Search Results (3,528)

Background and Objectives: Corneal collagen cross-linking (CXL) halts keratoconus progression, yet potential differences between conventional and accelerated protocols at one year remain uncertain. We analyzed the completed 12-month follow-up of a previously reported 6-month cohort to compare conventional (3 mW/cm² × 30 min; CXL 30) versus accelerated (9 mW/cm² × 10 min; CXL 10) CXL, interpreting outcomes within the ABCD framework alongside Kmax and curvature radii. Materials and Methods: In this single-center retrospective longitudinal analysis of prospectively collected routine clinical data, 22 eyes were included, with assessments performed at baseline and at 1, 3, 6, and 12 months of follow-up. Evaluated outcomes comprised ABCD stages (A–D), anterior and posterior radius of curvature (ARC and PRC), Kmax, pachymetric and elevation indices, as well as UDVA and BCVA. Within-group change used Friedman with Wilcoxon post hoc; between-group differences used Mann–Whitney (α = 0.05). Results: Both protocols resulted in significant visual improvement and Kmax reduction at 12 months (overall time effect: CXL 30 p < 0.001; CXL 10 p = 0.026). Median Kmax decreased 56.5 → 52.3 D (CXL 30) and 59.3 → 58.3 D (CXL 10). UDVA improved 0.2 → 0.6 (CXL 30) and 0.2 → 0.3 (CXL 10); BCVA 0.4 → 0.8 (CXL 30) and 0.2 → 0.5 (CXL 10). Tomographic analysis showed predominantly anterior changes, with a significant decrease in A stage in the CXL 30 group and an increase in ARC in both groups, more pronounced in CXL 30. In the late 6 → 12-month window, posterior metrics (PRC and posterior elevation) were largely stable; raw PRC change did not reach significance. Conclusions: Conventional and accelerated CXL both stabilized keratoconus at one year with meaningful functional gains. Beyond 6 months, remodeling was predominantly anterior; within-group findings suggested a more pronounced anterior tomographic response in the CXL 30 group. The 12-month visit may be useful for reassessing stability after CXL, although this study was not designed to determine optimal retreatment timing or optical rehabilitation strategy. Longer-term studies with standardized biomechanical and densitometric endpoints are warranted to assess durability and refine protocol selection. Full article

Background: Patients with prolonged mechanical ventilation (PMV) frequently require tracheostomy due to failure to wean, yet the pathway from ventilator dependence to successful decannulation remains complex and poorly standardised. Comprehensive respiratory rehabilitation is recognised as a core strategy for improving decannulation outcomes, but no unified, evidence-based guidelines currently exist for this population. This review addresses that gap by synthesising current evidence on respiratory rehabilitation and decannulation strategies for tracheostomized PMV patients. Methods: A narrative review was conducted through a systematic search of PubMed/MEDLINE covering publications indexed from May 2019 to February 2026, supplemented by targeted searches of Embase and the Cochrane Library. The search combined free-text keywords and Medical Subject Headings (MeSH) terms across eight search string combinations. Following title and abstract screening of 830 deduplicated records, 51 studies met eligibility criteria and were included in the final narrative synthesis. Results: Six core rehabilitation intervention domains were identified: respiratory muscle training, physical rehabilitation and nutritional optimisation, sedation and delirium management, speaking valve use, airway complication management, and ventilator mode optimisation. High-intensity inspiratory muscle training at no less than 50% of maximal inspiratory pressure is currently supported by the strongest available evidence among the interventions reviewed, although this threshold derives primarily from general ICU populations and has not been specifically validated in heterogeneous tracheostomized PMV cohorts. Decannulation readiness assessment may benefit from evaluating five core domains—neurological readiness, secretion management capacity (suctioning ≤ 4 times/24 h), cough efficacy (peak cough flow > 160 L/min), safe swallowing confirmed by instrumental assessment, and upper airway patency confirmed by fiberoptic bronchoscopy—using a structured multidisciplinary framework. Conclusions: Successful decannulation in tracheostomized PMV patients requires integration of evidence-based rehabilitation interventions, structured multidisciplinary assessment, and a patient-centred outcome framework that extends beyond physiological endpoints to encompass voice restoration, psychological well-being, and social reintegration. Significant evidence gaps remain—particularly for expiratory muscle training, population-specific decannulation protocols, and adapted rehabilitation models for resource-limited settings—representing priority areas for future research. Full article

Shear wave elastography (SWE) is an increasingly investigated ultrasound-based technique in musculoskeletal imaging that provides quantitative information on tissue stiffness and biomechanical properties. This narrative review aims to summarize the basic principles, technical considerations, current clinical applications, limitations, and future perspectives of SWE in musculoskeletal imaging. Unlike conventional grayscale and Doppler ultrasonography, which mainly assess morphology and vascularity, SWE may provide additional functional information in major musculoskeletal tissues, including tendons and ligaments, skeletal muscles, peripheral nerves, fibrocartilaginous structures, plantar fascia, and selected soft tissue lesions. Current evidence suggests potential roles for SWE in detecting early biomechanical alterations, assessing disease severity, differentiating symptomatic from asymptomatic tissues, and monitoring response to treatment or rehabilitation. However, musculoskeletal tissues are anisotropic, viscoelastic, and position-dependent; as a result, SWE measurements are influenced by acquisition-related factors, tissue biomechanics, positioning and loading conditions, region of interest (ROI) placement, tissue depth, and device-related variability. For this reason, SWE findings should not be interpreted as standalone diagnostic criteria but should be considered together with clinical findings, conventional ultrasonography, MRI, electrophysiology, histopathology, and patient-centered outcomes when appropriate. This review highlights the need for tissue-specific measurement protocols, standardized reporting, normative reference data, inter-vendor harmonization, and longitudinal validation against clinically meaningful outcomes before SWE can be more reliably integrated into routine musculoskeletal imaging and rehabilitation practice. Full article

Background: Stabilization of surgical guides in fully edentulous patients remains a clinical challenge due to mucosal resilience and potential micromovement, even when fixation pins are used. Guide instability may affect drilling accuracy and overall workflow predictability. This proof-of-concept case series describes a stabilization approach based on pre-placed tripod reference implants with multi-unit coupling, designed to create a mechanically defined prosthetic docking platform for fully guided implant surgery. Methods: Three fully edentulous patients requiring implant-supported rehabilitation were treated using a two-stage protocol. Three temporary reference implants were inserted in a tripod configuration 7–10 days prior to definitive surgery. Multi-unit abutments were mounted on the reference implants, and intraoral scanning was performed to design a surgical guide indexed to the prosthetic interfaces. During implant placement, the guide was screw-retained to the reference implants via the multi-unit connections. Postoperative implant positions were evaluated radiographically by superimposing postoperative datasets onto the preoperative planning model. Intraoperative guide stability, surgical events, and early postoperative outcomes were recorded. Results: Stable guide fixation was achieved in all three cases without detectable intraoperative displacement. Implant placement was completed as planned in each patient, and removal of the temporary reference implants was uneventful. No intraoperative or early postoperative complications were observed. Mean coronal, apical, and angular deviations between planned and achieved implant positions were 0.70 ± 0.16 mm, 0.39 ± 0.13 mm, and 3.30 ± 0.59°, respectively. These preliminary findings, derived from four treated arches, were comparable to ranges reported in selected studies on fully guided implant surgery; however, no direct statistical comparison with previously published datasets was performed. Conclusions: Within the limitations of this proof-of-concept case series, temporary reference implants arranged in a tripod configuration provided a stable and reproducible prosthetic indexing platform for guided implant surgery in fully edentulous patients. Further prospective studies involving larger patient cohorts and controlled comparative designs with conventional mucosa-supported or fixation-pin-supported surgical guides are required to evaluate the reproducibility, clinical performance, and long-term applicability of this stabilization concept. Full article

Background/Objectives: Advanced implant anchorage techniques are increasingly used to manage severe maxillary bone deficiency and to avoid extensive bone augmentation procedures. This case series report aimed to describe the canine bypass anchorage technique and to evaluate the short- to medium-term clinical outcomes and survival of implants placed using this approach. Materials and Methods: Thirteen patients presenting with missing maxillary premolars or posterior segments and insufficient alveolar bone height for conventional axial implant placement were treated using the canine bypass technique. A total of 19 long one-piece implants were inserted palatally to the canine root, engaging distant cortical bone of the nasal cavity and/or palatal alveolar process. Pre- and postoperative cone-beam computed tomography (CBCT) examinations were performed to assess implant positioning and anchorage. Patients were followed up to 3.5 years. Results: The mean follow-up period was 26.1 ± 10.8 months. Nasal cortical anchorage was achieved in 84.2% of implants, and palatal cortical anchorage in 73.7%; both anchorage types were obtained simultaneously in 57.9% of cases. The mean distance between the implant and canine root was 1.27 ± 1.4 mm (range: −1.0 to 4.5 mm), including cases of direct implant–tooth contact and periodontal ligament space transgression. All implants remained functional throughout the observation period, yielding a cumulative survival rate of 100%. Canine pulp vitality was preserved in all non-endodontically treated teeth. Conclusions: Within the limitations of this case series report, the canine bypass anchorage technique appears to be a feasible and minimally invasive treatment option for maxillary rehabilitation with implant-supported restoration in selected patients with severe bone deficiency, potentially allowing avoidance of sinus augmentation procedures. Further prospective studies with larger patient cohorts and longer follow-up periods are required to confirm the long-term safety, predictability, and clinical applicability of this approach. Full article

Introduction: Currently, there is an ongoing debate regarding the benefits of kinematic alignment (KA) versus mechanical alignment (MA) in total knee arthroplasty (TKA). Robotic-assisted TKA has been shown to improve implant positioning and precision of the KA technique, enabling successful kinematic alignment. However, its impact on early postoperative and functional outcomes remains unclear. This study aims to examine how imageless, table-mounted, robotic-assisted KA-TKA compares with conventional MA-TKA. Methods: Registry data of all primary TKAs using ATTUNE™ cruciate-retaining implants (January 2021–December 2024) performed by a single, experienced surgeon in a high-volume arthroplasty center were retrospectively reviewed. A total of 64 patients who underwent robotic-assisted KA-TKA were compared to 39 patients who underwent conventional MA-TKA. The mean age was 70.3 ± 7.71 and 69.3 ± 9.47 in the KA-TKA group and the MA-TKA group, respectively, while the male proportion was 32.8% and 30.7%, respectively. Early postoperative outcomes (static/dynamic pain score, ambulation distance, length of stay) and 6-month functional outcomes (range of motion, Knee Society Score, Oxford Knee Score, SF-36, patient expectation/satisfaction scores) were analyzed. Delta changes in outcome scores and proportion of patients attaining a minimum clinically important difference (MCID) were studied. Results: Robotic-assisted KA-TKA displayed benefits in the majority of the early postoperative outcomes, with significant improvements in ambulation distance (23.3 vs. 14.7 m, p = 0.002) compared to conventional MA-TKA. Both groups showed significant improvements in the majority of the functional outcomes at 6 months. Robotic-assisted KA-TKA also shows significant improvements in selected mental health aspects of SF-36, namely vitality (p = 0.001), mental health (p = 0.048), mental component summary (MCS) (p = 0.004), and a larger proportion attaining SF-36 vitality MCID (p = 0.045). Following false discovery rate correction for multiple comparisons, postoperative ambulation distance, SF-36 vitality, and MCS remained statistically significant between groups. No significant differences in KSS, OKS, and satisfaction/expectation fulfillment were noted. Conclusions: Robotic-assisted KA-TKA demonstrated early rehabilitation and select mental health-related quality of life improvements compared to conventional MA-TKA. Further studies are needed to examine its long-term clinical outcomes. Full article

Background: Patients undergoing open-heart surgery (OHS) are at risk of postoperative morbidity and mortality. Physical performance has been increasingly recognized as an important factor influencing postoperative outcomes. Therefore, the study aimed to investigate the associations and predictive value of physical performance on postoperative complications and duration of hospital stay. Methods: A prospective cohort study was conducted in 116 patients who were admitted to OHS. Preoperative assessment of physical performance, i.e., Short Physical Performance Battery (SPPB), Five Times Sit to Stand Test (5STS), gait speed (5 m walk test: 5MWT), Timed Up and Go (TUG), and handgrip strength. Duration of hospital stay and incidence of post-operative complications were recorded. Differences between participants with and without postoperative complications were analyzed using independent samples t-tests for continuous variables and chi-square tests for categorical variables. The associations between physical performance and postoperative outcomes were assessed using Spearman’s rank correlation coefficient. Hierarchical regression analysis was conducted to determine the predictive contribution of physical performance. Results: A total of 116 participants were submitted for OHS in two medical school hospitals; however, 108 individuals completed the pre-operative physical performance. The most common procedures were coronary artery bypass grafting and valve surgery. Fifty-one participants (47.22%) experienced postoperative complications, including five deaths, corresponding to 4.63% mortality. For the length of hospital stay analysis, five participants who died postoperatively were excluded, resulting in a final sample of 103 participants. Physical performance was significantly associated with the length of hospital stay (p < 0.05). Hierarchical regression analysis showed that the final prediction model explained 13.4% of the variance in length of hospital stay, with SPPB independently contributing an additional 6.0% to the model, followed by 5STS, 5MWT, handgrip strength, and TUG, which accounted for an additional 5.1%, 4.6%, 4.4%, and 3.7%, respectively. Conclusions: Preoperative physical performance was associated with length of hospital stay. While each measure explained a relatively small proportion of the variance in hospital stay, these assessments offer a simple, non-invasive, and clinically feasible approach to evaluating functional reserve before surgery. These findings highlight the importance of incorporating functional assessment into perioperative care to support risk stratification and guide rehabilitation strategies. Full article

Background: Sarcopenia and frailty are highly prevalent extrapulmonary manifestations of chronic obstructive pulmonary disease (COPD) and are strongly associated with reduced exercise tolerance, exacerbation risk, hospitalizations, and mortality. Beyond inflammation, oxidative stress, and physical inactivity, emerging evidence highlights nutrition as a major modifiable driver of muscle deterioration in COPD. Nutritional deficits impair anabolic signaling, exacerbate proteolysis, worsen mitochondrial dysfunction, and contribute to frailty progression. Methods: This narrative review synthesizes evidence from PubMed, Embase, Scopus, and Web of Science up to 2025, integrating mechanistic, metabolic, nutritional, and biomarker-related pathways underlying muscle dysfunction in COPD. Studies examining inflammation, hypoxemia, oxidative stress, hormonal imbalance, nutrition, and emerging biomarkers were included. Results: COPD-related sarcopenia results from converging inflammatory (TNF-α, IL-6), catabolic (FOXO, UPS), metabolic, and vascular mechanisms, compounded by energy deficiency, protein insufficiency, and micronutrient deficits. Inadequate intake of protein, vitamin D, antioxidants, and omega-3 fatty acids increase anabolic resistance, enhance muscle catabolism, and worsen frailty. Nutritional interventions, particularly high-protein supplementation, leucine-enriched formulas, vitamin D repletion, omega-3 fatty acids, and multimodal nutrition–exercise programs, demonstrate benefits in muscle mass, strength, and physical performance. Biomarkers such as GDF-15, CAF22, and specific microRNAs reflect nutritional status and correlate with muscle health in COPD. Conclusions: Sarcopenia and frailty in COPD arise from a complex interplay of inflammatory, metabolic, nutritional, and lifestyle-related factors. Integrating nutritional assessment and targeted dietary interventions with exercise and pulmonary rehabilitation is essential to counteract anabolic resistance and improve functional outcomes. Advances in biomarker research may support earlier diagnosis and personalized nutrition-based therapeutic strategies. Full article

Musculoskeletal pain is a major cause of disability and long-term analgesic use, increasing interest in safe non-pharmacological interventions. This focused narrative review examines light-emitting diode (LED)-based photobiomodulation (PBM) for musculoskeletal pain, integrating molecular, mechanistic, clinical, and translational evidence. Red and near-infrared LED-PBM may act through mitochondrial and non-mitochondrial photoacceptors, modulation of ATP production, reactive oxygen species, nitric oxide, calcium signaling, inflammatory pathways, oxidative stress responses, and extracellular matrix repair. Clinical evidence suggests a potential benefit in selected conditions, particularly temporomandibular disorders, fibromyalgia, cervical and myofascial pain, tendon and plantar fascia disorders, knee osteoarthritis, and mild-to-moderate peripheral nerve compression, while findings for non-specific low back pain remain inconsistent. The reviewed literature indicates that therapeutic response depends less on emitter identity alone than on wavelength, irradiance, radiant exposure, treatment geometry, target depth, timing, disease phenotype, and protocol quality. LED-based PBM appears generally well tolerated and clinically promising as an adjunct to rehabilitation, but current evidence is limited by heterogeneous devices, incomplete dosimetry, variable comparators, and short follow-up. Future studies should prioritize standardized reporting, depth-aware dosing, phenotype-based recruitment, biomarker-linked outcomes, and direct laser–LED comparisons under dosimetrically matched conditions. Full article

Fibropapillomatosis (FP) is a disease that threatens the health and safety of sea turtles globally, with green sea turtles having the highest FP prevalence. FP is associated with Chelonid alphaherpesvirus 5, but the primary etiological agent remains unknown as expression and severity of the virus are influenced by host susceptibility, immunological status, development of epithelial lesions, and environmental factors. This review explores current understanding of FP in green sea turtles, focusing on etiology, pathological features, diagnostic approaches, and rehabilitation strategies. Emphasis is placed on the compounded nature of the disease, integrating factors that influence disease expression. Screening challenges are examined through the limitations of clinical, histological, and molecular methods, particularly in distinguishing latent from active infection. Rehabilitation practices, including surgical intervention and long-term supportive care, are evaluated in the context of treatment outcomes and recurrence risk. Collectively, the evidence supports the interpretation of FP as a disease shaped by host–pathogen–ecology interactions. Improved integration of diagnostic tools and greater focus on natural drivers are essential for advancing understanding of the disease and informing conservation and management efforts. Full article

Background/Objectives: Dementia and cognitive decline place increasing demands on healthcare systems, rehabilitation services, long-term care, and community-based prevention. Structured exercise training is a promising strategy for adults at risk of cognitive decline, but it remains unclear how intervention studies integrate cerebrovascular and cognitive outcomes in ways that can inform clinical translation, rehabilitation planning, and exercise prescription. Methods: This scoping review followed PRISMA-ScR guidance. PubMed/MEDLINE and Scopus were searched for peer-reviewed English-language studies published from 2010 to 2026, supplemented by reference list checking and citation chasing. Eligible studies were human intervention studies involving structured exercise training and at least one cerebrovascular, vascular, brain-related, or cognitive outcome. Studies were mapped by exercise modality, population risk profile, grouped outcome domain, and outcome-integration category. Results: Fifty-four studies were included. A central finding was the vascular cognitive integration gap: only 7 studies assessed both cerebrovascular and cognitive outcomes within the same intervention design, whereas 38 studies reported cognitive outcomes only and 9 reported cerebrovascular or vascular outcomes only. Aerobic training formed the most developed evidence cluster for direct cerebrovascular outcomes, whereas other modalities were more often represented in cognition-focused studies but less frequently included direct cerebrovascular measures. Conclusions: Current evidence is limited by a major vascular cognitive integration gap. Because most exercise intervention studies separate cerebrovascular and cognitive outcomes, the field cannot yet determine whether exercise-induced cerebrovascular adaptations correspond to cognitive improvements in the same participants. Future trials should combine cerebrovascular assessment, domain-specific cognitive testing, dose reporting, adherence monitoring, safety reporting, feasibility evaluation, and mechanistic biomarkers to support more precise exercise prescription for dementia risk mitigation and cognitive health promotion. Full article

Culturally responsive frameworks are essential for delivering equitable rehabilitation services to diverse communities. Culturally informed practices that use evidence-based strategies facilitate holistic, family-centered interventions. This scoping review explores the literature published over the last 5 years on barriers and facilitators to the use of culturally responsive interventions for children and families receiving pediatric rehabilitation services. Databases searched included PubMed, CINAHL Complete, Medline, Cochrane Library, and OTseeker. Search terms included cultural competence, culturally informed, culturally grounded, pediatrics, rehabilitation, physical therapy, occupational therapy, barriers, facilitators, and a combination of these terms. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Published intervention studies that identified the barriers and facilitators of culturally responsive care were included in this review. Data from presentations, non-peer-reviewed literature, published abstracts, and dissertations were excluded. Ten studies were included, two Level III, three Level IV, and five Level V, according to the commonly accepted research Levels of Evidence. The outcomes of these studies suggest that rehabilitation providers should consider how to implement tailored, culturally informed interventions to improve holistic, accessible care for all communities. Full article

(1) Background: Physical fatigue, either in short anaerobic exercises or in aerobic ones, affects locomotion patterns. Those effects, if consistently observed, may function as fatigue proxies. The present study focuses on the regularity of the pseudo-periodic acceleration patterns measured by a wearable sensor. Studies during laboratory anaerobic tasks on healthy subjects and on persons with multiple sclerosis during 6 min walking tests demonstrated that regularity decreases with fatigue. This study’s objective is to verify if the gait regularity during an unsupervised endurance aerobic walking task progressively decreases in healthy subjects. (2) Methods: Ten healthy male adults, not competitive recreational athletes, equipped with an accelerometer, participated in a non-competitive 100 km walk in about 24 h. (3) Results: Eight participants took from about 22 to 25 h to complete the task. Two did not finish. The trend of locomotion regularity (on average −6.3%, p < 0.001, effect size 1.41) was negative for all the participants. The gait speed decrease, in all the participants, explained less than 20% of the regularity decrease. Other outcome indices, such as that related to cadence, did not provide unique trends. (4) Conclusions: Regularity decrease is associated with fatigue in submaximal locomotor efforts; due to the experimental group limitations in size and composition, further studies should extend regularity assessments to women, and to persons with neuromuscular disabilities or attending walking rehabilitation. Full article

Background: In patients with traumatic brain injury (TBI), proteins are considered the main source of energy. Previous studies have suggested that an increase in the urea-to-creatinine ratio (UCR) indicates the onset of protein catabolism. Therefore, we aimed to investigate the associations of the UCR with the functional independence measure (FIM). Methods: This single-center retrospective study included 291 patients aged 17–87 years who underwent inpatient rehabilitation within the first 6 months post-TBI. Their demographic, clinical, neuroradiological, and laboratory data (eGFR, urea, creatinine, UCR) were collected. Spearman’s correlation and hierarchical multivariate regression analyses adjusted for clinical covariates were performed. Results: The strongest significant positive correlation was found between the Glasgow Coma Scale (GCS) and FIM at admission (ρ = 0.488, p < 0.001) and between GCS and FIM at discharge (ρ = 0.340, p < 0.001). A significant negative correlation was found between the discharge UCR and FIM at discharge (ρ = −0.262, p < 0.003), as well as with the change in FIM (ρ = −0.207, p < 0.02). Patients with UCRs ≥ 80 had a significantly lower discharge FIM compared to patients with UCRs < 80 (median 27 vs. 40; p = 0.02). The significant independent predictors of discharge FIM were the nutritional route (NGT/PEG), level of consciousness, and FIM at admission. The UCR did not remain independently associated with the discharge FIM (ΔR² = 0.004, Cohen’s f² = 0.014). Conclusions: Although UCR is associated with functional outcomes measured by FIM in TBI patients, it is not an independent predictor of these outcomes but rather a biomarker of catabolic burden. Full article

Background: Idiopathic slow-transit constipation (STC) is a clinically significant event of chronic constipation. Total colectomy with ileorectal anastomosis is considered the standard surgical option for medically refractory STC but is associated with relevant morbidity and long-term functional impairment. This study aimed to evaluate safety and functional outcomes of partial colectomy (segmental or subtotal resection) as a potential alternative in patients with limited colonic involvement. Methods: A retrospective observational single-center study was conducted on patients with STC refractory to medical and rehabilitative treatment (1998–2021). Five-year follow-up data were collected. Results: On a cohort of 76 patients, 10 (13.2%) underwent total colectomy, 63 (82.9%) segmental, and 3 (3.9%) subtotal resections (left hemicolectomy). No perioperative mortality occurred. Overall, 30-day morbidity was 25.0%, with major complications observed in 12.1% after partial colectomy. Median hospital stay was three days longer after total colectomy. Constipation recurred in 20.3% of patients, exclusively after segmental resection, at a median follow-up of 7.7 years. Constipation severity significantly decreased postoperatively (p < 0.001), with the mean Wexner score improving from 21.5 to 6.1 (p < 0.001). Rates of diarrhea and fecal incontinence were comparable between segmental and total colectomy. Quality-of-life significantly improved in more than 75% of cases across all SF-36 domains. Conclusions: Segmental colectomy may be a safe and effective alternative to total colectomy in patients with limited STC, potentially offering durable symptom relief and favorable quality-of-life outcomes. Full article