Search Results (411)

Background/Objectives: Incretin-based therapies have demonstrated benefits in glycemic control and the prevention of long-term complications of diabetes. In addition to glucose-dependent insulin secretion stimulation, glucagon-like peptide-1 (GLP-1) also inhibits gastric acid secretion, delays gastric emptying, inhibits gut motility and induces satiety. We aimed to understand the modulation of gastric fundus motility by GLP-1 receptor agonists (GLP-1RA). Methods: We have studied the relaxation to sodium nitroprusside (SNP) and noradrenaline (NA) of gastric fundus isolated from Wistar rats and Goto-Kakizaki (GK) rats, an animal model of spontaneous non-obese type 2 diabetes, after Liraglutide treatment (200 μg/kg s.c., b.i.d., 14 days). Results: Decreased relaxation induced by SNP and NA (0.01–889 μM) was observed in treated groups, with no significant changes in SNP maximum relaxation or in nNOS/p-nNOS levels between treated and non-treated rats of both animal models. Accordingly, in rat gastric fundus pre-contracted with 5 µM of carbachol, GLP-1RA (0.05–111.1 nM) induced contractile responses that were GLP-1R-dependent and -independent. Exenatide showed more intrinsic activity, while Liraglutide showed more potency than GLP-1 in Wistar rats. Moreover, GLP-1 showed more intrinsic activity in diabetic rats compared to control ones. Conclusions: Liraglutide-induced increased gastric muscle tone may contribute to the significant decrease in caloric intake and body weight in all treated rats, causing a reduction in gastric accommodation during food intake. Thus, the increased gastric fundus tone induced by GLP-1RA may constitute a peripheral mechanism by which they can reduce food intake and induce satiety. Full article

The aim of this pilot study was to evaluate the relaxation, stress reduction and behavioral changes observed after manual therapy applied to horses exposed to racing and physical training stimulus. This descriptive approach is aimed at veterinary clinicians to evaluate the therapy process more effectively with behavioral feedback. For this purpose, the study was conducted in two different equestrian clubs in Adana (Adana Mediterranean and Suvari Equestrian Clubs) between 2023 and 2024. A total of 32 racehorses (16 Thoroughbred, 16 Arabian; 16 female, 16 male) of different ages, genders and breeds were included in the study. Five minutes of manual therapy was applied for each of 7 different muscle groups. After the massage, behavioral observations were made for 10 min by moving 2 m away from the animals, and no separate baseline assessment was performed prior to the intervention. The application was carried out by a veterinarian with 15 years of experience. Importantly, no separate baseline assessment or control group was performed, and only behavioral responses were evaluated, which represents a major limitation of this pilot study. Among the observed behaviors in all horses, blinking, muscle twitching, respiratory changes, lip relaxation, licking and chewing were recorded for all horses. Relaxation signs such as head dropping (78.1%), yawning (34.4%), and ears falling to the side (62.5%) were frequently observed. Behaviors such as the appearance of the third eyelid (3.1%), grunting (12.5%) and sneezing (15.6%) were observed at a low percentage. Individual variables such as gender and breed did not have a statistically significant effect on the percentage of behavior (Chi-square test, p > 0.05). In conclusion, these preliminary findings suggest that manual therapy applications might be effective in reducing stress by triggering relaxation behaviors in riding horses, as these behaviors have been previously reported in the literature as reliable indicators of relaxation. Evaluation of behavioral responses after massage could be an important tool in determining physiotherapeutic effects. The fact that the application is performed by experienced people is an important factor that increases the success of the therapy and shows that manual therapy provides relaxation regardless of individual differences. Future controlled studies integrating physiological stress biomarkers are warranted to confirm these observations. Full article

Dysfunctions and disorders of the craniomandibular system are accompanied by pathophysiological changes of muscle groups in the throat/neck and facial area, e.g., pain in the jaw and muscles of mastication and disturbance of occlusion, leading to teeth injury (loss of dental hard tissue, fractures/sensibility disorders, etc.). For muscular dysfunctions, even in the context of psychosomatic disorders and chronic stress, hippotherapy is particularly suitable, since it helps actively to relieve muscle tensions. In the current project we combined hippotherapy with progressive muscle relaxation (PMR) to achieve a synergistic effect. The horses used for therapy (two mares and five geldings between seven and twenty-one years old) were especially suitable because of their calm temperament. In two cases, trained therapy horses were used; in five other cases, the patients used their own horses, which were not specially trained. Right from the beginning, the project was accompanied by veterinary support. Conditions of horse keeping (active stable, same-sex groups, no boxes) were assessed as well as the horses themselves prior to, during, and after each therapy unit. In patients, cortisol, as a quantifiable parameter for stress, was measured before and after each therapy unit. From before the start until the end of each therapy unit of 15 min, the heart rate variability (HRV) of both patients and horses was registered continuously and synchronously. In addition, the behavior of the horses was monitored and recorded on video by an experienced coach and a veterinarian. The stress load during the tension phases in the therapy units was low, perceivable in the horses lifting their heads and a slightly shortened stride length. Likewise, the horses reflected the patients’ relaxation phases, so that at the end of the units the horses were physically and psychically relaxed, too, noticeable by lowering their necks, free ear movement, and a decreasing heart frequency (HF). Altogether, the horses benefited from the treatment, too. Obvious stress signs like unrest, head tossing, tail swishing, or tense facial expressions were not noticed at any time. Twenty jumpers served as a control group in different situations (training, tournament, and leisure riding). Full article

Background/Objectives: This systematic review evaluated the efficacy and safety of Emotional Freedom Techniques (EFT) for anxiety disorders, compared with conventional and alternative therapies. Methods: A comprehensive literature search was conducted across nine electronic databases up to February 2025, including only parallel-group randomized controlled trials (RCTs) that investigated EFT as a standalone intervention for anxiety symptoms. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias 2.0 tool. Results: Seven RCTs with 506 participants were included. Populations ranged from clinical to non-clinical groups. EFT interventions varied in duration (1–56 sessions), with control groups including no treatment, supportive interviews, cognitive behavioral therapy (CBT), breathing therapy, and progressive muscle relaxation. All six studies comparing EFT to no intervention reported significant reductions in anxiety symptoms in favor of EFT. Compared to active controls, EFT showed similar or superior effects to breathing therapy and muscle relaxation but no significant difference from CBT. Most studies showed “some concerns” in risk of bias, mainly due to self-reported outcomes and lack of blinding. Conclusions: EFT appears to be a promising and safe complementary intervention for reducing anxiety symptoms, with additional benefits for related psychological outcomes. However, methodological limitations and heterogeneity among studies preclude firm conclusions. High-quality RCTs using standardized protocols and objective outcome measures are warranted to confirm these findings and to explore the effectiveness of EFT as an adjunct to conventional therapies. Full article

Background: The increasing demand for care in hospital settings, often at a high intensity, requires organizing work according to 24 h shifts. Nevertheless, shift work (SW), especially at night, alters the circadian rhythm, negatively affecting the psychophysical health of nurses, compromising their quality of life, and jeopardizing patient safety. Shift-work-related diseases (SWDs) can arise from these disruptions. Methods: This systematic review aims to evaluate the effects of several types of medical, psychotherapeutic, and educational interventions and strategies on shift-work-related diseases (SWDs). The databases PubMed, Embase, Web of Science, and Cochrane were searched using the MESH terms “shift work” and “nurses” from January 2015 to March 2025. A total of 43 articles were included in the final analysis. Results: Quantitative findings from the studies showed, for example, improvements in sleep quality scores ranging from 15% to 40% with optimized shift planning, reductions in fatigue scores by 20–35% through strategic napping, and moderate effect sizes for light therapy interventions. Physical activity and relaxation techniques were associated with a 10–25% improvement in subjective well-being indices, while meal timing interventions led to reductions in gastrointestinal symptom prevalence by up to 18%. The selected articles were discussed by dividing them according to the type of intervention applied to shift nurses, namely improvement of shift planning, light and temperature modulation, introduction of napping, supplementation, meal management, psychotherapy, sleep education, physical activity, relaxation techniques and yoga, music therapy, and aromatherapy. This categorization was performed to highlight the range of strategies tested and their relative quantitative impact. Conclusions: There is evidence that SWDs can be mitigated through targeted interventions and strategies. The limitations of the studies examined include small sample sizes, extreme heterogeneity of follow-up, the few numbers of randomized controlled trials, and the prevalence of female or Intensive Care Unit nurses in study samples. Further research should focus on large-scale randomized controlled trials, multicenter longitudinal studies, and the evaluation of the most promising interventions—particularly light therapy, optimized shift scheduling, and structured napping protocols—to assess their long-term efficacy and generalizability. Full article

Background: Delayed onset muscle soreness (DOMS) frequently occurs after engaging in strenuous physical activity. The manifestation of DOMS is often associated with changes in the biomechanical and viscoelastic characteristics of the affected muscles. Materials and Methods: Forty participants were enrolled and randomly assigned to two groups: the intervention group receiving transcutaneous electrical nerve stimulation (TENS, n = 20) and a control group (n = 20). A fatigue-inducing protocol targeting the gastrocnemius muscle was implemented to elicit DOMS. The effectiveness of TENS was assessed by evaluating alterations in the biomechanical and viscoelastic properties of the muscle. Pain intensity was recorded using the Numeric Rating Scale (NRS) at five time points: before the study began, three times during the intervention, and once at the conclusion of the study. Results: No statistically significant changes have been found regarding muscle tone (p = 0.162) and stiffness (p = 0.212) in Group 1. However, a statistically significant lower level of stiffness in Group 1 after the end of therapy has been detected (p = 0.008). Decrement values decreased statistically significantly, both in Group 1 (p = 0.015) and in Group 2 (p = 0.014). There were no statistically significant differences in decrement level between Group 1 and 2. Relaxation and creep decreased statistically insignificantly in both groups. At the end of the observation period (Day 4), statistically significant (p = 0.027) lower pain intensity was observed in Group 1. Conclusions: It has been demonstrated that TENS has had limited effectiveness in restoring baseline biomechanical and viscoelastic parameters of muscles that undergo changes during DOMS. TENS significantly relieves pain symptoms occurring in DOMS. Full article

Background/Objectives: Early pain exposure in newborns is linked to negative short- and long-term outcomes. Preterm infants often require endotracheal intubation for mechanical ventilation or brief laryngoscopy for surfactant administration via Less Invasive Surfactant Administration (LISA) or Intubation–Surfactant–Extubation (INSURE). While premedication before intubation is well-studied, data regarding premedication for LISA/INSURE are limited. We aimed to explore premedication practices for intubation and LISA/INSURE procedures across Neonatal Intensive Care Units (NICUs) in Israel. Methods: An anonymous online questionnaire comprising 27 questions about premedication practices was distributed to neonatal caregivers in Israel. The questions addressed the use of premedication before intubation or LISA/INSURE, the existence of written protocols, pharmacological agents employed, and caregiver satisfaction with the medications used. Results: Questionnaires were collected between January and July 2023, yielding 69 responses from 20 NICUs. Almost all respondents (95.7%) routinely use premedication before intubation, but only 65.7% use it for LISA/INSURE. For non-emergency intubations, extremely low-birth-weight (ELBW) infants received premedication less often than the general neonatal population (75.4% vs. 95.7%, respectively). Most caregivers (91.2%) did not report increased procedure failure associated with premedication during LISA/INSURE. The vast majority of Israeli caregivers do not include muscle relaxants in their premedication regimen for intubation. Dual therapy regimens yielded higher satisfaction rates than monotherapy. Higher complication rates, particularly respiratory depression, were observed with Fentanyl, especially when used as monotherapy. Conclusions: Significant variations exist in premedication practices among caregivers across Israeli NICUs. Premedication is commonly administered for intubation but is considerably less frequent for LISA/INSURE, despite these procedures also being painful. ELBW infants received less premedication. Notably, muscle relaxants are infrequently used for premedication by Israeli NICU caregivers. Full article

Background and objectives: Mental health issues such as anxiety and stress are prevalent in educational settings, highlighting the need for individualized, scalable interventions. Mind–body approaches are promising for distress management, and this study explored which body-based strategies students found effective. Methods: A cross-sectional study assessed mental health and the use of body-based coping strategies among 152 primarily female students, age 21–52, in the Educational Program for Psychomotor Therapy, a group familiar with such strategies. An electronic survey assessed well-being (WHO-5), stress (PSS-10), anxiety (HADS-A), and use of 13 mind–body practices (e.g., breathing, grounding, muscle relaxation). Participants were grouped by mental health risk and a logistic regression explored associations with coping strategy use. Results: High-frequency use of more body-based strategies predicted lower odds of being in the high-risk group (p = 0.039), while sporadic use of more strategies predicted high mental health risk (p = 0.022). Breathing and grounding were the most frequently used and helpful practices, with minimal barriers. High-risk students cited capability concerns and time as barriers, while all participants mentioned forgetting to use the practices. Conclusions: High-risk students use a broader range of practices sporadically, whereas low-risk students adopt selected strategies more consistently. Proper integration of practices through education and training may be crucial for enhancing their efficacy. Full article

Background/Objectives: Individuals with posttraumatic stress disorder (PTSD) tend to show patterns of elevated cardiovascular disease (CVD) risk earlier in life than the general population. The need for effective interventions for CVD risk-reduction in PTSD is increasingly evident. In this paper we present preliminary results from a longitudinal study of a health behavior intervention, as an adjunct to standard trauma therapy in PTSD. The health behavior intervention addresses CVD-related heath behaviors (physical activity, nutrition, sleep, and stress) in a 12-week program delivered individually in 90-min sessions. Behavior change recommendations included: increased aerobic activity; establishing a balanced diet, enhancing consumption of fruits and vegetables and reducing sugars and fat/saturated fat; incorporating strategies to enhance sleep and lower PTSD-related disruptions (e.g., nightmares); and relaxation and cognitive coping skills to reduce general stress. Methods: Participants were randomized to the health behavior intervention plus standard trauma therapy experimental condition or a standard trauma therapy control group. Outcomes were measured at baseline and after the 12-week intervention phase. Sleep efficiency was measured from actigraphy watches. Physical activity was assessed by self-report and blood pressure was measured using an automated device. The preliminary outcomes are for 29 participants to date who have pre-post data. Results: Sleep efficiency was improved in the intervention group compared to controls (p < 0.05). The intervention group also evidenced significant pre-post increases in moderate physical activity compared to the control group (p < 0.05). Changes in vigorous physical activity did not reach statistical significance in this preliminary sample but the pattern of results are similar to those for moderate activity. Trends toward significance were also observed for pre-post changes in systolic (p = 0.06) and diastolic blood pressure (p = 0.07), with small reductions for the intervention group and increases for the control group. Conclusions: These findings provide preliminary information about the effectiveness of the health behavior intervention on multiple parameters for adults with PTSD. The findings suggest that focusing on health behavior change in multidisciplinary treatments for PTSD may enhance outcomes such as sleep and physical activity and potentially result in greater quality of life. However, the small preliminary sample size reported here should be considered when interpreting the outcomes. Further research may also determine how improvements in health parameters impact other indices of long-term cardiovascular health. Full article

Refugees experience disproportionately high rates of sleep disturbances due to trauma, displacement, and resettlement stressors. Sleep health is critically linked to both physical and mental well-being, yet remains an underexplored area of intervention for refugee populations. This systematic review aimed to (1) identify interventions implemented to improve sleep health among refugees, (2) assess their effectiveness, and (3) evaluate the extent of cultural adaptation in their design and implementation. A comprehensive search of peer-reviewed literature from 2004 to 2024 identified nine studies focused on adult refugees in high-income countries. Interventions included psychoeducation, music-assisted relaxation, guided imagery, and nightmare-focused therapies. Several demonstrated improvements in sleep quality, insomnia severity, and nightmare frequency. Music-based interventions and sleep health education stood out as accessible, non-stigmatizing strategies that may be particularly well suited to refugee contexts. However, cultural adaptation emerged as the most significant gap. Using the 4-Domain Cultural Adaptation Model (CAM4)—which assesses adaptation across context, content, delivery, and engagement—most studies showed only surface-level modifications. Few incorporated community voices, and none validated sleep assessment tools for cultural relevance. Future research should prioritize co-creation with refugee communities to ensure interventions are not only evidence-based, but also culturally grounded, trusted, and sustainable across diverse refugee populations. Full article

Background: Attachments are essential components in clear aligner therapy, enhancing retention and improving the predictability of tooth movements. Mechanical and wear properties of the composite resins used for attachment reproduction are critical to maintaining their integrity and shape over time. This study aimed to evaluate and compare the mechanical properties, thermal behavior, and wear performance of the hybrid composite Aligner Connect (AC) and the flowable resin (Connect Flow, CF). Methods: Twenty samples (ten AC and ten CF) were reproduced. All specimens underwent differential scanning calorimetry (DSC), combustion analysis, flat instrumented indentation, compression stress relaxation tests, and tribological analysis. A 3D wear profile reconstruction was performed to assess wear surfaces. Results: DSC and combustion analyses revealed distinct thermal transitions, with CF showing significantly lower Tg values (103.8 °C/81.4 °C) than AC (110.8 °C/89.6 °C) and lower residual mass after combustion (23% vs. 61%), reflecting reduced filler content and greater polymer mobility. AC exhibited superior mechanical properties, with higher maximum load (585.9 ± 22.36 N) and elastic modulus (231.5 ± 9.1 MPa) than CF (290.2 ± 5.52 N; 156 ± 10.5 MPa). Stress relaxation decrease was less pronounced in AC (18 ± 4%) than in CF (20 ± 4%). AC also showed a significantly higher friction coefficient (0.62 ± 0.060) than CF (0.55 ± 0.095), along with greater wear volume (0.012 ± 0.0055 mm³ vs. 0.0070 ± 0.0083 mm³) and maximum depth (36.88 ± 3.642 µm vs. 17.91 ± 3.387 µm). Surface roughness before wear was higher for AC (Ra, 0.577 ± 0.035 µm; Rt, 4.369 ± 0.521 µm) than for CF (Ra, 0.337 ± 0.070 µm; Rt, 2.862 ± 0.549 µm). After wear tests, roughness values converged (Ra, 0.247 ± 0.036 µm for AC; Ra, 0.236 ± 0.019 µm for CF) indicating smoothened and similar surfaces for both composites. Conclusions: The hybrid nanocomposite demonstrated greater properties in terms of stiffness, load-bearing capacity, and structural integrity when compared with flowable resin. Its use may ensure more durable attachment integrity and improved aligner–tooth interface performance over time. Full article

Background: Esophageal achalasia is a rare motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and food stasis. Surgical interventions, including Heller myotomy with fundoplication or peroral endoscopic myotomy (POEM), effectively alleviate symptoms but induce significant anatomical and functional alterations. In various gastrointestinal surgeries, microbiota have been implicated in modulating clinical outcomes; however, their role in achalasia surgery remains unexplored. Methods: We performed a narrative literature search of various databases to identify studies exploring potential interactions between the gastroesophageal microbiota, achalasia pathophysiology, and surgical treatment, proposing clinical implications and future research avenues. Results: Chronic esophageal stasis in achalasia promotes local dysbiosis by facilitating aberrant bacterial colonization. Surgical restoration of esophageal motility and gastroesophageal transit induces substantial shifts in the microbial ecosystem. Analogous microbiota alterations following procedures such as fundoplication, gastrectomy, and bariatric surgery underscore the significant impact of mechanical modifications on microbial composition. Comprehensive microbiota profiling in patients with achalasia may enable the identification of dysbiotic phenotypes predisposed to complications, thereby providing personalized therapeutic interventions including probiotics, prebiotics, dietary modulation, or targeted antibiotic therapy. These insights hold promise for clinical benefits, including the mitigation of inflammation and infection, monitoring of surgical efficacy through microbial biomarkers, and optimization of postoperative nutritional strategies to reestablish microbial homeostasis, ultimately enhancing patient outcomes beyond conventional treatment paradigms. Conclusions: The gastroesophageal microbiota is a compelling mediator of surgical outcomes in achalasia. Future investigations integrating microbiological and inflammatory profiling are warranted to elucidate the functional role of the gastroesophageal microbiota and assess its potential as a biomarker and therapeutic target. Full article

The Pennes bioheat equation is the most widely used model for describing heat transfer in living tissue during thermal exposure. It is derived from the classical Fourier law of heat conduction and assumes energy exchange between blood vessels and surrounding tissues. The literature presents various numerical methods for solving the bioheat equation, with exact solutions developed for different boundary conditions and geometries. However, analytical models based on this framework are rarely reported. This study aims to develop an analytical three-dimensional model using MATHEMATICA software, with subsequent mathematical validation performed through COMSOL simulations, to characterize heat transfer in biological tissues induced by laser irradiation under various therapeutic conditions. The objective is to refine the conventional bioheat equation by introducing three key improvements: (a) incorporating a non-Fourier framework for the Pennes equation, thereby accounting for the relaxation time in thermal response; (b) integrating Dirac functions and the telegraph equation into the bioheat model to simulate localized point heating of diseased tissue; and (c) deriving a closed-form analytical solution for the Pennes equation in both its classical (Fourier-based) and improved (non-Fourier-based) formulations. This paper investigates the nuanced relationship between the relaxation time parameter in the telegraph equation and the thermal relaxation time employed in the bioheat transfer equation. Considering all these aspects, the optimal thermal relaxation time determined for these simulations was 1.16 s, while the investigated thermal exposure time ranged from 0.01 s to 120 s. This study introduces a generalized version of the model, providing a more realistic representation of heat exchange between biological tissue and blood flow by accounting for non-uniform temperature distribution. It is important to note that a reasonable agreement was observed between the two modeling approaches: analytical (MATHEMATICA) and numerical (COMSOL) simulations. As a result, this research paves the way for advancements in laser-based medical treatments and thermal therapies, ultimately contributing to more optimized therapeutic outcomes. Full article

Background: Singlet oxygen (¹O₂) generation in biological samples remains a significant challenge. Studying the mechanism of ¹O₂ action during photodynamic therapy (PDT) in atherosclerotic plaques in vitro represents an innovative cardiological approach. Atherosclerosis, a chronic and progressive disease, is characterized by plaque buildup inside arterial walls. Objectives: This study focused on the use of spin–lattice (T₁) and spin–spin (T₂) relaxation times measured by Magnetic Resonance Imaging (MRI) before and after the administration of indocyanine green-mediated PDT (ICG-PDT). Methods: To enhance visualization of morphological changes in atherosclerotic plaques, the clinically approved MRI contrast agent Gadovist was utilized. A total of 12 atherosclerotic plaque samples were collected from six patients undergoing endarterectomy. The generation of ¹O₂ in these plaques was assessed using quantitative MRI measurements and microscopic imaging, which visualized structural changes induced by PDT. Results: This research explores the potential of T₁ and T₂ relaxation times as indicators of PDT efficacy, while Gadovist helped provide evidence of ¹O₂ diffusion within the samples. Conclusions: Considering advancements in modern treatment, PDT may offer a novel approach for targeting atherosclerosis. Full article

Background: Multiple Chemical Sensitivity (MCS) is a complex, disabling condition marked by non-specific symptoms in response to low-level chemical exposures. It often leads to substantial impairments in quality of life, psychological health, and daily functioning. Although non-pharmacological approaches—such as lifestyle and psychological interventions—are widely used, their clinical effectiveness remains unclear. Objective: We aim to evaluate the effectiveness of lifestyle-based approaches in improving clinical and psychosocial outcomes in adults with Multiple Chemical Sensitivity. Methods: A systematic review was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251013537). Literature searches were carried out in MEDLINE (PubMed), CINAHL, Google Scholar, and ResearchGate between March and April 2025. Eligible studies included adults (≥18 years) with a confirmed diagnosis of MCS and reported outcomes such as perceived stress, anxiety, depressive symptoms, or quality of life. Methodological quality and risk of bias were independently assessed using the PEDro scale, NIH Quality Assessment Tool, CEBMa checklist, and Cochrane RoB 2.0. Results: Twelve studies (N = 378) met the inclusion criteria. Cognitive and behavioral therapies demonstrated the most consistent evidence of efficacy, with reductions in symptom severity, maladaptive cognitive patterns, and functional limitations. Mindfulness-based stress reduction showed favorable outcomes, while other mindfulness-based interventions yielded mixed results. Exposure-based therapies contributed to increased chemical tolerance and reduced avoidance behavior. Electromagnetic and biomedical approaches demonstrated preliminary but limited effectiveness. Aromatherapy was well tolerated and perceived as relaxing, though its clinical impact was modest. Conclusions: Cognitive and behavioral therapies appear to be most effective among lifestyle-based interventions for MCS/IEI. However, study heterogeneity limits the generalizability of findings, underscoring the need for more rigorous research. Full article