Search Results (1,623)

Background/Objectives: Whole-gland surgery or radiotherapy for localized prostate cancer (PCa) can cure the disease but often impair urinary and sexual function. Focal therapy with high-intensity focused ultrasound (HIFU) seeks to eradicate the tumor while sparing uninvolved tissue. We prospectively evaluated oncological control, functional outcomes and safety of MRI-guided focal HIFU in patients with low- or intermediate-risk PCa. Methods: In this prospective, single-arm, phase II feasibility trial (three Austrian centres, 2021–2024), treatment-naive patients with D’Amico low/intermediate-risk, PSA ≤ 15 ng/mL, clinical stage ≤ T2 and MRI-targeted, biopsy-confirmed index lesions underwent lesion-targeted HIFU (Focal One™). The primary endpoint was failure-free survival (FFS: absence of salvage whole-gland or systemic therapy, metastasis or PCa-specific death). Secondary endpoints included biopsy-proven cancer, prostate-specific antigen (PSA), patient-reported symptoms as International Prostate Symptom Score (IPSS), 5-item International Index of Erectile Function (IIEF), Gaudenz Incontinence Questionnaire and adverse events. Planned follow-up was 24 months with PSA every 3 months, mpMRI and biopsies at 12 months, and imaging- or PSA-triggered biopsies thereafter. Results: Fifty-one men were analysed in the per-protocol cohort (median age 67 years, median PSA 7.55 ng/mL). Median treated volume was 12 mL; median procedure time 85 min. At 24 months, FFS was 94.1%: 3/51 patients (5.9%) required salvage radiotherapy. Among 31 patients who underwent follow-up biopsy, 26 (83.9%) had no cancer; the five positives included three ISUP 1, one ISUP2 and one ISUP 4 lesion. Mean PSA fell by 69% at 3 months (to 2.3 ng/mL) and then stabilized under 3 ng/mL, with a mean of 2.7 ± 1.5 ng/mL at 24 months. Transient acute urinary retention occurred in 11/51 (21.6%); no Clavien–Dindo grade ≥ 4 events were reported. IPSS returned to or improved beyond baseline, erectile function largely recovered by 6–12 months, and only one new case of grade 2 incontinence was observed. Conclusions: MRI-guided focal HIFU achieved high two-year failure-free survival with low morbidity and preserved quality of life in carefully selected patients with low- or intermediate-risk PCa. These data support further randomized and longer-term investigations of focal HIFU as an organ-sparing alternative to whole-gland treatment. Full article

Background/Objectives: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive loss of motor function, which affects mobility and leads to secondary complications, including altered dietary intake due to dysphagia, fatigue, and hypermetabolism, particularly affecting vitamin consumption, which are essential micronutrients for neuromuscular performance. The specific relationship between vitamin intake and muscle activation is not well understood in patients with ALS; thus, it is relevant to identify blood biomarkers that reflect muscle status. Methods: A cross-sectional study was conducted with 61 patients with bulbar- or spinal-onset ALS. The dietary intake of B vitamins (B1, B2, B6, B12, folate, and niacin); vitamins C, A, D, and E; and the B6/protein ratio were assessed using a seven-day dietary record and a Food Frequency Questionnaire. Blood concentrations of butyrylcholinesterase (BuChE), albumin, haptoglobin, C-reactive protein (CRP), and paraoxonase 1 (PON1) were determined. Basal muscle activation was measured using surface electromyography of the biceps brachii, triceps brachii, rectus femoris, and tibialis anterior muscles. Two confirmatory predictive models were developed to evaluate the effects of muscle damage and vitamin intake on muscle strength. Results: Arm muscle activation was negatively predicted by the B6/protein ratio (β = −0.33). Leg activation was positively predicted by vitamin B9 (β = 0.39) and B6/protein (β = 0.17) and negatively predicted by vitamin A (β = −0.24). For biomarkers, albumin (β = 0.18) and PON1 (β = 0.28) positively predicted activation. For legs, albumin predicted activation (β = 0.31), whereas BuChE and haptoglobin predicted negative activation (β = −0.32 and β = −0.15, respectively). Conclusions: Weak associations were observed in patients with ALS: vitamin B9 intake showed a modest association with leg activation, the B6/protein ratio exhibited inconsistent associations across muscle groups, and vitamin A showed a negative association with leg activation. Albumin demonstrated the most consistent association as a potential biomarker of muscle function. These findings are exploratory and require validation in larger, longitudinal studies. Full article

This study introduces an autonomous framework for grasping moving objects on a conveyor belt, enabling unsupervised detection, grasping, and categorization. The work focuses on two common object shapes—cylindrical cans and rectangular cartons—transported at a constant speed of 3–7 cm/s on the conveyor, emulating typical scenarios. The proposed framework combines a vision-based neural network for object detection, a target localization algorithm, and a deep reinforcement learning model for robotic control. Specifically, a YOLO-based neural network was employed to detect the 2D position of target objects. These positions are then converted to 3D coordinates, followed by pose estimation and error correction. A Proximal Policy Optimization (PPO) algorithm was then used to provide continuous control decisions for the robotic arm. A tailored reinforcement learning environment was developed using the Gymnasium interface. Training and validation were conducted on a 7-degree-of-freedom (7-DOF) robotic arm model in the PyBullet physics simulation engine. By leveraging transfer learning and curriculum learning strategies, the robotic agent effectively learned to grasp multiple categories of moving objects. Simulation experiments and randomized trials show that the proposed method enables the 7-DOF robotic arm to consistently grasp conveyor belt objects, achieving an approximately 80% success rate at conveyor speeds of 0.03–0.07 m/s. These results demonstrate the potential of the framework for deployment in automated handling applications. Full article

Background: This paper concerns the study of forces acting on the upper ankle joint of a human in static and quasi-dynamic positions. This paper aimed to determine the pressure forces on the axis of the upper ankle joint in the position of the body tilting forward and backward, as well as in a neutral position. Methods: A model with designated centres of gravity (including and excluding the weight of the platform imitating the foot) and the point of gravity imitating the proximal insertion of the triceps surae and tibialis anterior muscles was developed for this study. The forces and the weight of the tilted object were measured using dynamometers. A method for determining the arms of gravitational forces and the angle of inclination of an object is presented. The function describing the distribution of gravitational loading along its tilting part was described. Next, all measurements and calculations were referred to the human body. Results: Measurements of muscle force, body gravity, the arms of these forces, and the angles of the object’s inclination on the axis of rotation are presented. A methodology for determining the pressure force on the human upper ankle joint axis is presented. The distribution of the value of the pressure force and its components from the maximal forward, through the vertical body position, up to the maximal backward position of the body tilt, is provided. Conclusions: The ankle joint pressure force is the vector sum of the force of gravity and the force of the muscle counteracting the body tilt. This force is the smallest in the vertical body position and increases with the body tilt. It reaches 5.23 times the weight of the tilting part of the body when the body is tilted to its maximum forward position, and 3.57 times the weight when the body tilts backward. Regardless of the direction of the body tilt, the joint pressure vector always runs through the axis of the upper ankle joint. Full article

Fulfilling the demand for functional food with cost safety and environmental sustainability, our novel anthocyanin-enriched functional drink containing the purple waxy corn cob-derived functional ingredient “MP1” showed cognitive enhancing effects with safety in bilaterally ovariectomized rats, a validated model of menopause. Since no clinical evidence that confirms the mentioned effect was available until now, we conducted a two-arm, randomized, double-blind, placebo-controlled, crossover study to confirm the benefits mentioned above. A total of 32 menopausal participants were divided into placebo and MP1 (400 mg) groups, and were subject to a 2-month study period. Safety parameters, working memory and brain components, especially N100 and P300, the negative and positive potentials derived from the event-related potential (ERP) which indicated attention and cognitive processing, together with oxidative stress markers acetylcholinesterase (AChE) and monoamine oxidase (MAO), were assessed at baseline and every month. No serious side effects or toxicity signs were observed. Subjects who consumed MP1 also had decreased N100 and P300 latency, improved working memory and decreased oxidative stress status. Therefore, a byproduct of purple corn can successfully serve as a novel functional ingredient for developing a cognitive enhancer drink with the qualities of safety, cost reduction, and environmental sustainability promotion. Full article

Background: Most research on asthma and physical exercise is complex, costly, and often inconclusive, leading to minimal mention of exercise in international asthma management guidelines. Patients with mild asthma are frequently excluded from clinical trials, which focus on more severe cases, resulting in a lack of scientific evidence for this population. Objective: This study aimed to evaluate the effectiveness of a 3-month health intervention program promoting unstructured physical activity to improve asthma control, defined as a decrease of 0.5 points in the Asthma Control Questionnaire (ACQ-5). Methods: the study was designed as an open-label, two-arm randomized clinical trial involving sedentary asthmatic patients with intermittent to moderate persistent asthma. Participants were divided into an intervention group that attended three workshops based on World Health Organization recommendations for physical activity and a control group that continued their usual activities. All participants underwent three medical visits to assess variables such as asthma control, quality of life, rescue medication use, exacerbations, average steps taken, and respiratory function. Results: A total of 52 patients were recruited and randomized (26 patients per group), (73.1% women), with 48 completing the study (24 patients per group). The intervention group showed significant improvements in ACQ-5 scores (p = 0.035), mini-AQLQ score (p = 0.017), and average daily steps (p < 0.001). Significant differences were also observed between groups regarding respiratory function (p = 0.04) and average daily steps (p = 0.01). Conclusions: in sedentary asthmatic patients, including those with milder profiles, implementing low-resource physical exercise interventions significantly improved the average steps taken and respiratory function, while asthma control and rescue medication use showed a positive trend. Full article

Background: The family Sperchontidae Thor, 1900 is proposed as a transitional group between the “lower” and “higher” water mites (Subcohort Hydrachnidiae), and is important for understanding the evolutionary history of Hydrachnidiae. However, mitogenomic data are lacking. Methods: The first complete mitogenomes of Sperchontidae were sequenced from two species, Sperchon plumifer and Sperchon sp. Structural features were analyzed, gene rearrangements were compared with five published water mite mitogenomes, and phylogenetic relationships among 31 species within the order Trombidiformes were reconstructed. Results: Both mitogenomes contained the typical 37 genes and exhibited a strong A+T bias (73.1–73.6%), positive AT-skew, and negative GC-skew. Protein-coding genes (PCGs) were generally initiated with ATN/TTG codons and terminated with TAA/TAG or incomplete T–, with codon usage biased toward T/U-ending codons; all PCGs were under purifying selection (Ka/Ks < 1). Most tRNAs lacked canonical cloverleaf structures due to D- or T-arm loss. Gene rearrangements occurred in all examined water mite mitogenomes, with intrageneric rearrangements restricted to tRNAs in Hygrobatidae and Unionicolidae but involving both tRNAs and PCGs in Sperchontidae. Phylogenetic analyses using ML and BI (13 PCGs + 2 rRNAs) strongly supported a close relationship between Hydrachnidiae and Trombidiae (BS = 100%, PP = 1.00) and confirmed the three supercohorts in Trombidiformes (Eleutherengonides, Anystides, Eupodides), though relationships among them remained unresolved. Conclusions: This study reports the first two complete mitogenomes of Sperchontidae, providing preliminary insights into gene rearrangement patterns in water mites. The phylogenetic analyses based on mitochondrial genomes provide additional support for the consistency with traditional morphology at lower taxonomic levels, such as within genera and families, whereas relationships among supercohort-level taxa remain unstable and require additional data for further clarification. Full article

Early intervention is pivotal for optimizing neurodevelopmental outcomes in children with language delay, where increased language stimulation can optimize therapeutic outcomes. Extending speech–language therapy from clinical settings to the home is a promising strategy; however, practical barriers and a lack of scalable, customizable home-based models limit the implementation of this approach. The integration of AI-powered digital interactive tools could bridge this gap. This pilot feasibility study adopted a single-arm pre–post (before–after) design within a two-phase, mixed-methods framework to evaluate a generative AI-powered interactive platform supporting home-based language therapy in children with either idiopathic language delay or autism spectrum disorder (ASD)-related language impairment: two conditions known to involve heterogeneous developmental profiles. The participants received clinical language assessments and engaged in home-based training using AI-enhanced tablet software, and 2000 audio recordings were collected and analyzed to assess pre- and postintervention language abilities. A total of 22 children aged 2–12 years were recruited, with 19 completing both phases. Based on 6-week cumulative usage, participants were stratified with respect to hours of AI usage into Groups A (≤5 h, n = 5), B (5 < h ≤ 10, n = 5), C (10 < h ≤ 15, n = 4), and D (>15 h, n = 5). A threshold effect was observed: only Group D showed significant gains between baseline and postintervention, with total words (58→110, p = 0.043), characters (98→192, p = 0.043), type–token ratio (0.59→0.78, p = 0.043), nouns (34→56, p = 0.043), verbs (12→34, p = 0.043), and mean length of utterance (1.83→3.24, p = 0.043) all improving. No significant changes were found in Groups A to C. These findings indicate the positive impact of extended use on the development of language. Generative AI-powered digital interactive tools, when they are integrated into home-based language therapy programs, can significantly improve language outcomes in children who have language delay and ASD. This approach offers a scalable, cost-effective extension of clinical care to the home, demonstrating the potential to enhance therapy accessibility and long-term outcomes. Full article

Background: Spinal epidural abscess (SEA) is a rare but challenging disease. Hyperbaric oxygen therapy (HBOT) is used as an adjunctive therapy for SEA in a limited number of hospitals; however, its efficacy has not been well described. Case: A 70-year-old man presented at our hospital with cervical pain, fever, and impaired right shoulder movement. The patient fell after drinking 17 days prior to the presentation. He was diagnosed with an SEA secondary to a spinal epidural hematoma caused by a prior injury. The patient also had dental caries, and his blood culture was positive for Streptococcus intermedius. We diagnosed the patient with a spinal epidural abscess and hematoma that developed from the caries and the injury. Antibiotics were initiated; however, the motor function gradually worsened, and decompressive surgery was performed. After surgery, neurological impairment persisted, and HBOT was used as an adjunctive therapy. After initiating HBOT, the patient’s arm movements improved, and he was referred to a rehabilitation hospital on day 110 for further rehabilitation. Conclusions: HBOT is increasingly used for spinal cord infections and injuries in a limited number of institutions. It is a potentially effective adjunctive therapy for patients for whom antibiotics and surgery are ineffective. Full article

An incision point acts as the pivot point when a minimally invasive surgery procedure is applied. The assistive robot arms employed for such operation must have the capability to perform a remote center of motion (RCM) at this pivot point. Other than designing RCM mechanisms, a common practice is to use a readily available spatial serial robot arm and control it to impose this RCM constraint. When this assistive robot is required to be backdriven by the surgeon, the relation between the interaction forces/moments and the motion with RCM constraint becomes challenging. This paper carefully formulates a hybrid position/force control scheme for this relationship when any readily available robot arm that is coupled with a force/torque sensor is used for an RCM task. The verification of the formulation is carried out on a readily available robot arm by implementing the additional constraints that are derived from a surgical robot application. Full article

The motivations behind terrorism have emerged from debates on armed conflict. This article seeks to explore the membership status of the Taliban that maintained a positive social identity as an in-group to fight vigorously against the international community and seize Afghanistan in August 2021. With a range of semi-structured interviews with key security and justice stakeholders and civil society groups in Kabul from 2010 to 2016, opinions are based on efforts that engaged with Security Sector Reform (SSR) and fighting the resilience of the Taliban. It was found that the Taliban continued its fight and growth in membership and partial civic support due to its strong social identity (as an in-group) fighting an undesired, illegitimate, and corrupt state, judiciary, and police force supported by the international community. As part of social identity theory, poverty, unemployment, corruption and immorality are seen to serve a strategic and tactical purpose in aiding the socioeconomic, political and religious motives for recruitment towards the Taliban. However, after reseizing power, sanctions, a reduction in international aid, poverty and civic discontent with strict governance have resulted in other rival terrorist and resistance groups posing a threat to the Taliban, losing its positive social identity. Full article

Introduction: Linezolid is a reserve antibiotic used to treat infections caused by Gram-positive bacteria with resistance genes. In critically ill patients, high intra- and interindividual variability has been observed, prompting the search for alternative methods to reduce this variability and achieve the pharmacokinetic/pharmacodynamic indices necessary for a favorable efficacy–safety balance. Aim of the study: We wished to compare the safety and effectiveness of a continuous infusion (CI) versus an intermittent infusion (II) of linezolid in patients requiring intensive care. Materials and Methods: This study, registered under the number NCT05801484), was a prospective, open-label, single-center, two-arm study. Data on hematologic safety and effectiveness were collected and compared between patients receiving CI and II, respectively, at the same daily dose of linezolid (1200 mg). Results: Twenty-nine patients from the intensive care unit were included, divided into two groups. No statistically significant difference was found in 30-day mortality between the groups, nor in the likelihood of post-treatment culture negativity. However, a significantly greater reduction in C-reactive protein levels was observed in the CI group compared to the II group. Regarding safety, at CrCl < 60 mL/min, the decrease in platelets was statistically significant in group II but not in group CI. Additionally, at the 30-day follow-up, recovery from thrombocytopenia was better in the CI group. Conclusions: Continuous infusion of linezolid proved to be non-inferior to intermittent infusion at the same daily dose in terms of effectiveness. Furthermore, a lower risk of adverse reactions was identified with continuous infusion. Full article

This study introduces an innovative self-regulating intelligent optimal balancing control framework for inverted pendulum-type mechatronic platforms, designed to enhance reference tracking accuracy and improve disturbance rejection capability. The control procedure is synthesized by synergistically integrating a baseline Linear Quadratic Regulator (LQR) with a fuzzy controller via a customized linear decomposition function (LDF). The LDF dissociates and transforms the LQR control law into compounded state tracking error and tracking error derivative variables that are eventually used to drive the fuzzy controller. The principal contribution of this study lies in the adaptive modulation of these compounded variables using reconfigurable tangent hyperbolic functions driven by the cubic power of the error signals. This nonlinear preprocessing of the input variables selectively amplifies large errors while attenuating small ones, thereby improving robustness and reducing oscillations. Moreover, a model-free online self-tuning law dynamically adjusts the variation rates of the hyperbolic functions through dissipative and anti-dissipative terms of the state errors, enabling autonomous reconfiguration of the nonlinear preprocessing layer. This dual-level adaptation enhances the flexibility and resilience of the controller under perturbations. The robustness of the designed controller is substantiated via tailored experimental trials conducted on the Quanser rotary pendulum platform. Comparative results show that the prescribed scheme reduces pendulum angle variance by 41.8%, arm position variance by 34.6%, and average control energy by 28.3% relative to the baseline LQR, while outperforming conventional fuzzy-LQR by similar margins. These results show that the prescribed controller significantly enhances disturbance rejection and tracking accuracy, thereby offering a numerically superior control of inverted pendulum systems. Full article

Objectives: To compare the acute effects of upper cervical manipulation (CM) and manual massage (MM) to simulated CM (Sham) and Control conditions (Control) on heart rate variability (HRV) and blood pressure (BP) responses in women with non-elevated BP. Methods: A single-blind, four-arm, parallel-group, randomized, crossover, placebo-controlled trial recruited 15 apparently healthy women with non-elevated BP who visited the lab on four occasions with 48 h intervals to ensure adequate washout between interventions. A Latin square randomization approach was employed to assign participants to one of four experimental conditions: (1) Control: Rest without intervention; (2) CM: Bilateral high-velocity, low-amplitude manipulation of the upper cervical spine (C0–C2); (3) MM: A single 120 s session of MM release applied unilaterally to the anterior and posterior thigh, posterior lower leg, and lumbar musculature; or (4) Sham: Mimicking the positioning used in CM without the application of thrust manipulation. In each experiment, HRV, systolic and diastolic BP were measured at rest (Baseline) and every 15 min for 60 min after each intervention. All procedures were performed in the morning to avoid any confounding circadian rhythm effect on HRV and BP. Results: We found significant increases within conditions for RMSSDms (Control: Post-0 (p = 0.032), Post-15 (p = 0.023); Sham: Post-15 (p = 0.014); CM: Post-15 (p = 0.027)); SDNNms (Control: Post-45 (p = 0.037); CM: Post-45 (p = 0.014) and Post-60 (p = 0.019)); PNN50% (CM: Post-0 (p = 0.044), Post-15 (p = 0.044) and Post-45 (p = 0.019)); LF Power (ms2) (CM: Post-60 (p = 0.001)), and LF/HF ratio (MM: Post-60 (p = 0.022). Conclusions: Although no statistically significant between-condition differences were detected, within-condition changes with moderate-to-large effect sizes suggest potential clinical relevance of CM and MM. These preliminary findings emphasize the importance of effect sizes and may indicate greater translational significance in populations with non-elevated cardiovascular risk. Full article

Introduction: Cutaneous leishmaniasis (CL) poses a number of challenges when it comes to diagnosis and treatment, due to the variety of clinical presentations that mimic other conditions and hinder the choice of the most appropriate therapeutic approach, especially in the context of immunodepression. Case presentation: We present the case of a 63-year-old woman on anti-tumor necrosis factor (TNF) therapy, who underwent surgical excision for the diagnostic purposes of a chronic non-healing lesion located on her right arm. The histopathological examination revealed the presence of Leishmania amastigotes. CL relapsed in the following months, with new lesions appearing both close to the excision scar and at a different body site. At this point, in order to avoid another surgical intervention, cutaneous swabs for Leishmania Polymerase Chain Reaction (PCR) were performed on both lesions. Both samples yielded positive results, and the patient was treated with a 4-week course of miltefosine. Conclusions: These results support the use of cutaneous swabs as a highly sensitive and less invasive tool for the diagnostic workup of CL. In addition, our case prompts a reflection on the management of immunosuppressed patients with CL, with particular emphasis on the risk of reactivation or simultaneous involvement of multiple anatomical sites, thus suggesting the need for specific considerations and personalized management for this group of subjects. Full article