Search Results (60)

Data over sound (DoS) is an established technique that has experienced a resurgence in recent years, finding applications in areas such as contactless payments, device pairing, authentication, presence detection, toys, and offline data transfer. This study introduces CardiaWhisper, a system that extends the DoS concept to the medical domain by using a medical data-over-sound (MDoS) framework. CardiaWhisper integrates wearable biomedical sensors with home care systems, edge or IoT gateways, and telemedical networks or cloud platforms. Using a transmitter device, vital signs such as ECG (electrocardiogram) signals, PPG (photoplethysmogram) signals, RR (respiratory rate), and ACC (acceleration/movement) are sensed, conditioned, encoded, and acoustically transmitted to a nearby receiver—typically a smartphone, tablet, or other gadget—and can be further relayed to edge and cloud infrastructures. As a case study, this paper presents the real-time transmission and processing of ECG signals. The transmitter integrates an ECG sensing module, an encoder (either a PLL-based FM modulator chip or a microcontroller), and a sound emitter in the form of a standard piezoelectric speaker. The receiver, in the form of a mobile phone, tablet, or desktop computer, captures the acoustic signal via its built-in microphone and executes software routines to decode the data. It then enables a range of control and visualization functions for both local and remote users. Emphasis is placed on describing the system architecture and its key components, as well as the software methodologies used for signal decoding on the receiver side, where several algorithms are implemented using open-source, platform-independent technologies, such as JavaScript, HTML, and CSS. While the main focus is on the transmission of analog data, digital data transmission is also illustrated. The CardiaWhisper system is evaluated across several performance parameters, including functionality, complexity, speed, noise immunity, power consumption, range, and cost-efficiency. Quantitative measurements of the signal-to-noise ratio (SNR) were performed in various realistic indoor scenarios, including different distances, obstacles, and noise environments. Preliminary results are presented, along with a discussion of design challenges, limitations, and feasible applications. Our experience demonstrates that CardiaWhisper provides a low-power, eco-friendly alternative to traditional RF or Bluetooth-based medical wearables in various applications. Full article

Background/Objectives: Imposed sleep restriction leads to increased feelings of appetite and hedonic eating behaviors (or food rewards). No study to date has assessed home-based measures of sleep with appetite and food rewards exclusively in Black emerging adults (ages 18–28 years), despite higher risks of short sleep and obesity in this population. We examined associations between 6-month changes in sleep with changes in appetite and food reward in Black emerging adults. Methods: Fifteen Black emerging adults (12 females; age, 21 ± 2.5 years; body mass index, 25.7 ± 4.5 kg/m²; body fat, 25.8 ± 11.9%) completed two identical 7-day measurement bursts at baseline and 6 months. Sleep (duration, efficiency, and architecture) was captured via 7 days of actigraphy and 2 nights of in-home polysomnography. During a laboratory visit, participants completed appetite measures (desire to eat, hunger, fullness, and prospective food consumption) via visual analog scales before and for 3 h following standard breakfast intake. The food reward for the fat and sweet categories of food was measured before lunch with the Leeds Food Preference Questionnaire. Results: Fasting fullness scores decreased from baseline to 6 months (−8.9 mm, p < 0.01) despite increases in body weight (2.6 kg, p < 0.01) and waist circumference (2.4 cm, p = 0.03). Increases in actigraph-measured sleep duration were associated with decreases in fasting desire to eat (r = −0.58, p = 0.04). Increases in actigraph-measured sleep efficiency were also associated with decreases in explicit liking for sweet foods (r = −0.60, p = 0.03). Conclusions: Our findings suggest that improvements in sleep duration and sleep efficiency may lead to decreased feelings of appetite and food reward in Black emerging adults. Full article

Bagheria, located on the northern coast of Sicily, is home to one of the Mediterranean’s most remarkable ensembles of Baroque villas, constructed between the 17th and 18th centuries by the aristocracy of Palermo. Originally situated within a highly structured rural landscape of citrus groves, gardens, and visual axes, these monumental residences have undergone substantial degradation due to uncontrolled urban expansion throughout the 20th century. This study presents a diachronic spatial analysis of Bagheria’s territorial transformation from 1850 to 2018, integrating historical cartography, aerial photography, satellite imagery, and Geographic Information System (GIS) tools. A total of 33 villas were identified, georeferenced, and assessed based on their spatial integrity, architectural condition, and relationship with the evolving urban fabric. The results reveal a progressive marginalization of the villa system, with many heritage assets now embedded within dense residential development, severed from their original landscape context and deprived of their formal gardens and visual prominence. Comparative insights drawn from analogous Mediterranean heritage landscapes, such as Ortigia (Siracusa), the Appian Way (Rome), and Athens, highlight the urgency of adopting integrated conservation frameworks that reconcile urban development with cultural and ecological continuity. As a strategic response, the study proposes the creation of a thematic cultural route, La città delle ville, to enhance the visibility, accessibility, and socio-economic relevance of Bagheria’s heritage system. This initiative, supported by adaptive reuse policies, smart heritage technologies, and participatory planning, offers a replicable model for sustainable territorial regeneration and heritage-led urban resilience. Full article

Objectives: The aims of the presented study were to investigate and compare the effectiveness of Low-Level Laser Therapy (LLLT) and therapeutic ultrasound (US) on pain, function, emotional status, and sleep disturbances in patients with rotator cuff tendinopathy (RCT). Method: A total of 84 patients with RCT were included in the study and randomly divided into the US group (n = 42) and the LLLT group (n = 42). Hot-pack, transcutaneous electrical nerve stimulation, and a home-based exercise program were also administered to patients in each group. The patients were evaluated at baseline, and at 1st, 4th, and 12th weeks after treatment by Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), Constant Murley Score (CMS), Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), Hand Grip Strength (HGS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36). Results: Significant improvements in VAS, SPADI, CMS, DASH, BDI, BAI, PSQI, and SF-36 scores were observed over time in both groups (p < 0.05 for all). The improvements in HGS scores were significantly greater in the US group compared to the LLLT group (p < 0.05 for all). There were no statistically significant differences between the groups in VAS, SPADI, CMS, DASH, BDI, BAI, PSQI, and SF-36 scores at each time point (p > 0.05 for all). Conclusions: Both therapeutic US and LLLT are effective and safe in the treatment of patients with RCT. However, our findings indicate no superiority of one treatment over the other in terms of pain relief or improvements in function, emotional status, sleep disturbances, or quality of life. Full article

In this article, we present a case of a 49-year-old woman presenting with a recurrent metastatic neuroendocrine tumor. Background: Insulinomas are neuroendocrine tumors derived from beta cells of the pancreas that secrete insulin. Usually, they are benign tumors; however, metastatic insulinomas are an extremely rare malignant form of these tumors, carrying a significantly worse prognosis. Case Presentation: A 49-year-old woman, a patient in the University Hospital in Wroclaw in the Department of Endocrinology, Diabetes and Isotope Therapy, first presented with abdominal pain in 2009, when ultrasound and further examination led to the diagnosis of a tumor in the pancreas (a solid pseudopapillary tumor of the pancreas—meta NET G2), and the patient underwent distal pancreatectomy with splenectomy. For ten years, she was under observation, and her symptoms, such as abdominal pain, nausea, weight loss, and general weakness, reappeared in 2019. Then, magnetic resonance imaging (MRI) showed a lesion in the liver, and further histopathology revealed neuroendocrine tumor (NET) metastasis to the liver. In 2022, the patient presented with loss of consciousness and convulsion, loss of weight, and hypoglycemia after meals. In April 2022, the daily glycemic profile was recorded and a 72 h fasting test was performed; however, their results excluded insulinoma. Positron emission tomography–computed tomography (PET-CT) with 18F-fluorodeoxyglucose (18F-FDG) and PET with gallium-68-DOTA-(Tyr3)-octreotate (68Ga-DOTA-TATE) showed a metastatic proliferative process in the liver. Persistent hypoglycemia led to another hospitalization in May 2022, and repeated tests allowed for the diagnosis of insulinoma. Treatment with somatostatin analogs and diazoxide was started. A CT scan in November 2022 and a PET scan in January 2023 showed new metastases to the liver, bones, and cervical lymph nodes, and it was decided to intensify the treatment. In May 2023, the patient was qualified for Lutathera treatment for insulinoma at the University Clinical Hospital in Poznań. In June 2023, another disturbing symptom was reported by the patient, a painful lump in the breast. During diagnostics, metastases with high proliferation markers were found in both breasts. Two months later, in August 2023, the patient received another dose of Lutathera. In October 2023, significant progression of liver lesions, metastases to bones of the spine, ribs, and pelvis, and periaortic and pelvic lymphadenopathy were found as well as elevated values of neuron-specific enolase and calcitonin. The patient was also referred to the Palliative Medicine Home Hospice. In consultation with the Lower Silesian Cancer Center, the decision was made to forgo further treatment with PRRT and initiate systemic chemotherapy. Despite the chosen treatment, the patient died on 27/DEC/2023. Conclusions: This case report can serve clinicians, as it presents a case of an extremely rare and insidious tumor, metastatic insulinoma. Full article

The architectural artefacts, materials, and techniques used for constructing shelters may share some common properties derived from the architectural culture that has evolved within the human species. This article examines the material features and settlement organisations employed in the nest-building activities of early human species and the shelter forms of indigenous peoples residing in sub-Saharan Africa. It questions whether early modern human notions of architectural heritage, which lack substantiation, might have influenced nest construction, typological differentiation, material utilisation, and the transmission of practices to subsequent generations and habitats. The focus is on home-based spatial organisation and the construction of structures. We recognise the need to clarify some fundamental misunderstandings regarding the nature of cultural and archaeological taxonomies, as well as the misuse of analogical reasoning when comparing contemporary hunter–gatherer populations with certain hominin groups. The paper aims to explore whether the early ‘Homo architecture’ in Africa bears any resemblance to that of modern Africans. The central inquiry of this study is whether indigenous architectural artefacts, materials, and techniques have been passed down throughout the evolution of architectural culture. The discussion suggests that the architectural products found in the settlement remains of early Homo species may exhibit characteristics similar to the huts of the indigenous people, who live as hunter–gatherers in sub-Saharan Africa. Discussing the architectural activities of different human species proves fruitful, as early architectural understanding and principles can be adapted to contemporary placemaking scenarios, urban design approaches, and housing models. We believe that, with further evidence, this foundational idea has the potential to be developed further. Full article

Background/Objectives: There is a paucity of research that explores the effectiveness of the Sequential Oral Sensory (SOS) Approach to Feeding. The purpose of this feasibility study was to evaluate the necessary components for the implementation of a treatment effectiveness study on the Sequential Oral Sensory (SOS) Approach to Feeding. The primary aims were to develop a fidelity measure, determine the feasibility of video coding, create an observational coding scheme, and determine if the outcome measures were sensitive to change. Methods: Over a 4-year period, data were collected from twelve participants aged 4 to 8 years with developmental disorders, with the assistance of four occupational therapy doctoral students. A fidelity measure was created, and inter-rater reliability was established among the four coders. Videotapes were collected at home and in the clinic. A behavioral coding system, consistent with the SOS Steps to Eating hierarchy, was developed for scoring feeding behaviors. Results: The preliminary inter-rater reliability was reported, and the coding results were represented graphically. Two additional outcome measures were piloted—a visual analog scale (VAS) and the Parenting Stress Index (PSI). The VAS was sensitive to changes in each parent’s ability to support their child, as well as in each client’s progress. The PSI also showed sensitivity to changes in the decline of parent-reported stress and child stress indices. Conclusions: Findings demonstrate fidelity to the SOS Approach, as well as sensitive outcomes, using behavioral coding and parent-reported measures. These evidence-based tools and procedures offer researchers and clinicians objective and meaningful feeding outcomes. Full article

As artificial intelligence (AI) technology advances, there has been a diversification of home service functions and services, as well as a change in the applied technologies and functions. This is due to the fact that the needs and expectations vary depending on the purpose of performing the task in the same environment. Although interactions with AI often occur in the home environment, which is a personal space, there is a need for research that examines interactions in consideration of the concept of empathy. This study thus aims to identify previous studies that examine the interaction between users and technology and to systematize the elements of interaction that can be considered based on intelligent agents that are often used in the home environment. To this end, a framework was established to examine multifaceted elements through research that shows that the interaction between technology and users should be natural, with sophisticated psychological anthropomorphism. This study analyzed the literature for the establishment of an artificial empathy interaction system and presented an initial framework. Subsequently, we proceeded to the application of authentic industry cases to the framework, with the objective of ascertaining the feasibility of mapping groups exhibiting analogous trends. This process culminated in the categorization of these cases into three distinct types, alongside the identification of the empathy interaction elements that should be given consideration for each category. Moreover, we identified additional components necessary for the formulation of the final framework and elements that were deemed to be superfluous. Thereafter, we initiated the refinement process to elaborate the framework. The final framework is “Empathic HAX (human-agent interactions) Canvas”, which is designed to examine the necessity of empathic interaction between users and AI agents in the home service domain and to determine the optimal design for such interaction. The significance of this study lies in the creation of a framework that has not previously existed, and the presentation of a design tool that is highly likely to be used both academically and practically. Full article

Background/Objectives: High-intensity training (HIT) has been shown to enhance physical fitness and reduce functional impairments in persons with moderately disabling chronic nonspecific low back pain (CNSLBP). However, sustaining these improvements post-rehabilitation remains a challenge. To address this, a home-based, technology-supported HIT program utilizing telerehabilitation can be implemented at home. This study assesses the feasibility and clinical effectiveness of a telerehabilitation HIT program for persons with CNSLBP. Methods: The pilot clinical trial (NCT05234008) recruited 15 persons with CNSLBP. Participants completed a 6-week multimodal HIT intervention with 12 bi-weekly sessions. The first four sessions were organized at REVAL Research Center, followed by eight home-based sessions using the Physitrack^® platform. Assessments were conducted at baseline (PRE), two weeks into the intervention (MID), and immediately post-intervention (POST). Outcome measures included maximal oxygen uptake (VO2max) testing, disease-related outcomes, feasibility, motivation assessed via questionnaires, and system usability and adherence tracked through Physitrack^® technology. Results: Fourteen participants (seven females; age: 45.9 years) successfully completed the program without adverse events. Based on PRE–POST comparisons, motivation levels remained high (Motivation Visual Analog Scale: −1.2 ± 0.9, p = 0.043) despite reduced motivation at POST. Improvements were also observed in pain (Numeric Pain Rating Scale: −1.8 ± 0.2, p = 0.026), disability (Modified Oswestry Disability Index: −12.1 ± 10.2, p = 0.002), fear-avoidance (Fear-Avoidance Components Scale: −10.1 ± 5.8, p = 0.005), and exercise capacity (VO2max: 4.4 ± 1.6, p = 0.048). Conclusions: The HITHOME study is the first to investigate the feasibility and effectiveness of a telerehabilitation HIT program for persons with CNSLBP. The results underscore the feasibility of implementing a home-based HIT program to support adherence to vigorous exercise programs and improve clinical outcomes in this population. Additionally, the findings emphasize technology’s potential importance in enhancing home-based exercise therapy and lay the groundwork for future studies on blended care and telerehabilitation using HIT in CNSLBP. Full article

Background/Objectives: Cardiac implantable electronic devices (CIEDs) can prevent ventricular arrhythmia-related sudden cardiac death but cause paradoxical discomfort that impairs daily living and quality of life. No management guidelines exist for reducing pain, improving motion around the CIED implantation site, or preventing shoulder contractures. We evaluated the impact of continuous successive shoulder rehabilitation programs for CIED patients on reducing shoulder pain, improving shoulder range of motion, and patient satisfaction in daily living. Methods: In this prospective observational study, patients who had received CIED implantation underwent shoulder rehabilitation therapy with education during hospitalization from the day post-CIED implantation. After in-hospital rehabilitation, patients chose to undergo successive shoulder rehabilitation from their home and after 4 weeks in the outpatient clinic (rehabilitation group, n = 68) or not (non-rehabilitation group, n = 33). Pain and shoulder function was assessed using the Visual Analog Scale (VAS) and Disability of the Arm, Shoulder, and Hand (DASH) scores, respectively, the day following CIED implantation and at 1–3 months postoperatively. Patient satisfaction was evaluated using the 36-item Short Form Survey (SF-36). Outcomes were compared between groups. Results: VAS pain scores significantly decreased, while DASH scores substantially improved in the rehabilitation group compared to the non-rehabilitation group. Although the SF-36 subdomains were similar between groups, the rehabilitation group showed a better health-related quality of life trend. No complications were observed following post-CIED rehabilitation. Conclusions: Shoulder rehabilitation therapy with successive education after CIED implantation significantly improved pain and shoulder function. Definitive guidelines and long-term outcomes should be investigated further. Full article

Arsenic trioxide (ATO) has been shown to inhibit pancreatic cancer (PC) cell growth in vitro and to promote the inhibitory effects of gemcitabine (Gem) on PC in vivo. However, the high toxicity of ATO associated with the required high doses and indiscriminate targeting has limited its clinical application. This study aimed to determine whether coupling arsenic to a tumor homing peptide would increase the inhibitory potency against PC cells. The effects of this peptide-linked arsenic compound (PhAs-LHP), the analogous non-targeting arsenic compound (phenylarsine oxide, PAO), and marketed ATO on PC growth were tested in vitro and in a mouse model. The data demonstrated that PhAs-LHP inhibited PC cell growth in vitro more potently, with IC₅₀ values 10 times lower than ATO. Like ATO, PhAs-LHP induced cell death and cell cycle arrest. This cytotoxic effect of PhAs-LHP was mediated via a macropinocytosis-linked uptake pathway as amiloride (a macropinocytosis inhibitor) reduced the inhibitory effect of PhAs-LHP. More importantly, PhAs-LHP inhibited PC growth in mice and enhanced the inhibitory effect of Gem on PC growth at 2 times lower molar concentration than PAO. These results indicate that PhAs-LHP inhibited PC more potently than ATO/PAO and suggest a potential clinical use for the combination of Gem with the peptide-linked arsenic compound for the treatment of pancreatic cancer. Full article

Background: Lateral epicondylitis of the elbow, commonly known as tennis elbow, is a musculoskeletal disorder characterized by pain and degeneration of the common extensor tendon. Despite various treatments, optimal management remains debated. Objective: This study aimed to compare the effectiveness of focal extracorporeal shockwave therapy (F-ESWT) alone versus a combination of focal and radial pressure waves (F-ESWT+R-PW) in treating chronic lateral epicondylitis. Methods: This retrospective observational study included 45 patients diagnosed with chronic lateral epicondylitis divided into two groups based on the treatment received: group A (F-ESWT, n = 23) and group B (F-ESWT+R-PW, n = 22). Both groups underwent three weekly sessions of their respective treatments. Patients were also given a home exercise protocol. Primary outcomes were assessed using the Visual Analog Scale (VAS) for pain and the Patient-Rated Tennis Elbow Evaluation (PRTEE) for pain and functional impairment at baseline (T0), 4 weeks (T1), 12 weeks (T2), and 24 weeks (T3) post-treatment. Secondary outcomes included grip strength and ultrasonographic measurements of common extensor tendon (CET) thickness and vascularization. Results: Significant improvements in VAS and PRTEE scores were observed in both groups at all follow-up points. Group B showed greater pain reduction at T1 (VAS: 3.0 ± 1.6 vs. 4.43 ± 1.47; p < 0.005) and T2 (VAS: p < 0.030) compared to group A. Functional outcomes (PRTEE) also favored group B at T1 (p < 0.030) and in the pain section at T2 (p < 0.020). Grip strength improved similarly in both groups. CET thickness showed no significant differences at T3. Vascularization decreased significantly in both groups, with a non-significant trend favoring group B. Conclusions: The combined F-ESWT+R-PW therapy proved more effective than F-ESWT alone in the short- to mid-term management of chronic lateral epicondylitis, significantly enhancing pain reduction and functional outcomes. The combination of focal and radial pressure waves offers a superior therapeutic approach, leveraging the distinct mechanisms of each modality for better clinical results. Further research is needed to confirm these findings and establish long-term efficacy. Full article

Background/Objectives: Yoga is effective for adults with arthritis but unstudied in adolescents with juvenile idiopathic arthritis (JIA). Methods: A pilot study assessed the feasibility and acceptability of an 8-week group yoga intervention for adolescents ages 14–18 with JIA. Each 75-min session included breathing techniques, relaxation, mindfulness, and modified yoga postures, using yoga props and a rope wall. An online video was available for home practice. The outcome measures administered at the baseline and at 8 weeks were physician global assessment with joint count, visual assessment with a joint damage assessment index, the Pediatric Quality of Life Arthritis Module 3.0 (Peds QL), and the visual analog scale for pain. Results: Thirteen out of 25 participants attended ≥1 class with a mean of 5.7 ± 2.2 classes. Common reasons for non-enrollment included distance, schedule, and lack of interest. The average distance to classes was 29.0 ± 41.7 miles. There was a trend toward improvement for joint count (p = 0.07), global assessment (p = 0.10), and the Pain and Hurt domain of the Peds QL (p = 0.13), but no other outcomes approached significance. Satisfaction data from an anonymous survey (n = 8) were high in all areas. Conclusions: Adolescents with JIA who attended yoga reported enjoyment, pain reduction, and interest in continued practice with no adverse events. Future studies should consider stakeholder engagement to reduce barriers and larger sample sizes to test the effectiveness. Full article

Because of the high prevalence of bone destruction in patients with multiple myeloma (MM), physical exercise is oftentimes discouraged by healthcare providers. The goal of this prospective trial was to investigate the feasibility of two six-month exercise interventions in patients with MM (N = 42): a remotely prompted home-based walking intervention or a supervised strength training intervention. Physical function and pain were assessed with the Activity Measure for Post-Acute Care (AM-PAC) Basic Mobility Short Form raw score, a six-minute walk test (6 MWT), a 30-second sit-to-stand test (30 SST), a timed up-and-go (TUG) test, a visual analog scale (VAS) for pain, handheld dynamometer tests, heart rate at rest, blood oxygen saturation at rest, and body mass index. No intervention-related serious adverse events were observed. Adverse events mostly affected the musculoskeletal system. In the resistance training group (n = 24), patients showed significant improvements in AM-PAC, TUG, 6 MWT, and 30 SST, with all effects but the 6 MWT sustained six months after the intervention. The walking group (n = 18) saw improvements in the AM-PAC, TUG, 6 MWT, and 30 SST, with a sustained change in the AM-PAC and TUG. This trial shows the feasibility of both exercise interventions with a sustained beneficial effect on the physical functioning of a six-month strength training intervention and, to a lesser extent, a six-month unsupervised walking intervention. A larger study building on these findings is currently underway. Full article

Recently, the incidence of, and interest in, respiratory diseases has been amplified by severe acute respiratory syndrome coronavirus (SARS-CoV-2) and other respiratory diseases with a high prevalence. Most of these diseases require mechanical ventilation for homecare and clinical therapy. Herein, we propose a portable and non-invasive mechanical fan (NIV) for home and clinical applications. The NIV’s core is a turbine for airflow generation, which can provide and monitor a positive two-level pressure of up to approximately 500 lpm at 50 cmH₂O according to the inspiration/expiration phase. After calibration, the proposed NIV can precisely set the airflow with a pressure between 4 cmH₂O and 20 cmH₂O, providing a versatile device that can be used for continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP). The airflow is generated by a turbine monitored using a mass flow sensor. The whole NIV is monitored with a 16 MHz clock microcontroller. An analog-to-digital converter is used as the input for analog signals, while a digital-to-analog converter is used to drive the turbine. I2C protocol signals are used to manage the display. Moreover, a Wi-Fi system is interfaced for the transmission/reception of clinical and technical information via a smartphone, achieving a remote-controlled NIV. Full article