Search Results (1,883)

Background/Objectives: Lower limb amputation (LLA) negatively affects the physical and psychological health of individuals, leading to a lower quality of life and sedentary lifestyle. The objective of this scoping review is to search for evidence regarding physical activity interventions in individuals with LLA, investigating improvements in specific outcomes related to quality of life and performance. Methods: PRISMA guidelines—extension for scoping reviews—were used to structure the study. The research was conducted between 26 July 2023 and 30 September 2023; it was structured by defining two PICO questions (P = amputation, I = physical exercise, O1 = quality of life, and O2 = performance) through Pubmed, Cochrane, and Pedro databases. The study included subjects with LLA of any etiology, in prosthetic or pre-prosthetic phase, practicing non-competitive physical activity. The results were then subjected to both qualitative and quantitative analysis. Results: Of the 615 studies identified, 18 were included in the review. They consisted of 6 systematic reviews (SR), 5 RCTs, 4 case–control studies, 1 case report (CR), and 2 cross-sectional (CS). Physical activity (PA) interventions were extremely heterogeneous and were, therefore, categorized into 6 modalities: surveys were the most reported strategies (57%), followed by personalized training (23%), strength training (13%), endurance training (13%), combined training (2%), and gait training (5%). Due to the heterogeneity of the studies, the variety of interventions proposed and the different outcomes registered, there is no evidence that one approach is more effective than another, while each group showed benefits on different specific outcomes. In total, five outcome categories were identified: quality of life was the most frequently analysed (42%), followed by cardiovascular fitness (20%), muscular fitness (14%), gait parameters (13%), functionality and disability (11%). Conclusions: PA represents a valuable strategy for improving performance and quality of life in individuals with LLA, offering a variety of interventions. Although there is no evidence that one strategy is better than the others, each activity has proven to be effective on specific outcomes, therefore, the choice must depend on the patient’s necessities. The preferred option should be the personalization of the training according to individual needs, coupled with long-term planning and remote monitoring. Creating meeting places and supporting occasions for sports activities could be a valid option. Further research could help to clarify the benefits of such interventions and enhance the understanding of how to optimize the management of LLA patients. Full article

Background/Objectives: Biofeedback therapy is a technique that trains individuals to change their physiological activity for the purpose of improving their health. Despite its proven efficacy in 70 to 80% of patients in clinical trials, biofeedback is significantly underutilised in clinical practice worldwide. This scoping review aims to synthesise the current evidence on clinicians’ attitudes, knowledge, and experiences with anorectal biofeedback, highlight gaps in the existing literature, and guide future research directions. These findings are compared with new local Australian data. Methods: Systematic searches were conducted on five electronic databases including MEDLINE, Embase, CINAHL, Scopus, and APA PsycInfo. Eight articles were retrieved from title and abstract, full text, and reference list screening using Covidence. Results: The scoping review revealed substantial heterogeneity in the clinical indications for biofeedback. Both the scoping review and Australian study reported that over half of clinicians could not accurately define biofeedback or report familiarity with the technique, and that barriers to the implementation of biofeedback included long wait times, lack of trained personnel, and limited access to equipment. In the Australian study, proposed ways to improve the uptake of biofeedback included education of health professionals, government funding, and increased access to facilities. Conclusions: This scoping review and Australian cross-sectional study demonstrate that clinicians have limited knowledge of biofeedback and that a complex interplay between systemic barriers to access hinder its implementation. Further research into clinicians’ attitudes towards biofeedback should be conducted in more countries to build a more robust body of evidence. Full article

Smartphones are ubiquitous and continuously carried high-performance devices equipped with speech recognition capabilities that enable the analysis of surrounding conversations. When leveraged for public purposes, networks of smartphones can function as a large-scale sensing infrastructure capable of detecting and reporting early signs of serious crimes or terrorist activities. This paper proposes the concept of “Smartphone as Societal Safety Guard” as an approach to substantially enhancing public safety through relatively low additional cost and the combination of existing technologies (first pillar). At the same time, this concept entails serious risks of privacy infringement, as exemplified by the potential introduction of always-on eavesdropping through operating system updates. The originality of this study lies in redefining smartphones not merely as personal tools but as public safety infrastructure within democratic societies, and in systematizing the conditions for their social acceptability from the perspective of institutional design. This research presents a reference architecture and a regulatory framework, and organizes six key challenges that must be addressed to reconcile public safety with privacy protection: external attacks, mitigation of privacy information, false positives, expansion of the scope of application, discriminatory use, and misuse by authorized insiders. In particular, misuse by authorized insiders is positioned as the core challenge. As a necessary condition for acceptance in democratic societies (second pillar), this paper proposes a privacy-protective infrastructure centered on the Verifiable Record of AI Output (VRAIO). By combining on-device two-stage urgency classification with the review and recording of AI outputs by independent third-party entities, the proposed framework aims to provide a mechanism that can ensure, as a design requirement, that information unrelated to emergencies is not released outside the device. In summary, this paper presents a design framework for reconciling enhanced public safety with the protection of privacy. Full article

In today’s multicultural and interconnected societies, as schools and classrooms become more diverse, promoting inclusive attitudes and supportive learning environments is a central challenge for education systems. Present systematic review synthesizes evidence on the effectiveness of peer programs—including mentoring, tutoring, teaching, and peer support initiatives—in enhancing inclusivity within schools. A systematic search was conducted in Web of Science, Scopus, and ERIC for studies published between 2015 and 2024, following PRISMA 2020 guidelines. No review protocol was registered. Fifteen peer-reviewed articles were included based on criteria such as implementation in general education from grade 1 to grade 12 and a clear goal of improving community, social interactions, school climate, students’ attitudes, acceptance of differences, or overall inclusivity. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT), with most studies meeting all criteria. Findings demonstrate that peer programs are generally associated with improvements in inclusive attitudes, empathy, and community engagement, contributing to improved school climate and student well-being, while also supporting academic goals. Future research should expand the geographic scope of peer program studies and incorporate longitudinal designs to better understand their sustained impact across diverse educational contexts. Full article

Respiratory syncytial virus (RSV) is among leading global causes of lower respiratory tract infections, yet data from Russia and other states of the Former Soviet Union (FSU) remain fragmented and structurally inconsistent. This systematic review aims to map and synthesize existing evidence on RSV epidemiology and genotypic distribution across the FSU. Published studies from eLIBRARY and PubMed databases queried for RSV prevalence data, together with public health surveillance datasets, were used to summarize RSV prevalence research across eight FSU countries. Random-effects meta-analysis across age strata showed high prevalence in children before 6 (21%) and a progressive decline with age, which is in agreement with global data. Prevalence estimates showed a high degree of variability partially explained by study scope and clinical presentation. We observed COVID-19-related seasonal disruptions of RSV seasonality, followed by gradual post-pandemic stabilization. Genotypic data reflects global trends with two cosmopolitan clades, A.D and B.D, and their descendants, dominating in the region. The review is limited by uneven geographical and temporal coverage, and scarce data on adults. The review provides the first integrated summary of RSV epidemiology across the FSU and underscores the need for expanded regional surveillance and genomic reporting. Full article

Background/objectives: Cannabidiol (CBD) is a non-psychoactive constituent of Cannabis sativa, which has potential skeletal benefits through modulation of bone cell function and inflammatory signalling. However, evidence of its effects and mechanisms in bone health remains fragmented. This scoping review summarised the current findings on the impact of CBD on bone outcomes and its mechanisms of action. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted in October 2025 for original studies published in English, with the primary objective of examining the effects of CBD on bone health, regardless of study design. After applying inclusion and exclusion criteria, 24 primary studies were included. Data on model design, CBD formulation, treatment parameters, bone-related outcomes, and proposed mechanisms were extracted and analysed descriptively. Results: Among the studies included, eleven demonstrated beneficial effects of CBD on bone formation, mineralisation, callus quality, or strength; eleven showed mixed outcomes; and two demonstrated no apparent benefit. Previous studies have shown that CBD suppresses bone resorption by reducing osteoclast differentiation and activity while promoting osteoblast proliferation and matrix deposition. Mechanistically, CBD’s effects involve activation of cannabinoid receptor 2, modulation of the receptor activator of nuclear factor-κB ligand/osteoprotegerin pathway, and regulation of osteoblastogenic and osteoclastogenic signalling through bone morphogenetic protein, Wnt, mitogen-activated protein kinase, nuclear factor-κB, and peroxisome proliferator-activated receptor signalling. The anti-inflammatory and antioxidant actions of CBD further contribute to a favourable bone microenvironment. Conclusions: Preclinical evidence suggests that CBD has a bone-protective role through multifaceted pathways that enhance osteoblast function and suppress osteoclast activity. Nevertheless, robust human trials are necessary to confirm its efficacy, determine its optimal dosing, and clarify its long-term safety. Full article

Background/Objectives: The purpose of this umbrella review was to assess the risk of bias and the methodological and reporting quality of systematic reviews that evaluated the effects of thoracic spine manipulation (TSM) on individuals with mechanical neck pain. Methods: To be included, publications needed to be systematic reviews including studies with participants with neck pain >18 years old; at least two groups where the experimental intervention was TSM; assessed pain and/or function; and were published in English. Reviews limited to narrative, scoping, or retrospective studies, or those with cervical radiculopathy, were excluded. An electronic search was conducted in May 2025 using PubMed, CINAHL (EBSCO Host), and the Cochrane Library to identify relevant articles from inception to May 2025. Quality and risk of bias were assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020), and Risk of Bias in Systematic Reviews (ROBIS). Findings were summarized narratively and graphically. Results: Seven reviews (27 unique studies; 1394 participants, aged 18–62 years) met the inclusion criteria. Some evidence supported TSM for short-term improvement in neck pain, but confidence in results was low to critically low based on the AMSTAR 2 results. Four reviews had a high overall risk of bias, and three had a low risk. Reporting compliance varied widely (0–100%). Conclusions: While all the included systematic reviews suggested that TSM is a viable short-term option for individuals with neck pain, the overall confidence in these results ranged from low to critically low, making it difficult to draw firm conclusions about the true benefit of TSM in clinical practice. Registered prospectively in PROSPERO (CRD420251034330). Full article

The digital transformation of electric power systems into smart grids has significantly expanded the cybersecurity risk landscape of the energy sector. While advanced sensing, communication, automation, and data-driven control improve efficiency, flexibility, and renewable energy integration, they also introduce complex cyber–physical interdependencies and new vulnerabilities across interconnected technical and organisational domains. This study adopts a scoping review methodology in accordance with PRISMA-ScR to systematically analyse smart grid cybersecurity from an architecture-aware and resilience-oriented perspective. Peer-reviewed scientific literature and authoritative institutional sources are synthesised to examine modern smart grid architectures, key security challenges, major cyberthreats, and documented real-world cyber incidents affecting energy infrastructure up to 2025. The review systematically links architectural characteristics such as field devices, communication networks, software platforms, data pipelines, and externally operated services to specific threat mechanisms and observed attack patterns, illustrating how cyber risk propagates across interconnected grid components. The findings show that cybersecurity challenges in smart grids arise not only from technical vulnerabilities but also from architectural dependencies, software supply chains, operational constraints, and cross-sector coupling. Based on the analysis of historical incidents and emerging research, the study identifies key defensive strategies, including zero-trust architectures, advanced monitoring and anomaly detection, secure software lifecycle management, digital twins for cyber–physical testing, and cyber-resilient grid design. The review concludes that cybersecurity in smart grids should be treated as a systemic and persistent condition, requiring resilience-oriented approaches that prioritise detection, containment, recovery, and safe operation under adverse conditions. Full article

Background: Acquired brain injury (ABI) affects manual dexterity (MD) and cognitive functions, limiting daily activity performance. Occupational therapy aims to improve functionality and quality of life. Objective: To examine and describe the available evidence on the impact of MD training on cognitive processes and functional performance in adults with stroke, as well as to identify the most commonly used assessment tools and intervention techniques. Methods: Scoping review. A systematic literature search was conducted in PubMed and Scopus to identify experimental studies from the last 10 years involving adults with ABI who participated in interventions targeting upper-limb, MD, and cognitive function. A three-phase screening was carried out by two authors with duplicates removed using Zotero version 7.0. Results: Ten articles published between 2016 and 2023 were included. The most frequent interventions involved robotics and virtual reality. Eight studies were conducted by occupational therapists or included occupational therapy involvement, while two were conducted by physiotherapists. Training MD and upper-limb motor skills led to improvements in attention, memory, and executive functions. Conclusions: Findings support combined motor–cognitive interventions carried out by occupational therapists or physiotherapists to optimize rehabilitation outcomes, although further research is needed to strengthen the evidence. Full article

Non-digital traditional games such as board and card formats are increasingly recognised as valuable tools for active learning in higher education. These analogue approaches promote engagement, collaboration, and conceptual understanding through embodied and social interaction. This scoping review mapped research on the use of traditional, non-digital games as active learning strategies in tertiary education and examined whether the rise in generative artificial intelligence (GenAI) since 2022 has influenced their pedagogical role. Following the PRISMA-ScR framework, a systematic search of Scopus (October 2025) identified 2480 records; after screening, 26 studies met all inclusion criteria (explicitly using card and/or board games). Whilst this was a scoping, not a systematic review, some bias due to using only one database and evidence could have missed some studies. Results analysed the use and impacts of the games and whether AI was a specific driver in its use. Studies spanned STEM, business, health, and social sciences, with board and card games most frequently employed to support engagement, understanding, and collaboration. Most reported positive learning outcomes. Post-2023 publications suggest renewed interest in analogue pedagogies as authentic, human-centred responses to AI-mediated education. While none directly investigated GenAI, its emergence appears to have acted as an indirect catalyst, highlighting the continuing importance of tactile, cooperative learning experiences. Analogue games therefore remain a resilient, adaptable form of active learning that complements technological innovation and sustains the human dimensions of higher-education practice. Full article

Purpose: The effectiveness and feasibility of cancer prehabilitation have been well-validated in surgical settings, but its role in non-surgical treatments, such as chemotherapy and radiotherapy (RT), remains unclear. This scoping review aims to systematically explore the existing literature on prehabilitation programs for non-surgical cancer treatments. Methods: Following the scoping review methodology developed by the Joanna Briggs Institute, seven databases were systematically searched from their inception to October 2024 for peer-reviewed studies involving prehabilitation prior to non-surgical treatment. Data were extracted and reported adhering to PRISMA-ScR guidelines, using a convergent synthesis design to present qualitative and quantitative evidence. No formal risk-of-bias or quality appraisal was conducted. Results: Of 22,122 studies, 39 met the inclusion criteria, yielding a combined sample of 6073 patients and thirty-four unique interventions. Sample sizes ranged from 9 to 1992, with randomized control trials being the most common (16). Head and neck cancer was the most frequently studied, followed by breast, esophageal/gastric, and lung cancer. Of the included interventions, 23 were unimodal and 16 were multimodal. Exercise was the most common component (30), with nutrition (13), psychosocial (10), and educational (8) components also present. Most efficacy studies (84%) reported improved outcomes and nearly all (93%) feasibility studies found prehabilitation acceptable and implementable. Conclusions: This review highlights a growing body of literature examining prehabilitation prior to chemotherapy or RT in adult cancer patients, with studies suggesting potential benefits and feasibility. However, long-term trials, especially in diverse cancers and older populations, remain scarce. Our results provide insight into future implementation, evaluation of outcomes, and directions for future prehabilitation research. Full article

Background and Objectives: Bladder cancer (BC) represents a significant global health burden, ranking as the tenth most commonly diagnosed malignancy worldwide, with an incidence rate of 5.6 per 100,000 person-years annually. The research team aimed to summarize evidence on specialized nursing-led interventions for bladder cancer management across the disease continuum. Materials and Methods: This scoping review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology to search four databases from January 2018 to November 2025. Results: This concise but informative scoping review of 20 studies revealed substantial clinical and patient-reported benefits from specialized nursing interventions. Enhanced recovery after surgery (ERAS) protocols incorporating structured nursing care demonstrated a 35% reduction in postoperative complications. Integrated nursing interventions during postoperative intravesical therapy significantly improved patient satisfaction, treatment compliance, and self-efficacy while reducing anxiety and depression. Digital health platforms, including internet-based and mobile applications, proved effective in reducing caregiver burden, enhancing disease knowledge, and improving coping strategies. Preoperative stoma education and postoperative ostomy care management significantly improved self-efficacy, stoma care knowledge, and overall health-related quality of life. Psychosocial interventions, including cognitive behavioral therapy and mindfulness-based approaches, demonstrated significant improvements in quality of life and reductions in fear of recurrence, depression, and anxiety. However, a critical evidence gap exists regarding bladder cancer-specific mental health interventions. Conclusions: Specialized nursing-led care plays a critical role in strengthening clinical and assistive practice in bladder cancer. Evidence from this scoping review shows that nursing-led interventions significantly improve clinical outcomes, patient satisfaction, symptom management, and quality of life across all phases of bladder cancer care while reducing caregiver burden and enhancing psychological well-being for both patients and families, reinforcing the value of integrating specialized nursing roles into routine bladder cancer management. Full article

Background: In this new era, marked by increasing environmental concerns, geopolitical crises, and global disruptions, traditional efficiency-focused supply chains have shown significant vulnerabilities. As a result, the shift toward new strategies to maintain sustainability has become more crucial. Meanwhile, to withstand disruptions, supply chains must develop robustness and resilience. More recently, attention has turned toward viability to enable sustainable supply chain operations over the long term under uncertainty. Methods: This study conducts a systematic literature review (SLR) to explore the links between green supply chain management (GSCM), supply chain resilience (SCRES), and supply chain viability (SCV), guided by the PRISMA framework and structured using the PICO approach as a high-level scoping tool. We reviewed 70 peer-reviewed journal articles published between 2010 and 2024. Result: The study identified widely adopted green practices and explored their impact on supply chain resilience and sustainable performance. Many studies address GSCM, SCRES, and SCV either separately or in pairs, but few integrate all three dimensions. GSCM fosters resilience, and when the three aspects are combined, they serve as the cornerstones of viable supply chains. However, their potential contribution to supply chain viability is still unexplored. Conclusions: These insights provide useful guidance for creating supply chains that balance long-term continuity, disruption-readiness, and environmental goals. They also suggest a future research agenda to better align these three priorities. Full article

This scoping review aims to synthesize peer-reviewed literature exploring quality of life (QoL) for individuals with age-related hearing loss (ARHL), age-related central auditory processing (ARCAP) deficits, and age-related cognitive decline. A growing body of research has identified ARHL as a risk factor for the development of dementia, highlighting the connection between the sensory and cognitive systems. As the aging population continues to grow, examining comorbid age-related hearing and cognitive decline is especially relevant. These conditions may have potential negative consequences on the daily functioning, social participation, mental health, and overall wellbeing of older adults. A systematic search of peer-reviewed literature was conducted across multiple databases, adhering to the PRISMA guidelines for scoping reviews. Studies that focused on the impact of ARHL, ARCAP deficits, and/or related cognitive deficits on QoL were included in the present review. Key data extracted included QoL measures categorized into the ICF framework, the effects of hearing loss intervention on QoL, and the impact of ARHL on QoL for aging individuals. This review summarizes the reported effects that ARHL, ARCAP, and/or cognitive decline have on older adults, and discusses the clinical and practical implications for managing clients with these conditions. In addition to preventative measures and deficit management, maintenance of life participation, social engagement, and overall wellbeing should be considered when caring for aging adults with hearing and/or cognitive impairment. Full article

Hereditary ataxias are a heterogeneous group of disorders with overlapping clinical presentations but diverse genetic and molecular etiologies. Biomarkers are increasingly essential to improve diagnosis, refine prognosis, and accelerate the development of targeted therapies. Following PRISMA-ScR guidelines, we conducted a scoping review of PubMed and complementary sources (2010–2025) to map and describe the current landscape of genetic, imaging, fluid, electrophysiological, and digital biomarkers across the most prevalent hereditary ataxias, including SCA1, SCA2, SCA3, SCA6, SCA7, SCA17, SCA27B, dentatorubral–pallidoluysian atrophy (DRPLA), Friedreich’s ataxia (FRDA), RFC1-related ataxia (CANVAS), SPG7, and fragile X-associated tremor/ataxia syndrome (FXTAS). Eligible evidence encompassed observational cohorts, clinical trials, case series, and case reports providing primary biomarker data, with the objective of characterizing evidence breadth and identifying knowledge gaps rather than assessing comparative effectiveness. Across modalities, converging evidence highlights subtype-specific biomarker signatures. MRI volumetry, DTI, and FDG-PET map characteristic neurodegeneration patterns. Fluid biomarkers such as neurofilament light chain are informative across several SCAs and FRDA, while frataxin levels constitute robust endpoints in FRDA trials. Pathology-specific biomarkers such as ataxin-3 are advancing as tools for target engagement and may generalize to future gene-lowering strategies. Electrophysiological and oculographic measures show sensitivity for early disease detection, and wearable technologies are emerging as scalable tools for longitudinal monitoring. This scoping review synthesizes the heterogeneous evidence on hereditary ataxia biomarkers, highlighting multimodal frameworks that link molecular mechanisms with clinical endpoints. Mapping current approaches also reveals substantial variability and gaps across diseases and modalities, underscoring the need for harmonized validation in international multicenter cohorts and systematic integration into future clinical trials to advance precision medicine in hereditary ataxias. Full article