Search Results (617)

Open-plan workplaces are often associated with increased sensory exposure, which may present challenges for adults with Attention-Deficit/Hyperactivity Disorder (ADHD), a condition characterized by atypical arousal regulation and sensory sensitivity. Although the Prospect–Refuge Theory suggests that spatial configuration may influence perceived security and attentional states, objective neurophysiological evidence in workplace contexts remains limited. This exploratory pilot study employed a mixed design to examine whether desk orientation and office enclosure were associated with differences in neural activity among adults with ADHD (n = 6). Four desk configurations were tested within each office setting, while two office types (Open Office and Enclosed Private Office) were examined between participants. Neurophysiological data were collected using portable electroencephalography (EEG), and power spectral density (PSD) across canonical frequency bands was analyzed during standardized cognitive tasks. Results indicated context-dependent spatial effects. In the Open Office setting, configurations providing both outward visibility and visual backing were associated with lower beta and gamma power relative to orientations lacking these features. In the Enclosed Private Office, orientation-related differences were not statistically significant. These preliminary findings suggest that desk orientation may influence neural indicators of cognitive demand in open-plan environments. Given the small sample size, results should be interpreted cautiously but contribute initial physiological evidence to neurodiversity-informed workplace research. Full article

Anterior cruciate ligament (ACL) injuries frequently lead to persistent gait asymmetries, posing challenges for early rehabilitation and functional status. Comprehensive monitoring of pelvic gait symmetry during rehabilitation remains underexplored. This study evaluated post-operative functional status using an integrated monitoring approach combining pelvic-mounted inertial measurement unit (IMU) sensors with standardized clinical assessments in 32 individuals (9 women, 23 men; aged 19–64) following ACL reconstruction with patellar tendon autografts. IMU recordings captured pelvic oscillations in the sagittal, frontal, and transverse planes during standardized 10 m walking tests, providing objective digital biomarkers of gait symmetry. Clinical assessments included knee range of motion, thigh circumference, swelling, and pain using a modified 0–20 visual analogue scale (VAS). Across the early rehabilitation period, VAS scores decreased from 13.6 to 3.0, knee swelling from 2.88 cm to 1.09 cm, knee extension deficit from −9.38° to −2.03°, and knee flexion improved from 61.56° to 98.75°. Thigh hypotrophy increased from 1.13 cm to 2.53 cm. Pelvic oscillations improved in all planes (sagittal: 36.2 to 49.2; frontal: 71.9 to 92.2; transverse: 73.4 to 90.9), reflecting progressive restoration of gait control as patients transitioned from crutch-assisted to independent walking. The integration of wearable sensor data with clinical metrics enabled sensitive tracking of pelvic gait symmetry and functional status, demonstrating the utility of technology-supported monitoring to support individualized clinical assessment and early-phase monitoring following ACL reconstruction. Full article

Background/Objectives: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood and it tends to remain during adulthood. It not only affects cognitive abilities and behavior but also often presents emotional disturbances and alterations in the perceived quality of life. These symptoms are primarily related to dysfunctions in the ventromedial and dorsolateral prefrontal network. The main objective was to evaluate the feasibility and explore the initial outcomes of an integrated protocol combining neuropsychological treatment and transcranial direct current stimulation (tDCS). Methods: This study presents a single-case experimental A-B design of a 21-year-old woman, diagnosed with predominantly inattentive ADHD, treated at the University Psychology Clinic of Loyola Andalucía University. The treatment was carried out twice a week for 5 weeks (10 sessions in total), with 20 min of anodal tDCS at F3 and cathodal tDCS at F4 (2 mA), while digital neurorehabilitation exercises and psychotherapeutic support were provided. Results: An overall significant improvement was observed in cognitive functions (p = 0.008), with clinically significant gains in cognitive flexibility, visual working memory, and planning. Mixed results were found in inhibition, with improvement in interference control but no change in response inhibition. No significant changes were observed in sustained attention, auditory working memory, or processing speed. In terms of emotional state, an overall improvement was noted (p = 0.046), particularly in depression symptoms and perceived quality of life related to physical and psychological health. However, no significant changes were observed in anxiety symptoms or in areas related to the environment and social relationships. These findings reflect pilot-level evidence of clinical change within a feasibility framework. Conclusions: The combined treatment was found to be safe and feasible, showing promising preliminary improvements in cognitive and emotional domains. As a single-case study, these results serve as hypothesis-generating evidence for future controlled trials. Full article

Urban blue-green spaces (UBGS) are crucial nature-based solutions for enhancing urban resilience and improving public health. This study examined the experiential relationships linking BGS use to human well-being among users of five urban parks in Delhi, India. Using an integrated experience-centered framework, we collected in-situ survey data (n = 411) to profile usage patterns, assess environmental quality, and quantify restorative outcomes grounded in Attention Restoration Theory (ART) and Stress Reduction Theory (SRT). Advanced analytical techniques, including ordinal logistic regression and interpretable machine learning (SHAP), were used to identify the key factors associated with user satisfaction. The results revealed that for these respondents, BGS appeared to function as an essential neighbourhood, with over 40% visiting three or more times per week. Although visual attractiveness was rated positively, deficits in noise buffering and amenities indicated a gap between aesthetic and functional qualities. Restorative benefits, including emotional calmness, mood refreshment, and fatigue recovery, were consistently reported among respondents. Analyses showed that embodied experiences, particularly post-visit relaxation and physical comfort, were more strongly associated with user satisfaction. SHAP interpretation highlighted seating adequacy, routine use, and thermal comfort as prominent contributors, suggesting somatic relief may be particularly salient. This study provides exploratory evidence from a Global South megacity and context-sensitive insights into how restorative processes operate under high-density urban conditions. The findings show that routine accessibility, basic amenities, and thermal comfort are central to the everyday functioning of blue-green spaces as urban infrastructure, underscoring the need for experience-responsive and equity-oriented urban greening policies in high-density cities. Full article

Background: Tuberculous meningitis (TBM) is the most severe manifestation of tuberculosis in children, with high mortality rates and long-term neurological sequelae. Early diagnosis is challenging due to its nonspecific symptoms and insidious onset. Case Presentation: An 8-year-old previously healthy male, fully vaccinated, presented with a two-week history of fever, headache, vomiting, and abdominal pain. Cerebrospinal fluid (CSF) analysis revealed lymphocytic pleocytosis, elevated protein, and low glucose levels, while multiplex polymerase chain reaction (PCR) testing for bacteria and viruses yielded negative results. Brain computed tomography (CT) revealed mild ventricular dilation and pansinusitis. Empirical antibacterial and antiviral therapy were initiated; however, the patient subsequently experienced neurological deterioration, including cranial nerve deficits and hemiparesis. Brain magnetic resonance imaging (MRI) demonstrated acute infarctions of the basal ganglia, raising suspicion for TBM. Repeated CSF sampling and Xpert MTB/RIF assay confirmed infection with Mycobacterium tuberculosis. Anti-tuberculosis treatment was initiated in combination with adjunctive corticosteroids, anticonvulsant and anticoagulant therapies, and supportive care, including neurosurgical intervention for hydrocephalus. After 16 months of treatment, the patient showed clinical improvement but sustained left-sided hemiparesis, visual impairment, and cognitive deficits. Conclusions: This case highlights the diagnostic challenges of pediatric TBM in immunocompetent and Bacillus Calmette–Guérin (BCG)-vaccinated children, particularly in the presence of initially negative microbiological findings. It emphasizes the importance of maintaining a high index of clinical suspicion and the crucial supportive role of neuroimaging findings, as well as the earlier initiation of empirical TB therapy especially when epidemiological plausibility exists. Early recognition and intervention remain critical to reducing morbidity and mortality associated with this devastating disease. Full article

Background: Gait re-education is one of the key elements of comprehensive rehabilitation after total hip replacement. Recent technological advancements allow patients to benefit from increasingly sophisticated training solutions based on biofeedback. The aim of this study was to assess the impact of a treadmill training protocol with a digital biofeedback component on the gait parameters of patients after an uncomplicated total hip replacement and on their functional status. Methods: The study included 137 patients after total hip replacement. In the control group, traditional walking training with biofeedback in the form of a mirror was used. In the study group, the Biodex Gait Trainer 3 treadmill was used for this purpose, which also served as a diagnostic tool for both groups. The following parameters were assessed: distance, average walking speed, average step cycle, step length, coefficient of variability and time on each foot. Additionally, the study included the Timed Up & Go (TUG) test and the use of orthopedic supplies. Results were considered statistically significant at p < 0.05. Results: Significant statistical differences were found between the groups in terms of distance, average walking speed, and step length. Additionally, significantly shorter TUG times were observed and a higher rate of discontinuation of orthopedic supplies in the study group. However, the therapy method did not have a significant effect on the average step cycle, coefficient of variability or time on each foot. These parameters showed comparable improvement in both groups. Conclusions: Treadmill training with visual biofeedback has a positive effect on certain gait parameters. The greatest benefits from this type of training can be gained by patients with deficits in stability and mobility in space. Full article

Traditional concert-hall evaluations primarily rely on ISO 3382-1 scalar parameters (e.g., C₅₀ and C₈₀), which summarize temporal energy behavior but provide limited insight into the directional composition of early reflections, particularly in geometrically shadowed seating zones. This paper presents a first-order Ambisonics (FOA)-based 3D acoustic sensing framework to diagnose under-balcony directional imbalance, with emphasis on early vertical-reflection deficiency. Scene-based FOA impulse responses (WXYZ) were measured at 11 audience positions (P1–P11) in the National Concert Hall (Taipei) and analyzed using intensity-based direction-of-arrival (DoA) proxies, axis-resolved directional energy build-up, and a distributional descriptor based on directional spatial entropy. Results are presented at three representative frequencies (125 Hz, 1 kHz, and 4 kHz) and analyzed within full (0–200 ms), early (0–80 ms), and late (80–200 ms) windows. While the magnitude proxy $\mid p^{meas}\left(f\right)\mid$ exhibits strong seat-to-seat variability and does not support a uniform attenuation assumption under the balcony, direction-resolved metrics reveal a consistent under-balcony signature. Specifically, the early–late vertical energy discrepancy $\Delta R_z={\displaystyle R_z^{early}}-{\displaystyle R_z^{late}}$ is persistently negative at under-balcony positions (P7–P11) across all three frequencies, indicating a selective reduction in early vertical contribution relative to the late field. Directional entropy analysis further shows predominantly negative $\Delta H_n={\displaystyle H_n^{early}}-{\displaystyle H_n^{late}}$, with more negative values in the under-balcony group, consistent with stronger early directional constraint in shadowed seats. Spatial trend maps are provided via Gaussian RBF interpolation within the audience domain for visualization only. The proposed FOA-based diagnostic framework provides a practical and physically interpretable approach to identify direction-specific early-reflection deficits that remain masked in conventional scalar evaluations, supporting mechanism-oriented assessment and targeted intervention in geometrically constrained listening areas. Full article

Background: Posterior approaches to intramedullary spinal cord tumors traditionally rely on bilateral laminotomy or laminoplasty to ensure adequate midline exposure and contralateral dissection. Unilateral approaches are seldom applied in this context, due to concerns regarding insufficient visualization and limited working angles across the midline. Objective: To describe a modified hemilaminectomy technique designed to achieve safe midline myelotomy and bilateral tumor dissection through a unilateral corridor, preserving the structural and clinical benefits of minimally invasive posterior access. Methods: Fourteen patients with intramedullary spinal cord tumors underwent resection via a refined hemilaminectomy technique, which incorporated systematic thinning of the spinous process and strategic dural suspension. Pre- and postoperative neurological status was assessed using the modified McCormick scale. Surgical parameters, postoperative outcomes, and radiological follow-up were retrospectively collected. Results: Gross total resection was achieved in 13 of 14 patients (92.9%), with no new permanent neurological deficits. The mean surgical duration was 194.8 ± 55.9 min, and mean hemoglobin decrease was 1.47 ± 0.94 g/dL. Early postoperative improvement in McCormick grade was observed in 50% of cases, with statistically significant overall functional recovery (p = 0.013). No cases of postoperative cord tethering were identified on follow-up magnetic resonance imaging. The approach was technically reproducible and ergonomically favorable, with a shallow learning curve in surgeons experienced with conventional hemilaminectomy. Conclusions: The modified hemilaminectomy technique enables effective bilateral exposure and safe midline myelotomy through a unilateral approach, achieving high resection rates with minimal morbidity. It represents a feasible and reproducible alternative to bilateral approaches and warrants prospective validation. Full article

Background: Individuals with attention deficit hyperactivity disorder (ADHD) can exhibit neurocognitive deficits, psychosocial alterations, and changes in sleep regulation. In this sense, non-invasive techniques such as transcranial magnetic stimulation (TMS) can be used to assess and treat people with neurocognitive disorders. Studies using neuromodulation to estimate the timing and regulation of sleep remain scarce, revealing a gap in its understanding and treatment. Aim: To analyze whether the application of 10 Hz TMS modifies time estimation and sleep quality in people with ADHD for characteristics of inattention and hyperactivity. Material and Methods: Twelve adult male participants with high scores on the assessment of ADHD scale underwent a 10 Hz TMS protocol and a visual stimulus time estimation task. Daily rhythmicity was assessed by actigraphy before and after the repetitive transcranial magnetic stimulation (rTMS) intervention. Sleep quality was evaluated using the Pittsburg Sleep Quality Index and the Morning and Evening Questionnaire. Results: The results showed that rTMS modulated the interpretation of the 9 s long interval (p = 0.028). For the ADHD-AD instrument, no statistically significant differences were observed (p > 0.05). In relation to actigraphic variables—sleep time, bedtime, latency, sleep efficiency, and wakefulness after sleep onset—there were no differences after excitatory neuromodulation (p > 0.05). Conclusions: The findings demonstrate that the application of 10 Hz TMS enhances performance in long intervals during the time estimation task for individuals with ADHD, but does not affect sleep quality. Full article

With the global population predicted to reach 10 billion by 2050, pesticides are essential for agricultural production. However, they can introduce chemical stressors into aquatic ecosystems. Chlorpyrifos (CPF) is a widely used organophosphate insecticide that can enter aquatic environments and poses potential risks to early-life-stage fish. Because the retina is an extension of the central nervous system and vision-guided behaviors are highly sensitive to neural dysfunction, we hypothesized that CPF exposure disrupts neurobehavioral and visual function via oxidative stress and PPARα-related signaling. Zebrafish larvae were exposed to CPF (0.01, 0.1, 1, 10, and 100 μg/L) with a vehicle control (VC). During the photomotor response assay, exposure to 100 μg/L CPF reduced overall swimming activity by 48.90% and dark-period activity by 57.71%, whereas 1 μg/L CPF modestly increased total distance by 6.96% (p = 0.003) and dark-period distance by 5.40% (p = 0.011). Transcriptomic profiling highlighted nervous- and vision-related functional categories, and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment implicated pathways including gonadotropin-releasing hormone (GnRH), mitogen-activated protein kinase (MAPK), and peroxisome proliferator-activated receptor (PPAR) signaling. Targeted neurotransmitter metabolomics showed significant increases in dopamine, γ-aminobutyric acid (GABA), and acetylcholine across treatment groups, indicating broad neurotransmitter dysregulation. Consistent with these findings, neuronal fluorescence in Tg (elavl3: EGFP) larvae decreased by 12.1% and 32.5% in the 1 and 100 μg/L groups, respectively (p < 0.001), and glial fibrillary acidic protein (GFAP) immunofluorescence increased in the eye/brain/olfactory bulb at 1 μg/L (p = 0.037) and 100 μg/L (p = 0.002). Histology further showed retinal injury, with a 14.3% reduction in photoreceptor layer thickness at 100 μg/L (p = 0.034). Mechanistically, coexposure to a PPARα antagonist (GW6471) alleviated CPF-induced behavioral deficits (1.80-fold increase in dark locomotion) and reduced elevated GABA and dopamine levels by 36.8% and 47.3%, respectively. Together, these results indicate that CPF can impair neuro-visual development and that oxidative stress and PPARα-related signaling are closely associated with these effects. Full article

Background/Objectives: Attention-Deficit/Hyperactivity Disorder (ADHD) shows substantial cognitive heterogeneity, complicating individualized clinical formulation. This study examined whether Cognitive Disengagement Syndrome (CDS), anxiety, and ADHD symptom severity are associated with memory functions and visuospatial skills in children with ADHD. Methods: The sample included 120 children aged 6–12 years with ADHD (ADHD + CDS: n = 40; ADHD-only: n = 80). Memory was assessed with the Oktem Verbal Memory Processes Test (OVMPT) and Wechsler Memory Scale–Visual Reproduction (WMS–VR), and visuospatial skills with WISC-IV Block Design and Judgment of Line Orientation (JLO). ADHD symptoms were rated using combined parent–teacher Turgay-Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-Based Disruptive Behavior Disorders Scale (T-DSM-IV-S) scores; CDS symptoms with the Barkley Child Attention Scale; and anxiety with the SCARED-Child Form. Group comparisons, correlation analyses, and multivariable linear regression models were conducted. Results: The ADHD + CDS group performed worse on WISC-IV Block Design than the ADHD-only group (p = 0.005). In the ADHD + CDS group, inattention severity showed a strong negative association with WMS–VR short-term memory (r = −0.560, p < 0.001). In the ADHD-only group, inattention severity was negatively associated with OVMPT Spontaneous Recall (ρ = −0.319, p = 0.004) and JLO total score (ρ = −0.348, p = 0.002). Anxiety severity in the ADHD-only group was positively associated with OVMPT Total Learning (ρ = 0.350, p = 0.001), Highest Learning (ρ = 0.370, p = 0.001), and WMS–VR short-term memory (ρ = 0.304, p = 0.006). In regression analyses, the presence of CDS independently and negatively predicted WMS–VR short-term memory (β = −0.187, p = 0.018) and Block Design performances (β = −0.226, p = 0.016). Inattention symptom severity was also independently and negatively associated with Block Design performance (β = −0.243, p = 0.013). Conclusions: CDS status and symptom dimensions contribute to cognitive variability in pediatric ADHD, with CDS showing independent associations with timed visuospatial construction and short-term visual memory. Inattention severity emerged as a robust dimensional predictor of cognitive inefficiency across domains, supporting the clinical utility of symptom-based cognitive profiling in ADHD diagnostic evaluations. In addition, mild anxiety symptoms demonstrated meaningful associations with some learning and memory performances within the ADHD-only group, indicating that affective factors may modulate cognitive outcomes in ADHD. Taken together, these findings support considering CDS status and symptom dimensions jointly when characterizing cognitive variability in ADHD. Full article

Background/Objectives: Schemas support memory, but it is unclear how aging affects remembering when events deviate from schemas in different ways. We tested whether age differences depend on the integrability of schema-deviant object configurations and whether eye movement evidence sampling tracks retrieval decisions. Methods: Young and older adults completed a Restructured Object Memory Task. They encoded objects that were non-restructured (schema-consistent), reasonably restructured (deviant but integrable), or unreasonably restructured (deviant and non-integrable). At retrieval, participants made three-alternative forced-choice judgments while eye movements were recorded. Subjective ratings assessed perceived deviation, and representational similarity analysis related eye-movement patterns to memory confusions. Results: Older adults showed poorer cue discrimination and object memory, with the largest deficits for restructured objects. Their errors were schema-consistent, often selecting the typical object when targets were restructured. Ratings confirmed the intended deviation ordering, but older adults differentiated conditions less. Eye movements showed that young adults showed the highest target viewing proportion for reasonably restructured targets, and longer fixation durations for unreasonably restructured targets. In young adults, eye-movement representational structure tracked memory confusions. In older adults, early orienting and fixation duration were less predictive of choices, consistent with weaker coupling between sampling and decision. Conclusions: Aging was associated with poorer memory for schema-deviant objects, consistent with reduced representational fidelity and reduced flexibility in how online visual evidence is sampled and used when prior knowledge conflicts with new configurations. Full article

Background: Pelvic floor muscle dysfunction (PFD) is common during pregnancy. To counteract pregnancy-associated PFD, women require sufficient knowledge and structured guidance on correct pelvic floor muscle (PFM) contraction to improve PFM perception and functional control. Identifying pregnant women who are unable to perform correct PFM contraction despite structured teaching may allow early referral for rehabilitative measures. Objective: At measurement stage 1, this study aims to investigate the influence of structured PFM teaching on pregnant women’s ability to perform targeted PFM contraction (tPFMC-A), assess PFM strength, and describe possible early PFD symptoms. Material and Methods: “pelviTrust” is a two-arm randomized, controlled longitudinal study and has been conducted in the Department of Midwifery Science, University of Tuebingen since February 2023. The study sample comprised 221 healthy pregnant women with singleton pregnancy at 18–22 weeks of gestation. The intervention group (IG; n = 113) (69 nulliparous, 40 primiparous and four biparous) completed the validated German Pelvic Floor Questionnaire for Pregnant and Postpartum Women (GPFQppw) and received individualized midwife-led teaching on PFM anatomy, functional activation and PFM-friendly behaviour, followed by visual inspection and vaginal palpation. Objective-targeted PFMC ability (tPFMC-A) and PFM strength (modified Oxford Scale) were compared with self-assessed ability. The control group (n = 101) (61 nulliparous, 38 primiparous, and two biparous) receives routine prenatal and postnatal care and completes the GPFQppw. The present analysis focuses exclusively on the IG at T1. Results: At T1, 88% of the 113 women in the IG believed they could contract their PFM, but only 68% demonstrated a correct tPFMC-A on visual inspection. Following structured teaching with individualized feedback, 97% achieved correct PFM contraction while 2.7% still had deficits. The median PFM strength was three on the modified Oxford Scale (interquartile range: 3–4). Stress urinary incontinence and flatulence were the most frequently reported symptoms. Primiparous and multiparous women reported urinary incontinence and descensus symptoms more often than nulliparous women (p < 0.001). Conclusions: At the first prenatal assessment, pregnant women often overestimate their ability to contract their PFM correctly. A structured, midwife-led PFM teaching improves objectively assessed PFM contraction ability and may be integrated into routine antenatal care to support PFM health in pregnant women. Full article

Background: Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder that involves various biomechanical factors, including the altered positioning of the patella, weakness of the lower extremity muscles, delayed activation of the vastus medialis muscle, and excessive pronation of the foot. Although the short- and long-term effects of external support among the recommended conservative treatment methods for PFPS have been examined, there remains a lack of consensus regarding their impacts. This study was conducted to investigate the immediate effects of braces and rigid taping applied to control pain on proprioception, functional status, and balance in patients with PFPS, and to compare these outcomes with normative values obtained from healthy individuals. Methods: The study included 18 patients with PFPS and 18 healthy individuals who met the inclusion criteria. Through randomization of the intervention sequence, patients were evaluated under conditions of rigid taping, support, or without any support. Their pain levels before and after the application were assessed using the Visual Analog Scale; their functional status was evaluated with the Kujala Patellofemoral Scoring, the 10-Step Up Test, and the Squat; their balance performance was measured using the Y-Balance Test and the Single Leg Stance Test; and their proprioception was assessed with the Joint Position Sense Test. Results: It has been determined that rigid taping and bracing have similar effects in the immediate management of pain, proprioception, functional status, and balance issues in patients with PFPS. The interventions were observed to bring patients’ static balance and proprioception parameters closer to the values seen in healthy individuals. Conclusions: Rigid taping and bracing are both effective interventions in the management of PFPS, offering benefits such as pain relief, prevention of proprioceptive deficits, mitigation of balance impairments, and enhancement of functional outcomes. The selection of the most appropriate modality should be based on the individual patient’s characteristics and tolerance levels. Full article

This study examines how system resilience can be strained when governments define and mistranslate epistemological uncertainties into technical and managerial problems, using two comparative case studies of sociotechnical disasters (i.e., nuclear safety failure and pandemic digital surveillance). Drawing on Funtowicz and Ravetz’s post-normal science as a framework, the analysis introduces three types of uncertainties and conceptualizes the “mistranslation of uncertainties,” through which this research illuminates a structure whereby epistemic diversity is marginalized, and in turn, policy legitimacy deficits in implementation can be amplified, potentially eroding sociotechnical resilience. The article contributes to the field of sociotechnical resilience by (1) visualizing uncertainty mistranslation, which leads to a legitimacy deficit, (2) illustrating how mistranslation develops from a monolithic, technocentric understanding of uncertainties, and (3) proposing a framework of “resilience for legitimacy” that seeks to embed resilience work and co-production of responses within institutional practices. This research highlights how the co-production of epistemological translation and social order, encompassing deliberation and social feedback, can support democratic legitimacy and thereby resilient governance of sociotechnical systems. Full article