces (BCIs) enable direct communication between the brain and external devices using electroencephalography (EEG) signals, offering potential applications in assistive technology and neurorehabilitation. Code-modulated visual evoked potential (cVEP)-based BCIs employ code-pattern-based stimulation to evoke neural responses, which can then be classified to infer user intent. While increasing the number of EEG electrodes across the visual cortex enhances classification accuracy, it simultaneously reduces user comfort and increases setup complexity, duration, and hardware costs. (2) Methods: This online BCI study, involving thirty-eight able-bodied participants, investigated how reducing the electrode count from 16 to 6 affected performance. Three experimental conditions were tested: a baseline 16-electrode configuration, a reduced 6-electrode setup without retraining, and a reduced 6-electrode setup with retraining. (3) Results: Our results indicate that, on average, performance declines with fewer electrodes; nonetheless, retraining restored near-baseline mean Information Transfer Rate (ITR) and accuracy for those participants for whom the system remained functional. The results reveal that for a substantial number of participants, the classification pipeline fails after electrode removal, highlighting individual differences in the cVEP response characteristics or inherent limitations of the classification approach. (4) Conclusions: Ultimately, this suggests that minimal cVEP-BCI electrode setups capable of reliably functioning across all users might only be feasible through other, more flexible classification methods that can account for individual differences. These findings aim to serve as a guideline for what is currently achievable with this common cVEP paradigm and to highlight where future research should focus in order to move closer to a practical and user-friendly system. Full article

This study analyzes the design and performance of artificial lighting in a classroom setting, focusing on the balance between photopic and melanopic illuminance to optimize both visual comfort and circadian well-being. A three-dimensional simulated room model is used to evaluate three luminaires with different spatial distribution curves and two white LEDs, cool (CCT 6487 K) and warm (CCT 2268 K). The assessment includes an analysis of photopic and melanopic illuminance at the corneal plane, E_v and mEDI, respectively, with particular emphasis on the impact of the luminaires’ spatial distribution and the spectral characteristics of the light. The results indicate that a Lambertian spatial distribution of light achieves the best balance between illuminance uniformity and visual comfort. Illuminance uniformity is calculated on the horizontal work plane at 0.80 m, in line with the nature of visual tasks in classroom settings, making it the optimal solution for the simulated scenario. The cool LED provides greater melanopic stimulation, which is ideal for cognitive activation in the morning. Conversely, the warm LED creates a more relaxing atmosphere with lower melanopic values, making it better suited for the evening. Furthermore, this study proposes a dynamic lighting system that adjusts the correlated color temperature throughout the day by modifying the spectral power distribution of the light to accommodate both visual and biological needs. This research highlights the importance of integrating photopic and melanopic lighting considerations in luminaire design, offering practical insights for creating flexible and health-promoting environments in real-world settings. Full article

With the development of the knowledge economy, the significance of the creative industry has become increasingly prominent. Individual creativity can be stimulated by optimal lighting. This research consists of two parts: Part I examines the effects of illuminance and color temperature on creativity through three experiments, while Part II employs a two-factor repeated-measures design to investigate their interaction effects. The participants completed creativity tests during light exposure, including TTCT tasks in Part I of the experiment, and AUT and RAT tasks in Part II. They also completed questionnaires to assess their mood, and HRV data were collected for physiological analysis. The results showed that the subjects performed worse on a creativity test at an extremely low illuminance of 150 lx. Within a comfortable neutral lighting range, the participants’ creativity at 300 lx was superior to that at 1500 lx. In exploring light color, the conventional correlated color temperature (CCT) variable was replaced with colored lighting. The results indicated that both blue and orange light enhanced creative performance compared to white light. Additionally, an interactive effect of illuminance and colored lighting was observed. Fluency on the Alternative Uses Task (AUT) test was greater under 5000 K and 300 lx lighting, while originality on the AUT test was enhanced under 1500 lx, colored lighting. Emotional experience was found to be significantly correlated with creative performance. These findings contribute to the development of a design guideline that utilizes lighting intensity, color, and other elements to foster a relaxing indoor atmosphere that enhances positive mood and creativity. Full article

Purpose: Urinary incontinence (UI) significantly impacts the quality of life, necessitating a range of treatments, from behavioral changes to surgical interventions. Electromagnetic muscle stimulation (HIFEM™) therapy presents an innovative, non-invasive approach to strengthening pelvic floor muscles (PFMs). Subjects and Methods: This retrospective, non-interventional case series study explores the efficacy and safety of HIFEM™ treatment in parous women experiencing stress (SUI) and mixed urinary incontinence (MUI). Nineteen women (mean age 54 ± 16) underwent six HIFEM™ sessions, with symptom progression tracked using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), along with comfort and satisfaction questionnaires. Results: At baseline, the mean ICIQ-UI SF score was 7.9 ± 4.2 points. By the final questionnaire administration, the average score had dropped to 4.7 ± 3.5, reflecting a 50.6% reduction from baseline (p < 0.001). According to ICIQ-UI SF Item 6, 21% of subjects achieved complete continence. Additionally, the percentage of subjects experiencing urine leakage before reaching the toilet declined by 40% after the sixth treatment. Post treatment, the number of subjects who leaked urine while coughing or sneezing decreased by 50%. Conclusions: The treatment has shown high efficacy in lowering the ICIQ-SF scores across the study group, with a significant number of subjects regaining entire continence. Full article

Introduction: non-surgical periodontal treatment, primarily comprising scaling and root planing, is crucial for the maintenance and enhancement of oral health. However, the invasive nature of this procedure often leads to patient discomfort and pain, which may deter individuals from seeking necessary dental care, ultimately compromising their oral health outcomes. Methods: This prospective randomized crossover split-mouth study involved the application of Ultra-Low Frequency (ULF) Transcutaneous Electrical Nerve Stimulation (TENS) in 20 adult patients undergoing non-surgical periodontal treatment. Pain and discomfort levels were quantitatively assessed during procedures conducted with and without the ULF-TENS intervention. Results: The assessment of maximum voluntary opening, pain intensity, and overall comfort levels indicated a statistically significant reduction in pain (p < 0.0001) and discomfort (p < 0.0001) when ULF-TENS was employed during the treatment, and an increase in the maximum mouth opening after TENS (p = 0.00062). Conclusions: The findings of this pilot study suggest that ULF-TENS may serve as a valuable adjunctive therapy in non-surgical periodontal treatment by reducing pain and discomfort, potentially enhancing patient comfort and compliance. Further research with larger sample sizes is warranted to confirm these findings. Full article

In the years since the emergence of the railway, the main objective has been focused on trains arriving and stopping at stations, with stations being considered a secondary or even residual objective for bringing people or goods on or off. The arrival of high-speed trains at stations has allowed for the creation of integrated, environmentally friendly stations which have become mobility hubs, connecting different modes of transportation and cities, as well as being clusters of economic activities that stimulate the inclusive growth of the areas where they are located. These transport infrastructures condition the social and communication relationships of many spaces. The consequences that have been demonstrated in the stations analyzed have been strengthened intermodally with other means of transport, giving value to commercial developments and old stations, as well as the environments where they are located, a development aimed beyond the railway users themselves. From an operational point of view, the main consequence of this transformation is the necessity to absorb the increase in passenger demand. The integration of the railway within an urban space is shaped through the construction of new stations within the already existing urban framework or, in some cases, by relocating them to the periphery of the city. New stations have undergone changes compared to those built a century ago. Their conception has evolved, adapting to the architecture of their time, but the most radical change they have experienced is related to the new uses that have been developed within them and how these spaces are utilized. The introduction of high-speed trains has initiated a series of reflections on new station concepts. The new operation is characterized by journey times, frequency, and comfort. This comfort is not only perceived on board a train but also in stations during a passenger’s stay, which has a direct impact on the design of stations. Provisional railway stations are valuable tools in situations where flexibility, speed, and reduced costs are required. Although they are not designed to be permanent, their ability to adapt to specific needs makes them a strategic option for temporary projects, though not in the case studied of the Valencia station. The planning of projects makes it necessary to implement proxemic standards in the design of spaces that contribute to the diversification of economic activity around and in a station itself, such as commercial, residential, or cultural areas. Full article

The smart capsule bubble tile (SCBT) is an innovative flooring solution that combines acupressure-based reflexology with electromagnetic wave stimulation to enhance well-being. Designed for smart buildings and healthcare applications, SCBT integrates traditional construction techniques with advanced healing technologies to create a health-conscious, eco-friendly flooring system. For durability and thermal performance, SCBT tiles are manufactured using conventional concrete methods, enhanced with aluminum oxide (Al₂O₃). Each tile contains multiple pressure point capsules featuring a copper cap that emits electromagnetic waves when exposed to sunlight. This dual-function mechanism stimulates acupressure points on the feet, promoting better blood circulation, reducing stress, and enhancing relaxation. The heat release from the copper caps further improves thermal comfort and energy flow in the body, reinforcing the benefits of reflexology. The performance of SCBT tiles was extensively tested, demonstrating impressive physical and functional properties. They exhibit a flexural strength of 4.6 N/mm², a thermal emissivity of 0.878, a solar reflectance of 0.842, and a water absorption rate of 8.12%. In biomechanical assessments, SCBT showed significant benefits for balance and posture correction. Users experienced a 70.8% reduction in lateral stance ellipse area with eyes open and a 50.5% reduction with eyes closed, indicating improved stability and proprioception. By integrating acupressure and electromagnetic stimulation into flooring design, SCBT promotes a holistic approach to health. This technology supports energy efficiency in smart buildings and contributes to preventive healthcare by enhancing musculoskeletal health and reducing fatigue. SCBT represents a significant step in creating built environments supporting human well-being, merging traditional healing principles with modern material science. Full article

In various climate conditions, courtyards have a major impact on a building’s energy efficiency and thermal performance. The purpose of this study is to understand and analyze the environmental aspects of a courtyard in a particular area. The chosen region is Trichy, which has generally warm-humid climate. To understand environmental factors like thermal comfort, natural ventilation, natural lighting, and microclimate, cases from the region were chosen. The primary objective of this paper is to utilize computational fluid dynamics (CFD) to investigate how these environmental factors affect the courtyard in the stated location. The chosen case is stimulated using DesignBuilder software. The field investigation is the first step in the study, which is then followed by the model-making process and stimulation. This study investigates the impact of environmental parameters on courtyard efficiency, focusing on their response to environmental conditions. Through field investigation and modeling of chosen examples, the study reveals critical elements for courtyard design success, emphasizing the relevance of knowing these characteristics for effective courtyard planning in the region. The results are beneficial for analyzing the courtyard’s circumstances since they take into consideration the courtyard’s performance towards microclimate and influences on various courtyard components. Additionally, they offer a helpful coefficient factor for additional courtyard studies. Full article