Search Results (350)

Poor sleep quality and insomnia are increasingly linked to chronic inflammation and obesity-related metabolic dysfunction. Aerobic exercise is a promising non-pharmacological approach for enhancing sleep quality and reducing systemic inflammation; Therefore, we aim to systematically evaluate and quantify the effects of aerobic exercise interventions on subjective sleep quality, insomnia severity, and circulating markers (IL-6 and TNF-α) in adults. A systematic search was conducted in institutional databases (UNAM, UACJ) and PubMed to identify randomized controlled trials (RCTs) examining the effects of exercise on sleep and inflammation. Risk of bias was assessed using the Cochrane RoB2 tool. Meta-analyses were performed using RevMan 5.4 with random-effects models to estimate pooled mean differences (MD) and standardized mean differences (SMD), with 95% confidence intervals. Anaerobic protocols were excluded from the meta-analysis due to the insufficient availability of data. : Eleven RCTs met the inclusion criteria. Aerobic exercise showed a significant pooled effect on sleep outcomes (MD = −2.51; 95% CI: −4.80 to −0.23; p = 0.03). However, subgroup analyses for Pittsburgh Sleep Quality Index (PSQI) (MD = −2.27; p = 0.15) and Insomnia Severity Index (ISI) (MD = −2.98; p = 0.16) were not statistically significant. Two studies on IL-6 reported a non-significant reduction (SMD = −0.17; p = 0.66), with moderate heterogeneity. TNF-α results were also non-significant (SMD = 0.60; p = 0.29) with substantial variability. Our results showed that aerobic exercise may modestly improve sleep outcomes; however, current evidence does not support its effectiveness in reducing levels of IL-6 or TNF-α. Further well-controlled trials are needed to clarify its immunometabolic effects, particularly in populations with obesity or metabolic disorders. Full article

Shaking off the forgetfulness towards the methodological power of inosine-mediated error-prone PCR (epPCR), this study reintroduces an often-underappreciated method as a considerably powerful approach for generating aptamer libraries from a single decameric ATCG-repeat-oligonucleotide. The aim was to demonstrate that this simple way of creating sequence diversity was suitable for delivering functional starting libraries for a set of ten whole-cell-SELEX (Systematic Evolution of Ligands by Exponential Enrichment) processes. This epPCR method uses inosine to introduce targeted mutations, avoiding the need for commercial oligo pools or large-scale synthesis. We applied this method to a “universal aptamer” and subjected the three resulting libraries to two rounds of selection against ten diverse targets including probiotic and pathogenic bacteria (Gram-negative and -positive) as well as human cell lines. The enriched aptamers exhibited new binding specificities, demonstrating that the approach supports functional selection. Much like dusting off an old tool and finding it perfectly suited for a modern task, this work shows that revisiting established techniques can address current challenges in aptamer development. Our main finding is that epPCR provides a robust, cost-effective strategy for generating starting libraries and lowers the barrier for initiating successful SELEX campaigns. Full article

The impact of Environmental, Social, and Governance (ESG) scores on financial performance remains a subject of debate, as the literature reports mixed evidence regarding their effect on stock returns. This research aims to examine the relationship between ESG ratings and the change in ESG scores, or ESG Momentum, concerning both returns and risk of a large sample of stocks traded on U.S. exchanges. The study examined a sample of 3856 stocks traded on U.S. exchanges, considering 20 years of quarterly data from December 2002 to December 2022. We applied multi-factor models and tested them through pooled ordinary, fixed effects, and random effects panel regression methods. Our results show negative relationships between ESG scores and stock returns and between ESG Momentum and volatility. Contrarily, we find positive associations between ESG Momentum and returns and between ESG scores and volatility. Although high ESG scores are generally associated with lower long-term stock returns, an increase in a company’s ESG rating tends to translate into immediate positive returns and reduced risk. Accordingly, investors may benefit from strategies that focus on companies actively improving their ESG performance, while firms themselves stand to gain by signaling continuous advancement in ESG-related areas. Full article

Remote photoplethysmography (rPPG) enables non-contact physiological measurement for emotion recognition, yet the temporally sparse nature of emotional cardiovascular responses, intrinsic measurement noise, weak session-level labels, and subtle correlates of valence pose critical challenges. To address these issues, we propose a physiologically inspired deep learning framework comprising a Multi-scale Temporal Dynamics Encoder (MTDE) to capture autonomic nervous system dynamics across multiple timescales, an adaptive sparse α-Entmax attention mechanism to identify salient emotional segments amidst noisy signals, Gated Temporal Pooling for the robust aggregation of emotional features, and a structured three-phase curriculum learning strategy to systematically handle temporal sparsity, weak labels, and noise. Evaluated on the MAHNOB-HCI dataset (27 subjects and 527 sessions with a subject-mixed split), our temporal-only model achieved competitive performance in arousal recognition (66.04% accuracy; 61.97% weighted F1-score), surpassing prior CNN-LSTM baselines. However, lower performance in valence (62.26% accuracy) revealed inherent physiological limitations regarding a unimodal temporal cardiovascular analysis. These findings establish clear benchmarks for temporal-only rPPG emotion recognition and underscore the necessity of incorporating spatial or multimodal information to effectively capture nuanced emotional dimensions such as valence, guiding future research directions in affective computing. Full article

The emergence of generative artificial intelligence (GenAI) chatbots, such as ChatGPT, presents unique challenges and opportunities in an educational setting; however, they lack empirical evidence as teaching and learning tools. This study sought to investigate the impact of teacher-led AI-focused interventions in higher education institutions in different subject areas. Our aims were to support student engagement, explore the impact of AI tools for learning engagement and efficiency and skill development, and promote awareness of the strengths and limitations of GenAI tools in an educational context. This study was carried out with three distinct cohorts; Physiology, Initial Teacher Education, and Engineering, with year 3 and 4 undergraduate students. Each cohort received two 50 min teacher-led AI-focused interventions, including practical exercises relevant to the specific discipline. Following the interventions, students from all three cohorts received a common (optional) survey that quantitatively and qualitatively evaluated their experiences. Data from the three cohorts was pooled for analysis, with individual cohort analyses for Physiology, Initial Teacher Education, and Engineering provided. Our data indicates that teacher-led introductions to AI tools have positive effects on student engagement with peers, educators, and most notably the subject the students engage in. Students also reported very positive supportive effects with respect to learning engagement, learning efficiency, and critical thinking skills. Students found GenAI tools most useful for gathering knowledge and research purposes, while notable limitations included challenges associated with generating prompts and the accuracy of information. Students noted plagiarism as a significant ethical concern. Taken together, our data collected from diverse teaching and learning contexts support the use of teacher-led AI-focused interventions, specifically ChatGPT, in third-level education. Approaches like this are highly relevant to the university teaching of Physiology, Initial Teacher Education, and Engineering but are also more broadly applicable to third-level education in general to inform opportunities, limitations, and ethical considerations of GenAI in education. Full article

Background/Objectives: Previous research has established that beta-blockers significantly reduce all-cause mortality, cardiovascular mortality, and recurrent acute myocardial infarction (AMI) in patients with left ventricular dysfunction following AMI. However, their efficacy in patients with preserved left ventricular ejection fraction (LVEF) who undergo timely reperfusion and revascularization while receiving evidence-based medical management remains inconclusive. To address this uncertainty, we conducted a systematic review and meta-analysis to synthesize the available evidence on the impact of beta-blocker therapy in patients with AMI and preserved LVEF. Methods: A comprehensive literature search was conducted across PubMed, the Web of Science, and Scopus from their inception until November 2024. The search strategy incorporated three primary keywords and their corresponding Medical Subject Headings (MeSH) terms: “preserved”, “myocardial infarction”, and “beta-blocker”. Data analysis was performed using Review Manager 5.4 software. A random-effects model was applied to account for the study’s heterogeneity, while a fixed-effects model was utilized for homogeneous outcomes. Pooled odds ratios (ORs) and hazard ratios (HRs) were calculated for dichotomous outcomes, with a 95% confidence interval (CI) and a significance threshold of p < 0.05. Results: Beta-blocker therapy was significantly associated with a reduction in all-cause mortality compared to non-use, with an OR of 0.73 (95% CI: 0.61–0.88, p = 0.001) and an HR of 0.78 (95% CI: 0.67–0.91, p = 0.002). Similarly, beta-blocker administration was linked to a lower risk of cardiovascular mortality, demonstrating an OR of 0.76 (95% CI: 0.68–0.84, p < 0.00001) and an HR of 0.76 (95% CI: 0.59–0.99, p = 0.04). Furthermore, beta-blocker use was significantly correlated with a decreased risk of major adverse cardiovascular events (MACEs) compared to non-use, with an OR of 0.84 (95% CI: 0.75–0.95, p = 0.004) and an HR of 0.84 (95% CI: 0.71–0.99, p = 0.04). Conclusions: The current meta-analysis suggests a potential beneficial association between beta-blocker use and outcomes in patients with AMI and preserved LVEF, including lower rates of all-cause mortality, cardiovascular mortality, and MACEs; however, these findings should be interpreted with caution due to the observational nature of most included studies. Therefore, further randomized controlled trials (RCTs) are needed to confirm these findings, particularly in distinguishing outcomes among patients with and without heart failure. Full article

Background: The morphology of the occipital condyles (OCs) and foramen magnum (FM) is critical for neurosurgical planning and forensic identification. However, pooled reference values and the impact of study-level moderators on morphometric estimates remain underexplored. Methods: A systematic review and meta-analysis were conducted to estimate pooled morphometric values of the OCs and FM. Databases were searched for studies reporting relevant data in adult human subjects. A random-effects model was used to calculate pooled means and mean differences (MDs) by sex and side (left vs. right). Risk of bias and study quality were assessed. Subgroup analyses were conducted based on study design (osteological vs. imaging) and geographical region. Meta-CART (classification and regression trees) was used to explore moderator interactions and identify data-driven subgroups contributing to heterogeneity. Results: A total of 61 studies comprising 8010 adult skulls met the inclusion criteria. Substantial heterogeneity was observed across studies; most were assessed as having low-to-moderate methodological quality and a high risk of bias. The pooled mean values were as follows: OC length (OCL): 21.51 mm, OC width (OCW): 11.23 mm, OC thickness (OCT): 9.11 mm, FM length (FML): 35.02 mm, and FM width (FMW): 28.94 mm. Morphometric values reported in imaging-based studies were consistently lower than those from osteological studies. Evident sexual dimorphism was identified, with males exhibiting larger dimensions than females. The most pronounced sex-based mean differences (MDs)—approximately 2 mm—were found in OCL, FML, and FMW. In contrast, differences in OCT and OCW were under 1 mm. No significant side-related asymmetries were observed overall. Subgroup analysis revealed that sex-related MDs were more prominent in imaging studies, particularly for the right OCL and OCW. Meta-CART analysis identified study design as the strongest moderator for OCL, OCW, and FML. Sexual dimorphism was more pronounced in imaging studies but statistically insignificant in osteological samples. Furthermore, sex emerged as a stronger predictor for OCL than OCW, while geographical region had a greater impact on OCW. For OCT, geographical region was the main influencing factor, whereas sex was the primary moderator for FMW. Conclusions: OC and FM morphometry exhibit substantial heterogeneity across studies. Imaging-based methods more effectively detect sex-related differences, underscoring their utility in forensic identification and neurosurgical planning. These findings emphasize the need for more standardized, high-quality morphometric research to support population-specific anatomical reference data. Full article

Background/Objectives: The workplace represents an ideal context for applying policies to foster a healthy lifestyle, guaranteeing advantages both to the individual and the company. Nevertheless, motivation to change one’s lifestyle remains an issue. This study aimed to determine subjects’ most valued intentions toward lifestyle changes and the target actions to improve lifestyles that they would be willing to invest in economically, information which might help design effective intervention programs. Methods: Classification trees were applied to 2762 employees/ex-employees (55.09 ± 13.80 years; 1107 females and 1655 males) of several Italian companies who voluntarily filled out an anonymous questionnaire on lifestyles (inquiring about, e.g., exercise, nutrition, smoking, and stress) to unveil specific subject typologies that are more likely associated with, e.g., manifesting a specific intention toward lifestyle changes and choosing the two most popular target actions resulting from the survey. Results: The main lifestyle aspect that respondents desired to improve was to become more physically active, and the most preferred tools chosen to improve their lifestyle were the possibility of having a medical specialist consultant to prescribe a tailored lifestyle program and buying a gym/swimming pool membership. Conclusions: This observational study might help tailor worksite health promotion and insurance services offered to employees, initiatives that may play an important role in fostering health/well-being and preventing chronic diseases in the more general population, especially in healthy or young subjects who are more prone to change their behavior if immediate benefits are seen instead of only advantages in the future. Full article

Background: The objective of the present systematic study was to analyze and characterize the gastric vein (GV) variations to understand their significance within clinical contexts, particularly in gastric and liver surgeries and managing conditions associated with the portal vein system. Methods: We conducted a systematic review, examining various databases, including Medline, Scopus, Web of Science, Google Scholar, CINAHL, and EMBASE, up to April 2025. Two independent authors conducted the literature search, selected pertinent studies, and extracted relevant data. The methodological quality of the studies was evaluated utilizing the Assessment Tool for Anatomical Studies (AQUA). The pooled prevalence was estimated through the application of a random effects model. Results: Among the 279 articles reviewed, 11 studies were ultimately incorporated into the systematic analysis, encompassing 47,993 subjects. The pooled prevalence of GV variants was determined to be 8.32%, revealing considerable heterogeneity (I² = 98.92%). A subgroup analysis showed a greater prevalence of GV variants in diagnostic imaging studies than in cadaveric studies, with a higher frequency observed in males than in females. Conclusions: The morphological variability of the GVs holds clinical significance, as it may significantly impact the management of abdominal disorders, particularly during surgical and endovascular interventions. This study emphasizes the necessity of thorough preoperative evaluations to identify these variations, thereby minimizing surgical complications and enhancing therapeutic outcomes for patients suffering from gastric and portal vein system disorders. Integrating advanced imaging techniques into clinical practice may facilitate improved surgical and therapeutic planning. Full article

Electrocardiogram (ECG) interpretation using deep learning models holds immense potential for improving cardiac diagnosis. However, existing models often suffer from overconfident predictions and lack the capability to directly quantify uncertainty, leading to unreliable clinical guidance. To address this challenge, we propose a model for uncertainty-aware ECG interpretation. The model employs a deep convolutional architecture with max-pooling residual modules to capture both local and global spatiotemporal features from raw ECG signals. The architectural design respects the symmetry inherent in ECG waveforms—such as periodicity and morphological consistency across cardiac cycles—enabling the network to extract clinically relevant features more effectively. Then, unlike conventional models that rely on softmax-based probability outputs, our approach parameterizes class distributions using the Dirichlet distribution, while Subjective Logic translates these parameters into interpretable belief masses and uncertainty scores. We evaluate the model on the PhysioNet Challenge 2017 dataset, our model achieves an accuracy of 86.12%, an F1 score of 83.14%, a Precision-Recall Area Under the Curve (PR-AUC) of 85.25%, and a Receiver Operating Characteristic Area Under the Curve (ROC-AUC) of 92.87%—outperforming baseline models in three out of four metrics. Critically, the model reduces overconfidence to 0.59% (compared to 12–22% in softmax-based baselines), aligning prediction confidence with true accuracy. By progressively increasing the uncertainty threshold u, the model dynamically filters low-confidence predictions, leading to consistently improved performance—reaching up to 93.59% accuracy, 93.22% F1 score, 89.17% PR-AUC, and 95.10% ROC-AUC at u = 0.1. These results validate the model’s capacity for reliable ECG interpretation while leveraging physiological signal symmetry for enhanced feature extraction. Full article

Background/Objectives: The objective of this study was to expose the ability of neurophysiotherapeutic management to reduce spasticity through a modified Ashworth Scale. Methods: The sample, consisting of 102 subjects divided into control and study groups, was selected from an initial pool of N = 1007 patients diagnosed with stroke by a neurosurgeon that was later confirmed with imaging (MRI, CT). The study scheme included statistical differentiation between the study and control groups before and after applying specific rehabilitation programs and statistical differentiation within these groups before and after their rehabilitation procedures. Results: The results of this study revealed statistically significant improvements in reducing spasticity, as assessed by the Ashworth scale, within the group that participated in the neurorehabilitation program. It also confirmed that using neurophysiological methods is a highly effective approach to managing spasticity in post-stroke patients. Conclusions: Using neurophysiological methods in the standard physiotherapy treatment of spasticity is very effective for managing post-stroke spasticity. Full article

This study aimed to investigate the effects of exercise on aerobic capacity and quality of life (QOL) in heart failure (HF) patients and to identify the optimal exercise prescription for improving aerobic capacity and QOL. A comprehensive search was conducted in Embase, PubMed, Cochrane Library, Web of Science, and Scopus covering data published up to 9 October 2024. The Population, Intervention, Comparison, Outcome (PICO) framework was used to define the inclusion. (a) Population: patients with HF; (b) Intervention: randomized controlled trials (RCTs) with subjects randomly assigned to either the intervention or control group; (c) Comparison: studies that measured peak oxygen uptake (VO₂peak), maximal oxygen uptake (VO₂max), or the Minnesota Living with Heart Failure Questionnaire (MLHFQ) at baseline and compared results post-intervention; (d) Outcome: the primary outcomes were aerobic capacity and QOL. The Physiotherapy Evidence Database (PEDro) scale and the Cochrane Risk of Bias 2 (RoB-2) tool were used to assess the quality of the included studies. Weighted mean difference (WMD), standardized mean difference (SMD), and 95% confidence interval were used to pool data. A total of 47 studies met the inclusion criteria. Exercise significantly improved aerobic capacity (WMD, 2.85, p < 0.00001) and QOL (SMD, −0.79, p < 0.00001) in HF patients. Subgroup analyses indicated that combined exercise, session duration ≥ 60 min, ≥3 sessions per week, ≥180 min per week, and supervised exercise showed more significant improvements in aerobic capacity and QOL. Additionally, exercise had greater benefits in middle-aged patients. To improve aerobic capacity and QOL, the optimal exercise prescription for HF patients involves engaging in supervised combined exercise at least three times per week, with each session lasting at least 60 min, to achieve a total weekly duration of 180 min. These recommendations are particularly relevant for middle-aged patients, who may experience greater benefits from exercise interventions. The protocol has been registered on PROSPERO with the registration number CRD420250632915. Full article

Background/Objectives: Adequate vitamin D levels are critical for overall health, yet vitamin D deficiency remains prevalent. This study aims to evaluate the efficacy and safety of a standardized weekly supplementation regimen of 100 μg calcifediol for patients with varying degrees of vitamin D deficiency. Methods: A post hoc pool analysis was conducted from a randomized, double-blind, placebo-controlled, multicenter, two-cohort trial. Cohort 1 included vitamin D mild deficiency patients (25(OH)D levels > 10 < 20 ng/mL) and Cohort 2 severe deficiency patients (25(OH)D levels ≤ 10 ng/mL). As both had placebo and weekly calcifediol 100 μg arms (ratio 1:2), a pooled analysis of safety and efficacy was conducted. The primary outcome was the percentage of subjects achieving 25(OH)D levels ≥ 20 ng/mL and/or ≥30 ng/mL at various time points. Results: A total of 401 participants across both cohorts were included in the analysis, 130 who received a placebo and 271 calcifediol 100 µg weekly. By week 52, 94.5% of individuals in the calcifediol group achieved 25(OH)D levels ≥ 20 ng/mL, compared to 25.3% in the placebo group (p < 0.0001). At this same week, 80.5% of subjects in the calcifediol group, but none in the placebo group (p < 0.0001), had 25(OH)D levels ≥ 30 ng/mL. The mean 25(OH)D level plateaued around 40.7 ng/mL from weeks 16 to 52. The frequency of treatment-emergent adverse events was similar in both groups, placebo and calcifediol. Conclusions: Weekly supplementation of 100 μg calcifediol effectively restores vitamin D levels in individuals with both mild and severe deficiencies, demonstrating a favourable safety profile. Full article

Anisotropic microstructures and wear resistance are caused by large thermal gradients during selective laser melting (SLM). Investigating the wear resistance in different planes of SLM specimens is crucial. Hence, the effect of heat treatment on the anisotropy of the microstructure, density, microhardness, and wear resistance of SLM 316L stainless steel was studied. Specimens subjected to solution + aging treatment exhibited γ austenite and α ferrite phases with lower microstrain, as determined via X-ray diffraction (XRD) analysis. Microstructure observations demonstrated that SLM 316L appears as intersecting melt pools on the XOY plane and fish scale-like melt pools on the XOZ plane. After heat treatment, the melt boundaries disappeared, carbides (M₂₃C₆) precipitated at grain boundaries and within the grains, and the microstructures coarsened and became more uniform. The microhardness and wear resistance of the XOY plane were shown to be superior to those of the XOZ plane, and the microhardness decreased following heat treatment. Compared with SLM 316L, the microhardness of the XOY and XOZ planes of the specimen subjected to solution + aging treatment decreased by 5.96% and 4.98%. The friction and wear test results revealed that the specimen after solution + aging treatment had the lowest friction coefficient and the smallest wear rate. The wear rates of specimens from the XOY and XOZ planes after solution + aging treatment were 21.1% and 27.1% lower than that of SLM 316L, exhibiting the best wear resistance. Full article

Background and Objectives. Our recent systematic review and meta-analysis of all studies on meditation as treatment for PTSD (61 studies) found a moderate effect size of Hedges’s g = −0.67 for post-minus-pre change in symptom scores. Separate tests of the four meditation categories found a large effect size of g = −1.13 for the Transcendental Meditation (TM) technique that is significantly greater than for each other category. The present follow-up used a different method, calculating effects relative to internal controls, to better characterize the effects of this meditation technique. Materials and Methods. Our study followed Prisma guidelines. Major databases, research anthologies, and bibliographies were searched for studies that used TM for treating PTSD, all military and civilian populations, and all age groups. Results. The searches located 15 controlled trials on TM that met the inclusion criteria (longitudinal and reporting sufficient statistics to calculate effect sizes), 1248 subjects total, mean age 40.5 years (range 20.6 to 54.4 years), and 46.9% males (range 0% to 100%). Using the random effects model, the pooled effect across all studies of TM compared to other treatments was g = −1.01, 95% CI = −1.29 to −0.74, p < 0.000000001. One-study removed analysis found that no study reduced the pooled effect to less than −1.0. Funnel plots indicated no risk of bias. TM was non-inferior to prolonged exposure therapy, p = 0.0001, and it worked significantly faster (p = 0.04 at week six). Conclusions. TM produced clinically meaningful reductions in PTSD for civilian and military personnel, young and older adults, and for both men and women. We recommend phase-III multisite studies comparing TM with known first-line treatments for PTSD. Full article