With an increase in proportion of elderly patients, the global burden of spinal disease is on the rise. Likewise, there has been an increasing trend in the number of spine surgeries being performed worldwide. As we know, rehabilitation following spine surgery is critical for optimal recovery. However, current literature lacks consensus regarding the appropriate post operative rehabilitation protocol. The goals of rehabilitation after lumbar spine surgery are to improve physical and psychosocial function and may include multiple modalities such as physical therapy, cognitive behavioral therapy, specialized instruments, and instruction to be followed during activities of daily living. In recent years, not only are a greater number of spine surgeries being performed, various different techniques of lumbar spine surgery and spinal fusion have emerged. Physical therapy programs need to be curated after assessing the functional status of the patient by using various patient reported outcome measures and taking into consideration the technique of spinal fusion used and the muscle groups involved in these surgeries. By doing so it is possible to assess the level of functional impairment and then specifically target strengthening of those muscle groups affected by surgery whilst also improving impaired balance and allowing return to activities of daily living. We reviewed available literature pertaining to the history of spinal rehabilitation, the popular patient reported outcome measures used and different rehabilitation methods with the purpose of summarizing the current guidelines for postoperative rehabilitation after spine surgery and to introduce the rehabilitation after lumbar surgeries that we provide at our hospital.

Within rehabilitation, there is great need for a simple method to monitor wheelchair use, especially whether it is active or passive. For this purpose, an existing measurement technique was extended with a method for detecting self or attendant pushed wheelchair propulsion. The validity was determined by comparison with manual annotation of wheelchair use. Twenty-four amputation and stroke patients completed a semi-structured course of active and passive wheelchair use. Based on a machine learning approach, a method was developed that detected the type of movement. The machine learning method was trained based on the data of a single wheel sensor as well as a setup using an additional sensor on the frame. The method showed high accuracy (F1 = 0.886, frame and wheel sensor) even if only a single wheel sensor was used (F1 = 0.827). The developed and validated measurement method is ideally suited to easily determine wheelchair use and the corresponding activity level of patients in rehabilitation.

A large proportion of chronic stroke survivors still struggle with upper limb (UL) problems in daily activities. We investigated clinical outcomes and assessed the quality of movement before and after a 5-hour error-enhancement training. The pilot study had a pre-post intervention design, recruiting 22 patients in the chronic phase post-stroke with UL motor impairments. Patients received 1-hour robot treatment for five days. Patients were assessed at baseline and after training, collecting (1) clinical (UL Fugl-Meyer assessment (FMA-UE)), action research arm test (ARAT), motor assessment scale UL and tone), (2) patient-reported (hand subscale of the stroke impact scale, motor activity log (MAL), visual analogue scale of pain and tone) and (3) kinematic (KINARM, BKIN Technologies Ltd., Canada) outcome measures. Our analysis revealed significant improvements (median im-provement (Q1-Q3); p<0.05) in (1) FMA-UE (1.0 (0.8–3.0), p<0.001) and ARAT (2 (0.8–2.0), p<0.001); (2) MAL amount of use (0.1 (0.0–0.3), p<0.001) and MAL quality of use (0.1 (0.1–0.5), p<0.001); (3) KINARM-evaluated position sense ((-0.45 (-0.81–0.09), p=0.030) after training. These findings provide insight into kinematic, clinical, and self-reported improvements in UL functioning after five hours of error-enhancement UL training.

The aim of this study was to evaluate the clinical and radiographic outcomes of the All-on-4 technique in fully edentulous maxilla using R2GATE software for flapless, computer-guided surgery and immediate loading. Ten adult patients with fully edentulous maxilla, aged between 35 and 60 years, were included in the study between April 2021 and April 2022. The surgical procedure was performed under local anesthesia and followed the All-on-4 approach with immediate loading of implants using a screw-retained provisional acrylic resin prosthesis on the same day. Final prosthesis was delivered four months after the surgery. Clinical and radiographic outcomes were evaluated at four- and twelve-months post-operation. The study reported a 95% implant survival rate using the All-on-4 technique. The mean marginal bone level was recorded at 0.35 mm and 0.66 mm during the 4 and 12-month follow-up periods, respectively. Fixed provisional prosthesis fracture, abutment, and prosthesis screw loosening were the most frequent mechanical complications reported. Within the limitations of this study, the use of computer-guided surgery in the All-on-4 technique seemed to be a promising treatment option with high implant survival rates that may help reduce post-surgical discomfort and mechanical complications in the rehabilitation of the edentulous maxilla.

Sports traumatic brain injury (TBI) accounts for up to 20% of all sports injuries, and the number of cases is growing year by year due to an increase in the number of people involved in sports, the growing popularity of extreme and contact sports, as well as a high level of motivation to achieve record results. Mild TBI dominates, which can provoke the development of a very wide range of complications and negative consequences. In the programs for the prevention of complications and the rehabilitation of athletes after TBI, TBI features are not sufficiently considered, which significantly differ from household, road or criminal injuries. There are no instrumental methods for diagnosing the severity of the injury. Sports TBI is characterized by repeated frequent TBI, elevated body and brain temperature, peripheral redistribution of blood flow and hypocapnia, which significantly affect cerebral blood flow. Brain injury is an independent cause of the development of cerebral hyperthermia, which significantly worsens the consequences of TBI. To diagnose sports TBI, the method of microwave radiometry of the brain (MWR) can be used. For the prevention of complications, the technology of craniocerebral hypothermia (CCH), which allows for to reduce of physical general and cerebral hyperthermia, and increases the resistance of cerebral cortex neurons to hypoxia and trauma could be used However, these approaches in sports medicine are used sporadically, which, is due to the lack of awareness of coaches and doctors of sports teams. The purpose of the review is to present MWR and CCH in sports TBI.

The article considers an approach to the problem of assessing the quality of speech during speech rehabilitation as a classification problem. For this, a classifier is built on the basis of an LSTM neural network for dividing speech signals into two classes: before the operation and immediately after. At the same time, speech before the operation is the standard to which it is necessary to approach in the process of rehabilitation. The metric of belonging of the evaluated signal to the reference class acts as an assessment of speech. An experimental assessment of rehabilitation sessions and a comparison of the resulting assessments with expert assessments of phrasal intelligibility were carried out.

The purpose of this scoping review was to examine the literature on the use of anti-gravity treadmill and its effects on lower limb motor functions in children and adolescents with locomotor impairments. Four databases (MEDLINE, CINAHL, Embase, Web of Science) were searched for articles from inception to August 2021. Inclusion criteria were: (1) experimental or quasi-experimental studies using the anti-gravity training as the primary intervention; (2) studies conducted in paediatricpediatric participants; (3) articles reporting outcomes related to the lower limb functions; and (4) studies published in French or English. Fifteen articles were included in the review. Studies included children and adolescents aged 4–18 years with locomotor impairments. The intervention duration was ranged from 2 and to 12 weeks, with 2-5 sessions per week. Included studies showed reported that anti-gravity training induces improvements in muscle strength, balance, spatiotemporal gait parameters, and walking endurance in children with locomotor impairments. This review provides relevant information about the modalities, outcomes and limits associated with the anti-gravity training protocol reported in the literature. Overall, the anti-gravity treadmill training could be viewed as a valuable training modality for children with cerebral palsy. However, more precise, and comprehensive description of anti-gravity rehabilitation protocols would be useful.

Social character is the key for someone to interact with the surrounding community. Interaction and socialization need to be introduced early by parents. If the results turned in reverse, then there must be other ways to be learned and practiced in family life. This study aims to cultivate social characters to children in the Juvenile Rehabilitation Institution through poetry learning. Changes continue to occur in handling and coaching juvenile delinquency in Indonesia. Regulations for the management of coaching continue to be carried out from Law No. 3 of 1997 concerning the Law on Juvenile Justice, then it was changed to Act No. 11 of 2012 concerning the System of Juvenile Criminal Justice. Characteristics of this relatively new law contain the main mechanisms of protecting children, who have problems with the law and following the Convention on the Rights of the Child. Education in the Juvenile Rehabilitation Institution has been carried out with all the limitations and can bring changes in the correctional behavior of children to be better that makes education restore the child's identity. Education held at this institution is expected to be able to achieve the ideals of children to be more beneficial after completing a kind of inclusive education. By applying a pragmatic approach, the study expects that there will be a change in children since they can learn the contents of poems, and at the same time, they are able to express their feeling by writing poems as well. From the process of learning, social characters in children such as honesty, openness, tolerance, cooperation, will be growing step by step.

The rapid development of algorithms for skeleton detection with relatively inexpensive contactless systems and cameras opens the possibility of virtual exercise therapy for patients with different complications. However, evaluation and confirmation of posture classifications is still needed. The purpose of this study was therefore to find the most accurate algorithm for automatic classification of human exercise movement. A Kinect V2 with 25 joints identification was used to record movements for data analysis. A total of 10 subjects volunteered for this study. Four algorithms were tested for the classification of different postures in Matlab. These were based on: total error of vector lengths, total error of angles, multiplication of these two parameters and simultaneous analysis of the first and second parameters. A base of 13 exercises was then created to test the recognition of postures by the algorithm, and to analyse subject performance. The best results for posture classification was shown by the second algorithm with an accuracy of 94.9%. The average correctness of exercises among the 10 participants was 94.2% (SD1.8%). The algorithms tested in this study therefore proved to be effective and could potentially form the basis for developing a system for remote monitoring of rehabilitation involving exercise.

Background: Knee joint is a common site for injury among younger people, the purpose of this study is to measure the skeletal muscle endurance and strength on people with prior knee reconstruction surgery. Methods: Young healthy female subjects were tested who reported having knee reconstruction surgery of over one year prior to testing. The skeletal muscle endurance index of the hamstring and quadriceps muscles was determined as the decline in the specific muscle acceleration in response to 2, 4, and 6 Hz electrical stimulation. Maximal isometric muscle strength (MVC) was measured in the hamstring and quadriceps muscles. Results: The hamstring muscles in the affected leg had less endurance than the non-affected leg at 6 Hz stimulation (55.5 ± 13.2% versus 78.0 ± 13.3%, P = 0.01). Muscle endurance was not reduced in the quadriceps muscles in the affected leg compared to the non-affected leg at 6 Hz stimulation (78.0 ± 13.3% versus 80.3 ± 10.0%, P = 0.69). There were no differences in MVC between the affected and non-affected legs for either the hamstring (P= 0.20) or quadriceps muscles (p = 0.67). Conclusions: Muscle endurance is reduced in the hamstring muscles at least one-year post injury, while hamstring strength is not. Reduced hamstring muscle endurance could be a result of a lack of focus on muscle endurance during rehabilitation after injury and may contribute to re-injury in the particular muscle even in people who have recovered muscle strength.

Background: Rangeland degradation means that a reduction both in rank and status of general floral/ fauna composition, energy flow and biomass of a certain ecosystem. Objective: The review was conducted to assess rangeland degradation, cause and its impact on local livelihood in Yabello district and also suggests appropriate methods used to rehabilitate it. Methods: The data and literatures were collected from different both domestic and abroad researcher research result reviewed and internet sources. The research paper review mainly addresses concepts of rangeland degradation, major causes in tropics and Ethiopia particularly in Yabello rangelands, impacts of rangeland degradation, principles of rangeland restoration and common restoration techniques.Result: Based on those research papers and the current fact situations the major drivers leading to rangeland degradation includes climate change, overgrazing, bush encroachment, both human and livestock population pressure, drought, and government policy . Of all bush encroachment is becoming the major threat to Yabello rangelands. And this led to decline in rangeland condition, water potential, soil status, and animal performance, livestock holding at the household level and community become destitute and in the long run poverty. In spite of these impacts, the action of restoration techniques in the area is highly insufficient. Conclusion: Generally in order to address rangeland degradation problems, there is a strong need to coordination between the local community and the scientific community for sustainable land management trough post management techniques by applying reseeding technology.

Most European cities are characterized by very large areas, often formed by buildings with low quality, from a series of point of view. The possibility of renovating them is strategic to improve both the quality of life and to the possibility of economic recovery for building companies. In the last decades, the attention of the scientific community has been addressed to the energy renovation, thanks to the strong activities of the European Community in this field. However, since a relevant part of the EC territory is at risk of earthquake, the possibility to combine both energy and seismic renovation actions may be strategic for many countries. In particular, Italy and Romania are linked by a common social tradition that springs from the Roman Empire. Nowadays, this link is stronger, thanks to common interests in social, cultural and business fields. Therefore, the investigation of possible synergies for seismic and energy renovation strategies may be really interesting for both countries. This paper represents the first step in this direction. After an overview of regulations and common practices for buildings with reinforced concrete structures, in both states, some key combined renovation interventions will be described and discussed, as well as advantages and perspectives of integrated renovation approaches.

Neuro-rehabilitation services are essential in reducing post-stroke impairments, enhancing independence, and improving recovery in hospital and post-discharge. However these services are therapist-dependent and resource intensive. Patients’ disengagement and boredom in stroke units are common which adversely affect functional and psychological outcomes. Novel techniques such as use of iPads™ are increasingly researched to overcome such challenges. The aim of this review is to determine the feasibility, effectiveness, acceptability, and barriers to the use of iPads™ in stroke neuro-rehabilitation. Four databases and manual literature search were used to identify published studies using the terms “iPad”, “Stroke”, and “neuro-rehabilitation”. Studies were included in accordance with the review selection criteria. A total of 16 articles were included in the review. The majority of the studies focused on iPads use in speech and language therapy. Although of small scale, the studies highlighted that iPads are feasible, have the potential to improve rehabilitation outcomes, and can improve patient’s social isolation. Patients’ stroke severity and financial limitations are some of the barriers highlighted in this review. This review presents preliminary data supportive for the use of iPad technology in stroke neuro-rehabilitation. However, further research is needed to determine impact on rehabilitation goals acquisition, clinical efficacy, and cost-efficiency.

In this paper, we investigate several relations for p-adic gamma function by means of their Mahler expansion and fermionic p-adic q-integral on ℤ_{p}. We also derive two fermionic p-adic q-integrals of p-adic gamma function in terms of q-Boole polynomials and numbers. Moreover, we discover fermionic p-adic q-integral of the derivative of p-adic gamma function. We acquire a representation for the p-adic Euler constant by means of the q-Boole polynomials. We finally develop a novel, explicit and interesting representation for the p-adic Euler constant including Stirling numbers of the first kind.

In this paper, we investigate p-adic q-integral (q-Volkenborn integral) on ℤ_{p} of p-adic gamma function via their Mahler expansions. We also derived two q-Volkenborn integrals of p-adic gamma function in terms of q-Daehee polynomials and numbers and q-Daehee polynomials and numbers of the second kind. Moreover, we discover q-Volkenborn integral of the derivative of p-adic gamma function. We acquire the relationship between the p-adic gamma function and Stirling numbers of the first kind. We finally develop a novel and interesting representation for the p-adic Euler constant by means of the q-Daehee polynomials and numbers.

It is increasingly common for experiments in biology and medicine to involve large numbers of hypothesis tests. A natural graphical method for visualizing these tests is to construct a histogram from the p-values of these tests. In this article, we examine the shapes, both normal and abnormal, that these histograms can take on, as well as present simple inferential procedures that help to interpret the shapes in terms of diagnosing potential problems with the experiment. We examine potential causes of these problems in detail, and discuss potential remedies. Throughout, examples of abnormal-looking p-value histograms are provided and based on case studies involving real biological experiments.

Our findings illustrate that CS should be employed as a means of popularizing scientific output, facilitating the promotion of political decision-making processes, and acting as a knowledge broker to reverse consumer behavior towards more environmentally friendly and conducive to SUP usage.

We propose a multi-sensor fusion localization framework for autonomous heavy-duty trucks suitable for mining scenarios, which enables high-precision, real-time trajectory generation and map construction. The motion estimated through pre-integration of the Inertial Measurement Unit (IMU) can eliminate distortions in the point cloud and provide an initial guess for LiDAR odometry optimization. The point cloud information obtained from LiDAR can assist in recovering depth information from image features extracted by the monocular camera. To ensure real-time performance, we introduce an iKD-Tree to organize the point cloud data. To address issues arising from bumpy road segments and long-distance driving in practical mining scenarios, we can incorporate a large number of relative and absolute measurements from different sources, such as GPS information and AprilTag-assisted localization data, including loop closure as factors in the system. The proposed method has been extensively evaluated on public datasets and self-collected datasets from mining sites.Our implementation is available at https://github.com/wangyicxy/iLM-slam.

This study investigates the impact of water stress on grapevines, specifically examining the role of rootstocks and aquaporins. Two experiments on potted plants were conducted in central Chile during the summer, under conditions of high water demand, involving various rootstock genotypes and combinations of Cabernet Sauvignon (CS) grafted onto rootstocks. Significant differences were observed among plants in terms of stem water potential, stomatal conductance, and growth rate. Notably, the CS/CS combination consistently displayed the slowest growth rate, regardless of the irrigation treatment. The study also analyzed the expression levels of plasma membrane intrinsic proteins (PIPs) and tonoplast intrinsic proteins (TIPs) aquaporins in the leaves of grafted plants. Specifically, VvPIP2;2 aquaporins showed reduced expression after 14 days without irrigation, whereas VvTIP1;1 and VvTIP2;1 expression levels correlated positively with gs responses in grafted plants, suggesting their role in modulating water content in leaves under water stress. TIP aquaporins likely play a significant role in the differential responses of CS plants towards nearly isohydric or anisohydric behaviour. The CS/CS combination exhibited near isohydric behavior, correlating with lower TIP aquaporin expression, while the combination of CS onto 1103P and 101-14 showed higher expression, indicating anisohydric behavior. The findings suggest that grafted plants are more resilient to water stress, supporting the idea that rootstocks can mitigate the effects of water stress on the scion.

Breast cancer is currently the second leading cause of death worldwide, accounting for 15% of all deaths (8.2 million deaths). Approximately 20% of breast cancer diagnoses are triple-negative breast cancer (TNBC), a type of cancer that lacks receptors for estrogen (ER negative), progesterone (PR negative), and human epidermal growth factor receptor 2 (HER2/neu negative). Consequently, TNBC doesn’t respond to hormonal or targeted therapies, making it challenging to treat due to its rapid growth, metastasis, and high recurrence rate within the first three years of therapy. Alternative chemotherapies are needed to address this problem. Pharmacological dose of vitamin C (high-dose VC) has been identified as a potential treatment for some cancer cells. The present study aimed to evaluate whether VC has a therapeutic effect on TNBC using MDA-MB-231 cells as the model. MTT assay, Hoechst 33342 staining, Nuclear ID Red/Green staining, Rhodamine 123 staining, and Western blot analysis were employed to test the hypothesis that pharmacological dose of VC can kill TNBC cells. Upregulation of Apaf-1, caspases -3, -6, -7, -8, and -9, inhibition of matrix metalloproteinases (MMP-2 and MMP-9), reduction in cell cycle protein expression, and enhancement of tumor suppressor proteins such as p53 and p21 indicated that pharmacological dose of VC has promising anti-cancer properties in the treatment of TNBC.

The rapid pace of urbanization, coupled with the growing need for environmental sustainability and technological innovation, has brought smart city initiatives to the forefront of global urban development. This paper provides a comparative analysis of smart city policies from leading cities such as Oslo, Zurich, and Canberra, and derives strategic insights for Qatar. By examining the strategies, priorities, outcomes, and challenges associated with implementing smart city initiatives in these cities, the study identifies areas of alignment and divergence with Qatar's own smart city policy framework. The research highlights potential opportunities for cross-learning and suggests how Qatar can leverage lessons from international best practices to enhance its smart city initiatives. Key areas of focus include fostering strategic partnerships, promoting innovation, and ensuring effective governance and data management systems. The findings provide actionable insights to improve the effectiveness of Qatar's smart city projects, aligning them with the Qatar National Vision 2030.

Recent studies with ApoE knockout (ApoE-/-) mice deficient for PACAP (pituitary adenylate cyclase-activating polypeptide) or its receptor PAC1 provide evidence for a possible involve-ment of immune- and vasoregulatoy PACAP signaling at the PAC1 receptor in atherogenesis and plaque associated vascular inflammation. Therefore, we tested the PAC1 receptor agonist Maxadilan and the PAC1 selective antagonist M65 on plaque development and lumen stenosis in the ApoE-/- atherosclerosis model for possible anti-atherogenic effects. Adult male ApoE-/- mice were fed a cholesterol-enriched diet (CED) or standard chow (SC) treat-ed with Maxadilan, M65 or Sham. Effects of treatment on atherosclerotic plaques, lumen stenosis, apoptosis and pro-inflammatory signatures were analyzed in the brachiocephalic trunk (BT). The percentage of Maxadilan treated mice exhibiting plaques under SC and CED was lower than that of Sham or M65 treatment indicating opposite effects of Maxadilan and M65. Maxadilan ap-plication inhibited lumen stenosis under SC and CED compared to Sham. In spite of significantly increased cholesterol levels, lumen stenosis of Maxadilan-treated mice was similar under CED and SC. In contrast, M65 under SC or CED did not reveal a significant influence on lumen steno-sis. Maxadilan significantly reduced the TNF-α+ area in the plaques under CED, but not under SC. In contrast, the IL-1β+ area was reduced after Maxadilan treatment under SC, but remained unchanged under CED compared to Sham. Maxadilan reduced the caspase-3+ area in the media under both SC and CED without affecting lipid content in plaques. Despite persisting hypercholesterolemia, Maxadilan reduces lumen stenosis, apoptosis and TNF-α driven inflammation. Our data suggest that Maxadilan provides atheroprotection by act-ing downstream of cholesterol-induced vascular inflammation. This implicates the potential of PAC1-specific agonist drugs against atherosclerosis even beyond statins and PCSK-9.

Background: Urinary tract infections (UTI) are a significant health concern, particularly in women, with almost half of them experiencing at least one UTI in their lifetime. This problem is further compounded by the high recurrence rate within 6-12 months. Postmenopausal women are especially vulnerable to recurrent UTI due to the natural decline in estrogen levels, which alters the urogenital epithelium and subsequently affects the urogenital microbiome. Methods: This study included 674 female patients that were admited at "Dr. Carol Davila" Central Military Emergency University Hospital in Bucharest over a period of 3 years. Results: Of the 674 women with urinary tract infection, 435 (79.3%) had more than one positive culture, and 239 (35.4%) experienced at least one recurrent urinary tract infection 6-12 months after the initial diagnosis. The mean age of women with urinary tract infection was 63 (± 15.61 years). Recurrent urinary tract infections were most prevalent in those aged 65-80 years (52%). Escherichia coli was detected in 71% of the positive cultures. Conclusions: The management of recurrent urinary tract infections in women presents a complex challenge that necessitates a multifaceted approach. The emerging understanding of the urobiome and its role in bladder health offers promising avenues for developing targeted interventions. As research in this field advances, it is imperative to integrate these new insights into clinical practice to balance traditional antibiotic treatments with novel strategies that consider the intricate microbial ecosystem of the urinary tract.

Disruptions in power quality have a negative impact on many energy consumers. These include lighting, where interference manifests itself, among others, in the form of light flickering. The article presents phenomena accompanying the operation of modern light sources against the background of exemplary results of studies on the flicker of conventional light sources, such as incandescent or fluorescent lamps. To assess the effects of these phenomena, it is necessary to use measures other than those traditionally used. The results of measurements carried out in accordance with different recommendations take into account both power supply disturbances and the properties of modern light sources.

To evaluate the efficacy of percutaneous dilatational tracheostomy (PDT) combined with adjuvant therapies in preserving vocal function in amyotrophic lateral sclerosis (ALS) patients. Methods: We performed a retrospective analysis of 47 ALS patients who underwent PDT at the Rodem Hospital from 2021 to 2023. Post-operatively, these patients were provided with a comprehensive treatment plan that included regenerative injection therapy, low-frequency electrical stimulation, respiratory rehabilitation, and swallowing rehabilitation therapy. Additionally, a balloon reduction program was implemented for effective Tracheostomy tube (T-tube) management. The preservation of vocal functions was evaluated 4 weeks following the procedure. Results: While some patients maintained or slightly improved their ALSFRS-R speech scores, the overall trend indicated a de-crease in speech scores post-PDT. This suggests that PDT combined with adjuvant therapies may not universally improve vocal function, but can help maintain it in certain cases. Conclusion: Our findings indicate that PDT combined with mesotherapy, low-frequency electrical stimulation, and swallowing rehabilitation therapy may play a role in maintaining vocal function in limb type ALS patients, though further research is needed to optimize patient management and validate these results.

Introduction: Previous research has suggested, that primary breast cancer (PBC) and ovarian cancer (OC) risks can be modified by mutation location in BRCA1 gene. In this study we assessed and compared the risks of contralateral breast cancer (CBC) and OC after the event of PBC in carriers of regionally frequent BRCA1 founder pathogenic variants (PV) c.5266dup and c.4035del. Subjects and Methods: In the analysis of CBC and OC risk, 1364 cases with BRCA1 PV and PBC were included. The control group consisted of 11350 consequent unselected and unscreened cases with PBC. The follow-up started at the time of PBC diagnosis and continued till the event of CBC or OC had occurred. The cumulative risks of CBC and OC were calculated using the Kaplan-Meier analysis. Risk factor for developing CBC/OC (age < 40 years) was calculated using cox proportional hazards model. Results: Cumulative 10 years risk of developing CBC was 3.0% in control group, and 20.1% in study group of BRCA1 carriers (log-rank p < 0.001). Cumulative risk of CBC at 10,15 and 20 years was 25.0%, 37.0% and 51.4% in PV c.5266dup subgroup, as opposed to 14.1%, 27.2% and 44.5% in PV c.4035del subgroup (log-rank p = 0.045). Age younger than 40 years at the time of PBC was risk factor for CBC (hazard ratio 2.06, 95% CI 1.83-2.29, p < 0.001). Cumulative risk of developing OC at 10 and 15 years was 1.0% and 1.2% in control group, 10.8% and 16.8% for PV c.5266dup, 13.5% and 30.8% for PV c.4035del. There was difference in OC risks between control group and BRCA1 carriers (log-rank p< 0.001). PV c.4035del showed higher risk of OC, compared to PV c.5266dup, however, this was of borderline statistical significance (log-rank p = 0.057). Age younger than 40 years at the time of PBC was not associated with any difference in future OC risks (hazard ratio 1.03, 95% CI 0.77-1.29, p = 0.23). Conclusion: The data of this study confirms previously established evidence that in cases of PBC the risk of future CBC and OC is increased significantly for BRCA1 carriers in comparison to general unscreened population. Moreover, BRCA1 PV c.5266dup is associated with higher CBC risk and possibly lower OC risk in comparison to BRCA1 PV c.4035del. Age younger than 40 years at diagnosis of PBC is risk factor for CBC, but does not seem to alter the risk of OC.

Helium is a strategic rare gas resource related to national security and the development of high-tech industries, the high-quality development of helium industry chains has a great significance to improve the security of helium resource. This paper through literature and market research, summarizes the progress of helium resource endowmen, exploration and development, supply and demand pattern, trade market and industrial technology, equipment through literature and market research in the world, analyses the development situation of global helium resources industry chains. This study proposes the development status and challenges of China's helium industry and the corresponding development path of helium industry based on the upstream, midstream, downstream and downstream indicators. Most of the countries in the world have not started helium exploration or remain in low exploration level, but the exploration practice shows that global helium resource potential is considerable; helium exploration and development subjects become diversified in recent years, which may change the global helium supply and demand pattern; The helium reservoir forming theory and exploration and development technology are underdeveloped, and the helium extraction equipment is continuously improved; The global helium production capacity, supply and demand，trade pattern market would be profoundly changing. For a long time, the United States has had an absolute say in the global helium trade system, the contradiction between supply and demand would persist for a long time and significant price fluctuations. China's helium development challenges and opportunities coexist considering the global helium industry chain existing pattern and the new trend of development. There is an urgent need to build an independent and controllable , stable and resilient helium industrial chain, and provide helium resources guarantee for the development of high-tech industries.

The proliferation of cloud computing has given rise to challenges in security that established perimeter-based models cannot easily adapt to. The new buzzword Zero Trust, which is based on the principle of "never trust, always verify," has been looked up as one of the promising solutions. Is Zero Trust a certainty or pie in the sky for security in the cloud? This is discussed further in this paper. This philosophical approach leads us through the earlier work and scientific literature available on the subject, presenting Zero Trust's capabilities, advantages when introduced into cloud security architecture, and obstacles about its incorporation. The study finds that Zero Trust holds the potential to enhance cloud security significantly, but it is no silver bullet and demands careful implementation and further studies to understand its intricacies as well as pitfalls.

Insurance companies need to calculate solvency capital requirements in order to ensure that they can meet their future obligations to policyholders and beneficiaries. The solvency capital requirement is a risk management tool essential for, when extreme catastrophic events occur, resulting in a high number of possibly interdependent claims. This paper studies the problem of aggregating the risks coming from several insurance business lines and analyses the effect of reinsurance in the level of risk. Our starting point is to use a Hierarchical Risk Aggregation method, which was initially based on 2-dimensional elliptical copulas. We then propose the use of copulas from the Archimedean family and a mixture of different copulas. Our results show that a mixture of copulas can provide a better fit to the data than an individual copula and consequently avoid over or underestimating of the capital requirement of an insurance company. We also investigate the significance of reinsurance in reducing the insurance company’s business risk and its effect on diversification. The results show that reinsurance does not always reduce the level of risk, but can also reduce the effect of diversification for insurance companies with multiple business lines.

The primary goal of Theory of Everything (ToE) is to unify General Relativity and Quantum Mechanics, establishing a theoretical framework that explains all natural phenomena and fundamental laws of the universe. The rapid development of artificial intelligence in the 21st century presents new opportunities for the establishment of TOE. Research has revealed that the observer and the agent, as key concepts in physics and intelligence science respectively, share intrinsic consistency. Using this as a breakthrough point, we first proposed Standard Agent Model, which, from the perspective of information processing, establishes a unified structure for agents. This model posits that any agent possesses five essential capabilities: input, output, storage, creation, and control of these four capabilities.By setting the values of these five essential capabilities in Standard Agent Model to either zero or infinity, we identify two extreme states of agents: Absolute Zero Agent (α Point) and Omniscient and Omnipotent Agent (Ω Point). Based on the evolution of agents towards these two extreme states, we derive two driving forces for agent evolution: α Gravity and Ω Gravity. These elements collectively form General Model of Agent Evolution.Building on the first two models, we further derive Intelligent Universe Evolution Model, proposing that Universe, as an agent, evolves dynamically between α Point and Ω Point under the influence of α Field and Ω Field. These three models together constitute "Theory of Universal Intelligent Evolution," abbreviated as Ω Theory. According to Ω Theory, we demonstrate that the observer in physics and a wide range of research objects can be unified within the framework of Standard Agent Model. Additionally, we argue that the four fundamental forces have the potential to be unified into α Gravity and Ω Gravity.Within the framework of Ω Theory, through theoretical analysis and experimental validation, it has been demonstrated that the differences between classical mechanics, relativity, and quantum mechanics stem from the varying intelligence levels assigned to observers. Furthermore, it has been discovered that the differences in intelligent characteristics between the theoretical Universe proposed by these three major physical theories and Universe in which humanity currently resides are the root cause of the varying precision and limitations of these theories.

As the global economy pays increasing attention to sustainable development and environmental protection, the role of green finance in promoting regional technological innovation is becoming more and more prominent. This study aims to analyse the impact of green finance on regional technological innovation and its mechanism of action, with special attention to the mediating effect of R&D inputs and the moderating role of regional characteristics. By analysing the panel data of 30 provinces in China from 2008 to 2021 with fixed and mediated effect models, the results show that green finance significantly promotes regional technological innovation. R&D investment intensity partially mediates this effect, while regional innovation and entrepreneurship capacity plays a significant moderating role in this relationship. Specifically, regional innovation and entrepreneurship capacity reinforces the positive impact of green finance on R&D investment, but the marginal effect of R&D investment is reduced in regions with stronger innovation and entrepreneurship capacity. The findings provide a theoretical basis for formulating relevant policies to promote green finance development and sustainable innovation in regional economies.

Here, we describe the bicomplex (p,q)- Fibonacci numbers and the bicomplex (p,q)- Fibonacci quaternions that are based on these numbers and give some of their equations, including the Binet formula, generating function, Catalan, Cassini, d’Ocagne’s identities, and some summation formulas for both of them. Finally, we create a matrix for bicomplex (p,q)- Fibonacci quaternions, and we obtain a determinant of a special matrix that gives the terms of that quaternion.

In this paper, some convexity properties and some inequalities for the (p,k)-analogue of the Gamma function, Г_p,k(x) are given. In particular, a (p,k)-analogue of the celebrated Bohr-Mollerup theorem is given. Furthermore, a (p,k)-analogue of the Riemann zeta function, ζ_p,k(x) is introduced and some associated inequalities are derived. The established results provide the (p,k)-generalizations of some known results concerning the classical Gamma function.

Background/Objectives: Chronic Musculoskeletal Pain (CMP) is a rather widespread and heterogeneous health problem whose evaluated framework can be of fundamental importance to intervene effectively and rapidly on the causes and consequences of the pathology, as well as on the dominant symptom of pain. One of the evaluation parameters that is increasingly gaining consensus in the assessment of the health status is the Phase Angle (PA), obtained through bioelectrical monitoring with body Bioimpedance Analysis (BIA); Methods: To evaluate the reliability of the PA as a tool for assessing CMP, data from 53 patients, with an average age of 60 years, were observed. They underwent assessment of perceived pain using the Numeric Pain Rating Scale (NPRS) and of the body's bioelectrical status using the BIA, before the beginning (T0) and after the end (T1) of a cycle of 10 treatment sessions with Ion Cyclotron Resonance - Bioresonance Therapy (ICR-BT); Results: At the end of the observation we detected a significant reduction in the NPRS value and a positive but not statistically significant increase in the PA value. Furthermore, given the misalignment in the significance of the positive trend of the two observed variables, it was not possible to define a clear correlation between pain and the bioimpedenziometric values ​​of patients. Conclusions: The study confirms the efficacy of ICR-BT as a therapeutic tool in the presence of CMP. However, it was not possible to define a clear reliability of PA as a diagnostic tool for CMP. Although PA has shown a promising trend during the study, its non-significant correlation to the pain trend would suggest investigating the topic more deeply, through larger and better structured experimental studies.

Invasive species are non-native organisms that are introduced to a particular environment with a potential to spread from the place of introduction and cause biodiversity loss. This research was done in Gullele Botanical Garden with the objective of advancing management strategies for invasive and potentially invasive species by examining their abundance, distribution, impacts. Proportional number of plots with a size of 10m by 10m was laid at each land use types to collect vegetation and environmental data. The impact rank was analysed as a data frame using the R-statics packages, which shows the lower and higher impact rate ranges for the sampled land use types. ArcGIS was used to map the spatial distributions of each species. A total of 2550 individuals from 12 families comprising 16 invasive and potentially invasive species have been recorded in 40 sample plots across all sampled land use types. The highest species abundance appeared near the roadside among the sampled plots. Acacia decurrens, Cyathula uncinulata, and Acacia melanoxylon were the three most predominant species, had a substantial contribution to the high impact on the native species. Either intentionally by planting for their advantageous qualities or unintentionally associated with other seeds or other vectors, invasive and potentially invasive species were introduced into the garden. Although there are various techniques to control invasive species, mechanical controlling mechanisms like hand-weeding, uprooting, cutting, and rehabilitation with native species, along with regular monitoring, are highly recommended for the current challenge in the garden.

This study aimed to investigate the efficacy of manual therapy and exercise versus synchronized telerehabilitation with self-manual therapy and exercise in treating Subacromial Pain Syndrome (SPS). Sixty individuals diagnosed with SPS, aged 18-50 years, were randomly assigned to home exercise (HE), manual therapy (MT), and telerehabilitation (TR) groups. Treatment protocols were administered over 8 weeks and included specific exercises and therapy interventions. Out-come measures included Visual Pain Scale (VAS), shoulder range of motion (ROM) via gonio-metric measurements, Quick Disability Arm-Shoulder-Hand Problems Survey (Q-DASH), and patient satisfaction. Results revealed that both MT and TR groups exhibited reduced pain, in-creased ROM, lower Q-DASH scores, and higher patient satisfaction compared to the HE group. However, no significant differences were found between MT and TR groups in pain levels, ROM, Q-DASH scores, or patient satisfaction. The study concludes that both telerehabilitation and manual therapy effectively alleviate pain and are well-received by patients with SPS. Addition-ally, manual therapy demonstrates superiority in enhancing functional levels compared to exer-cise-based interventions. (Registration: NCT05200130)

Immediate load of full-arch rehabilitations over implants, specially over 4 implants are very well documented in the literature. More recently, the use of computed surgical guides to help the planning and the execution of these treatments, in many situations without the need of raising a flap, and diminishing the appearance of hematomas, bleeding and with less trauma to the patient has gained preference among implantologists. The objective of this case report is to show a clinical case of an immediate load full-arch fixed rehabilitation over 4 implants produced by 3D printing manufacturing technology, and placed with a computed surgical guide, in the same appointment, and the 24 months follow-up. The patient returned after 3 months to replace the immediate temporary fixed prosthesis for a new one, with metallic bar, better teeth and more delicate. Soft and hard tissue around the implants seemed to be stable, without signs of inflammation, either on the 3 or the 24 months follow-up. 3D printing of implants by direct metal laser sintering is a technology that seems to be promising for oral implantology, with solid studies showing reliable results, as seen in this single case. More clinical studies are necessary to testify its efficacy.

The objective of this study was to analyze the effects of a pulmonary telerehabilitation (TR) program in young adults with post-COVID-19 syndrome. The information of sixteen students' medical files were analyzed and allocated to one of two groups (control=CG/experimental=EG). Twelve TR sessions were performed distantly and asynchronously at the EG patients' homes during 4-weeks. The program included diaphragmatic pattern breathing and aerobic exercises. The parameters: i) vital signs (oxygen saturation "SpO2", heart rate "HR", respiratory rate "RR" and blood pressure "BP"; ii) physical capacity “Sit-to-stand test”; iii) cardiorespiratory capacity “6-Minute Walk Test”; and iv) perceived effort "Borg scale" were assessed in both groups. The statistical analyses showed a significant decrease of RR and HR (p < 0.012) accompanied by a significant increase in SpO2 (p < 0.042), physical (p < 0.012) and respiratory (p < 0.028) capacity. The perceived effort decreased significantly in both groups (CG: p < 0.006; EG p < 0.001) only for physical but not for cardiorespiratory capacity (p < 0.106). There were no statistical changes registered in BP (p > 0.05). The current study suggests that a TR program that involves breathing and aerobics exercises is feasible and effective in treating post-COVID-19 syndrome in young patients.

A 5.1 kg, 7-year-old, castrated Maltese dog with a tibial plateau-leveling osteotomy (TPLO) in the right hindlimb 42 days prior to presentation. The patient’s right hind limb showed lameness, intermittent limping, and atrophy, and had never experienced rehabilitation since TPLO surgery. The patient showed a pain reaction at the end of the stifle extension, and an increased body temperature was identified on the medial side of the right hindlimb compared with the left hindlimb using a digital thermal imaging device. In addition, a type of lameness, partial weight bearing in the right hindlimb, was also identified in the gait analysis. The pain was relieved by applying a cold pack and transcutaneous electrical nerve stimulation and the patient was trained on muscles that were atrophied during treadmill exercise. In this study, physical therapy and rehabilitation exercises controlled pain and induced rapid recovery, indicating that rehabilitative intervention is required after TPLO surgery.

There are no studies that have investigated the characteristics of car use across THA patients, including those who do not drive. This study aimed to evaluate, in THA patients, (1) postoperative car usage, (2) comfort while entering and exiting a car, and (3) whether lower limb muscle strength affects action comfort. One hundred seventy-two post-THA patients completed the questionnaire in 2020, along with assessments of hip abductor and knee extensor muscle strength before surgery and at discharge. Patients whose overall comfort level was judged as “comfortable” were defined as the “comfort” group; others were placed in the “discomfort” group. Of the 172 patients, 161 reported car usage at a mean of 5.6 years after THA. Of these, 114 and 47 patients were placed in the "comfort" and "discomfort" groups, respectively. Patients in the "discomfort" group were three times more likely to experience discomfort using the contralateral side door than the surgical side door, and about twice as many patients experienced discomfort when entering as when exiting. Lower preoperative contralateral hip abductor muscle strength was the only independent predictor for discomfort. The take-home messages were that prevention of contralateral-side weakness may improve comfort during the action after THA.

Objective: To sort out the research hotspots of the application of VR in rehabilitation medicine, analyse its research themes and research trends, and offer a reference for future related research in this field. Methods: This paper provides an in-depth analysis of the development process, research hotspots and research trends in the field of VR application in rehabilitation medicine research, taking the Web of Science core dataset as the source and using bibliometric analysis by CiteSpace. Results: The application of VR in rehabilitation medicine was composed of three stages, and the research topics were reviewed in five aspects: neurological rehabilitation, psychology treatment, pain distraction, cardiopulmonary rehabilitation, and visual spatial disorder. Limitations: The literature data only come from the Web of Science core dataset, and the data sample size was not comprehensive. Conclusion: Overcoming VR technology-induced vertigo and mental disorders from overuse of VR are both challenges to research on the application of VR in rehabilitation medicine. In addition, developing VR products with better experience, developing standardized guidelines, and conducting more high-quality clinical studies are all future research trends for the application of VR in rehabilitation medicine.

Important current limitations of the implementation of Evidence-Based Practice (EBP) in the rehabilitation field are related to the validation process of new technologies and interventions. Indeed, most of the strict guidelines that have been developed for the validation of new drugs (i.e., double or triple blinded, strict control of the doses and intensity) cannot – or only partially – be applied in rehabilitation. Well powered high quality randomized controlled trials are more difficult to organize in rehabilitation (e.g., longer duration of the intervention in rehabilitation, more difficult to standardize the intervention compared to drugs’ validation studies, limited funding’s since not sponsorized by big pharma companies), which reduces the possibility of conducting systematic reviews and meta-analyses, as currently high level of evidence is sparse. The current limitations of EBP in rehabilitation are presented in this paper and innovative solutions are suggested such as: technology-supported rehabilitation systems, continuous assessment, pragmatic trials, rehabilitation treatment specification systems, and advanced statistical methods, to tackle the limitations to increase the quality of the research in rehabilitation. The development and implementation of new technologies should increase the quality of research and the level of evidence supporting rehabilitation provided some adaptation in our research methodology.

Background: Tele-rehabilitation has grown significantly in the past years, especially in 2020 when it has been a crucial tool for supporting patients during the COVID-19 pandemic. Within the context of tele-rehabilitation, serious games have a significant role. However, realizing software for serious games capable of responding to the variety of user needs is resource demanding. Methods: we present Proteo, a modular framework for developing serious games from scratch, but with the ability of providing a high-level interface for game customization by therapists and researchers. We also present two serious game implementation examples with analysis of end user’s and therapists/researchers’ satisfaction. Results: by involving a group of 11 specialized therapists and 9 end users we analyzed the Proteo user’s satisfaction. We found that therapists and end users scored high level of involvement, and the therapists scored also high level of suitability. More in depth, both groups showed significant differences between positive and negative feeling, with positive feeling scoring higher than negative ones. Finally, concerning Users’ level of suitability the condition of successfulness of the system, ability to control, clarity and helpfulness were reported as high while the difficulty of the system and the difficulty of the task were reported as low. Conclusions: the proposed framework is a step forward in providing a comprehensive open-source, modular framework, to develop serious games for tele-rehabilitation. Proteo is distributed with a MIT license and available to researchers on GitHub and has been well accepted by the users we involved in the evaluation tests.

What do you want to do ?New mailCopyBackground: to analyze the changes that a therapeutic physical exercise program is capable of causing in the functionality of patients suffering from ALS and in addition, to analyze the respiratory capacity. Methods: a systematic review of the PubMed, SCOPUS, Cochrane, SciELO, PEDro, CINAHL and MEDline databases is carried out. The information was filtered using the following MeSH terms: "Amyotrophic lateral sclerosis", "Physical Therapy", "Physical and Rehabilitation Medicine". Clinical trials published in the last 5 years were included in which one of the interventions was therapeutic physical exercise in patients with ALS, which included the ALSFRS-R as a result variable. Results: 10 clinical trials with a total of 421 patients were analyzed, of which 183 underwent rehabilitation with physical exercise and were part of the case group; the rest belong to the control group and their treatment was mostly passive. The observed trend is of a decrease of approximately 6 points in the ALSFRS-R scale at 6 months in the case groups; however, no behavior pattern was met in the controls. Conclusions: Therapeutic physical exercise could contribute to slow down the deterioration of the musculature of people with ALS, thus facilitating the performance of their daily activities.

Background: to analyze the changes that a therapeutic physical exercise program is capable of causing in the functionality of patients suffering from ALS and in addition, to analyze the respiratory capacity. Methods: a systematic review of the PubMed, SCOPUS, Cochrane, SciELO, PEDro, CINAHL and MEDline databases is carried out. The information was filtered using the following MeSH terms: "Amyotrophic lateral sclerosis", "Physical Therapy", "Physical and Rehabilitation Medicine". Clinical trials published in the last 5 years were included in which one of the interventions was therapeutic physical exercise in patients with ALS, which included the ALSFRS-R as a result variable. Results: 10 clinical trials with a total of 421 patients were analyzed, of which 183 underwent rehabilitation with physical exercise and were part of the case group; the rest belong to the control group and their treatment was mostly passive. The observed trend is of a decrease of approximately 6 points in the ALSFRS-R scale at 6 months in the case groups; however, no behavior pattern was met in the controls. Conclusions: Therapeutic physical exercise could contribute to slow down the deterioration of the musculature of people with ALS, thus facilitating the performance of their daily activities.What do you want to do ?New mailCopy

Background: After the increasingly common anterior cruciate ligament reconstruction (ACLR) procedure in competitive athletes, rehabilitation is crucial for facilitating a timely return to sports (RTS) and preventing re-injury. This pilot study investigates the biomechanical and psychological outcomes of postoperative rehabilitation in competitive athletes, comparing supervised rehabilita-tion (SVR) and home-based rehabilitation (HBR). Methods: After ACLR, 60 (out of 74 screened) athletes were recruited and equally divided into 2 groups using non-probability convenience sam-pling: 30 HBR and 30 SVR (each group comprising 15 males and 15 females). Rehabilitation out-comes in respective groups were evaluated at 8 months using measures (Tegner-Activity-Scale [TAS], International Knee Documentation Committee subjective knee form [IKDC-SKF], ACL Return to Sport after Injury [ACL-RSI]) and objective parameters (isometric muscle strength, hamstring/quadriceps asymmetry). RTS was evaluated at 9 months; with ACL re-injury rates rec-orded approximately 6 months post-RTS. Results: Both groups exhibited decreased TAS scores (HBR: 8 to 6, SVR: 8 to 7), with the SVR group demonstrating superior post-operative IKDC-SKF scores (81.82 vs. 68.43) and lower ACL-RSI scores (49.46 vs. 55.25). Isometric and isokinetic mus-cle strength, along with asymmetry values, favored the SVR group 8 months post-ACLR (p

We introduce the notion of p-adic equiangular lines and derive the first fundamental relation between common angle, dimension of the space and the number of lines. More precisely, we show that if {τj} n j=1 is p-adic γ-equiangular lines in Qd p , then (1) |n| 2 ≤ |d| max{|n|, γ2 }. We call Inequality (1) as the p-adic van Lint-Seidel relative bound. We believe that this complements fundamental van Lint-Seidel [Indag. Math., 1966] relative bound for equiangular lines in the p-adic case. Keywords: Equiangular lines, p-adic Hilbert space.

This article presents a proposed system that enables energy transfer from the dc grid to a single-phase onboard grid, operating at an hi frequency. In addition to the energy transfer function, it additionally enables compensation of reactive power in the ac grid when the converter operates at less than rated power. To operate in compensator mode, it is necessary to decouple the current from the grid into active and reactive components and control them independently. To achieve good dynamics, synchronizers that operate in the dq system are used. In the case of a single-phase grid, it requires such a synchronizer to generate virtual quadrature signals. The used systems based on second-order generalized integrator are good, but to improve dynamics in the work a quadrature generator based on trigonometric calculations was proposed. The developed system was implemented in a proportional resonant current control system. Tests performed in steady state and in dynamic states related to typical grid disturbances showed better dynamic properties than the standard integrator-based system.Keywords: power transfer; compensator; P+R controller

Arc sensors have been used in seam tracking and widely studied since the 80s; commercial arc sensing products for T and V shaped grooves have been developed. However, it is difficult to use these arc sensors in narrow gap welding because arc stability and sensing accuracy are not satisfactory. Pulse gas melting arc welding (P-GMAW) has been successfully applied in narrow gap welding and all position welding processes, so it is worthwhile to research P-GMAW arc sensing technology. In this paper, we derived a linear mathematical P-GMAW model for arc sensing, and the assumptions for the model are verified through experiments and finite element methods. Finally, the linear characteristics of the mathematical model were investigated. In torch height changing experiments, uphill experiments, and groove angle changing experiments the P-GMAW arc signals all satisfied the linear rules. In addition, the faster the welding speed, the higher the arc signal sensitivities; the smaller the groove angle, the greater the arc sensitivities. The arc signal variation rate needs to be modified according to the welding power, groove angles, and swing or rotate speed.

Pardosa pseudoannulata is one of the most common wandering spiders in agricultural fields and a potentially good bioindicator for heavy metal contamination. However, little is known about the mechanism by which spiders respond to heavy metals at the molecular level. In this study, high-throughput transcriptome sequencing was employed to characterize the de novo transcriptome of the spiders and to identify differentially expressed genes (DEGs) after cadmium exposure. We obtained 60,489 assembled unigenes, 18,773 of which were annotated in the public databases. Ultimately, 3450 cDNA simple sequence repeats were identified and validated as potential molecular markers in the unigenes. A total of 2939, 2491 and 3759 DEGs were detected among the three libraries of two Cd-treated groups and the control. Functional enrichment analysis revealed that metabolism processes and digestive system function were predominately enriched in response to Cd stress. At the cellular and molecular levels, significantly enriched pathways in lysosomes and phagosomes as well as replication, recombination and repair demonstrated that oxidative damage resulted from Cd exposure. Based on the selected DEGs, certain critical genes involved in defence and detoxification were analysed. These results may elucidate the molecular mechanism underlying spiders' responses to heavy metal stress.

Understanding the factors that contribute to slope failures, such as soil saturation, is essential for mitigating rainfall-induced landslides. Cost-effective capacitive soil moisture sensors have the po-tential to be widely implemented across multiple sites for landslide early warning systems. How-ever, these sensors need to be calibrated for specific applications to ensure high accuracy in readings. In this study, a soil-specific calibration was performed in a laboratory setting to integrate the soil moisture sensor with an automatic monitoring system using the Internet of Things (IoT). This re-search aims to evaluate a low-cost soil moisture sensor (SKU:SEN0193) and develop calibration equations for the purpose of slope model experiment under artificial rainfall condition using silica sand. The results indicate that a polynomial function is the best fit, with a coefficient of determi-nation (R²) ranging from 0.92 to 0.98 and a root mean square error (RMSE) ranging from 1.17 to 2.67. The calibration equation was validated through slope model experiments, with soil samples taken from the model after the experiment finished. Overall, the moisture content readings from the sensors showed approximately a 10% deviation from the actual moisture content. The findings suggest that the cost-effective capacitive soil moisture sensors has the potential to be used for the development of landslide early warning system.

In the present study, we introduce the two dimensional Chlodovsky type Bernstein operators based on (p,q)−integer. We examine approximation properties of our new operator by the help of Korovkin-type theorem. Further, we present the local approximation properties and establish the rates of convergence by means of the modulus of continuity and the Lipschitz type maximal function. Also, we give a Voronovskaja type theorem for this operators. And, we investigate weighted approximation properties of these operators and estimate rate of convergence in the same space. Finally, with the help of Maple, illustrative graphics show the rate of convergence of these operators to certain functions . The optimization of approximation speeds by operators during system control provides significant improvements in stability and performance. As a result, the control and modeling of dynamic systems become more efficient and effective through innovative methods. These advancements in the fields of modeling fractional differential equations and control theory offer substantial benefits to both modeling and optimization processes, expanding the range of applications in these areas.

This article advances the discourse on sustainable and energy-efficient software by examining the performance and energy efficiency of intelligent algorithms within the framework of green and sustainable computing. Building on previous research, it explores the theoretical implications of Bremermann's Limit on efforts to enhance computer performance through more extensive methods. The study presents an empirical investigation into heuristic methods for search and optimisation, demonstrating the energy efficiency of various algorithms in both simple and complex tasks. It also identifies key factors influencing the energy consumption of algorithms and their potential impact on computational processes. Furthermore, the article discusses cognitive concepts and their interplay with computational intelligence, highlighting the role of cognition in the evolution of intelligent algorithms. The conclusion offers insights into the future directions of research in this area, emphasising the need for continued exploration of energy-efficient computing methodologies.

Technology-based approaches for upper limb (UL) motor rehabilitation after stroke are designed mostly for severely affected patients to increase their recovery chances. However, the available randomised controlled trials (RCTs) focused on efficacy of technology-based interventions often include patients with a wide range of motor impairment. This scoping review aims at overviewing the actual severity of stroke patients enrolled in RCTs which claim to specifically address UL severe motor impairment. The literature search was conducted on Scopus and PubMed databases and included articles from 2008 to May 2024, specifically RCTs investigating the impact of technology-based interventions on UL motor functional recovery after stroke. Forty-eight studies were selected. They showed that upon patients’ enrolment the values of the UL Fugl-Meyer Assessment and Action Research Arm Test covered the whole range of both scales, thus revealing the non-selective inclusion of severe impaired patients. Heterogeneity in terms of numerosity, characteristics of enrolled patients, trial design, implementation, and reporting were present across studies. No clear difference in the severity of the included patients according to the intervention type was found. Patient stratification upon enrolment is crucial to best direct resources to those patients who will benefit the most from a given technology-assisted approach (personalised rehabilitation).

Purpose: People with Williams syndrome (WS, n = 20, CA = 12.5, MA = 8.9) have strong verbal short-term memory but challenged verbal long-term memory. This study aimed to evaluate the memory abilities of people with WS and examine the possibility of improving their memory performance. Methods: Twelve navigations completed the study. Fourteen indexes were used for each navigation. Controls matched in chronological age (CA, n = 20, mean age = 12.5), mental age (MA, n = 20, mean age = 8.8), 5th graders (n = 20, mean age = 10.3), and college students (CS, n = 20, mean age = 20.2) were recruited. Results: The WS group was slowest and erred more in completing tasks than the CA and MA groups. The error patterns revealed group differences in the number of extra items purchased and missed correct items. The 5th graders erred more than the CS on extra items purchased; the CA group erred more than the CS and the 5th graders on missed correct items. The WS group erred more than the CA and MA groups for incorrect items purchased, extra items purchased, missed correct items, and incorrect types purchased. The error patterns yielded replacements and confusion. Semantic features attributed to atypical processing during navigation have emerged in people with WS. Conclusion: These findings suggest that people with WS have developmental disorders in verbal long-term memory. The current study serves as a foundation for future interventions in people with WS.

The revolution of physiotherapy is achieved by the application of artificial intelligence (AI) in medical rehabilitation programs. While the integration of virtual reality (VR) and robotics has already marked significant strides in the industry, AI is taking patient rehabilitation to new heights. The integration of AI, VR and robotics in physiotherapy linked to a significant leap forward in patient rehabilitation. These technologies not only increase the effectiveness of the treatment, but also make it more accessible and attractive. In this article, we propose to study the use of AI in the management of medical rehabilitation programs, and we present a comprehensive survey of the latest empirical studies, highlighting AI-based technologies that facilitate the rehabilitation process, trying to demonstrate that the integration of AI in medical rehabilitation programs offers a transformative approach to patient care.

The study presents the conceptual development and simulation of a robotic exoskeleton for ankle rehabilitation. The device is designed for ankle rehabilitation in patients with musculoskeletal disorders, injuries, or neurological diseases. The exoskeleton is equipped with three linear electric actuators that provide precise control of joint movements in multiple planes, allowing dorsiflexion and plantar flexion, inversion, and eversion. By utilizing a screw drive, the exoskeleton provides smooth and controlled movements, significantly reducing the risk of re-injury and improving rehabilitation. Simulation of the device and simulation results showed its high compatibility with the biomechanical features of the ankle joint. Virtual testing confirmed that the exoskeleton provides the smooth, controlled movements necessary for effective rehabilitation. Due to its ability to adapt to the individual physical capabilities of the patient, the device can be used in both active and passive forms of movement support. The results of the study demonstrate the potential of the exoskeleton in clinical applications, including its use in rehabilitation centers and at home. Its cost-effectiveness, ease of use, and high accuracy of movement control make this device a promising solution for restoring the functions of the lower extremities in patients with various musculoskeletal disorders.

The recent commercial availability of stacked dielectric elastomer actuators (SDEAs) has unlocked new opportunities for their application as "artificial skeletal muscles" in rehabilitation robots and powered exoskeletons. Composed of multiple layers of thin, elastic capacitors, these actuators present a lightweight, soft, and acoustically noiseless alternative to traditional DC motor actuators commonly used in rehabilitation robotics, thereby enhancing the natural feel of such systems. Building on our previous research, this study aimed to evaluate the most recent version of commercial SDEAs to assess their potential for mechanizing rehabilitation robots. We quantified the stress and strain behavior and stiffness of these actuators in both single and 1x3 configurations (with three SDEAs connected in series). The actuators demonstrated the capability to generate up to 25 N of force, 103 KPa, a value closely resembling human biceps, with a longitudinal strain measured at about 11%. The significant increase in force generation from 10 N, in the previous version, to 25 N and displacement from 3.3% to 11% substantially enhances the applicability of this actuator rehabilitation robotics. SDEAs' high force generation capability, combined with their strain and stress characteristics comparable to that of human biological muscles make them ideal alternative actuators for biomimetic robots and applications where actuators must operate in the vicinity of the human body.

this paper focuses on a scientific study of the restoration, rehabilitation and reuse of the great throne hall, the most important hall in al-jawhara palace. it also aims to study the most important factors and forces of damage that affected the great throne hall, natural, biological, and human, and the resulting damage. field tests were performed, laboratory tests to determine fracture stress, liquidity and spandex limits tests, chemical analysis on soil samples and geoelectrical testing of the soil, and the results did not show caves or voids in the ground until a depth of 10.00 m, construc-tion materials were studied and tested using x-ray, (xrd), mechanical tests (tensile, shear, com-pression), and a study of the effect of seismic loads on the walls; the results showed horizontal and vertical cracks; based on the study and analysis of these cracks, it was possible to present modern techniques in restoration and reinforcement methods, and in conclusion, the researcher's recommendations.

Kagoshima Prefecture, Japan, is highly vulnerable to natural disasters, and requires effective disaster response and rehabilitation measures, particularly for vulnerable populations. This study aimed to investigate the current state of disaster preparedness in municipalities and identify gaps in support for vulnerable populations during disasters. A cross-sectional survey was conducted from January to March 2023, targeting officers in disaster countermeasures-related municipal departments. The survey assessed municipality awareness of vulnerable populations, understanding of their support needs, and the status of support systems during emergency evacuations. Overall, 51.2% of municipalities responded, of whom 86.4% were aware of vulnerable populations in their areas. However, only 54.5% had a clear understanding of their support needs. A small proportion of municipalities (18.2%–36.4%) had comprehensive support systems in place for vulnerable populations during emergency evacuations. Only 4.5% of municipalities were familiar with the concept of disaster rehabilitation, but 63.6% expressed interest in discussing evacuation plans with medical professionals. The findings reveal significant gaps in municipalities’ awareness and preparedness on disaster rehabilitation measures for vulnerable populations. This highlights the need for increased training, resources, and collaboration between local governments and healthcare professionals to ensure the safety and well-being of vulnerable populations during disasters.

(1) Background: With the global population aging, the demand for effective rehabilitation products for the elderly is increasing. Traditional products often fail to meet the comprehensive needs of elderly users, who require solutions addressing physical, psychological, and social aspects; (2) Methods: Using the Analytic Hierarchy Process, Quality Function Deployment, Axiomatic Design, and the System Usability Scale to identify and prioritize user needs, market research and user interviews were conducted to understand the preferences of the elderly and obtain design specifications. The focus was on multimodal sensory feedback, which was validated through the study; (3) Results: Elderly users have a strong preference for rehabilitation products that are durable, easy to use and have comprehensive sensory feedback. Intelligent rehabilitation bed as the carrier, strengthened structure, high strength material, ergonomic adjustment, integrated health monitoring system. Using digital technology for real-time health monitoring and personalized feedback to provide a comprehensive recovery experience, high user satisfaction was reported in the evaluation; (4) Conclusion: It is important to emphasize user-centered design and integrate multi-modal sensory feedback to meet the comprehensive rehabilitation needs of elderly users. Future studies should expand user samples and expert opinions to refine and validate the design and improve its effectiveness and usability.

Fatigue and dyspnea are the most commonly presented long-term complaints in individuals previously infected with SARS-CoV-2. The purpose of the study was to comprehensively evaluate diaphragm muscle function in COVID-19 survivors, as well as investigate whether potential diaphragm dysfunction will contribute to physical functioning impairment. 46 patients qualified to pulmonary rehabilitation were examined. Diaphragm muscle function parameters were evaluated using ultrasonography, while severity of dyspnea, aerobic capacity and amount of energy used by the body during physical activity were assessed by 6-minute walk test, mMRC scale and Metabolic Equivalent Task (MET), respectively. We identified 69.5% patients with diaphragm atrophy and 6.5% with diaphragm paralysis. Percentage of atrophy was not related to age, gender, BMI index, oxygen therapy use during COVID-19 infection course and severity of disease. Patients with presence of cough, fever and without loss of smell during COVID-19 course had a significantly greater values of diaphragm inspiratory thickness, while patients with cough and no smell disorders had a significantly lower percentage of diaphragm atrophy. Diaphragm functional parameters were strongly associated with selected variables of person's exercise tolerance, such as distance in 6-minute walk test, saturation level, fatigue and exertion in Borg scale. In conclusion, diaphragm muscle dysfunction is a serious long-term post-COVID aftermath and can be viewed as a major contributing factor of prolonged functional impairments.

In schizophrenia, cognition is closely linked to social competence and influences long-term prognosis. Thus, treatment should target cognitive improvement to enhance the patients’ societal adaptation. This study evaluated the effects of computer-assisted cognitive remediation therapy (CR) using RehaCom® on cognition in patients with schizophrenia. Thirty patients were randomized, with 15 assigned to the CR group and treatment usual care (TAU) and 15 to the TAU alone groups. Over 12 weeks, patients received CR twice weekly, including two computer sessions and one verbal session. Outcomes measured were cognition using the Brief Assessment of Cognition in Schizophrenia and Schizophrenia Cognition Rating Scale, intrinsic motivation using the Quality of Life Scale and Intrinsic Motivation Inventory, psychiatric symptoms using the Positive and Negative Syndrome Scale, negative symptoms using Scale for the Assessment of Negative Symptoms, and functional level using modified Global Assessment of Functioning scale for Functioning. The CR + TAU group demonstrated considerable improvements in cognition, intrinsic motivation, negative symptoms, and functional level compared to the TAU-alone group. These findings indicate that the CR using RehaCom® enhances cognition and other outcomes in schizophrenia.

People experiencing homelessness are at risk from a number of co-morbidities including traumatic brain injury, mental health disorders and various infections. Little is known about the rehabilitation needs of this population. This study took advantage of unique access to a specialist ‘Access’ GP practice for people experiencing homelessness and a local inclusion health initiative to explore the five year period prevalence of these conditions in a population of people experiencing homelessness, through electronic case record searches; and identify barriers and facilitators to healthcare provision for this population in the context of an interdisciplinary and multi specialist inclusion health team, through semi structured interviews with 12 staff working in primary and secondary care who interact with this population. The five year period prevalence of TBI, infections and mental health disorders was 9.5%, 4% and 22.8% respectively. Of those who had suffered a brain injury only 3, had accessed rehabilitation services. Themes from thematic analysis of interviews included: lack of resource, stigmatisation, under recognised multi-morbidity (including from brain injury) as barriers, trauma-informed, person-centred, adaptable, &amp; integrated and collaborative models of care as facilitators. The combination of quantitative and qualitative data suggests a potential role for rehabilitation medicine in inclusion health initiatives.

Introduction: Cleft lip with or without cleft palate (CL/P) is the most common congenital face anomaly in the world of multifactorial etiology. Objective: To determine the prevalence and characteristics of cleft palate. To identify associated risk factors to guide prevention and/or prenatal detection for early intervention and better health outcomes. To assess the rehabilitation protocols after operations in cleft palate. Design: Retrospective descriptive and clinical study. Patients: One hundred and three children with cleft palate treated in the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury, were included in the study. Methods: Records evaluation was conducted regarding sex, cleft type, mother occupation, parents education, histories of cleft in any of parents. The data were analyzed using R (R core team 2021) and the ordinal logistic regression analyses. Results: Children of stressed mothers during pregnancy had 9.4 times higher odds of having bilateral cleft. While there was no evidence that children sex, order of birth, and body mass as well as risk of maternal toxicity at work or reporting infections or drugs toxicity had a significant effect on the dependent variable. Conclusions: Children of parents with cleft history and having low educated mothers had higher probability of bilateral cleft palate. Children of stressed mothers during pregnancy had higher odds of having bilateral cleft. In literature, there is a lack of reports about rehabilitation in different operations methods in children with cleft palates.

Background: Cardiovascular diseases (CVDs) are a rising global burden. Preventative strategies such as Cardiac Rehabilitation (CR) have shown a marked reduction of disease burden. Despite this, CR is underutilized worldwide. This study aims to identify the barriers to CR among patients diagnosed with CVD. Methods: A scoping review of the literature was conducted following the Joanna Briggs Institute (JBI) guidelines. Three major databases including CINAHL, PubMed, EBSCOhost and Scopus were used to obtain studies published between 2010 and 2023. Search terms such as “Cardiac rehab*”, “Barrier*”, “Cardiovascular”, “Disease” And “diagnosis*” Were utilized in order to obtain subject-specific studies relevant to the research question. Results: From the initial 2098 studies only 14 were included in the final analysis, consisting of both qualitative and quantitative designs. The thematic analysis included “healthcare system-related factors”, “Socioeconomic factors”, and “individual characteristics”. Healthcare system-related factors were mostly related to poor availability of CR programs, lack of proper referral strategies, inadequate knowledge of CR provider and inter-provider communication issues, and lack of alternative methods of CR delivery. Socioeconomic barriers were lack of education, longer distance to CR facilities, high cost of care, unemployment, and poor income status. Identified individual characteristics were female gender, older age, and comorbidities. Conclusion: Lack of resources, poor access, educational attainment, and high cost of care were some of the barriers to CR, particularly in low and middle-income countries (LMICs). Health policymakers and healthcare providers should implement strategies incorporating issues identified in this scoping review. Systematic reviews may be required to confirm these findings.

Background: It is not clear whether rehabilitation after surgery for trigger finger is effective. The aim of this study was to reveal the effectiveness for trigger finger. Methods: This study was a randomized, controlled trial that included patients who underwent operations for trigger fingers. The patients in the rehabilitation group had postoperative occupational therapy (OT) for 3 months, while the patients in the control group were not referred for rehabilitation but received advice for a range of motion exercise. We evaluated the severity of trigger finger, Disability of Arm-Shoulder-Hand (DASH) score, pain-visual analogue scale (VAS), grip strength, whether they gained a full range of motion (ROM), and complications before and after surgery. Results: Finally, 29 and 28 patients were included in the control and rehabilitation groups, respectively. DASH score, grip strength, and ROM were significantly improved in the rehabilitation group from that preoperatively at final follow-up. Pain was significantly improved in both groups from that preoperatively at final follow-up. Subgroup analysis showed that there is a significant difference in the DASH score of patients doing housework or light work and those with a duration of symptoms &gt; 12 months between the control and rehabilitation groups at the final follow-up.

Derelict asbestos mine sites in South Africa pose a considerable risk to human, environmental and socio-economic health. Comprehensive mineralogical and geochemical datasets for the existing hazardous geological materials still exposed in Southern African derelict asbestos mines remain largely non-existent, as very little published and up-to-date literature is available. In this study three representative types of asbestos mineral fibres from derelict asbestos mines in Southern Africa, namely chrysotile from Havelock mine, amosite from Penge mine and crocidolite from Prieska mine are characterized mineralogically and geochemically to critically evaluate real-life hazards in rural and asbestos-fibre contaminated regions. The samples were examined using polarising light microscopy, X-ray fluorescence (major and trace elemental analysis), X-ray diffraction (including Rietveld refinement), specific surface area analyses and bio-durability tests. Data are discussed in view of their potential toxicities on both human health and the environment in the context of developing countries. Finally, information on the mineralogical and geochemical status of asbestos mine waste and its importance as baseline data for rehabilitation considerations is also evaluated.

Background: A growing number of studies have reported Coronavirus disease (COVID-19)-related to both respiratory and central nervous system dysfunctions. This study evaluates the neuromodulatory effects of spinal cord transcutaneous stimulation (scTS) on the respiratory functional state in healthy controls and patients with post-COVID-19 respiratory deficits as a step toward the development of a rehabilitation strategy for these patients.; Methods: In this before-after, interventional, case-controlled clinical study, ten individuals with post-acute COVID-19 respiratory deficits and eight healthy controls received a single twenty-minute-long session of modulated monophasic scTS delivered over the T5 and T10 spinal cord segments. Forced Vital Capacity (FVC), Peak Forced Inspiratory Flow (PIF), Peak Expiratory Flow (PEF), Time-To-Peak of Inspiratory Flow (tPIF), and Time-To-Peak of Expiratory Flow (tPEF) were assessed before and after the intervention; Results: In COVID-19 group, the scTS intervention led to significantly increased PIF (p= .040) and PEF (p= .049) in association with significantly decreased tPIF (p= .035) and tPEF (p= .013). In the Control Group, the exposure to scTS also resulted in significantly increased PIF (p= .010) and significantly decreased tPIF (p= .031). Unlike the results in COVID-19 group, there was significantly decreased PEF (p= .028) in association with significantly increased tPEF (p= .036). There were no changes for FVC after scTS in both groups (p= .67 and p= .503); Conclusions: In post-COVID-19 patients scTS facilitates excitation of both inspiratory and expiratory spinal neural networks leading to an immediate improvement of respiratory functional performance. This neuromodulation approach could be utilized in rehabilitation programs for patients with COVID-19 respiratory deficits.

Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n=76) or control (n=69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points respectively (p&lt;0.05). The control group showed reductions of 1.5 and 1.2 points (p&lt;0.05). The difference in depression (HRDS) between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized effect size (SMD) was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. Limitations include the lack of blinding of study participants and a relatively small sample size.

Abstract: (1) Background: existing treatment methods for neglect are concentrated on egocentric neglect and lead to various problems, such as cost/space constraints and portability. Therefore, this study seeks to determine how treatment (a.k.a., Twins Therapy, TT) can improve an existing problem in relation to neglect in stroke patients; (2) Method: The research design was a pre-post test control group design and both groups maintained existing rehabilitation treatment and added TT intervention only to the experimental group. TT intervention was conducted for a total of 20 sessions (1 session 30 min/day, 5 days/week for 4 weeks); (3) Result: as a result of comparison be-fore and after the TT intervention, there was no significant difference in MFT and MBI items (p>.05). However, the score and execution time of the Apple Cancellation Test showed significant reduction only in the experimental group (p<.05); (4) Conclusion: as a result of the study, TT im-proved not only egocentric neglect, but also allocentric neglect symptoms in stroke patients

About 70% of children and adolescents with cerebral palsy experience gait impairments which affect their autonomy and well-being. Robotic-assisted gait training using the Lokomat is particu-larly promising for rehabilitation as it provides a standardized environment favoring the massive repetition of the movement, in which physical demands are low on the therapist and high training loads can be achieved. As no guidelines exist regarding training protocols and Lokomat settings, the goal of this study was to review the literature on Lokomat-assisted gait therapy and possibly make training recommendations. The twelve studies reviewed reported both positive and null effects of Lokomat training on gait. Half of the studies combined Lokomat with other types of training and only five used a control intervention to assess its benefit. Overall, training was administered 1-5 times per week for 20-60 minutes, over 1-12 weeks. Although Lokomat settings were not always described, progressively decreasing body-weight support and guidance, while increasing treadmill speed appear to be prioritized. The variety of training protocols and settings used did not allow pooling of the studies to assess effects of interventions on gait parameters in children and adoles-cents with cerebral palsy. This review highlights the need for homogenization of interventions so that clear guidelines can emerge and be applied in rehabilitation centers.

Background: The COVID-19 pandemic has disproportionately affected people from more deprived communities. The experience of Long Covid is similarly distributed but very few investigations have concentrated on the needs of this population. The aim of this project was to co-produce an acceptable intervention for people with Long Covid, living in communities recognised as more deprived. Methods: The intervention was based on a multi-disciplinary team using approaches from sport and exercise medicine and functional rehabilitation. The co-production process was undertaken with a stakeholder advisory group and patient public involvement representation. This study identified participants by postcode and the indices of multiple deprivation (IMD); recruitment and engagement were supported by an existing health and wellbeing service. A virtual ‘clinic’ was offered with a team of professional practitioners who met participants three times each; to directly consider their needs and offer structured advice. The acceptability of the intervention was based on the individual’s participation and their completion of the intervention. Results: Ten participants were recruited with eight completing the intervention. The partnership with an existing community health and wellbeing service was deemed to be an important way of reaching participants. Two men and six women ages ranging from 38 to 73 were involved and their needs were commonly associated with fatigue, anxiety and depression with overall de-conditioning. None reported serious hardship associated with the pandemic although most were in self-employment/part-time employment or were not working due to retirement or ill-health. Two older participants lived alone, and others were single parents and had considerable challenges associated with managing a household alongside their Long Covid difficulties. Conclusions: This paper presents the needs and perspectives of eight individuals involved in the process and discusses the needs and preferences of the group in relation to their support for self- managed recovery from Long Covid.

This article explored how some state policies on rehabilitation, protection and utilization of mangroves are implemented at two locals; namely, Ca Mau provice and its sub-unit Ngoc Hien District as well as Ho Chi Minh City and its sub-unit Can Gio District and what are considered as emgerging issues in the implementation process. The study employed mixed research methods including document and thematic analysis, in-depth interviews, and group discussion. The findings showed that state policies would be adapted through the ways in which these two locals manage to silmultaneously orient their work toward accommodating the madates placed upon them and cope with the reality of socio-economic difficulties at their levels. The findings also showed some issues that need to consider addressing; namely, locals’ struggles to fill the gaps between written and implemented policies in mangrove rehabilitation, conflict among sectors and stakeholders in mangrove utilization and protection, problems in guaranteeing adequate budget for in-need-locals, inconsistence in policies on "forest: water surface” ratio in mangrove-shrimp farm, and unintended consequences in forest thinning and exploitation regimes. Based on the finding analysis, the articles discussed lessons learned from the policy implementation process on mangrove rehabilitation, management and forest allocation to household in the south of Vietnam.

Chronic diseases are characterised by cell’s autophagy and proteins disarrangement resulting in sarcopenia, hypoalbuminemia and hypo-haemoglobinaemia. Hypo-haemoglobinaemia couses worse prognosis independentely of the principal disease. Currently, the cornerstone of therapy of anaemia is iron supplementation, with or without erythropoietin for the stimulation of hematopoiesis. However, treatment strategies should incorporate the addition of heme, the principal biochemical constituent of haemoglobin. Heme synthesis follows a complex biochemical pathway. The limiting step of heme synthesis is D-ALA availability which, for its synthesis, requires Glycine and Succinil-CoA. Consequently, treatment of anaemia should not be based only on iron availability, but also on the availability of the molecules fundamental for heme synthesis. Therefore, an adequate clinical therapeutic strategy should integrate the standard iron infusion and the supply of essential amino acids and vitamins involved in the heme synthesis. We report preliminary data in selected elderly anaemic patients with congestive heart failure (CHF) and catabolic disarrangement, who, in addition to standard iron therapy, received personalized therapy with essential-AAs and vitamins involved in the maintenance of heme. Notably, such individualized therapy resulted in a significant increase in the serum concentration of haemoglobin after 30 days of treatment compared to standard iron therapy.

(1) Background: Chronic musculoskeletal pain (CMP) in adolescents can negatively affect physical, psychological and social functioning, resulting in functional disability. This study aims to evaluate the effectiveness of an outpatient rehabilitation program based on graded exposure in vivo (EP) compared with care as usual (CAU) in a RCT. The aim of the interventions (EP and CAU) is to improve functional ability in adolescents with CMP, CAU is interdisciplinary outpatient rehabilitation care, based on graded activity. (2) Methods: A pragmatic multicenter randomized clinical trial with a 12-month follow-up was used. Adolescents (12-21 years) with musculoskeletal pain were invited to participate. Primary outcome was functional disability (Functional Disability Inventory). Most important secondary measures: perceived harmfulness, pain catastrophizing and intensity. Data analysis was performed by intention-to-treat linear mixed model analysis. (3) Results: Sixty adolescents were randomized to EP or CAU and data of 53 adolescents (93% female) could be analyzed (25 EP, 28 CAU). Mean age was 16.0 years (SD=1.87). Adolescents in EP showed a clinically relevant and statistically significant decrease in functional disability (estimated mean difference at least -8.81,p-values≤0.01) compared with CAU at all time points. Significant differences in favor of EP were found for perceived harmfulness at all time points (p-values≤0.002), for pain catastrophizing (PCS) at 2 months follow-up (p-value=0.039) and for pain intensity at 4 and 10 months follow-up (p-values≤0.028). (4) Conclusion: The effectiveness of the trial is in favor of the EP and leads to a significant and clinically relevant decrease in functional disability compared to usual care.

This article presents a methodology for the design of rehabilitation devices that considers factors involved in a clinical environment. This methodology integrates different disciplines that work together. The methodology is composed by 3 phases and 13 stages with specific tasks, the first phase includes the clinical context considering the requirements of the patient and therapist during the rehabilitation, the second phase is focused in engineering based on the philosophy of digital twin, and in the third phase is evaluated the device. This article explains the characteristics of the methodology and how it was applied in the design of an exoskeleton for passive rehabilitation of the upper limb.

As construction costs continue to rise and adequate amounts of funding continues to be a challenge, the allocation of resources is of critical importance when it comes to the maintenance and rehabilitation (M&R) of highway infrastructure. A Life Cycle Assessment (LCA) methodology is presented here that integrates realistic traffic conditions in the operational phase to compare M&R scenarios over the analysis period of a 26-km stretch of Interstate-495. Pavement International Roughness Index (IRI) were determined using AASHTO’s PavementME System. Meanwhile, vehicle fuel consumption and emission factors were calculated using a combination of Google Maps®, the U.S. EPA’s Motor Vehicle Emission Simulator, the SHRP2 Naturalistic Driving Study, and MassDOT’s Transportation Data Management System. The evaluation of pavement performance with realistic traffic conditions, varying M&R strategies and material characteristics was quantified in terms of Life Cycle Cost (LCC), Global Warming Potential (GWP) and Cumulative Energy Demand (CED) for both agencies and users. The inclusion of realistic traffic conditions into the use phase of the LCA resulted in a 6.4% increase in CED and GWP when compared to baseline conditions simulated for a week long operation duration. Results from this study show that optimization of M&R type, material selection and timing may lead to a 2.72% decrease in operations cost and 47.6% decrease in construction/maintenance costs.

Background: This study aims to compare the impact of early and late post-discharge cardiopulmonary rehabilitation on the outcomes of intensive care unit (ICU) survivors. Methods: The retrospective, cohort study used a sub-database of the Taiwan National Health Insurance Research Database (NHIRD) that contains information of all patients had ICU admission between 2000 and 2012. Early group was defined if patients had received cardiopulmonary rehabilitation within 30 days after ICU discharge, and late group was define as if patients had received cardiopulmonary rehabilitation between 30 days and one year after ICU discharge. The end points were mortality and re-admission during the 3-year follow-up. Results: Among 2136 patients received cardiopulmonary rehabilitation after ICU discharge, 994 was classified early group and other 1142 patients were classified as late group. Overall, early group had a lower mortality rate (6.64% vs 10.86%, p = 0.0006), and a lower ICU readmission rate (47.8% vs 57.97%, p < 0.0001) than late group after 3-year follow-up. Kaplan-Meier analysis showed that early group had significantly lower mortality (p=0.0009) and readmission rate (p<0.0001) than late group. In multivariate analysis, the risk of ICU readmission was found to be independently associated with late group (HR, 1.28; 95% CI, 1.13-1.47). Conclusions: Early post-discharge cardiopulmonary rehabilitation among ICU survivors has the long-term survival benefit and significantly decreases the readmission rate.

This article explores how Artificial Intelligence (AI) is drastically changing the logistics industry by transforming operations and significantly improving customer satisfaction. Through meticulous analysis of real-life cases and extensive examination of numerical data, this comprehensive research thoroughly investigates the profound impact of AI on supply chain management. The findings clearly reveal the multifaceted role of AI in significantly reducing costs, greatly improving delivery accuracy, and significantly enhancing inventory control. AI is not just an incremental advancement, but rather a revolutionary leap forward for the future logistics industry, firmly paving the way for unparalleled automation, digital transformation, and operational effectiveness.

Pancreatic cancer, one of the deadliest cancers worldwide, necessitates improved therapeutics due to its low survival rate (12% in 5 years) and typically late-stage diagnosis [1]. This malignancy tends to present asymptomatically until advanced stages, leading to high rates of metastasis and limiting surgical options [2]. Genetic mutations in key genes like KRAS, CDKN2A, TP53, and SMAD4 are central to pancreatic cancer pathogenesis, driving uncontrolled cell proliferation and making treatment difficult [3]. Current treatment modalities include surgery, chemotherapy, radiation, and emerging immunotherapies. Surgery, particularly the Whipple procedure, offers the only potential cure but is applicable in just 15-20% of cases due to the late diagnosis [4]. Chemotherapy, though commonly used, offers limited long-term survival benefits [5]. Radiation therapy has seen advancements with techniques like stereotactic body radiation therapy (SBRT), which shows promise in reducing toxicity and improving outcomes [6] . Immunotherapy, particularly mRNA vaccines, has demonstrated potential in prolonging recurrence-free survival (>18 months), especially when combined with traditional therapies (13.4 months with surgical resection alone) [7] . Combinations of different treatments have been found to be effective. The challenge of early pancreatic cancer diagnosis mirrors the difficulty of disease management. Prophylactic immunotherapies, like vaccines, could offer a crucial breakthrough for prevention and recurrence reduction. As pancreatic cancer remains difficult to treat effectively, continued research and development in preventative and therapeutic strategies are essential to improving outcomes.

In an outstanding article published in 2008, Suzuki obtained a nice generalization of the Banach contraction principle from which derived a characterization of metric completeness. Although Suzuki’s theorem has been successfully generalized and extended in several directions and contexts, we here show by means of a simple example that the problem of achieving, in an obvious way, its full extension to the framework of w-distances does not have an emphatic response. Motivated by this fact we introduce the concept of presymmetric w-distance on metric spaces, we give some properties and examples of this new structure and show that it provides a reasonable setting to obtain a real and hardly forced w-distance generalization of Suzuki’s theorem. This is realized in our main result, which is a fixed point theorem that involves presymmetric w-distances and certain contractions of Suzuki-type. We also discuss the relationship between our main result and the well-known w-distance full generalization of the Banach contraction principle, due to Suzuki and Takahashi. Connected to this approach we prove another fixed point result that compare with our main result through some examples. Finally, we state a characterization of metric completeness by using our fixed point results.

Polychlorinated dibenzo-p-dioxins and polychlorinated dibenzo-p-furans (PCDD/Fs) are environmental pollutants with a great persistence, capacity of bioaccumulation, and well known important toxic effects in humans and animals. Incinerators of hazardous, municipal and medical waste, chlorine bleaching of paper pulp, cement plants, and the traffic of motor vehicles are the most frequent emission sources of these compounds. The diet, followed at a great distance by inhalation, is generally the main way of human exposure to PCDD/Fs. Human biomonitoring is of a great importance to prevent potential adverse effects derived from exposure to chemicals such as PCDD/Fs. In relation to this, blood is among the most used biological monitors. In the current review, we have summarized the recent information (2000-2009) published in the scientific literature (databases: Scopus and PubMed) on the concentrations of PCDD/Fs in blood samples of non-occupationally exposed populations, as well as in some groups of occupationally exposed individuals. We have revised a number of studies conducted in various African American, Asian and European countries, and Australia. Unfortunately, the information is quite limited. No data are available for most countries over the world. Based on the results here reviewed –where available- the current health risks for the general populations do not seem to be of concern. Moreover, taking into account the important reductions observed in the levels of PCDD/Fs in foodstuffs, new decreases in the concentrations of PCDD/Fs in blood -and other biological tissues- are very probable in the immediate years.

The earthquake alert of the early warning systems is based on the delay that the S waves have in reference to the P waves and on the interpretation of the P waves’ specific parameters. One of the most used parameters for estimating the moment magnitude of an earthquake is the characteristic period measured in the first 3 seconds of the appearance of the P wave. The typical method determines the characteristic period in the time domain, based on the velocity wave and the displacement wave. In the present work, we present a method for estimating the frequency of the characteristic period. This method includes zero padding of the P wave sequence, conversion of the extended sequence from the time domain to the frequency domain, the identification of local frequency maxima and the calculation of the weighted average of the frequency based on the identified maxima. Tests conducted on synthetic signals, as well as standard deviation evaluation tests for simultaneous recordings on several stations, reveal better performance to the usual method.

Cell migration crucial contributor to metastasis, a critical process associated with the mortality of cancer patients. The initiation of metastasis is triggered by epithelial-mesenchymal transition (EMT), along with the changes of the expression of EMT marker proteins. Inflammation plays a significant role in carcinogenesis and metastasis. Lipopolysaccharide (LPS), a typical inflammatory agent, promoted the generation of superoxide through the activation of p-Tyr42 RhoA, Rho-dependent kinase 2 (ROCK2) and the phosphorylation of p47phox. In addition, p-Tyr42 RhoA activated phospholipase D1 (PLD1), with PLD1 and phosphatidic acid (PA) being involved in superoxide production. PA also regulated the expression of EMT maker proteins. Consequently, we have identified MHY9 (Miosin IIA, NMIIA) as a PA-binding protein in response to LPS. MYH9 also contributed cell migration and the alteration of the expression of EMT marker proteins. P-Tyr42 RhoA, PLD1 and MYH9 associated to form a complex, which was distributed in both the cytosol and nucleus. In addition, we have found that p-Tyr42 RhoA and PLD1 associated with the ZEB1 promoter. Taken together, we propose that p-Tyr42 RhoA and PLD1, responsible for producing PA, and PA-bound MYH9 are involved in the regulation of ZEB1 expression, thereby promoting cell migration.

Abstract: (1) Background: Surgery is the best curative option for Gastric Cancer (GC). However, morbimortality associated with surgery still a significant problem. Thus, it is essential to determine the preoperative surgical risk, to optimize outcomes in higher risk patients. (2) Methods: Patients who underwent curative gastrectomy between January 2010 and December 2013 were included, obtaining a sample of 131 patients, and the acuity of the scales understudy was evaluated. The predictive power of the scales was evaluated through calibration and discrimination. (3) Results and Conclusions: Regarding mortality, the scales demonstrated good calibration, with POSSUM and P-POSSUM obtaining the best O:E ratio. The scales presented good discrimination, with POSSUM showing the best result. Considering morbidity, the scales showed good calibration and discrimination. POSSUM and P-POSSUM seem to have potential in predicting morbidity and mortality when applied to the studied population, but there is a need for further studies in this area.

Emerging evidence has shown that microRNAs play pivotal roles in wound healing. MicroRNA-21 (miR-21) was previously found to upregulate in order to fulfill an anti-inflammation role for wounds. Exosomal miRNAs have been identified and explored as essential markers for diagnostic medicine. However, the role of exosomal miR-21 in wounds has yet to be well studied. In order to facilitate the early management of poorly healing wounds, we developed an easy-to-use, rapid, paper-based microfluidic-exosomal miR-21 extraction device to determine wound prognosis in a timely manner. We isolated and then quantitatively examined exosomal miR-21 in wound fluids from normal tissues, acute and chronic wounds. Eight improving wounds displayed lower levels of exosomal miR-21 expression after wound debridement. However, four instances of increased exosomal miR-21 expression levels were notably associated with patients with poor healing wounds despite aggressive wound debridement, indicating a predictive role of tissue exosomal miR-21 for wound outcome. Paper-based nucleic acid extraction device provides a rapid and user-friendly approach for evaluating exosomal miR-21 in wound fluids as a means of monitoring wounds. Our data suggest that tissue exosomal miR-21 is a reliable marker for determining current wound status.

If an algebra of type $A$ contains a subalgebra which is also an algebra of type $B$, then it is a Smarandache $B$-type $A$-algebra provided the subalgebra of type $B$ contains at least two elements. This generalizes the notion of Smarandache group, where the group of order $\geq 2$ is a subsemigroup of a semigroup. In this paper we investigate a number of such pairings and we deduce a number of conclusions as a consequence.

The Median Based Unit Weibull is a new 2 parameter unit Weibull distribution defined on the unit interval (0,1). Estimation of the parameters using MLE encountered some problems like large variance. Using generalized method of moments (GMMs) and percentile method may ameliorate this condition. This paper introduces GMMs and the percentile methods for estimating the parameters of the new distribution with illustrative real data analysis.

Interspecific competition between mosquito larvae may affects adult vectorial capacity, potentially reducing disease transmission. It also influences population dynamics, cannibalistic and predatory behaviors. However, knowledge of interspecific competition between Ae. aegypti and Anopheles species is limited. The study examined interspecific competition between Ae. aegypti larvae and either An. arabiensis, An. gambiae, or An. funestus on individual fitness in semi-field settings. The experiments involved density combinations of 100:100, 200:0, and 0:200 (Ae. aegypti: Anopheles), reared with and without food, in small habitat (8.5 cm height × 15 cm diameter) with 0.5 litre and medium habitats (15 cm height × 35 cm diameter) with 1 litre of water. The first group received Tetramin® fish food (0.02 g), while the second group was unfed to assess cannibalism and predation. While, interspecific competition affected both genera, Anopheles species experienced greater effect, with reduced survival and delayed development, compared to Ae. aegypti. The mean wing lengths of all species were significantly small in small habitats in mixed population (p &lt; 0.001). The presence of food reduced cannibalism and predation compared to its absence. These interactions have implications for diseases transmission dynamics and can serve as biological indicators to signal the impacts of vector control interventions.

In response to a perceived epidemic of coronary heart disease, Ancel Keys introduced the lipid-heart hypothesis in 1953 which asserted that high intakes of total fat, saturated fat, and cholesterol lead to atherosclerosis and that consuming less fat and cholesterol, and replacing saturated fat with polyunsaturated fat, would reduce serum cholesterol and consequently the risk of heart disease. Keys proposed an equation that would predict the concentration of serum cholesterol (DChol.) from consumption of saturated fat (DS), polyunsaturated fat (DP), and cholesterol (DZ): ΔChol. = 1.2(2ΔS − ΔP) + 1.5ΔZ. However, the Keys equation conflated natural saturated fat and industrial trans-fat into a single parameter and considered only linoleic acid as the polyunsaturated fat. This ignored the widespread consumption of trans-fat and its effects on serum cholesterol and promoted an imbalance of omega-6 to omega-3 fatty acids in the diet. Numerous observational, epidemiological, interventional, and autopsy studies have failed to validate the Keys equation and the lipid-heart hypothesis. Nevertheless, these have been the cornerstone of national and international dietary guidelines which have focused disproportionately on heart disease and much less so on cancer and metabolic disorders, which have steadily increased since the adoption of this hypothesis.

In this paper, we define and investigate modified p-Leonardo, p-Leonardo-Lucas and p-Leonardo sequences as special cases of the generalized Leonardo sequence. We present Binet's formulas, generating functions, Simson formulas, and the summation formulas for these sequences. Moreover, we give some identities and matrices related with these sequences. Furthermore, we show that there are close relations between modified p-Leonardo, p-Leonardo-Lucas, p-Leonardo numbers and Fibonacci, Lucas numbers.

For evaluating probabilities of arbitrary random events with respect to a given multivariate probability distribution, specific techniques are of great interest. An important two-dimensional high risk limit law is the Gauss-exponential distribution whose probabilities can be dealt with based upon the Gauss-Laplace law. The latter will be considered here as an element of the newly introduced family of (p,q)-spherical distributions. Based upon a suitably defined non-Euclidean arc-length measure on (p,q)-circles we prove geometric and stochastic representations of these distributions and correspondingly distributed random vectors, respectively. These representations allow dealing with the new probability measures similarly like with elliptically contoured distributions and more general homogeneous star-shaped ones. This is demonstrated at hand of a generalization of the Box-Muller simulation method. En passant, we prove an extension of the sector and circle number functions.

In this research paper, we implement the theory of the primorial function, to develop the Supremum and Infimum bounds for the sum of (log(p))². There are, however, considerable computational difficulties related to these bounds. Therefore, from a pragmatic point of view, a set of Upper and Lower bounds had been developed to bypass this issue. Despite the increased estimation error, the Upper and Lower bounds are still considered sufficiently accurate, while facilitating an easy and fast computation of the estimate of the sum.

Background/Objectives: The aim of the narrative review was to identify information on the impact of technological interventions (such as telehealth and mobile health) on the health promotion of cardiac patients from diverse populations; Methods: Online databases of PubMed, and Cochrane Library were searched for articles in the English language regarding technological interventions for health promotion in cardiac patients. In addition, a methodological quality control process was conducted. Exclusion was based on first reading the abstract and then the full manuscript confirming content was not related to cardiac patients and technological interventions; Results: 11 studies were included in the review after quality control analysis. The sample size reported in these studies ranged from 12 to 1424 subjects. In 8 studies mobile phones, smartphones and apps were used as mHealth intervention with tracking and texting component; 2 studies used videoconferencing as a digital intervention program, while one study focused on using physical activity trackers; Conclusions: This review highlights the digital divide as individuals with limited eHealth literacy and lack of technological knowledge are not motivated or able participate in these interventions. Finding methods to overcome these barriers are important and can be solved to some extent by providing the technology and technical support.

ACL injuries present significant challenges in sports medicine, particularly in restoring knee joint function and preventing further complications like subsequent injuries or post-traumatic osteoarthritis. Traditional rehabilitation techniques, which often rely on pre-planned exercises and standardized assessments, may not adequately prepare athletes for the unpredictable nature of sports. This paper argues for a comprehensive approach that recognizes ACL injuries as failures of complex nonlinear systems rather than merely biomechanical deficiencies. The complexity of ACL injuries involves a dynamic interplay of individual skills, team dynamics, and external conditions. Traditional rehabilitation approaches that focus solely on biomechanical factors overlook the critical role of interpersonal dynamics and sensorimotor control. The brain’s integration of sensory information to form a comprehensive environmental representation is vital for motor actions. Disruptions in this sensorimotor feedback loop can impair motor control, increasing the risk of ACL injuries. Effective rehabilitation should enhance sensory integration and feedback mechanisms, improving motor control and reducing re-injury risk. Addressing proprioceptive deficits and arthrogenic muscle inhibition (AMI) is crucial for successful rehabilitation. Neurocognitive training, focusing on enhancing decision-making and motor responses, is essential for sports performance and injury prevention. Techniques like neurofeedback training can optimize brain activity patterns, leading to better motor responses and adaptation to dynamic environments. Psychological factors such as motivation, anxiety, and fear significantly influence recovery. Integrating psychological support into rehabilitation programs can address these factors, leading to more comprehensive and effective recovery strategies. Innovative rehabilitation approaches, including EMG biofeedback, motor imagery, and virtual reality-based training, can enhance reactive motor planning and adaptability, preparing athletes for the demands of their sport. The future of ACL rehabilitation lies in embracing the complexity of the sensorimotor system and developing multidisciplinary interventions that promote beneficial neuroplasticity. Advances in neuroscience and technology, such as artificial intelligence, can lead to more personalized and effective rehabilitation programs. Recognizing and addressing the multifaceted nature of ACL injuries can significantly improve rehabilitation outcomes, ensuring athletes can safely and effectively return to their sports.

This study aimed to elucidate the perception gap regarding instructional matters between special education teachers and vocational rehabilitation practitioners involved in transition support in Japan. To this end, 126 vocational support providers affiliated with the Employment and Life Support Centers for persons with disabilities, which are vocational rehabilitation institutions in Japan, and 129 special education teachers from schools for students with intellectual disabilities in Prefecture X, Japan, were surveyed. They were asked to respond on the importance of teaching skills that constitute vocational readiness by means of a questionnaire comprising 25 items across five layers: vocational aptitude, basic work habits, interpersonal skills, daily living management, and health management, both during school and after graduation. The results revealed a perception gap in each of the first layer, vocational aptitude, and second layer, work habits. Additionally, only in the second layer, work habits, did special education teachers recognize the importance of instruction more during the school period than after graduation. Moving forward, it is necessary for both institutions involved in transition support to collaborate, focusing on students with disabilities based on the identified gap.

Exoskeleton technology has been shown to be useful for individuals with spinal cord injury (SCI), potentially facilitating their recovery of motor function and social reintegration. However, studies on the safety and usability of exoskeletons are limited. This study aimed to design a powered exoskeleton for SCI and evaluate its safety and usability. Ten healthy adults participated in this study. The prototype exoskeleton featured an adjustable frame, computer-controlled hip and knee joint actuators, and a gait-trigger sensor. The experimental actions included walking, standing, and sitting, with and without the prototype. Safety outcomes included adverse events, vital signs, numerical rating scale (NRS) scores for pain, discomfort, and fatigue, and prototype-human body clearance. Usability outcomes included donning and doffing times, subjective ratings, gait speed, stride length, and kinematic parameters of hip and knee joint angles. Safety outcomes showed no serious adverse events, stable vital signs, minimal NRS scores, and acceptable clearance. Usability outcomes showed high efficiency and received positive ratings. Kinematic parameters showed significant positive correlations between normal walking and walking with the prototype for both hip and knee joint angles, confirming its effectiveness in assisting walking. However, further device improvements and gait parameter tuning are necessary for future clinical application.

Spina bifida, a congenital neural tube defect, presents a complex set of challenges, particularly in motor function, for individuals across the lifespan. The condition is characterized by incomplete closure of the spinal column during embryonic development, leading to a spectrum of motor impairments such as gait abnormalities, muscle weakness, and compromised functional mobility. The prevalence of spina bifida remains a global concern, affecting approximately 1 in 1000 live births. This research investigates the potential impact of virtual reality (VR) rehabilitation on motor function in individuals with spina bifida in Tanzania. A randomized controlled trial involving 120 participants is designed, with one group undergoing traditional rehabilitation and another engaging in a six-week VR rehabilitation program. Motor function assessments, including gait analysis, muscle strength measurements, and functional mobility tests, were conducted at baseline, midpoint, and post-intervention. Preliminary analysis suggests that VR rehabilitation may offer unique benefits, leading to improvements in motor function. The study aims to contribute valuable insights into the efficacy of VR-based interventions for enhancing the motor capabilities of individuals with spina bifida, providing a foundation for future rehabilitation strategies in this population.

This prospective observational cohort pilot study included 22 cats diagnosed with partial traumatic brachial plexus injury (PTBPI), aiming to explore the response of an early intensive neurorehabilitation protocol in a clinical setting. This protocol included functional electrical stimulation (FES), locomotor treadmill training and kinesiotherapy exercises, starting at the time with highest probability of nerve repair. The synergetic benefits of this multimodal ap-proach were based on the potential structural and protective role of proteins and release of neurotrophic factors. Furthermore, parametrization of FES was according to the presence or absence of deep pain. Results have shown that 72.6% (16/22) cats achieved ambulation, with 9 cats within 15 days, 2 cats until 30 days and 5 cats until 60 days. During the 4 years follow-up, there was evidence of improvement on both muscle mass and muscle weakness, in addition to the disappearance of neuropathic pain. Notably, after the 60 days of neurorehabilitation, 3 cats improved ambulation after arthrodesis of the carpus. Thus, early rehabilitation, with FES ap-plied at the first weeks after injury and accurate parametrization according to the deep pain perception, is suggestive to help in functional recovery and ambulation, reducing probability of amputation.