In recent years, numerous approaches have been developed to comprehend the molecular altera-tions underlying thyroid cancer (TC) oncogenesis and explore novel therapeutic strategies for TC. It is now well established that the neurokinin-1 receptor (NK-1R) is overexpressed in cancer cells and that NK-1R is essential for viability of cancer cells. The binding of substance P (SP) to NK-1R in neoplastic cells plays a pivotal role in cancer progression by promoting neoplastic cell growth, protecting tumour cells from apoptosis, triggering invasion and metastasis through enhanced migration of cancer cells, and stimulating endothelial cell proliferation for tumour angiogenesis. Remarkably, all types of human TC (papillary, follicular, medullary, anaplastic), as well as met-astatic lesions, exhibit overexpression of SP and NK-1R compared to the normal thyroid gland. TC cells synthesize and release SP, which exerts its multiple functions through autocrine, para-crine, intracrine, and neuroendocrine processes, including the regulation of tumour burden. Con-sequently, the secretion of SP from TC results in increased SP levels in plasma, which are signifi-cantly higher in TC patients compared to controls. Additionally, NK-1R antagonists have demonstrated a dose-dependent antitumour action. They impair cancer cell proliferation on one side and induce apoptosis of tumour cells on the other side. Furthermore, it has been demonstrat-ed that NK-1R antagonists inhibit neoplastic cell migration, thereby impairing both invasiveness and metastatic abilities, as well as angiogenesis. Given the consistent overexpression of NK-1R in all types of TC, targeting this receptor represents a promising therapeutic approach for TC. Therefore, NK-1R antagonists, such as the drug aprepitant, may represent novel drugs for TC treatment.

The aim of this systematic review is to describe and to identify prospect of β-Tricalcium Phosphate (β-TCP) as Alveolar Bone Grafting (ABG) in Cleft Lip/Palate (CL/P) or alveolar bone cleft defect. A systematic review protocol based on Preferred Reporting Items for Systematic Reviews and Meta Analyses 2020 (PRISMA 2020) was drafted. The literature search was conducted with MEDLINE/PubMed, Web of Science/ ISI-Web of Knowledge, Scopus and Cochrane Library with English language and no publication year limits. The keywords yielded a total of 5824 publications. There are 3196 suitable articles to evaluate after removing duplicates and languages. Afterward, 1315 studies left after doing title and abstract reading. In addition, 85 full-articles were assessed for eligibility. The read the complete texts of those papers and eventually chose 20 that matched the inclusion requirements. Thirteen of the twenty studies included in this systematic review had a low risk of bias, one had a high risk of bias, and six had moderate bias which not report the randomization. β-TCP as ABG is biocompatible, visible and practical, offers a less invasive procedure, and does not interfere with orthodontic treatment. β-TCP as synthetic ABG can be the alternative to autologous bone grafts with several terms and conditions. Improvement of β-TCP efficacy for ABG in CL/P or alveolar bone cleft defects can be done by a tissue engineering approach combining β-TCP with growth factor, mesenchymal stem cells, or other graft materials and modification of β-TCP physical properties.

Respiratory syncytial virus (RSV) RNA synthesis takes place in cytoplasmic viral factories also called inclusion bodies (IBs), which are membrane-less organelles concentrating the viral RNA polymerase complex. IBs assembly is driven by liquid-liquid phase separation promoted by interactions between the viral nucleoprotein N and the phosphoprotein P. We recently demonstrated that cyclopamine (CPM) inhibits RSV multiplication by disorganizing and hardening IBs. Although a single mutation in the viral transcription factor M2-1 induced resistance to CPM, the mechanism of action of CPM still remains to be characterized. Here, using FRAP experiments on reconstituted pseudo-IBs both in cellula and in vitro, we first demonstrated that CPM activity depends on the presence of M2-1 together with N and P. We show that CPM impairs the competition between P and RNA binding to M2-1. As mutations on both P and M2-1 induced resistance against CPM activity, we suggest that CPM may affect the dynamics of the M2-1−P interaction, thereby affecting the relative mobility of proteins contained in RSV IBs. Overall, our results reveal that stabilizing viral protein-protein interactions is an attractive new antiviral approach. They pave the way for the rational chemical optimization of new specific anti-RSV molecules.

The paper considers coherent states for the representation of Weyl commutation relations over a field of $p$-adic numbers. A geometric object, a lattice in vector space over a field of p-adic numbers, corresponds to the family of coherent states. It is proved that the bases of coherent states corresponding to different lattices are mutually unbiased, and the operators defining the quantization of symplectic dynamics are Hadamard operators.

A paradigm shift away from null hypothesis significance testing seems in progress. Based on simulations, we illustrate some of the underlying motivations. First, P-values vary strongly from study to study, hence dichotomous inference using significance thresholds is usually unjustified. Second, statistically significant results have overestimated effect sizes, a bias declining with increasing statistical power. Third, statistically non-significant results have underestimated effect sizes, and this bias gets stronger with higher statistical power. Fourth, the tested statistical hypotheses usually lack biological justification and are often uninformative. Despite these problems, a screen of 48 papers from the 2020 volume of the Journal of Evolutionary Biology exemplifies that significance testing is still used almost universally in evolutionary biology. All screened studies tested default null hypotheses of zero effect with the default significance threshold of p = 0.05, none presented a pre-specified alternative hypothesis, pre-study power calculation, and the probability of ‘false negatives’(beta error). The results sections of the papers presented 49 significance tests on average (median 23, range 0–390). Of 41 studies that contained verbal descriptions of a ‘statistically non-significant’ result, 26 (63%) falsely claimed the absence of an effect. We conclude that studies in ecology and evolutionary biology are mostly exploratory and descriptive. We should thus shift from claiming to ‘test’ specific hypotheses statistically to describing and discussing many hypotheses (possible true effect sizes) that are most compatible with our data, given our statistical model. We already have the means for doing so, because we routinely present compatibility (‘confidence’) intervals covering these hypotheses.

A vivid debate is ongoing in the scientific community about statistical malpractice and the related publication bias. No general consensus exists on the consequences and this is reflected in heterogeneous rules defined by scientific journals on the use and reporting of statistical inference. This paper aims at discussing how the debate is perceived by the agricultural economics community and implications for our roles as researchers, contributors to the scientific publication process, and teachers. We start by summarizing the current state of the p-value debate and the replication crisis, and commonly applied statistical practices in our community. This is followed by motivation, design, results and discussion of a survey on statistical knowledge and practice among the researchers in the agricultural economics community in Austria, Germany and Switzerland. We conclude that beyond short-term measures like changing rules of reporting in publications, a cultural change regarding empirical scientific practices is needed that stretches across all our roles in the scientific process. Acceptance of scientific work should largely be based on the theoretical and methodological rigor and where the perceived relevance arises from the questions asked, the methodology employed, and the data used but not from the results generated. Revised and clear journal guidelines, the creation of resources for teaching and research, and public recognition of good practice are suggested measures to move forward.

We utilized laser irradiation as a potential technique in tuning the electrical performance of NiOx/SiO2 thin film transistors (TFTs). By optimizing the laser fluence and the number of laser pulses, the TFT performance is evaluated in terms of mobility, threshold voltage, on/off current ratio and subthreshold swing, all of which were derived from the transfer and output characteristics. The 500 laser pulses irradiated NiOx/SiO2 TFT exhibited an enhanced mobility of 3 cm2/V-s from a value of 1.25 cm2/V-s for as-deposited NiOx/SiO2 TFT. The laser-irradiated NiOx material likely has a significant concentration of defect gap states, which could also be involved in light absorption processes. Second, and more importantly, the excess energy that the photogenerated charge carriers possess (due to the significant difference between the photon energy and the bandgap of NiOx), combined with the very high light intensity, would result in complex thermal and photo thermal changes thus resulting in an enhanced electrical performance of p-type NiOx/SiO2 TFT structure.

Increasing evidence suggests that prenatal exposure to opioids can adversely influence brain development, yet, limited data exists on the effects of opioid-exposure on preschool language development. Our study aimed to characterize the nature and prevalence of language problems in children prenatally exposed to opioids, and the factors that support or hinder language acquisition. A sample of 100 children born to pregnant women in methadone maintenance treatment and 110 randomly identified non-exposed children were studied from birth to age 4.5 years. At 4.5 years, 89 opioid-exposed and 103 non-exposed children completed the preschool version of the Clinical Evaluation of Language Fundamentals (CELF-P) as part of a comprehensive neurodevelopmental assessment. Children prenatally exposed to opioid had poorer receptive and expressive language outcomes at age 4.5 years compared to non-exposed children. After adjustment for child sex, maternal education, other pregnancy substance use, maternal pregnancy nutrition and prenatal depression, opioid exposure remained a significant independent predictor of children’s total CELF-P language score. Examination of a range of potential intervening factors showed that a composite measure of the quality of parenting and home environment at 18 months and early childhood education participation at 4.5 years were important positive mediators.

A renewable cyclic monoterpene obtained from citrus peel, limonene is widely used as a fra-grance, nutraceutical ingredient, antibacterial, biopesticide, and green extraction solvent. Indus-trial demand largely exceeds supply. After reviewing recent advances in the recovery of limonene from citrus peel and residues with a particular attention to benign-by-design extractive processes, we focus on the latest results in its dehydrogenation to p-cymene via heterogeneous catalysis.

Distinguishable annual growth rings produce in Pinus roxburghii are an asset to find out the age of individual tree. This paper aimed to determine the age of P. roxburghii through coring samples and test the relationship with forest production. The biomass estimated, girths measured at two different sections and heights measured which allowed to determine the rate of tapering of the stand. The regression analysis was performed to test the relationship between various variables. The mean age of the P. roxburghii stand was found to be 23.97 (~24 years). The result showed the significant (p<0.05) positive correlation coefficient has been seen between age with girth at breast height, biomass, volume and carbon stock. However, no significant (p>0.05) correlation (r = 0.08) was found between age and height of the stand. In contrast, a correlation between diameter at breast height (DBH) was significant (p<0.05) and positive with volume, biomass, but no significant (p>0.05) correlation (r = 0.14) found between DBH and height of the stand. However, height has a significant (p<0.05) positive correlation with biomass. The mean biomass was 375 kg and mean annual increment (MAI) was 15 kg per tree. Rate of tapering of the studied stand predicted to be 3 cm diameter decreased with trunk height running at 100 cm from base to upward of P. roxburghii stand and vice versa. Result suggests that height-age relation is very weak whereas age, DBH, biomass and carbon has a significant correlation signifies that time-based forests' production and potential production estimation can be obtained in a relatively accurate way by utilizing the age of stand. The time-based forest production analysis is pioneer work in Nepal. The study affirms the tree ring count in P. roxburghii would be a credible and accurate method to determine the age of standing trees.

In this work, magnetic CuFe₂O₄/Ag nanoparticles activated by porous covalent organic frameworks (COF) was fabricated to evaluate the heterogenous reduction of 4-nitrophenol (4-NP). The core-shell CuFe₂O₄/Ag@COF was successfully prepared by polydopamine reduction of silver ions on CuFe₂O₄ nanoparticles, followed by COF layer condensation. With integrating the intrinsic characteristics of the magnetic CuFe₂O₄/Ag core and COF layer, the obtained nanocomposite exhibited features of high specific surface area (464.21 m² g^-1), ordered mesoporous structure, strong environment stability, as well as fast magnetic response. Accordingly, the CuFe₂O₄/Ag@COF catalyst showed good affinity towards 4-NP via π-π stacking interactions and possessed enhanced catalytic activity compared with CuFe₂O₄/Ag and CuFe₂O₄@COF. The pseudo-first-order rate constant of CuFe₂O₄/Ag@COF (0.77 min^-1) is 3 and 5 times higher than CuFe₂O₄/Ag and CuFe₂O₄@COF, respectively. The characteristics of bi-catalytic CuFe₂O₄/Ag and the porous COF shell of CuFe₂O₄/Ag@COF made a contribution to improve the activity of 4-NP reduction. The present work demonstrated a facile strategy to fabricate COF activated nano-catalysts with enhanced performance in the fields of nitrophenolic wastewater treatment.

In this paper, we have used magnetron sputtering to grow the high-quality GeSn layer on Ge (100) with Sn compositin up to 7%. The crystallinity of the GeSn layer is pretty good, and the strain relaxation degree of the GeSn layer is evaluated to be approximately 50%. The root mean square (RMS) value is 0.8 nm, and the averaged TDDs in the GeSn layer is 8.7×109 cm-2, which is obtained from the rocking curve of GeSn layer along (004) plane. PL measurement result shows the significant optical emission from the deposited high-quality GeSn layer, which also means that magnetron sputtering is an optional way to achieve the higher Sn composition GeSn luminescent material. To verify whether our deposited GeSn can used for optoelectronic devices, we fabricate the simple vertical p-i-n diode, and the room temperature current-voltage (I-V) characteristic was obtained. This result paves the way for future sputtered-GeSn optimization, which is critical for the optoelectronic application.

In this work, nylon 6/ P(N-phenylmaleimide-alt-styrene) blends were prepared by melt blending, and the mechanical, heat-resistant, crystallographic and dynamical mechanical properties of nylon 6/ P(N-phenylmaleimide-alt-styrene) blends with different contents were investigated and analyzed. The results showed that the mechanical properties decreased with increasing PNS, while the heat deflection temperature (HDT), relative crystallinity (Xn), and storage modulus (G’) increased with increasing PNS. The results of differential Scanning Calorimetry (DSC) proved the PNS played the positive role of nucleating PA6. And the results of dynamic mechanical analysis (DMA) proved the PNS could improve the rigidity of PA6/PNS blends. From the SEM, these PNS domains were between 0.2 and 4 μm in diameter. The experimental results indicated that the addition of PNS improved the rigidity of PA6/PNS blends, and then improved the heat-resistant property.

Incidental P losses from non-point sources may contribute to eutrophication and to decreased soil fertility. These incidents have been related to heavy rainfall on freshly fertilized agricultural soils and little is known about such incidents on more natural soils or in forests. The aim of this work is to determine if incidents of high P leaching also occur in spruce forests, and if such incidents are of significance in P cycling. We found a peak in the mineral soil solution showing that single events of high P leaching occur. The orthophosphate concentration in the Bf-horizon of the 80-year old spruce forest peaked in the autumn of the second year of a continuous monitoring. The concentration increased by more than 85 times compared to the highest concentration obtained earlier during the sampling. The amount leached during this 6 months peak is 10 times higher than the average annual leaching. This P leaching might be due to a combination of high P deposition/through-fall and a high anion exchange with dissolved-organic-carbon and Cl-. We suggest that single events of high sub-surface P leaching may contribute to the overall P leaching, and might increase with the global warming as more DOC is expected to be released to the soil solution.

Delirium is the most common complication after major surgeries, with incidence rates ranging from 50% to 87%. Fortunately, postoperative delirium is preventable in up to 50% of patients, with the best preventive strategy being non-pharmacological interventions. However, these therapeutic approaches often face scalability challenges due to the complexity and high variability of their delivery, low patient engagement, and the existing clinical workforce constraints in the hospital setting. Cognitive stimulation is a non-pharmacological intervention with the potential to overcome the scalability and sustainability challenges of other non-pharmacological approaches, but evidence supporting its use is limited, especially in older adults at high risk for delirium. This narrative literature review examines evidence-based cognitive stimulation techniques being used as a non-pharmacological approach to prevent delirium in hospital settings.

Background/Objectives: Nowadays there is a progressive increase in surgical interventions in the fields of cardiology and oncology. This situation increasingly involves the need to identify strategies for managing complications that may affect patients in the post-surgical period, during the rehabilitation phase. Among the symptoms most frequently encountered in this context are pain and postural dysfunction, for which a decisive support could derive from the application of Focused Mechano-Acoustic Vibrations (FMAVs) therapy. Methods: In this pilot observational study, 20 patients (12 women and 8 men; average age of 48 years) who underwent cardiac or oncological surgery were observed during the execution of a FMAVs treatment protocol applied in the post-operative period. Patients were evaluated at the beginning and at the end of the protocol through the Numeric Pain Rating Scale (NPRS) and the computerized postural analysis for the calculation of the Postural Biometric Index (PBI), that quantifies postural dysfunctions. All patients were treated with 8 biweekly sessions of FMAVs applied on specific Myofascial Trigger Points (MTrPs). Results: At the end of the protocol, significant reductions of 26.4% for pain detected by NPRS and 17.9% for postural dysfunction detected by PBI were observed. Conclusions: Treatment with FMAVs can determine improvements in pain and postural dysfunction in cardiac and oncological patients subjected to surgery. This preliminary study lays the foundation for further in-depth research on the topic.

This study presents the innovative design and fabrication of a 3D-printed prosthesis arm aimed at enhancing automated hand rehabilitation for targeting hemiplegic patients who cannot open and close their hands. By leveraging surface electromyography (EMG) signals, the prosthesis arm translates muscle contractions in the forearm into precise hand movements, facilitating more effective rehabilitation. A comprehensive analysis of existing prosthesis designs guided the creation of a new, improved prototype. Using a concept scoring evaluation matrix, the best concept design was selected, designed, and fabricated through additive manufacturing. The finished prosthesis improves grip stability by imitating natural finger movements with flexible materials and a tendon system made of elastic ropes and fishing lines. Experimental comparisons between the designed prosthesis arm and a human hand showed significant similarities in flexion angles, though further refinement is needed for measurement accuracy and tactile feedback. The result presents the designed prosthesis arm validity and can be used in automated control rehabilitation in the future. This research also highlights the potential of 3D printing and EMG technology in creating customizable, efficient prosthesis arms for automated rehabilitation, suggesting pathways for future improvements and broader applications.

Objective: To analyze and investigate the impact of early rehabilitation training based on developmental sequencing on the growth and development of late preterm infants. Methods: This study focused on preterm infants admitted to our hospital from June 2021 to November 2021. Strict screening was applied to select 54 cases for inclusion. Clinical data were collected for all study subjects, and based on different intervention plans, they were divided into a control group and an experimental group, with 27 cases in each group. The experimental group received intervention based on a developmental sequencing early rehabilitation model in addition to routine care, while the control group only received routine care intervention. The growth and development of the two groups of preterm infants were compared during the study, including physical indicators, intellectual-motor skills, neurobehavioral assessments, and developmental monitoring. Results: The clinical data of the two groups of preterm infants were comparable, with no significant differences (P>0.05). The experimental group exhibited significantly higher values in physical indicators such as weight, head circumference, and height compared to the control group (P<0.05). Intellectual-motor scores (MDI and PDI) of the experimental group were higher than those of the control group (P<0.05). The NBNA scale scores for various dimensions were higher in the experimental group compared to the control group (P<0.05). The DQ values of the experimental group were higher than those of the control group (P<0.05). Conclusion: Early rehabilitation training based on developmental sequencing has a positive impact on the growth and development of late preterm infants. Through systematic and sequenced rehabilitation interventions, various aspects of development in late preterm infants can be promoted effectively. This approach not only improves physical development but also enhances intellectual-motor skills, neurobehavioral development, and overall developmental levels. The results are significant, indicating the worthiness of widespread application and promotion.

This paper presents an interpretable support vector machine (SVM) and its application to rehabilitation assessment. We introduce the concept of nearest boundary point to standardize the one-class SVM decision function and determine the shortest path for data from abnormal cases to become those from normal cases. This analytical approach is computationally simple and provides a unique solution. The nearest boundary point of abnormal data can also be used to analyze the cause of abnormal classification and indicate countermeasures for normalization. These properties render the proposed interpretable SVM valuable for medical assessment applications and other problems that require careful consideration of classification results for treatment. Simulation and application results demonstrate the feasibility and effectiveness of the proposed method.

Background/Objectives: Instability is one of the main symptoms in patients with vestibular and neurological disorders and therapeutic exercise interventions are increasing its popularity as a way of treatment for those. Additionally, the limits of stability measurement are known to be a good tool for balance evaluation and monitoring of this interventions. The aim of this work is to understand better how a specific protocol provokes changes on this variable and study the characteristics of those who respond and non-respond to it. Methods: A retrospective study was developed with the data of 40 patients treated in the Otorhinolaryngology department in Clínica Universidad de Navarra (Madrid, Spain). Those had an initial reduction in limits of stability, completed the protocol proposed with home-based and hospital-based exercises with frequent limits of stability remeasurement, and assist to the follow-up retest after 1-2 months. Results: A progressive improvement in limits of stability measure was developed through the intervention and partially retained at follow-up visit. Differences were found between responders and non-responders patients. More specifically an initial measure of the limits of stability was able to differentiate those groups with a cut-off data of 56cm2. Conclusions: The protocol proposed was able to induce motor learning in patients included in this study with good retention after 1-2 months. Besides, there is some variability in how patients respond to the treatment. Age and diagnostic should be considered, and an interesting cut-off data for clinal decision making was found.

As the global population faces an increasing prevalence of physical disabilities, the challenge of motor rehabilitation has become increasingly urgent. Considering that approximately 15% of the global population lives with some form of disability, with a significant number having motor disa-bilities that greatly impact their quality of life, the integration of robotic technologies into rehabili-tation processes offers an opportunity for significant improvement in functional recovery and pa-tient autonomy. This analysis aims to evaluate the progress and challenges encountered in imple-menting robotic technology for the rehabilitation of patients with physical disabilities, highlighting the potential of emerging technologies such as exoskeletons, assisted training devices, and brain-computer interface systems in facilitating motor recovery. By examining relevant clinical studies, the analysis demonstrates the varied effectiveness of robotic therapies compared to traditional re-habilitation methods, while also highlighting the need for ongoing research to optimize care prac-tices and address challenges related to cost, accessibility, and treatment personalization. In con-clusion, robotic technologies represent a promising direction in motor rehabilitation, with the po-tential to revolutionize the care of patients with physical disabilities, significantly improving quali-ty of life and social integration.

Stroke survivors often face diverse unmet needs, highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for assessing the needs of stroke patients in the Greek context. Additionally, the research sought to identify potential differences in the assessment of stroke patients' needs based on their stroke phase and National Institutes of Health Stroke Scale (NIHSS) scores. A sample of 71 adult stroke survivors, adhering to World Health Organization guidelines and providing autonomous consent, participated in the study. The mNAQ, comprising 141 items across 12 domains, was uti-lized to evaluate stroke patients' needs. The NIHSS and Barthel Index (BI) were employed for functional independence and mobility assessment. Data analysis incorporated confirmatory fac-tor analysis, exploratory factor analysis, and Cronbach's reliability analysis to establish con-struct validity and internal consistency. Concurrent and known-groups validity analyses were conducted, and Spearman’s rho correlation explored the relationship between mNAQ and BI scores. Non-parametric analyses were applied to identify differences based on stroke phase and NIHSS scores. The study revealed that the mNAQ initially lacked satisfactory psychometric properties in the Greek context. Subsequent modifications, guided by confirmatory and explora-tory factor analyses, resulted in a refined three-factor scale encompassing 31 items in the domains of communication, mobility, and social functioning needs. This adapted measure effectively dif-ferentiated between acute and chronic stroke patients and those with minor and moderate strokes. In conclusion, the validated 31-item Greek mNAQ emerges as a crucial tool for compre-hensively assessing the needs of stroke patients. Its application holds promise for optimizing post-stroke care, improving functional outcomes, and ultimately enhancing the overall well-being and quality of life for stroke survivors.

The clinical neurophysiological tests allow determine the type, extent, and nature of brachial plexus damage. They are crucial in decision-making regarding surgical procedures or conservative treatment. This report aimed to present an algorithm for rehabilitation procedures in patients with brachial plexus injury of various origins based on the results of neurophysiology findings for the selection of procedures supporting the process of nerve and muscle regeneration. The research group consisted of patients whose medical documentation was analyzed concerning the reason, level, and localization of damage to the brachial plexus structures, surgical and or rehabilitative treatment as well as the MRI results. Among the group of ten patients, the clinical studies showed the greatest incidence of brachial plexus injuries of the mixed (both pre- and postganglionic), all trunks, and cervical root injuries, respectively. Results of the motor evoked potentials (MEP) and electroneurography (ENG) recordings induced at levels of spinal roots and Erb's point showed a decrease of more than 40% in amplitudes on the symptomatic side in comparison to the asymptomatic side. This difference was recorded for the axillary and radial innervation and the C5, C6, and C7 root domains, ranging from 56% to 71%; the lowest decrease was recorded following electrical stimulation at Erb's point for the ulnar nerve (41.5%). The latency prolongation on the symptomatic side in CMAP and MEP tests ranged from 0.2 to 1.9 ms, the most following magnetic stimulation of the C5 cervical root for the axillary innervation. All results indicated the axonotmesis and neuropraxia type of injury in motor fibers (40%) confirmed by EMG results. The sensory conduction studies (SNCS) in distal nerve branches did not confirm the severe advancement of the brachial plexus injury (22%). The proposed algorithm of the physiotherapeutic procedures should be mainly targeted for recovery of motor dysfunction as the consequence of brachial plexus injury. Rehabilitation should incorporate the treatment supporting nerve regeneration, muscle strengthening, and maintaining functional ranges of motion of the injured extremities. The rehabilitation treatment for patients with brachial plexus injuries is an individualized process, and the selection of procedures and the effectiveness of the treatment undertaken should be confronted with results of neurophysiological tests verifying the motor neural transmission from the level of the cervical motor center to the effector, peripheral nerve function, and muscle’s motor unit activity.

Nowadays, it can be observed that all kinds of technology are gradually being incorporated to assist the human being in the performance of their frequent and daily tasks. Technological tools provide means to facilitate, improve, help and support any activity which, in itself, may be complicated, either because of the difficulty involved in carrying it out, or because the person carrying it out has limited capabilities due to the environment not being prepared for their abilities and skills. In this sense, Special Education is currently receiving special attention from researchers, especially those aimed at children. Although the proposals that have appeared recently provide perfect solutions to improve educational processes with ingenious didactic applications, there is still an interesting line of study on how to interact with these younger people in these educational processes. In this sense, haptic technologies can play a very important role, complementing all these solutions by incorporating tools that facilitate direct contact with people, especially in their initial stages, which are the most complicated. This paper aims to provide an overview of haptic technologies and how they present solutions that can be integrated into the aforementioned educational processes.

This study presents a novel kinematic tracking model, designed for a networked exoskeleton system that is asynchronously taught by a remote therapist. On the server side, the therapist’s rehabilitation exercises are quantitatively assessed using a monocular passive vision system. The resultant analytical metrics are then transmitted asynchronously over the network to patients equipped with exoskeletons. On the client side, the exoskeleton utilizes these analytical metrics as reference paths for exercises, complemented by electromyography (EMG) feedback. This work introduces a calibration approach aimed at estimating angular positions by utilizing EMG observations. The calibration model establishes real-time correlations between polynomial reference positions. This calibration mechanism is integrated into simulations of both upper and lower limb exoskeletons. We further explore redundant kinematics, incorporating an EMG observer for linear, time-variant rehabilitation tracking control. Our methodology is validated using vision-based metric data and experimental EMG measurements for various exercises, including shoulder flexion, elbow flexion, and rowing-like movements. This work also includes computer simulations for tracking the control of rehabilitation exercises, demonstrating the adaptability of the system in reliably, robustly, and effectively following desired trajectories.

Functional neurological disorders (FND) are relatively frequent disabling conditions. Given their complexity, multidisciplinary rehabilitation is envisaged. Whole-body cryostimulation (WBC) represents a promising adjuvant treatment, mainly because of its anti-inflammatory and exercise-mimicking effects. Here, we propose a novel use of WBC in a wheelchair-ridden 61-year-old woman diagnosed with FND and other comorbidities, who, after several therapeutic and rehabilitation failures, underwent a multidisciplinary rehabilitation program including WBC. The 4-week program included physiotherapy, nutritional intervention, psychological support, and WBC. Questionnaires to assess disease impact, pain level, perceived fatigue and sleep quality were administered. At discharge, improvements in body composition, haematological biomarkers, physical performance, and questionnaire scores were observed. The patient was able to walk with a walker for medium distances, even outdoors. We observed unprecedented improvements, particularly in functional parameters and questionnaire scores. Although we cannot ascertain to which extent WBC per se contributed to the improvements measured, subjective reporting and our clinical observation were that WBC, the only intervention not previously experienced by the patient, acted as a booster for the rehabilitation interventions. Further research will be necessary to rule out any possible placebo effect and to assess the effects of WBC on FND.

Urban waterways are significant natural elements in urban development activities, which might cause long-term changes in the historic built environment. As it runs through the historic city center of Bursa, a World Heritage Site in Türkiye, Cilimboz (Phillippoz) Creek has witnessed urban development activities along its surrounding landscape. Its valley, the study area, is composed of natural, residential, and industrial heritage as well as archaeological remains dating to ancient times while having undergone permanent changes as a result of the rapid increase in population and squatting, since the 1960s. This study aims to assess the challenges of sustainability in a multi-layered historic urban landscape while discussing the outcomes of various land use implementations along Cilimboz Creek. The cultural assets in the study area are presented by using a combination of interpretive-historical and case-study research methods to understand historic urban texture. Afterward, the changes in the composition of natural and architectural heritage are described to assess the impacts of urban development activities on the sustainability of its multi-layered historic urban identity. Consequently, this evaluation reveals the need for a holistic approach by the participation of all relevant stakeholders to co-develop solutions for architectural, social, and environmental conservation issues in this cultural landscape.

Psychological readiness following Anterior Cruciate ligament Reconstruction (ACLR) correlates with different return to sport outcomes. However, the relationship between strength and power and psychological readiness remains unexplored. The aim of this study was to investigate the relationship between the Anterior Cruciate Ligament Return to Sport After Injury (ACL-RSI) scores and various hamstrings and quadriceps strength and power variables. Twelve participants (20.7±2.5 years old; 174.2±7.5 cm; 70.2±8.5 kg; 18.2±8.3% of body fat) who had an ACLR nine months or more before the study completed the ACL-RSI questionnaire and isokinetic strength testing of the hamstrings and quadriceps (60°.s-1 and 180°.s-1). Based on ACL-RSI scores, they were divided into “cases” and “controls”, deemed not psychologically ready and psychologically ready to return to previous sport performance (PILOS), respectively. The main findings are that quadriceps’ and hamstrings’ rate of torque development (RTD) and time since surgery were determinants of psychological readiness following ACLR. Furthermore, compared to controls cases showed significantly lower angle-specific quadriceps and hamstrings torque close to extension and lower RTD, but no difference in peak torque. These results suggest that physiotherapists should facilitate athletes’ RTS by focusing on the restoration of RTD and strength at angles close to full knee extension.

Background - Mandibular flexion (MF) is a complex biomechanical phenomenon, which involves a deformation of the mandible, due mainly to the contraction of the masticatory muscles, and can have numerous clinical effects. The main aim of the current systematic review is to highlight the different factors that can increase MF, to help clinicians, identify patients to whom they should pay more attention. As a secondary outcome, we wanted to analyze the preventive measures and suitable techniques to be adopted to minimize the negative effects of this phenomenon on oral fixed rehabilitations. Methods - The review, which was carried out in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) flowchart, was recorded in the “International Prospective Register of Systematic Reviews” (PROSPERO). As research questions, “Patient/Population, Intervention, Comparison and Outcomes” (PICO) questions were employed. Using the ROBINS-I technique, the risk of bias in non-randomized clinical studies was evaluated. Results - The initial electronic search identified over 1300 potential articles, of which 54 studies were included in this systematic review. Information regarding the relationship between MF and individual factors, mandibular movements, impression-taking and fixed rehabilitations were obtained. Conclusions – The studies included in this systematic review showed that MF is greater during protrusive movements, in the posterior areas of the lower jaw, and in patients with brachial facial type, greater jaw length, small gonial angle and less density, length and bone surface of the symphysis. The biomechanical effects of mandibular flexion on fixed restorations are debated. Prospective clinical and radiological observational studies should be conducted to evaluate the potential short-, medium- and long-term consequences of MF.

The aim of this article was to evaluate properties of new polymer material, based on PEEK, for FPDs in patients with parafunctions. Methods: Prospective clinical study involved patients with diagnosed signs and symptoms of parafunctions, restored with 100 units, PEEK based FPDs, veneered with composite material. During one year observation period the following parameters were evaluated: color changes, periodontal indices, treatment success using FDI criteria, occlusal parameters, patient-reported outcome measures (OHIP-49) and occurrence of complications. Results: Spectrophotometry revealed that 63% of bridges experienced changes for L*, a*, b* color parameters, but it was not clinically significant for patients. Periodontal indices (PI, GI, BOP) revealed statistically significant higher values around restorations. According to FDI criteria, therapy was considered successful and 86.7% of FPDs were acceptable. Computerized occlusal analysis demonstrated no significant difference in the number of occlusal contacts and the intensity of relative forces between restoration and control side. Results of OHIP-49 questionnaire showed improved patient’s quality of life. Complications appeared in a limited number of cases. Conclusion: PEEK based FPDs could be indicated for successful prosthodontic rehabilitation in patients with parafunctional activities, but further material improvements and long-term clinical trials should be conducted to analyze performance of this material in challenging cases, for patients with CMD and in implant therapy.

(1) Background: Breast cancer-associated lymphedema (BCRL) is a major complication of breast cancer treatment, affects the quality of life of breast cancer survivors who develop it. Manual lymphatic drainage has a beneficial result in combating lymphedema in patients who have undergone breast cancer surgery. The hypothesis consists in complete decongestive therapy reduces the lymphedema at the level of the upper limb on the side of mastectomy. (2) Methods: Twenty-five patients with radical mastectomy and upper limb lymphedema on the mastectomy side were included in this study. Upper limb circumferences were measured with a tape measure at the following levels: metacarpophalangeal joint; distal radioulnar joint; 10 cm distal to lateral epicondyle; 5 cm proximal to elbow joint; 10 cm proximal to lateral epicondyle. (3) Results: Patients received twice weekly manual lymphatic drainage, multi-layer compression bandaging and upper limb muscle stimulation exercises on the mastectomy side twice weekly. The circumference assessed at the level of the metacarpophalangeal joints and distal radio-carpal joint decreased at the final evaluation. Forearm perimetery - 5 and 10 cm distal to the lateral epicondyle the circumference decreased at the final assessment. (4) Conclusions: Patients with breast cancer-related lymphedema should receive comprehensive decongestive therapy in the early stage of lymphedema to achieve rapid clinical results and improved quality of life

Objective: Design and validate a wireless, low-cost, easy-to-use, mobile, dry-electrode headset for scalp electroencephalography (EEG) recordings for closed-loop brain-computer (BCI) interface and internet-of-things (IoT) applications. Approach: The EEG-based BCI headset was designed from commercial off-the-shelf (COTS) components using a multi-pronged approach that balanced interoperability, cost, portability, usability, form factor, reliability, and closed-loop operation. Main Results: The adjustable headset was designed to accommodate 90\% of the population. A patent-pending self-positioning dry electrode bracket allowed for vertical self-positioning while parting the user's hair to ensure contact of the electrode with the scalp. In the current prototype, five EEG electrodes were incorporated in the electrode bracket spanning the sensorimotor cortices bilaterally, and three skin sensors were included to measure eye movement and blinks. An accelerometer provides monitoring of head movements. The EEG amplifier operates with 24 bits resolution up to 500 Hz sampling frequency, and can communicate with other devices using 802.11 {b/g/n/WiFi}. It has high SNR and CMRR (121 dB and 110 dB, respectively), and low input noise. In closed-loop BCI mode, the system can operate at 40 Hz, including real-time adaptive noise cancellation and 512 MB of processor memory. It supports LabVIEW as backend coding language and JS, CSS, HTML as front-end coding languages, and includes training and optimization of Support Vector Machine (SVM) neural classifiers. Extensive bench testing supports the technical specifications and human subject pilot testing of a closed-loop BCI application to support upper-limb rehabilitation provides proof-of-concept validation for device use at both the clinic and at home. Significance: The low-cost, accessibility, usability, interoperability, and programmability of the proposed closed-loop BCI system provides a low-cost solution for BCI and neurorehabilitation research and IoT applications.

Background: Low-level (LLLT) and high-intensity laser therapy (HILT) can be beneficial additions to knee osteoarthritis (KOA) rehabilitation exercises; however, it is still being determined which modality is more effective. Aim: To compare the effects of LLLT and HILT as adjuncts to rehabilitation exercise (LL+EX and HL+EX) on clinical outcomes in KOA. Methods: Thirty-four adults with mild to moderate KOA were randomly allocated to either LL+EX (n = 17) or HL+EX (n = 17) groups. All participants underwent their designated laser treatment combined with rehabilitation exercises weekly for twelve consecutive weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Numerical Pain Rating Scale (NPRS), active knee flexion, and Timed Up-and-Go test (TUG) were assessed at baseline and immediately post-intervention. Results: Post-intervention, both groups significantly improved their KOOS, NPRS, active knee flexion, and TUG scores compared to baseline (p &lt; 0.01). The mean difference of change in KOOS, NPRS, and active knee flexion scores for the HL+EX group surpassed the minimal clinically important difference threshold. In contrast, the LL+EX group only demonstrated clinical significance in NPRS scores. Conclusions: Incorporating HILT as an adjunct to usual KOA rehabilitation led to significantly higher improvements in pain, physical function, and knee-related disability compared to LLLT.

The present study concerns the application of electrochemical chloride extraction to concrete designed with partial replacements of Ordinary Portland Cement (OPC) from different binders, namely ground granulated blast furnace (GGBS), pulverized fly ash (PFA) and Silica Fume (SF), to attend the need of corrosion repair for modern constructions. Electrochemical Chloride Extraction (ECE) was applied to the specimens at a current density of 2A/m2 for 4 weeks. The chloride types and binding mechanisms appeared to have important implications on the different performance of treatment perceived for all binders. Considering total chlorides, removal was more significant for OPC and GGBS when compared to others. The main difference noted was that for GGBS the removal of bound chlorides was more significant due to a possible release of adsorbed chlorides from the silicate hydrates, present at higher intensities in this case. However, even though GGBS had greater rates of bound chloride removal it had still the same percentage as OPC for total efficiency due to the fact that in OPC the removal of free chlorides is more expressive.

Foot drop is a common disability in post-stroke patients and represents a challenge for the clinician. To date, Ankle Foot Orthosis (AFO) combined with conventional rehabilitation is the gold standard of rehabilitation management. AFO has a palliative mechanical action without actively restoring the associated neural function. Functional Electrical Stimulation (FES), consisting in stimulation of the peroneal nerve pathway, represents an alternative approach. By providing a FES device (Bioness L-300, BIONESS, USA) for 6 months to a post-stroke 22-year-old woman with a foot drop, our goal was to quantify its potential benefit on walking capacity. Gait parameters and the temporal evolution of the speed were collected with a specific connected sole device (Feet Me®) during the 10-meter walking, the Time Up and Go, and the 6-minute walking tests with AFO, FES or without any device (NO). As a result, the walking speed changes on 10-meters were clinically significant with an increase from baseline to 6 months in AFO and FES conditions (+0.14m-1 and +0.36m-1), without any changes in NO condition. In addition, speed decreased at about 4-minutes of the 6-minute walking test in NO and AFO conditions, while speed increased in FES conditions at baseline and after 1, 3 and 6 months. Monitoring gait speed in an endurance test after an ecological rehabilitation training program helps to examine walking performance in post-stroke patients and to propose a specific rehabilitation program depending on a fatigue threshold.

Cognitive rehabilitation is useful for many after traumatic brain injury (TBI), but we lack critical knowledge about which patients benefit the most from different approaches. Advanced neuroimaging techniques have provided important insight into brain pathology and systems plasticity after TBI and have potential to inform new practices in cognitive rehabilitation. In this study, we aimed to identify candidate structural brain measures with relevance for rehabilitation of cognitive control (executive) function after TBI. Twenty-eight patients (9 female, mean age 40.5 (SD = 13.04) years) with moderate/severe TBI (>21 months since injury) that participated in a randomized controlled cognitive rehabilitation trial (NCT02692352) were included in the analyses. Regional brain volume was extracted from T1-weighted MRI scans before treatment using tensor-based morphometry. Both positive and negative associations between treatment outcome (everyday cognitive control function) and regional brain volume were observed. The most robust structural brain measures with relevance for improvement in function were observed in midline fronto-parietal regions, including the anterior and posterior cingulate cortices. The study pro-vides proof of concept and valuable insight for planning future studies focusing on neuroimaging in cognitive rehabilitation after TBI.

Traumatic brain injury represents one of the main health problems in developed countries. Growth Hormone (GH) and rehabilitation have been claimed to significantly contribute to the recovery of lost motor function after acquired brain injury, but the mechanisms by which this occurs are not well understood. In this work, we have investigated cell proliferation in the piriform cortex (PC) of adult rats with ablation of the frontal motor cortex treated with GH and rehabilitation, in order to evaluate if this region of the brain, related to the sense of smell, could be involved in benefits of GH treatment. Male rats were either ablated the frontal motor cortex in the dominant hemisphere or sham-operated and treated with GH or vehicle at 35 days post-injury (dpi) for five days. At 36 dpi, all rats received daily injections of bromodeoxyuridine (BrdU) for 4 days. We assessed motor function through the paw-reaching-for-food task. GH treatment and rehabilitation at 35 dpi significantly improved the motor deficit caused by the injury and promoted an increase of cell proliferation in the PC ipsilateral to the injury, which could be involved in the improvement observed. Cortical ablation promoted greater number of BrdU+ cells in the piriform cortex that was maintained long-term, which could be involved in the compensatory mechanisms of the brain after injury.

Treating a patient with traumatic brain injury requires an interdisciplinary approach because of the pervasive, profound and protean manifestations of this condition. In this review, key aspects of the medical history and review of systems will be described in order to highlight how the role of any provider must evolve to become a better patient advocate. Although this review is written from the vantage point of a vision care provider, it is hoped that patients, caregivers and providers will recognize the need for the team approach; it truly takes a village.

Background: Many randomized controlled trials (RCTs) and systematic reviews (SRs) on acupuncture treatment for post-acute stroke dysphagia have been published. Due to conflicting results an overview of SRs to summarize and assess the quality of this evidence to determine whether acupuncture is effective for this disease was conducted. Methods: Seven databases were searched for SRs and/or Meta-analysis of RCTs and quasi-RCTs on acupuncture for post-acute stroke dysphagia. Two authors independently identified SRs and meta-analyses, collected data to assess the quality of included SRs and meta analyses according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the revised Assessment of Multiple Systematic Reviews (AMSTAR 2). Results: 31 SRs were identified. Quality of 22 SRs was critically low, 5 SRs were low, and 4 Cochrane SRs were moderate when evaluated by AMSTAR2. 17 SRs reported 85.2-96.3% items of PRISMA. Five SRs included explanatory RCTs, 16 SRs included pragmatic RCTs, and 10 SRs included both. Conclusion: Currently evidence on the effectiveness of acupuncture on post-acute stroke dysphagia is low quality. Type of study appeared to have no direct influence on the result, but the primary outcome measures showed a relationship with the quality of SRs. High quality trials with large sample sizes should be the focus of future research. PROSPERO REGISTRATION NUMBER: CRD42019134163

The objective of the this study was to reduce the benzo[a]pyrene-induced hepatotoxicity method in herbal medicine products and to give proof that neferine, daidzein, genistein possess antihepa-totoxic effects. B[a]P which classified as a group 1 carcinogen and metabolized to B[a]P-7,8-dihydrodiol-9,10-epoxide (BPDE) causes mutagenic DNA addition products. The reduc-tion of BPDE-DNA adduct formation by B[a]P-7,8-dihydrodiol-9,10-epoxide (BPDE) was derived by benzo[a]pyrene (B[a]P). In HepG2 cells, B[a]P exhibited toxicity and substance treatment of the cells with B[a]P with neferine in lotus and daidzein, genistein in soybean reduced the BPDE-DNA ad-ducts level. The level of B[a]P-metabolites in the substance treatment of the cells was presented that BPDE levels were reduced by neferine in lotus and daidzein, genisten in soybean. These results suggest that neferine in lotus and daidzein, genistein in soybean prevent B[a]P-induced hepato-toxicity for BPDE-DNA adduct formation.

J/ψ, a charmonium bound state made of a charm and an anti-charm quark, has been discovered in the 1970s and confirmed the quark model. Because the mass of charms quarks is significantly above the Quantum Chromodynamics (QCD) scale ΛQCD, charmonia are considered as excellent probes to test perturbative Quantum Chromodynamics (pQCD) calculations. Over the past decades, they have been studied extensively at different high energy colliders. However, their production mechanisms, which involves multiple scales, are still not very well understood. Recently, in high multiplicity p+p collisions at RHIC and at the LHC, a significant enhancement of J/ψ production yield has been observed, which suggests a strong contribution from the Multi-Parton Interaction (MPI). This is different from the traditional pQCD picture where charm quark pairs are produced from a single hard scattering between partons in p+p collisions. In this work, we will report the J/ψ normalized production yield as a function of normalized charged particle multiplicity over a board range of rapidity and event multiplicity in the J/ψ→μ+μ− channel with PHENIX Run 15 p+p data at \sqrt{s}=200 GeV. The results are compared with PYTHIA 8 simulations with the MPI option on and off. Finally, the outlooks of J/ψ in p+Au and Au+p collisions along with Color Glass Condensate (CGC) predictions and of multiplicity dependent ψ(2S)/J/ψ ratio in p+p data will be briefly discussed.

This review explores the prevalence and implications of muscular power and dynamic balance asymmetry among soccer players, focusing on its impact on performance and injury risk. Asymmetry is common in soccer due to the sport's specific demands, such as the frequent use of one leg for kicking and passing. While some asymmetry may allow for functional specialization and may not impair performance, significant imbalances are often linked to an increased risk of injuries, particularly to the lower extremities. Dynamic balance asymmetry is also associated with a higher risk of non-contact injuries, highlighting the importance of joint stability in preventing such injuries. However, the direct impact of balance asymmetry on performance metrics like sprint speed and agility is less definitive, suggesting that compensatory mechanisms or training adaptations might mitigate potential negative effects. Advancements in assessment technologies, such as motion capture systems and wearable devices, have enhanced the precision of asymmetry evaluations, enabling more targeted interventions. Despite these technological advancements, further research is needed to understand the long-term effects of asymmetry across different player demographics, including youth and female athletes, and to evaluate the effectiveness of specific training interventions. This review recommends a multidisciplinary approach, integrating biomechanics, sports medicine, and coaching insights, to develop comprehensive strategies for managing asymmetry in soccer. Such strategies will be crucial for optimizing player performance, minimizing injury risk, and improving training and rehabilitation programs tailored to the diverse needs of soccer players.

The access to cardiac rehabilitation (CR) is contingent upon physician referrals, yet these are often inadequate, particularly in low-resource settings. This multi-method study aimed to translate, culturally adapt, and validate the Portuguese version of the Provider Attitudes toward CR and Referral (PACRR-P) scale, as well as to identify key factors influencing CR referral in a Latin American context for the first time. The PACRR was translated into Brazilian-Portuguese through a rigorous process involving independent translation, back-translation, and expert panel review to ensure face, content, and cross-cultural validity. A total of 44 Brazilian physicians completed the questionnaire, allowing for an assessment of internal consistency, criterion validity, and convergent validity. The findings confirmed the face, content, and cultural validity of the 20 translated items, with a mean item clarity rating of 4.8/5. The final version included 17 of the original 19 PACRR-P items, with a Cronbach’s alpha of 0.73. Referral rates were significantly associated with specific PACRR-P items, supporting the scale's criterion validity, while correlations with ReCaRe scores further supported convergent validity. The most prominent barriers to referral were a lack of familiarity with CR site locations, absence of a standard referral form, and lack of automatic referral processes. The PACRR's validity and reliability among Portuguese-speaking providers are preliminarily supported.

Background/Objectives: Rehabilitation helps reduce disability in dementia. The Australian National Dementia Action Plan identifies a gap in clear treatment pathways post-diagnosis, affecting the quality of life for those with dementia. This study assessed the impact of a one-day dementia training course and follow-up on GPs' and practice nurses' knowledge, attitudes, and confidence regarding dementia rehabilitation. Methods: The training, led by two experienced GPs and an academic physiotherapist, covered dementia diagnosis, allied health roles, care planning, and referrals. The follow-up involved applying the learnt material and completing a reflective task. Three longitudinal surveys (Dementia Knowledge Assessment Scale - DKAS, General Practitioners’ Attitudes and Confidence towards Dementia Survey - GPACS-D, and Dementia Rehabilitation Scale) and Likert-scale statements were conducted pre-course, post-course, and at 4-month follow-up, alongside a focus group. Descriptive and regression analyses were applied to survey data, and content analysis was used for focus group data. Results: Seventeen participants (14 GPs, 3 nurses) completed the pre-post course survey, with eight (6 GPs, 2 nurses) participating in follow-up and focus group discussions. Post-course, DKAS scores increased by 12.1%, GPACS-D by 10.1%, and the dementia rehabilitation scale by 9.4%. Likert-scale statements improved by 8-79%. At the four-month follow-up, there was a slight, non-significant decline in most measures. Focus groups highlighted the training’s impacts, useful components, barriers, and suggestions for improvement. Conclusion: Training GPs and practice nurses in dementia rehabilitation enhances knowledge, awareness, and confidence. Ongoing efforts are needed to sustain benefits and address referral barriers for better access to dementia rehabilitation services.

Digital solutions in the field of restorative neurology offer significant assistance, enabling patients to engage in rehabilitation activities remotely. This research introduces ReMoVES, an Internet of Medical Things (IoMT) system delivering telemedicine services specifically tailored for Multiple Sclerosis rehabilitation, within the overarching framework of the STORMS project. The ReMoVES platform facilitates the provision of a rehabilitative exercise protocol, seamlessly integrated into the Individual Rehabilitation Project, curated by a multidimensional medical team operating remotely. This manuscript delves into the second phase of the study, elucidating the technology employed, the outcomes achieved, and the practical, professional, and academic implications. The STORMS initiative, as the genesis of digital telerehabilitation solutions, aims to enhance the quality of life for Multiple Sclerosis patients.

Introduction: The COVID-19 pandemic challenged people with spinal cord injury (SCI) regarding a variety of mental and physical issues. New challenges may arise as the effects of the pandemic continue. The objective of the present study was to explore the social participation of Canadians with SCI during the second wave of COVID-19. Methods: Participants with SCI from two Canadian provinces (Quebec and British Columbia) were interviewed. Results: Eighteen participants completed interviews. Facilitators of social participation remain similar since the first wave of COVID-19, such as the use of technology, help received by relatives and the use of delivery services to obtain groceries and other essentials. Obstacles to mobility due to winter conditions and lack of considerations related to COVID-19 public health measures specific to wheelchair users were also discussed by participants. Conclusions: People with SCI perceived participation restrictions, little changes in life habits, and uncertainty about the future during the second wave of COVID-19. The unique living conditions of people with SCI, ability to adapt life habits, and the lived experiences of people with SCI may have contributed to an overall resilience during the pandemic. Adaptive families, social contacts and technology made a difference during the pandemic.

Background: GaitSmart (GS) is a sensor-based digital medical device that can be used with the integrated app vGym to provide a personalised rehabilitation programme for older people undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study aimed to determine whether the GS intervention used in the rehabilitation of older people undergoing THA or TKA is potentially cost-effective compared to the current standard of care (SoC). Methods: Decision-analytic modelling was conducted to estimate cost-effectiveness over a seventeen- week time horizon, from an NHS perspective. UK clinical and cost data from the GaitSmart randomised clinical trial was used to obtain input parameters, and sensitivity analysis was performed to address uncertainty. Results: Over a seventeen-week time horizon, GS incurred cost savings of £450.56 and a 0.02 gain in quality-adjusted life years (QALYs) compared to the SoC. These results indicate that GS is the dominant intervention because the device demonstrated greater effectiveness and lower costs. Probabilistic sensitivity analyses confirm the robustness of our results. Conclusion: GS appears to offer short-term efficiency benefits and demonstrates cost-effectiveness for the improvement of gait in people undergoing THA or TKA, compared to the SoC. These findings provided new evidence to inform policymakers.

In India, epilepsy is often viewed with superstition, considered a curse rather than a medical condition. Unfortunately, many affected individuals never receive proper medical attention from neurologists, leading them to seek out alternative remedies, including sorcery. Presently, the number of neurologists in India stands at approximately 3000, a concerning figure given the prevalence of epilepsy, which is reported to affect 5.59 to 10 individuals per 1000. This equates to over one million epilepsy patients across the country, representing more than 1% of the total population. Alarmingly, rural areas experience a higher incidence of epilepsy, around 2%, compared to urban centres, where the incidence is approximately 0.5%. This stark contrast underscores the urgent need for improved access to neurological care, particularly in underserved regions.The term "epilepsy" originates from the Greek verb meaning "to seize" or "to get hold of," forming the basis of its etymology. In certain societies, epilepsy is still interpreted as a "penalty for involvement in a forbidden ritual," although perceptions vary among different cultural groups. Individuals diagnosed with epilepsy (PWE) often exhibit behaviours that have led some to speculate about demonic possession or past-life transgressions as causative factors. Consequently, the term "epilepsy" carries diverse social connotations, leading to variations in treatment approaches based on differing perspectives of the condition. Regrettably, some negative attitudes towards epilepsy have fueled stigma, enduring disability, and significant adverse outcomes for those living with the condition.The majority of unreported cases turn to sorcery, exacerbating the already high mortality rates associated with epilepsy disorder and status epilepticus. Various treatment modalities exist for patients with epilepsy to manage their seizures. Given the debilitating and life-altering nature of epilepsy, India offers a range of options including medications (antiepileptic drugs or AEDs), devices, and surgical interventions. When an individual receives a diagnosis of epilepsy (defined as experiencing at least two unprovoked seizures within a short timeframe), life can be dramatically impacted. Several cases highlight the challenges patients face, leading to an increase in Disability Adjusted Life Years (DALY) overall. For newly born infants, constant vigilance from the mother is essential to monitor for any signs of seizure activity around the clock. When a pediatric patient is enrolled in school, their education is often profoundly disrupted. Should the patient be female, her existence would undergo a profound transformation, marked by societal perceptions deeming her as unfortunate and rendering the prospect of marriage untenable. Seizures in young adults precipitate job loss, thereby exacerbating societal burdens. Conclusion: There is a pressing need to raise awareness about epilepsy among the general populace of India. Dispelling misconceptions surrounding epilepsy is essential to steer individuals away from reliance on superstition, and instead, encourage them to seek guidance from certified specialists in nervous system disorders. Thankfully, by following the treatment regimen prescribed by a qualified neurologist, patients can significantly increase their chances of living a life free from seizures, thereby enhancing their overall quality of life and personal fulfilment.

Cancer patients undergoing major interventions face numerous challenges, including the adverse effects of cancer and the side effects of treatment. Cancer rehabilitation is vital in ensuring cancer patients have the support they need to maximise treatment outcomes and minimise treatment-related side effects and symptoms. The Active Together service is a multi-modal rehabilitation service designed to address critical support gaps for cancer patients. The service is located and provided in Sheffield, UK, an area with higher cancer incidence and mortality rates than the national average. The service aligns with local and regional cancer care objectives and aims to improve clinical and quality of life outcomes of cancer patients by using lifestyle behaviour change techniques to address their physical, nutritional, and psychological needs. This paper describes the design and initial implementation of the Active Together service, highlighting its potential to support and benefit cancer patients.

Chronic Low Back Pain (CLBP), defined as pain persisting for at least 12 weeks, is a significant public health issue, with prevalence intensifying due to an ageing global population, amassing approximately 619 million cases in 2020 and projected to escalate to 843 million by 2050. Given the multitude of therapeutic modalities available for CLBP, this research sought to ascertain their respective efficacies in ameliorating pain and disability. We specifically scrutinized Multidisciplinary Biopsychosocial Rehabilitation (MBR) among adults enduring non-specific low back pain for over 12 weeks, excluding acute pain conditions and pre-study surgical interventions. MBR is an approach encompassing various modalities, including exercise, behavioral therapies, educational programs, and work conditioning aspects, necessitating a comprehensive Network Meta-Analysis (NMA) to fully grasp the extensive scope of its impact. The constructed network comprised diverse MBR modalities (behavioral, educational, and work conditioning) alongside exercise therapy (ET), minimal intervention, and usual care, serving as controls with pain and disability as outcomes. Through the analysis of 4,619 initially identified studies, 93 were included, encompassing a total of 8,059 participants. The NMA conducted substantiated that both ET and MBR modalities were notably effective in alleviating CLBP, with education-oriented MBR emerging as the most efficacious for pain mitigation and behavior-focused MBR for disability reduction. Nevertheless, the discerned differences amongst the treatments were minimal and uncertain, highlighting that no modality was definitively superior to the others. The analysis revealed low global and local inconsistency within the network, underscoring the reliability of the observed outcomes. Given the intricate nature of CLBP, embodying various facets, our findings advocate for a combined therapeutic approach to optimize treatment efficacy. Nonetheless, the presence of high study heterogeneity and potential biases necessitates cautious interpretation of the results, prompting future research.

Landform Evolution Modelling (LEM) provides an avenue for simulating how a landscape may evolve over extended time periods of thousands of years. The CAESAR-Lisflood LEM that includes a hydrologic model (TOPMODEL) and a hydraulic model (Lisflood) can be used to assess the proposed final landform morphology of a mine site by simulating how the mine landform and the landscape would evolve over a 1,000-year period. The accuracy of future simulations depends on the calibration and validation of the model to the past and present events. Calibration and validation of the model involves finding a combination of parameters of the model which when applied and simulated gives model outputs similar to those observed for the real site scenario for corresponding input data. Calibrating the sediment output of the CAESAR-Lisflood model at the catchment level and using it for studying the equilibrium conditions of the landform is an area yet to be explored. Therefore, the aim of this study was to calibrate the CAESAR-Lisflood model and then validate it. To achieve this, the model was run for a rainfall event with a set of parameters, plus discharge and sediment data for the input point of the catchment, to analyze how similar the model output would behave when compared with the discharge and sediment data for the output point of the catchment. The model parameters were then adjusted until the model closely approximate the real site values of the catchment. It was then validated by running the model for a different set of events and checking that the model gave similar results to the real site values. The outcomes demonstrated that while the model can be calibrated to a greater extent for hydrology (discharge output) throughout the year, the sediment output calibration may be slightly improved by having the ability to change parameters to take into account the seasonal vegetation growth during the start and end of the wet season. This study is important for designing and testing post-mining rehabilitated landscape systems that assess hydrology and sediment movement in seasonal biomes.

Isometric exercises for physiotherapeutic rehabilitation are often prescribed, with little quantification of the load being prescribed. This article aimed to provide a framework and practical examples of how the physiotherapist may take a more quantitative evidence-based approach to isometric assessment, monitoring, and exercise prescription of knee osteoarthritis, by integrating a strain gauge into their practice. Strength measures to monitor were discussed. A series of fourteen studies were reviewed, with the intent of identifying isometric exercises that had been utilized in the rehabilitation of knee osteoarthritis. Of the fourteen studies, the three most identified isometric exercises were seated knee extension, knee flexion, and the supine straight leg raise. The integration of strain gauge technology with these exercises provided the focus of the remainder of the article.

The need for new technologies into healthcare services has been stressed. However, little is known about the effectiveness of digital interventions integrated in psychosomatic rehabilitation processes. Data from 724 patients from psychosomatic rehabilitation clinics were analyzed for effectiveness of digital trainings examined by a change in symptoms related to depression, anxiety, stress and loneliness from pre- to post-rehabilitation. Rehabilitation satisfaction was examined in association with reaching rehabilitation goals and satisfaction with communication. Mixed repeated measures analysis of covariances, analysis of covariances, and hierarchical stepwise regression analyses were performed. Results indicated a superior effectiveness for the intervention group receiving all offered digital treatments in addition to the regular face-to-face rehabilitation program with regard to symptoms of depression, F(2,674)=3.93, p<.05, ηp2=.01), and anxiety, F(2,678)=3.68, p<.05, ηp2=.01), post-rehabilitation with large effect sizes for both depression (d=1.28) and anxiety (d=1.08). In addition, rehabilitation satisfaction was positively associated with reaching rehabilitation goals and perceived communication with healthcare workers. Digital interventions appeared effective in supporting mental health of psychosomatic rehabilitation patients post-rehabilitation. This finding supports the inclusion of multidisciplinary and interdisciplinary digital and face-to-face treatment programs and call for more implementations of new technologies in a context of complexity to improve health and healthcare service.

Field experiments were carried out during 2011-2014 at the Research and Experimental Center to Combating Desertification located in the Elsen Tasarkhai station of central Mongolia. The study was aimed to identify the effects of oxidized brown coal humic acid fertilizer on the relative growth rate of several trees for forest rehabilitation. The trees used were Populus sibirica, Salix ledebouriana and Acer tataricum. The experiment was carried out with the concentrations of 2,000, 10,000 and 20,000 mg L-1 of humic acid fertilization treatments. The measurement of relative height growth rate (RHGR) was conducted for a period of 4 years. The treatments showed significant differences within humic fertilizer concentrations which differed depending on the species. Compared to the monthly RHGR over the study, the treatment of fertilizers were significantly better for tree growth. P. sibirica in the 10,000 and 20,000 mg L-1 humic acid fertilizers had significant height growth rates. In addition, when the humic acid treatments were compared to control, A. tataricum decreased over the years which were statistically significant for high growth rate and a positive effect of humic acid fertilization treatments was observed. Furthermore, results showed that oxidized brown coal humic acid fertilizers as organic fertilizer can have a positive effect for the growth of A. tataricum during the study years. The results showed that the soil chemical properties EC, CO2, NO3, and K2O were significant among all the treatments compared to the control. The effect on P2O5 statistically significantly increased among all the treatments. However, pH and Mg were not significant effect among all the treatments. Combining the results obtained from the oxidized brown coal humic acid fertilization with sustainable land management practices can help improve soil organics for environmental issues in degraded sandy soil regions.

In this paper, the P versus NP problem is studied based on a six-dimensional space-time perspective. The gap between the P-class and NP-class arises from the relationship between time and the solution, as well as the answer that is independent of time. The complexity of solving a problem depends on the time dependence of the answer. Solving problems whose answers do not depend on the passage of time is very difficult and impossible. Like the description of the gravitational factor in Newtonian physics, NP class problems require different mathematical tools. Based on the generalization of physical facts in mathematics, based on six-dimensional space-time, a method to solve problem P versus NP problem has been stated. The results of this study offer a fresh insight into information processing that occurs independent of the passage of time.

In this work, a GaN-on-Si quasi-vertical Schottky diode was demonstrated on a locally grown n-GaN drift layer. The diode achieves a high current density of 2.5 kA/cm², a specific on-resistance RON,sp of 1.9 mΩ.cm² despite the crowding effect in quasi-vertical device and on/off current ratio (Ion/Ioff) of 1010. Temperature-dependent current-voltage characteristics have been measured in the range of 300-433 K to investigate the mechanisms of leakage conduction in the device. At near zero bias, thermionic emission (TE) was found to dominate. At voltage range from -1 to -10 V, electrons gain enough energy to excite into trap states, leading to the dominance of Frenkel-Poole emission (FPE). For a higher voltage range (-10V to -40V), the increased electric field promotes electron hopping along the threading dislocations in the “bulk” GaN layers, and thus, Variable Range Hopping becomes the main mechanism for the whole temperature range. This work provides an in-depth insight into the leakage conduction mechanisms on vertical GaN-on-Si Schottky barrier Diodes (SBDs) grown by localized epitaxy.

The correct selection of the value of p is a complex and iterative procedure that requires experience in the interpretation of the obtained interpolated maps. Inverse Distance Weighting is a method applied to the porosities of the K and L hydrocarbon reservoirs, discovered in the Neogene (Lower Pontian) subsurface sandstones in the northern Croatia (Pannonian Basin System). They represent small and large data samples. Also a standard statistical analysis of the data was made, followed by the qualitative-quantitative analysis of the maps, based on the selection of different values of the power distance exponent (p-value) for the K and L reservoirs maps. According to the qualitative analysis, for a small data set, p-value could be set on 1 or 2 giving the most optimal result, while for a large data set, a p value of 3 and 4 could be applied. By quantitative analysis, for the case of small data p=2 is recommended, resulting in a root mean square error value of 0.03458, a mean absolute error of 0.02013 and a median absolute deviation of 0.00546. Oppositely, a p-value of 3 and 4 is selected as appropriate for a large data set, with root mean square errors of 0.02435 and 0.02437, mean square errors of 0.01582 and 0.01509 and median absolute deviations 0.00896 and 0.00444. Eventually for a small data set, it is recommended to use a p-value of 2, and for a large data set, a p-value of 3 or 4.

Mesoporous silica nanoparticles (MSNs) can be used as carrier materials for the controlled release of pesticides while reducing their negative environmental impact. In this study, we screened an active ingredient, p-cymene (PC), with an excellent inhibitory effect on rice bacterial blight. Subsequently, the PC was successfully loaded onto MSNs via physisorption(PC@MSNs). PC@MSNs, characterized by a regular spherical shape, smooth surface, and an MSN average size of 262.9 nm, achieved an 8.6 % drug loading capacity. The release kinetics of the PC from the PC@MSNs demonstrated a sustained release (288 h) pattern influenced by drug diffusion. The efficacy of the PC@MSNs against Xanthomonas oryzae pv. Oryzae paralleled those of PC. Acute toxicity assays re-vealed that the PC@MSNs were less toxic to aquatic life (LC50=257.867 mg/L) and that the formu-lation showed no adverse effects on rice seedling growth. In summary, these results suggest that PC@MSNs can broaden PC's application scope in managing rice diseases.

Given a set of distinct non-negative integers X^n and a target certificate S in parametrized form: ∃X^k⊆X^n,∑_(x_i∈X^k)▒x_i =S (k=|X^k |,n=|X^n |). We present a polynomial solution of the subset sum problem with time complexity T≤O(kn)≤O(n^2) and space complexity S≤O(((n-1)n)/2)≤O(n^2 ), so that P = NP.

Clopidogrel is one of the most prescribed antiplatelet drugs for cardiovascular diseases prevention. Clopidogrel is a prodrug metabolised by CYP2C19 in active metabolites with anti-aggregant effect. Pharmacogenetic variants such as CYP2C19*2 variant can alter the anti-aggregant effect of clopidogrel leading to a higher risk of cardiovascular disease relapse. The aim of this study was to evaluate the prescription characteristics of CYP2C19 pharmacogenetics in patients on clopidogrel treatment, based on a specific query in a clinical data warehouse. We evaluated the demographics of patients, prescribers, medical indications, CYP2C19 pharmacogenetic tests and therapeutic changes. Neurologists were the main prescribers of CYP2C19 pharmacogenetic tests associated with clopidogrel treatment in a context of suspicion of stroke relapse. Pharmacogenetic tests were mainly prescribed a posteriori to clopidogrel prescription. Clopidogrel pharmacogenetic resistance was associated with the prescription of lysine acetylsalicylate in substitution of clopidogrel. Clear clinical practice guidelines are needed to position CYP2C19 pharmacogenetic testing for patients on clopidogrel treatment.

Electrocardigraphy remains as a first-line evaluation method for cardiac function, recording the electrical activity of the heart from the body surface. Since atrial activation is seen on the ECG as P-wave, several factors are known to impact the appearance of the P-wave, such as direction of electric impulse, conduction abnormalities and anatomical characteristics of the atria. The aim of this retrospective study was to find statistically significant associations between anatomy of pulmonary veins (PVs) osberved in cardiac computed tomography (CT) and P-wave appearance during sinus rhythm on resting ECG. For each patient, a resting 12-lead ECG was recorded, the field of analysis was P wave – its’ duration, morphology and axis. The evaluation of the CT scan recordings was performed by creating 3D models of the left atrium and analyzing anatomy of the PVs and left atrial appendage (LAA). Noteworthy correlations were found: anatomy of the left PVs showed an association with LAA volume, LAA morphology and P-wave notching in lead II. The right PVs demonstrated relation with P wave axis and amplitude. Although these correlations cannot be classified as strong, they may play a role in significant scientific discoveries in future research projects.

The scope of this study was twofold: first, to introduce a new method in examining measurement invariance, especially with large-scale studies where a large number of group comparisons are involved: the alignment approach, where only configural invariance is necessary to achieve measurement invariance. Second, to evaluate the psychometric robustness of this approach using real-life data. Particularly, we applied this approach to examine whether the factor structure of a cognitive ability test (PGAT) exhibits measurement invariance across the 26 universities of the Kingdom of Saudi Arabia. The sample consisted of 9,849 graduate students from 26 universities around the Kingdom. The results indicated a robust configural model suggesting that the P-GAT subscales were invariant across the 26 universities. Finally, the aligned factor mean values were estimated, and factor mean comparisons of every group’s mean with all other group means were conducted for both cognitive domains (Verbal and Quantitative). In both domains, King Saud University had the highest mean score among all universities. Moreover, its mean factor score was significantly higher than any other university besides Dammam University. On the other hand, several universities allocated at the northern and Southern borders of the country exhibited the lowest factor mean scores.

Panax ginseng C. A. Meyer (P. ginseng), has been widely used in traditional Chinese medicine (TCM). It contains a number of chemical components and possesses a variety of pharmacological activities. Alzheimer's disease (AD) is neurodegenerative disease that creates a huge burden on the lives and health of individuals. In recent years, studies have indicated that the chemical components of P. ginseng, especially ginsenosides, play a pronounced positive role in the prevention and treatment of neurological diseases. This review aimed to summarize currently studies on chemical components and the mechanisms action in AD intervention treatment of P. ginseng, especially ginsenosides. In this review, the components of P. ginseng and their respective active effects were first introduced. Then the key molecular mechanisms and signaling pathways of P. ginseng were introduced, and its different active ingredients in the prevention and treatment of Alzheimer's disease-related pathogenesis were also summarized from the pathogenesis of AD Aβ generation and aggregation, hyperphosphorylation of tau protein，oxidant stress，neuroinflammation，mitochondrial damage，disorder of neurotransmitter and gut microbiota. Signaling pathway networks related to the action of ginseng active ingredients was constructed, which could serve as a therapeutic target for Alzheimer's disease. In addition to a detailed report on P. ginseng in improving Alzheimer's disease-related pathogenesis, the application of the current technology, spatial metabonomics in AD therapeutics and diagnostics were later discussed. Spatial metabonomics could be applied to investigate the multi-target intervention of P. ginseng on Alzheimer's disease. Research perspectives for the study of P. ginseng in the treatment of Alzheimer's disease were provided for further studies.

The research is a deep study of the CBOE Volatility Index (VIX), which represent the market sentiments of the S & P 500 Index (SPX) over a period of 33 years. It evaluates how the two indexes perform in the stock market crash and how reliable VIX is in predicting market sentiments. The research distributes the market rally in two forms, and one is a trust rally, when investors are happy to see the market in a stable form, and investors' sentiments are positive towards the stock market. Second is a fear rally, where investors' sentiments are negative, and their outlook is bearish for various reasons. It observes the pattern of rallies, like the longest trust or fear rally, in which year and its duration. The research analyzes data to reach a meaningful conclusion and various inferences that can be drawn from the study of historical data.

When 2−1/Q<p≤2, we establish the C^{0,1} and C^{1,α}-regularities of weak solutions to quasi-linear p-Laplacian type non-homogeneous equations in the Heisenberg group.

Paenibacilli are efficient producers of potent agents against bacterial and fungal pathogens, which are of great interest both for therapeutic applications in medicine as well as in agrobiotechnol-ogy. Lipopeptides produced by such organisms play a major role in their inactivation potential. In this work we investigated two lipopeptide complexes, the fusaricidins and the polymyxins, produced by Paenibacillus polymyxa strains DSM 32871 and M1 by MALDI-TOF mass spectrometry. The fusaricidins show potent antifungal activities and are distinguished by an unusual variabil-ity. For strain DSM 32871 we identified numerous yet unknown variants mass spectrometrically. DSM 32871 produces polymyxins of type E (colistins), while M1 forms polymyxins P. For both strains novel, but not yet completely characterized polymyxin species were detected, which pos-sibly are glycosylated. These compounds may be of interest therapeutically, because polymyxins attain increasing attention as last-resort antibiotics against multiresistant pathogenic Gram-negative bacteria. In addition, the volatilomes of DSM 32781 and M1 were investigated with a GC-MS approach using different cultivation media. Production of volatile organic com-pounds (VOCs) was strain and medium dependent. In particular, strain M1 manifested as an effi-cient VOC-producer that exhibited formation of 25 volatiles in total. A characteristic feature of Paenibacilli is the formation of volatile pyrazine derivatives.

The trace element selenium (Se) is taken up from the diet and becomes metabolized mainly by hepatocytes. Selenoprotein P (SELENOP) constitutes the liver-derived Se transporter. Biosynthesis of extracellular glutathione peroxidase (GPx3) in kidney depends on SELENOP-mediated Se supply. We hypothesized that Se status may serve as a useful prognostic marker for outcome in patients undergoing liver transplantation. Serum samples from patients were routinely collected before and after transplantation. Concentration of serum SELENOP and total Se as well as GPx3 activity were determined by standardized tests and related to survival, aetiology and pre-operative Child-Pugh and Model for End-Stage Liver Disease Scores. A total of 314 serum samples from 78 transplanted patients were available for analysis. The Se and SELENOP concentrations were on average below the reference ranges of healthy subjects. Patients with ethanol toxicity-dependent aetiology showed particularly low SELENOP and Se concentrations and GPx3 activity. Longitudinal analysis indicated declining Se concentrations in non-survivors. We conclude that severe liver disease necessitating organ replacement is characterized by a pronounced Se deficit before, during and after transplantation. A recovering Se status after surgery is associated with positive prognosis, and an adjuvant Se supplementation may thus support convalescence.

In developed countries, especially the big-sized ones like Australia and the USA, a car is almost an inevitable necessity to carry out daily activities. Due to this, used cars have become a great alternative to brand new cars because of their cost effectiveness. In this work, estimation of prices of used cars based on numerous factors is studied statistically. Data is based on prices of used cars sold across Australia. Statistical methods like correlation and permutation tests using linear regression model, exact tests and non-parametric bootstrapping is implemented to study the relationship of price with mileage and year of manufacture of the car using p-values and null hypothesis. Predictions are also made on the price by calculating a 95% confidence interval (CI) of median prices in small portions of the dataset. The study presents potential ideas for understanding correlation between variables and parameters in business studies.

Epigallocatechin-3-gallate (EGCG) is the most abundant polyphenol in green tea. In this study, the effects of dietary EGCG on oxidative stress and the metabolism and toxicity of acetaminophen in liver were investigated. Rats were fed the diets with (0.54 %) or without EGCG supplementation for four weeks and were then intraperitoneally injected with acetaminophen (1g/kg). Results showed EGCG lowered hepatic oxidative stress and cytochrome P450 (CYP) 1A2, 2E1, and 3A, and UDP-glucurosyltransferase activities prior to acetaminophen injection. After acetaminophen challenge, the elevations in plasma alanine aminotransferase activity and histological changes in liver were ameliorated by EGCG treatment. EGCG reduced acetaminophen-induced apoptosis by increasing the Bax/Bcl2 ratio in liver. EGCG mildly increased autophagy by increasing the LC3B II/I ratio. Lower hepatic acetaminophen-glutathione and acetaminophen-protein adducts contents were observed after EGCG treatment. EGCG increased glutathione peroxidase and NAD(P)H quinone 1 oxidoreductase activities and reduced organic anion-transporting polypeptides 1a1 expression in liver after acetaminophen treatment. Our results indicate that EGCG may lower oxidative stress and reduce the metabolism and toxicity of acetaminophen. The reductions in CYP-mediated acetaminophen bioactivation and uptake transporter, as well as enhanced antioxidant enzyme activity, may limit the accumulation of toxic products in liver and thus lower hepatotoxicity

Copulas are useful tools for modeling the dependence structure between two or more variables. Copulas are becoming a quite flexible tool in modeling dependence among the components of a multivariate vector, in particular to predict losses in insurance and finance. In this article, we study the dependence structure of some well-known real life insurance data (with two components mainly) and subsequently identify the best bivariate copula to model such a scenario via VineCopula package in R. Associated structural properties of these bivariate copulas are also discussed.

In this paper, we introduced many new notions and new contraction named as S-weakly contraction after that we obtained the p-common best proximity point theorems for different types of contractions in the setting of complete metric spaces by using weak P_p-property and proved the uniqueness of these points. Also we presented some examples to prove the validity of our results.

Metal oxide p-n heterojunction nanofibers (NFs) are among the most promising approaches to enhancing the efficiency of gas sensors. In this paper, we report the preparation of a series of p-NiO-loaded n-ZnO NFs, namely (1 − x) ZnO-xNiO (x = 0.03, 0.05, and 0.1 wt%), for hydrogen gas sensing experiments. Samples were prepared through the electrospinning technique followed by a calcination process. The sensing experiments showed that the sample with 0.05 wt% NiO loading resulted in the highest sensing performance at an optimal sensing temperature of 200 °C. The sensing mechanism is discussed in detail and contributions of the p-n heterojunctions, metallization of ZnO and catalytic effect of NiO on the sensing enhancements of an optimized gas sensor are analyzed. This study demonstrates the possibility of fabricating high-performance H₂ sensors through the optimization of p-type metal oxide loading on the surfaces of n-type metal oxides.

Kummerowia striata is a traditional medicine used for the therapy of inflammation-related diseases. Herein, we investigated the anti-melanogenic and antioxidant activities of an ethanolic extract of K. striata (EKS) using a number of in vitro and cell culture model systems. The anti-melanogenic effect was assessed in B16F10 melanoma cells based on melanin synthesis and in vitro tyrosinase inhibitory activity and the anti-oxidant activity assays were performed using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2ʹ-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS); EKS exhibited strong anti-oxidant activities in both the assays. The expression of tyrosinase, tyrosinase-related protein 1, tyrosinase-related protein 2, and microphthalmia-associated transcription factor was decreased in a dose-dependent manner at mRNA and protein levels upon treatment with EKS. Notably, EKS did not affect the cell viability at all the EKS concentrations used in this study, indicating that EKS-mediated inhibition of melanin synthesis is not accompanied with cytotoxicity. Collectively, our findings demonstrate, for the first time, that EKS possesses anti-melanogenic and anti-oxidant activities, and suggest that further evaluation and development of EKS as a functional supplement or cosmetic might be useful for skin whitening and for reduction wrinkles.

Graph coloring is a manifestation of graph partitioning, wherein, a graph is partitioned based on the adjacency of its elements. Partitioning serves potentially as a compartmentalization for any structural problem. Vertex coloring is the heart of the problem which is to find the chromatic number of a graph. The fact that there is no general efficient solution to this problem that may work unequivocally for all graphs opens up the realistic scope for combinatorial optimization algorithms to be invoked. The algorithmic complexity of graph coloring is non-deterministic in polynomial time (NP) and hard. To the best of our knowledge, there is no algorithm as yet that procures an exact solution of the chromatic number comprehensively for any and all graphs within the polynomial (P) time domain. However, several heuristics as well as some approximation algorithms have been attempted to obtain an approximate solution for the same. Here, we present a novel heuristic, namely, the 'trailing path', which returns an approximate solution of the chromatic number within polynomial time, and, with a better accuracy than most existing algorithms. The ‘trailing path’ algorithm is effectively a subtle combination of the search patterns of two existing heuristics (DSATUR and Largest First), and, operates along a trailing path of consecutively connected nodes (and thereby effectively maps to the problem of finding spanning tree(s) of the graph) during the entire course of coloring, where essentially lies both the novelty and the apt of the current approach. The study also suggests that the judicious implementation of randomness is one of the keys towards rendering an improved accuracy in such combinatorial optimization algorithms. Apart from the algorithmic attributes, essential properties of graph partitioning in random and different structured networks have also been surveyed, followed by a comparative study. The study reveals the remarkable stability and absorptive property of chromatic number across a wide array of graphs. Finally, a case study is presented to demonstrate the potential use of graph coloring in protein design – yet another hard problem in structural and evolutionary biology.

This paper includes some new investigations and results for post quantum calculus, denoted by (p,q)-calculus. A chain rule for (p,q)-derivative is developed. Also, a new (p,q)-analogue of the exponential function is introduced and some its properties including the addition property for (p,q)-exponential functions are investigated. Several useful results involving (p,q)-binomial coefficients and (p,q)-antiderivative are discovered. At the final part of this paper, (p,q)-analogue of some elementary functions including trigonometric functions and hyperbolic functions are considered and some properties and relations among them are analyzed extensively.

In this paper we establish several Hermite-Hadamard type integral inequalities for hyperbolic p-convex functions. Applications for special means are provided as well.

In this paper, we introduce a new generalization of the Hermite polynomials via (p, q)-exponential generating function and investigate several properties and relations for mentioned polynomials including derivative property, explicit formula, recurrence relation, integral representation. We also de…ne a (p, q)-analogue of the Bernstein polynomials and acquire their some formulas. We then provide some (p, q)-hyperbolic representations of the (p, q)-Bernstein polynomials. In addition, we obtain a correlation between (p, q)-Hermite polynomials and (p, q)-Bernstein polynomials.

In this study, a graphene-doped porous silicon (G-doped/p-Si) substrate for low ppm H₂ gas detection by an inexpensive synthesis route was proposed as a potential noble graphene-based gas sensor material and to understand the sensing mechanism. The G-doped/p-Si gas sensor was synthesized by a simple capillary force-assisted solution dropping method on p-Si substrates, whose porosity was generated through an electrochemical etching process. G-doped/p-Si was fabricated with various graphene concentrations and exploited as a H₂ sensor operated at room temperature. The sensing mechanism of the sensor with/without graphene decoration on p-Si was proposed to elucidate the synergetic gas sensing effect generated from the interface between the graphene and p-type silicon.

The current generation of nuclear reactors are evolutionary in design, mostly based on the technology originally designed to power submarines, and dominated by Light Water Reactors. The aims of the GenIV consortium are driven by sustainability, safety and reliability, economics, and proliferation resistance. The aims are extended here to encompass the ultimate and universal vision for strategic development of energy production, the ‘perpetuum mobile’ – at least as close as possible. We propose to rethink nuclear reactor design with the mission to develop a system which uses no fresh resources and produces no fresh waste during operation as well as generates power safe and reliably in economic way. The results of the innovative simulations presented here demonstrate that, from a theoretical perspective, it is feasible to fulfil the mission through the reuse of spent nuclear fuel from currently operating reactors as the fuel for a new reactor. The produced waste is less burdensome than current spent nuclear fuel which is used as feed to the system. However, safety, reliability and operational economics will need to be demonstrated to create the basis for the long term success of nuclear reactors as a major carbon free, sustainable, and applied highly reliable energy source.

The presence of potentially pathogenic bacteria on veterinary clinic surfaces may be problematic. In this study we collected swab samples (Fisherbrand, double transport swabs with Stuart’s liquid medium) and water samples from five veterinary rehabilitation clinics. Swabs and water samples were transported to a microbiology lab for processing. At the lab swabs were used to inoculated Hardy’s Cdiff Banana broth (for Clostridium difficile [Cdiff]), and five different types of bacterial growth media, including: Hardy CHROM MRSA agar (methicillin resistant Staphylococcus aureus [MRSA], and S. pseudintermedius [SIM]), Mannitol Salt Agar (S. aureus), Eosin Methylene Blue agar (enterics [ENT]), Pseudomonas Isolation agar (Pseudomonas sp.), and Tryptic Soy Agar [TSA] (non-specific). The most prominent species cultured was Cdiff (on nearly 55% of swabs). Bacillus sp. and Enterics were encountered on nearly 35% of swabs, with MRSA and SIM on just over 10% of swabs. The most contaminated sample site was harnesses/life jackets used with the underwater treadmill (33% of swabs). Underwater treadmill water had total bacterial counts from 1.6 to 2.7 e3 cfu/ml. Of all bacterial species detected SIM tends to be more pathogenic for dogs. Targeted cleaning/disinfecting in these clinics could help reduce risks for both animals and caregivers utilizing these clinics.

We know that the classical Mittag-Leffler function play an important role as solution of fractional order differential and integral equations. We introduce the j-generalized p - k Mittag-Leffler function. We evaluate the second order differential recurrence relation and four different integral representations and introduce a homogeneous linear differential equation whose one of the solution is the j-generalized p-k Mittag-Leffler function. Also we evaluate the certain relations that exist between j-generalized p - k Mittag-Leffler function and Riemann-Liouville fractional integrals and derivatives. We evaluate Mellin-Barnes integral representation of j-generalized p-k Mittag-Le er Function. The relationship of j-generalized p-k Mittag-Leffler Function with Fox H-Function and Wright hypergeometric function is also establish. we obtained its Euler transform, Laplace Transform and Mellin transform. Finally we derive some particular cases.

In this paper, we derive multifarious relationships among the two types of higher order q-Daehee polynomials and p-adic gamma function via Mahler theorem. Also, we compute some weighted p-adic q-integrals of the derivative of p-adic gamma function related to the Stirling numbers of the both kinds and the q-Bernoulli polynomials of order k.

Can the type of implant rehabilitation influence peri-implant bone loss in case of full-arch mandibular prosthesis? The purpose of the study was to assess, by orthopantomograms (OPG), bone loss around implants in different types of implant-supported prosthetic rehabilitations and evaluate potential risk factors associated with the number and location of implants that may have an association with bone defect. A radiographic study was conducted on 22317 OPGs in the time range from 2010 to 2024. All OPGs with implant-supported prosthetic mandibular rehabilitations were included in the study. A total of 155 OPGs were evaluated, with peri-implant bone loss identified in 64 (41.3%). Distal implants (furthest from the center) across various positioning patterns were most susceptible to bone loss, with positions 3.6 and 4.6 demonstrating the most frequent occurrences (25 and 26 cases, respectively). χ² test revealed significant associations between both implant positioning pattern (p &lt; 0.001) and number of implants (p &lt; 0.001) with peri-implant bone loss. Also by updating the sample of OPGs, increased susceptibility to bone resorption was found for implants placed distal to the mental foramen compared to mesial ones in full-arch implant-supported fixed prostheses. Prospective clinical studies will then be useful to investigate this finding further.

One of the most common complications of neurogenic bladder secondary to spinal cord injury (SCI) is urinary incontinence, possibly related to bladder-emptying methods and changes in quality of life. This study aimed to identify the occurrence of this complication in adults with SCI and analyze its relationship with bladder-emptying methods, satisfaction, and lifestyle. This is a quantitative, exploratory, cross-sectional study. The variables were collected using the Bowel and Bladder Treatment Index during a telephone interview with 290 participants from February to November 2021. According to the results, 70% of the participants were male and 74.1% performed clean intermediate catheterization (CIC) as the main bladder-emptying method. Moreover, 55.6% were considered incontinent in the last year. Emptying by normal urination and bladder reflex triggering had a statistically significant relationship with urinary incontinence. A statistical association was observed between all the variables of satisfaction and lifestyle with urinary incontinence. Although CIC reduced urine leakage, a considerable number of participants still presented with frequent urine leakage. Urinary incontinence negatively altered satisfaction with the bladder-emptying method, effectiveness of bladder management, quality of life, and personal and social relationships.

The clinical features of increasing muscle weakening are shared by a diverse set of illnesses known as muscular dystrophies. In early childhood, males with Duchenne muscular dystrophy (DMD) exhibit proximal muscle weakening and calf enlargement, making it the most frequent X-linked disease of muscular dystrophy in children. Development of motor skills is typically delayed, and wheelchair confinement eventually leads to early death from heart or lung problems. In terms of function, ambulation, quality of life, and life expectancy, treatment approaches like corticosteroid therapy and intermittent positive pressure breathing have improved. This is a case report of a 6-year-old kid who had early ambulatory stage Duchenne Muscular Dystrophy and complained to the neuro-physiotherapy department about frequent falls, walking difficulties, and dyspnea when walking. Other grievances included being unable to get off the ground and having trouble ascending stairs. He had physiotherapy and dynamic neuromuscular stabilization for his complaints. The main goals of treatment were educating the family, respiratory training, preventing ankle plantar flexors, maintaining strength, balance and gait training.

Introduction: Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific postoperative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms have been not clarified yet. Methods: This retrospective series of 31 patients undergoing ACDF for CDH at a single Academic Hospital. Baseline and postoperative clinical, radiological, and surgical data were analyzed. The linear regression analysis was conducted to identify any factor independently influencing the occurrence rate of postoperative interscapular pain. Results: The mean age was 57.6±10.8 years, and the M:F ratio was 2.1. The preoperative mean VAS-arm was 7.15±0.81 among the 20 patients reporting brachialgia, and the mean VAS-neck was 4.36±1.43 among those 9 patients reporting cervicalgia. At 1 month interscapular pain was still reported by 8 out of the 17 patients who experienced it postoperatively, and it was recovered in all patients after 2 months. The regression analysis showed how the interscapular pain was not directly associated to age(p=0,74), gender(p=0,46), smoking status(p=0,44), diabetes(0,42), preoperative brachialgia(p=0,21) or cervicalgia(p=0,48), symptoms duration(p=0,13), baseline VAS-arm(p=0,11), VAS-neck(p=0,93), or mJOA(p=0,63) scores, or disc height modification(p=0,90). However, the postoperative increase of the mean zygapophyseal joint rims distance was identified as an independent factor in determining interscapular pain (p=0,02). Conclusions: Our study revealed that the onset of interscapular pain following ACDF may be determined by over-distraction of the zygapophyseal joints rim. Then, proper sizing of prosthetic implants could reduce this painful complication.

Background: Neuromuscular electrical stimulation (NMES) has beneficial effects on physical functions in Multiple Sclerosis (MS) patients. However, the neurophysiological mechanisms underlying these functional improvements are still unclear. This study aims at comparing acute responses in spinal excitability, as measured by soleus Hoffmann reflex (H-reflex), between MS patients and healthy individuals, following three experimental conditions involving the ankle planta flexor muscles: 1) passive NMES (pNMES); 2) NMES superimposed to isometric voluntary contraction (NMES+); and 3) isometric voluntary contraction (ISO). Methods: 20 MS patients (MSp) and 20 healthy individuals as control group (CG) took part in a single experimental session. During each condition, participants performed 15 repetitions of 6 seconds at 20% of maximal voluntary isometric contraction, with 6 seconds of recovery between repetitions. Before and after each condition, H-reflex amplitudes were recorded. Results: In MSp, H-reflex amplitude did not change following any experimental condition (ISO: p = 0.506; pNMES: p = 0.068; NMES+: p = 0.126). In CG, H-reflex amplitude significantly increased following NMES+ (p = 0.01), decreased after pNMES (p = 0.000) and was unaltered following ISO (p = 0.829). Conclusion: the different H-reflex responses between MS and CG might reflect a reduced ability of MS patients in modulating spinal excitability.

The overhead squat movement engages various bodily structures, and its interaction with three-dimensional elastic resistance along the kinetic chain approach remains insufficiently comprehended. This study aimed to describe the scapular kinematics during an overhead squat with the forearm in a supination exercise against an ER and clarify the therapeutic potential of this exercise on scapular rehabilitation. Using an electromagnetic tracking system, we recorded the three-dimensional shoulder kinematics of 19 male participants across seven humeral elevation positions. These positions were captured at 15-degree intervals, spanning from 30 to 120 degrees. The results indicated notable distinctions in scapular upward rotation [F(1,17)=6.09, p=0.024] and scapular posterior tilt [F(1,17)=6.04, p=0.025] between the phases. Furthermore, the interactions revealed significant differences in resistance and phases during humeral elevation for scapular upward/downward rotation [F(3.77,62.48)=7.99, p&lt;0.001], scapular internal/external rotation [F(2.98, 50.64, p&lt;0.001)], and scapular tilt [F(2.58, 43.81)=4.76, p=0.008]. The findings demonstrated that increasing resistance through elastic resistance played a pivotal role in enhancing scapular stability throughout the humerus elevation motion. This underscores the potential of the overhead squat movement as a valuable tool for both shoulder assessment and treatment.

Asymmetry plays a major role in biology at all scales. This can be seen examining the helix of DNA, the fact that the human heart is on the left side, or that most people use their right hand. A single protein such as Myosin 1D can induce helical motion in another molecule. This causes cells, organs, and even entire bodies to twist in a domino effect, causing left-right behaviour. More in general, athlete movements are often asymmetric and, during the physical rehabilita-tion after injury the asymmetry is visually discernible. Herein we review the molecular basis of movement asymmetries and report on the available knowledge on the few therapeutics inves-tigated so far such as meloxicam. From a more rehabilitative perspective, it is very important to use effective methods to control the process of resolving the injury-related movement asym-metry through the complex use of specialized exercises, measurements and gait analysis which all can provide useful information on the effectiveness of rehabilitation plans. If for each athlete the normal range of asymmetry is known, the asymmetry can be treated individually and the evolution can be monitored over time. Appropriate measures should be taken if the movement asymmetry is outside this range. In addition, genetic, physiological, and psychological factors relevant to athlete health should be considered in the process of assessing and improving exer-cise asymmetry as we also discuss in this review. The main proposal of this work is that move-ment asymmetries in athletes should be treated individually, taking into account the athlete’s genetics, physical condition, and previous injuries.

Spinal cord injuries (SCI) can result in sensory and motor dysfunctions, which were long-considered permanent. Recent advancement in electrical neuromodulation has been proven to restore sensorimotor function in people with SCI. These stimulation protocols, however, were mostly invasive, expensive, and difficult to implement. In this study, transcutaneous electrical stimulation (tES) was used to restore over-ground walking of an individual with 21 years of chronic paralysis from a cervical SCI. After a total of 66 weeks of rehabilitation training with tES, which included standing, functional reaching, reclined sit-up, treadmill walking and active biking, significant improvement in lower-limb volitional movements and overall light touch sensation were shown by International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) score. By the end of the study, the participant could walk in a 4-meter walking test with the aid of a walking frame and ankle foot orthoses. The success in the sensorimotor recovery of our study participant sheds light on the future of non-invasive neuromodulation treatment for SCI paralysis.

Background: Micronutrient deficiencies are common at the time of cancer diagnosis and are associated with worse prognosis. Little is known about them in cancer rehabilitation. Methods: Data from routine health related quality of life (HRQOL) were analyzed at an inpatient cancer rehabilitation center. Rehabilitation patients completed the EORTC QLQ-C30 questionnaire before and after multidisciplinary rehabilitation treatment, and three month after discharge. Selenium and zinc status was measured in whole blood at these three time points. In case of selenium deficiency up to 600 µg selenium per day as sodium selenite was supplemented. Results: A total of 271 patients (breast, colon, and pancreatic cancer) were included in the analysis. There was clinically meaningful improvement in many domains of the EORTC QLQ-C30 during rehabilitation. However, effect often waned in the three months after. Prevalence for selenium deficiency varied between 34 to 90 percent depending on cancer type (breast &lt; colon &lt; pancreas). In contrast, zinc deficiency was rare. Daily selenium supplementation of 600 µg was more efficient to correct selenium deficiency compared to 300 µg selenium per day. Rehabilitation and increasing selenium status after rehabilitation were associated with improved global quality of life, physical and emotional functioning, and fatigue. In cancer patients with decreasing selenium status, values of global quality of life, physical and emotional functioning, and fatigue were back to the values at the beginning of rehabilitation. Conclusions: Selenium deficiency is common in cancer patients admitted to a cancer rehabilitation clinic. Selenium supplementation during rehabilitation effectively corrected selenium deficiency in most cases. The positive effects of rehabilitation persisted longer, when selenium status did not decrease after rehabilitation.

The environmental legacy of post-closure mine sites poses a significant risk to the sustainability of mining operations and natural resource development. This study aims to advance the understanding of sustainable mine site reclamation behavior in Canada by using multi-temporal Landsat satellite images to examine the long-term land cover changes at post-closure mine sites. Six representative post-closure mine sites were selected for the evaluation and comparison. The Normalized Difference Vegetation Index (NDVI) analysis, Landsat image classification, post-classification change detection, and Regrowth Index (RI) analysis were conducted to assess the speed and extent of landscape and vegetation recovery at the target mine sites. A significant vegetation recovery was quantified for the mine sites that have experienced active reclamation activities. In contrast, the post-closure mine area undergoing only the passive revegetation typically demonstrated a slow and minor increase in vegetation over time. The actively revegetated mine sites can typically be restored to a level that equals or better than the pre-mining situation. This work confirms that active reclamation and revegetation at post-closure mine sites is critically important in sustainable mining. The quantified mine site reclamation behavior and the relevant sustainable practices would be useful for evidence-based sustainable resource management in Canada.

Maximal heart rate (HRmax) is a widely used measure of cardiorespiratory fitness. Prediction of HRmax is an alternative to cardiopulmonary exercise testing (CPET), but its accuracy among endurance athletes (EA) requires evaluation. This study aimed to externally validate HRmax prediction models in the EA independently for running and cycling CPET. 4043 runners (age=33.58 (8.12) years; 83.53% males; BMI=23.66 (2.54) kg·m−2) and 1026 cyclists (age=36.88 (9.03) years; 89.67% males; BMI=24.04 (2.65) kg·m−2) underwent maximum CPET. Student t-test, mean absolute percentage error (MAPE), mean absolute error (MAE), and root mean square error (RMSE) were applied to externally validate 8 running and 5 cycling HRmax equations. HRmax was 184.60 (9.79) beats·min−1 and 182.66 (10.28) beats·min−1 respectively for running and cycling, p=0.001. Measured and predicted HRmax differed significantly (p=0.001) for 9 of 13 (69.23%) models. HRmax was overestimated by 8 (61.54%) and underestimated by 5 (38.46%) formulae. Overestimated HRmax ranged 0.08-4.94 beats·min−1 and underestimated HRmax ranged 0.03-4.90 beats·min−1. MAE and RMSE were 0.18-4.94 beats·min−1 and 9.13-10.47, respectively. MAPE ranged 3.95-4.69%. Prediction models do not allow for accurate estimation of HRmax. HRmax was more often underestimated than overestimated. Predicted HRmax can be implemented for EA as a supplemental method but CPET is the preferable approach.

Although Cable driven rehabilitation devices (CDRD) have advantages over traditional link-driven devices, including lightweight, ease of reconfiguration, remote actuation, etc, the majority of existing lower-limb CDRD is limited to rehabilitation in the sagittal plane. In this work, we extend our previous sagittal plane model (2DOF) to accommodate hip motion in the frontal plane (abduction/adduction) toward studying the feasibility of tracking bi-planar motion (combined frontal and sagittal plane motion) via intra-planar cable routing. Two optimization problems have been formulated to estimate an optimal location of the hip cuffs, first to estimate the optimal cuff location at each time step to identify a single ‘averaged’ optimal cuff location and second to calculate a single optimal cuff location for the entire gait cycle. The optimization solutions identified for the 3DOF model revealed that optimization of the location of cuffs on the anterior and posterior side of the hip joint for 4 cable configuration is not sufficient to generate the desired bi-planar motion. For simultaneous tracking of the bi-planar motion, 2 additional cables have been added at hip joints and are routed in an intra-planar manner. The simulation result with the 3DOF model confirmed successful bi-planar trajectory tracking. The various number of cables and cable routings for tracking bi-planar motion will be studied in future work.

An early hypothesis in robot-assisted stroke therapy was that sensorimotor stimulation through robotic assistance is beneficial for recovery. Despite 25 years of upper-limb rehabilitation robotics research, this hypothesis remains untested barring a few studies with small sample sizes. This review aims to provide a critical summary of the current state of this hypothesis by collating evidence from rehabilitation robotics and other related therapeutic approaches. The review starts with a causal model to expose the various direct and indirect routes through which robotic assistance can aid sensorimotor recovery. The indirect routes include the influence of robotic assistance on therapy intensity, patient motivation, and active participation. The direct route is through changes in cortical networks through Hebbian(-like) learning and changes in peripheral tissue properties. There is currently mixed evidence for the direct causal effect of robotic assistance on recovery from the upper-limb rehabilitation robotics literature. However, evidence from the neuromuscular electrical stimulation literature provides some support for this causal role. Based on the data at hand, we hypothesize that the enhanced movement-related sensory feedback from robotic assistance has a direct, possibly small, causal role in the sensorimotor recovery of the upper-limb, and this effect might be detectable with high-intensity therapy. Large, high-intensity, controlled studies are warranted to support or refute the role of robotic assistance on recovery, which is both scientifically and practically important.

This report is a narrative of a certified nurse working on a long-term rehabilitation ward for patients with dementia in Japan during the early phase of the COVID-19 pandemic. During this time visitation restrictions had been implemented to prevent the spread of COVID-19 causing psychological distress for patients and their families which nurses had to cope with . The nurse was interviewed twice September–October 2020. The recordings were transcribed verbatim and analysed thematically. Three themes were identified relating to changes in care in response to the pandemic which nurses had to adapt to: the risk of collapse of family members’ roles, anxiety caused by patients forgetting family members and family memories and increased disorientation. During the pandemic, nursing care needs to adapt, ensuring that family attachments and ties continue and minimizing the disruption caused by the pandemic, while ensuring that everyone remains Covid-safe.

Patients often need the use of their arms to assist with functional activities, but after bone disruption, pushing is frequently limited to less than 4.5 kg. No method exists to measure arm weight bearing objectively in clinical settings. This project aimed to design, construct, and test a walker for patients who need to limit arm force to prevent excessive bone stress during post-fracture (iatrogenic or traumatic) ossification. First, a qualitative study was conducted to obtain critiques of a Clinical Force Measuring (CFM) walker prototype from rehabilitation professionals. Key statements and phrases were coded that allowed “themes” to emerge from transcribed interviews, which guided device revisions. Next, a second CFM Walker prototype was designed based on the qualitative data and device criteria/constraints and finally tested. The result was fabrication of a new lightweight, streamlined, and cost-effective prototype walker with a simple visual display and auditory cue with upper limit alarms. Key features included attachments for medical equipment and thin film force-sensing resistors integrated into the walker handles that progressively activated 3 LEDs and a buzzer when arm force exceeded programmed thresholds. The innovative CFM Walker will help patients with restricted arm weight bearing, especially elderly adults, recover safer and faster in the future.

The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on "Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin" (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The 5-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results; therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.

This study presents three forms of interdisciplinary expertise in the healthcare design context to approach a particular multifaceted problem around the current healthcare for older adult patients with chronic low-back pain (LBP). Using an interdisciplinary co-design framework, first, our design approach performs the role of an initiator to define the problem by exploring the current context of healthcare. Second, it facilitates the experiences of experts and patients to reach the roots of the problem by functioning as a mediator. Third, our approach fulfills the primary role of healthcare design in producing new meanings considering the principles of patient-centeredness. These roles significantly contributed to the design of healthcare innovations. Our framework transformed the distributed disciplinary knowledge developed while tackling the multifaceted problem into new forms of expertise for collaboration in healthcare innovation.

The deterioration of gait can be used as a biomarker for ageing and neurological diseases. Continuous gait monitoring and analysis are essential for early deficit detection and personalized rehabilitation. The use of mobile and wearable inertial sensor systems for gait monitoring and analysis have been well explored with promising results in the literature. However, most of these studies focus on the technologies for gait characteristic assessment, few of them have considered the data acquisition bandwidth of the sensing system. Inadequate sampling frequency will sacrifice signal fidelity, thus leading to an inaccurate estimation especially for spatial gait parameters. In this work, we developed an inertial sensor based in-shoe gait analysis system for real-time gait monitoring and investigated the optimal sampling frequency to capture all the information on walking patterns. An exploratory validation study was performed using an optical motion capture system on four healthy adult subjects, where each person underwent five walking sessions, giving a total of 20 sessions. Percentage mean absolute errors (MAE%) obtained in stride time, stride length, stride velocity, and cadence while walking were 1.19%, 1.68%, 2.08%, and 1.23%, respectively. In addition, an eigen-analysis based graphical descriptor from raw gait cycle signals was proposed as a new gait metric that can be quantified by principal component analysis to differentiate gait patterns, which has great potential to be used as a powerful analytical tool for gait disorder diagnostics.