Search Results (26,555)

Background: Multilevel posterior spinal fusion to T10 often encounters complications such as screw loosening and proximal junctional kyphosis. Cement augmentation or prophylactic vertebroplasty is used to prevent these, but their biomechanical effects remain unclear. Methods: A validated finite element model (T8–pelvis) from CT data of a 57-year-old male was tested in five configurations: fusion only, fusion with cement augmentation at T10, T10–T11, T10–T11 plus T9 vertebroplasty, and T10–T11 plus T8–T9 vertebroplasty. Range of motion (ROM), intradiscal pressure (IDP), posterior ligament/facet stress, and cement–bone interface stresses were analyzed under a 400 N follower load and 10 N·m moments. Results: Cement augmentation at the upper instrumented vertebra produced <5% changes in ROM, IDP, and posterior ligament/facet stresses compared with fusion only, indicating preserved stability. Prophylactic vertebroplasty redistributed stress proximally, with elevated cement–bone interface stresses localized at T9 when vertebroplasty was performed at a single adjacent level (T9) and distributed to both T8 and T9 when performed at two adjacent levels (T8–9)—with T9 stressed mainly during lateral bending and extension, and T8 during flexion and lateral bending. Conclusion: Cement augmentation alone did not compromise adjacent-level biomechanics, but prophylactic vertebroplasty created abnormal stress concentrations at adjacent interfaces, potentially increasing fracture risk. These findings highlight the need for careful patient selection and further studies in osteoporotic populations. Full article

The synergy between carbon neutrality and urbanization is essential for effective climate governance and socio-ecological intelligent transition. From the perspective of coupled urban dynamic evolution and carbon metabolism systems, this study integrates the Sen-MK trend test and the geographical detector model to explore the spatial–temporal differentiation patterns and driving mechanisms of carbon balance across 337 prefecture-level cities in China from 2012 to 2022. The results reveal a spatial–temporal mismatch between carbon emissions and carbon storage, forming an asymmetric carbon metabolism pattern characterized by “expansion-dominated and shrinkage-dissipative” dynamics. Carbon compensation rates exhibit a west–high to east–low gradient distribution, with hotspots of expansionary cities clustered in the southwest, while shrinking cities display a dispersed pattern from the northwest to the northeast. Based on the four-quadrant carbon balance classification, expansionary cities are mainly located in the “high economic–low ecological” quadrant, whereas shrinking cities concentrate in the “low economic–high ecological” quadrant. Industrial structure and population scale serve as the dual-core drivers of carbon compensation. Expansionary cities are positively regulated by urbanization rates, while shrinking cities are negatively constrained by energy intensity. These findings suggest that differentiated regulation strategies can help optimize carbon governance within national territorial space. Full article

This narrative review synthesizes PubMed- and Scopus-indexed studies from 2020 to 2025, including preclinical animal models, prospective cohort studies, and level I and II randomized trials, to compare two leading biologic augmentation strategies: platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC). The review examines underlying mechanisms of action, delivery techniques, imaging biomarkers of graft maturation, patient-reported and functional outcomes, safety profiles, cost-effectiveness, and regulatory frameworks. PRP provides early anti-inflammatory and proangiogenic signaling, while BMAC delivers a concentrated population of mesenchymal stem cells and growth factors to the tendon–bone interface. Both modalities consistently enhance MRI-defined graft maturation, yet evidence of long-term functional or biomechanical superiority remains inconclusive. Emerging therapies such as peptide hydrogels, adipose-derived stem cells, and exosome delivery offer promising avenues for future research. Standardized protocols and large multicenter trials are needed to clarify comparative efficacy and inform personalized rehabilitation strategies. Full article

Elucidating amyloid formation inside biomolecular condensates requires models that resolve (i) local, chemistry specific contacts controlling β registry and (ii) mesoscale phase behavior and cluster coalescence on microsecond timescales—capabilities beyond single resolution models. We present a hybrid united atom/coarse grained (UA–CG) force field coupling a PACE UA peptide model with the MARTINI CG framework. Cross resolution nonbonded parameters are first optimized against all atom side chain potentials of mean force to balance the relative strength between different types of interactions and then refined through universal parameter scaling by matching radius of gyration distributions for specific systems using. We applied this approach to simulate a recently reported model system comprising the LVFFAR₉ peptide that can co-assemble into amyloid fibrils via liquid–liquid phase separation. Our ten-microsecond simulations reveal rapid droplet formation populated by micelle like nanostructures with its inner core composed of LVFF clusters. The nanostructures can further fuse but the fusion is reaction-limited due to an electrostatic coalescence barrier. β structures emerge once clusters exceed ~10 peptides, and the LVFFAR₉ fraction modulates amyloid polymorphism, reversing parallel versus antiparallel registry at lower LVFFAR₉. These detailed insights generated from long simulations highlight the promise of our hybrid UA–CG strategy in investigating the molecular mechanism of condensate aging. Full article

Background: Metabolic syndrome is a constellation of medical conditions including central obesity, high blood sugar, and high triglycerides known to increase the risk of heart disease, stroke, and type 2 diabetes, with significant sex differences in the syndrome’s incidence and prevalence. These clinical symptoms may be accompanied by cognitive impairment. Methods: In the present experiment, we fed rabbits a diet high in fat and sugar (HFSD), assessed symptoms, and measured changes in cognition using trace eyeblink conditioning. Results: We show that a range of symptoms of metabolic syndrome resulted from HFSD in male and female rabbits and obesity, high blood sugar, and glucose intolerance were higher in male than female rabbits. Specifically, HFSD male rabbits gained more weight and had a higher body-mass index, more body fat, higher fasting glucose levels, and greater glucose intolerance. Importantly, using trace and delay eyeblink conditioning, we show that there was cognitive impairment because of the high-fat and high-sugar diet in both male and female rabbits, but this was greater in HFSD male rabbits than HFSD female rabbits. Conclusions: Metabolic syndrome modeled in rabbits fed a diet high in fat and sugar reflects trends in the adult population including central obesity, high blood sugar, and high triglycerides and cognitive impairment and provides an important model and test bed for assessing interventions. Full article

Background: Tumor-associated macrophages (TAMs) are important contributors to tumor progression and metastasis. Therefore, the identification of molecules that mediate these cells’ tumor-promoting functions is highly warranted. VSIG4 has been proposed as a macrophage immune checkpoint. Hence, we aim to investigate this marker in preclinical models. Methods: Publicly available scRNAseq datasets of human colorectal (CRC) and triple-negative breast (TNBC) carcinomas and their murine counterparts were reanalyzed to investigate the expression of VSIG4 in the different TAM populations. Moreover, tumors were grown in Vsig4-deficient mice to evaluate the effect on primary tumor characteristics. Finally, since liver Kupffer cells and large peritoneal macrophages are at least partly VSIG4-high, and are implicated in metastasis to those organs, the dissemination of CRC cancer cells to those sites was assessed in the Vsig4-deficient mice. Results: We demonstrate that VSIG4 expression in human CRC and TNBC is mostly restricted to TAMs, and that its expression correlates with a worse prognosis. However, a striking finding was that no Vsig4 mRNA nor protein could be detected in the microenvironment of primary CRC and TNBC murine tumors, resulting in a similar tumor growth in wild type versus Vsig4-deficient mice. Moreover, no major differences were observed in metastatic tumor load in the liver and peritoneal cavity, apart from a reduced metastasis to the omentum in Vsig4-deficient animals. Conclusions: Murine cancer models are not suitable to investigate the role of VSIG4 in primary tumors and VSIG4 deficiency did not alter liver nor peritoneal cavity metastasis in murine models, with the exception of the omentum. Full article

Background: There is an emerging need for new scalable behavioral assays, i.e., assays that are feasible to administer from the comfort of the person’s home, with ease and at higher frequency than clinical visits or visits to laboratory settings can afford us today. This need poses several challenges which we address in this work along with scalable solutions for behavioral data acquisition and analyses aimed at diversifying various populations under study here and to encourage citizen-driven participatory models of research and clinical practices. Methods: Our methods are centered on the biophysical fluctuations unique to the person and on the characterization of behavioral states using standardized biorhythmic time series data (from kinematic, electrocardiographic, voice, and video-based tools) in naturalistic settings, outside a laboratory environment. The methods are illustrated with three representative studies (58 participants, 8–70 years old, 34 males, 24 females). Data is presented across the nervous systems under a proposed functional taxonomy that permits data organization according to nervous systems’ maturation and decline levels. These methods can be applied to various research programs ranging from clinical trials at home, to remote pedagogical settings. They are aimed at creating new standardized biometric scales to screen and diagnose neurological disorders across the human lifespan. Results: Using this remote data collection system under our new unifying statistical platform for individualized behavioral analysis, we characterize the digital ranges of biophysical signals of neurotypical participants and report departure from normative ranges in neurodevelopmental and neurodegenerative disorders. Each study provides parameter spaces with self-emerging clusters whereby data points corresponding to a cluster are probability distribution parameters automatically classifying participants into different continuous Gamma probability distribution families. Non-parametric analysis reveals significant differences in distributions’ shape and scale (p < 0.01). Data reduction is realizable from full probability distribution families to a single parameter, the Gamma scale, amenable to represent each participant within each subclass, and each cluster of similar participants within each cohort. We report on data integration from stochastic analyses that serve to differentiate participants and propose new ways to highly scale our research, education, and clinical practices. Conclusions: This work highlights important methodological and analytical techniques for developing personalized and scalable biometrics across various populations outside a laboratory setting. Full article

Social communication difficulties characterize autism spectrum disorders (ASD). Gastrointestinal (GI) symptoms are more common in ASD than in the general population. The identification of GI problems in individuals with ASD is challenging due to their altered pain perception and irregular behaviors. Importantly, GI symptoms and ASD can potentially aggravate each other. However, it is unclear if GI problems cause ASD symptoms or vice versa. A crosstalk between the digestive system, gut microbiota, and the central and enteric nervous systems (CNS and ENS, respectively) has been repeatedly reported. The ENS regulates the GI tract with the CNS and the autonomic nervous system (ANS), as well as independently through specific neural circuits. Several mechanisms contribute to GI problems in ASD, including genetic mutations that affect the ENS, dysregulation of the ANS, alterations in gut microbiota, unhealthy dietary preferences, and changes in metabolomic profiles. Furthermore, studies have shown molecular and cellular differences in the GI biopsy of children with and without ASD. These findings highlight the unique nature of GI issues in ASD, underscoring the importance of further investigating the changes that occur in the digestive system and ENS in ASD models. Full article

The U.S. loneliness epidemic is associated with substantial morbidity and mortality. While higher social media use (SMU) has been associated with higher loneliness among youth, these associations have not been sufficiently examined in adult populations. Additionally, insufficient research has assessed both SMU time and frequency in the same study. Therefore, the primary aim was to evaluate associations between SMU, both by time and frequency, and loneliness in a nationally representative sample of U.S. adults. We recruited 1512 U.S. adults ages 30–70 in 2023. We assessed loneliness using the NIH PROMIS four-item scale and self-reported SMU time and SMU frequency. Survey-weighted logistic regression models determined associations between both SMU measures and loneliness, controlling for gender, age, sexual orientation, educational attainment, employment status, and marital status. Both SMU time and SMU frequency were independently and linearly associated with loneliness (p < 0.001 for both). Although odds of loneliness increased for each increase in frequency, the association between time spent on social media and loneliness demonstrated an inverted U-shape with maximal loneliness in the third quartile of SMU. Results suggest that both time and frequency of SMU may be useful targets for interventions aimed at curbing the negative impact of SMU on loneliness. Full article

Background/Objectives: Depression accompanying hypertension increases the burden of illness and negatively affects patients’ lives. However, depression among elderly with cardiovascular diseases in general and hypertension in specific has not been paid proper attention, especially in the context of Vietnam. Therefore, we expected to examine the prevalence, characteristics, and related factors of depression on elderly patients with hypertension. Methods: A cross-sectional study at the Department of Geriatrics, Can Tho Central General Hospital (from April 2020 to February 2022), involving 414 patients aged ≥60 years with hypertension. Depression was assessed using ICD-10 diagnostic criteria; related factors were evaluated using the Pittsburgh Sleep Quality Index (PSQI), KATZ12 index, and UCLA-LS3-J11 scale. Results: 31.4% of participants were found to have depression (mild 17.7%, moderate 9.7%, severe 4.0%). Common characteristics of depression included sleep disturbances, decreased energy, and low mood. Poor sleep quality, being female, lower socioeconomic status, higher hypertension grade, and increased loneliness were found to be significantly associated with depression. Conclusions: The high prevalence of depression among elderly hypertensive patients highlights the need for effective screening and intervention strategies. Addressing factors such as sleep quality, gender, socioeconomic challenges, and social isolation may help mitigate the burden of depression in this vulnerable population. This research should be expanded to elderly patients with hypertension in society, outpatients, and individuals with other chronic diseases. Developing a predictive model for depression in elderly patients, particularly those with chronic diseases, can improve early detection, treatment effectiveness, and overall care quality. Full article

Bus stops in Riobamba had significant deficiencies in safety, accessibility, and comfort, which limited the effective use of public transport and affected the urban mobility of the population. Improving these conditions was crucial to promote sustainable, inclusive and safe mobility in the city. This study was quantitative and descriptive, based on 420 user surveys and the direct observation of 140 stops, complemented with georeferencing and comparative review of specialized literature. The findings showed that most of the stops lacked adequate lighting, shelter, signage and universal access, with 68% of users perceiving low safety. The most in-demand technologies included real-time information systems (72%) and video surveillance (65%). The proposed model of smart stops will improve accessibility, safety and comfort for users, encouraging greater use of public transport. By addressing the main infrastructure and technology gaps, the intervention contributed to inclusive and safe urban mobility, directly contributing to Sustainable Development Goal 11 and offering a replicable framework for other medium-sized cities seeking to optimize their public transport systems. Full article

Multiple myeloma (MM) is one of the most common hematological malignancies and remains incurable. However, the survival of multiple myeloma patients has significantly increased due to the implementation of novel therapies along with autologous stem cell transplantation, changing the natural history of the disease. Consequently, there is an unmet need for more sensitive response assessment techniques capable of quantifying minimal tumor burden to identify patients at higher risk of early relapse. Multiparameter flow cytometry (MFC) is an essential tool for diagnosing and monitoring patients with various hematological conditions and has recently gained prominence in identifying, characterizing, and monitoring malignant plasma cells. The implementation of Next-Generation Flow (NGF) by EuroFlow aims to overcome the pitfalls of conventional MFC, including lack of standardization and lower sensitivity, by offering standardized and optimized protocols for evaluating response depth. Both MFC and NGF have wide-ranging applications in MM for diagnosis and measurable residual disease (MRD) monitoring. Plasma cell identification and clonality evaluation through MFC and NGF assist in diagnostic workup and are routinely used to assess therapeutic response through MRD analysis. Additionally, flow cytometry is applied for circulating tumor plasma cell (CTPC) enumeration, which has demonstrated significant prognostic value. Immune composition studies through MFC may provide better understanding of disease biology. Furthermore, MFC provides additional information about other bone marrow cell populations, assessing cellularity, immunophenotypic characteristics of plasma cells, and possible hemodilution. This review explores the applications of MFC and NGF in MM, highlighting their roles in diagnosis, response assessment, and prognosis. Beyond their established use in MRD monitoring, flow cytometry-derived immunophenotypic profiles show strong potential as cost-effective prognostic tools. We advocate for future studies to validate and integrate these markers into risk stratification models, complementing cytogenetic analyses and guiding individualized treatment strategies. Full article

Participation in sports and the presence of sports injuries have a lasting impact on youth athletes’ physical, cognitive, and emotional development and sense of self-identity. There is an ongoing growth in participation in sports for youth, as well as growing literature on the epidemiology and outcomes of sports-related injuries. However, there is a paucity of published research regarding the psychological aspects of sports injury, including psychosocial factors, stressors, and responses, from the perspective of young athletes. Key risk factors include the youth’s sex, the types of sports activity, and any previous injuries. Psychosocial models, such as the stress-injury model, help explore such risk factors and their relationship to outcomes of stress. Implications for sports injury outcomes vary within the pediatric population, and the recovery and rehabilitation process requires integrated healthcare to optimize health and mental health outcomes. This review aims to describe the psychosocial factors related to sports injuries in children and adolescents, provide an understanding of sports injury models for youth athletes, and point to recovery and prevention through integrated behavioral health interventions. Based on a literature search, we identified 40 articles most relevant to our aims to explore psychosocial factors and stressors, predisposing and risk factors, and developmental aspects of sports injuries in children and adolescents. Full article

The acquisition of a person’s first language is one of their greatest accomplishments. Nevertheless, being fluent in sign language presents challenges for many deaf students who rely on it for communication. Effective communication is essential for both personal and professional interactions and is critical for community engagement. However, the lack of a mutually understood language can be a significant barrier. Estimates indicate that a large portion of New Zealand’s disability population is deaf, with an educational approach predominantly focused on oralism, emphasizing spoken language. This makes it essential to bridge the communication gap between the general public and individuals with speech difficulties. The aim of this project is to develop an application that systematically cycles through each letter and number in New Zealand Sign Language (NZSL), assessing the user’s proficiency. This research investigates various machine learning methods for hand gesture recognition, with a focus on landmark detection. In computer vision, identifying specific points on an object—such as distinct hand landmarks—is a standard approach for feature extraction. Evaluation of this system has been performed using machine learning techniques, including Random Forest (RF) Classifier, k-Nearest Neighbours (KNN), AdaBoost (AB), Naïve Bayes (NB), Support Vector Machine (SVM), Decision Trees (DT), and Logistic Regression (LR). The dataset used for model training and testing consists of approximately 100,000 hand gesture expressions, formatted into a CSV dataset for model training. Full article

Older adults often face significant challenges in understanding medical information due to cognitive aging and limited health literacy. Existing simplification models, while effective in general domains, cannot adapt content for elderly users, frequently overlooking narrative tone, readability constraints, and semantic fidelity. In this work, we propose GENSIM—a Generative Expert-Narrated Simplification Model tailored for age-adapted medical text simplification. GENSIM introduces a modular architecture that integrates a Dual-Stream Encoder, which fuses biomedical semantics with elder-friendly linguistic patterns; a Persona-Tuned Narrative Decoder, which controls tone, clarity, and empathy; and a Reinforcement Learning with Human Feedback (RLHF) framework guided by dual discriminators for factual alignment and age-specific readability. Trained on a triad of corpora—SimpleDC, PLABA, and a custom NIH-SeniorHealth corpus—GENSIM achieves state-of-the-art performance on SARI, FKGL, BERTScore, and BLEU across multiple test sets. Ablation studies confirm the individual and synergistic value of each component, while structured human evaluations demonstrate that GENSIM produces outputs rated significantly higher in faithfulness, simplicity, and demographic suitability. This work represents the first unified framework for elderly-centered medical text simplification and marks a paradigm shift toward inclusive, user-aligned generation for health communication. Full article