Search Results (718)

Objectives: To synthesize evidence on structural and functional neuroplasticity in patients after anterior cruciate ligament reconstruction (ACLR) and its clinical implications. Methods: Adhering to the PRISMA guidelines for systematic reviews and meta-analyses, a literature search was conducted using PubMed, Embase, Web of Science, Scopus, and Cochrane CENTRAL (2018–2025) using specific keyword combinations, screening the results based on predetermined inclusion and exclusion criteria. Results: Among the 27 included studies were the following: (1) sensory cortex reorganization with compensatory visual dependence (5 EEG/fMRI studies); (2) reduced motor cortex efficiency evidenced by elevated AMT (TMS, 8 studies) and decreasedγ-CMC (EEG, 3 studies); (3) progressive corticospinal tract degeneration (increased radial diffusivity correlating with postoperative duration); (4) enhanced sensory-visual integration correlated with functional recovery. Conclusions: This review provides a novel synthesis of evidence from transcranial magnetic stimulation (TMS), electroencephalography (EEG), functional near-infrared spectroscopy (fNIRS), diffusion tensor imaging (DTI), and functional magnetic resonance imaging (fMRI) studies. It delineates characteristic patterns of post-ACLR structural and functional neural reorganization. Targeting visual–cognitive integration and corticospinal facilitation may optimize rehabilitation. Full article

Background/Objectives: Neck pain caused by myofascial pain syndrome (MPS) is a highly prevalent musculoskeletal condition. Repetitive peripheral magnetic stimulation (rPMS) is a promising treatment option; however, its therapeutic effect and optimal treatment frequency remain unclear. This study aimed to investigate the therapeutic effect and duration of effect of rPMS in patients with MPS of the neck. Methods: In this randomized, sham-controlled, crossover trial, 27 patients with neck MPS and baseline visual analog scale (VAS) scores ≥ 40 were enrolled. The mean age was 43.8 ± 9.1 years, and 63% were female. Participants were randomly assigned to receive either an initial rPMS treatment (a 10 min session delivering 3900 pulses at 5–10 Hz) or sham stimulation. After 7 days, groups crossed over. Pain intensity (VAS), disability (Neck Disability Index; NDI), and analgesic use were recorded daily for seven consecutive days. A linear mixed-effects model was used for analysis. Results: At baseline, the VAS and NDI scores were 61.8 ± 10.5 and 26.0 ± 6.3, respectively. rPMS produced a significantly greater reduction in both VAS and NDI scores, with the greatest differences observed on Day 4: the differences were −24.1 points in VAS and −8.5 points in NDI compared to the sham group. There was no significant difference in analgesic use between the two groups. Conclusions: A single rPMS session provides short-term improvement in pain and disability in neck MPS. Based on the observed therapeutic window, more frequent sessions (e.g., twice weekly) may provide sustained benefit and should be explored in future studies. Full article

Background: We recently reported sex-dependent impairment in cognitive functions in male and female mice exposed for 24 h, 48 h or 15 days to 2G hypergravity (HG). Methods: In the present study, we investigated brain functional correlates by analyzing synaptic activity and plasticity in the CA1 area of the hippocampus in both genders of mice previously exposed to 2G for the same duration. This was assessed by electrophysiological extracellular recordings in ex vivo slice preparations. Results: Basal synaptic transmission and glutamate release were unchanged regardless of HG duration. However, plasticity was altered in a sex- and time-specific manner. In males, long-term potentiation (LTP) induced by strong high-frequency stimulation and NMDA receptor (NMDAr) activation was reduced by 26% after 24 h of exposure but recovered at later timepoints. This deficit was reversed by D-serine or glycine, suggesting decreased activation at the NMDAr co-agonist site. In females, LTP deficits (23%) were found only after 15 days following mild theta burst stimulation and were not reversed by D-serine. Long-term depression (LTD) was unaffected in both sexes. Conclusions: This study highlights, for the first time, sex-dependent divergence in the CA1 hippocampal plasticity timeline following 2G exposure. The synaptic changes depend on exposure duration and the stimulation protocol and could underlie the previously observed cognitive deficits. Full article

Brain–computer interface (BCI) technology holds promise for improving motor rehabilitation in stroke patients. This review explores the immediate and long-term effects of BCI training, shedding light on the potential benefits and challenges. Clinical studies have demonstrated that BCIs yield significant immediate improvements in motor functions following stroke. Patients can engage in BCI training safely, making it a viable option for rehabilitation. Evidence from single-group studies consistently supports the effectiveness of BCIs in enhancing patients’ performance. Despite these promising findings, the evidence regarding long-term effects remains less robust. Further studies are needed to determine whether BCI-induced changes are permanent or only last for short durations. While evaluating the outcomes of BCI, one must consider that different BCI training protocols may influence functional recovery. The characteristics of some of the paradigms that we discuss are motor imagery-based BCIs, movement-attempt-based BCIs, and brain-rhythm-based BCIs. Finally, we examine studies suggesting that integrating BCIs with other devices, such as those used for functional electrical stimulation, has the potential to enhance recovery outcomes. We conclude that, while BCIs offer immediate benefits for stroke rehabilitation, addressing long-term effects and optimizing clinical implementation remain critical areas for further investigation. Full article

Background/Objective: One third of “non-functioning adrenal tumours” (NFAs) have mild autonomous cortisol secretion (MACS). An updated analysis of the hormonal biomarkers profile, including risk factors and the rate of post-surgery adrenal insufficiency (PSAI), the duration of restoring the normal adrenocortical function in MACS/NFA and potential impacts on clinical comorbidities. Methods: Comprehensive review based on PubMed search (January 2020–January 2025). Results: The studies (n = 14) included 2623 patients (N = 1158 underwent unilateral adrenalectomy), aged 18–93 (mean = 57.49 years), with a female-to-male ratio = 1.54. Post-adrenalectomy (n = 9, N = 753) analysis: the PSAI risk correlated with the severity of baseline hypercortisolism. PSAI incidence: 50% of MAC. The rate after 4–6 weeks follow-up was 71.9% (adrenal Cushing’s syndrome) vs. 50% (MACS) vs. 14.4% (NFA). PSAI duration was up to 35 months. Early PSAI diagnosis was reflected by post-operative cortisol assay on day 1 (cut-off ≤ 5 µg/dL) and an ACTH (Cosyntropin) stimulation test (CST) (cortisol cut-off ≤ 14 µg/dL). Pre-operatory PSAI predictors: higher serum cortisol-DST (1 mg dexamethasone testing) and lower baseline plasma ACTH (not all studies agreed). Conclusions: A stratified strategy is encouraged following a unilateral adrenalectomy in MACS; PSAI is expected in almost half of patients, with a potential improvement of hypertension. Serum cortisol assays serve as most useful biomarker as pre-operatory PSAI predictor (after DST) and, potentially, in addition with baseline ACTH. Post-surgery basal cortisol measurement (± CST) helps the decision of glucocorticoids replacement since first post-operative day and during follow-up, serial testing at 3 months is a useful tool. Full article

Aim: To prepare two different kinds of wound care creams containing plant extracts and examine their effectiveness in comparison with a placebo cream and a commercial wound care cream, Madecassol^®. Methods: The two cream formulations were developed using the same placebo cream (PC) as base cream. One formulation contained balsam of oriental sweet gum, or Levant storax, named as Levant Storax Cream (LSC); the other contained oil of Calendula, extract of St. John’s Wort, aescin (an extract of horse chestnut), and freeze-dried powder from Aloe vera (L.) Burm. f. leaf juice, designated as Complex Cream (CC). In the characterization of the creams, organoleptic properties, pH, viscosity, size distribution, and zeta potential of oil globules were measured. Furthermore, the stability of the creams was assessed under different environmental conditions. In vitro studies were performed by using an excisional wound model in rats to assess the potential of the creams for stimulating wound healing. The efficacy of LSC and CC was compared with a commercial reference cream, Madecassol^® (M), and the placebo control. The study was also designed with a negative control group of rats that were not treated but handled the same way as the other treatment groups. The wound contraction rate, total skin thickness recovery, and results of histopathological parameter examinations were used to compare the effectiveness of the treatments. Results: The stability of formulated creams confirmed that they were stable for the duration of the study. In vivo studies showed that rats treated with LSC achieved the highest wound healing rates when compared with the other groups. A better response was recorded for the CC-treated population when compared to both control and placebo groups, but there was no significant difference seen in healing score between CC and M groups. Full article

Electrical restitution (ER) is a determinant of cardiac repolarization stability and can be measured as steady action potential (AP) duration (APD) at different pacing rates—the so-called dynamic restitution (ER_dyn) curve—or as APD changes after pre- or post-mature stimulations—the so-called standard restitution (ER_s1s2) curve. Short-term AP memory (M_s) has been described as the slope difference between the ER_dyn and ER_s1s2 curves, and represents the information stored in repolarization dynamics due to previous pacing conditions. Although previous studies have shown its dependence on ion currents and calcium cycling, a systematic picture of these features is lacking. By means of simulations with a human ventricular AP model, I show that APD restitution can be described under randomly changing pacing conditions (ER_rand) and M_s derived as the slope difference between ER_dyn and ER_rand. Thus measured, M_s values correlate with those measured using ER_s1s2. I investigate the effect on M_s of modulating the conductance of ion channels involved in AP repolarization, and of abolishing intracellular calcium transient. I show that M_s is chiefly determined by ER_dyn rather than ER_rand, and that interventions that shorten/prolong APD tend to decrease/increase M_s. Full article

Background: Androgenetic alopecia (AGA) is a prevalent condition characterized by progressive follicular miniaturization. Minoxidil topical treatment and finasteride oral treatment are the golden standard, but they are limited by local and systemic adverse effects. Combination therapies targeting both follicular stimulation and nutritional support may enhance clinical outcomes. Objective: To evaluate the efficacy of a combined topical and oral therapy compared to topical monotherapy in patients with AGA using trichoscopic and clinical parameters. Methods: In this open-label, prospective trial, 48 patients were assigned to receive either a topical spray alone (Group A) or in combination with oral capsules (Group B) for 3 months. Trichoscopic parameters were assessed at baseline and post-treatment. Paired and independent t-tests, along with Cohen’s d effect sizes, were used to evaluate intra- and inter-group changes. Results: Both groups demonstrated improvements in hair density, thickness, and anagen/telogen ratio. Group B exhibited significantly greater increases in total hair count and anagen conversion (p < 0.05). The effect sizes ranged from small to large, with the most pronounced changes observed in anagen/telogen ratio (Cohen’s d = 0.841) in males. Conclusions: The combination of topical and oral treatment led to greater trichologic improvements than topical therapy alone. While extrapolated projections at 6 and 12 months suggest continued benefit, future studies with longer duration and placebo controls are required to validate these findings. Full article

Background: Previously, we found that the pathological changes in the corpus spongiosum (CS) in hypospadias were mainly localized within smooth muscle tissue, presenting as a transformation from the contraction phenotype to synthesis. The role of low-intensity pulsed ultrasound (LIPUS) in regulating smooth muscle cells (SMCs) and angiogenesis has been confirmed. Objectives: To demonstrate the feasibility of regulating the phenotypic transformation of corpus spongiosum smooth muscle cells (CSSMCs) in hypospadias using LIPUS and to explore the potential mechanisms. Materials and Methods: The CSSMCs were extracted from CS in patients with proximal hypospadias. In vitro experiments were conducted to explore the appropriate LIPUS irradiation intensity and duration which could promote the phenotypic transformation of CSSMCs. A total of 71 patients with severe hypospadias were randomly divided into a control group and a LIPUS group to verify the in vivo transition effect of LIPUS. Consequently, the potential mechanisms by which LIPUS regulates the phenotypic transformation of CSSMCs were explored in vitro. Results: In vitro experiments showed that LIPUS with an intensity of 100 mW/cm² and a duration of 10 min could significantly increase the expression of contraction markers in CSSMCs and decrease the expression of synthesis markers. Moreover, LIPUS stimulation could alter the phenotype of CSSMCs in patients with proximal hypospadias. RNA sequencing results revealed that peroxisome proliferator-activated receptor gamma (PPAR-γ) significantly increased after LIPUS stimulation. Overexpression of PPAR-γ significantly increased the expression of contraction markers in CSSMCs, and the knockdown of PPAR-γ blocked this effect. Conclusions: LIPUS can regulate the transition of CSSMCs from a synthetic to a contractile phenotype in hypospadias. The PPAR-γ-mediated signaling pathway is a possible mechanism involved in this process. Full article

Introduction: Substance use disorders (SUDs) pose a significant public health challenge, with current treatments often exhibiting limited effectiveness and high relapse rates. Transcranial direct current stimulation (tDCS), a noninvasive neuromodulation technique that delivers low-intensity direct current via scalp electrodes, has shown promise in various psychiatric and neurological conditions. In SUDs, tDCS may help to modulate key neurocircuits involved in craving, executive control, and reward processing, potentially mitigating compulsive drug use. However, the precise neurobiological mechanisms by which tDCS exerts its therapeutic effects in SUDs remain only partly understood. This review addresses that gap by synthesizing evidence from clinical studies that used neuroimaging (fMRI, fNIRS, EEG) and blood-based biomarkers to elucidate tDCS’s mechanisms in treating SUDs. Methods: A targeted literature search identified articles published between 2008 and 2024 investigating tDCS interventions in alcohol, nicotine, opioid, and stimulant use disorders, focusing specifically on physiological and neurobiological assessments rather than purely behavioral outcomes. Studies were included if they employed either neuroimaging (fMRI, fNIRS, EEG) or blood tests (neurotrophic and neuroinflammatory markers) to investigate changes induced by single- or multi-session tDCS. Two reviewers screened titles/abstracts, conducted full-text assessments, and extracted key data on participant characteristics, tDCS protocols, neurobiological measures, and clinical outcomes. Results: Twenty-seven studies met the inclusion criteria. Across fMRI studies, tDCS—especially targeting the dorsolateral prefrontal cortex—consistently modulated large-scale network activity and connectivity in the default mode, salience, and executive control networks. Many of these changes correlated with subjective craving, attentional bias, or extended time to relapse. EEG-based investigations found that tDCS can alter event-related potentials (e.g., P3, N2, LPP) linked to inhibitory control and salience processing, often preceding or accompanying changes in craving. One fNIRS study revealed enhanced connectivity in prefrontal regions under active tDCS. At the same time, two blood-based investigations reported the partial normalization of neurotrophic (BDNF) and proinflammatory markers (TNF-α, IL-6) in participants receiving tDCS. Multi-session protocols were more apt to drive clinically meaningful neuroplastic changes than single-session interventions. Conclusions: Although significant questions remain regarding optimal stimulation parameters, sample heterogeneity, and the translation of acute neural shifts into lasting behavioral benefits, this research confirms that tDCS can induce detectable neurobiological effects in SUD populations. By reshaping activity across prefrontal and reward-related circuits, modulating electrophysiological indices, and altering relevant biomarkers, tDCS holds promise as a viable, mechanism-based adjunctive therapy for SUDs. Rigorous, large-scale studies with longer follow-up durations and attention to individual differences will be essential to establish how best to harness these neuromodulatory effects for durable clinical outcomes. Full article

Background and Aims: Vitamin D is currently well regarded for its pleiotropic effects on the immune system, stimulating an anti-inflammatory response and enhancing immune tolerance. Vitamin D deficiency is an established risk factor for multiple sclerosis (MS). Additionally, lower vitamin D serum levels are associated with worse disease outcomes. However, current randomized clinical trials provide conflicting evidence about the beneficial role of vitamin D on disease progression. Most studies have evaluated the effect of vitamin D supplementation on clinical and radiological activity, yet very few have examined the impact on brain atrophy. Methods: A 4-year observational, non-interventional study design was applied to evaluate the association between vitamin D supplementation and disease progression. Altogether, 132 relapsing–remitting multiple sclerosis patients were enrolled in the study (97 subjects in the group with vitamin D supplementation and 35 subjects in the group without supplementation). The analyzed groups were similar in terms of age, body mass index, sun exposure, comorbidities, nicotinism, duration of the disease, and current treatment. The number of relapses, Expanded Disability Status Scale assessments, and the number of new/enlarged T2-weighted lesions and gadolinium-enhancing lesions in magnetic resonance imagining analyses, as well as 25-hydroxyvitamin D serum levels, were assessed every 12 months of a 4-year follow-up, whereas brain atrophy was assessed at the baseline and after 36 months using two-dimensional measurements. Results: After 36 months, a significant increase in atrophy was observed in both groups; however, patients without vitamin D supplementation had a significantly higher increase in intercaudate distance, third ventricle width, and bicaudate ratio after 36 months of observation (p < 0.05). Vitamin D supplementation among the studied group did not affect other disease activity outcomes. Conclusions: Our study revealed an observed association between vitamin D supplementation and reduced brain atrophy in patients with MS. Randomized controlled trials are required to establish the impact of vitamin D supplementation on brain atrophy progression. Full article

This work presents a comparative analysis of the results of silicon carbide synthesis through the carbonization of Si (001) and Si (111) substrates in the temperature range 1130–1140 °C. The synthesis involved chemical vapor deposition utilizing thermally stimulated methane reduction in a hydrogen gas stream. The experiments employed an Oxford Nanofab Plasmalab System 100 apparatus on substrates from which the native oxide was removed according to established protocols. To minimize random experimental variations (e.g., deviations from set parameters), short synthesis durations of 3 and 5 min were analyzed. The resultant thin films underwent evaluations through several techniques, including X-ray photoelectron spectroscopy, X-ray diffractometry, optical emission spectroscopy with glow discharge, and transmission electron microscopy. A comparison and analysis were conducted between the results from both substrate orientations. Full article

Background/Objectives: European Brown Hare Syndrome (EBHS) is an acute and highly contagious viral disease of hares that causes considerable economic losses on wild and captive-reared hares. No preventive treatments are currently available to defeat the disease. Immunoprophylactic and biosafety measures could be applied to prevent EBHS only in captive-reared hares, where vaccination is proposed as an effective strategy. Due to the lack of a cellular substrate for virus growth, commercially available vaccines are autovaccines produced from inactivated liver suspensions of hares dead for EBHS. Therefore, using a recombinant vaccine based on VP60 major capsid protein seems a viable alternative to overcome such a problem. Methods: the 6xHis C-terminal tagged VP60 protein of EBHSV was expressed and produced in baculovirus, purified by affinity chromatography and the self-assembled recombinant (rEVP60-His₆) protein. To establish the protective properties of rEVP60-His₆-based VLPs, hares were immunised with 50 and 100 µg of VLPs and parenterally challenged with EBHSV. Results: all hares vaccinated with 100 µg of VLPs survived after the experimental infection, demonstrating the excellent protective ability of this prototype VLPs-based vaccine. Conclusions: self-assembled EBHSV rEVP60-His₆ protein was successfully produced following a rapid, simple, low-cost protocol. Although the protective efficacy of such VLPs were experimentally demonstrated, some key aspects remain to be clarified, including the duration of protection, the entity of the antibody response, and the ability to stimulate cell-mediated response. Last, an additional aspect to be evaluated is whether the use of an adjuvant can determine whether its presence improves the performance of the recombinant VLPs vaccine. Full article

Micro-fracturing technology is a key approach to enhancing the flow capacity of oil sands reservoirs and improving Steam-Assisted Gravity Drainage (SAGD) performance, whereas heterogeneity in reservoir physical properties significantly impacts stimulation effectiveness. This study systematically investigates the coupling mechanisms of asphaltene content, clay content, and heavy oil viscosity on micro-fracturing stimulation effectiveness, based on the oil sands reservoir in Block Zhong-18 of the Fengcheng Oilfield. By establishing an extended Drucker–Prager constitutive model, Kozeny–Poiseuille permeability model, and hydro-mechanical coupling numerical simulation, this study quantitatively reveals the controlling effects of reservoir properties on key rock parameters (e.g., elastic modulus, Poisson’s ratio, and permeability), integrating experimental data with literature review. The results demonstrate that increasing clay content significantly reduces reservoir permeability and stimulated volume, whereas elevated asphaltene content inhibits stimulation efficiency by weakening rock strength. Additionally, the thermal sensitivity of heavy oil viscosity indirectly affects geomechanical responses, with low-viscosity fluids under high-temperature conditions being more conducive to effective stimulation. Based on the quantitative relationship between cumulative injection volume and stimulation parameters, a classification-based optimization model for oil sands reservoir operations was developed, predicting over 70% reduction in preheating duration. This study provides both theoretical foundations and practical guidelines for micro-fracturing parameter design in complex oil sands reservoirs. Full article

Background/Objectives: We showed that a tailored strengthening intervention based on the size of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) in the affected hemisphere resulted in an improved affected arm function, regardless of stroke severity. Also, adding anodal transcranial direct stimulation (atDCS) during training did not alter the results as participants receiving real or sham stimulation showed similar gains. The goal of this study was to report on the changes in basic measures of corticomotor excitability in response to the intervention and to determine whether these changes were influenced by tDCS and correlated with those measured in arm function. Methods: The TMS measures consisted of the resting motor threshold (rMT), MEP amplitude at rest, and the silent period (SP) duration. Clinical outcomes included the Box and Block test (BBT) and grip strength (GS). Results: Post-intervention, regardless of atDCS (p > 0.62), no significant change in corticomotor excitability was noted (p > 0.15), as well as no association between the changes in TMS measures and arm function gains (p > 0.06). Conclusions: As observed for clinical measures, atDCS did not influence corticomotor excitability. The absence of an increase in the excitability of the affected hemisphere and important associations between changes in corticomotor excitability and clinical gains suggest that factors other than brain plasticity could mediate gains in arm function. Further investigations are required regarding the role of tDCS in stroke rehabilitation. Full article