Search Results (177)

Telerehabilitation is an effective, accessible addition or alternative to conventional rehabilitation for fracture management, especially in older adults after hip fractures, leveraging video visits, mHealth apps, virtual reality (VR), and wearable sensors to deliver exercise, education, and monitoring at home with high satisfaction and adherence. Across non-surgical and surgical contexts, telemedicine shows feasibility and cost benefits, with mixed superiority but consistent non-inferiority for functional outcomes versus in-person care. In hip fracture populations, randomized and non-randomized studies indicate improvements in functional independence measure (FIM), Timed Up and Go test (TUG), Activities of Daily Living/Instrumental Activities of Daily Living (ADLs/IADLs), and quality of life, with some evidence for reduced anxiety and depression, while effects on mobility, pain, and adverse events remain uncertain overall. In patients with upper-limb fractures, telerehabilitation appears to improve function and pain, though strength gains may lag compared with in-person therapy in some trials; adjuncts like motor imagery and virtual reality may enhance outcomes and motivation. Application is facilitated by user-friendly platforms, caregiver involvement, and simple modalities such as structured phone follow-up. Limitations include small samples, heterogeneous protocols, scarce long-term data, and a predominance of non-inferiority or complementary designs, warranting larger, definitive trials. This technology can lead to improved patient management at home, effortlessly verifying treatment compliance, efficacy, and safety, while simultaneously reducing the need for hospitalization, promoting a more peaceful recovery. Here, we have undertaken a narrative review of the medical–scientific literature in this field. Full article

Background: Total hip (THR) and knee replacement (TKR) effectively treat end-stage osteoarthritis, but many patients continue to experience functional limitations and reduced quality of life (QoL) after rehabilitation. The aim of this pilot study was to assess the changes in terms of QoL in people with THR and TKR after a specifically designed PA intervention. The secondary aim was to evaluate changes in physical function through strength and mobility tests. Methods: Eighteen participants (mean age 65.8 ± 7.1 years) were enrolled at the Rizzoli Orthopedic Institute and were randomly assigned to an intervention group (IG), which completed a six-month supervised PA program (6 months after surgery), or a control group (CG), which received standard care. Assessments were conducted at four time points: before surgery, after rehabilitation, and at 9- and 12-month post-surgery. Repeated measures ANOVA was used to assess within- and between-group differences over time, with post hoc pairwise comparisons conducted using independent t-tests with Sidak correction. The level of statistical significance was set at p < 0.05 for all analyses. Results: Both groups showed significant improvements in QoL over time, with greater gains in physical functioning observed in the IG. Lower limb strength increased more in the IG; however, the differences between groups were not statistically significant. The Timed Up and Go and 30-Second Chair Stand Test improved in both groups. No adverse events were reported. Conclusions: These findings support the feasibility and potential benefits of adapted PA programs after rehabilitation. Although no significant differences emerged between groups, clinically relevant improvements were observed in the IG. Larger studies are warranted to confirm these results and explore long-term outcomes across multiple domains. Full article

Dehydration response element binding proteins (DREBs) have been identified as major regulators of cold acclimatization in many angiosperms. Cold stress is one of the primary abiotic stresses affecting kiwifruit growth and development. However, kiwifruit is currently one of the most widely consumed fruits worldwide because of its high nutritional value. 5-Aminolevulinic acid (5-ALA) is a nonprotein amino acid known for its distinct promotional effects on plant resistance, growth, and development. However, studies on the function of the kiwifruit DREB gene in alleviating low-temperature stress in its seedlings via exogenous 5-ALA have not been reported. Therefore, in this study, we performed a genome-wide identification of DREB gene family members in kiwifruit and analyzed the regulatory effects of exogenous 5-ALA on kiwifruit DREB genes under low-temperature stress. A total of 193 DREB genes were identified on 29 chromosomes. Phylogenetic analysis classified these genes into six subfamilies. Although there were some differences in cis-elements among subfamilies, all of them contained more biotic or abiotic stresses and hormone-related cis-acting elements. GO and KEGG enrichment analyses revealed that AcDREB plays an essential role in hormone signaling, metabolic processes, and the response to adverse stress. Under low-temperature stress, the application of exogenous 5-ALA inhibited the accumulation of APX and DHAR, promoted an increase in chlorophyll, and increased the accumulation of enzymes and substances such as 5-ALA, MDHAR, GR, ASA, GAH, and GSSH, thereby accelerating ROS scavenging and increasing the cold hardiness of kiwifruits. Functional analysis revealed that 46 differentially expressed DREB genes, especially those encoding AcDREB69, AcDREB92, and AcDREB148, which are involved in ethylene signaling and defense signaling, and, after the transcription of downstream target genes is activated, are involved in the regulation of low-temperature-stressed kiwifruits by exogenous 5-ALA, thus improving the cold tolerance of kiwifruits. Notably, AcDREB69, AcDREB92, and AcDREB148 could serve as key genes for cold tolerance. This study is the first to investigate the function of AcDREB genes involved in the role of exogenous 5-ALA in regulating low-temperature stress, revealing the regulatory mechanism by which DREB is involved in the ability of exogenous 5-ALA to alleviate low-temperature stress. Full article

Periodontal disease in dogs leads to progressive bone loss and adversely impacts overall health. However, cost-effective regenerative strategies are still limited in veterinary practice. This study aimed to develop and evaluate a novel tannic acid (TA)–gelatin-based hydrogel (Gel), incorporating graphene oxide (GO) and hydroxyapatite nanoparticles (HA), as a potential barrier material for guided tissue regeneration (GTR) applications. The hydrogels—Gel, Gel-GO, Gel-HA, and Gel-GO-HA—were characterized for chemical structure, molecular interactions, surface morphology, nanoparticle dispersion, and tensile strength. Cytotoxicity was assessed using L929 fibroblasts (ISO 10993-5), while cell viability/proliferation, morphology, and alkaline phosphatase (ALP) production were evaluated using canine periodontal ligament-derived cells. Results show that crosslinking with tannic acid enhanced the incorporation of graphene oxide and hydroxyapatite nanoparticles via hydrogen bonding into TA–gelatin-based hydrogels. This combination increased surface roughness, reduced degradation rate, and enabled shape memory behavior, critical for guided tissue regeneration (GTR) membranes. The extracts from Gel-HA-GO showed that cytotoxicity was both time- and concentration-dependent in L929 fibroblasts, whereas enhanced cell proliferation and increased ALP production were observed in cultures derived from canine periodontal ligament cells. These findings suggest that TA–gelatin-based hydrogels incorporating GO and HA demonstrated favorable mechanical and physicochemical properties, biocompatibility, and osteogenic potential. These attributes suggest their viability as a promising composite for the development of innovative GTR strategies to address periodontal tissue loss in veterinary medicine. Full article

In recent years, industrial wastewater discharge containing heavy metals has increased significantly and has adversely affected both human health and the aquatic ecosystem. The increasing demand for metals in industry has prompted researchers to focus on developing effective and economical methods for removal of these metals. In this study, the removal of Ni(II) from wastewater using the Graphene oxide@Fe₃O₄@Pluronic-F68 (GO@Fe₃O₄@Pluronic-F68) nano composite as an adsorbent was investigated. The nanocomposite was characterised using a series of analytical methods, including Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), X-ray diffraction (XRD), and Brunauer-Emmett-Teller (BET) analysis. The effects of contact time, pH, adsorbent amount, and temperature parameters on adsorption were investigated. Various adsorption isotherm models were applied to interpret the equilibrium data in aqueous solutions; the compatibility of the Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich models with experimental data was examined. For a kinetic model consistent with experimental data, pseudo-first-order, pseudo-second-order, Elovich, and intra-particle diffusion models were examined. The maximum adsorption capacity was calculated as 151.5 mg·g⁻¹ in the Langmuir isotherm model. The most suitable isotherm and kinetic models were the Freundlich and pseudo-second-order kinetic models, respectively. These results demonstrate the potential of the GO@Fe₃O₄@Pluronic-F68 nanocomposite as an adsorbent offering a sustainable solution for Ni(II) removal. Full article

Skipjack tuna constitutes a crucial fishery resource in the Western and Central Pacific Ocean (WCPO) purse seine fishery, with high economic value and exploitation potential. It also serves as an essential subject for studying the interaction between fishery resource dynamics and marine ecosystems, as its resource abundance is significantly influenced by marine environmental factors. Skipjack tuna can be categorized into unassociated schools and associated schools, with the latter being predominant. Overfishing of the associated schools can adversely affect population health and the ecological environment. In-depth exploration of the spatial distribution responses of these two fish schools to environmental variables is significant for the rational development and utilization of tuna resources and for enhancing the sustainability of fishery resources. In sparsely sampled and complex marine environments, geographic similarity methods effectively predict tuna resources by quantifying local fishing ground environmental similarities. This study introduces geographical similarity theory. This study focused on 1° × 1° fishery data (2004–2021) released by the Western and Central Pacific Fisheries Commission (WCPFC) combined with relevant marine environmental data. We employed Geographical Convergent Cross Mapping (GCCM) to explore significant environmental factors influencing catch and variations in causal intensity and employed a Geographically Optimal Similarity (GOS) model to predict the spatial distribution of catch for the two types of tuna schools. The research findings indicate that the following: (1) Sea surface temperature (SST), sea surface salinity (SSS), and net primary productivity (NPP) are key factors in GCCM model analysis, significantly influencing the catch of two fish schools. (2) The GOS model exhibits higher prediction accuracy and stability compared to the Generalized Additive Model (GAM) and the Basic Configuration Similarity (BCS) model. R² values reaching 0.656 and 0.649 for the two types of schools, respectively, suggest that the geographical similarity method has certain applicability and application potential in the spatial prediction of fishery resources. (3) Uncertainty analysis revealed more stable predictions for unassociated schools, with 72.65% of the results falling within the low-uncertainty range (0.00–0.25), compared to 52.65% for associated schools. This study, based on geographical similarity theory, elucidates differential spatial responses of distinct schools to environmental factors and provides a novel approach for fishing ground prediction. It also provides a scientific basis for the dynamic assessment and rational exploitation and utilization of skipjack tuna resources in the Pacific Ocean. Full article

Children living with chronic diseases represent a great challenge for the health care system, their families, and communities. These young patients face continuous medical needs that affect not only their health but also their daily routines, emotional well-being, and family dynamics. In response, clinical practice is increasingly integrating psychosocial indicators alongside traditional medical parameters. Consequently, there is a growing consensus that the evaluation of pediatric chronic diseases should address not only clinical dimensions but also the disease’s impact on socialization, emotional health, and daily functioning. This narrative review explores the role of psychosocial variables in the management of pediatric chronic illnesses, including the experiences of parents and siblings, with a focus on effective strategies to improve everyday life. The integration of quality of life and well-being within a multidimensional care model could be instrumental in both symptom management and psychosocial support. Recognizing that children with chronic conditions are at increased risk for long-term adverse outcomes, it is critical to develop interventions that go beyond clinical care, encompassing education, coping reinforcement, and family-centered approaches. Full article

The study examined the relations and Granger causality among environmental pollution, air quality, life expectancy, religious tourism, petroleum consumption and economic growth in three countries, Italy, Saudi Arabia and Türkiye, three countries with a prominent role of religious tourism, given the high shares of religious tourism revenues in their economies and due to pilgrimage-type religious tourism activities in total tourism activities. The study employed a yearly sample of 1975–2019 and novel Fourier-augmented vector autoregressive and Fourier Granger causality tests, under the structural breaks in the data. The findings indicate negative effects on environmental pollution and air quality from tourism in addition to such effects on life expectancy in all countries analyzed, and in this relation, fossil fuel consumption in these nations and its acceleration with tourism play crucial roles. These effects are amplified by economic growth coupled with tourism revenues that go in hand with high fossil fuel consumption, which further worsen the impacts on the environment. In the causality testing stage, the results determined unidirectional causality from tourism, fossil fuel energy consumption, and economic growth to both carbon dioxide emissions and to particulate matter 2.5. These effects are also reinforced by feedback effects between air pollution and life expectancy, which enhance the effects on both environment and air quality. These findings are used to suggest important policy recommendations, among which, the reduction in high dependency on fossil fuel in the energy mix is most central. Equally, policies are suggested to encourage sustainable tourism to reverse the adverse effects on health, environmental degradation and worsened air quality in these nations. Full article

Background/Objectives: Systemic lupus erythematosus is an autoimmune disease. The musculoskeletal system is affected in 90% of patients. The most common symptoms are myalgia, arthralgia, and arthritis. The objective was to analyze the efficacy of an intervention using myofascial techniques and proprioceptive neuromuscular facilitation in patients with systemic lupus erythematosus. Methods: A randomized, single-blind, crossover clinical trial. Seventeen patients with systemic lupus erythematosus were randomly assigned to two sequences: Sequence A–B (intervention phase first, then control phase) and Sequence B–A (control phase first, then intervention phase). The intervention lasted for four weeks, with two weekly sessions lasting 50 min each. The intervention consisted of myofascial and proprioceptive neuromuscular facilitation techniques. The variables were: pain intensity (Visual Analog Scale), functional capacity of lower limbs (2-Minute Walk Test), physical function (Timed Up and Go Test), and fatigue (Fatigue Assessment Scale). After a 2-week follow-up and a 2-week washout period, the patients switched groups, and the methodology was replicated. Results: None of the patients developed injury or adverse effects as a direct consequence of the intervention. There were statistically significant differences between groups (p < 0.001) in the intensity of ankle (η²_p = 0.38) and knee (η² = 0.37) pain, functional capacity (η² = 0.33), and physical function (η² = 0.56). There were also intergroup changes in fatigue (η² = 0.52), and the relevant mental (η² = 0.26) and physical (η² = 0.45) components. Conclusions: Proprioceptive myofascial and neuromuscular facilitation techniques are safe in patients with systemic lupus erythematosus. This physical therapy protocol can improve the intensity of knee and ankle joint pain in these patients. This intervention can improve functional capacity, physical function, and fatigue in people with systemic lupus erythematosus. Full article

Oxide (GO) has emerged as a highly versatile nanomaterial due to its exceptional physicochemical properties, including large surface area, and strong drug-loading capacity. These characteristics have enabled its broad application in fields such as wound healing, targeted drug delivery, and antimicrobial therapies. However, despite its promise, concerns surrounding GO’s cytotoxicity, biocompatibility, and potential pathological effects have limited its clinical translation. Addressing these limitations requires a deeper understanding of GO’s interactions with biological systems and the development of strategies to mitigate its adverse effects. Recent advances in surface functionalization, covalent crosslinking, and the incorporation of GO into biocompatible matrices have shown great potential in enhancing its performance while minimizing toxicity. This review provides a comprehensive overview of the antibacterial mechanisms of GO and highlights recent progress in chemical modification approaches that improve its efficacy in biomedical applications, particularly in wound healing and drug delivery. By critically examining both the advantages and limitations of GO, this work aims to inform future research directions and support the safe and effective integration of GO-based materials in advanced therapeutic systems. Full article

Formulating effective typhoon avoidance routes is crucial for ensuring the safe navigation of ocean-going vessels. From a maritime safety perspective, this paper investigates ship route optimization under typhoon forecast uncertainty. Initially, the study calculates the probability of a ship encountering a typhoon based on the distribution of historical typhoon data within the radius of seven-level winds and the distance between the ship and the typhoon. Subsequently, the minimum safe distance is quantified, and a multi-objective ship route optimization model for typhoon avoidance is established. A three-dimensional multi-objective ant colony algorithm is designed to solve this model. Finally, a typhoon avoidance simulation experiment is conducted using Typhoon TAMRI and a classic route in the South China Sea as a case study. The experimental results demonstrate that under adverse conditions of uncertain typhoon forecasts, the proposed multi-objective typhoon avoidance route optimization model can effectively avoid high wind and wave areas of the typhoon while balancing and optimizing multiple navigation indicators. This model can serve as a reference for shipping companies in formulating typhoon avoidance strategies. Full article

Background/Objectives: Falls are a leading cause of morbidity in older adults, particularly those with multiple comorbidities. A multidisciplinary approach addressing physical, psychological, and environmental factors is essential for reducing fall risk and supporting aging in place. This report evaluates the effectiveness of a multidisciplinary, multifactorial approach in managing high fall risk in an older adult with diabetes, hypertension, and osteoporosis. Methods: A 72-year-old woman with a recurrent history of falls participated in an 8-week intervention as part of the American Physical Therapy Association (APTA) balance and falls prevention credential program. This study was conducted in Virginia Beach, USA, at the participant’s residence. A single-subject design investigation was conducted, measuring outcomes including the Balance Evaluation Systems Test (BESTest), gait speed, Timed Up and Go (TUG), fear of falling, and balance confidence at baseline and post-intervention. Results: The participant had impaired baseline values across various variables and was classified as a recurrent high-risk faller. After 8 weeks of intervention, clinically meaningful improvements with large effect sizes were observed: self-selected gait speed improved by 25%, BESTest scores improved by 50%, Falls Efficacy—International (FES I) scores improved by 26%, and Activity Balance Confidence (ABC) scores improved by 26%. No falls or adverse events occurred during the intervention period, and the patient reported enhanced mobility and safety at home. Conclusions: A tailored multidisciplinary approach effectively addressed the physical, psychological, and environmental factors contributing to high fall risk. This highlights the importance of patient-centered interventions in managing fall risk and promoting safe aging in place. Continued education, environmental adaptations, and regular follow-up are essential for long-term fall prevention. Full article

Background: Ammonia (NH₃), a harmful gas, reduces livestock productivity, threatens their health, and causes economic losses. Luteolin (Lut), an anti-inflammatory flavonoid, may counteract these effects. Methods: Our study explored luteolin’s protective mechanisms on chicken splenic lymphocytes under ammonia stress using a simulation model and four-dimensional fast data-independent acquisition (4D-FastDIA) proteomics. We identified 316 proteins, with 69 related to ammonia’s negative effects and 247 to Lut’s protection. Thirty differentially expressed proteins (DEPs) were common to both groups, with 27 showing counter-regulation with Lut. Results: Gene Ontology (GO) analysis showed DEPs enriched in molecular responses to interferons and the negative regulation of immune responses, mainly located extracellularly. Molecular function analysis revealed DEPs in antigen binding and synthase activity. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis linked DEPs to pathways like estrogen signaling, NOD-like receptor signaling, cytokine–cytokine receptor interaction, and JAK-STAT signaling. The quantitative real-time polymerase chain reaction (qRT-PCR) results indicated that the mRNA levels of Interferon Alpha and Beta Receptor subunit 2 (IFNAR2) and Signal Transducer and Activator of Transcription 1 (STAT1) were trending downward. This observation was in strong agreement with the downregulation noted in the proteomics analysis. Conclusions: Lut’s protective role against ammonia’s adverse effects on chicken splenic lymphocytes is linked to the modulation of key signaling pathways, offering insights for further research on treating ammonia exposure with Lut. Full article

The amygdala, especially its central nucleus (CeA), is one of the key brain structures regulating fear, anxiety and stress responses and is also involved in gut microbiota signal processing. Amygdala hyperactivity, as well as microbiota alterations, plays an important role in the pathophysiology of anxiety disorders, depression or post-traumatic stress disorder (PTSD). The present study determines whether 3 weeks of galactooligosaccharide (GOS) supplementation alleviates behavioural, haematological, immunological and gut microbiota disturbances induced by long-term electrical stimulation of the CeA in rats (Stim). The unsupplemented Stim group showed locomotor hyperactivity and higher anxiety (measured with an actometer and the elevated plus maze, respectively), as well as a decrease in white blood cells (WBCs), lymphocytes (LYMs), red blood cells (RBCs) and platelets (PLTs); an elevation of TNFα; a reduction in IL-10 concentration in plasma; and microbiota alterations as compared to the control (Sham) group. GOS supplementation alleviated all these Stim-induced adverse effects or even normalised them to the sham group level. The effect of GOS was comparable to citalopram and even more effective in WBC and PLT normalisation and IL-10 induction. The obtained results indicate the high therapeutic potential of GOS in anxiety and stress-related disorders. GOS supplementation may support conventional therapy or the prevention of PTSD, depression and anxiety disorders. Full article

Background/Objectives: Osteoarthritis (OA) is a leading cause of mobility impairment in older adults, yet few studies have explored exergames (EXGs) as a complementary therapy for knee and/or hip OA (KOA/HOA). This study evaluated the effects of integrating EXGs into conventional therapy (CT) on functional mobility. Methods: Sixty participants were randomized into an EXG/CT group or a CT-only group. The interventions lasted 10 weeks (3 sessions/week), and the EXGs were selected from the interactive game Ring Fit Adventure (Nintendo Switch^®, Kyoto, Japan). Results: Functional mobility (Timed Up and Go test) significantly improved in the EXG/CT group but not in the CT group. Additionally, lower-limb strength and aerobic endurance increased in the EXG/CT group. No adverse events were reported, and the adherence was high. Conclusions: These findings support EXG-based interventions as a viable complement to CT. Future studies should design OA-specific EXGs and include patient subgroups to expand the impact of interventions using virtual systems. Full article